Progesterone, selected heavy metals and micronutrients in pregnant Nigerian women with a history of recurrent spontaneous abortion

Background

Environmental and endocrine factors have been implicated in the aetiology of recurrent abortion, with poorly understood roles. Luteal phase insufficiency marked with insufficient progesterone secretion has been reported.

Objective

To define the involvement of progesterone, trace metals, and Vitamin E in pregnant women with history of recurrent spontaneous abortion.

Methods

Convenience sampling method was used to recruit 69 pregnant women aged 21–41 years with gestational age of 0–20 weeks in this case-control study. Thirty five (cases) and thirty four (controls) had previous and no history of recurrent spontaneous abortion respectively. Demographic characteristics and 10mls of blood samples were obtained from each subject. Serum obtained was used for the determination of progesterone, zinc, copper, selenium, iron, magnesium, manganese, chromium, lead, cadmium, and serum vitamin E by standard methods.

Results

Results showed statistically significant decreases (p<0.05) in the serum zinc, copper, and vitamin E and a significant elevation (p<0.05) in the serum selenium, lead, and cadmium in cases compared with controls. Insignificant decrease (p=0.07) was observed in the serum progesterone when cases were compared with controls.

Conclusion

Results suggest that elevated serum heavy metals (cadmium and lead) and reduction of essential micronutrients (zinc, copper and vitamin E) may contribute to recurrent spontaneous abortion.     

Correlation between functional assessment staging and the 'Basic Age' by the Binet scale supports the retrogenesis model of Alzheimer's disease: a preliminary study

Background: In the progression of their disease, Alzheimer's disease (AD) patients have been observed to demonstrate various clinical features reminiscent of children. Based on behavioral, neurological and neuropathological findings, Reisberg et al. noted the relationships between development and dementia and proposed the ‘retrogenesis’ model. Methods: The functional assessment staging procedure (FAST) was used for assessment of functional ability, and the Tanaka–Binet intelligence scale (TB scale) was used to assess intellectual ability in 24 patients with moderate to severe AD. Results: Overall, there was a significant Spearman's correlation between the FAST stage and the basic age (BA) value (r = ?0.85, P < 0.01). The BA by the TB scale was significantly different between FAST stages 5 and 6 to 7. The mean (standard error [SE]) BA values of FAST stages 5 and 6 were 4.2 (0.9) and 2.3 (0.7), respectively, the latter being significantly lower than the former (F = 10.2, P < 0.01 one‐way anova ). The TB scale could not assess the BA of the FAST stage 7 patients because of floor effects. Conclusion: Although further investigation using larger samples would be needed, the findings support the general concordance of intellectual and functional decline in AD with the converse developmental acquisition of the same capacities, as hypothesized in the retrogenesis model.     

不同焦虑水平的操作员在有目的竞争活动中的心理生理参数

研究并讨论了在模拟状态下飞行员的心理－生理活动的焦虑水平。焦虑指的是一种特定的性格状态，从事危险职业的人由于经常性地受到紧张因素的影响，会产生长期的或暂时的焦虑。研究结果表明，当选拔在复杂环境条件下工作的操作者时，应优先考虑低焦虑水平的人；而当小组共同完成任务时，应着重考虑焦虑水平相当的人。     

Physical Functionality and Self-Rated Health Status of Adult Patients With Knee Osteoarthritis Presenting in a Primary Care Clinic

Background

Knee osteoarthritis is a chronic medical condition of public health importance in Nigeria which causes disability and impacts daily activities in the sufferers. This study aimed to describe the physical functionality and self-rated health status of adult patients with clinical knee osteoarthritis presenting at the Family Medicine Department, University College Hospital, Ibadan, Nigeria.

Methods

This was a cross-sectional study of 400 respondents. Knee osteoarthritis was diagnosed clinically using the criteria of the American College of Rheumatology. Morbidities, self-rated health status and physical functionality of the respondents were also assessed.

Results

Knee osteoarthritis was diagnosed in 46(11.5%) respondents. Respondents with knee osteoarthritis significantly rated their health worse than those without knee osteoarthritis (p <0.0001). Experience of pain, stiffness and performance of daily activities were significantly worse among respondents with knee osteoarthritis. Those who had knee osteoarthritis had significantly higher waist (p <0.0001), hip (p <0.0001) and knee circumferences (p <0.0001) respectively. Logistic regression analysis showed increasing age (OR=1.103; 95% CI=1.022 – 1.191), self-rated health worse than six months ago (OR=12.562; 95% CI=1.178–125.243), experience of stiffness after waking up in the morning (OR=12.758; 95% CI=3.572–45.569), stiffness after sitting/lying down/resting (OR=21.517; 95% CI=2.213–209.220) and waist circumference (OR=1.225;95% CI=1.017–1.477) to be the most significantly associated with knee osteoarthritis.

Conclusion

Knee osteoarthritis significantly impairs the health and daily activities of adult patients in Ibadan, Nigeria. Healthcare workers need to screen adult patients routinely at first-contact to detect knee osteoarthritis clinically early and manage appropriately.     

Attitudes and knowledge of colorectal cancer and screening in Hong Kong: A population-based study

Background: Colorectal cancer (CRC) ranks third of all cancer mortalities in Hong Kong. CRC screening can reduce mortality. However, participation in the CRC screening program depends on the knowledge and attitude of the population. The aim of this study is to investigate the knowledge and attitude towards CRC screening in the Hong Kong population. Methods: One thousand and thirty‐three patients were interviewed by telephone survey. Knowledge and attitudes were assessed by using questionnaires. Results: Only 8.9% of the respondents were able to mention that CRC was the second commonest cancer cause of death; 4.5% believed they would have a higher chance of developing CRC as compared to other cancers, and 7.4% could mention one of the screening methods. Approximately half (50.3%) were unable to identify any available screening venue. Approximately one‐third (29.5%) indicated that they would definitely join a free CRC screening program, but the percentage dropped to 7.9% when a paid screening program was offered. Some (30.4%) of the respondents had the wrong impression that they did not require CRC screening because they were asymptomatic. Multivariate analysis showed that the independent predictor for participating in free screening was the concern level of getting CRC, while that for a paid screening program was a positive family history of CRC and the concern level. The concern level was dependent on a positive family history and knowledge of CRC. Conclusion: The general population in Hong Kong had deficient knowledge of CRC and screening. Education on the impact of CRC and beneficial effects of CRC screening should be offered before launching a CRC screening program.