Atherosclerosis: A Journey around the Terminology

The term atherosclerosis underwent a tedious pathway to arrive at its current status and interpretation. Furthermore, terms such as atherosclerosis, arteriosclerosis and arteriolosclerosis appear similar and are misused interchangeably. This chapter highlighted the various terminologies linked with atherosclerosis. This chapter highlighted how the terminology of atherosclerosis evolved and, also, the various classifications, e.g., atherosclerosis, Monckeberg calcific sclerosis and arteriolosclerosis, and gave mention to the differences among them

Utilization of Digital Information Resources by Undergraduates at Lead City University, Ibadan Nigeria

The innate need for growth and the growing popularity of digital information resources have prompted many academic libraries, including Lead City University to invest on the provision of digital information resources. However, studies have shown that provision of digital information resources does not automatically guarantee utilization. This study therefore investigates the utilization of digital information resources among undergraduate students at Lead City University, Ibadan Nigeria. The study adopted a quantitative research method with a questionnaire used as research instrument. The study sample consists of 342 undergraduate students and the data collected was analysed with aid of the Statistical Package for Social Sciences (SPSS). The findings show that there is a low level of digital resources utilization among the undergraduates. It was also found that challenges such as lack information retrieval skills, slow internet and inadequate computer system are among the challenges affecting the utilization of digital information resources by the undergraduate students

Prevalence and presentation of hyperdontia in a non-syndromic, mixed Nigerian population

Although there have been studies on the prevalence and pattern of hyperdontia in sub-Saharan African subjects with similar cultural backgrounds, based on our search, none have been able to consider these epidemiological parameters in a multiethnic black population, which is expected to add substantial knowledge to what is available. This is a retrospective study on the panoramic radiographs of subjects who presented at two dental centres in Abuja, Nigeria between June 2013 and June 2018. Radiographic interpretations were carried out by three independent observers, trained on computer assisted radiographic image interpretation. Data were collected and analyzed using Statistical package for the Social sciences (SPSS) version 22 (IBM Corp, Armonk, USA). One thousand eight hundred and thirty seven (1837) panoramic radiographs were studied. Subject comprised males and females between ages 12 ? 95 years with an average of 35.0 years. The prevalence of unilateral hyperdontia was 1.47% while an occurrence rate of 0.27 was observed for bilateral and multiple hyperdontia. For maxillary hyperdontia, a prevalence of 1.09% was recorded which was significantly more common than the mandibular type (0.65). Of note is that all the supernumerary teeth types were commonly observed in the maxilla except the parapremolar type, with a mandibular occurrence rate of 76.9%. From this study, we can conclude that the prevalence of hyperdontia (across different black ethnicities) is low. Although, follicular epithelium around the tooth and root resorption of the enlargement around the adjacent teeth was observed, most were asymptomatic (87.0%) and required no intervention

Right ventricular systolic function in Nigerians with heart failure secondary to hypertensive heart disease

Background: Right ventricular (RV) dysfunction has been shown to be a major contributor to the adverse outcomes in subjects with heart failure. Few studies evaluating the right ventricle in heart failure subjectshave been carried out in Sub-Saharan Africa. This study was therefore designed to evaluate the right ventricular systolic function in subjects with heart failure secondary to hypertensive heart disease presenting to the University College Hospital, Ibadan Nigeria.Methodology: Seventy-six subjects with heart failure secondary to hypertension and 92 normal controls underwent clinical, electrocardiographic and echocardiographic evaluation. Indices of right ventricular systolic function that were measured include tricuspid annular plane systolic excursion (TAPSE), tissue Doppler derived tricuspid peak systolic lateral annulus velocity(S') and right ventricular fractional areachange(RVFAC).Results: Sixty-two (81.6%) heart failure subjects had right ventricular systolic dysfunction, 31(40.8%) had abnormal TAPSE, 42(55.5%) had abnormal S' while 49(64.5%) had abnormal RVFAC. Elevated pulmonary artery systolic pressure was found in 25(32.9%) of the subjects. There was no relationship between the indices of right ventricular systolic function and the estimated systolic pulmonary artery pressures. The independent predictor of right ventricular systolic dysfunction was the right atrial size.Conclusion: Right ventricular systolic function is impaired in patients with heart failure secondary to hypertensive heart disease. There is no relationship between the indices of right ventricular systolic function and systolic pulmonary artery pressure. Furtherstudies are needed to assess right ventricular systolic function in Nigerians.Keywords: Hypertension, Heart Failure, Right ventricular dysfunction, Nigeria, Sub- Saharan Africa

Requirements for driving and perceived barriers to accessing eye care services; a comparative study of government and commercial drivers in southwestern Nigeria

