Blood pressure to height ratios as simple, sensitive and specific diagnostic tools for adolescent (pre)hypertension in Nigeria

<p>Abstract</p> <p>Background</p> <p>The age-, gender-, and height-percentile requirements of the 'gold-standard' for the diagnosis of (pre)hypertension in adolescents make it time-consuming for clinicians and difficult-to-use by non-professionals. Simplified diagnostic tools are therefore needed. The use of blood pressure-to-height ratio (BPHR) - systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) - has been reported in Han adolescents, but it requires validation in other racial groups. The diagnostic accuracy of SBPHR and DBPHR in a population of 1,173 Nigerian adolescents aged 11-17 years, was therefore studied.</p> <p>Methods</p> <p>Blood pressures were measured using standard procedures and (pre)hypertension were defined according to international recommendations. ROC curve analyses were used to assess the diagnostic accuracy of BPHR in defining (pre)hypertension in this population. Sex-specific threshold values for SBPHR and DBPHR were determined, and thereafter used to define (pre)hypertension. The sensitivity/specificity of this method was determined.</p> <p>Results</p> <p>The accuracies of SBPHR and DBPHR in diagnosing (pre)hypertension, in both sexes, was >92%. The optimal thresholds for diagnosing prehypertension were 0.72/0.46 in boys and 0.73/0.48 in girls; while for hypertension, they were 0.75/0.51 in boys and 0.77/0.50 in girls. The sensitivity and specificity of this method were >96%.</p> <p>Conclusions</p> <p>The use of BPHR is valid, simple and accurate in this population. Race-specific thresholds are however needed.</p

Effect of Traditional Processing Techniques on the Nutritional and Phytochemical Composition of African Bread-Fruit (Treculia africana) Seeds

The effects of three traditional processing methods on the phytochemical, nutrient and mineral composition of Treculia africana seeds were evaluated. Mean proximate contents of dehulled raw samples (g/100mg) were protein (18.32 ± 0.54), fat (1.31 ± 0.02), ash (1.62 ± 0.02), crude fibre (1.31 ± 0.01) and carbohydrate (77.44 ± 8.46). Their phytochemical constituents yielded (g/100g) alkaloids (0.58 ± 0.08), phenols (0.82 ± 0.00), tannins (0.14 ± 0.00), flavonoids (1.30 ± 0.10), oxalate (11.37 ± 0.10), and saponins (0.37 ± 0.03). Mean mineral contents (mg/100g) of these raw samples were calcium (5.34 ± 1.15), magnesium (2.00 ± 0.35), iron (8.00 ± 0.00), selenium (0.18 ± 2.89), copper (0.35 ± 0.00), iodine (0.30 ± 0.01) and chromium (0.04 ± 0.00); while the vitamin A level was 2.24 ± 0.22 μg/100g. Boiling and drying resulted in a significant increase in only the carbohydrate content. Dehulling and roasting resulted in a significant decrease in selenium content and all the nutrients and phytochemicals estimated except for carbohydrates and flavonoids. Roasting of undehulled samples resulted in a significant decrease only in protein, fat and carbohydrate contents, and all phytochemicals except phenolic contents; while it increased the mineral content except for selenium, significantly (p < 0.05). All forms of processing reduced the vitamin A content of the seeds significantly (p < 0.05). Comparing the processing methods, boiling and drying resulted in less percentage decrease in nutrient and vitamin A composition but higher percentage loss in most phytochemicals. Roasting of undehulled seeds preserved the mineral elements better than the other methods. @JASEMJ. Appl. Sci. Environ. Manage. December, 2010, Vol. 14 (4) 169 - 17

Togo to go: Products and compounds derived from local plants for the treatment of diseases endemic in Sub-Saharan Africa

Background: Many African countries suffer from endemic diseases which are often caused by infections and seriously affect the social and economic development of these nations. While the access to proper medication is still limited, many of these countries are, at the same time, rich in medical plants.Materials and Methods: A review of relevant scientific (and gray) literature was carried out and information obtained from local authorities in medicinal plants. A synthesis of the data obtained was thereafter performed and recommendations for the future proposed.Results: Plants such as Cissus aralioides, Securidaca longipedunculata, Piliostigma thonningii, Nauclea latifolia, Ocimum gratissimum and Newbouldia laevis are widely reported to be used in the treatment of endemic diseases in Togo and her neighbouring countries.These plants often contain highly potent chemical compounds, such as quinones, xanthones, tannins and terpenes and therefore may provide an alternative avenue to short-term treatment. A combination of further analysis of plant materials and their active ingredients on the one hand, and modern technology to turn such natural products into commercial equivalents on the other, is required in order to identify the targets and modes of action of these natural materials, unlock access to them, and ultimately produce valuable medicines and phytoprotectants based on locally grown plant materials.Conclusion: The production of plant-derived products, as advocated in this paper, is in line with the WHO’s traditional medicine strategy 2014-2023, and will eventually yield a sustainable health-and-wealth generating cycle that will benefit a countries in the region, economically and ecologically.Keywords: Togo, redox active secondary metabolites, phytochemicals, antimalarial activity,  antidiarrheal activity, tropical diseases

