Nigerian Hospital Practice

Evaluation of Serum High-Sensitivity C-reactive Protein and Uric Acid and their Correlation in Hypertensive Patients in Southern Part of Nigeria.

Eguvbe AO — 2024-11-30

Summary:

Inflammation has been shown to contribute to the pathogenesis of hypertension and cardiovascular disease. Consequently, markers of low-grade inflammation such as high-sensitivity C– reactive protein (HSCRP) have been reported to be elevated in hypertension. Also, serum uric acid (SUA) concentrations have been linked with an increased risk of cardiovascular disease. This study was aimed at evaluating the serum levels of HSCRP and uric acid and their correlation in hypertensive patients. This was a cross-sectional study done in the hospital between October 2022 and January 2024 involving three hundred participants, composed of two hundred hypertensive and one hundred normotensive individuals. The mean HSCRP were 4.23 ± 3.31 vs. 1.50 ± 1.49 mg/L in the hypertensive and control groups respectively. The difference in the two groups was statistically significant (<0.001). The mean SUA were 0.26 ± 0.18 vs. 0.14 ± 0.03 mmol/l in the hypertensive and control groups respectively. The differences in the two groups were statistically significant (<0.001). There was a significant weak positive correlation between HSCRP with SUA in the hypertensive group (Pearson's Correlation = 0.222, P-value = 0.012). Serum levels of HSCRP and uric acid were significantly higher in the hypertensive patients than in normotensive controls. Also, there was a significant weak positive correlation between HSCRP and serum uric acid in the hypertensive group.

Depression in Patients with Diabetes Mellitus in a Northern Nigeria Teaching Hospital

Maigari JM — 2024-11-30

Summary

Depression in Patients with Diabetes Mellitus in a Northern Nigeria Teaching Hospital Diabetes mellitus is a public health concern and a chronic disease characterized by relative or absolute insulin deficiency. Depression is common and it is a debilitating illness globally. This work set out to study the association of depression in patients with diabetes mellitus at Ahmadu Bello University Teaching Hospital, Zaria. This was a cross sectional descriptive study conducted at the Endocrinology Clinic of the Ahmadu Bello University Teaching Hospital, Zaria. Adults with type I or type II Diabetes mellitus for at least six months were included. Subjects were screened with GHQ-12 and those with score of ≥3 were administered with Schedule for Clinical Assessment in Neuropsychiatry (SCAN) [Depression module]. All subjects were administered with the WHO Quality of Life bref (WHOQoLbref) and the WHO Disability Assessment Schedule WHODAS 2.0 Questionnaires. The study found a high prevalence rate of depression among diabetes mellitus patients but no significant association between socio-demographic factors and depression. There is need for depression screening and management in diabetes mellitus care to improve outcomes.

Estimation of Live Virus Content of Yellow Fever Vaccine by Tissue Culture Technique

Talle M — 2024-11-30

Summary

Efforts to develop yellow fever vaccines began soon after the isolation of the virus in 1927. Use of the French Neurotropic vaccine began in the 1930s and proved to be effective, but this vaccine was discontinued in 1982 because of the unacceptably high incidence of adverse events, especially encephalitis . All current yellow fever vaccines are derived from the 17D strain, 2 main lineages of the 17D line (17D204 and 17DD) were used for vaccine production . Since there is no specific antiviral drugs available for yellow fever, the use of live attenuated yellow fever vaccine was recommended for children of age 6-9 month and individuals traveling to regions where yellow fever is endemic. The potency of live attenuated yellow fever vaccine collected from ten (10) different hospitals/immunization centers in Maiduguri were determined using Vero cell line obtained from National Polio Laboratory Maiduguri by micro titration method. The seven (7) different batches of yellow fever vaccines (606, 604, 612, 614, 720, 726 and 9945781A) collected from primary immunization centre (NH, SH and USH) show low/lost potency which consequently may affect their efficacy as compare to WHO standard titer of 10 ten dose/ vial. This may be linked to inadequate storage facility at the primary immunization centers, poor power supply (lack of 24hrs stand by generator/power back up) and lack of strict adherence to WHO guidelines for yellow fever vaccine storage /administration are possible factors to the low titer vaccine obtained in this study. Thus, improvement of these facilities within the vaccine storage and distribution network is therefore advocated to keep the yellow fever vaccine at the optimal WHO standard titer.

Case Report: Umbilical Cord Accident; An Obstetric Tragedy Still with us.

Ogunlaja IP — 2024-11-30

Summary

Intrauterine fetal demise (IUFD) is a tragic event that can have various etiologies, including maternal, fetal, and placental factors. Cord accidents, although not highly frequent, are a substantial cause of IUFD, particularly in the late stages of pregnancy. Cord accidents are a significant but often underreported cause of IUFD in Nigeria. We present a case of Mrs M.O. a 32-year-old booked G2P1 + 0 (not alive) woman with a known history of sickle cell disease (SCD) and a previous Caesarean section scar who experienced IUFD of a 24-week-old fetus due to a cord accident. The SCD status, the history of previous caesarean section and the need for expeditious management, allowed for a decision to proceed with an hysterotomy to deliver the fetus. Although cord accidents are unpredictable, understanding risk factors and employing advanced diagnostic tools can aid in early detection and management in order to prevent intrauterine fetal death.