Complementary and alternative medicine use among adults in Enugu,Nigeria

Background  

Attention and interest in the use of Complementary and Alternative Medicine (CAM) has been reawakened globally. Evidence from studies carried out in different parts of the world has established that CAM use is very common and varies among populations. This study investigated the use of CAM among adults in Enugu urban, irrespective of their health status. It provided information on the prevalence of CAM use, forms of CAM remedies used and reasons for utilizing them     

Prevalence of CKD-MBD in pre-dialysis patients using biochemical markers in Enugu,South-East Nigeria

BackgroundAs kidney function declines, there is a progressive deterioration in mineral homeostasis with disruption of normal serum and tissue concentration of phosphorus and calcium, and changes in circulating levels of hormones-parathyroid hormone (PTH), calcitriol (1,25(OH)2 D), and Fibroblast growth factor-23 (FGF-23).ObjectiveThis study was aimed at determining the prevalence of markers of CKD-MBD in pre-dialysis patients.MethodsWe evaluated consecutively 168 subjects made up of 85 CKD patients and 83 healthy controls, who were attending the renal clinics and medical outpatient of University of Nigeria Teaching Hospital, Enugu. GFR was estimated and serum calcium, phosphorus, alkaline phosphatase, PTH, and 25(OH) D levels assayed.ResultsThe prevalence of various mineral bone disease abnormalities were 70% hyper-phosphatemia, 85% hyper-parathyroidism, and 100% low levels of 25 (OH) D among the patients. Estimated GFR correlated negatively with both serum phosphorus, and PTH. Age of the patients ranged from18–76 years with a male to female ratio of 1.7:1. Chronic Glomerulonephritis (CGN), hypertension and diabetes mellitus caused CKD in 75% of the patients. There was no significant decrease in serum calcium levels of patients compared to controls. The patients did not have pathologically raised alkaline phosphatase, although their mean level was significantly higher than that of the control group.ConclusionLow 25 (OH) D levels (insufficiency/deficiency), hyperparathyroidism, and hyper-phosphatemia were the obvious markers of CKD-MBD in our pre-dialysis patients. These should be evaluated at presentation in these patients.     

江苏汉族成人皮褶厚度

目的探讨江苏汉族成人皮褶厚度的特征。方法在江苏淮安调查了311例城市汉族(男157例,女154例)与421例乡村汉族(男213例,女208例)成人的6项皮褶(面颊皮褶、肩胛下皮褶、髂前上棘皮褶、二头肌皮褶、三头肌皮褶、腓肠肌皮褶)厚度值。结果城市女性各皮褶厚度值均比城市男性高,乡村女性与乡村男性相比亦如此;江苏汉族皮褶厚度存在显著性城乡差异;江苏城市汉族6项皮褶厚度值多与年龄呈正相关。结论江苏汉族成人城市男女间、乡村男女间差异极显著。     

Prevalence of rifampicin resistant tuberculosis among pulmonary tuberculosis patients In Enugu,Nigeria

ObjectiveWe determined the prevalence of rifampicin resistance in pulmonary tuberculosis patients in Enugu Nigeria.MethodsA prospective hospital-based study involving 1300 presumptive multidrug-resistant tuberculosis patients was conducted in Enugu between April 2017 and 31st March, 2019.Participants age ranged from 15 years and older and each submitted one sputum specimens Sputum specimens were analyzed using the Gene Xpert MTB/RIF assay to detect resistance to rifampicin according to manufacturer''s protocol.ResultsThe prevalence of rifampicin resistant tuberculosis was 6.8% (95% CI: 5.5- 8.3). Rifampicin resistance was significantly higher in males (9.0%) than females (4.2%) (P = 0.036< 0.05). Most of the cases were seen in the age group 35–44 years (28.4%). Prevalence of rifampicin resistant tuberculosis was 2.7% in treatment naive (new) patients and 4.1% in patients on anti-tuberculosis therapy (previously treated).ConclusionThe prevalence of rifampicin resistant tuberculosis in Enugu was high. Rifampicin resistance in treatment naive (new) patients was also high. This study therefore highlights that active transmission of Multidrug-resistant tuberculosis among young males could be on-going.     

