Hormonal Profile of Women Attending Fertility Clinic in Zaria, North-west, Nigeria.

BACKGROUND: Infertility affects approximately 186 million people worldwide and 8-12% of couples of reproductive age worldwide. Female infertility remains the commonest gynaecological case attended to in many fertility centres across Nigeria with a national prevalence of infertility between 10-23.6%. The hypothalamic-pituitary-gonadal (HPG) axis of hormonal interplay and organ sensitivity account for about 19% of the cause of infertility in females in Nigeria and the laboratory assessment of the hormones of this axis have been a significant goal standard in the diagnosis as well as treatment. OBJECTIVES: The study investigated the pattern of the HPG hormones seen in infertile women in a Nigerian fertility treatment centre to identify and classify the causes. METHODS: A descriptive cross-sectional randomized study of 125 participants was selected and stratified into 47 primary and 78 secondary infertility participants respectively, conducted between Oct 2016 and August 2017. The control participants consisted of apparently healthy women, age-matched. Serum levels of four hormones [luteinizing hormones (LH), follicle-stimulating hormones (FSH), prolactin, and oestradiol] were assayed using the ELISA technique. The data were analyzed using SPSS version 20, p-value ≤ 0.05 was considered significant. RESULTS: The mean age of infertile women was 30.4±5.8 years. Serum levels of prolactin (10.6±9.3) and oestradiol (301±157.9) were significantly (p= ≤ 0.05) higher among the participants. However, the levels of LH and FSH were similar among the participants and controls (p = ≤0.77 and ≤0.07 respectively). CONCLUSION: Hyperprolactinaemia and oestradiolaemia are characteristics of secondary female infertility in Nigeria. Laboratory evaluation of the hypothalamic-pituitary-gonadal axis with thyroid hormones cannot be over- emphasized for a proper diagnosis and impact on the treatment of infertility.

CONTEXTE: L'infertilité touche environ 186 millions de personnes dans le monde et 8 à 12 % des couples en âge de procréer. L'infertilité féminine reste le cas gynécologique le plus fréquent dans de nombreux centres de fertilité au Nigeria, avec une prévalence nationale de l'infertilité comprise entre 10 et 23,6 %. L'axe hypothalamohypophyso- gonadique (HPG) de l'interaction hormonale et de la sensibilité des organes représente environ 19 % des causes d'infertilité chez les femmes au Nigeria et l'évaluation en laboratoire des hormones de cet axe a été une norme importante dans le diagnostic et le traitement. OBJECTIFS DE L'ÉTUDE: L'étude a examiné le profil des hormones HPG observées chez les femmes infertiles dans un centre Nigérian de traitement de la fertilité afin d'identifier et de classer les causes. MÉTHODES: Une étude descriptive transversale randomisée de 125 participants a été sélectionnée et stratifiée en 47 participants d'infertilité primaire et 78 participants d'infertilité secondaire respectivement menée entre octobre 2016 et août 2017. Les participants de contrôle étaient des femmes apparemment en bonne santé appariées par l'âge. Les niveaux sériques de quatre hormones (hormones lutéinisantes (LH), hormones folliculo-stimulantes (FSH), prolactine et oestradiol) ont été dosés en utilisant la technique ELISA. Les données ont été analysées à l'aide de SPSS version 20, la valeur p d"0,05 a été considérée comme significative. RÉSULTATS: L'âge moyen des femmes infertiles était de 30,4±5,8. Les niveaux sériques de prolactine (10,6±9,3) et d'oestradiol (301±157,9) étaient significativement (p= ≤ 0.05) plus élevés chez les participantes. Cependant, les niveaux de LH et de FSH étaient similaires chez les participants et les témoins (p = ≤ 0.77 and ≤ 0.07 respectivement). CONCLUSION: L'hyperprolactinémie et l'oestradiolémie sont des caractéristiques de l'infertilité féminine secondaire au Nigeria. L'évaluation en laboratoire de l'axe hypothalamo-hypophysogonadique avec les hormones thyroïdiennes ne peut pas être trop soulignée pour un diagnostic approprié et un impact sur le traitement de l'infertilité. Mots clés: Profil, Hormones de reproduction, Infertilité.

Relationship between Serum 25-Hydroxy Vitamin D and Severity of Asthmatic Attack in Children.

