Adeolu Oladayo Akinboro

Quality of life of Nigerians living with human immunodeficiency virus

Introduction Few reports from Nigeria have examined the quality of life (QOL) of people living with HIV/AIDS (PLWHA) despite the fact that Nigeria has the second largest number of PLWHA in the world. This study evaluated the QOL of Nigerians living with HIV/AIDS using the World Health Organization Quality of Life Questionnaire for HIV-Brief Version (WHOQOL-BREF) instrument and assessed the impact of demographic, laboratory and disease-related variables on QOL. Methods This cross-sectional study involved 491 consecutive PLWHA aged ≥ 18 years attending the dedicated clinic to PLWHA in South-west Nigeria. Results The lowest mean QOL scores were recorded in the environment and social domains. Participants aged ≥ 40 years had better QOL in the environment (p = 0.039) and spirituality (p = 0.033) domains and those in relationships had better QOL in the social relationship domain (p = 0.002). Subjects with no or primary education and those who rated their health status as good gave significantly higher ratings in all QOL domains. Participants with AIDS had significant lower QOL in the level of independence domain (p = 0.018) and those with CD4 count ≥ 350 cells /mm3 had better QOL scores in the physical, psychological and level of independence domains. Subjects without tuberculosis co-infection and those on antiretroviral therapy (ART) reported significantly better QOL in the physical, psychological, level of independence and spirituality domains. Conclusion Marital relationship, absence of tuberculosis, CD4 count ≥ 350 cells /mm3 and use of ART positively impacted QOL of our patients.

The impacts of first line highly active antiretroviral therapy on serum selenium, cd4 count and body mass index: a cross sectional and short prospective study

Introduction The relationship that exists between body weights, serum selenium and immunological markers of HIV/AIDS continue to provoke more researches in the recent times. The objectives of this study were to examine baseline body mass index, CD4 count and serum selenium and to prospectively assess the impacts of HAART on same parameters 48 weeks post HAART among HIV patients. Methods A cohort comprising 140 newly diagnosed HIV positive were prospectively studied. Anthropometric measurements, serum selenium and CD4 count were assessed at diagnosis and 48 weeks post HAART. Results The mean age for patients was 35±8.8 years; 68% was female. Patients’ mean weight was 56.79±10.22kg, BMI; 21.59±3.53, serum selenium; 0.55 ± 0.45µmol/L and CD4 count; 288.36 ± 232.23 at the baseline. At diagnosis, 47 (33.6%) were in stage 1, 49 (35.0%) in stage 2, 26 (18.6%) and 18 (12.9%) were in stage 3 and 4 respectively. Similarly, most patients had normal body mass index, 94 (67.14%), 26 (18.57%) were underweight, (12.86%) were overweight and two (1.43%) were obese at diagnosis. At 48 weeks post HAART, the mean weight, BMI, serum selenium and CD4 count were significantly increased. Conclusion HAART repleted CD4 count and serum selenium, Post HAART overweight was associated with lesser CD4 count reconstitution and selenium repletion. A renew call for weight monitoring in HAART era.

Frequency, pattern, and extent of skin diseases in relation to CD4+ cell count among adults with human immunodeficiency virus infection or acquired immunodeficiency syndrome in Osogbo, southwestern Nigeria

Skin diseases characterize all stages of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) and contribute significantly to associated morbidity and mortality.

Spectrum of skin diseases presented at LAUTECH Teaching Hospital, Osogbo, southwest Nigeria.

Patterns of skin disease in developing nations are changing as frequencies of non‐communicable diseases continue to increase. Appraisal of the current status of the disease profile is of utmost importance for health planning and resource allocation.

The Prevalence, Risk Factors and Changes in Symptoms of Self Reported Asthma, Rhinitis and Eczema Among Pregnant Women in Ogbomoso, Nigeria.

