Epigenome-wide meta-analysis of BMI in nine cohorts: Examining the utility of epigenetically predicted BMI

This study sought to examine the association between DNA methylation and body mass index (BMI) and the potential of BMI-associated cytosine-phosphate-guanine (CpG) sites to provide information about metabolic health. We pooled summary statistics from six trans-ethnic epigenome-wide association studies (EWASs) of BMI representing nine cohorts (n = 17,034), replicated these findings in the Women's Health Initiative (WHI, n = 4,822), and developed an epigenetic prediction score of BMI. In the pooled EWASs, 1,265 CpG sites were associated with BMI (p < 1E−7) and 1,238 replicated in the WHI (FDR < 0.05). We performed several stratified analyses to examine whether these associations differed between individuals of European and African descent, as defined by self-reported race/ethnicity. We found that five CpG sites had a significant interaction with BMI by race/ethnicity. To examine the utility of the significant CpG sites in predicting BMI, we used elastic net regression to predict log-normalized BMI in the WHI (80% training/20% testing). This model found that 397 sites could explain 32% of the variance in BMI in the WHI test set. Individuals whose methylome-predicted BMI overestimated their BMI (high epigenetic BMI) had significantly higher glucose and triglycerides and lower HDL cholesterol and LDL cholesterol compared to accurately predicted BMI. Individuals whose methylome-predicted BMI underestimated their BMI (low epigenetic BMI) had significantly higher HDL cholesterol and lower glucose and triglycerides. This study confirmed 553 and identified 685 CpG sites associated with BMI. Participants with high epigenetic BMI had poorer metabolic health, suggesting that the overestimation may be driven in part by cardiometabolic derangements characteristic of metabolic syndrome

Meta-analysis of type 2 Diabetes in African Americans Consortium

Type 2 diabetes (T2D) is more prevalent in African Americans than in Europeans. However, little is known about the genetic risk in African Americans despite the recent identification of more than 70 T2D loci primarily by genome-wide association studies (GWAS) in individuals of European ancestry. In order to investigate the genetic architecture of T2D in African Americans, the MEta-analysis of type 2 DIabetes in African Americans (MEDIA) Consortium examined 17 GWAS on T2D comprising 8,284 cases and 15,543 controls in African Americans in stage 1 analysis. Single nucleotide polymorphisms (SNPs) association analysis was conducted in each study under the additive model after adjustment for age, sex, study site, and principal components. Meta-analysis of approximately 2.6 million genotyped and imputed SNPs in all studies was conducted using an inverse variance-weighted fixed effect model. Replications were performed to follow up 21 loci in up to 6,061 cases and 5,483 controls in African Americans, and 8,130 cases and 38,987 controls of European ancestry. We identified three known loci (TCF7L2, HMGA2 and KCNQ1) and two novel loci (HLA-B and INS-IGF2) at genome-wide significance (4.15 × 10(-94)<P<5 × 10(-8), odds ratio (OR)  = 1.09 to 1.36). Fine-mapping revealed that 88 of 158 previously identified T2D or glucose homeostasis loci demonstrated nominal to highly significant association (2.2 × 10(-23) < locus-wide P<0.05). These novel and previously identified loci yielded a sibling relative risk of 1.19, explaining 17.5% of the phenotypic variance of T2D on the liability scale in African Americans. Overall, this study identified two novel susceptibility loci for T2D in African Americans. A substantial number of previously reported loci are transferable to African Americans after accounting for linkage disequilibrium, enabling fine mapping of causal variants in trans-ethnic meta-analysis studies.Peer reviewe

