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   2005| July-December  | Volume 5 | Issue 2  
    Online since November 1, 2014

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Dyslipidaemia in Type 2 Diabetes Mellitus with Metabolic Syndrome
OS Adediran, AE Edo, AK Jimoh, AE Ohwovoriole
July-December 2005, 5(2):54-56
Background: Dyslipidaemia is a prominent feature of Type 2 Diabetes Mellitus (T2DM) and is usually characterized by hypertriglyceridaemia, low HDL-cholesterol and high LDL-cholesterol (especially the small dense LDL-cholesterol). It is a very important risk factor for cardiovascular events among patients with T2DM. What needs to be properly documented is whether the pattern of Dyslipidaemia is similar in both patients with Metabolic Syndrome X (MSX) and patients with only T2DM; at least among Africans. This study is aimed at determining the pattern of dyslipidaemia among patients with T2DM who had MSX and those who did not. Materials and Methods: Ninety-six patients with T2DM who had MSX and another 96 without MSX were randomly selected for the study at the Lagos University Teaching Hospital (LUTH), Lagos between April and September, 2002. MSX was determined by the presence of systemic hypertension and obesity in addition to T2DM. They were physically examined and blood samples were obtained for plasma lipid profile estimation. In addition, anthropometric indices were taken. Results: Patients with MSX had higher means of triglyceride, total cholesterol and LDL cholesterol levels (0.9 ± 0.4 vs 0.5 ± 0.3 mmol/l, 5.2 ± 1.1 vs 4.4 ± 1.1 mmol/l and 3.9 ± 0.9 vs 3.5 ± 1.2 mmol/l respectively) than the controls, <0.01. Most patients with MSX [85.4%] and controls [83.3%] had low HDL-cholesterol level, =0.98, whereas those who had hypertriglyceridaemia [2(2.1%) and 1(1%) respectively] were few, =0.96. Conclusion: In the two groups studied, the HDL-cholesterol levels were generally low while those of triglyceride and total cholesterol were normal. However, patients with MSX had higher mean values for triglyceride, total cholesterol and LDL- cholesterol than those who did not have MSX.
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A Review of 10 Years Autopsy of children with Cardiovascular Disorders
EN Ekure, FB Abdulkareem
July-December 2005, 5(2):35-39
Objectives: To review the prevalence and pattern of cardiovascular disorders in childhood autopsies in Lagos University Teaching Hospital (LUTH). To also determine the frequency of associated extra cardiac complications and characteristics of children with cardiovascular diseases that died. Materials and Methods: The autopsy register of the department of Morbid anatomy for the years 1991 to 2000 in LUTH was retrospectively reviewed. Data extracted including age, sex, primary diagnosis and cause of death was obtained for children aged less than 18years and analysed using SPSS 11.0 software. Results: Cardiovascular disorder was found in 93 of 2,032 autopsies (4.6%) done on children in LUTH for the study period. Sixty nine (74.1%) of the cardiovascular disorders were congenital heart diseases while 22 (23.7%) were acquired heart diseases. The commonest acyanotic and cyanotic congenital heart diseases were ventricular septal defect and tetralogy of fallot respectively. Rheumatic heart disease was the predominant acquired heart disease. The peak incidence was in the neonatal period with 31 (33.3%) neonates. There were extra cardiac complications in 23% of cases. These mostly involved the respiratory and central nervous system with bronchopneumonia being the commonest non-cardiac complication. The primary cause of death for 70 (75.3%) of them was cardiac failure. Conclusion: Majority of children with cardiovascular diseases die in the neonatal period making cardiac diseases one of the contributions to neonatal deaths. Early diagnosis, appropriate medical management and surgical intervention will help prevent these deaths thereby reducing neonatal and child mortality.
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Assessment of Plasma Electrolytes in Nigerians with Complicated and non-complicated Type 2 Diabetes Mellitus
ES Idogun, EI Unuigbe, PS Ogunro, OT Akinola, AA Famodu
July-December 2005, 5(2):40-42
Objectives: The objective of the study was to assess the plasma electrolytes of Nigerians with complicated and non-complicated type 2 diabetes mellitus. Setting: University of Benin Teaching Hospital, Benin - City. Study design: The study was cross-sectional in design. Patients and Methods: A total of 52 patients were studied. The patients' population consisted of 23 normotensive diabetics, 16 hypertensive diabetics and 13 patients with diabetic nephropathy. The plasma electrolytes were assayed in patients and controls using standard and established assay methods. Results: The mean serum sodium was significantly lower in patients than the controls: 129.7 ± 4.3 mmol/L in diabetic nephropathy patients, 133.4 ± 12.3 mmol/L in hypertensive diabetics, 132.7.5 mmol/ L in normotensive diabetics compared with 137.7 ± 3.4 mmol/L in controls, P = 0.026. Serum potassium was also higher in patients than controls: 5.4 ± 0.6 mmol/L in diabetic nephropathy, 3.8 ± 0.9 mmol/L in hypertensive diabetics and 4.07 ± 1.0 mmol/L in normotensive diabetics compared with 4.1 ± 0.6 mmol/L in controls, P< 0.0001. But plasma chloride and bicarbonate were not significantly different in the patients and the controls. Conclusion: We report disorders of sodium and potassium electrolytes in patients with complicated and non-complicated type 2 diabetes mellitus. These data highlight the risk of electrolyte disorders even when the patient is not in any acute complication.
