Knowledge and practice of hypertensive patients as seen in a tertiary hospital in the middle belt of Nigeria

No Abstract

Prognostic Significance Of QT Interval Prolongation In Adult Nigerians With Chronic Heart Failure.

Prognostic survival studies for heart-rate corrected QT interval in patients with chronic heart failure are few; although these patients are known to have a high risk of sudden cardiac death. This study was aimed at determining the mortality risk associated with prolonged QTc in Nigerians with heart failure. Ninety-six consecutive patientswith heart failurewere recruitedwith 90 age and sexmatched controls.All the subjects had a 12-lead electrocardiogramat a paper speed of 25mm/sec and a rhythm strip (lead II) at 50mm/sec.The latterwas used to calculate theQTc using the Bazett\'s formula. Left ventricular systolic and diastolic functions were assessed using 2D guided M-mode and Doppler echocardiogram respectively.Theywere followed-up for sixmonths. Ninety-one patients and 90 controls completed the study. Five patients were lost to follow-up. The mean age (51.9±16 years) of the patientswas similar to that of the controls (50.3±15) (P= 0.475).Twenty-eight (30.8%) patients died after 6months of follow-up against none of the controls.The mean QTc was significantly longer in the non-survivors (0.494±0.027) than in the survivors (0.462±0.035) (P = 0.0001). The percentage mortality in patients with prolonged QTc against those with normal QTc was 41% and 14% respectively (P = 0.001). In the stepwise regression analysis, QTc was an independent predictor of mortality (R = 0.412, R = 0.17, P= 0.001). QTc prolongation is a predictor of mortality in CHF and may be an important adjunct in risk stratification of patientswith heart failure. Keywords: Chronic Heart Failure, QTc Prolongation, Mortality Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 336-34

Prevalence and Predictors of Tuberculosis Coinfection among HIV-Seropositive Patients Attending the Aminu Kano Teaching Hospital, Northern Nigeria

Background: The HIV/AIDS epidemic has been accompanied by a severe epidemic of tuberculosis (TB), although the prevalence of coinfection is largely unknown, especially in developing countries, including Nigeria. The aim of this study was to determine the prevalence and predictors of TB coinfection among HIV-seropositive Nigerians. Methods: The case files of HIV/AIDS patients attending Aminu Kano Teaching Hospital, Nigeria from January to December 2006 were reviewed. Results: A total of 1320 HIV/AIDS patients had complete records and were reviewed, among which 138 (10.5%) were coinfected with TB (95% CI, 8.9% to 12.2%). Pulmonary TB was diagnosed in 103 (74.6%) patients, among whom only 18 (17.5%) were sputum-positive. Fifty (36.2%) coinfected patients had some type of extrapulmonary TB (EPTB); 15 had both pulmonary TB and EPTB. Among the 35 patients with EPTB only, 20 (57.1%) had abdominal TB, 5 (14.3%) had TB adenitis, 5 (14.3%) had spinal TB, 3 (8.6%) were being monitored for tuberculous meningitis, and 1 (2.9%) each had renal TB and tuberculous adrenalitis. The highest prevalence of TB, 13.7% (n = 28), was seen among patients aged 41–50 years. TB coinfection was significantly associated with marital status, WHO clinical stage, and CD4 count. Marital status (OR, 2.1; 95% CI, 1.28–3.59; P = 0.04), WHO clinical stage at presentation (4.81; 1.42–8.34; P = 0.001), and baseline CD4 count (2.71; 1.51–6.21; P = 0.02) remained significant predictors after adjustment for confounding. Conclusions: The moderately high prevalence of TB among HIV-seropositive patients underscores the urgent need for strategies that lead to rapid identification and treatment of coinfection with active or latent TB

Nigeria's National Health Insurance Scheme: a critical reappraisal.

For well over four decades, the National Health Insurance Scheme (NHIS) remained on the drawing board. It is now a little over half a decade since the actual commencement of the implementation of the scheme. This review, therefore, chronicles the historical background to the introduction of the scheme, highlighting the main objectives and critically re-appraising the extent of realization of these objectives and mandates. This was essentially through the review of all available relevant literature from the NHIS Headquarter and Google search. In the process, factors militating against smooth operation of the scheme were identified and important solutions were also proffered. The review concluded by emphasizing the desirability of the NHIS and the need for all hands to be on the deck if only the scheme is to realize its mandate of efficient, effective and qualitative health care for all Nigerians

Antihypertensive therapy among hypertensive patients as seen in the middle belt of Nigeria

No Abstract Available Key words: hypertension, drugs, therapy, Nigerians I>Annals of African Medicine Vol.3(4) 2004: 177-18

Awareness and Attitude of Medical Practitioners in Ilorin Towards the National Health Insurance Scheme

National Health Insurance Scheme (NHIS) has remained on the drawing board since 1962. With the renewed interest and efforts at full commencement of the Scheme, an attempt was therefore made to study tle awareness and the attitude of 112 doctors practising across disciplines at University of Ilorin Teaching Hospital. Even though all the respondents (100%) were aware of the Scheme, only 23.3% considered themselves as having adequate information on it. Newspapers (61.1%) and seminars/workshop (35.2%) were the major sources of information on the Scheme. Majority of the respondents opined that both the public (94.6%) and the health care providers (89.3%) have not been adequately mobilized for the scheme. Also worthy of note was the fact that even though 43.9% of the respondents had reservations on the Scheme as presently packaged, majority of them (66.1%) were willing to participate in it. It is, therefore, suggested that efforts should be made to improve the level of information and mobilization on the Scheme using the media of newspapers and scientific meetings. KEY WORDS: NHIS, knowledge, attitude, doctors. Sahel Med. J. Vol.6(1) 2003: 14-1

Rheumatic valvular heart disease as seen at echocardiography in Ilorin, Nigeria

No Abstrac

Correlation of Admission Blood Pressures with 30-Day Outcome in Acute Ischaemic Stroke in Nigerians.

Background: There is a lot of controversy on the prognostic value of admission blood pressures in acute ischaemic stroke, but in Nigeria, there is no information on this. Objective: The objective of this study was to correlate the effect of blood pressures measured on admission with 30-day mortality and neurological handicap in Nigerians with acute ischaemic stroke. Methods: This was a prospective observational study carried out between February, 2003 and May, 2004 at the Lagos University Teaching Hospital, Lagos, Nigeria. All eligible consecutively consenting ischaemic stroke patients were recruited. Systolic (SBP) and diastolic blood pressures (DBP) were measured on admission while pulse pressure (PP) and mean arterial pressure (MAP) were derived. Patients were periodically evaluated for progress and/or development of complications. Primary outcome was mortality within 30 days while secondary outcome was level of handicap on the modified Rankin Scale. Results: 100 patients were studied (mean age 58.56±14.12 years); 53% were males. Overall 30-day case fatality rate was 28%. There was no significant correlation between admission blood pressures and 30-day mortality (SBP: r = -0.05, p= 0.62; DBP: r = -0.12, p= 0.23; PP: r = 0.01, p= 0.90; MAP: r = -0.09, p= 0.36) or modified Rankin Score (SBP: r = -0.11, p= 0.29; DBP: r = -0.13, p= 0.21; PP: r= -0.06, p= 0.54; MAP: r = -0.13, p= 0.21). Conclusion: Admission blood pressures do not have significant influence on 30-day mortality and level of handicap in Nigerians with ischaemic stroke. Keywords: correlation, ischaemic stroke, blood pressure, outcome, Nigerians Nigerian Medical Journal Vol. 48 (3) 2007: pp. 58-6