Mean platelet volume and platelet counts in type 2 Diabetes: Mellitus on treatment and non-diabetic mellitus controls in Lagos, Nigeria

Introduction: The Mean platelet volume and platelet counts are indicators of thrombotic potentials, and risk factors for microvascular complications in diabetics. This study aimed to establish variations in platelet counts and mean platelet volume in type 2 diabetic patients on treatment and non-diabetic controls. Methods: This was an unmatched case-control study involving 200 participants consisting of 100 diabetics and 100 non-diabetic controls. Four and half milliliters of blood was collected from diabetics and non diabetic controls into EDTA anticoagulant tubes. Full blood count was performed using the Sysmex KN-21N, (manufactured by Sysmex corporation Kobe, Japan) a three- part auto analyzer able to run 19 parameters per sample including platelet counts and mean platelet volume. Results: The mean fasting blood sugar for the diabetics was 147.85±72.54 mg/dl and the controls 95.20±30.10 mg/dl. The mean platelet count for the diabetics was 235.29±76.81*109/L and controls, 211.32±66.44*109/L. The mean platelet volume, for the diabetics was 8.69±0.67 fl and the controls, 8.91±0.80 fl. There was a statistically significant difference in platelet counts of diabetics and healthy controls p =0.038 while none existed between the mean platelet volume in diabetics and healthy controls p=0.593. Conclusion: This study revealed a higher mean platelet count for diabetics on treatment than for non diabetic controls while mean platelet volume was lower in cases than controls. However, both parameters in diabetics on treatment were within the normal reference range for healthy individuals

Evaluation of patients with suspected obstructive sleep apnea in a low-middle income country: Lagos experience

Obstructive sleep apnea (OSA) is a common chronic disorder that decreases the quality of life of patients. It is an underdiagnosed medical condition in Nigeria. This study aimed to describe the clinical presentations and validate the sleep apnea screening questionnaires with a home sleep study for the diagnosis of patients with suspected OSA seen in Lagos. This was a descriptive cross sectional study carried out on adult patients with suspicion of OSA referred to the Respiratory Clinic of Lagos State University Teaching Hospital. A proforma was used to obtain information and also data from home polysomnography was obtained for each patient. We selected 22 patients. The commonest presentations include snoring (20 or 90.9%), daytime somnolence (16 or 72.7%) and choking while sleeping (12 or 54.5%). The commonest comorbidities were hypertension (16 or 72.7%) and obesity (6 or 27.3%). The STOP-Bang  score identified more patients with a high clinical probability for OSA than the Epworth score (20 and 12 patients respectively). Polysomnography showed evidence of sleep apnea in most suspected patients with severity ranging from mild, to moderate to severe disease (3 or 13.6%, 3 or 13.6%, and 10 or 45.5% respectively). The use of combined Epworth and STOP-Bang questionnaires combination is great tool in identifying patients with suspected cases of OSA based on clinical presentations that will eventually benefit in a resource-limited environment like Lagos. There should be increased awareness of the use of this readily available and cheap questionnaire among physicians in Lagos for ease of OSAS diagnosis for many patients

Cardiovascular health implications of worsening economic indices in Nigeria: A narrative review

Poor economic indices are implicated in adverse health outcomes. Cardiovascular diseases are the leading cause of death globally with more impact in low- and middle-income countries. Despite some documented associations between worsening economic indices and cardiovascular health, there is however knowledge gap on this topic in this environment. We conducted a narrative review to provide an overview of the impact of dwindling economy and cardiovascular health in Nigeria. A comprehensive search of electronic databases including PubMed, Scopus, and Google Scholar was conducted. The search terms were cardiovascular health, economic indices, and Nigeria. Inclusion criteria were studies published in English language between 2010 and 2021. There is limited knowledge on the association between worsening economic indices and cardiovascular health in Nigeria. The Nigerian government's spending on health care was less than the recommended 15% of the budget. There was a decline in gross domestic product from 5.31% in 2011 to 3.65% in 2021 and a rise in the inflation rate and unemployment rate from 10.84% and 3.77% to 16.95% and 9.79%, respectively, over this period. The prevalence of hypertension, diabetes mellitus, and dyslipidemia, which are the leading causes of cardiovascular morbidity, increased in the period of study. The exchange rate of naira to other global currencies worsened with attendant rise in the cost of health-care and cardiovascular medications. There is a huge knowledge gap on the impact of worsening economic indices and cardiovascular health. However, the existing evidence showed that the Nigerian government's spending on health is low and poor economic indices may be related to the worsening cardiovascular health in Nigeria. There is a need for more research to assess the impact of these indices on cardiovascular health