Choice of antihypertensive medications among physicians and its impact on blood pressure control among Nigerians living with hypertension

Background: Hypertension, if untreated or uncontrolled, leads to damage of vital organs such as the brain, heart and the kidneys among others. These complications have been shown to be severer in black Africans. Benefit of treatment has been repeatedly demonstrated by many studies. Therefore, many guidelines have been produced by relevant bodies in different countries in order to assist physicians in making the right choices for blood pressure (BP) control. Most of these bodies produce the guidelines based on the peculiarities of hypertension in their respective population. Several reports have shown how different hypertension is, in black Africans, still there is no published unified guideline for its treatment in this population.Methods: This was a survey of known hypertensives who were on follow up visit. Their prescriptions were assessed for drug name, class and number. Their blood pressures at that visit were also recorded. Prevalence of single therapy and combination therapy were determined. Compliance with the AHA recommended 2 – drug combination was determined. The percentage of BP control as well as the prescribed drugs in each group were also obtained.Results: Those on single agents were 13% out of which 52% were controlled. 87% were on various combination of 2 or more drugs of whom 41.9% of those on 2 drugs and 21.1% of those on more than 2 drugs had controlled BP. BP control in those on 2 drugs was better than in those with > 2 drugs, (p=0.0027).ACEI were the commonest used drug either as single agent (55.9%) or as 2 – drug combination as seen in 54.8% of the subjects on 2 – drug combination. 13 different 2 – drug combinations were identified with the best control in ARB + Diuretic, ACEI + Diuretic and CCB + Diuretic. The least control was observed in the ACEI + CCB group. Compliance with AHA recommendation was good but still 7.7% were under unacceptable group while another 7.7% were unclassified.Conclusion: ACE-Is are becoming the drugs of choice both as monotherapy and as combination therapy. Despite good compliance to AHA recommendation on drug combination, overall control is still a problem which calls for a revisit of these recommendations in Africans.Keywords: Ahtihypertensives; Physicians; Impact; Blood Pressure; Nigerian

Abattoirs – A Hidden Centre for Livestock Genetic Resources Loss in Nigeria

Nigeria is naturally blessed with wide diversity of native animal genetic resources. Indigenous ruminant livestock such as cattle, camel, donkey, sheep and goat contributes largely in both protein supply, revenue generation and national economy. In Nigeria, these animal resources are mismanaged and undermined through the indiscriminate slaughter of pregnant animals and foetal losses in abattoirs. This unethical practice resulted in the loss of genetic diversity, preferred traits and superior females ruminant animals. The current research focus on reported incidences across abattoirs, which is a centre where such practice is highly occurs within the country.  Lack of modern facilities, law enforcement, poor management and animal welfare in abattoirs to protect pregnant animals are among few factors responsible for an increase in incidences. It is unprofitable to continue the tradition of pregnant animal slaughter that causes foetal losses. This is a condition that significantly threatens the animal genetic resources and general livestock industry in Nigeria. This practice must be discard with a proper conservation and documentation of these valuable animal genetic resources. Both long and short terms conservation programs must aim for substantial benefits of these resources. Laws must be enforced with strict penalties to those involved in pregnant animal slaughter. Genetic resources of these species and meat industry future could be safe with proper implementation of these laws and conservation measures

Prevalence and Outcome of Increased Nuchal Translucency in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria: A Cohort Study

Background: An important component of the first‑trimester scan is nuchal translucency thickness at 11 weeks to 13 weeks 6 days of gestation. A nuchal translucency ≥3.3 mm is a significant early pregnancy scan finding associated with Trisomies 13, 18, and 21 and congenital heart diseases. Aims: To determine the prevalence and outcome of increased fetal nuchal translucency among pregnant women. Subjects and Methods: A prospective cohort study at the Obstetrics and Gynaecology Department of Usmanu Danfodiyo University Teaching Hospital Sokoto. This was a prospective study of 265 consecutively recruited women in the first trimester of pregnancy who presented to antenatal clinics over a 20‑week period. An NT scan was conducted at 11 weeks to 13 weeks 6 days followed by an anomaly scan at 18–22 weeks. Patients were followed up to delivery and 6‑week post‑partum. The neonates were examined at delivery and at 6‑week postnatal life. Data entry and analysis was done with IBM SPSS version 20. The level of significance was set at less than 0.05. Frequency distribution; student t‑test and Chi‑squared test. Results: The 95th percentile NT was 3.3 mm and the prevalence of increased  NT above 3.3 mm was 3%. The mean maternal age of the participants was28.1 ± 5.1 years and the modal parity was Para 0. The most common anomalies associated with increased NT were ventricular septal defect and spina bifida. A congenital anomaly was significantly associated with increased NT (P <0.001). Conclusions: The prevalence of increased fetal nuchal translucency is relatively high in our environment and is associated with congenital fetal defects. Routine screening with first‑trimester ultrasound will help detect congenital anomalies early