Olatunde Odusan

Stigmatising attitude of medical students towards a psychiatry label

BackgroundThe aim of this study is to evaluate the effect of a psychiatric label attached to an apparently normal person on the attitude of final year medical students at a Nigerian university.MethodsA questionnaire with sections on demographic information, a single-paragraph case description illustrating a normal person, a social distance scale and questions on expected burden was used to elicit responses from 144 final year medical students who have had previous exposure to psychiatric posting. The students consisted of two randomly assigned groups; group A received a case description with a psychiatric label attached while group B received the same case description but without a psychiatric label.ResultsA total of 68 (47.2%) of the students responded to the questionnaire with the attached psychiatric label, while 76 (52.8%) responded to the questionnaire without the attached label. There was no statistical difference in age (p = 0.187) and sex (p = 0.933) between the two groups of students. The students who responded to the questionnaire with the attached psychiatric label would not rent out their houses (p = 0.003), were unwilling to have as their next-door neighbour (p = 0.004), or allow their sister to get married (p = 0.000) to the man depicted in the case description compared with those that responded to the questionnaire without label. This group also felt that the man would exhaust them both physically (p = 0.005) and emotionally (p = 0.021) in any relationship with him.ConclusionThese results strengthen the view that stigma attached to mental illness is not limited to the general public; medical students are also part of the stigmatising world. There is, therefore, a need to incorporate issues concerning stigma and its reduction as a core component of the mental health curriculum of medical schools.

Community based diabetes risk assessment in Ogun state, Nigeria (World Diabetes Foundation project 08-321).

Objective: The study assessed the risk of developing type 2 diabetes Mellitus in Ogun State, Nigeria. Materials and Methods: Finnish Medical Association diabetes risk score was administered across 25 communities facilitated by non-communicable disease clinics established under a World Diabetes Foundation project. Subjects in the high risk group had blood glucose estimated. Results: 58,567 respondents included 34,990 (59.6%) females and 23,667 (40.3%) males. Majority (61.2%) were between 25 years and 54 years. Considering waist circumference, 34,990 (38.1%) females and 23,667 (5.3%) males had values above 88 cm and 102 cm respectively. Overall, 11,266 (19.2%) were obese and 28.9% overweight using body mass index (BMI). More females had elevated BMI than males. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were 129.54 mm Hg ± 23.5 mm Hg and 76.21 mm Hg ± 15.5 mm Hg respectively. Prevalence of hypertension (Joint National Committee VII classification) was 27.7%. More subjects had normal DBP than SBP (68.2% vs. 42.5% P < 0.05). Mean fasting blood glucose (FBG) of all subjects was 5.5 mmol/L ± 0.67 mmol/L. Using a casual blood glucose >11.1 mmol/L and/or FBG >7 mmol/L, the total yield of subjects adjudged as having diabetes was 2,956 (5.05%). Mean total risk score was 5.60 ± 3.90; this was significantly higher in females (6.34 ± 4.16 vs. 4.24 ± 3.71, P < 0.05). A total of 2,956 (5.05%) had high risk of developing DM within 10 years. Conclusion: The risk of developing DM is high in the community studied with females having a higher risk score. There is urgent need to implement diabetes prevention strategies.

Physical activity among type‑2 diabetic adult Nigerians

BACKGROUND Regular participation in physical activity (PA) programs is a key concept included in current public health guidelines. Therefore, this study was aimed to determine PA level among adult with type 2 diabetes. METHODS A cross-section of 122 participants selected consecutively were categorized as physically inactive or active using International Physical Activity Questionnaire. Data was assessed using descriptive and inferential statistics. RESULTS About 31% of the respondents were physically inactive. Residential areas were significantly associated with PA. A high proportion of those who lived in the metropolitan area were physically inactive. Less likely to be physically inactive were married (odds ratios [OR] =0.29, confidence interval [CI] =0.09-0.93) and living in an urban area (OR = 0.19, CI = 0.40-0.87). The degree holders are least physically inactive while the primary school leavers are highest. The median energy expenditure for walking, moderate and vigorous PA was 280.5, 80 and 0 MET-min/week respectively. The sedentary behavior of the respondents was 288 min/day, behavior which increases with age. CONCLUSION This study suggests that the prevalence of physical inactivity was high among type 2 diabetics and their sedentary behavior is over 4 h/day. This group of people should be encouraged to participate regularly in PA.

Patterns and correlates of serum magnesium levels in subsets of type 2 diabetes mellitus patients in Nigeria

