Pseudohyperglycemia: Effects of Unwashed Hand after Fruit Peeling or Handling on Fingertips Blood Glucose Monitoring Results

Background: Self‑monitoring of blood glucose (SMBG) is an important component of management for diabetes mellitus (DM), especially in T1DM and T2DM patients who are on insulin therapy. Adequate blood glucose monitoring and prompt intervention are necessary to prevent blood glucose (BG) fluctuation and delay long‑term diabetes complications. People with DM are advised to clean their hands before SMBG to remove any dirt or food residue that might affect the reading. Aim: The study tested the hypothesis that falsely elevated BG levels from fingertip occur after peeling or handling fruits in an unwashed hand. Methods: Fifty apparently healthy nondiabetes volunteers were enrolled. Capillary BG samples were collected from the fingertips after peeling or handling apple, orange, banana, watermelon, and pawpaw, followed by no hand washing for 1 h, cleaning the fingertip with alcohol swab once, five times, and washing hand thoroughly with tap water and drying. These samples were then analyzed with two different glucose meters. Results: The mean BG values, measured from fingertip blood samples after peeling, and handling any of the fruits followed by no hand washing were significantly high, even after cleaning fingertip with a swab of alcohol once. However, there were no significant difference in BG levels measured after peeling and handling fruits followed by hand washing and the level of BG before peeling and handling fruits. Conclusion: Handling of peeled fruits with no hand washing with tap water is associated with overestimation of capillary BG (Pseudohyperglycemia) monitored with glucose meters.Keywords: Diabetes, Fruits, Glucose meter, Hand washing, Pseudohyperglycemia, Self‑monitoring of blood glucos

Relationship between socioeconomic status and HIV infection in a rural tertiary health center

Olarinde Jeffrey Ogunmola,1 Yusuf Olatunji Oladosu,2 Michael Adeyemi Olamoyegun31Cardiac Care Centre, Department of Internal Medicine, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria, 2Department of Internal Medicine, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria, 3Endocrinology, Diabetes and Metabolism Unit, Department of Internal Medicine, Ladoke-Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State, NigeriaBackground: There is a scarcity of data in rural health centers in Nigeria regarding the relationship between socioeconomic status (SES) and HIV infection. We investigated this relationship using indicators of SES.Methods: An analytical case-control study was conducted in the HIV clinic of a rural tertiary health center. Data collection included demographic variables, educational attainment, employment status, monthly income, marital status, and religion. HIV was diagnosed by conventional methods. Data were analyzed with the SPSS version 16 software.Results: A total of 115 (48.5%) HIV-negative subjects with a mean age of 35.49±7.63 years (range: 15–54 years), and 122 (51.5%) HIV-positive subjects with a mean age of 36.35±8.31 years (range: 15–53 years) were involved in the study. Participants consisted of 47 (40.9%) men and 68 (59.1%) women who were HIV negative. Those who were HIV positive consisted of 35 (28.7%) men and 87 (71.3%) women. Attainment of secondary school levels of education, and all categories of monthly income showed statistically significant relationships with HIV infection (P=0.018 and P<0.05, respectively) after analysis using a logistic regression model. Employment status did not show any significant relationship with HIV infection.Conclusion: Our findings suggested that some indicators of SES are differently related to HIV infection. Prevalent HIV infections are now concentrated among those with low incomes. Urgent measures to improve HIV prevention among low income earners are necessary. Further research in this area requires multiple measures in relation to partners’ SES (measured by education, employment, and income) to further define this relationship.Keywords: socioeconomic status, HIV infections, income, employment status, education, Nigeri

Bardet-biedel syndrome: a case report and a review of literature

Background: Bardet- Biedl syndrome (BBS) is a group of autosomal recessive conditions with overlapping phenotype of rod-cone dystrophy, central obesity, mental retardation, and hypogonadism. There are very fewreports of BBS from Sub-Saharan Africa.Objective: To report a case of BBS and review existing literature on BBS, highlighting the challenges in its management in a resource poor setting.Methods: A 17 year old girl presented for evaluation. A full history and physical examination were performed. Investigations carried out include basal hormonal profile, pelvic ultrasound, bone age determination and brain imaging.Results: The patient presented with blindness worse at night, obesity, delayed developmental milestones, learning difficulties and delayed puberty. She had a short neck, acanthosis nigricans, brachydactyly and hirsuitism. There was a positive family history of similar problems in her younger sister who also had polydactyly and bladder instability but had not been investigated. The parents had difficulty coping with their care especially their educational needs in view of the multiplicity of their problems. The patient weighed 80kg, was 1.43 m tall (BMI-39.1kg/m2), had arm span 1.23m, crown-pubis 0.73m, pubis-heel 0.70m, waist circumference 0.88m, hip circumference 1.22m. Opthalmologic evaluation revealed rotary nystagmus, astigmatism, reduced visual acuity and retinal pigment mottling. Oral glucose tolerance test (OGTT) revealed normal glucose tolerance. Basal hormone profile showed hypogonadotrophic hypogonadism, normal thyroid function and hyperinsulinaemia. Her bone age was appropriate for chronological age. Her parents sought contact with BBS groups due to the challenges in educational needs and care being experienced.Conclusion: Management of BBS involves a multidisciplinary approach the burden of which can be overwhelming for care- givers, moreso in a resource constraint setting as ours.Keywords: Biedl- Bardet syndrome, night blindness, Nigeri