MMTV promoter-regulated caveolin-1 overexpression yields defective parenchymal epithelia in multiple exocrine organs of transgenic mice

Caveolin-1 (Cav-1) is a major structural protein of caveolae, specialized plasma membrane invaginations that are involved in a cell-specific fashion in diverse cell activities such as molecular transport, cell adhesion, and signal transduction. In normal adult mammals, Cav-1 expression is abundant in mesenchyme-derived cells but relatively low in epithelial parenchyma. However, epithelial Cav-1 overexpression is associated with development and/or progression of many carcinomas. In this study, we generated and characterized a transgenic mouse model of Cav-1 overexpression under the control of a mouse mammary tumor virus (MMTV) long terminal-repeat promoter, which is predominantly expressed in specific epithelial cells. The MMTVcav-1⁺ transgenic mice were fertile, and females bore litters of normal size with no obvious developmental abnormalities. However, by age 11 months, the MMTVcav-1⁺ mice demonstrated overtly different phenotypes in multiple exocrine organs when compared with their nontransgenic MMTVcav-1⁻ littermates. Cav-1 overexpression in MMTVcav-1⁺ mice produced organ-specific abnormalities, including hypotrophy of mammary glandular epithelia, bronchiolar epithelial hyperplasia and atypia, mucous-cell hyperplasia in salivary glands, elongated hair follicles and dermal thickening in the skin, and reduced accumulation of enzymogen granules in pancreatic acinar cells. In addition, the MMTVcav-1⁺ transgenic mice tended to have a greater incidence of malignant tumors, including lung and liver carcinomas and lymphoma, than their MMTVcav-1⁻ littermates. Our results indicate that Cav-1 overexpression causes organ-specific, age-related epithelial disorders and suggest the potential for increased susceptibility to carcinogenesis.     

Knowledge and indulgence in substsance abuse among adolescents in Anambra state,South-East Nigeria

BackgroundSubstance abuse is a growing societal problem with adolescents being at increased risk. The few studies in Nigerian adolescents have not factored in their knowledge base with regard to the concept of substance abuse.ObjectivesThis study determined the indulgence in and knowledge of substance abuse and associated factors among adolescents.MethodsThis was a questionnaire based study involving 10 to 19year olds recruited from an adolescent summer camp in Anambra state, South-East Nigeria.ResultsThe data of 276adolescents was analyzed, male–91, 33%, M: F = 1: 2. Mean age was 16.4 ± 1.4years. 13.8% (38) accepted they had abused substances in the past; 74.3% (205) had the correct knowledge of the meaning of substance abuse; 10.1% (28) admitted taking substances for pleasure. The substances taken included Alcohol (67.9%), Cigarette (25.0%), Tramadol (10.7%), Cocaine (7.1%), among others. Multiple substances were taken 28.6% of the time.Age category had no significant association with the abuse of substances (X2–2.656, p = 0.282). Stratified by age category, gender had a significant association with substance abuse in Late adolescence (n = 11; M–9, 81.8%; F–2, 18.2%; X2 = 6.893, p = 0.016) but not Mid-adolescence (n = 27; M – 10, 37.0%; F – 17, 63.0%; X2 = 0.749, p = 0.500).ConclusionAn unacceptable proportion of the adolescents were already exposed to substances/drugs in spite of having suboptimal knowledge. Adolescents need to be educated on substance abuse and its dangers in order to curb this in the society.     

乌孜别克成人皮褶厚度的年龄变化

目的：探讨乌孜别克族体脂发育水平。方法：测量乌孜别克成人6项皮脂厚度值,并探讨了皮褶厚度随年龄而变化的特征。结果：(1)躯干皮下脂肪厚于面颊与四肢;(2)男性躯干皮褶厚度随年龄增长而明显增长,四肢皮褶厚度随年龄增长而缓慢增长,女性皮褶厚度增长到最大值后,随年龄增加而下降;(3)随年龄增长,男女皮下脂肪发育的差异越来越反映在躯干部位。结论：在我国民族中,乌孜别克族女性皮下脂肪比较发达。     

Relationship between sonographic umbilical cord size and gestational age among pregnant women in Enugu,Nigeria

Background

Common fetal parameters for gestational age (GA) estimation have pitfalls especially in advanced pregnancy and pregnancy complicated by fetal structural anomaly.

