Relationship between body mass index, waist circumference, waist hip ratio and erosive gastroesophageal reflux disease in a tertiary centre in Nigeria: A case control study

Background: Gastro-oesophageal reflux disease (GERD) is a condition that develops when the reflux of stomach content causes troublesome symptoms with or without mucosa damage and or complications. GERD is believed to be evolving among blacks.Objectives: The objective of this study was to look at the relationship of GERD to body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist hip ratio (WHR) among patients with distal oesophageal erosive GERD and controls.Methods: A case control study among patients with dyspepsia that had diagnostic upper gastrointestinal endoscopy. Patients with erosive GERD were grouped into cases while those without GERD were controls. GERD was graded using the Los Angeles classification. BMI, WC, HC and WHR were measured among cases and controls. Obesity was defined as BMI ≥ 30 kg/m2 or WC ≥ 88 cm or ≥WHR 0.85 in females and BMI ≥ 30 kg/m2 or WHR ≥ 0.9 or WC ≥102 cm for males. Data were analysed using descriptive and inferential statistics.Results: A total of 160 subjects (80 cases and 80 controls) were analysed. Mean (SD) age for cases was 51.1 (±12.4) years and 50.1 (±13.7) years for controls. When cases with GERD were compared with controls; males were less likely to be obese, BMI < 30 kg/m2, have normal WC, HC and WHR while females were more likely to be obese, BMI ≥ 30 kg/m2 and have increased WC, and HC, (p < 0.05).Conclusion: Central obesity is a risk factor for distal oesophageal erosive GERD among female Nigerians but not among males.Keywords: Gastro esophageal reflux, Central obesity, Dyspepsia, Nigeri

Factors Associated with the Survival Outcome of Hepatocellular Carcinoma Patients on Supportive Care in a Tertiary Hospital in South-West Nigeria

Background: Hepatocellular carcinoma (HCC) is a primary liver cancer. This study assessed the factors associated with the survival outcome of HCC on supportive care. Methods: This was a prospective cohort study carried out from January 2010 to June 2016 on cases of HCC recruited into a cancer data registry. Clinical, laboratory and survival outcomes were obtained. Data obtained were analyzed using descriptive and inferential statistics. Results: A total of 149 cases were analyzed: 120 (80.5%) males and 29 (19.5%) females. Age range was 18-87years, with mean (SD) being 45.0 (14.3) years. Identifiable aetiological factors were hepatitis B and C viruses, alcohol and herbal preparations in 94% while no risk factor was identified in 6%. Some risks co-occurred in multiples in 71.2% of cases. The overall median survival was 20 days, and general survival was 59.1% at two weeks, 33.6 % at one month, and only 7.3% surviving beyond thirty one days to two years. The survival of cases, according to the Child-Pugh (CTP) class, was CTP A: 36 days (ranged 4 to 730 days), CTP class B: 22 days (ranged 1 to 210 days) and CTP class C: 14 days (ranged 2 to 660 days). Higher proportion of young cases was HBsAg positive. Factors significantly associated with survival outcome included older age, female sex, abdominal pain, jaundice, elevated creatinine, bilirubin, AST, ALT, white cell count and hyponatreamia. Conclusion: Overall survival outcome among cases of HCC was poor. It is necessary to prevent HBV, reduce alcohol use, detect and treat HCC early

Willingness of Family Caregivers to Consent to Relative’s Postmortem Examination that Die Suddenly in a Nigerian Tertiary Hospital

BACKGROUND: Postmortem examination is necessary to diagnose the cause of sudden death, and family caregivers are expected to consent to this examination. This study assessed knowledge, attitude, practices and willingness of family caregivers to consent to postmortem examination of their relative if they die suddenly in a Nigerian tertiary hospital.METHODS: Descriptive cross-sectional study of family caregivers of our patients that completed an interviewer administered semistructured questionnaire assessing their knowledge, attitude, practices and willingness to consent to postmortem examination of their relative if they die suddenly. Data were analyzed using descriptive and inferential statistics.RESULTS: A total of 224 caregivers were interviewed. The mean age (SD) was 34.95 (11.74), ranging 22-75 years. They were parents (32.6%), siblings (37.9%), spouses (11.2%) and other relatives (18.3%). Only 17% had adequate knowledge, 44.6% positive attitude and 11.2% good practices to postmortem examination of sudden death. The majority (75.9%) would consent to postmortem examination of their relatives if they die suddenly. Sociodemographic variables associated with willingness to consent to postmortem examination after relative’s sudden death include being male (AOR 3.61; 95%CI 3.09-8.92; p=0.001), having tertiary education (AOR 4.83; 95%CI 1.01-8.29; p=0.034), Christianity (AOR 2.59; 95%CI 1.25-5.35; p=0.010) and skilled worker (AOR 1.43; 95%CI 1.33-3.80; p=0.020).CONCLUSION: Some family caregivers would not consent to postmortem examination of their relatives when they die suddenly. Sensitization programs targeting family caregivers are necessary to increase knowledge and enhance prevention of sudden death as well as improve willingness to consent to postmortem examination when their relatives die suddenly