TOGO TO GO: PRODUCTS AND COMPOUNDS DERIVED FROM LOCAL PLANTS FOR THE TREATMENT OF DISEASES ENDEMIC IN SUB-SAHARAN AFRICA

Background: Many African countries suffer from endemic diseases which are often caused by infections and seriously affect the social and economic development of these nations. While the access to proper medication is still limited, many of these countries are, at the same time, rich in medical plants. Materials and Methods: A review of relevant scientific (and gray) literature was carried out and information obtained from local authorities in medicinal plants. A synthesis of the data obtained was thereafter performed and recommendations for the future proposed. Results: Plants such as Cissus aralioides, Securidaca longipedunculata, Piliostigma thonningii, Nauclea latifolia, Ocimum gratissimum and Newbouldia laevis are widely reported to be used in the treatment of endemic diseases in Togo and her neighbouring countries.These plants often contain highly potent chemical compounds, such as quinones, xanthones, tannins and terpenes and therefore may provide an alternative avenue to short-term treatment. A combination of further analysis of plant materials and their active ingredients on the one hand, and modern technology to turn such natural products into commercial equivalents on the other, is required in order to identify the targets and modes of action of these natural materials, unlock access to them, and ultimately produce valuable medicines and phytoprotectants based on locally grown plant materials. Conclusion: The production of plant-derived products, as advocated in this paper, is in line with the WHO’s traditional medicine strategy 2014- 2023, and will eventually yield a sustainable health-and-wealth generating cycle that will benefit a countries in the region, economically and ecologically

Variations in the prevalence of point (pre)hypertension in a Nigerian school-going adolescent population living in a semi-urban and an urban area

<p>Abstract</p> <p>Background</p> <p>Hypertension has been shown to start in early life and to track into adulthood. Detecting adolescents with hypertension and prehypertension will aid early intervention and reduce morbidity and mortality from the disorders. This study reports the point-prevalence of the two disorders in a semi-urban and an urban population of school-going adolescents in Nigeria.</p> <p>Methods</p> <p>A total of 843 adolescents from two places of domicile were studied. Their blood pressures and anthropometric indices were measured using standard protocol. Point-hypertension and point-prehypertension were defined with respect to each subject's gender, age and height. The prevalence of the disorders was calculated and reported age-wise and nutritional status-wise.</p> <p>Results</p> <p>The prevalence of point-prehypertension in the semi-urban area was 22.2% (20.7% for girls and 23.1% for boys) while it was 25.0% (21.8% for girls and 29.2% for boys) in the urban area. The prevalence of point-hypertension was 4.6% (4.1% for girls and 4.8% for boys) in the semi-urban area and 17.5% (18.0% for girls and 16.9% for boys) in the urban area. Point-prehypertension was not detected among the thin subjects of both places of domicile. The prevalence of point-prehypertension was similar in both the urban and semi-urban areas among the subjects who had normal BMI-for-age, and over-weight/obese subjects respectively. From the semi-urban to the urban area, the prevalence of point-hypertension increased approximately 3-folds among thin and normal BMI-for-age subjects, and 10-folds among overweight/obese subjects. Systolic hypertension was more preponderant in both the semi-urban and urban areas.</p> <p>Conclusions</p> <p>The prevalence of both disorders is considerably high in the studied populations. Urgent pediatric public health action is needed to address the situation.</p

Towards the Prevention and Management of Prostatic Diseases in Nigeria: A Framework

The prevalence of prostatic diseases is reportedly high in Nigeria, and in some cases, it is comparable to figures from industrialised countries. However, to date, the research and policy responses in Nigeria are regrettably inadequate. The presence of “the double burden of diseases” and a limited appreciation of recent trends in prostatic diseases may be partly responsible for this situation. Given the frequently meagre healthcare budgetary allocations, it is pertinent to develop a properly thought-out plan for the prevention and management of prostatic diseases in Nigeria. A framework aimed at contributing to the development of such a plan is presented here. The development of a Central Prostatic Diseases Unit (CPDU) in the Federal Ministry of Health is advocated. The CPDU would be responsible for planning research and information dissemination programmes. Emphasis should be placed on targeting modifiable risk factors at the population level, proper surveillance to identify emerging trends, and research on both the operational dynamics and the efficacy of locally available herbs that could be useful in the management of prostatic diseases

Association between anxiety and obesity: A study of a young.adult Nigerian population