BACKGROUND Allergic disorders have become a major public health concern worldwide. No Nigerian study has examined the epidemiology of allergic diseases among women. AIM To document the prevalence, risk factors and the changes in the symptoms of allergic disorders during pregnancy. SETTINGS AND DESIGN Cross-sectional study conducted at the booking and antenatal clinics of LAUTECH Teaching Hospital and Millennium Development Goals (MDG) Clinic of the Comprehensive Health Center, Oja Igbo, Ogbomoso, Nigeria. MATERIALS AND METHODS Study enrolled 432 women from two public hospitals. Sociodemographic and clinical history were obtained and allergic disorders were diagnosed using ISAAC questionnaires. RESULTS The prevalence of wheezing, eczema and rhinitis in pregnancy are 7.5%, 4.0% and 5.8% respectively. The prevalence of wheezing and eczema was slightly higher among the pregnant in past 12 months. Wheeze worsened in 70% (18/26), improved in 15% (2/26), and stable in 15% (2/26). Eczema worsened in 50% (7/14), improved in 7.1% (1/14) and stable in 42.9% (6/14), while allergic rhinitis worsened in 50% (11/22), improved in 22.7% (5/22) and stabilized in 27.3 % (6/22). In multivariate analysis, the risk of allergic diseases in pregnancy was increase 2 times by low income earning (CI: 1.2 - 2.1, p = 0.002), low level education (OR = 0.6, CI: 0.3 - 0.9, p = 0.011) and by family history of asthma, OR-4.3, CI - 1.3 - 13.9, p = 0.015. Family history of asthma increase the chances of asthma by 18.7 times, CI-2.3 - 152.2, p = 0.006, while the odd of eczema was increased 9.1 times (CI-2.7 - 30.6, p<0.001) and 2.4 times (CI: 1.2 - 4.7, p = 0.008) by second hand home smoking and low-family income respectively. The risk of allergic rhinitis were raised 1.8 times by low family income (CI 1.1 - 2.8, p = 0.013) and 3.9 times by family history of rhinitis (OR = 3.9, CI 1.2 - 12.7, p = 0.024). CONCLUSION Prevalence of wheezing and eczema are higher in pregnancy probably due to exacerbation induced by pregnancy. Social and genetic factors are important risk factors for allergic disorders in pregnancy.

Prevalence of end-digit preference in recorded blood pressure by nurses: a comparison of measurements taken by mercury and electronic blood pressure-measuring devices

Abstract Objectives: When compared with the use of a mercury sphygmomanometer, the use of a validated digital blood pressure (BP) measuring device eliminates the risk of exposure to mercury. Digital devices are also associated with a lesser degree of end-digit preference (EDP). EDP refers to the occurrence of a particular end digit more frequently than would be expected through chance alone. There have been only a few reports from Africa on the occurrence of EDP in BP measurement. This study examined EDP in BP taken by nurses before and after the introduction of a digital BP-measuring device. Design: The design was a retrospective study. Settings and subjects: We reviewed the BP readings of 458 patients who presented at the dedicated clinic for people living with human immunodeficiency virus/acquired immune deficiency syndrome of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria, before and after the introduction of the digital BP-measuring device. Outcome measures: The prevalence of end-digit zero of systolic and diastolic BP readings before and after the introduction of the digital device was compared using McNemars test. Results: There was a large and significant fall in end-digit zero when BP readings that were taken using the mercury and digital devices were compared (systolic 98.1% vs. 10.9%, p-value < 0.001; diastolic 97.1% vs. 14.9%, p-value < 0.001 (McNemars test). Conclusion: There was a significant reduction in the frequency of end-digit zero when BP was taken with the digital device rather than the mercury device. Regular training and certification of healthcare workers in BP measurement is recommended to ensure a high quality BP measurement standard.

Idiopathic scrotal calcinosis: report of 2 cases, and review of pathogenesis and factors that determine patients’ acceptance of surgical treatment

Introduction Idiopathic scrotal calcinosis is a benign and rare disease of the scrotal skin that presents as solitary or multiple asymptomatic calcified nodules in the absence of systemic disorders of calcium/phosphorus balance. Case reports We report the management of 2 cases and review the literature with comments on factors that determine acceptance or otherwise of surgical treatment. Our patients were 29 and 33 years old and presented with nodular scrotal lesions. Through multiple elliptical incisions, all nodules were excised from patient 1, but patient 2 refused surgery. Reasons for rejection included fear of future reproductive performances. Histology shows calcium deposition in basophilic globules of varying sizes and shapes within the reticular dermis, multinucleated giant cells, dense collagenous stroma, areas of fibrosis, and sparse lymphocytic infiltrate. Conclusion In the management of idiopathic scrotal calcinosis, factors that determine acceptance of surgical treatment could include impaired quality of life, reduced self-esteem, fear of future sexual dysfunction, and development of complications.

The impact of acne and facial post-inflammatory hyperpigmentation on quality of life and self-esteem of newly admitted Nigerian undergraduates

Background Acne and facial post-inflammatory hyperpigmentation are relatively common clinical conditions among adolescents and young adults, and inflict psychosocial injuries on sufferers. Objective To document the psychosocial and self-esteem implications of acne and facial hyperpigmentation on newly admitted undergraduates. Materials and methods A cross-sectional survey was conducted among 200 undergraduates. Demographics and clinical characteristics were obtained and acne was graded using the US Food and Drug Administration 5-category global system of acne classification. Participants completed the Cardiff Acne Disability Index (CADI) and the Rosenberg self-esteem scale (RSES), and data were analyzed using SPSS 20. Results Mean age of acne onset was 16.24 ± 3.32 years. There were 168 (84.0%) cases categorized as almost clear, 24 (12.0%) as mild acne, 4 (2.0%) as moderate acne and 4 (2.0%) as severe acne. Acne with facial hyperpigmentation, compared to acne without hyperpigmentation, was associated with significant level of anxiety in 30 participants (26.5% vs 10.3%, p=0.004) and emotional distress in 40 (35.4% vs 10.3%, p<0.001). Acne severity correlated with total CADI score but not with total RSES score. Quality of life (QoL) was significantly reduced among acne patients with facial hyperpigmentation (1.77±1.62, vs 1.07±1.02, p<0.001) compared to those without hyperpigmentation. Acne and facial hyperpigmentation was associated with social life interference, avoidance of public facilities, poor body image and self-esteem and perception of worse disease. There was no association between gender and QoL but acne was related to a reduction of self-worth. Low self-esteem was present in 1.5%, and severe acne was associated with an occasional feeling of uselessness in the male gender. Conclusion Acne with facial hyperpigmentation induces poorer QoL and self-esteem is impaired only in severe acne. Beyond the medical treatment of acne, dermatologists should routinely assess the QoL and give attention to treatment of facial post-inflammatory hyperpigmentation among people of color.

Adherence to antiretroviral therapy: prevalence, determinants and impact on body weight and immunological recovery among people living with human immunodeficiency virus in Osogbo, Nigeria.

Background: antiretroviral therapy has changed the outlook of AIDS. However, identifying factors that will strengthen its maintenance is vital to treatment success. Advocacy is growing on the need for close attention to immunological progress, prevention of excessive body weight gain and associated immunological and metabolic

Serum selenium and skin diseases among Nigerians with human immunodeficiency virus/acquired immune deficiency syndrome

Background The role of selenium as an antioxidant micronutrient has garnered the unprecedented focus of researchers in recent times. No clinical study has related serum selenium concentration to skin diseases in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. Methods In this study, 134 newly diagnosed HIV patients that satisfied the inclusion criteria were included. Skin diseases were clinically diagnosed and fasting venous blood was taken for assessment of serum selenium using an atomic absorption spectrophotometer. Results The mean age of HIV subjects with and without skin disease were not significantly different: 32.72 ± 9.21 versus 35.86 ± 8.55 years, P = 0.077, respectively. The mean of serum selenium (0.51 ± 0.48 versus 0.81 ± 0.39), CD4+ count (228.06 ± 212.89 versus 446.41 ± 182.87), and body mass index (BMI; 21.09 ± 3.58 versus 23.53 ± 3.35) were significantly lower (P < 0.001) for HIV/AIDS participants with skin disease than those without skin disease. We found significant clustering of symptoms and signs: fever (P = 0.037), weight loss (P = 0.009), oral candidiasis (P = 0.038), pallor (P = 0.037) among HIV/AIDS subjects with skin diseases than those without. Low serum selenium concentration was significantly associated with primary skin disease of HIV/AIDS, such as pruritic papular eruption of AIDS (P = 0.003), xeroderma (P = 0.030), fluffy hair (P = 0.021), blue-black nail hyperpigmentation (P = 0.033) and secondary skin disease, such as oral candidiasis (P = 0.002). There was a significant association between low serum selenium concentration and increasing frequency of skin diseases (P = 0.002), but serum selenium was not significantly related to extents of distribution of skin diseases (P > 0.05). Conclusion serum selenium concentration was lower among HIV subjects with skin diseases than those without skin disease. Pruritic papular eruption, xeroderma, fluffy hair, blue-black nail hyper pigmentation, and oral candidiasis were significantly associated with low serum selenium concentration.