BACKGROUND: Globally, the number of diagnosed asthma has increased by 4.3 million from 2001 to 2009.The prevalence of asthma in Africa has increased from 64.9 million (11.8%)to 102.9 million (13.8%) over the past two decades among children less than 15 years. The burden of this consequence is the exacerbations of attacks with resultant absence from school by children, loss of man hour by parents who stay with them while on admission as well as increased healthcare expenditures. The association between the serum level of vitamin D with the severity of the asthmatic attack and its control has been reported in respect of its role as a significant immunomodulator and inhibition in the pathogenesis of allergies. The aim of the study was to correlate serum 25-Hydroxy Vitamin D with the severity of Asthmatic attack in children and possibly provide a rationale for clinical supplementation. MATERIALS AND METHODS: This was a descriptive, cross-sectional study conducted between November 2016and August 2017 involving 128 participants. A stratified random sampling method was used to select the participants based on control a level using the GINA classification of asthma control levels. Serum vitamin D level was determined by CalbiotechInc, kit and Pearson correlation was carried out to determine relationship. RESULTS: The uncontrolled (22.4±2.9ng/mL) and partly controlled (25.6±3.9ng/mL) groups had low serum vitamin D levels as compared to the well-controlled group (35.1±4.9ng/mL) which had vitamin D within the reference interval. There was a strong negative correlation (p-value < 0.001) between serum vitamin D levels and all the criteria (GINA) of asthma control. CONCLUSION: The serum vitamin D levels correlated well with the severity of an asthmatic attack as well as its control (GINA).

CONTEXTE: À l'échelle mondiale, le nombre de cas d'asthmes diagnostiqués a augmenté de 4,3 millions de 2001 à 2009. La prévalence de l'asthme en Afrique est passé de 64,9 millions (11,8%) à 102,9 millions(13,8 %) au cours des deux dernières décennies chez les enfants de moins de 15 ans.Le fardeau de cette conséquence est l'exacerbation des attaques avec absence de l'école des enfants qui en résulte, perte d'heure de travail par les parents qui restent avec eux pendant leur admission ainsi que des soins de santé accrus dépenses. L'association entre le taux sérique de vitamine D avec la gravité de la crise d'asthme et son contrôle a été fait rapport en ce qui concerne son rôle en tant qu'immunomodulateur important et inhibition de la pathogenèse des allergies. L'objectif de l'étude était de corréler la 25-hydroxy-vitamine D sérique avec la gravité de Crise d'asthme chez les enfants et éventuellement fournir une justification pour supplémentation clinique. MATÉRIAUX ET MÉTHODES: Il s'agissait d'une étude descriptive et transversale menée entre novembre 2016 et août 2017 impliquant 128 participants. Une méthode d'échantillonnage aléatoire stratifiée a été utilisé pour sélectionner les participants en fonction du contrôle d'un niveau à l'aide de l'Classification GINA des niveaux de contrôle de l'asthme. Le taux sérique de vitamine D a été déterminée par CalbiotechInc, la corrélation entre kit et Pearson était effectué pour déterminer la relation. RÉSULTATS: Les non contrôlés (22,4±2,9 ng/mL) et partiellement contrôlés(25,6 ±3,9 ng / mL) avaient de faibles taux sériques de vitamine D par rapport au groupe bien contrôlé (35,1±4,9 ng/mL) qui avait de la vitamine D dans l'intervalle de référence. Il y avait une forte corrélation négative(valeur p < 0,001) entre les taux sériques de vitamine D et tous les critères(GINA) de contrôle de l'asthme. CONCLUSION: Les niveaux de vitamine D de Theserum étaient bien corrélés avec la gravité d'une crise d'asthme ainsi que son contrôle (GINA). Mots-clés: Contrôle de l'asthme, Vitamine D sérique, Enfants.

THYROID DYSFUNCTION IN WOMEN OF REPRODUCTIVE AGE: LABORATORY PROTOCOL FOR INFERTILITY EVALUATION.

