Prevalence and perceived health effect of alcohol use among male undergraduate students in Owerri,South-East Nigeria: a descriptive cross-sectional study

Background  

Alcohol use during adolescence and young adulthood remains a prominent public health problem. Despite growing problems of global alcohol abuse, accurate information on the prevalence and pattern of use in Nigeria remain sparse. This study examines the prevalence and perceived health effects of alcohol use among undergraduate students in Owerri, Nigeria.     

Prevalence of Microalbuminuria among secondary school children

Background

Microalbuminuria is an early sign of kidney and cardiovascular damage. Therefore, early detection in asymptomatic individuals may be helpful in preventing deterioration in renal function.

Methods

We carried out a cross-sectional study of 820 secondary school students aged 10 – 19 years from September to November 2008. The urine samples of 615 (75.0%) without overt proteinuria and haematuria were tested for microalbuminuria using the micral test strips. Values of greater than 20mg/L were considered positive.

Results

There were 299 (48.6%) males and 316 (51.4%) females, with a M:F ratio of 1:1.1. The prevalence of microalbuminuria as seen in 214 of the students was 33.2%. It was significantly higher in females (45.3%), obese subjects (35.4%), those with hypertension (70.6%), those with positive family history of hypertension (59.5%), and diabetes mellitus (46.4%). Microalbuminuria was found in 1 of the 2 subjects who had features of DM and in one subject with sickle cell anemia.

Conclusion

The prevalence of microalbuminuria in Nigerian adolescents is high. We recommend routine screening for microalbuminuria in adolescents for early detection and prevention of renal damage.     

Revisiting gonadotrophin-releasing hormone agonist protocols and management of poor ovarian responses to gonadotrophins

Within the past decade, gonadotrophin-releasing hormone (GnRH)agonists have contributed greatly to the success of cycles programmedfor in-vitro fertilization and embryo transfer. However, apartfrom a preventive effect on the luteinizing hormone (LH) surge,most of the beneficial effects of these molecules are stillonly partly known. A precise analysis of regimens using GnRHagonists for ovarian stimulation shows that many parametersmay interfere with the outcome of long-term and short-term protocols.The great variability between these protocols hampers our comprehensionof the mechanisms involved in the overall clinical improvementseen with this therapy. The hypothyseal desensitization inducedby GnRH agonists is greatly dependent on the dose and durationof their administration, but the residual gonadotrophin secretionis imperfectly estimated by hormonal measurements using radio-immunometricassays. Moreover, the specific role of GnRH agonist-inducedovarian quiescence on subsequent ovarian responsiveness to gonadotrophinsand on endometrial receptivity deserves further investigation.Finally, a direct ovarian action of GnRH agonists on steroidogenesis,folliculogenesis and embryo quality is still controversial inhumans. These putative deleterious effects of GnRH agonistshave led some authors to recommend a reduction of both doseand duration of GnRH agonist administration for women identifiedby a poor response to gonadotrophins. Using this approach, afew reports have recently shown some clinical advantages forovarian responsiveness but no convincing evidence for any improvementin pregnancy rate. It thus appears that the overall impact ofGnRH agonists on reproductive function is still partly misunderstood.     

Paracetamol administration is associated with hypotension in the critically ill

An association between the administration of paracetamol and relative hypotension in critically ill intensive care patients has been reported anecdotally by nursing staff working in the Intensive Care Unit (ICU) of Prince Henry Hospital. An observational study was therefore undertaken, to determine whether there is a temporal association between the administration of paracetamol and changes in blood pressure.

A dose of 1 gram of paracetamol was administered orally or by feeding tube. Blood pressure was recorded 30 minutes prior to paracetamol administration, at the time of administration and then at 15-minute intervals for the first hour and at half-hour intervals for the second hour after administration.

Analysis of data from 37 individuals using a repeated measures ANOVA showed that systolic arterial pressure (SAP) and mean arterial pressure (MAP) were reduced significantly over the observation period (p < 0.0001 for both). SAP and MAP fell by an average of approximately 10 and 7 per cent respectively, with maximum falls of 36 and 34 per cent respectively.

Paracetamol administration may be indicated for the control of fever in critically ill patients, thereby reducing oxygen demand. However, this must be balanced against the possibility of causing a significant fall in blood pressure.