Background: Magnesium (Mg) is the 4th most common mineral and the 2nd most abundant intracellular cation in the body. It plays major roles in various physiological activities and has been implicated in many disease states. Aim: The aim of this study was to study the patterns and correlates of serum Mg in cohorts of type 2 diabetic patients in Nigeria. Subjects and Methods: One hundred and twenty-five patients comprising 63 with type 2 diabetes mellitus (T2DM) alone and 62 with diabetes and hypertension (HT) were compared with fifty controls matched for sex and age. Basic data, HbA1c, and fasting blood glucose (FBG) were obtained while serum Mg was measured by colorimeter. Relationship between serum Mg and glucose control was considered while serum Mg < 1.6 mg/dl was considered as hypomagnesemia. Results: The mean serum Mg of all patients was 2.06 ± 0.49 mg/dl, not statistically different from controls at 2.22 ± 0.48 mg/dl. About ¼ (23.2%) of the patients had hypomagnesemia which was significantly more than 12% of controls. Although the patients with diabetes and HT were older and more of females than those with DM alone, the mean serum Mg was comparable (2.03 ± 0.49 vs. 2.09 + 0.50 mg/dl). Twenty-seven percent (27%) of patients who had DM alone was more than 19.3% with HT and diabetes combined. Whereas the FBG was comparable in patients with hypomagnesemia and normal serum Mg, HbA1c was significantly higher in the hypomagnesemia group (8.39 ± 0.98 vs. 6.75 ± 1.22%, P = 0.021). Conclusion: Hypomagnesemia is common in T2DM outpatients occurring approximately one in four patients. It is associated with poor long-term control.

Spectrum and prevalence of thyroid diseases seen at a tertiary health facility in Sagamu, South-West Nigeria

Background: The prevalence of goitrous swelling has reduced in Nigeria since the introduction of salt iodisation programme. Thyroid disorders are the second most common endocrine disorder after diabetes mellitus worldwide. They present to general outpatient, medical and surgical clinics accompanied by great anxiety and poor health-related quality of life. Objectives: The study aimed to determine and describe the spectrum of thyroid disorders seen at Olabisi Onabanjo University Teaching Hospital over a 10-year period. Materials and Methods: This was a retrospective analysis of records of patients who presented to the hospital with thyroid swellings over a 10-year period (June 2004 to June 2014). Clinicopathological and demographic data obtained from hospital records in 175 patients diagnosed by clinical examination, thyroid ultrasound, hormone profile and histological confirmation in cases that had surgery were analysed for this study. Results: The records of 175 patients were obtained comprising 151 (86.3%) females and 24 (13.7%) males (female to male ratio of 6.3:1) with age range from 18 to 76 years and mean age of 42.3 years, standard deviation 13.5. With clinical diagnosis, distribution of thyroid diseases was simple goitre 103 (58.9%), toxic goitre 64 (36.6%), hypothyroidism 3 (1.7%), malignant goitre 4 (2.3%) and thyroiditis 1 (0.6%). The age group of 30–49 years had the highest prevalence of the thyroid diseases 100 (57.2%) while the extremes of age, below 20 and over 70 years had the least (5.1 and 2.9%, respectively). Conclusion: The prevalent form of thyroid diseases seen at Olabisi Onabanjo University Teaching Hospital was simple goitre and most common in females. Studies on autoimmunity and other goitrogens are required to further elucidate the cause of this high prevalence.

Pattern of ankle brachial index among adults in Sagamu South-West Nigeria

Background: The ankle-brachial index (ABI) is a ratio of Doppler recorded ankle and brachial systolic blood pressure. ABI value of <0.9 is diagnostic of peripheral arterial disease (PAD) and is associated with increased risk of cardiovascular morbidity and mortality. ABI is a simple and noninvasive tool that can be used in primary care as part of cardiovascular risk assessment. Objectives: To determine the pattern of ABI, the prevalence of PAD, and the risk factors for low ABI. Subjects and Methods: Four hundred subjects aged 50 years and above were selected by systematic random sampling. Their demographic data and cardiovascular risk factors were assessed, and their ABI was measured. ABI value of ≤0.9 was taken as low ABI indicating PAD while a value >1.3 was taken as high ABI indicating arterial calcification. Results: Two hundred and eighty-eight (72.0%) of the participants had normal ABI, 99 (24.8%) had low ABI indicating PAD, and 13 (3.3%) had high ABI. The prevalence of low ABI increased from 4.9% between 50 and 59 years to 25.3% and 58.7% between 60 and 69 and ≥70 years, respectively. The risk factors for low ABI were age (P = 0.00), history of hypertension (P = 0.03), and diabetes mellitus (DM) (P = 0.00). Conclusion: 24.8% of the participants had low ABI indicating PAD. The prevalence of PAD increases by 5–10 folds after the fifth decade of life. Low ABI was associated with advancing age, DM, and hypertension.

Performance of waist circumference and proposed cutoff levels for defining overweight and obesity in Nigerians

Background: Waist circumference (WC) is a simple tool for measuring central obesity in routine clinic settings. Gender- and ethnic-specific optimal cutoff points for WC are encouraged for populations lacking such data. Objectives: To derive WC cutoff values, predictive of overweight and obesity in Nigerians and to evaluate the performance of currently recommended values. Subjects and Methods: Apparently, healthy urban dwellers from six cities spread across Nigeria were selected for this cross-sectional study. Biophysical profiles such as blood pressure and anthropometric indices were measured according to the World Health Organizations STEPs instrument protocol. Receiver operating characteristics curve analysis was used to determine the optimal cutoff levels using the decision rule of maximum (sensitivity + specificity). The level of significance was set at P < 0.05. Results: A total of 6089 subjects (3234 males and 2855 females) were recruited for the study. WC demonstrated a high area under the curve in both genders. Selected cutoff points ranged from 83 to 96 cm with high sensitivities and specificities. Conclusions: The currently recommended gender-specific WC cutoff values proved inappropriate in this study group, but WC remains a reliable tool for measuring obesity.