Prevalence of priapism and its awareness amongst male homozygous sickle cell patients in Lagos

Background. Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Impotence and infertility are major problems in male sickle cell disease patients, and priapism has been implicated as a cause of impotence and infertility. The aim of this study is to determine priapism prevalence and assess the knowledge of male homozygous male patients about it in Lagos, Nigeria. Methods. A cross-sectional study was conducted amongst male homozygous sickle cell disease patients of Lagos State University Teaching Hospital. Pretested questionnaires were distributed to determine the prevalence and assess their knowledge on priapism. Data were analyzed using SPSS version 16.0. Results. A total of 114 consenting subjects filled the questionnaires, 85 of 114 (74.6%) had not heard about priapism before this study. A total of 77 of 114 (67.5%) did not know that they are at risk of priapism. Whilst 84 of 114 (73.7%) were not aware that priapism is a complication of SCD. The majority, 94 of 114 (82.5%), were not aware that priapism could cause impotence. Conclusion. There is a need to create more awareness about this complication amongst sickle cell disease patients in order to stem the incidence of impotence and infertility amongst them

Prevalence of Asymptomatic Bacteriuria in HIV Infected Patients in a Tertiary Hospital in Lagos, Nigeria

Background: People living with Human Immunodeficiency Virus (HIV) are more predisposed to urinary tract infections due to suppression of their immunity by the virus. Asymptomatic bacteriuria is associated with an increased risk of symptomatic urinary tract infection and the latter being an important contributor to development of chronic renal failure, hypertension and toxaemia of pregnancy. The aim of this study was to determine the prevalence of asymptomatic bacteriuria in HIV-infected patients and proffer a recommendation on the need or otherwise to screen. Methods: This was a cross sectional study of treatment-naive HIV-infected patients attending the HIV clinics of Lagos State University Teaching Hospital (LASUTH), Ikeja. A single voided aseptically collected mid-stream urine (MSU) was obtained from each patient and all samples processed immediately, were sent for urinalysis and culture. Isolates were considered significant if there were ≥105 colony forming unit/mL (CFU/mL) with 2 or less isolates, doubtful significance if <105 CFU/mL. Significant isolates were selected for identification. Data were analyzed using SPSS version 16.0 (Statistical Package for Social Sciences, Inc., Chicago, Ill). Results: A total of 156 consenting participants were recruited into the study. The mean age was 36.45 ± 8.65 years. There were 60 of 156 (38.4%) males and 96 of 156 (61.56%) females. Only 33 of 156 (21.2%) had significant bacteriuria, out of the 33 participants, 19 (57.8%) were asymptomatic, while 14 of 33 (42.4%) had significant growth but were symptomatic or on antibiotics. E. coli was isolated in 9 of 19 (47.3%), followed by Staph aureus 4 of 19 (21.05%). Conclusion: More than half of participants who had significant growth had asymptomatic bacteriuria, while one-fifth of all patients had significant growth. Considering this statistics, screening for or treatment of asymptomatic bacteriuria may be recommended in all HIV-infected patients

The importance of need‐altruism and kin‐altruism to blood donor behaviour for black and white people

BackgroundNeed-altruism (a preference to help people in need) and kin-altruism (a preference to help kin over non-kin) underlie two hypotheses for voluntary blood donation: (i) Need-altruism underlies motivations for volunteer blood donation and (ii) Black people express a stronger preference for kin-altruism, which is a potential barrier to donation. This paper tests these hypotheses and explores how need- and kin-altruism are associated with wider altruistic motivations, barriers, and strategies to encourage donation.MethodsWe assessed need- and kin-altruism, other mechanisms-of-altruism (e.g., reluctant-altruism), barriers, strategies to encourage donation, donor status, and willingness-to-donate across four groups based on ethnicity (Black; White), nationality (British; Nigerian), and country-of-residence: (i) Black-British people (n = 395), and Black-Nigerian people (ii) in the UK (n = 97) or (iii) across the rest of the world (n = 101), and (v) White-British people in the UK (n = 452). We also sampled a Black-Nigerian Expert group (n = 60).ResultsNeed-altruism was higher in donors and associated with willingness-to-donate in non-donors. Levels of kin-altruism did not differ between Black and White people, but need-altruism was lower in Black-British people. Kin-altruism was associated with a preference for incentives, and need-altruism with a preference for recognition (e.g., a thank you) as well as an increased willingness-to-donate for Black non-donors. Need-altruism underlies a blood-donor-cooperative-phenotype.ConclusionNeed-altruism is central to blood donation, in particular recruitment. Lower need-altruism may be a specific barrier for Black-British people. Kin-altruism is important for Black non-donors. The blood donor cooperative phenotype deserves further consideration. Implications for blood services are discussed