Introduction: Satisfactory driving and eye tests at accredited centers by national traffic regulatory agencies are prerequisites for issuance of driver's license. Objectives: We assessed driving requirements and perceived barriers to accessing eye care services among government and commercial drivers in Osun state, Southwest Nigeria. Méthodes: We conducted a comparative cross-sectional study among 120 male commercial and government drivers each. Data were collected using a pre-tested semistructured questionnaire. A focus group discussion (FGD) was used to obtain information on criteria for issuance of driver's license and perceived barriers to accessing eye care services. Frequency and chi-square test were done. Level of significance was set at p-value <0.05. Responses from the FGD recordings were analyzed using detailed content analysis with similar patterns of responses grouped together. Résultats: One hundred and five (89.7%) government and 86 (76.1%) commercial drivers had undertaken driving test (p=0.006), 35 (29.9%) government and 16 (14.2%) had eye test (p=0.004) before issuance of driver's license. One hundred and seventeen (97.5%) government and 113 (94.2%) commercial drivers had driver's license. Commercial drivers mentioned expensive medical services, busy work schedule, nonchalant attitude to health matters and ignorance as some of the barriers to eye care services. Conclusion: Driving and eye tests were mostly done by government drivers. Inability to afford treatment services, busy work schedule and ignorance about visual status were perceived barriers to accessing eye care services mostly amongst commercial drivers. Public enlightenment on driving test with visual screening and provision of subsidized serial eye examination for drivers in Osun state was recommended

National Health Insurance Scheme: An Assessment of Service Quality and Clients’ Dissatisfaction

BACKGROUND: Health Insurance Scheme (NHIS), a medical package to start with a fraction of Nigerians at its inception, with the expectation of optimal services to all in the long The Nigerian government established National run. However, there are complaints and dissatisfaction of enrolees of the scheme. This study determined factors responsible for enrolees’ dissatisfaction of services in a general hospital within the federal capital territory, Abuja.METHOD: Three hundred enrolees of National Health Insurance Scheme at the Kubwa general hospital were enrolled. Semi structured questionnaires were used to obtain information on socio-demography, education, enrolee status, perception of the scheme and factors responsible for enrolees’ dissatisfaction. SPSS version 22 was used to analyse Data using percentage.RESULTS: Majority (66.3%) of the respondents were between 35 and 54years while 28.5% were below 35years and 11.8% (32) were above 54years with the male to female ratio was 1.03:1. Sixty percent (179) of the respondents had a minimum of tertiary education with just 1.8% having primary education. Most (69.9% and 79.6%) respondents were principal enrolees and public servants respectively. Seventy percent of the respondents have been enrolled in NHIS for more than 3years and had a good perspective of the scheme. However, 30% of the respondents were not satisfied with NHIS services with 8.6% and 15.4% describing the services as substandard and below expectations respectively. Half (50.7%) of the respondents would consider an alternative to NHIS suggesting their dissatisfaction. The major factors responsible for dissatisfaction were billing system, long waiting hours and staff attitude accounting for 46.9%, 59.4% and 7.8% respectively.CONCLUSION: This study revealed that the level of clients’ dissatisfaction with NHIS services is high despite their acceptance of the scheme with the major areas of concern being the billing system, waiting time and staff attitude. Therefore, it is necessary for the providers to look more into these areas as targets for service delivery improvement

Case Report: Unilateral post-tuberculosis lung destruction and massive haemoptysis in pregnancy with successful outcome

Post-tuberculosis destroyed lung is a fatal complication of pulmonary tuberculosis which can manifest with severe life-threatening haemoptysis. Its occurrence during pregnancy is rare and challenging because of the significant risk to both the mother and the foetus. We present an unbooked 36 year old G6P4+1 (4 alive) woman who presented with chronic cough, massive haemoptysis and multiple pregnancy (twin) at 35 week gestation. She had completed anti-tuberculosis treatment twice at and over nine years prior to presentation. On evaluation, there were clinical and radiological evidences of unilateral (right) destroyed lung but no evidence of active tuberculosis; resuscitation was with antibiotics, blood transfusion and oxygen therapy followed by an emergency caesarean delivery due to significant maternal compromise. The  symptoms resolved following antibiotic therapy and she was subsequently discharged home. Post-tuberculosis destroyed lung is a fatal uncommon condition that may present during pregnancy and requires a multi-disciplinary specialist care to ensure good maternal and foetal outcome. Keywords: Unilateral post-tuberculosis lung destruction; Massive haemoptysis; Twin pregnanc

Prevalence of ECG abnormalities among adults with metabolic syndrome in a Nigerian Teaching Hospital

