Fibronectin abnormalities in diabetes mellitus, vascular and neoplastic diseases

The involvement of the glycoprotein fibronectin in some cardiovascu1ar and other disease states has been investigated. In particular the technique of venous compression and later release has been applied to patients with peripheral vascular disease (PVD), diabetes mellitus (DM), and to young smokers, together with further studies on platelets from PVD patients. PVD patients showed an abnormal fibronectin release after compression, an effect not seen in diabetics or young smokers. Using flow cytometry, platelet surface fibronectin was also shown to be increased on thrombin stimulation. In rats, plasma levels were not affected by induced diabetes, but were reduced in plasma, liver and kidney by semi-starvation. Tissue localisation and plasma levels of fibronectin were investigated in rats with either streptozotocin-induced diabetes, or after a period of semi-starvation. Neonatal but not maternal plasma fibronectin was associated with the extent of intrauterine growth retardation (lUGR). Fibronectin staining was also increased in the stroma of breast carcinoma biopsies, and in aortic atheromatous plaques, with lower levels when calcification was present. Plasma fibronectin was also increased in patients undergoing successful liver transplantation, although sepsis, rejection and transfusion were confounding factors. The relevance of fibronectin and fibronectin measurement, to the pathology, diagnosis and management of these various disorders is discussed

Physicochemical assessment of water quality in selected borehole in Anyigba Town, Kogi State, Nigeria

Borehole is an important source of water on which many people in Anyigba metropolis depend for their livelihood. The people of Anyigba in Kogi East of Nigeria depends on this source of water for domestic purpose and other uses hence the need to investigate the quality of the water to ascertain it suitability for domestic and other uses. The physicochemical properties of the water were analyzed using different standard analytical techniques: UVspectrophotometer was used to analyze Nitrate, Sulphate and Ammonia in the water samples. Also, Flame photometer was used to analyze Calcium, Potassium and Sodium in the water samples. the results of the physicochemical analyzed showed the following ranges: pH 6.5-7.6mg/L, Temperature 26-28oC, Conductivity 10-20us/cm, Dissolved oxygen 0.49- 9.3mg/l, Total alkalinity 10-20mg/l, Total hardness 18-40mg/l, chloride 28.4-71mg/l, Acidity 210mg/l, Sodium 33.5- 38.4mg/l, Potassium 9.90-10.70mg/l, Calcium 92.5-167.8mg/l, Nitrate 26-35mg/l, Ammonia 79-107mg/l and Sulphate 42.5-78mg/L. Some of the parameters were observed to be within the permissible limit stipulated by the World Health Organization, there is still need to protect the underground water bodies against any in flush of pollutants.Keywords: Borehole, Pollution, physicochemical, Qualit

Common echocardiographic abnormalities in Nigerians of different age groups

Background: Transthoracic echocardiography (TTE) is one of the most commonly performed cardiac investigations. It can provide comprehensive information about cardiac structure and function, helping to establish a diagnosis and guide therapy, and it is no longer the preserve of the specialist cardiology department. Previous studies on echocardiographic findings in our environment had documented valvular heart disease, hypertensive heart disease and congenital heart diseases as the commonest echocardiographic findings in Nigerians.Aims: The study aimed to provide an update on the common echocardiographic findings in different age groups in this part of the world, since some of the previous similar studies were done over a decade ago.Materials and Methods: We reviewed the echocardiogram reports of 608 consecutive patients done from July 2009 to October 2011 at a private echocardiographic laboratory in Enugu, South-East Nigeria. Data was analyzed for age, gender and echocardiographic findings.Results: The age range of the patients was from 3 days to 98 years with a mean age of 46.4 ± 21.4 years. The mean age of the males was 47.6 ± 21.3 years, while the mean age of the females was 45.2 ± 21.1 years. The commonest echocardiographic abnormality in children was atrial septal defect, while rheumatic heart disease was the commonest in adolescents and young adults. Left ventricular diastolic dysfunction and degenerative valvular diseases respectively were the commonest in the middle-aged and elderly populations in this study.Conclusion: This study has reaffirmed rheumatic heart disease (predominantly mitral valve regurgitation) as the commonest cardiac abnormality in adolescents and young adults. Degenerative valvular diseases, left ventricular diastolic dysfunction, and atrial septal defects were the commonest abnormalities in the elderly, middle-aged population and children, respectively.Key words: Different age groups, echocardiographic abnormalities, Nigerian