Background: Infertility in developing counties worldwide is associated with many social, financial, and medical challenges. With a prevalence rate of between 10 - 14 % and biochemical etiology of about 80% of the cases among Nigerian women, laboratory diagnosis has gradually assumed an important role in improved diagnosis. Objective: The aim was to evaluate the prevalence of thyroid dysfunction in infertility and need to evaluate. Methods: This was a descriptive cross-sectional case study of one hundred and twenty-five (125) women selected by stratified random sampling method into two groups of primary and secondary infertility. A total of 125 healthy fertile women served as the control group. Serum freeT3 (fT3), feeT4 (fT4), and TSH were analyzed using commercial ELISA kits. Data were analyzed using SPSS version 20.0 and the p-value of ≤0.05 was considered statistically significant. Results: Twenty participants (16%) were observed to have associated thyroid dysfunction with infertility. The commonest thyroid dysfunction was overt hypothyroidism (9.6%) and subclinical hypothyroidism (4.0%) respectively and this was found to be commoner in secondary infertility (21.8%). Conclusion: Thyroid function evaluation (especially serum TSH) should be included as a routine assessment in infertility protocol, especially in secondary infertility cases.

Gas sensing materials roadmap.

Gas sensor technology is widely utilized in various areas ranging from home security, environment and air pollution, to industrial production. It also hold great promise in non-invasive exhaled breath detection and an essential device in future internet of things. The past decade has witnessed giant advance in both fundamental research and industrial development of gas sensors, yet current efforts are being explored to achieve better selectivity, higher sensitivity and lower power consumption. The sensing layer in gas sensors have attracted dominant attention in the past research. In addition to the conventional metal oxide semiconductors, emerging nanocomposites and graphene-like two-dimensional materials also have drawn considerable research interest. This inspires us to organize this comprehensive 2020 gas sensing materials roadmap to discuss the current status, state-of-the-art progress, and present and future challenges in various materials that is potentially useful for gas sensors.

COVID-19 PANDEMIC AND ITS POTENTIAL IMPACT ON SEXUAL AND REPRODUCTIVE HEALTH INDICATORS IN NIGERIA.

The impact of the novel corona virus disease (COVID-19) pandemic cuts across all sectors and has brought to the fore the true realities and status of health systems globally, revealing the gaps and cracks even in seemingly perfect health systems. The fragile and weak health system in the country is also riddled with a lot of sub-optimal health indicators including reproductive health. It is important to anticipate and look out for these effects in order to plan for and ensure early detection and necessary intervention to mitigate such. This paper discusses the potential effect of COVID-19 on reproductive health indicators in Nigeria. The reproductive health indices of a population have far and wide reaching impact on the health status of the population. However, reproductive health indicators are usually among the worst hit during health emergencies or disasters as seen in the Ebola pandemic in sub-Saharan Africa. Interventions must be put in place so that the pandemic does not set Nigeria back from the marginal gains made in reproductive health over the years.

Biochemical Assessment of Cardiovascular Risk Associated with the Duration of Antipsychotic Therapy in Patients with Schizophrenia.

BACKGROUND AND OBJECTIVES: Schizophrenia accounts for 78% of cases managed in Behavioural Sciences in Nigeria, and treatments with antipsychotic drugs may contribute to the onset of coronary heart disease (CHD) due to dyslipidaemia - associated complications. The prevention of CHD is preferable and less expensive than its management; thus, early identification and treatment may offer the possibility of reducing the devastating sequel. The aim of this study was to investigate the pattern of dyslipidaemia and cardiovascular risk (CVR) associated with duration of antipsychotic therapy inorder to improve awareness on early diagnosis, treatment and CVR reduction. METHODS: This was a longitudinal (prospective) study involving 44 participants recruited through systematic random sampling. Each participant served as their own control. Four blood samples were obtained from each participant, starting with a baseline before the onset of antipsychotic therapy and subsequently at monthly intervals for three consecutive months from commencement of therapy. Parameters of routine and advanced lipid profiles were assayed and the atherogenic indices were calculated. RESULTS: Both the routine and advanced lipid profiles werewithin reference limits at baseline. A significant increase in monthly levels was observed with dyslipidaemia noticed by the second month of antipsychotic therapy. There was an association established between the duration of therapy and a high CVR. The TC/HDL-C ratio performed better than apo B-100 and individual routine lipid profile fractions in the evaluation of CVR. CONCLUSIONS: Dyslipidaemia associated with high CVR may develop with antipsychotic therapy. Calculation of atherogenic indices was a good indicator of CVR.

