Type 2 diabetes mellitus risk assessment among doctors in Ondo state

IntroductionDiabetes Mellitus (DM) has become a disease of public health importance in Nigeria. Early identification of DM risk is important in the reduction of this disease burden. This study assessed ten-year risk of developing type 2 DM among some medical doctors in Ondo State.MethodsThis was a cross-sectional study that assessed ten-year risk of developing type 2 DM among some doctors using the Finland Diabetic Risk Score form. Known diabetics were excluded from the study. Body mass index (BMI), waist circumference (WC), blood pressure and total DM risk score were determined for each participant.ResultsOne hundred and ninety-two doctors participated in the study with a male: female ratio of 1.3:1. Majority (92.2%) were below 55 years, 22 (11.5%) were obese, 32(16.7%) had central obesity, 46(24%) reported physical inactivity, 49(25.5%) had family history of DM, 141(73.4%) do not take fruits and vegetables regularly. Forty-three (22.4%) were found to have elevated blood pressure while 6(3.1%) had elevated blood glucose. Fifty-seven (29.7%) of the participants had increased ten-year DM risk. Significant predictors of increase DM risk were age ≥ 45 years (AOR:9.08; CI 3.13–26.33; p = <0.001); BMI ≥25kg/m² (AOR:11.41; CI:4.14–31.45; p = <0.001); family history of DM (AOR:9.93; CI:3.25–30.39; p = <0.001); abdominal obesity (AOR:6.66; CI:2.08–21.29; p= < 0.001); and infrequent dietary intake of fruits and vegetable (AOR:3.11;CI:1.03:9.37: p = 0.04)ConclusionThere was increased 10-year DM risk in about 30% of the participants. Lifestyle modification such as physical activity and regular consumption of fruits and vegetables should be encouraged among doctors.     

Biochemical evidence for the differential association of metabotropic glutamate receptors within synaptic complexes

The distribution of metabotropic glutamate (mGlu) receptors within the synapse is an important determinant of function. mGlu have been grouped together into three main sub-classes: Group I mGlu (1 and 5) are predominantly situated on the post-synaptic membrane, whereas Group III (4, 6, 7 and 8) are largely pre-synaptic. Group II mGlu (2 and 3) are distributed peripheral to the active zone, on both sides of the synaptic cleft. Methods based on a distinct pH-dependent extractability of the pre- and post-synaptic marker proteins can provide insight into the molecular organization of synaptic junctions [G.R. Phillips, J.K. Huang, Y. Wang, H. Tanaka, L. Shapiro, W. Zhang, W. Shan, K. Arndt, M. Frank, R.E. Gordon, M.A. Gawinowicz, Y. Zhao and D.R. Colman, The presynaptic particle web: ultrastructure, composition, dissolution and reconstitution, Neuron 32 (2001) 63–77]. We have applied such procedures to rat brain cortical synaptosomes to explore the biochemical evidence for the accepted localisations of metabotropic glutamate receptors. As shown previously a number of post-synaptic marker proteins remained detergent-insoluble at both pH 6 and pH 8. There was an increased extraction of a number of pre-synaptic plasma membrane and cytomatrix proteins consistent with dissolution of the pre-synaptic aspect of synaptic junctions at elevated pH. We similarly observed modest extraction of Group I mGlu at either pH consistent with their post-synaptic organization. However, we observed increased extractability of Group II mGlu at pH 8. The extractability of Group III mGlu was slightly increased at pH 8 but these receptors were largely refractory to extraction. We have also applied the approach to scaffolding proteins implicated in mGlu localisation to define the biochemical correlates of mGlu scaffolding.     

Editorial Perspective: Mental health needs of children and young people of Black ethnicity.1 Is it time to reconceptualise racism as a traumatic experience?

We explore racial inequality in relation to Black children and young people (CYP) and Child and Adolescent Mental Health Services (CAMHS). We argue that the experience of racism should be universally considered an Adverse Childhood Experience (ACE). We argue that racism and the vicarious trauma arising from exposure to frequent media reports of racially motivated violence against persons of Black ethnicity can all predispose Black CYP to increased risk of mental health problems. We make recommendations to improve Black CYP’s early access to CAMHS, and to reduce their overrepresentation in psychiatric in-patient settings in the UK. This would require making CAMHS more welcoming to Black CYP and consideration of the impact of racism and trauma in the diagnostic and treatment formulation for Black CYP. This should include: the impact of racism in staff training, improving the cultural competence of CAMHS staff, and supporting Black CYP to articulate their experiences of racism and related traumas whilst facilitating their development of coping strategies to manage these experiences.     

Detection of Human Papilloma Virus (Type 16) among HIV-Positive Women in Ogbomoso,South-Western Nigeria

Background: Human papilloma virus (HPV) is a common sexually transmitted virus which infects the cutaneous and mucosal epithelium. HPV Type 16 is one of the viruses that causes cervical cancer and immunocompromised individuals are at high risk of different co-infections. Women living with Human Immunodeficiency Virus (HIV) have greater risk to the virus due to their impaired immunity. This study aimed at determining the seroprevalence of HPV IgM (Type 16) among HIV-infected women in Ogbomoso.