Conducting defect with atrial septal aneurysm in a preterm neonate: A case report from resource limited setting

Conducting defect (CD) co-existing with interatrial septal anomaly (ISA) like Atrial Septal Aneurysm (ASA) is a rare congenital heart disease presenting with bradyarrhythmia in-utero due to defects in the heart electrical conducting system. We report a case of a preterm female ‘CC’ (GA=35weeks) low birth weight (2.4kg) neonate with CD and associated ASA. CC’s mother presented with poor foetal movements and bradyarrhythmia and had an emergency caesarian section at 35weeks with Apgar score of 3, 5. She was managed for perinatal Asphyxia. This report highlights the fact that ASA resolved at around the first year of life but the associated heart electrical conducting system defects persisted. The report also emphasizes the challenges of managing a rare neonatal cardiac condition in a resource limited setting and the importance of thorough foetal biophysical profile and early interventional delivery when it is necessary.Keywords: Conducting defect; neonatal; Atrial Septal Aneurysm

Role of social protection in mitigating the impact of coronavirus disease on household welfare: panel data evidence from Nigeria

COVID-19 has had huge impacts on households across the world. The economic impact is particularly great in Africa. This paper analyses the role of social protection in mitigating the impact of COVID-19 on household welfare measured in terms of ability to afford food. The results of panel logit regressions on data from 1 925 Nigerian households show that social protection in the form of food or direct cash transfers is associated with a higher probability of households being able to afford the food they need. This positive effect is, however, offset by the increasing intensity of the pandemic. Our results are robust even when using alternative measures of pandemic intensity and controlling for household characteristics. This implies the need for more robust social protection programmes (such as health insurance and employment benefits) that are responsive to household needs, especially in times of crisis

Left ventricular systolic function in sickle cell anaemia: an echocardiographic evaluation in adult Nigerian patients.

Background: Reliable diagnostic measures for the evaluation of left ventricular systolic performance in the setting of altered myocardial loading characteristics in sickle cell anaemia remains unresolved. Objective: The study was designed to assess left ventricular systolic function in adult sickle cell patients using non-invasive endsystolic stress \u2013 end-systolic volume index ratio. Methods: A descriptive cross sectional comparative study was done using 52 patients recruited at the adult sickle cell anaemia clinic of the University of Nigeria Teaching Hospital Enugu. An equal number of age and sex-matched healthy volunteers served as controls. All the participants had haematocrit estimation, haemoglobin electrophoresis, as well as echocardiographic evaluation. Result: The mean age of the patients and controls were 23.93 \ub1 5.28 (range 18-42) and 24.17 \ub1 4.39 (range 19 -42) years respectively, (t = 0.262; p= .794). No significant difference was seen in estimate of fractional shortening, and ejection fraction. The cardiac out-put, cardiac index and velocity of circumferential shortening were all significantly increased in the cases compared with the controls. The end systolic stress \u2013 end systolic volume index ratio (ESS/ESVI) was significantly lower in cases than controls. There were strong positive correlation between the ejection phase indices (ejection fraction and fractional shortening) and end systolic stress and ESS/ESVI. Conclusion: The study findings suggest the presence of left ventricular systolic dysfunction in adult sickle cell anaemia. This is best detected using the loading-pressures independent force-length relationship expressed in ESS/ESVI ratio

