Thoracic aortic dissection in a patient with autosomal dominant polycystic kidney disease

Autosomal dominant polycystic kidney disease is one of the most common hereditary diseases, and frequently has well defined extrarenal manifestations. Very few cases of aortic aneurysms associated with this disorder are described in literature. We report a 42-year-old male with autosomal dominant polycystic kidney disease presenting with dissecting aneurysm of the thoracic aorta.     

"He does his own and walks away" perceptions about male attitudes and practices regarding safe motherhood in Ekiadolor, Southern Nigeria

The main study objectives were to highlight male attitudes and practices regarding safe motherhood, and to demonstrate the usefulness of qualitative research methods in studying behaviour-related health problems. The setting was Ekiadolor, a semi-urban Nigerian community with an under-resourced district hospital. The study design was a qualitative research, using Focus Group Discussions (FGDs) with females and the local hospital staff as participants, triangulated with Free Listing Interviews (FLIs) and group interviews of males. The FGD findings showed a consensus that male practices and attitudes were generally unsatisfactory, as exemplified by physical violence against females, delay in enabling access to emergency obstetric care and a general perception that males were uncaring. However, many males paid parts of their partners' routine obstetric care bills. These findings were largely corroborated and enriched by those of the FLIs and group interviews, albeit with differing emphases; they provided vital inputs into health education of the community males. In conclusion, the wide range of attitudes and practices described, and the socioeconomic settings in which they occur, pose challenges and opportunities for behaviour change interventions primarily targeting males, poverty reduction and health service reforms. Health researchers are challenged to draw from the varied strengths of qualitative research methods.     

Using Local Culture and Gender Roles to Improve Male Involvement in Maternal Health in Southern Nigeria

Group health talks were conducted in Ekiadolor, Southern Nigeria, to improve male attitudes and practices regarding their involvement in prenatal care and family planning. Intervention planners highlight the importance of embedding local cultural norms along with co-opting gendered beliefs for purposes of planning and implementing the group talks. The authors facilitated 9 groups of adult males mostly from the traditional hierarchy of the community. Using gender theory as an analytical lens along with the application of local cultural beliefs and norms, a useful communication intervention was developed that increased the possibility of positive male engagement in maternal health in 1 Nigerian community.     

The Relationship Between Glycaemic Control and Non-Alcoholic Fatty Liver Disease in Nigerian Type 2 Diabetic Patients

Background

Metabolic risk factors associated with non-alcoholic fatty liver disease (NAFLD) include Type 2 diabetes mellitus (T2DM), obesity and dyslipidaemia. Prevention or management of these risk factors with glycaemic control, weight reduction and low serum lipid levels respectively have been reported to reduce the risk of NAFLD or slow its progression. Since ultrasound (USS) is a safe and reliable method of identifying fatty changes in the liver, this study was done to determine the relationship between glycaemic control and ultrasound diagnosed NAFLD in T2DM.

Nonshaved cranial surgery in black Africans: a short-term prospective preliminary study

BACKGROUND: Many studies on white populations have shown the absence of any scientific, or even beneficial, basis for the traditional preoperative ritual of shaving the operative field. We were not able to lay our hands on any document regarding this subject on any black African population. METHODS: We prospectively performed 17 cranial procedures in nonshaved fields in 15 selected black Africans in the Lagos State University Teaching Hospital, Ikeja, Nigeria. RESULTS: There was no serious complication recorded over a short-term follow-up of 2 to 6 months. The short, curly, crimpy, and densely knotted black African scalp hairs however did pose some unique perioperative challenges to us. CONCLUSIONS: Nonshaved cranial surgery, as in whites/Asians, can also be safely carried out in black Africans. This however demands some attention to details in the perioperative care of the incision sites. We found this caveat to be particularly more imperative in black Africans because of their unique anthropological scalp hair characteristics.     

Lymphocyte subpopulations and antibody levels in immunized malnourished children

1. The proportions of lymphocyte subpopulations (by rosette tests) and the serum antibody levels (using haemagglutination techniques) were estimated in malnourished and well fed Nigerian children before and up to 21 d after immunization with tetanus toxoid or measles virus vaccine. 2. Significantly diminished (P less than 0.01) mean percentage T lymphocyte levels and considerably higher mean percentage null cell levels were observed in the malnourished children before immunization with either of the vaccines. 3. There was comparable in vivo increases in percentage T lymphocytes in malnourished and control children following the administration of each antigen. 4. The mean percentage B lymphocyte levels were similar in the control and malnourished children before and after the immunization. 5. There was a slight depression in the tetanus antibody levels (P greater than 0.2) but a significant diminution (P less than 0.01) in measles virus antibody concentrations in the malnourished children. 6. Rise in mean percentage T lymphocytes corresponded with the elevation in mean tetanus antibody levels in both malnourished and control children following tetanus toxoid immunization. This was however not the situation in the malnourished children following immunization with measles virus. 7. The observed depressed T lymphocyte number in malnourished children may in practice affect their handling of antigens such as measles virus in vivo.     

Left ventricular diastolic function in normotensive type-2 diabetic subjects

BACKGROUND: Most previous studies on diastolic function in diabetics are confounded by coexisting ischemic heart disease, obesity and hypertension. Therefore, there may be advantages in studying patients with diabetes mellitus in developing nations where confounding variables are less prevalent. The aim of this study was to assess the effect of type-2 diabetes mellitus on left ventricular diastolic function in normotensive subjects in Nigeria. METHODS: One-hundred-twenty-two patients with type-2 diabetes mellitus aged 35-74 years with a mean age of 55.30 +/- 8.53 years were studied. Patients with blood pressure > or =140/90 mmHg or on treatment for hypertension were excluded from the study. Ninety-one healthy volunteers aged 40-75 years with a mean age of 55.30 +/- 8.56 years were recruited as normal controls. Transthoracic echocardiography was performed in all subjects to assess their left ventricular diastolic filling pattern by analyzing mitral and pulmonary flow velocities. RESULTS: Seventy-one (58%) of the type-2 diabetic subjects had evidence of impaired relaxation, 9 (7%) had pseudonormal filling and 7 (6%) had a restrictive filling pattern. Only 29% of the diabetics had a normal filling profile compared to 58% of the normal controls (X2 = 19.4, p = 0.0002). CONCLUSIONS: The result of the study shows that Nigerian type-2 diabetics have impaired left ventricular filling compared with normal subjects independent of confounding factors such as obesity and blood pressure. Therefore, not only Caucasians, African Americans and Asians but also African diabetic subjects suffered from diastolic dysfunction.