Left ventricular structure and function in black normotensive type 2 diabetes mellitus patients

Background: Relationship between type 2 DM and cardiovascular disease (CVD) is well known, with CVD being the most common cause of mortality in diabetics. Significant myocardial injury before overt CVD in DM can be identified early using echocardiography. This study therefore aimed at evaluating left ventricular structure and function of patients with type 2 DM.Materials and Methods: One hundred and fifty adult type 2 DM patients were recruited with 150 age- and sexmatched controls. Patients and subjects with systemic hypertension, pregnancy, sickle cell disease and structural heart disease were excluded from the study. Participants were evaluated clinically; had anthropometric parameters and electrocardiogram taken. Echocardiograms were obtained according to the American Society of Echocardiography (ASE) recommendations.Results: Mean age of the patients (55.4±11.6 years) was similar to that of the control (54.2±9.6 years) (P=0.348) and the duration of DM was 4.53 years. Left ventricular (LV) systolic function was normal in both groups but was higher in patients than controls (ejection fraction=70.3±10.7% and 64.4 ± 9.4%, P =0.001 respectively). The prevalence of LV diastolic dysfunction (LVDD) was 72% in the patients compared with 6% in controls (P=0.001). Patients’ age, body weight, duration of DM, LV mass index and left atrial dimension were positive correlates of LVDD while patients’ age, weight and left atrial dimension were independent predictors of LVDD.Conclusion: There is high prevalence of alterations in LV structure and function in normotensive type 2 DM; and there is a need for early intervention to prevent overt LV dysfunction

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

Self-reported sleep parameters among secondary school teenagers in middle-belt Nigeria

Background: Available evidences seem to suggest increasing trend in sleep deficit among teenagers worldwide, and there is limited information on this among Nigerian teenagers. This study was carried out to determine the basic sleep schedule and sleep duration among schooling teenagers in Ilorin, Nigeria.Methods: This is a descriptive cross‑sectional study conducted among 20 selected public secondary schools in Ilorin, Nigeria. A multistage sampling technique was used to randomly select participating schools.Result: A total of 1033 students participated in the study; of these 47.3% were males and 51.7% females. Students mean age (standard deviation) was 15.3 ± 1.6 years with a range of 12–19 years. Majority (76.2%) of participants co‑share bed with at least one person and some (23.8%) slept alone in bed. The three leading reasons given for going to bed were: Tiredness ‑ 31.1%, completion of house assignment ‑ 20.5%, and parental directive ‑ 12.4%. 10% of teenagers do make regular phone calls at night and 5.5% surf internet and use computers at night. Regular habits of daytime sleepiness were reported by 8.2% of study participants. Students’ mean sleep duration during school days was 9.33 ± 2.29 h compared to 10.09 ± 1.32 h at weekend (P < 0.05). The duration of night time sleep was adequate (>9 h) in 41% of students; borderline (8–9 h) in 44.3% while 13.3% of the students had insufficient nighttime sleep duration (<8 h) P < 0.05.Conclusion: A substantial number of students had borderline nighttime sleep duration and so had potentials to transit into the problematic insufficient range. To prevent this, there is a need to educate schooling teenagers on the dangers associated with prolonged sleep insufficiency.Key words: Bedtime, schooling, sleep duration, teenagers, wake‑up‑tim

Intracardiac tumor: A risk factor for stroke in the young –A case report

Stroke occurs commonly in individuals above 65years, especially in the background of atherosclerosis and other risk factors. In young persons below 45 years it is a rare disorder with devastating sequelae on the affected individual. Presently there are few reports on the aetiology/risk factors for stroke in young adults in Nigeria. This is due to limited facility for thorough investigation; therefore management of such cases poses a diagnostic challenge. In this report we present a case of embolic stroke in a male undergraduate that began with two brief episodes of transient left sided weakness before a completed stroke four hours later. 2-D echocardiography showed that the likely source of emboli to be a non-pedunculated left atria tumour attached to the root of posteriormitral valve leaflet. Intracardiac mass should be considered a possible risk factor for ischemic stroke in young adult, especially in the absence of other risk factors such as connective tissue disorders, HIV/AIDS, hemoglobinopathy or use of recreational drugs. High index of suspicion is required in order not to overlook such source of emboli. Early diagnosis offers the best panacea for a definitive therapy and prevention of stroke recurrence with its devastating sequelae.Intracardic tumour, risk factor, stroke . Nigerian Journal of Clinical Practice Vol. 11 (1) 2008: pp. 82-8

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining https://researchonline.ljmu.ac.uk/images/research_banner_face_lab_290.jpgunderweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity

Plasma Total Homocysteine (tHcy) Levels in Healthy Nigerian Volunteers

Establishment and stratification of reference values for a laboratory area of practice enhances the test result interpretation and sensitivity. Plasma total homocysteine (tHcy) is a metabolite of methionine which is dependent on vitamin B6, B12 and folate as co-factors. Plasma level (Hyperhomocysteinemia) is influenced by age, sex and diet. High levels can be associated with an increased risk of cardiovascular diseases such as myocardial infarction and stroke. This is why plasma tHcy determination is assuming a routine screening test of cardiovascular profile in patients with increased risk of cardiac event from existing cardiovascular diseases. This study was to determine the age, sex stratified reference interval in aNigeria population. Fifty eight reference individuals were selected randomly from a North Central zone, Nigeria population and tHcy was determined by fluorescent polarization Immunoassay method using IMX immunoanalyser. The reference interval of tHcy determined in our study was 1.7 – 17.7 μmol/L (minimum = 4.9μmol/L, maximum = 21.4μmol/L). Plasma tHcy level is influenced by diet, sex and age, laboratories may need to establish their practice area reference interval for proper interpretation of test result

Miliary tuberculosis masquerading as pyrexia of obscure origin: A case report

The diagnosis of miliary tuberculosis may be difficult as clinical features are often non-specific and plain chest radiograph may fail to reveal classical miliary shadows, even in endemic areas. A 48 year old immunecompetent male with pyrexia of obscure origin is presented. The diagnosis was made with the aid of computed tomogram of the chest as plain chest radiograph was apparently normal and sputum examination for alcohol acid fast bacilli was negative. He responded well to anti-tuberculosis drugs. The significance of imaging techniques in the diagnosis of this disease when routine conventional tests are unhelpful is emphasized

Polymorphic ventricular arrhythmia successfully managed by electrical defibrillation: a case report and review of literature

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An Open Comparative Antihypertensive Effects of Amlodipine (“Norvasc®”), Lisinopril (“Zestril®”) and Bendrofluazide

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