Background: Co-existence of metabolic syndrome (MetS) and electrocardiography (ECG) abnormalities heightens the risk of sudden cardiac death. However, there is a gap in evidence of how ECG changes cluster among continental Africans with or without MetS. Methods: We included 491 participants with interpretable ECG tracings who were consecutively recruited into the Cardiovascular Risk Prediction Registry (CRP). CRP is a registry of newly presenting patients into cardiology clinic of the University College Hospital, Nigeria, with a main objective of cardiovascular risk stratification to prevent cardiovascular morbidity and mortality. Using the International Diabetic Federation (IDF) criteria they were divided into those with metabolic syndrome and non-metabolic syndrome. Results: Four hundred and ninety-one participants comprising 48.3% women with mean age 53.72\ub115.2 years who met the IDF criteria with complete ECG interpretations were analyzed with 44.2% (men 38.6%; women 50.2%) of the participants having MetS while 74% had ECG abnormalities. Compared to women, men had higher mean serum total cholesterol, creatinine, smoking, and alcohol use, family history of hypertension and diabetes mellitus, QT prolongation, LVH plus or minus strain pattern, and ECG abnormalities in general. Women were heavier, had higher heart rate and proportions of MetS. ECG findings among those with or without MetS were not significantly different. In men, IDF metabolic score was associated with conduction abnormalities (p=0.039) and combined ECG abnormality (p=0.042) which became more significant with an exclusion of QT prolongation (p=0.004). Also, IDF abdominal obesity was associated with QT prolongation (p=0.017), combined ECG abnormality (p=0.034) while HDLc correlated with ECG abnormalities (0.037) in men. There was no significant associations of components of metabolic syndrome with ECG abnormalities among women. Conclusion: There was a high prevalence of MetS and abnormal ECG among the studied population. Abnormal ECG findings were more common in men with no differential association in people with or without MetS. However, a significant association existed between certain components of MetS and ECG abnormalities in men only. Male gender and HDLc were independent predictors of ECG Abnormalities

Microalbuminuria, Other Markers of Nephropathy and Biochemical Derangements in Type 2 Diabetes Mellitus: Relationships and Determinants

Background: Microalbuminuria is an early indicator of Diabetic nephropathy and cerebrovascular disease.Objective: To evaluate relationships between microalbuminuria and other predictors of morbidity and mortality in type 2 DM.Methods: Fifty type 2 diabetic subjects were recruited each for three groups separated by disease durations. Thirty non-diabetic subjects were recruited to control each group. Urine albumin-to-creatinine ratio (ACR) was estimated. Fasting plasma glucose (FPG), serum creatinine, urea, total cholesterol (TC), triglycerides (TG), high- and low density lipoprotein (HDL, LDL) were measured.Results: The diabetics with longest disease duration of >10 years were the oldest (65.86±1.71), had highest systolic BP (147.12±3.39mmHg) and least BMI (27.20±0.71Kg/m2); they had poorest lipid control (TC:5.54±0.26mmol/L),though with the least TG (0.97±0.09mmol/L); they also had the most severe microalbuminuria (33.63±8.03g/L) and ACR (65.85±10.38mg/gm). Patients with diabetes of 5-10 years had the poorest glycaemic control:FPG- 7.82±0.47mmol/L; HbA1c-13.09±0.74%). Significant negative correlations exist between microalbuminuria,HBA1c(r=-2.28, p=0.028) and serum creatinine(r=-2.11,p=0.042) in patients with 5-10 years disease; a positive correlation between the ACR and TC(r=1.00,p<0.01) in those with >10 years disease. In multivariate analysis, independent predictors of microalbuminuria were disease duration (OR 2.2, p< 0.001); HBA1c (OR 7.3, p=0.02); LDL/HDL ratio (OR 13.4, p< 0.001).Conclusion: The severity and progression of albuminuria are associated with longer duration of diabetes and poor glycaemic control. Significant relationships exist between ACR and HBA1c, TC, HDL-C, TG, creatinine. Disease duration, ethnicity, HBA1c, TC, TG, HDL-C and LDL/HDL ratio are independent predictors of albuminuria.Keywords: diabetes, microalbuminuria, albumin-to-creatinine ratio, dyslipidaemia, nephropathy, cardiovascular diseaseFunding: None declare

A 45-year old man with recurrent syncope: an unusual presentation of coronary artery disease

A 45-year old normotensive, euglycaemic, non-smoker was referred from a peripheral hospital to the Cardiology unit of the University College Hospital, Nigeria for evaluation of recurrent exercise induced syncope. Initial 12-lead electrocardiogram (ECG), 24-hr ambulatory ECG, transthoracic echocardiogram and electroencephalogram (EEG) were normal. A repeat episode of syncope warranted further investigation. Immediate post syncope ECG showed deeply inverted symmetrical T waves in the anterior leads. He underwent coronary angiogram which revealed distal left main disease and 70-80% stenosis of the proximal Left Anterior Descending Artery (LAD). The Circumflex artery was non dominant with normal Right Coronary artery. He subsequently had Percutaneous Transluminal Coronary Angioplasty (PTCA) of the LAD. Post-revascularisation course has been satisfactory with no recurrence of syncope. In view of the rising trend of cardiac death in the country, there is the need for high index of suspicion in making diagnosis of coronary artery disease in patients with syncope.Pan African Medical Journal 2013; 14: 7