Gestational headaches: characteristics and influencing factors in South-Western Nigeria

Background: Headache is one of the common neurological diseases in pregnancy but its pattern and influencing factors are yet to be determined in our environment in Nigeria. The aim of this study was to determine the prevalence and characteristics, as well as the modifying factors for gestational headaches in Ogbomoşo, Nigeria.Methods: This study was a bi-institutional cross-sectional descriptive study. Three hundred and eight (308) eligible pregnant women attending the ante-natal care of the Ladoke Akintola University of Technology and Ogbomoso South local government hospitals in Ogbomoso were recruited consecutively, between November10, 2012 and February 28, 2013. Using an interviewer administered questionnaire, socio-demographic, obstetrics and headache related variables were obtained from eligible pregnant women. Gestational headaches were characterized using the international classification of headache disorders II (ICHD-II). The prevalence of migraine and tension type headache were determined before and during pregnancy. Improvement rates (defined by reduced headache frequency and severity) were determined.Results: The prevalence of Headaches before and during pregnancy was 25% and 23.3% respectively (P = 0.661).Migraine prevalence was 8.4% and 5.5% before and during pregnancy respectively (P = 0.34); while the prevalence of Tension-Type Headaches (TTH) was 16.5% and 17.9% before and during pregnancy (P = 0.63). Improvement rate was 100% for migraine and 85.5% for TTH. Multiple logistic regressions revealed that poor personal income, unemployment and multi-parity were predictive factors for headaches in pregnancy.  Conclusions: Migraine and Tension type headaches were prevalent in this population and they are worsened by poor personal income, unemployment and multi-parity. Interventions and programs to subsidize antenatal care may prevent gestational headaches in this population.

Snoring and obstructive sleep apnoea syndrome among hypertensive Nigerians: Prevalence and clinical correlates

Background: Obstructive sleep apnoea (OSA) syndrome is a common disorder in the community. Association between hypertension and sleep apnoea and /or snoring has been described. The Berlin questionnaire is a validated instrument that is used to identify individuals who are at risk for OSA. The study aim to describe the prevalence of snoring and OSA among hypertensive subjects in South Western, Nigeria. Methods: This was a descriptive study conducted at the Cardiology clinic of Ladoke Akintola University of Technology LAUTECH Teaching Hospital, Osogbo, South West Nigeria. One hundred consecutive hypertensive patients were recruited from the clinic. The Berlin questionnaire and the Epworth sleepiness scale (ESS) were used to determine excessive daytime sleepiness and the risk of having OSA. Statistical analysis was done using SPSS 16.0. Data were summarized as means ± S.D and percentages. Results: The study participants consisted of 40 males (40.0%). The demographic data were similar between both genders except that females had higher mean body mass index than males. The prevalence of snoring was 50.0%. 52% were categorized as being at high risk of having OSA. Snorers were more likely to be older, males and to have a higher fasting blood sugar than non-snorers.96% of snorers reported excessive daytime somnolence as predicted by the ESS score compared to 4% of non snorers. Prevalence of snoring was also higher among overweight and obese hypertensive subjects than normal body mass index hypertensive subjects. Conclusion: Snoring is common among hypertensive subjects in South Western Nigeria. Clinically suspected OSA was similarly high in prevalence among them. Early identification and management may reduce the cardiovascular risk of hypertensive subjects

The impact of systemic hypertension on outcomes in hospitalized COVID-19 patients – a systematic review

Background: Several observational reports from different parts of the world have shown that systemic hypertension (hypertension) was the single commonest comorbid condition in hospitalized COVID-19 patients. Hypertension is also the most prevalent comorbidity reported among patients who developed severe disease, were admitted to Intensive Care Unit, needed mechanical ventilatory support, or who died on admission. The objective of this systematic review is to study the association between hypertension and specific clinical outcomes of COVID-19 disease which are- development of severe COVID-19 disease, need foradmission in the intensive care unit (ICU) or critical care unit (CCU), need for mechanical ventilation or death Methods: We searched the PubMed, SCOPUS, and Google Scholar databases up till June 28, 2020 for original research articles that documented the risk factors of mortality in patients with COVID-19 using the PRISMA guideline. Results: One hundred and eighty-two articles were identified using pre-specified search criteria, of which 33 met the study inclusion criteria. Only three were prospective studies. Most studies documented hypertension as the most prevalent comorbidity. The association of hypertension with development of severe COVID-19 disease was not conclusive, majority of studies however found an associated with mortality. Conclusion: Hypertension affects the clinical course and outcome of COVID-19 disease in many cohorts. Prospective studies are needed to further understand this relationship. Keywords: Hypertension and COVID-19; SARS –Cov-2; severity; mortality; ICU care; mechanical ventilation