Objective

To assess the relationship between umbilical cord size and gestational age of the fetus.

Subjects and Methods

A sonographic cross sectional study involving 300 pregnant women with GA between 14 weeks to 40 weeks was done in Enugu, Nigeria. Gestational ages were first estimated by use of Naegele''s formula for GA estimation based on the date of onset of each subject''s last menstrual period. Fetal parameters such as biparietal diameter, femur length, head circumference and abdominal circumference were measured and also used to estimate GA. Umbilical cord diameters were measured and used to compute the umbilical cord cross-sectional area.

Results

The mean umbilical cord diameter and cross-sectional area were 14.5mm ± 7.2mm and 201.6mm ± 139.5mm² respectively. Umbilical cord growth rate of 1.0mm/week was noted between the 14^th and 35^th week of pregnancy. There were significant correlations (p < 0.001) between umbilical cord size and other fetal parameters for GA estimation.

Conclusion

Umbilical cord size had strong linear relationship with common fetal GA estimation parameters and could be used to compliment these parameters for GA estimation.     

Atherogenic index of plasma as useful predictor of cardiovascular risk among postmenopausal women in Enugu, Nigeria

Background

Menopausal health in our environment has received little attention. As an independent risk factor for dyslipidaemia, the degree and pattern of derangement, though difficult to assess may adversely affect the cardiovascular health of our women.

Objectives

To estimate the serum lipid profile and the atherogenic index of plasma in normal post menopausal women.

Methods

This is a cross sectional study involving 80 apparently healthy women voluntarily recruited from staff of the University of Nigeria and the Teaching Hospital (UNTH) located in Enugu. They include 50 postmenopausal subjects aged between 50 and 70 years and 30 premenopausal controls aged between 25 and 49 years. Total cholesterol (TC), and the various subfractions; high density lipoprotein cholesterol (HDL-C), very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG) were determined. Atherogenic index of plasma (AIP); log (TG/HDL-C) was calculated.

Results

There were statistically significant increases (P< 0.0001) in TC, TG, LDL-C, VLDL-C and AIP but a statistically significant decrease (P<0.0001) in HDL-C in postmenopausal women when compared with the premenopausal subjects. Except HDL-C that showed insignificant reduction, there were statistically significant derangement of other lipid subfractions as the duration of menopause increased.

Conclusion

Menopause, no doubt alters lipid profile. A triglyceride based index (AIP) can significantly add value when assessing the risk of developing atherosclerosis in Nigeria.     

Sonographic biometry of spleen among school age children in Nsukka,Southeast, Nigeria

Background

Normative value of spleen size among school age children is important for objective assessment of the spleen.

Objectives

This study was aimed at determining sonographically the normal limits of the spleen size according to age, sex, and somatometric parameters among school age children.

Methods

A cross sectional study was done on 947 apparently healthy subjects (496 boys and 451 girls) aged 6 – 17 years. The subjects were recruited from some primary and secondary schools within Nsukka metropolis and also from out patients in the study centre. A pilot study was done to determine the intra- and inter rater reliability of sonographic measurements of the spleen. The sonographic examination was performed on Shenzhen DP-1100 machine with 3.5 and 5 MHz convex transducers. Spleen sizes were obtained with the subject in a right lateral decubitus position.

Results

Measurement of spleen length was reliable while measurement of spleen width was less reliable within and between sonographers. Dimensions of the spleen were not statistically different in boys and girls (p > 0.05). Height correlated best with spleen dimensions.

Conclusions

Normogram of the spleen size with respect to height is important in the determination of some pathology associated with changes in its size.     

