Implication of oestrogen in the development of breast cancer: a brief narrative review

The presence of hormones in milk and dairy foods was discussed decades ago but more concerns were with respect to finding hormones as biomarkers in milk for diseases and pregnancy diagnosis. Considerable amount of studies demonstrated that milk is essential for infants growing and immunity, while increasing body of evidence are indicating possible negative impact on human health including the role of some estrogens in the initiation and provoking of breast cancer. In this brief narrative, we reviewed recent data on oestrogens and breast cancer risk including comparative levels of hormones in cow milk, risk of breast cancer attributable to intake of different foods and lifestyle factors. Empirical findings indicate that consumption of cow milk is probably being over-emphasized as source of exogenous oestrogen, whereas control of alcohol as well as obesity and physical activity are under-emphasized in discourses on preventive protocols.

Evaluation of acetylator phenotype of isoniazid among tuberculosis patients in delta state Nigeria: update on management of toxicity

Background: In 1996, acetylator phenotype of thirteen consenting tuberculosis patients who were being treated with isoniazid was briefly examined as part of an MSc biochemistry program. Initial agenda were to determine the half-life of isoniazid and evaluate potential toxicity associated with long-term treatment regimen. This report presents findings of the study, but with the aim of providing an update on diagnosis and monitoring of the treatment of tuberculosis by laboratory methods.Methods: Firstly, the report submitted for the award of MSc Biochemistry was reviewed and reformatted. Secondly, a follow up survey was performed to determine the current practice at the general hospital and ‘tuberculosis and leprosy’ referral centres where the original study was carried out. Thirdly, a brief literature review was performed for any potential update on clinical practices.Results: The study has shown that 53.8% of patients are fast acetylators (t½2.5 hr). The follow-up on current practice indicates that molecular technology has been introduced, but limited to susceptibility testing. Whether a patient could be a fast acetylator (requiring long term drug regimen) or slow acetylator (deserving short term drug regiment) is very much appreciated, but test is neither available, nor considered. Conventional diagnostic indices applicable for clinical laboratory monitoring in a drug-responsive patient in terms of efficacy and toxicity of the treatment are discussed.Conclusions: Development of molecular technology has improved and revolutionized TB diagnosis, especially drug resistance testing. However, it is still limited to being an add-on test to conventional microscopy if a new patient is to be initially investigated for pulmonary TB.

Clinical laboratory testing for smoking toxicity: implications for early identification of respiratory diseases

Smoking toxicity has short and long term clinical effects and also leads to organ damage. However, clinical assessment in the context of early identification of smoke toxicity by evidence-base pathology is yet to be practiced. The present study was aimed to assess the knowledge and practice of health practitioners regarding clinical laboratory testing of smoking toxicity, with a view to generate a debate on why and how to test. In this pilot study, various health practitioners and students were asked via interviews about laboratory testing of smoking toxicity. There is considerable dismissal of ‘why’ to test and up 57% responded that it was unnecessary. However, there is general opinion that laboratory routine tests can be used to identify toxicity. It appears that there is a gap between knowledge and practice of clinical laboratory testing of cigarette toxicity. Students and health practitioners have the knowledge on smoke toxicity but this requires articulation into evidence-base pathology for early identification and intervention of subclinical pathology in smoking toxicity, especially before noticeable organ damage

Evaluation of oxidative stress and whole blood viscosity for clinical laboratory testing of smoking toxicity

Background: There are no clearly established clinical biochemical markers for cigarette smoking despite the knowledge that cigarette smoking is a risk factor for various diseases, especially cardiovascular complications of respiratory pathologies. However, there are reports of significant increases in blood viscosity and oxidative stress among smokers. The main objective of the study was to ascertain the association of toxicity from cigarette smoking on whole blood viscosity in our data.Methods: This study analysed the archived clinical data of 20 cigarette smokers and 20 apparently healthy individuals.Results: The data show that on average, oxidative stress levels are relatively the same between groups, while whole blood viscosity is statistically significantly lower in non-smokers compared to smokers.Conclusions: This report suggests that oxidative stress induced whole blood hyper-viscosity could be a valid biomarker for laboratory testing of smoking toxicity among cigarette smokers

Evaluation of utilization of insecticide treated nets among pregnant women in Bayelsa State of Nigeria: a case study of Sagbama community