CONTEXTE ET OBJECTIFS: La schizophrénie représente pour 78 % des cas pris en charge en sciences du comportement au Nigeria, et les traitements par antipsychotiques peuvent contribuer à l'apparition de l'apparition de maladies coronariennes dues à la dyslipidémie et à ses complications. complications associées. La prévention des maladies coronariennes est préférable et moins coûteuse que leur gestion alors l'identification et le traitement précoces peuvent offrir la possibilité de réduire les séquelles dévastatrices. L'objectif de cette étude était d'examiner les caractéristiques de la dyslipidémie et du risque cardiovasculaire (CVR) associés à la durée du traitement antipsychotique afin d'améliorer la sensibilisation au antipsychotique afin de sensibiliser au diagnostic précoce, au traitement et à la à un stade précoce. MÉTHODES: Il s'agissait d'une étude longitudinale (prospective) impliquant 44 participants recrutés par échantillonnage aléatoire systématique. Chaque participant a servi comme une charge Quatre échantillons de sang ont été prélevés chez chaque participant, en commençant par une ligne de base avant le début du traitement. de référence avant le début du traitement antipsychotique, puis à intervalles puis à intervalles mensuels pendant trois mois consécutifs à partir du début du traitement. Les paramètres des profils lipidiques de routine et et avancés ont été analysés et les indices athérogènes ont été calculés. ont été calculés. RÉSULTATS: Les profils lipidiques de routine et avancés étaient tous deux dans les limites de référence au début du traitement. Une augmentation significative des Une augmentation significative des niveaux mensuels a été observée avec une dyslipidémie remarquée audeuxième mois de traitement antipsychotique. Une association a été établie établie entre la durée du traitement et un CVR élevé. Le rapport TC/HDL-C s'est révélé plus performant que l'apo B-100 et les les fractions individuelles du profil lipidique de routine dans l'évaluation de la CVR. CONCLUSIONS: Une dyslipidémie associée à une CVR élevée peut se se développer avec un traitement antipsychotique. Le calculdes indices athérogènes est un bon indicateur du CVR. MOTS CLÉS: Risque cardiovasculaire, Dyslipidémie, Antipsychotiques, Schizophrénie.

A Survey of Plants used in Treatment of Hypertension and Diabetes Mellitus in Ilorin, Kwara State, Nigeria

Background: Hypertension and Diabetes mellitus have emerged as the leading non-communicable disease worldwide, thus, the increasing need to continuously explore more and better ways of treating these diseases.Objectives: To carry out a survey of plants used in the treatment of hypertension and Diabetes mellitus in Ilorin, Kwara State, Nigeria. Materials and methods: Interview was conducted among respondents using semi-structured questionnaires and asking open-ended questions. Descriptive statistics were used for data analysis.Result: A total of 30 respondents comprising of 60.0% male and 40.0% female with the highest distribution of age range at above 50 years old (50.0%) was reported. Forty (40) medicinal plant species belonging to thirty-one (31) plant families were cited with the Apocynaceae family having the highest number of medicinal plants, followed by Asteraceae. For hypertension, 32 plant species were reported of which the most cited were Allium sativum (4) and Ficus asperifolia (2) while for Diabetes mellitus, 20 plant species were mentioned, of which the most cited were Hunteria umbellata (10) and Vernonia amygdalina (9). Of particular interest in this study were the plants that appeared for both hypertension and Diabetes treatment.Conclusion: This survey has helped to increase available medicinal plants knowledge and documentation in the management of hypertension and Diabetes. However, further work on the pharmacological activity of these plants as well as formulation in proper dosage form is recommended

Effect of Hepatitis B Virus Co-Infection on CD4 Cell Count and Liver Function of HIV Infected Patients.

BACKGROUND: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share similar routes of transmission, making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naïve patients and investigate the effect of co-infection on CD4 count and liver function. STUDY DESIGN: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count, Hepatitis B surface antigen, Serum albumin, total Protein, and liver enzymes were determined using standard techniques. RESULTS: The prevalence of HIV and HBV co-infection was 37%. The mean serum ALT and ALP were significantly higher in the co- infected patients (P-values <0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT, AST and ALP of mono and co-infected patients with CD4 count<200/µl were significantly higher than those with count ≥ 200 cells/µl. (p-value of <0.01). The mean ALT and AST of the co-infected patients and all patients with CD4 count <200 cells/µl were higher than the normal reference range. CONCLUSION: Approximately one third of HIV positive patients had hepatitis B virus co-infection. Co-infection and CD4 count <200 cells/µl are likely to result in abnormal ALT and AST. We recommend that co-infected patients and those with CD4 count <200 cells/µl should be given non-hepatotoxic antiretroviral drug.