The clinical value of the Tei index among Nigerians with hypertensive heart failure: correlation with other conventional indices

BACKGROUND: Various conventional methods are used for functional evaluation and risk stratification in heart failure. A combined index of global myocardial performance called the Tei index has been described. The aim of this study was to evaluate the correlation of the Tei index with other conventional indices of systolic and diastolic function among Nigerians with hypertensive heart failure. METHODS: Fifty-five subjects with hypertensive heart failure and 30 controls were examined, a clinical history was taken, and echocardiography was performed on them. The subjects were categorised into four groups based on their ejection fraction (normal ejection fraction, mild, moderate and severe heart failure). The Tei index was calculated as the sum of the isovolumic relaxation and contraction time, divided by the ejection time. Statistical analysis was done using SPSS 16.0. RESULTS: The Tei index was significantly higher among subjects with hypertensive heart failure compared with the controls (0.91 ± 0.33 vs 0.28 ± 0.16, p < 0.005). The Tei index also increased with the severity of the heart failure and was inversely correlated with ejection fraction (r = –0.697, p < 0.001) and fractional shortening (r = –0.580, p = 0.001). It was directly correlated with mitral E/A ratio (r = 0.246, p = 0.030), left ventricular internal diastolic dimension (r = 0.414, p = 0.002), left ventricular internal systolic dimension (r = 0.596, p < 0.001) and deceleration time (r = 0.219, p = 0.032). CONCLUSION: The Tei index correlated significantly with other conventional indices of systolic and diastolic function among Nigerians with hypertensive heart failure. It can be used as a risk-stratification index similar to other traditional indices of systolic and diastolic function

Anthropometric differences among natives of Abuja living in urban and rural communities: correlations with other cardiovascular risk factors

Background: There is an increase of obesity and other cardiovascular risk factors worldwide, but especially in developing countries where multifaceted transitions are occurring. There is need for more evidence for the cardiometabolic effect of changing lifestyles and urbanization in Nigeria. This study aimed at defining rural–urban differences in anthropometric parameters in two Nigerian communities of the same ancestral origin and to determine the cardiovascular risk correlates of these anthropometric measurements. This was a cross-sectional epidemiological study using stratified cluster sampling method. We studied 335 and 332 urban and rural dwellers respectively. A complete cardiovascular profile as well as anthropometric measurements was compared between the two populations. Results: All anthropometric indices considered in this study (weight, BMI, waist circumference, waist circumference/ height ratio, abdominal height; biceps, triceps, sub-scapular, abdominal, superior iliac skinfold thicknesses) were significantly higher in urban than in the rural population (p = \u3c0.001). Overweight, obesity and hypertension were significantly prevalent among the urban population (p = \u3c0.001) while there was no significant difference in the prevalence of dyslipidaemia (p = 0.096) and diabetes (p = 0.083) between the two cohorts. Females tend to have a higher chance of obesity than males although there was no gender difference in waist circumference and central skin fold thickness in the rural population. Age was the significant predictor of systolic blood pressure among the rural (R2 = 0.157, β = 0.258, p = 0.016) and urban female population (R2 = 0.201, β = 0.351, p= \u3c0.001) while Abdominal height (R2 = 0.16, β =0.281, p=0.001) and waist circumference (R2 = 0.064 β = 0.064, p= .003) were predictors of systolic blood pressure in urban and rural men respectively. Conclusion: Anthropometric indices were significantly higher among the urban than the rural populations. Cardiovascular risks were equally more prevalent among the urban population. Appropriate health education and lifestyle modification strategies may reduce the increased burden of cardiovascular risk factors associated with rural–urban migration

