Relationship between parental socio-economic status and casual blood pressure in coastal Nigerian adolescents.

BACKGROUND: Emerging data suggest that essential or primary hypertension occurs in the young. Parental socioeconomic status may play a role but the exact mechanisms still remain unclear. OBJECTIVE: This study was aimed at determining the relationship between parental socioeconomic status and casual blood pressure in adolescents. METHODS: One thousand and eight adolescents attending two secondary schools in Calabar, Nigeria were selected by stratified random sampling. Their blood pressure, weights and heights were taken using standard methods and sociodemographic data were obtained using a pretested semistructured questionnaire. RESULTS: Blood pressure was increased with age with males having higher values. The other major determinants of blood pressure were weight, height, body mass index, level of physical activity and parental socioeconomic status (p <0.05). No relationship was established between these determinants as well as dietary habits with parental socioeconomic status (p > 0.05). Female adolescents with parents in the lower socioeconomic classes had significantly higher systolic and diastolic blood pressure (p < 0.05). In contrast, parental socioeconomic status showed no significant relationship with systolic blood pressure and diastolic blood pressure in males (p >0.05).The prevalence of elevated blood pressure was higher in females than in males. CONCLUSION: Low parental socioeconomic status appear to be associated with higher casual blood pressure especially in female coastal Nigerian adolescents. Traditional determinants did not appear to play a significant role. Psychological stress arising from environmental and economic stressors may be responsible.

Hypokalaemia in children hospitalised for diarrhoea and malnutrition in Calabar, Nigeria.

OBJECTIVE: To describe the acid base and electrolyte pattern of morbidity and mortality in children with diarrhoea and protein energy malnutrition. SETTING: The diarrhoea treatment and training unit of the university of Calabar teaching hospital was used for the study. DESIGN/METHODS: It was a prospective study in which consecutive children below the age of 15 years with protein energy malnutrition and diarrhoeal diseases admitted into the DTU were screened for acid base and serum electrolyte abnormalities. The study was carried out over a two year period from January 1997 to December 1998. RESULTS: Hypokalaemia was seen in 45 (23.4%) patients. This was second to acidosis. Metabolic acidosis was the commonest abnormality in this study and was seen in 108(56.3%) of the patients included in the study. There was hyponatraemia in 25(13%). Hypochloraemia in 8(4.2%) and hypernatraemia in 6(3.1%) of the patients respectively. CONCLUSION: This study has shown that hypokalaemia is a common electrolyte abnormality in children with severe protein energy malnutrition and diarrhoeal diseases. There is need to encourage the use of readily available interventions such as the UNICEF and WHO oral rehydration solution in patients with diarrhoea and/or severe protein energy malnutrition to reduce morbidity and mortality from acid base and electrolyte disturbances.

Junctional epidermolysis bullosa in a female Nigerian child: a case report.

AIM: To report the case of Junctional Epidermolysis bullosa seen in the University of Calabar Teaching Hospital, Calabar and to draw attention to the existence of this condition among Nigerians. SUBJECT AND METHODS: A Nigerian female infant, normal at birth, developed extensive blistering skin eruptions from the age of ten days. The lesions involved the face, neck, shoulders, upper trunk and the buccal mucosa of the lower lip sparing the limbs. The cornea were cloudy. The history, type and distribution of the lesions were consistent with Junctional Epidermolysis bullosa (EB). This was confirmed by skin biopsy and histology. Various medications including systemic and topical steroids, antibiotics and other topical creams only produce transient relief with frequent relapses. The Junctional EB type is known to be autosomal recessive in inheritance though there was no positive family history. Avoidance of heat, warm bath and trauma and genetic counseling can be helpful in reducing frequent relapses of the condition that has no specific treatment. CONCLUSION: This appears to be the first case of Epidermolysis bullosa to be reported from Calabar, south eastern Nigeria. This case report shows that this rare condition does affect people in the tropics. Efforts should always be made to reach a definitive diagnosis whenever unusual conditions are encountered in clinical practice.

Lipid profiles of apparently healthy adolescents in Calabar, Nigeria.

OBJECTIVE: To determine the lipid profiles of adolescents in Calabar, Nigeria. DESIGN: A cross sectional prospective study. SETTING: The study was carried out in Calabar, a city located on the south-eastern axis of Nigeria. Calabar is rapidly acquiring the status of a tourism destination in the country and as such the lifestyles of the city dwellers are changing rapidly. SUBJECTS: The subjects were apparently healthy students 10 to 18 years old attending day secondary schools in the city. A structured questionnaire was used to collect demographic and anthropometric data from the students. Blood samples were collected from 375 adolescents and used for analyzing their lipid profiles. MAIN OUTCOME MEASURES: Abnormal levels of serum lipids. RESULTS: The results showed that only one subject (0.3%) had an abnormally high total cholesterol (TC) level and 33% of the subjects had low levels of high density lipoprotein cholesterol (HDL-C). Borderline high levels of total cholesterol, low density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were found in 2.4%, 3.2% and 5.1% of subjects respectively. CONCLUSION: This study shows that the lipid profiles of Nigerians are low but gradually rising towards values seen in places where coronary heart disease occurs in epidemic proportions. This may point to an increased risk ofarteriosclerosis in future generations.