Background: The relationship between anxiety and obesity is still debatable and seems to vary between cultures. The subject has been scarcely investigated in Nigeria, hence this study. Materials and Methods: A total of 1584 young‑adult Nigerians (56.4% males) of mean age 21.8 ± 2.2 years were studied. Anxiety was assessed using the Beck’s Anxiety Index (BAI), while obesity was determined using the bioelectrical impedance analysis (BIA) and body mass index (BMI) methods. Standard protocols were followed for all assessments and measurements. Appropriate descriptive statistics were carried out, while regression and correlation analyses (for continuous variables) and the Chi square tests (for categorical variables) were used to assess the relationship between anxiety and obesity. Results: The degree of adiposity of the subjects (males and females alike) classified by %BF standards did not significantly (P > 0.05) affect the proportion of the population with any degree of anxiety. The proportion of population with high anxiety (for both sexes) was similar (P > 0.05) irrespective of their BMI status. All the obese (BMI‑wise only) males had low anxiety, while the proportion of thin females (in the low anxiety group) was significantly (P 0.05) between the BAI scores and the studied measures of adiposity in both male and female subjects. Conclusion: The low prevalence of both anxiety and obesity in the studied population may explain the observed lack of association between the studied variables. These findings do not support the “jolly fat” hypothesis

Usefulness of the American urological association's benign prostate hyperplasia symptom index in Nigeria: Validation using biochemical markers

Benign prostate Hyperplasia (BPH) is an age-related neoplastic condition of the prostate gland that is characterised by lower urinary tract symptoms (LUTS), in the clinical setting. A variety of factors, especially weather conditions and diet, impart on the nature of the manifestations of LUTS experienced by sufferers, suggesting a possible difference in the clinical presentation of BPH across cultures. One of the tools used in the screening and diagnosis of BPH is the American Urological Association’s (AUA’s) symptom index. However, the validity of this instrument in Nigeria has not been tested. This work used two biochemical markers of prostate pathologies – prostate specific antigen (PSA) and prostatic acid phosphatase (PAP) – to test the validity of the AUA symptom index in Nigeria. Our results show a positive correlation between PAP and the AUA symptom index (r = +0.275,

Obesity in young-adult Nigerians: variations in prevalence determined by anthropometry and bioelectrical impedance analysis, and the development of % body fat prediction equations

Abstract Background Overweight/obesity is a growing global public health concern. The variations in the prevalence of overweight/obesity, defined by Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Height Ratio (WHtR), Waist-to-Hip Ratio (WHpR) and Bioelectrical Impedance Analysis (BIA), were studied and a prediction equation for % body fat (%BF) developed. Methods A total of 1584 subjects (56.4% males) were recruited for the study. Data on age, gender, height, weight, hip circumference and WC were collected from the subjects using standard protocols. BMI, WHtR and WHpR were derived using standard equations. %BF was measured using a BIA device (Omron BF-400). Appropriate statistical tools were used for the data analysis. Results The prevalence of overweight/obesity in the population was 28.4% (36.3% for males; 22.6% for females) (BIA); 20.7% (17.5% for males; 24.8% for females) (BMI); 7.5% (1.3% for males; 16.1% for females) (WC); 2.9% (4.3% for males; 1.2% for females) (WHpR); and 15.4% (14.8% for males; 16.2% females) (WHtR). Taking BIA as the reference point, WC misclassified overweight/obesity the most for males (35%), while for the females, WHpR misclassified both disorders the most (21.4%). Correlation studies showed that only BMI correlated significantly, albeit weakly, with %BF among the males, whereas all the anthropometric measures, but WHpR correlated significantly with % body fat in females. Two prediction equations for %BF were generated, and %BF predicted with the two equations correlated significantly (P  Conclusion The prevalence of overweight/obesity in this population vary widely depending on the definition used. The developed prediction equations could be useful in resource-poor settings, but require validation.</p

Hypertension and anxiety in young Nigerian Adults: A study of an undergraduate population

There is, as yet, no consensus on the relationship between anxiety and hypertension. While a few studies have investigated the topic in sub-Saharan Africa, there is no such literature in Nigeria. A cross-sectional study of 1654 apparently healthy young (mean age: 21.6±2.2 years), Nigerian adults (57.6% males) was conducted. Their blood pressures (BPs), weights and heights were measured using standard protocols. Body mass index (BMI) was calculated, and self-reported age at last birthday was recorded per subject. Anxiety was measured using the Beck Anxiety Inventory. Appropriate statistical tools were used to analyze the data generated. A total of 1.5% (1.6% for males and 1.4% for females, P = 0.561) had high degree of anxiety. Hypertension was found in 2.4% (4% for males and 0.1% for female, P = 0.043) of the population while prehypertension was found in 39.7% (53.2% for males and 21.5% for females, P = &lt;0.001) of the population. Of the hypertensive subjects, 2.6% (2.6% for males Vs 0.0% for females) had high degree of anxiety. Mean blood pressures (within the sexes) were similar (P&gt;0.05) between the low anxiety group and each of the moderate and high anxiety groups. No significant correlations or associations were found between BAI scores and systolic or diastolic BPs. Hypertension was not associated with anxiety in the studied population. The prevalence of both hypertension and anxiety in this population is one of the lowest in recorded literature. Further studies are warranted (especially in sub-Saharan Africa) to examine further, the hypothesis that both factors are associated.Keywords: anxiety, association, blood pressure, hypertension, young adultsJournal of Pharmaceutical and Allied Sciences Vol. 9 No. 3 (2012