Prevalence of Priapism and Its Awareness amongst Male Homozygous Sickle Cell Patients in Lagos, Nigeria

Background. Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Impotence and infertility are major problems in male sickle cell disease patients, and priapism has been implicated as a cause of impotence and infertility. The aim of this study is to determine priapism prevalence and assess the knowledge of male homozygous male patients about it in Lagos, Nigeria. Methods. A cross-sectional study was conducted amongst male homozygous sickle cell disease patients of Lagos State University Teaching Hospital. Pretested questionnaires were distributed to determine the prevalence and assess their knowledge on priapism. Data were analyzed using SPSS version 16.0. Results. A total of 114 consenting subjects filled the questionnaires, 85 of 114 (74.6%) had not heard about priapism before this study. A total of 77 of 114 (67.5%) did not know that they are at risk of priapism. Whilst 84 of 114 (73.7%) were not aware that priapism is a complication of SCD. The majority, 94 of 114 (82.5%), were not aware that priapism could cause impotence. Conclusion. There is a need to create more awareness about this complication amongst sickle cell disease patients in order to stem the incidence of impotence and infertility amongst them

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care

The importance of need‐altruism and kin‐altruism to blood donor behaviour for black and white people

Publication status: PublishedFunder: Research England Policy Support FundAbstractBackgroundNeed‐altruism (a preference to help people in need) and kin‐altruism (a preference to help kin over non‐kin) underlie two hypotheses for voluntary blood donation: (i) Need‐altruism underlies motivations for volunteer blood donation and (ii) Black people express a stronger preference for kin‐altruism, which is a potential barrier to donation. This paper tests these hypotheses and explores how need‐ and kin‐altruism are associated with wider altruistic motivations, barriers, and strategies to encourage donation.MethodsWe assessed need‐ and kin‐altruism, other mechanisms‐of‐altruism (e.g., reluctant‐altruism), barriers, strategies to encourage donation, donor status, and willingness‐to‐donate across four groups based on ethnicity (Black; White), nationality (British; Nigerian), and country‐of‐residence: (i) Black‐British people (n = 395), and Black‐Nigerian people (ii) in the UK (n = 97) or (iii) across the rest of the world (n = 101), and (v) White‐British people in the UK (n = 452). We also sampled a Black‐Nigerian Expert group (n = 60).ResultsNeed‐altruism was higher in donors and associated with willingness‐to‐donate in non‐donors. Levels of kin‐altruism did not differ between Black and White people, but need‐altruism was lower in Black‐British people. Kin‐altruism was associated with a preference for incentives, and need‐altruism with a preference for recognition (e.g., a thank you) as well as an increased willingness‐to‐donate for Black non‐donors. Need‐altruism underlies a blood‐donor‐cooperative‐phenotype.ConclusionNeed‐altruism is central to blood donation, in particular recruitment. Lower need‐altruism may be a specific barrier for Black‐British people. Kin‐altruism is important for Black non‐donors. The blood donor cooperative phenotype deserves further consideration. Implications for blood services are discussed.</jats:sec

Gestational thrombocytopaenia among pregnant women in Lagos, Nigeria

Background: Thrombocytopaenia is a common haematologic abnormality during pregnancy. Pregnant women with thrombocytopenia have a higher risk of bleeding excessively during or after childbirth, particularly if they need to have a caesarean section or other surgical intervention during pregnancy, labour or in the puperium. The aim of this study was to determine the prevalence of gestational thrombocytopaenia among pregnant women reporting for antenatal care at tertiary health care centres in Lagos. Materials and Methods: Platelet count was analyzed in 274 consecutive pregnant women who gave informed consent and 70 non-pregnant female staff of the hospitals. Platelet count was performed on each sample using the Sysmex KN-21N automated haematology analyzer. The study design was cross-sectional, proportions were analyzed for statistical significance with the chi-square, and Odds ratio was also calculated. Thrombocytopaenia is classically defined as a platelet count of less than 150 × 10 [9] /L. [3],[4] Counts from 100 to 150 × 10 [9] /L are considered mildly depressed, 50 to 100 × 10 [9] /L are moderately depressed and less than 50 × 10 [9] /L are severely depressed. Results: Thirty-four (13.5%) pregnant women were thrombocytopaenic compared with three (4.3%) non-pregnant women. This was statistically significant; P = 0.03; Odds ratio: 3.5 (95% CI 1.03-11.82). Out of the 37 pregnant women who were thrombocytopaenic, most of them (78%) had mild thrombocytopenia, only 6% had severe thrombocytopaenia. Conclusion: The prevalence of gestational thrombocytopaenia in this study was 13.5%. Although majority of the pregnant women had mild thrombocytopaenia, healthcare providers should screen all pregnant women routinely for thrombocytopaenia to avoid excessive bleeding during or after childbirth