The risk of obstructive sleep apnea and its association with indices of general and abdominal obesity in a Nigerian family practice clinic: a cross-sectional study

Introduction: Obstructive sleep apnea (OSA) is associated with considerable morbidity and mortality. This study assessed the prevalence of high risk of OSA and investigated which anthropometric measure best predicts the OSA risk among patients attending a family practice clinic in a tertiary hospital. Methods: We conducted a descriptive cross-sectional study of 362 consecutive patients (64% females; median age of 54 years). OSA risk was assessed by the Berlin Questionnaire and the patients were divided into two groups according to OSA risk: high and low risk. Anthropometric measurements were conducted as stated in the protocol established in the 3rd National Health and Nutrition Examination Survey. Results: Out of 362 participants, 84 [23.2% (95% CI 19.0%, 28.0%)] had high risk of OSA. Subjects with a high risk of OSA had significantly higher body mass index, waist circumference, hip circumference, and waist-to-height ratio (24.9 vs 23.8, p = 0.002; 89.0 vs 84.0, p < 0.001; 95.0 vs 91.0, p < 0.001; 0.56 vs 0.52, p < 0.001, respectively). Body mass index, waist circumference, hip circumference, and waist-to-height ratio performed similarly in predicting high risk of OSA with Area Under the Curve (AUC) of 0.661, 95% CI (0.592,0.730); 0.659, 95% CI (0.596,0.723); 0.668, 95% CI (0.604,0.733); 0.659 95% CI (0.592,0.725) respectively. The AUCs were similar when the analysis was restricted to those who were overweight. Conclusion: High risk of OSA is moderately prevalent in this population, with measures of central and abdominal adiposity equally predicting the risk

Targeting women with free cervical cancer screening: challenges and lessons learnt from Osun state, southwest Nigeria

Introduction: the study was conducted to determine the challenges and suggest solutions to conducting free cervical cancer screening among Nigerian women. Methods: awareness was created among women groups and mass media in Osun State for women to undergo free cervical cancer screening programme. Consenting women had their sociodemographic characteristics, awareness and uptake of HPV vaccine documented and papanicolaou smear procedure done with adequate referral for treatment given where necessary. Results: a total of 287 women had cervical cancer screening. Mean (SD) age was 51.6 (14.3) years. Most participants were urban based (87.1%), married (63.1%), had secondary education (39%) and were traders (79.1%). None of the women were aware of the preventive HPV vaccine or had been vaccinated against HPV. About 6% were pre-invasive while 0.7% had invasive cervical cancer. The highest proportions of respondents affected were young, married and had lower education. Challenges identified included poor attendance, low risk perception and logistic issues. Conclusion: most participants were urban based. There is need to decentralize cancer of cervix screening through mobile clinics and establishment of screening centres in the rural areas. Neighbour to neighbour sensitization is essential. Also, HPV vaccine should be available and affordable to all girls before sexual maturity.The Pan African Medical Journal 2016;2

Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria: A Community-Based Study

Introduction. Cancer of the cervix is the leading cause of cancer deaths among women in developing countries. Screening is one of the most cost effective control strategies for the disease. This study assessed the determinants of cervical cancer screening uptake among Nigerian women. Methodology. This cross-sectional study was conducted using multistage sampling technique among 338 participants in Ilorin, North Central Nigeria. A pretested questionnaire was used for data collection and data analysis was done using SPSS version 21. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis. Statistical significance was set at p<0.05. Results. Only 8.0% of the respondents had ever been screened for cancer of the cervix. The proportion of women who had ever been screened was significantly higher among those who demonstrated positive attitude to screening (81.5%, p=0.001), respondents who were aware of the disease (100.0%, p=0.001), and those who were aware of cervical cancer screening (88.9%, p=0.001). Respondents who had negative attitude had 63% lesser odds of being screened compared to those who had positive attitudes towards screening (AOR; 0.37, 95% CI; 0.01–0.28). Conclusion. There is urgent need to improve the knowledge base and attitude of Nigerian women to enhance cervical cancer screening uptake among them