Gestational headaches: characteristics and influencing factors in South-Western Nigeria

Background: factor s Headache is one of the common neurological diseases in pregnancy but its pattern and influencing are yet to be determined in our environment in Nigeria. The aim of this study was to determine the prevalence and characteristics, as well as the modifying factors for gestational headaches in Ogbomoşo, Nigeria. Methods: This study was a biinsti pregnant women attending the antetutional crosssectional descriptive study. Three hundred and eight (308) eligible natal care of the Ladoke Akintola University of T local government hospitals in Ogbomoso were recruited consecu 2013. Using an interviewer administered questionnaire, sociodemographic, obstetrics and headache related variables were obtained from eligible pregnant women. Gestational headaches were characterized using classification of headache disorders II (ICHD determined before and duriII). ng pregnancy. Improvement rates (d were determined. Results: The prevalence of Headaches before and during pregnancy w 0.661).Migraine prevalence was 8.4% and 5.5% before and prevalence of Tension Conclusions:Type Headaches (TTH) was echnology and Ogbomoso South tively, between November10, 2012 and February 28, the international The prevalence of migraine and tension type headache were efined by reduced headache frequency and severity) as 25% and 23.3% respectively (P during pregnancy respectively (P = = 0.34); while the 16.5% and 17.9 % before and during pregnancy (P 0.63). Improvement rate was 100% for migraine and 85.5% for TTH. Multiple logistic regressions revealed that poor personal income, unemployment and multi-parity were predictive factors for headaches in pregnancy. = Migraine and Tension type headaches were prevalent in this population and they are worsened by poor personal income, unemployment and multiparity. Interventions and programs to subsidize antenatal care may prevent gestational headaches in this population

Gestational headaches: characteristics and influencing factors in SouthWestern Nigeria

Background: factor s Headache is one of the common neurological diseases in pregnancy but its pattern and influencing are yet to be determined in our environment in Nigeria. The aim of this study was to determine the prevalence and characteristics, as well as the modifying factors for gestational headaches in Ogbomoşo, Nigeria. Methods: This study was a biinsti pregnant women attending the antetutional crosssectional descriptive study. Three hundred and eight (308) eligible natal care of the Ladoke Akintola University of T local government hospitals in Ogbomoso were recruited consecu 2013. Using an interviewer administered questionnaire, sociodemographic, obstetrics and headache related variables were obtained from eligible pregnant women. Gestational headaches were characterized using classification of headache disorders II (ICHD determined before and duriII). ng pregnancy. Improvement rates (d were determined. Results: The prevalence of Headaches before and during pregnancy w 0.661).Migraine prevalence was 8.4% and 5.5% before and prevalence of Tension Conclusions:Type Headaches (TTH) was echnology and Ogbomoso South tively, between November10, 2012 and February 28, the international The prevalence of migraine and tension type headache were efined by reduced headache frequency and severity) as 25% and 23.3% respectively (P during pregnancy respectively (P = = 0.34); while the 16.5% and 17.9 % before and during pregnancy (P 0.63). Improvement rate was 100% for migraine and 85.5% for TTH. Multiple logistic regressions revealed that poor personal income, unemployment and multi-parity were predictive factors for headaches in pregnancy. = Migraine and Tension type headaches were prevalent in this population and they are worsened by poor personal income, unemployment and multiparity. Interventions and programs to subsidize antenatal care may prevent gestational headaches in this population

Task Sharing and Task Shifting (TSTS) in the Management of Africans with Hypertension: A Call For Action-Possibilities and Its Challenges

Hypertension is a leading cause of mortality globally and one of the most common risk factors for cardiovascular disease. Diagnosis, awareness, and optimal treatment rates are suboptimal, especially in low- and middle-income countries, with attendant high health consequences and grave socioeconomic impact. There is an enormous gap between disease burden and physician-patient ratios that needs to be bridged. Task sharing and task shifting (TSTS) provide a viable temporary solution. However, sociocultural, demographic, and economic factors influence the effective uptake of such interventions. This review discusses the dynamics of TSTS in the African context looking at challenges, feasibility, and approach to adopt it in the management of hypertension in Africa