Prevalence of Priapism and Its Awareness amongst Male Homozygous Sickle Cell Patients in Lagos, Nigeria

Background. Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation. Impotence and infertility are major problems in male sickle cell disease patients, and priapism has been implicated as a cause of impotence and infertility. The aim of this study is to determine priapism prevalence and assess the knowledge of male homozygous male patients about it in Lagos, Nigeria. Methods. A cross-sectional study was conducted amongst male homozygous sickle cell disease patients of Lagos State University Teaching Hospital. Pretested questionnaires were distributed to determine the prevalence and assess their knowledge on priapism. Data were analyzed using SPSS version 16.0. Results. A total of 114 consenting subjects filled the questionnaires, 85 of 114 (74.6%) had not heard about priapism before this study. A total of 77 of 114 (67.5%) did not know that they are at risk of priapism. Whilst 84 of 114 (73.7%) were not aware that priapism is a complication of SCD. The majority, 94 of 114 (82.5%), were not aware that priapism could cause impotence. Conclusion. There is a need to create more awareness about this complication amongst sickle cell disease patients in order to stem the incidence of impotence and infertility amongst them. Background Sickle Cell Disease. Sickle cell disorder is a genetic abnormality involving haemoglobin and red cells. The glutamine on the 6th position of the chain is replaced with valine consequent on a single point mutation in which thymine replaces adenine on the deoxyribonucleic acid structure. Haemoglobin S resulting from the substitution causes polymerization of haemoglobin and red cell sickling on exposure to low-oxygen tension and unsickle on oxygenation. The sickled red cells obstruct blood vessels and impede free flow of blood of the affected vessel causing vascular congestion, oxygen deprivation, anaerobic glycolysis, lactic acidosis, and pain. This may be responsible for priapism, an acute complication of sickle cell disease. Priapism in Sickle Cell Disease. Priapism is a pathological condition of penile erection that persists beyond, or is unrelated to, sexual stimulation Priapism is due to occlusion of the outflow vessels from the corpora cavernosa by sickled cells, consistent with significantly lower HbF levels in affected cases Priapism may be self limited, and of short duration usually lasting less than 3 hours. It may also be chronic and recurrent lasting more than 24 hours. Increased rate of impotence has been reported in sickle cell patients whose attacks lasted more than 24 hours Sexual intercourse has been implicated to precipitate attack amongst Jamaican. Others reported spontaneous attacks that wake the patient from sleep Many treatment modalities are available for priapism, these include the use of drugs, exchange blood transfusion and surgical intervention. Drugs like -adrenergic agonist which increase the contractile state of the trabecular/arterial meshwork and facilitate venous outflow from the corpora Adequate hydration and analgesia may dislodge the trapped sickled red cells, partial exchange blood transfusion to lower the HbS level to less than 30% has been tried Surgical interventions which is usually the last procedure for unresolved priapism involves aspiration and irrigation of the corpora cavernosa with saline Infertility is a major problem in male sickle cell disease patients reported by Abudu et al. in which they noted a lower testosterone levels in males compared with age-matched controls Methods This cross-sectional study to determine the prevalence and assess the knowledge of male sickle cell disease patients on Consenting participants were recruited consecutively into the study after obtaining the institution&apos;s ethics and research committee approval. Pretested questionnaires were distributed to them to determine the prevalence and assess their knowledge on priapism. The questionnaire was designed by the authors, adapted from previous related studies Statistical Assessment Data were analyzed using SPSS version 16.0 (Statistical Package for Social Sciences, Inc., Chicago, IL, USA). The descriptive data was given as mean ± standard deviation (SD). The Pearson chi-squared test was used to test for association between discrete variables. A value was considered to be statistically significant when &lt;0.05. Result A total of 114 consenting subjects filled the questionnaires; the mean age was 21.97 ± 7.51, with a minimum of 14 years and maximum of 53 years. A total of 105 of 114 (92.1%) were single, while 9 of 114 (7.9%) were married. The majority, 65 of 114 (57%), had secondary education, 36 of 114 (31.6%) had tertiary education, 10 of 114 (8.8%) had primary education, while 3 of 114 (2.7%) had no education The A total of 23 of 45 (51.11%) did not get any treatment, 6 of 45 (13.33%) were admitted, and 8 of 45 (17.77%) were treated but not admitted. When asked about how many times they had episode of priapism, the majority, 11 of 45 (24.44%), had it twice followed by 9 of 45 (20%) once, 4 of 45 (8.8%) thrice, and 3 of 45 (6.66%) 5 times. When asked about precipitating factors, 17 of 45 (37.77%) had it after waking up from sleep followed by no known factors in 10 of 45 (22.22%), followed by 5 of 45 (11.11%) following bone pain crises, and 4 of 45 (8.88%) after sexual intercourse