Background: There has been a roll back mosquito (RBM) program in Nigeria. This study was carried out to determine the effectiveness and utilization of insecticide treated nets (ITNs) among pregnant women in Bayelsa State, Nigeria.Methods: A descriptive survey design was used to assess usage and patient experience. A total of 250 completed survey were returned out of 260 questionnaires distributed. Statistical analysis was in frequency counts and percentages.Results: Over 55% of respondents are aware that the best way to prevent malaria in pregnancy is to always sleep in ITNs. 20% of the respondents lack ITNs due to non-availability in the clinic or unaffordability in the market. Among those that own ITNs, only 31% utilize it every day. Suffocation and skin irritation were reasons for non-utilization. On effectiveness, among those who use their ITNs, 24.3% never suffered malaria or mosquito bite.Conclusions: ITNs utilization seems to have reached the RBM target. However, the study shows patient experience that use of ITNs seems to have limited effectiveness in prevention of malaria during pregnancy, while affordances and quality are barriers to utility. Ministry of Health and especially antenatal and community healthcare workers need to intensify health education campaign to improve attitude and practice of ITNs utility among pregnant mothers. Manufacturers of ITNs also need to improve on the quality of ITNs to reduce skin irritation or suffocation in order to encourage usage among pregnant mothers

Consumption and factors associating the provision of fruits and vegetables to children in Bayelsa state of Nigeria

Background: The provision of adequate nutrition is of the utmost importance for the promotion of optimal growth and development in the early stages of human life as well as the stimulation of immune system function to combat infections. Therefore, this study aimed to assess the level of consumption and the factors affecting the provision of fruits and vegetables to children in Bayelsa state of Nigeria. Methods: This was a population-based survey conducted among 360 parents/caregivers of children aged 5 years and below randomly selected from Bayelsa state, Nigeria. The data for this study was collected with in-person interviews utilizing a standardized questionnaire. The results were presented in frequency and percentage. The level of significance was determined using a confidence interval of 95% and p<0.05. Results: Most of the respondents 355 (98.6%) were female with the age range 25-44 making 86.65% of the total population. Findings show that 40.8% of respondents gave their children fruits and vegetables only once a week while 3.6% gave their children fruits and vegetables 4 times and above a week. The majority of respondents 240 (66.7%) indicated that the high cost of fruits and vegetables was the main factor that affected consumption of fruits and vegetables. Conclusions: The findings demonstrated a low consumption level of fruits and vegetables among the children in Bayelsa state. Therefore, health professionals should be obliged to educate parents and caregivers of children on adequate provision of fruits and vegetables for their children

Prevalence of cardiovascular disease risk factors among a Nigerian adult population: relationship with income level and accessibility to CVD risks screening

BackgroundIn Nigeria, reports on the prevalence of modifiable cardiovascular disease (CVD) risk factors are scarce. In addition, socio-economic status (SES), an important component of the socioeconomic gradient in CVD and its risk factors has not been clearly elucidated. This study sought to assess the prevalence of CVD risk factors and how the difference in prevalence and accessibility to CVD risk screening across income levels and educational backgrounds contributes to disease diagnosis in rural and urban Nigerian adults.MethodsA cross sectional study was carried out on a sociocultural ethnic group of persons living in rural and urban settings. All participants were aged ≥ 18 years. The WHO STEPS questionnaire was used to document the demographics, history of previous medical check-up or screening, anthropometric and biochemical measurements of the participants. Average income level and educational status were indicators used to assess the impact of SES. Multivariate analyses were performed to assess any difference between the geographical locations and SES indicators, and prevalence of CVD risk factors and access to CVD risk screening.ResultsThe 422 participants (149 males and 273 females) had mean age (± standard deviation) of 38.3 ± 20.5 and 42.9 ± 20.7 years, respectively. Only total cholesterol (p = 0.001), triglyceride (p = 0.005), high density lipoprotein cholesterol (HDL) (p < 0.0001), body mass index (BMI) (p = 0.03) and average income rate (p = 0.01) showed significant difference between gender groups. Overall prevalence of prediabetes (4.9%), diabetes (5.4%), hypertension (35.7%), low HDL (17.8%), hypertriglyceridemia (23.2%), hypercholesterolemia (38.1%) and central obesity of 52.2% was recorded. Except between total cholesterol (p = 0.042) and HDL (p = 0.017), other CVD risk factors did not show a statistical significance across income levels. Participants with ‘university and postgraduate education’ had higher access to blood pressure and blood glucose screening compared to other educational groups; and this showed a statistical significance.ConclusionThis study has shown that a significant number of modifiable CVD risk factors exist in the rural and urban migrants of an adult Nigerian population. While income level did not affect the CVD risk factor prevalence, it did affect accessibility to CVD risk screening. There is a need for access to diagnosis of modifiable risk factors at all levels of society