Effect of hepatitis-B virus co-infection on CD4 cell count and liver function of HIV infected patients.

BACKGROUND: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share similar routes of transmission making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naïve patients and investigate the effect of co-infection on CD4 count and liver function. STUDY DESIGN: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count, Hepatitis B surface antigen. Serum albumin, total Protein, and liver enzymes were determined using standard techniques. RESULTS: The prevalence of HIV and HBV co-infection was 37%. The mean serum ALT and ALP were significantly higher in the co-infected patients (P-values <0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT, AST and ALP of mono and coinfected patients with CD4 count<200/µl were significantly higher than those with count ≥ 200 cells/µl. (p-value of <0.01). The mean ALT and AST of the co infected patients and all patients with CD4 count <200 cells/µl were higher than the normal reference range. CONCLUSION: Approximately one third of HIV positive patients had hepatitis B virus co-infection. Co-infection and CD4 count <200 cells/µl are likely to result in abnormal ALT and AST. We recommend those co-infected patients and those with CD4 count <200 cells/µl should be given non-hepatotoxic antiretroviral drug.

Effect of Hepatitis B Virus Co-Infection on CD4 Cell Count and Liver Function of HIV Infected Patients

Background: Human immunodeficiency virus (HIV)and Hepatitis B virus (HBV) share similar routes of transmission; making it possible for an individual to have a co-infection. HBV infection is well known to be a major cause of chronic liver diseases worldwide. The aim of this study was to determine the prevalence of HBV infection among HIV infected HAART naive patients and investigate the effect of co-infection on CD4 count and liver function. Study design: This was a hospital based descriptive cross sectional study of one hundred consecutive therapy-naive HIV-infected individuals. The CD4 count; Hepatitis B surface antigen; Serum albumin; total Protein; and liver enzymes were determined using standard techniques. Results:The prevalence of HIV and HBV co-infection was 37. The mean serum ALT and ALP were significantly higher in the co- infected patients (Pvalues 0.05). The mean CD4 count of the mono infected patients was significantly higher (p-value of 0.014). The mean serum ALT; AST and ALP of mono and co-infected patients with CD4 count200/?l were significantly higher than those with count ? 200 cells/?l. (p-value of 0.01). The mean ALT and AST of the co -infected patients and all patients with CD4 count 200 cells/?l were higher than the normal reference range. Conclusion : Approximately one third of HIV positive patients had hepatitis B virus co-infection. Coinfection and CD4 count 200 cells/?l are likely to result in abnormal ALT and AST. We recommend that co-infected patients and those with CD4 count 200 cells/?l should be given non-hepatotoxic antiretroviral drug

Serum lipids and glucose abnormalities in HIV/AIDS patients on antiretroviral therapies.

BACKGROUND: With the introduction of highly active antiretroviral therapy (HAART) the outlook of HIV/AIDS has changed from a killer disease to a treatable chronic infectious one. However HAART is associated with some metabolic disorders some of which are now being seen in people living with HIV/ AIDS (PLWHA) accessing care from our centre. OBJECTIVE: To determine the prevalence and pattern of dyslipidaemia and dysglycaemia amongst Nigerian HIV/AIDS patients on HAART. METHODS: PLWHA who were regular on ART for at least three months and had pre-treatment CD4+ count, fasting lipid and glucose profiles were grouped into two treatment regimens: protease inhibitor, (PI) or non-nucleoside reverse transcriptase inhibitor (NNRTI). Pre and post-exposure metabolic and non-metabolic variables were compared for each regimen as well as within regimen comparison of the differences between post exposure metabolic variables. RESULTS: Three hundred and twenty-seven patients; [male = 134 (41%), female = 193 (59%)] met the study criteria in the two groups: PI = 94 (29%) and NNRTI = 233 (71%). The pretreatment metabolic changes in both groups (PI vs. NNRTI) were low HDL-C; 29 (31%) vs. 77 (33%), followed by hypertriglyceridaemia; 16 (17%) vs. 38 (16%) and hypercholesterolaemia; 6 (6%) vs. 10 (4%). After exposure to two different HAART regimens hypertriglyceridaemia and hypercholesterolaemia became more prevalent especially with Pi based therapy than NNRTI; 74 (79%) vs. 108 (54%) and 58 (51%) vs.72 (31%) respectively. These relative higher risks of a PI containing regimen to induce hypertriglyceridaemia and hypercholesterolaemia were about three times more than that of NNRTI, both risks were statistically significant; p = 0.0003 and p = 0.0001. CONCLUSION: Low HDL-C, hypertriglyceridaemia and hypercholesterolaemia are common in untreated HIV/AIDS patients. HAART especially those including protease inhibitors worsens this dyslipidaemia.