Lipoatrophy among patients on antiretroviral therapy in Lagos, Nigeria: Prevalence, pattern and association with cardiovascular risk factors

Context: Antiretroviral therapy (ART) is linked with morphologic abnormalities such as lipoatrophy (LA), which may accompany metabolic alterations (dysglycemias, dyslipidemia and insulin resistance) that increase cardiovascular disease risk. LA and its association with metabolic alterations have been infrequently studied amongst Nigerians on ART.Aims: To determine the prevalence, pattern and association of LA with metabolic abnormalities and hypertension among patients on ART attending an ambulatory human immunodeficiency virus clinic in Lagos, Nigeria.Subjects and Methods: A cross‑sectional study was carried out among patients on ART using a structured interviewer administered questionnaire. Data obtained included patients and physician’s assessment of body fat changes, drug history, blood pressure, body composition assessment using bioelectrical impedance analysis and biochemical evaluation (glucose, lipids). LA was defined clinically. Data were analyzed using IBM SPSS statistical software version 21.Results: A total of 48 (33.1%) of the 145 patients had LA. The face was the most frequently affected body region. Patients with LA with lower body circumferences, skin‑fold thickness and body fat (P < 0.05). The frequencies of lipid abnormalities were: Reduced high density lipoprotein–cholesterol (47.1%), elevated total cholesterol (35.6%), reduced low density lipoprotein-cholesterol (19.2%), elevated triglycerides (14.4%). Fasting plasma glucose (FPG)≥6.1 mmol/l and hypertension were present among 9.6% and 40.7% respectively. LA was not significantly associated with the presence of glucose intolerance, dyslipidemia or hypertension (P > 0.05).Conclusions: Lipoatrophy, though commonly encountered in patients on ART in Nigeria was not associated with the presence of dyslipidemia, abnormal FPG or hypertension. Regular monitoring by the physician and increased patients awareness are necessary to reduce its prevalence and impact.Key words: Antiretroviral therapy, cardiovascular, lipoatrophy, metabolic, Nigeri

Self-Reported Physical Activity among Health Care Professionals in South‑West Nigeria

Introduction: Physical activity (PA) is a key requirement for maintaining good health. There is growing evidence of declining PA worldwide. Physical inactivity is linked with the global obesity pandemic and increasing burden of noncommunicable diseases (NCDs) in developing countries. A barrier to PA counseling by health care providers (HCPs) is personal PA habits. Information regarding PA among HCPs in Nigeria is limited. We aimed to determine the adequacy and predictors of PA among HCPs of a tertiary health care facility in Lagos, Nigeria.Methods: A cross‑sectional study was carried out with the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Using the World Health Organization (WHO) guideline, PA was categorized as adequate or inadequate. Predictors of PA were explored with multivariate logistic regression.Results: A total of 300 HCPs were recruited, comprising 47.7% doctors and dentists, 43.3% nurses and 9.0% other HCPs. Mean age was 39.9 (9.0 years), 79.2%, 9.7% and 11.1% of the HCPs had low, moderate or high PA levels respectively. Thus, only 20.8% had adequate PA. 71.3% had body mass index (BMI) above the recommended value. BMI of ≥ 25 kg/mS2 was associated with inadequate PA (Adjusted Odds Ratio-2.1, P = 0.018).Conclusion: Majority of the HCPs had inadequate PA levels according to WHO guidelines. BMI ≥ 25 kg/m2 was associated with inadequate physical inactivity. The low level of PA implies that these HCPs are at risk for NCDs. This will have a negative impact on availability of human resource for health. There is an urgent need to establish programs to increase PA among HCPs.Keywords: Body Mass Index, Health Care Professionals, International Physical Activity Questionnaire, Nigeria, Physical Activit