Comparison of Serum Calcium Level in Hypertensive and Normotensive Pregnant Women

Background: Calcium deficiency in pregnancy is linked to the risk of development of hypertensive disorders of pregnancy. At present,hypertensive disorders of pregnancy are among leading causes of maternal death in Nigeria. This study was aimed to compare the serumcalcium level of women with hypertensive disorders of pregnancy and normotensive controls. Methodology: This was a comparative descriptive study among patients with hypertensive disorders of pregnancy (45 pre‑eclampsia [PE] and 45 gestational hypertension [GH]) and comparative group of 45 normotensive pregnant women at Federal Medical Center, Abeokuta. Results: The serum calcium level in normotensive controls (mean ± standard deviation) was 2.64 ± 1.38 mmol/l, women with GH was 2.39 ± 1.15 mmol/l, and PE was 2.08 ± 0.76 mmol/l (P = 0.065). Hypocalcemia was found to have an incidence rate of 33% in normotensive  controls, 51.1% among GH, and 51.1% among PE. Conclusion: Pregnant women with hypertensive disorders of pregnancy showed nonsignificant difference in mean serum calcium level. Keywords: Calcium, gestational hypertension, hypertensive, normotensive, preeclampsi

Economic burden of heart failure: investigating outpatient and inpatient costs in abeokuta, southwest Nigeria

Background: Heart failure (HF) is a deadly, disabling and often costly syndrome world-wide. Unfortunately, there is a paucity of data describing its economic impact in sub Saharan Africa; a region in which the number of relatively younger cases will inevitably rise. Methods: Heath economic data were extracted from a prospective HF registry in a tertiary hospital situated in Abeokuta, southwest Nigeria. Outpatient and inpatient costs were computed from a representative cohort of 239 HF cases including personnel, diagnostic and treatment resources used for their management over a 12-month period. Indirect costs were also calculated. The annual cost per person was then calculated. Results: Mean age of the cohort was 58.0±15.1 years and 53.1% were men. The total computed cost of care of HF in Abeokuta was 76, 288,845 Nigerian Naira (US$508, 595) translating to 319,200 Naira (US$2,128 US Dollars) per patient per year. The total cost of in-patient care (46% of total health care expenditure) was estimated as 34,996,477 Naira (about 301,230 US dollars). This comprised of 17,899,977 Naira- 50.9% ($US114,600) and 17,806,500 naira −49.1$US118,710) for direct and in-direct costs respectively. Out-patient cost was estimated as 41,292,368 Naira ($US 275,282). The relatively high cost of outpatient care was largely due to cost of transportation for monthly follow up visits. Payments were mostly made through out-of-pocket spending. Conclusion: The economic burden of HF in Nigeria is particularly high considering, the relatively young age of affected cases, a minimum wage of 18,000 Naira ($US120) per month and considerable component of out-of-pocket spending for those affected. Health reforms designed to mitigate the individual to societal burden imposed by the syndrome are required

Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans

Background Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans. Objectives The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS). Results Patients\u27 mean age was 58.4 ± 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p = 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p = 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02). Conclusions About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability

Shows summary of the cost components.

<p>Shows summary of the cost components.</p

Components of direct cost (In-patient).

<p>Components of direct cost (In-patient).</p

Cost of investigations (In-patient).

<p>Note: Cost based on the hospital costing list for 2009.</p><p>Note: Calculation based on those that survived, it is assumed that same proportion on admission.</p><p>performed these investigations during follow up.</p><p>Cost of investigations (In-patient).</p

Indirect cost (In-patient/outpatient).

<p>Note: Income loss was based on 5 working days in a week, **Income loss was based on median Los of 9 days.</p><p>Note: *Assigned the minimum wage in Nigeria, Income loss was based on 5 working days in a week,</p><p>Because most mortality occurred early, it was assumed that 205 subjects completed follow up, 1dollar  = 150Nigerian Naira.</p><p>Indirect cost (In-patient/outpatient).</p

Summary of various aspects of costs of in-patient/out-patient care.

<p>Summary of various aspects of costs of in-patient/out-patient care.</p

Components of direct cost (out-patient).

<p>Components of direct cost (out-patient).</p