ECG abnormalities among HIV infected children placed on ART at Enugu,South East of Nigeria

BackgroundCardiovascular abnormalities are not much reported among human immunodeficiency virus (HIV) infected children especially in Africa where there is high HIV disease. In addition, the use of highly active antiretroviral therapy (HAART) in such children may have a protective effect on the cardiovascular system.MethodsCross-sectional study of randomly selected eighty HIV infected and 80 aged matched non- HIV-infected children were used. HIV-infected children were on HAART for more than 5years and had steadily received the treatment for 6 months prior to the time of the tests. Heights and weights were measured and body mass index calculated. Cardiac indices evaluated were heart rate (HR), PR interval, QRS duration, QT/QTC Interval, P/QRS/T Axis, RV5/SV1 voltage and RV5+SV1 voltage.ResultsThe average heart rate was significantly higher among HIV infected children on HAART than their non-infected counterparts (P= 0.019). At 0.05 significance level, their PR interval was significantly higher than those in the control group (P=0.050). The average QRS duration result also showed a significant difference between that of test and control subjects (P = 0.022)ConclusionThe HAART usage possibly improved the cardiovascular functioning in the infected children but the protective effects diminish with increase age and longer exposure     

湖南宁乡汉族成人皮褶厚度

目的:研究湖南汉族成人皮褶厚度发育状况.方法:采用随机抽样调查法在湖南调查了737例(城市男、女149、170例,乡村男、女197、221例)汉族成人的面颊部、肱二头肌、肱三头肌、肩胛下、髂前上棘、腓肠肌6项皮褶厚度值,分析了湖南汉族成人皮褶厚度值随年龄变化的特征.结果:除面颊部和髂前上棘皮褶外,女性其他皮褶厚度值均高于男性;肱三头肌、肩胛下和髂前上棘皮褶厚度的城乡差异有统计学意义;随着年龄增长,湖南汉族6项皮褶厚度值逐渐增大,多在30～49岁达最大值,之后略有下降,部分指标在60～岁组有回升趋势;聚类结果显示,湖南汉族与江西汉族等南方人群的皮褶厚度值较近.结论:湖南汉族皮褶发育具有南亚类型族群特点.     

Relationship between religiosity,religious coping and socio-demographic variables among out-patients with depression or diabetes mellitus in Enugu,Nigeria

BackgroundReligion is a powerful coping strategy. Diabetes and depression are common conditions in our environment that induce psychological distress, thus requiring coping for better outcome. Studies indicate that increased religiosity is associated with better outcome in clinical and general populations. Therefore, studies of the distribution of religiosity and religious coping among these populations are essential to improve outcome.ObjectivesTo assess the association between religiosity, religious coping in depression and diabetes mellitus, and selected sociodemographic variables (age, gender and occupational status).MethodsUsing simple random sampling we recruited 112 participants with diabetes and an equal number with depression consecutively, matching for gender. Religiosity was determined using religious orientation scale (revised), religious coping with brief religious coping scale and socio-demographic variables with a socio-demographic questionnaire.ResultsIntrinsic religiosity was greater among older people with depression than among older people with diabetes(t=5.02,p<0.001); no significant difference among young people with depression and diabetes(t=1.47,p=0.15).Positive religious coping was greater among older people with depression than among older people with diabetes(t=2.31,p=0.02); no difference among young people with depression and diabetes(t=0.80,p=0.43). Females with depression had higher intrinsic religiosity scores than males with depression(t=3.85,p<0.001); no difference in intrinsic religiosity between females and males with diabetes(t=0.99,p=0.32).Positive religious coping was greater among participants with diabetes in the low occupational status(t=2.96,p<0.001) than those in the high occupational status.ConclusionReligion is indeed a reliable coping method, most commonly used by the elderly and females with depression. Positive religious coping is more common among diabetic patients who are in the low occupational status.     