Arterial blood pressure in adult Nigerians with sickle cell anemia

SummaryAim and objectiveThis study was aimed at comparing the arterial blood pressures in steady state adult sickle cell patients with those of age- and sex-matched healthy controls.MethodsA descriptive cross-sectional study of 62 sickle cell anemia patients and 62 age- and sex-matched healthy controls was carried out in the adult outpatient sickle cell clinics and the cardiac center of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. Brachial blood pressures were measured in the right arm in all subjects.ResultsSignificant increase in pulse rate was found in the study subjects (87.68±8.91bpm) compared with the controls (72.13±6.79bpm) (p<0.05). The mean systolic blood pressure was comparable in the two groups. However, the patients had significantly lower diastolic blood pressure, lower mean arterial blood pressure, as well as a higher pulse pressure than the control subjects. Significant correlations were found between blood pressure indices and hematocrit, body mass index, frequency of crisis, and body surface area.ConclusionRelatively lower arterial blood pressure is a significant finding in patients with sickle cell anemia. Hematocrit, frequency of crisis, body mass index, and body surface area are significant determinants of blood pressure indices in sickle cell anemia

Pattern of Blood Pressure Indices among the Residents of a Rural Community in South East Nigeria

Cardiovascular diseases (CVDs) are the main causes of death in industrialized countries, and are significant causes of morbidity and mortality in sub-Saharan Africa. Hypertension is the most common cardiovascular disease in Nigerians, and the risk of CVD associated with hypertension is independent of other risk factors. Despite the high level of awareness of its presence in the developed countries, the level of control is still poor. CVDs tend to be commoner in urban settlements, and it has been hypothesized that rural sub-Saharan Africa is at an early stage of epidemiological transition from communicable to non-communicable diseases (NCD) because of the gradual adoption of unhealthy lifestyles. This study aimed at describing the pattern of blood pressure indices among the hypertensive residents of a rural community in South East Nigeria. A total of 858 individuals comprising 247 males and 611 females took part in the study. 46.4% of the subjects had hypertension. Hypertension was commoner in the males (50.2% vs. 44.8%) (χ2(1) = 1.484; P = 0.223). The males were significantly older and heavier than the females while the females had higher mean values of BMI and WC. The prevalence of hypertension is becoming alarmingly high in the rural communities of sub-Saharan Africa

Intra‑cardiac masses in adults: A review of echocardiogram records at two echocardiographic laboratories in Enugu, South‑East Nigeria

Background: Transthoracic echocardiography (TTE) is an excellent initial diagnostic technique used to evaluate and diagnose cardiac masses, even though transoesophageal echocardiography (TEE) provides superior image resolution and better visualization of cardiac masses, especially in patients with suboptimal transthoracic echocardiographic studies. TTE is the clinical procedure of choice for identification of left ventricular thrombi. TTE has greater than 90% sensitivity and greater than 85% specificity for detection of left ventricular thrombi and is probably superior to the sensitivity and specificity of TEE, especially for apical thrombi.Aims: The study aimed to identify the common types of cardiac masses and their commonest locations in the heart.Materials and Methods: We did a retrospective review of our echocardiogram reports from May 2003 to July 2012 to identify the frequency of intra‑cardiac masses in adults, as well as the gender distribution and commonest location of these masses.Results: There were 2,814 echo examinations in adults over this period, comprising 1,661 males (59.1%) and 1,153 females (40.9%). Intra‑cardiac masses were found in 20 of these patients representing 0.7% of the study population. Thrombi were the commonest masses noted in our study, and there were more masses in the atria than in the ventricles. The left heart chambers also had more masses than the right heart chambers. There was no sex difference in the frequency of cardiac masses.Conclusion: Intra‑cardiac masses are rare, and transthoracic echocardiography is still valuable in the diagnosis and initial characterization of cardiac masses.Keywords: Adults, echocardiography, intra‑cardiac masses, NigeriaNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue