Ei Unuigbe

Tetanus: an analysis of the prognosticating factors of cases seen in a tertiary hospital in a developing African country between 1990 and 2000

This is an analysis of the effects of prognosticating factors on the outcome of a case series of 66 patients with tetanus, presenting between 1990 and 2000. The mortality rate was 26.2% with a fatality rate of 16.2% for those under 40 years of age. This increased to 75% for those patients above 70 years of age. The socio-economic status, immunization status, the incubation period, and age of the patient together with the severity of the spasms, duration of hospital stay, type of treatment received and time of onset were found to affect the outcome of the patients.

Dyslipidemias in type 2 diabetes mellitus patients in Nnewi South-East Nigeria

BACKGROUND Dyslipidemia has been noted to play an integral role in the pathogenesis and progression of micro and macrovascular complications in diabetes mellitus patients. The complications exemplified by renal vascular and cardiovascular disease cause the most morbidity and mortality in this group of patients. OBJECTIVE This study is aimed at understanding the pattern of dyslipidemia among type 2 diabetic patients. MATERIALS AND METHODS A total of 108 consenting adult type 2 diabetic patients seen in the medical unit of the Nnamdi Azikiwe University Teaching Hospital Nnewi were evaluated in this crosssectional study. Their fasting lipid profile, fasting blood glucose, weight, height and blood pressure were evaluated. RESULT The prevalence of dyslipidemia (at least one abnormal lipid profile) was 90.7%. The 24.1% had single dyslipidemia while 66.6% had combined dyslipidemia. Reduced HDL constituted the highest single abnormality (62%) followed by hypertriglyceridemia (56.5%), hypercholesterolemia (53.7%) and high LDL in (44.4%). The duration of DM was not significantly associated with dyslipidemia (P > 0.05). CONCLUSION Dyslipidemia is highly prevalent among type 2 diabetic patients in Nigeria with the majority of the patients having combined dyslipidemia. We recommend that aggressive treatment of lipidemia and hyperglycemia can be instituted to reduce the risk of macro and microvascular complications.

Serum Lipids in Patients with Stroke—A Cross-Sectional Case-Control Study

BACKGROUND Vascular disease remains the prime contributor to the pathogenesis of stroke, but dyslipidemia has not been clearly established as a risk factor for stroke the same way it has been for coronary artery disease. There is no case-controlled study on the contribution of serum lipids to stroke in Nigerians. This study aimed at assessing the possibility of serum lipids as risk factor for stroke in Nigerian patients. METHOD The demography, blood pressure, fasting plasma glucose and fasting serum lipids of 87 consecutive patients with first-ever stroke managed at the University of Benin teaching hospital between January and December 2005 were analyzed and compared with those of age- and sex-matched controls. RESULTS Eighty-seven stroke patients (55 males and 32 females; mean age 61.25 +/- 14.77 years) were compared with age- and sex-matched controls. Ischemic stroke constituted 64.37%, while the rest had hemorrhagic stroke. There were no significant differences in the serum cholesterol, HDL-C and LDL-C levels of stroke patients and controls (p > 0.05), but the serum triglyceride level was higher among the stroke patients (p < 0.001) with a significant relative risk (RR = 1.77; p < 0.01). CONCLUSION In this cross-sectional case-control study, there is no significant difference in the serum lipids of Nigerian patients with stroke with the exception of serum triglyceride, which seems to confer significant stroke risk.

Prevalence and correlates of chronic kidney disease among civil servants in Bayelsa state, Nigeria.

INTRODUCTION Chronic kidney disease (CKD) has become a public health problem with rising incidence and prevalence world-wide. Despite the fact that Sub-Saharan Africa, including Nigeria appears to be badly hit by this epidemic, there is a paucity of data on CKD prevalence in these regions and where data exists, they are mostly hospital-based. OBJECTIVES The present study was carried out to determine the prevalence and correlates of CKD in an urban civil service population in Bayelsa State, Nigeria. MATERIALS AND METHODS A total of 179 civil servants in the Bayelsa State secretariat were screened for CKD during the World Kidney Day on March 2012. CKD was defined as estimated glomerular filtration rate <60 ml/min/1.73 m 2 body surface area and/or proteinuria. Socio-demographic data was obtained using interviewer-administered semi-structured questionnaire while anthropometric measurements were taken. Blood pressure (BP), urinalysis, serum urea and creatinine were also assessed. RESULTS The prevalence of CKD in the study was 7.8%. Age >50 years was associated with CKD in univariate analysis but none of age, gender, body mass index, BP or hyperglycemia independently predicted it. CONCLUSION The prevalence of CKD among Nigerian civil servants was fairly high and was associated with advancing age. Routine screening for CKD in this population is recommended.

Screening for risk factors of chronic kidney disease in a community in Niger Delta Nigeria

BACKGROUND Chronic kidney disease (CKD) is associated with many traditional and nontraditional risk factors. Screening for these risk factors has been associated with appropriate interventions and preventive measures in the management of CKD. The aims and objective of this study are to screen for risk factors of CKD in a Niger Delta community in Nigeria. SUBJECTS AND METHODS This was a cross-sectional study. The study location was Ido, a Niger Delta community in Rivers State. All subjects aged 18 years and above who gave consent were recruited for the study. Their bio data, relevant medical history, clinical and laboratory parameters were documented. The obtained data were analyzed with SPSS versions 17.0. RESULTS A total of 105 persons participated in the study. The age range was 18-86 years, 50.5% were above 50 years. Females were 75.0%, 66.7% had either primary or no education, 14.6% were retiree and 40.4% were traders. 14.1% were known hypertensive, and 39.4% had elevated blood pressure. 6.1% were known diabetic and 6.1% had random blood sugar of 200 mg/dl and above. 27.2% of subjects were obese. About 10.5% and 27.8% had a history of significant intake of tobacco and alcohol respectively. Total serum cholesterol was higher than 200 mg/dl in 51.5%. None of the participants had past or family history of kidney disease. CONCLUSION The prevalence of risk factors for CKD in the Niger Delta community is high.

Screening for kidney disease in an oil producing community in Nigeria: A pilot study

Petroleum products have been associated with acute and chronic kidney disease. Nigeria is a major oil producing and exporting country. The aim of this study was to screen for kidney disease in an oil producing community in Nigeria. This was a cross-sectional study carried out in Ido, Asari-Toru Local Government Area of Rivers State. All subjects were resident in the town and those aged 18 years and above were eligible. Spot urine samples were collected for dipstick urinalysis, and venous blood was collected for estimation of serum electrolyte, urea, creatinine, and lipid profile. The estimated glomerular filtration rate (eGFR) was calculated using the Cockcroft and Gault formula. A total of 99 participants were screened: 75% were females, over 50% aged above 50 years, and the majority had low socioeconomic status. The mean eGFR of the participants was 80.2 ± 33.3 mL/min/1.73 m 2 , 32.6% of the participants had eGFR <60 mL/min, and 2% had eGFR <30 mL/min. Furthermore, 36.5% of the participants had proteinuria and 29.8% had 1 + proteinuria. There was a significant negative correlation of eGFR with a family history of diabetes mellitus (-0.35, P = 0.016), elevated systolic hypertension (-0.29, P = 0.035), and elevated total cholesterol (-0.23, P = 0.045), but there was a positive correlation with body mass index (0.24, P = 0.018). We conclude that the prevalence of kidney disease was high in the screened population in a Nigerian oil producing community.

Factors associated with blood pressure control in predialysis chronic kidney disease patients: Short-term experience from a single center in Southern Nigeria

Background: Hypertension is a leading cause of kidney disease worldwide, and chronic kidney disease (CKD) is a known cause of secondary hypertension. Blood pressure (BP) control is a main-stay in the management of CKD because it retards the progression of established CKD. Aim: To determine BP control and its associated factors in predialysis CKD patients in a tertiary hospital setting. Methodology: CKD patients who attended the renal outpatient clinic during the period from December 2013 to June 2014 were recruited into the study. Demographic and clinical information were obtained from their case records. The average of the three most recent clinic BPs was calculated for each patient. Good BP control was taken as an average BP of <140/90 mmHg. Results: One hundred and three patients (53 males and 50 females) met inclusion criteria for the study. The mean age of the patients was 40.6 ± 17.4 years. Estimated glomerular filtration rate was <60 ml/min in 49.5% of patients. Good BP control was seen in 57 (55.3%) patients. Poor BP control was associated with middle age, proteinuric CKD, and prescription of 3 or more BP medication. Conclusion: BP control in predialysis CKD patients still needs to be optimized. Special attention should be given to middle-aged patients who have proteinuric CKD and those on multiple BP drugs without optimal BP control.

Prevalence of chronic kidney disease in patients with metabolic syndrome: a single centre experience in Nigeria

BAcKgrounD The prevalence of metabolic syndrome (MS) is increasing worldwide, not sparing developing countries like Nigeria. Chronic kidney disease (CKD) is also assuming epidemic proportions globally. Metabolic syndrome has been associated with CKD in several reports, most of which are foreign based. Given that data on CKD in MS patients is rare in this part of the world, the study was undertaken with the aim of determining the prevalence of CKD in patients with MS.