Diameter, thickness, area, and volume of skin-prick histamine weals. Measurement of skin thickness by 15 MHz A-mode ultrasound

Twelve healthy persons were prick-tested on the volar forearm with three concentrations of histamine chloride (0.1 mg/ml; 1.0 mg/ml; 10 mg/ml) and an isotonic sodium chloride control. Weal diameters were measured, and skin thickness representing weal thickness was measured by high frequency ultrasound. Relative increases in weal parameters as measured and calculated between weak and strong concentrations of histamine (0.1 and 10 mg/ml) were: mean diameter 139%, weal thickness 46%, tangential area 443%, cross-sectional area 218%, and weal volume 680%. All the parameters of weal size measured and calculated showed significant differences between the three concentrations of histamine. However, a better distinction might be obtained by calculating weal volume. Coefficients of variation ranged from 12–28% for the weal diameter, 11–14% for the weal thickness, 24–53% for the tangential area, 14–39% for the cross-sectional area, and 23–55% for the weal volume. The increase in thickness was correlated to weal diameter up to a diameter of 5 mm ( r = 0.64; P < 0.001), after which weals only expanded tangentially. Weal thickness as measured by ultrasound is a potentially important parameter in experimental studies of inflammatory skin reactions. With this new technique it is possible to compare with normal skin and skin treated with solvent for control. For routine prick-testing of patients with allergy, measurement of weal diameter is still a valid and easy method.     

广西仫佬族成人皮下脂肪发育趋势的研究

目的研究广西罗城仫佬族成人皮下脂肪的发育现状及年龄变化趋势。方法采用人体测量法调查了410例(男167,女243)仫佬族成人的肱三头肌位、肩胛下位、髂前上棘位和腓肠肌位共4项皮褶厚度状况,分析了仫佬族男女皮褶厚度随年龄变化的特点。结果①仫佬族成人躯干部的皮下脂肪厚于四肢部,其中背部脂肪最厚;②4项皮褶厚度值女性均高于男性,差异有统计学意义(P<0.05);③男女性皮下脂肪的发育随第二性征的发育成熟而达到高峰,女性优先于男性;④四肢的脂肪含量男女均以青年期最高,而躯干的脂肪发育略有不同,男性以中年早期含量最高,女性在青年期达到高峰后稍下降再上升并维持在较高水平;⑤仫佬族男女皮下脂肪的发育总体劣于我国的北方民族,优于侗族、壮族等南方民族。结论广西仫佬族成人皮下脂肪的发育在我国各民族中属中等水平,结果可为仫佬族的体成分研究及疾病预防提供基础数据。     

Prevalence of venous thromboembolism risk factors in hospitalized patients at the University of Nigeria Teaching Hospital,Enugu Nigeria

BackgroundVenous thromboembolism (VTE) is a common and lethal disease. Assessing the risk factors will help to modify exposures.AimThis study, assessed VTE risk factors in hospitalized patients at the University of Nigeria Teaching Hospital, Enugu.Patients and MethodsThis was an observational, case-control study. Three hundred and fifty (350) patients were recruited for the study: This comprised 150 medical patients, 140 surgical patients and a population of 60 healthy control group. Subjects were evaluated once using the Caprini risk assessment model (RAM).ResultsOver 50% of all hospitalized patients, were at risk for VTE. Surgical patients were at a higher risk than medical patients. Hemoglobin concentration was associated with the risk of VTE in surgical patients, while d-dimer was associated with VTE risk in medical patients.ConclusionThis study shows a high prevalence of VTE risk factors among hospitalized patients at the University of Nigeria Teaching Hospital.     

Ear-related problems among children attending the paediatric and otorhinolaryngology out-patients clinics of the University of Nigeria Teaching Hospital,Enugu

BackgroundEar related diseases are commonly seen in clinics worldwide especially among children. They are associated with significant morbidity and frequent hospital visits. Limited data exists regarding the burden of ear disease among Nigerian children.ObjectiveTo determine the prevalence of ear-related problems among children presenting at the Paediatric and Otorhinolaryngology clinics of the University of Nigeria Teaching Hospital, Enugu.ResultsThree thousand and twenty-one children were seen during the study period. Out of these, 248 children (8.2%) presented with ear-related problems. Chronic otitis media (30.5%), acute otitis media (29.9%), cerumen auris (11.3%), otitis externa (10.1%), hearing impairment (7.3%) and foreign body in the ear (5.7%) were the most commonly diagnosed ear-related problems.ConclusionEar-related problems among children presenting at the UNTH Enugu were not uncommon. However, otitis media was the most commonly diagnosed ailment affecting the ears in children.     