Methods: The blood sample of 180 consenting subjects were obtained and their sera subjected to serological assay using Enzyme Linked Immunosorbent Assay. Samples were collected over a period of 6 months (July–December 2014).

Results: The mean age and mean CD4+ count of the subjects was 38.22 ± 0.79 years and 392.80 ± 20.98 cells/μL, respectively. Out of 180 subjects tested, 18 (10%; 95% confidence interval) were positive for HPV Type 16 IgM. HPV Type 16 IgM was highest among the age group 31–45 (61.11%), traders (38.89%), >500 CD4/μL (33.33%). The seroprevalence using logistic regression at P < 0.05 shows there is a significant difference between the age and CD4 ⁺ cell count.

Conclusion: The result provides evidence that HPV Type 16 is present among HIV-infected women in Ogbomoso and they are susceptible to cervical cancer. This seroepidemiological survey is important for the prevention efforts such as availability of vaccine.     

Echocardiographic evaluation of calcific aortic stenosis in the older adult

Aortic stenosis is the most predominant valvular pathology occurring in older adults with an expected increase over time. Multiple comorbidities and highly variable clinical presentations which characterize the aging population necessitate the use of echocardiography in the assessment of valvular structure and real time hemodynamic evaluation. This article reviews the pathophysiology and clinical presentation of aortic stenosis in this unique population and the critical role of various echocardiographic modalities. The value of real time three-dimensional real time echocardiography in the assessment and management of aortic stenosis in older adults is emphasized.     

Classification of mismatch repair gene missense variants with PON-MMR

Numerous mismatch repair (MMR) gene variants have been identified in Lynch syndrome and other cancer patients, but knowledge about their pathogenicity is frequently missing. The diagnosis and treatment of patients would benefit from knowing which variants are disease related. Bioinformatic approaches are well suited to the problem and can handle large numbers of cases. Functional effects were revealed based on literature for 168 MMR missense variants. Performance of numerous prediction methods was tested with this dataset. Among the tested tools, only the results of tolerance prediction methods correlated to functional information, however, with poor performance. Therefore, a novel consensus-based predictor was developed. The novel prediction method, pathogenic-or-not mismatch repair (PON-MMR), achieved accuracy of 0.87 and Matthews correlation coefficient of 0.77 on the experimentally verified variants. When applied to 616 MMR cases with unknown effects, 81 missense variants were predicted to be pathogenic and 167 neutral. With PON-MMR, the number of MMR missense variants with unknown effect was reduced by classifying a large number of cases as likely pathogenic or benign. The results can be used, for example, to prioritize cases for experimental studies and assist in the classification of cases.     

Review of prostate cancer research in Nigeria

Prostate cancer (CaP) disparities in the black man calls for concerted research efforts. This review explores the trend and focus of CaP research activities in Nigeria, one of the ancestral nations for black men. It seeks to locate the place of the Nigerian research environment in the global progress on CaP disparities. Literature was reviewed mainly through a Pubmed search with the terms "prostate cancer"and "Nigeria", as well as from internet and hard copies of journal pages.Findings: One of the earliest publications about CaP in Nigeria was in 1973 from the nation's 1st tertiary hospital in Ibadan, reporting low incidence, followed by a lull of nearly one decade. In 1980, the incidence rate of CaP was reported as almost similar for black men in Ibadan and Washington and from then on, research work from surgeons and pathologists, from the south to the north, east to west, continued to report increasing prevalence of CaP. Apart from epidemiology, other areas of research include KAP (knowledge attitude and practice) studies (poor education of caregivers and population), histopathology (mostly adenocarcinoma), diagnosis (digital rectal examination [DRE], prostate specific antigen [PSA], ultrasound), clinical features (late presentation and high mortality), and prevention (lifestyle, education and screening). As of today there is a gaping dearth of molecular and genetic studies. Conclusion: The global focus on CaP disparities in black men calls for more efforts from Africa, in all areas of research, along with international collaborations for capacity building.     

HIV-1 molecular epidemiology evidence and transmission patterns in the Middle East and North Africa

The distribution of HIV-1 subtypes in a population tracks the spread and evolution of the epidemic. This study is a systematic review of all available evidence on HIV-1 molecular epidemiology and subtype distribution in the Middle East and North Africa. Sources of data included Medline and various institutional documents and databases. In several countries, a diverse distribution of HIV-1 subtypes was observed principally reflecting travel-related exogenous exposures. A trend for a dominant HIV-1 subtype was observed in a few other settings and was often linked to HIV transmission within specific high-risk groups such as subtype A and CRF35_AD among injecting drug users and subtype C among commercial sex networks. Multiple exogenous introductions of HIV-1 variants seemed common to all countries, as observed from the high diversity in subtypes, or the high genetic divergence among any specific subtype even if predominant. In several countries though, epidemic-type clustering of specific subtypes suggests established or nascent HIV epidemics among classic core risk groups for HIV infection. HIV prevention efforts in MENA must be prioritized for these high-risk groups.