Accidental denture ingestion in two teaching hospitals in Lagos

Background: Accidental foreign body ingestion is a common cause for emergency treatment. Dentures can be accidentally ingested.Objective: This study investigated accidental denture ingestion, and management outcome.Materials and Methods: A prospective study involving patients at 2 teaching hospitals in south-west Nigeria, who presented in the emergency room within a period of two years (2016-2018) with a previous history of wearing dentures were included. Information collected included patients' demography, presenting complaints, investigations done, type of dentures/prostheses, surgical procedure performed and outcome.Results:&nbsp;A total of 20 cases were seen during the period of the study. The age range was from 28-75 years. More males 16 (80.0%) presented than females 4(20.0%). Patients presented with pain on swallowing 9(45.0%), while 11(55.0%) gave a positive history of ingesting dentures. Dentures ingestion occurred more frequently while taking medications 12(60.0%). Most patients (80.0%) presented with denture impaction in the upper oesophagus, while 3 (15.0%) were lodged in the hypopharynx. All dentures ingested were more often upper dentures 13(65.0%) and made of acrylic with no metallic attachment. Most dentures were used for more than five years (76.5%). Radiographs showed widened prevertebral shadow in 13(65.0%) patients, air trapping and widening of hypopharynx in 3(15.0%). Seventeen of the 20 ingested dentures were successfully removed without complication. Complications included oesophageal perforation with secondary mediastinitis, and oesophageal mucosal tear without perforation.Conclusion: Denture use after more than 5years, with or without signs of lack of retention have a higher tendency to be ingested accidentally, leading to impaction in the upper oesophagus. The impacted denture can be successfully removed through oesophagoscopy. Key words: Dentures, Accidental Ingestion, Impaction

Appropriateness of Intra-Operative Blood Transfusion In Children at the Lagos University Teaching Hospital. – An Initial Survey

Background: The decision to transfuse intra-operatively is based on preoperative haemoglobin (Hb), estimated blood loss and physiological variables. The visual estimate of blood loss is notoriously unreliable especially with small volumes of blood losses in children. Objectives :We sought therefore to determine the appropriateness of intra-operative blood transfusion in a sample of children Methods : All children requiring intra-operative blood transfusion between May and June 2008 were prospectively studied. Neonates and children already on blood transfusion at induction were excluded. Transfusion was prescribed at the discretion of the attending anaesthetist. The Estimated blood volume (EBV) and estimated blood loss (EBL)were determined. Appropriate transfusion was defined as blood transfusion at EBL > 15% of EBV, maximum allowable blood loss to PCV of 27% and pre-transfusion Hb < 8g/dl. Results : Twenty-five patients were studied with a mean age of 4.16 ± 3.59 years (Range 0.33 – 11 years). The mean preoperative PCV was 31.14 ± 3.53 % (range 25 – 34%). Twelve patients (48%) were appropriately transfused when MABL was calculated to PCV of 27%. Nine patients (36%) had appropriate blood transfusion at an EBL greater or equal to 15% of the EBV. Of the 12 patients that had pre-transfusion Hb measured, 2 (16.6%) were appropriately transfused at Hb < 8g/dl. Conclusion : The use of near patient monitoring devices should be encouraged as this will give an accurate assessment of Hb and appropriate indication for transfusion. Equipment should be made available to perform gravimetric estimation of blood loss as the visual method is notoriously unreliable.Keywords : intra-operative, blood transfusion, paediatric

Pregnancy epulis associated with life threatening haemorrhage in a Nigerian woman

No Abstrac

A comparative Study on the Knowledge of Cleft Lip and Palate among Antenatal attendees in urban and Sub-urban Health Facilities in Lagos, Nigeria

Background: Several countries have reported a low level of awareness and knowledge of cleft lip and palate (CLP) in their populations. Little is known about the level of awareness and knowledge of CLP in Nigeria among antenatal attendees.Objective: The aim of the study is to evaluate and compare the awareness and knowledge of oro-facial cleft among antenatal attendees at sub-urban and rural health facilities in Lagos state.Methods: A cross-sectional descriptive study was undertaken on pregnant women attending the antenatal clinics in two sub-urban and two urban health facilities in Lagos state. Data was obtained by interviewer administered questionnaire. Information requested in the questionnaire include biodata, awareness using images of orofacial cleft and knowledge was also assessed among the respondents.Results: Atotal of 424 respondents participated in this study (one hundred and ninety seven respondents from rural facilities and 227 from Sub-urban facilities). Forty eight percent had tertiary education, while only 1.7% had received no form of formal education. Thirty percent were Professionals/ large scale business owners and 7.5% were petty traders/laborers. Of all the respondents 77.8% had notheard of cleft lip and 85.6% of cleft palate. A total of 61.7% and 54.1% of the respondents from the rural health facilities had some knowledge of cleft lip and palate respectively, while at the sub-urban facilities only 38.3% and 45.9% had heard of cleft lip and palate respectively.Conclusions: The knowledge and awareness of orofacial cleft lip and palate was low among antenatal attendees in this study. The knowledge and awareness was lower in urban facilities than sub-urban health facilities. There is a need to include awareness about orofacial cleft in the health promotion programs targeting mothers attending antenatal clinics, particularly urban facilities. Keywords: Knowledge; antenatal attendees; orofacial cleft&nbsp