三维超声测量肾实质容积比率评估小儿肾积水患侧肾脏功能的临床价值

目的 探讨三维超声测量肾实质容积比率(RPVR)间接评估小儿肾积水患侧肾脏功能的临床价值.方法 25例单侧肾积水患儿,其中男性21例,女性4例;年龄3个月～14岁,平均年龄4.4岁.进行三维超声检查测定患侧肾脏RPVR,进行肾核素动态显像测定肾小球滤过率(GFR),并将两者作相关性分析.结果 患侧RPVR明显低于健侧(...     

Trends in HIV prevalence from 2008 to 2012 among young adults in Port Harcourt,Nigeria

BackgroundThe pandemic of HIV lines amongst the utmost infectious disease menaces in antiquity. HIV remains a problem worldwide and it''s a grave health snags in developing nations particularly in Nigeria.ObjectiveThis study focused on “trends in HIV reporting from 2008 to 2012 among young adults in Port Harcourt, Nigeria.MethodsSecondary data were collected from BMSH, Port Harcourt using a Performa specifically intended for this determination. Socio-demographic data for the subjects were recovered from coded patients'' medical records kept at BMSH. The data generated was exposed to Fisher''s Exact Test.ResultsThe study showed that a total of 3081 HIV-positive cases were reported between 2008 and 2012. The HIV trend were not well defined, it peaked in 2009(36.6%) and 2008(32.8%) and a decrease in 2011(16.6%), 2012(8.3%) and 2010(5.7%). A 3.8% increase was observed between 2008 and 2009 and 30.9% decrease between 2009 and 2010. However, the prevalence seemed to stabilize between 2009 and 2012. HIV patterns among various age-groups is not well-defined, it rose with increasing age and peaked at 26–30 years (35.7%) after which it declined. Sex differences (P<0.05) in the trend was observed. Males ages 26–30 years showed uniform pattern with an increasing trend while 36–40 years showed decreasing trend except in 2009(34.1%). Females ages 26–30 years showed uniform pattern with an increasing trend from 2008(21.7%) to 2010(41.9%) and decreased from 41.9% (2010) to 36.5%(2012). The low HIV prevalence in 2010 could be attributed to the fact that the proportion of centers giving ART enlarged from 2005 to date. Health care facilities providing HIV/AIDS counselling and testing services also increased.ConclusionThe long decades fight against HIV especially in Rivers State is making progress, though an unstable one. The observed increase in years with high HIV prevalences calls for an intensified focus of intervention.     

汉族人群围度、皮褶厚度及体脂的地区差异

目的：探讨围度、皮褶厚度和体脂表型在汉族人群间的地区差异。方法：2015 年至2019 年,在广西南宁、 河南郑州、江苏泰州3 个地区,调查了共计3 003 例汉族个体样本的32 项围度、皮褶厚度和体脂等表型,并对其 进行性别差异分析、年龄与表型间的相关性分析、地区差异分析、主成分分析。结果：绝大多数围度、皮褶厚度 和体脂表型在3 个汉族人群中均存在明显的性别间和地区间差异,年龄与部分表型呈正或负相关性。无论男女, 广西汉族的围度与体脂明显小于河南和江苏汉族,在第一主成分上与河南、江苏两地区较好地区分开,而河南汉 族的皮褶厚度则明显大于广西和江苏汉族。此外,在女性样本中,江苏女性的内脏脂肪率、身体脂肪率明显大于 河南和广西女性。结论：围度、皮褶厚度和体脂等表型在3 个汉族人群间存在明显的地区差异,支持汉族人群存 在南、北、中部3 个地区类型。