The relationship between serum cortisol, adrenaline, blood glucose and lipid profile of undergraduate students under examination stress.

Background: Stress is an extremely adaptive phenomenon in human beings and cortisol is a known stress hormone. Examination has been described as a naturalistic stressor capable of affecting human health.Objectives: To estimate the relationship between serum cortisol, adrenaline, fasting blood glucose (FBG) and lipid profile during examination stress.Methods: Two hundred and eight (208) apparently-healthy undergraduate students (aged, 24 ± 6 years) were involved in the study. Exactly 5 mls of venous blood was collected from each subject 1-3 hours before a major examination. A second assessment was done on the same students 3-4 weeks before any examination (control samples). Cortisol and adrenaline were assayed using ELISA techniques, FBG was assayed using enzymatic method while lipid parameters were assayed using standard enzymatic- spectrophotometric methods.Results: There was statistically significant increase in serum cortisol, adrenaline, Total cholesterol, HDL-cholesterol and LDL-cholesterol levels in students under examination stress compared to the non examination period (p=0.001, 0.013, 0.0001, 0.0001 and 0.0001, respectively). FBG showed no significant increase. There was also significant positive correlation (r=0.297, p=0.032) between serum cortisol and TC/HDL ratio (cardiac risk factor) before examination stress but not during the stress period.Conclusions: Significant positive correlation was observed between cortisol and TC/HDL ratio before examination stress.Key words: academic examination, stressors, cortisol, lipid profil

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

The activity of glucose-6-phosphate dehydrogenase (G6PD) in stored blood

Background: Blood transfusion is a critical component of supportive therapy. Red blood cell viability in stored blood determines successful transfusion. Glucose-6-phosphate dehydrogenase (G6PD) activity has been shown to maintain red blood cell membrane integrity. This study was, therefore, aimed at estimating the G6PD activity in stored blood bags at the blood bank of the University of Nigeria Teaching hospital (UNTH) Enugu.Methodology: The activity of G6PD in 100 stored blood bags consisting of different ABO groups [A (n=30); B (n=30); O (n=30) and AB (n=10)], stored at the blood bank of the UNTH Enugu between April and August 2009, was determined using methhaemoglobin reduction and ultraviolet (UV) spectrophotometric quantitative methods. The data obtained were statistically analyzed using student’s t-test and analysis of variance.Results: There was statistically significant decrease in the G6PD activity from the third week of storage (p<0.05) at the blood bank, under optimum storage conditions. The different ABO blood groups did not show any significant variation (p>0.05) in G6PD activity.Conclusion: Storage of whole blood for up to three weeks results in significant decrease in the G6PD activity and possibly, affects the red cell viability. Stored blood in the blood bank should be used up before the third week to ensure viability of red blood cells.Keywords: ABO groups, blood transfusion, blood donors, haemolytic anaemia, red blood cell

Atherogenic index of plasma as useful predictor of cardiovascular risk among postmenopausal women in Enugu, Nigeria

Background: Menopausal health in our environment has received little attention. As an independent risk factor for dyslipidaemia, the degree and pattern of derangement, though difficult to assess may adversely affect the cardiovascular health of our women. Objectives: To estimate the serum lipid profile and the atherogenic index of plasma in normal post menopausal women. Methods: This is a cross sectional study involving 80 apparently healthy women voluntarily recruited from staff of the University of Nigeria and the Teaching Hospital (iJNTH) located in Enugu. They include 50 postmenopausal subjects aged between 50 and 70 years and 30 premenopausal controls aged between 25 and 49 years. Total cholesterol (TC), and the various subfractions ;high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were determined. Atherogenic index of plasma (AIP); log (TG/HDIrC) was calculated. Results: There were statistically significant increases (P< 0.0001) in TC, TG, LDL-C, VLDL-C and AIP but a statistically significant decrease (P<0.0001) in HDL-C in postmenopausal women when compared with the premenopausal subjects. Except HDIrC that showed insignificant reduction, there were statistically significant derangement of other lipid subfractions as the duration of menopause increased. Conclusion: Menopause, no doubt alters lipid profile. A triglyceride based index (AIP) can significantly add value when assessing the risk of developing atherosclerosis in Nigeria