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Determinants of correct Case Management of Common Childhood Illness by Primary Health Care Workers in an Urban LGA in Ibadan, Oyo State
BE Ogunnowo, AO Osibogun, AT Onajole, KA Odeyemi
July-December 2005, 5(2):43-47
Background: Inappropriate case management of common childhood illnesses is one of the factors responsible for the high childhood mortality in developing countries. Identification of factors which influence correct case management by health workers is imperative for interventions to improve Quality of case management. Objective: to identify determinants of correct case management of common childhood illnesses by primary health care workers in Ibadan South East LGA. Design: A descriptive cross sectional study was carried out over a 3-week period in September 2002 at Ibadan South East LGA. Study materials included observation checklists, validation checklist, and health worker interview questionnaires. Results: Twenty health workers were observed managing 132 children with various childhood conditions that was subsequently validated by the investigators. 9.2% , 81.8% and 23.1% of children with malaria, diarrhoea with severe dehydration and pneumonia received correct treatment respectively even though some children had more than one diagnosis. In-service training was significantly associated with correct treatment of ARI and Diarrhoea (odd's ratio 7.43 and 16.2 respectively.) Category of health worker was not significantly associated with correct management in all the disease categories. Conclusions: In-service training had a significant impact on correct case management of childhood illness. There is a need for training in Integrated Management Childhood Illness (IMCI) for all health workers in the LGA in order to improve the quality of care of children.
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Doppler Sonography in Nigerians investigated for Deep Vein Thrombosis: A Five-Year Review
OA Fasanmade, SO Giwa, MO Kehinde, MO Ibidapo, JN Ajuluchukwu, KO Soyebi
July-December 2005, 5(2):48-53
Vascular Doppler ultrasonography reports of patients in a private medical diagnostic centre over a 62-month period (Feb 1999 – April 2004) were traced and analysed. There were a total of 203 reports, which consisted of 98 males and 105 females. Patients were aged between 6– 91 years. Mean age of the patients was 52 years. One hundred and eight (53.2%) of the patients were referred with a diagnosis of suspected deep vein thrombosis (DVT), 25 others had clinical diagnosis of peripheral artery disease with or without leg ulcers/gangrene. Of the 108 (48 males and 60 females) suspected to have DVT only 45 (41.6%) had ultrasonographic evidence of DVT. These consisted of 23 males and 22 females. Twenty-four (12.3%) had valvular insufficiency, comprising 18 females and 6 males.
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Patterns of Presentation of Periodontal Conditions seen in Juvenile Periodontitis Patients In Lagos
PO Ayanbadejo, KO Savage, PA Akeredolu
July-December 2005, 5(2):57-61
Objective The objective of this study was to determine the oral hygiene and periodontal condition of juvenile periodontitis patients. Methodology Seventeen patients diagnosed with juvenile periodontis aged 18 to 29 years were identified. The oral hygiene status was determined using the Simplified Oral Hygiene Index by Greene and Vermillion. The periodontal status was assessed using the Community Periodontal Index of Treatment Needs. Results The predominant oral hygiene status was fair (64%). Only 12% exhibited good oral hygiene and this was noted more among the females (15%) more than males (10%). The most predominant periodontal status was code 3 (47%) of which 57% occurred among the females. No subject had a healthy sextant. The most frequent treatment needed was code II (65%). Conclusion Forty-seven per cent of juvenile periodontitis patients seen at our centre presented predominantly with moderately severe periodontal status (Code 3). No patient presented with a healthy sextant. Only about 12% had good oral hygiene. It is recommended that oral health education particularly oral hygiene measures are emphasized and periodontal clinical examination of adolescents be performed to detect early or insidious sites. More regular oral hygiene maintenance should be adopted among juvenile periodontitis patients.
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