Evaluation of acetylator phenotype of isoniazid among tuberculosis patients in delta state Nigeria: update on management of toxicity

Background: In 1996, acetylator phenotype of thirteen consenting tuberculosis patients who were being treated with isoniazid was briefly examined as part of an MSc biochemistry program. Initial agenda were to determine the half-life of isoniazid and evaluate potential toxicity associated with long-term treatment regimen. This report presents findings of the study, but with the aim of providing an update on diagnosis and monitoring of the treatment of tuberculosis by laboratory methods.Methods: Firstly, the report submitted for the award of MSc Biochemistry was reviewed and reformatted. Secondly, a follow up survey was performed to determine the current practice at the general hospital and ‘tuberculosis and leprosy’ referral centres where the original study was carried out. Thirdly, a brief literature review was performed for any potential update on clinical practices.Results: The study has shown that 53.8% of patients are fast acetylators (t½<2 hr), 30.8% are intermediate acetylators (t½: 2.0–2.5 hr), and 15.4% are slow acetylators (t½>2.5 hr). The follow-up on current practice indicates that molecular technology has been introduced, but limited to susceptibility testing. Whether a patient could be a fast acetylator (requiring long term drug regimen) or slow acetylator (deserving short term drug regiment) is very much appreciated, but test is neither available, nor considered. Conventional diagnostic indices applicable for clinical laboratory monitoring in a drug-responsive patient in terms of efficacy and toxicity of the treatment are discussed.Conclusions: Development of molecular technology has improved and revolutionized TB diagnosis, especially drug resistance testing. However, it is still limited to being an add-on test to conventional microscopy if a new patient is to be initially investigated for pulmonary TB.

Prevalence of cardio-metabolic syndrome in Nigeria: A systematic review

ObjectiveThis is a systematic review of the distribution of cardiometabolic syndrome (CMS) in Nigeria, the clinical definitions widely used and how it affects the proposition of a national prevalence of CMS that will advise management interventions.Study designSystematic review of literature.MethodsTo present a comprehensive report of the distribution of CMS in Nigeria, extensive searches was carried out on PubMed, African Journals Online (AJOL), SCOPUS, EBSCOhost (CINAHL Plus), Google Scholar and Science Direct using terms: Nigeria, metabolic syndrome, cardio-metabolic syndrome, syndrome X, World Health Organization, International Diabetic Federation, National Cholesterol Education Program Adult Treatment Panel III, European Group for study on Insulin Resistance, American Association of Clinical Endocrinologist, American Heart Association/National Heart, Lung and Blood Institute. All published data between January 2002 and December 2013 were collated into a database. Information gathered and recorded for each source were the population sampled, age and number of population, locality, clinical definition used, longitude and latitude, and period of the study.ResultsOut of 32 studies, 9 (28.1%) adopted the WHO classification, 19 (59.4%) used the ATPIII definition, while the remaining 10 (31.3%) studies used the IDF definitions. Twenty (62.5%) were hospital-based studies on diabetic, hypertensive, HIV, asthmatic and thyroid disorder patients. The remaining 12 (37.5%) studies were population-based studies in urban, suburb and rural settings. The mean overall prevalence of CMS in Nigeria is 31.7%, 27.9% and 28.1% according to the WHO, ATPIII and IDF definitions, respectively. Most of the studies were from the Southern region. Age groups mostly studied were those from ≥35 years.ConclusionThe report of this review provides an essential overview on the current distribution of CMS in Nigeria. It provides an insight to direct future studies such as the need to (1) study rural communities where lifestyles are not westernized as in the urban areas, and (2) young adults, as well as (3) develop a consensus on the definition of CMS among the Sub-Saharan African populations