Biochemical infertility among females attending University of Ilorin Teaching Hospital, Nigeria.

BACKGROUND: Biochemical laboratory investigations potentially contribute to the diagnosis of over 50-75% of couples being investigated for infertility. Both hormonal and anti-hormonal treatments have achieved great successes in the treatment of infertility. Our aim therefore was to investigate the pattern of biochemical abnormalities in females diagnosed as infertile form anovulation. MATERIAL AND METHODOLOGY: One hundred and twenty women diagnosed clinically as primary or secondary infertility from anovulation referred from the gynecological clinic of UITH and private hospitals in Ilorin were investigated by routine fertility test profile. RESULT: The age ranged between 20-40 years (mean = 32.9, sd +/- 4.7) for the primary infertility and 23-47 years (mean = 34.4, sd +/- 5.4) for the secondary infertility groups respectively. Ninety six (80%) subjects were found to have hormonal abnormalities. Pattern of biochemical diagnosis amongst the 33 (34.4%) primary infertility subjects included hypergonadotrophic hypogonadism 21 (63.6%), hypogonadotrophic hypogonadism 9 (27.3%), and hyperprolactinemia 3 (9.1%). Among the 63 (65.6%) cases of secondary infertility, there were 31 (49.2%) cases of hypergonadotrophic hypogonadism, 30 (47.6%) hypogonadotrophic hypogonadism, and 2 (3.2%) hyperprolactinemia. There was no statistical difference in the mean values in the various biochemical parameters. CONCLUSION: Hormonal profile should be a goal standard in the diagnosis of anovulation.

Infants with severe neonatal jaundice in Lagos, Nigeria: incidence, correlates and hearing screening outcomes.

OBJECTIVES: To establish the incidence, correlates and hearing screening outcomes of infants with severe neonatal jaundice in Nigeria. METHODS: Community-based study in which all infants attending Bacille Calmette-Guérin immunisation clinics in inner-city Lagos were enrolled into a universal hearing screening programme during which correlates of severe neonatal jaundice (requiring phototherapy and/or exchange blood transfusion) were explored with multivariable logistic regression. RESULTS: Of the 5262 infants enrolled, only 48.7% were born in hospitals although almost all mothers (97.9%) attended antenatal clinics. 6.7% had a history of neonatal jaundice of whom 5.5% (95% CI:4.9-6.2) received phototherapy and 1.9% (95% CI:1.5-2.3) had an exchange blood transfusion. Factors independently associated with severe neonatal jaundice were maternal religion, occupation, use of herbal preparations during pregnancy, infant's gender, weight at screening, multiple gestation and place of birth. All but two infants with severe neonatal jaundice were exclusively breast-fed. Of those who failed the hearing tests, 17.3% were treated with phototherapy and 11.3% had an exchange blood transfusion. At least 8.9% of infants requiring phototherapy and 17.3% of those requiring exchange blood transfusion were at risk of sensorineural hearing loss. CONCLUSIONS: Severe neonatal jaundice is a significant condition associated with modifiable risk factors in this population. Policy initiatives for prevention, early detection followed by appropriate and timely intervention are urgently needed to reduce the disease burden.

Glycaemic Response to Different Preparations of Yam in Diabetic and Non-Diabetic Nigerians

Post-pandial glycaemic responses to food can be affected by the method involved in the preparation of the food. Dietary intervention with food modification forms the corner- stone of management of type 2 diabetes worldwide. The effect of processing on yam; a staple food in Nigeria; was studied among diabetic and non-diabetic Nigerians. Despite undergoing more processing; amala prepared from yam flour had a better post-pandial glycaemic response index (PGRI) compared to other yam preparations; and this was also significantly higher among the diabetic subjects. Yam-based products; particularly amala; should be encouraged among diabetic Nigerians

Serum uric acid level as an independent component of the metabolic syndrome in type 2 diabetic blacks.

CONTEXT: No consensus has been achieved on the components included in the definition of Metabolic Syndrome (MS). Uric acid and Gamma glutamyl transpeptidase are however newer markers not included in previous studies. OBJECTIVES: This study was carried out to determine the prevalence of MS in Diabetes Mellitus, the correlation between hyperuricaemia and MS as well as make a case for the inclusion of serum Uric acid level as a new marker for MS. METHODOLOGY: Fasting venous sample from the cubital vein of 77 females and 44 males diagnosed NIDDM patients for enzymatic determination of serum lipids, glucose and uric acid using QCA kits. The demographic records were obtained from the folders. Metabolic syndrome was diagnosed using the WHO criteria. RESULT: The prevalence of the new component hyperuricaemia among the study subjects was 10.7%. Thirty-eight (31.6%) of the subjects who had high blood pressure, hypertriglyceridemia, low HDL-C and BMI > 30 kg/m2 diagnostic of MS also had hyperuricaemia as against the 29 (23.9%) subjects who hadMS only. About 23.7% of the 38 subjects who had MS and hyperuricaemia had serum uric acid values above 0.38 mmol/l recommended as the cut off value. There was a significant correlation (r = 0.301, p < 0.01) between serum uric acid level, BMI, total cholesterol, LDL-C and HDL-C/TC, among the female subjects while the male subjects showed significant correlation (p < 0.05) between their BMI and serum HDL-C level only. There was a significant difference (p < 0.001) in the CHD risk ratio between the male and the female MS subjects. CONCLUSION: The correlation between hyperuricaemia and other components of MS as demonstrated in this study may suggest a common etiological factor between the MS components as suggested in other studies. Insulin resistance has been implicated as a common denominator. Thus a further investigation in this direction would be needed.

High Risk Coronary Heart Disease, Lipid Fractions and Transferrin Saturation among Hypertensive Nigerians.

BACKGROUND AND OBJECTIVES: Hypertension and hypercholesterolemia are well established independent risk factors of coronary heart disease. Moreover, drug treatment of hypertension also affects lipid metabolism. Recently, body iron status has also been implicated as a risk factor of coronary heart disease. It is not however clear whether hypertension or hypercholesterolaemia directly or indirectly influences body iron status. This study was therefore decided to look at the association between transferrin saturation and hypercholesterolaemia in adult hypertensive Nigerians with high risk Coronary Heart Disease (CHD) lipid fraction. MATERIALS AND METHODS: The study group comprises eighty two adult Nigerians who are known hypertensives with high risk coronary heart disease lipid fraction: that is the ratio of high density lipoprotein cholesterol to total cholesterol (HDL-C/TC) <= 0.13 while the control subjects comprises eighty adult Nigerians who are also known hypertensives with normal HDL-C/TC ratio (>=0.30). RESULTS: The total iron binding capacity is not significantly different between the two groups. Also, serum iron and transferrin saturation were not significantly different in the two groups. Transferrin saturation does not show appreciable correlation with total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels in any of the two groups. CONCLUSION: The association between transferrin saturation and hypercholesterolaemia in hypertensive is not strong enough to possibly suggest that one influences the other. However, the influence of antihypertensive drugs on lipid metabolism cannot be ruled out in this study because subjects and controls were not selected based on type or class of medication. KEYWORDS: transferrin saturation, high risk CHD lipid fraction, hypertensives.

Prevalence of coronary heart disease risk factors in Nigerians with systemic hypertension.

This study is to determine the prevalence of coronary heart disease risk factors in Nigerians with systemic hypertension. Serum lipid profile and fasting blood glucose were determined in one hundred and thirty six newly diagnosed hypertensives selected from the Medical Outpatient Department. Basic demographic data as well as medico-social history was extracted from the records. Coronary heart disease risk was calculated from the ratios of high-density lipoprotein cholesterol to total cholesterol. High risk were defined as CHD ratio <0.18, while average and low CHD risk ratio was 0.18 to 0.40 and >0.40 respectively, according to the European Athersclerosis society guidelines. There were 76 (55.9%) males and 60 (44.1 %) females aged 24-70 years (mean = 47+8.5) studied. The coronary risk ratio in the study groupts was 0.34 as against 0.57 in the controls. The prevalence of high coronary heart disease risk in newly diagnosed hypertensives was 22%. The overall prevalence rate of hypercholesterolaemia was 62.5%, with high-risk group prevalence of 70%. The high-risk group was also associated with other non-lipid factors such as overweight -54% (BMI > 25Kg/m2), glucose intolerance-55% (FBS > 6.1 mmol/L), and alcoholism (55%). The overall prevalence of hypertriglyceridaemia was 20.4%, with higher serum values amongst females, and no risk group difference. The female patients were more affected by the metabolic risk parameters especially in the high and average risk groups. There is a need therefore, for clinicians to be encouraged to investigate lipid, lipoprotein cholesterol indices and other non-lipid risk factors to calculate the risk run by hypertensive patients of developing cardiovascular complications.

Relation of electrocardiographic left ventricular hypertrophy to blood pressure, body mass index, serum lipids and blood sugar levels in adult Nigerians.

Left ventricular hypertrophy (LVH) is considered an independent risk factor even in the absence of systemic hypertension. Electrocardiographic (ECG) LVH with repolarisation changes has been found in some countries to carry more coronary risk than LVH alone. How far this observation is true among adult Nigerians is not known. We therefore decided to study adult Nigerians with ECG-LVH with or without ST-T waves changes and compare them with normal age matched controls (without ECG-LVH) in relation with established modifiable risk factors such as systemic hypertension (BP), body mass index (BMI), fasting blood sugar (FBS) and serum lipids such as total cholesterol (Tc), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG). Adult Nigerians who were consecutively referred to the ECG laboratory were randomly recruited. Three hundred patients were studied. Their blood pressures (BP) as well as body mass indices were recorded after recording their resting 12 read ECG using portable Seward 9953 ECG machine. Their waist-hip ratio (WHR) was also recorded. Blood samples were taken to determine their fasting blood sugar and serum lipids. Their ECG tracings were read by the cardiologists involved in the study while the blood samples were analysed by the chemical pathologist also involved in the study. At the end of the ECG reading, the patients were divided into 3 groups according to whether there was no ECG-LVH (control group A), ECG-LVH alone (group B), and ECG-LVH with ST-T waves changes (group C). One hundred and fifty (50%) patients belonged to group A, 100 (33.3%) patients to group B and 50 (16.7%) group C. Group B patients were found to have higher modifiable risk factors in form of systemic BP. Tc, LDL-C, and WHR compared to group A. However, the group C patients had increased load of these coronary risk factors in terms of BP elevation, higher BMI, FBS, and scrum cholesterol compared to group B. In addition, more female patients were involved in group C. The mean age of group C patients compared to group B was also significantly higher (P<0.001) even though no significant age difference was noted between group C and group A patients. It is concluded that Nigerians with ECG-LVH with ST-T waves changes have increased risk of cardiovascular risk factors compared to normal group A patients and even patients with EGC-LVH (group B) alone. Hence, they represent subset of patients to be aggressively followed up with multiple risk factors intervention.

Blood sugar control among fasting Muslims with type 2 diabetes mellitus in Ilorin.

Fasting in the month of Ramadan represents a recurring annual event in the life of a Muslim. It also represents one of the five pillars around which the Islamic faith revolves making it desirable to even diabetic Muslims if only to live a spiritually fulfilling life. We therefore embarked upon the study of 33 patients with Type 2 Diabetes Mellitus who fasted in the month of Ramadan of 1417 Hijra year (1997 Gregorian) with a view to establishing the effect of fasting on their blood sugar control. This is meant to serve as a framework for establishing a scientific basis for advice to Muslim diabetic patients who may wish to fast in subsequent years. Eight point three percent of patients considered for enrollment signified their non-willingness to fast even after health-education. In the month preceding fasting the mean +/- SD for fasting blood sugar (FBS) was 6.71 +/- 2.81 mmol/L, 6.50 +/- 2.34 mmol/L for the month of Ramadan and 6.93 +/- 2.53 mmol/L for the month after. There was no statistically significant difference between the means for the three months. However, larger percentage of patients (76%) had their fasting blood sugar improved upon during fasting than either before or after. In addition, there was no reported case of acute complication from diabetic emergencies all through the period of the study. Based on these findings, it was concluded that most Type 2 diabetic patients actually do as well, like their normal counterparts during fasting and could be encouraged to do so provided they are clinically stable.