Abstract: Kidney plays a very important role in the control of blood pressure and it is one of the vital organs frequently damaged when there is hypertension. There is increase urinary albumin and creatinine excretion in hypertensive nephropathy. This increase may be explained by factors such as renal haemodynamic changes, selectivity changes of the glomerular filters and structural arteriolar and glomerular changes due to nephrosclerosis. This research aimed at assessing the suitability of first voided spot urine albumin creatinine ratio as screening test of microalbuminuria in hypertensive Nigerians. Method: Forty (40) normal subjects were enrolled as controls, the control population was make-up of 23 healthy male and 17 females aged between 20-70 years. Based on the effect of treatment on blood pressure of subject, 30 well controlled BP <140/100mmHg and 30 poorly controlled BP > 140/100mmHg benign essential hypertensive patients were recruited and studied. They were also of the same age range as the control subjects. Urinary albumin was measure by ELISA( Enzyme Linked Immunosorbent Assay) method from 2 types of patient's urine samples (a) an 8-hours overnight urine sample and (b) an early morning first voided spot urine. Albumin excretion rates (AER) was calculated from urinary albumin concentration, urine volume and the collection time. Urinary creatinine was also measured on early morning (first voided) spot urine by modified Jaffe method. The AER of 8-hours overnight urine sample was compared with the albumin creatinine ratio of first voided early morning urine. Statistical analysis was by EPI info programme, Harvard graphic and Spearman's rank correlation coefficient programme. Results: The results showed significant positive correlation between AER and Albumin creatinine ratio (ACR). Among the control subject 12.5% has AER > 20μg/min and 10% has ACR > 3.0mg/mmol. Among well-controlled patients, 40% has AER > 20μg/min while 33% has ACR > 3.0mg/mmol. Among poorly controlled patients 56.7% has AER > 20μg/min and 50% has ACR > 3.0mg/mmol. The correlation between AER and ACR increased significantly with severity of hypertension. In control, r = 0.84 p < 0.05, in well control r = 0.86 P < 0.05 and in poorly controlled r = 0.99, p < 0.05 Conclusion: Assessment of first voided spot urine albumin creatinine ratio from early morning (first voided) spot urine is a good alternative to precisely times and conducted overnight albumin excretion rate.

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Aim/Objective: The aim of this study was to identify and characterize the rhythm of blood glucose levels within a 24-hour period in rats kept under standard photoperiodic conditions of 12 hours of light alternating with 12 hours of darkness in the Department of Anatomy, College of Medicine, University of Lagos. Subjects/Materials/Method: 30 adult male Sprague-Dawley rats weighing 150-170g were used. Basal blood glucose levels were taken at 0700h (week 1) in all the rats after an unrestricted overnight access to food and water. Following an interval of one week (i.e. week 3), the fasting blood glucose levels of all the animals were also determined at 0700h (i.e. after 12 hours of overnight fasting). 4-hourly serial blood glucose levels were then determined at 0700, 1100, 1500, 1900, 2300 and 0300h (week 5) in all the rats and these were repeated after two weeks (week 8). Prior to each sampling of the serial blood glucose assessments, the animals were allowed unrestricted access to food and water in the first one-hour while they were fasted for the following 3 hours. Result: The results of our study showed that the blood glucose level varied with the time of the day. The mean basal blood glucose at 0700h after an unrestricted access to food and water was 85.33 ± 6.02 mg/dL while the mean fasting blood glucose at 0700h was 41.33 ± 1.69 mg/dL. The mean serial blood glucose levels at 0700, 1100, 1500, 1900, 2300 and 0300h in week 5 were 63.31 ± 5.72, 54.78 ± 3.55, 69.98 ± 4.78, 80.78 ± 5.08, 69.02 ± 5.61and 76.58 ± 6.13 mg/dL while the values obtained in week 8 were 62.95 ± 5.02, 53.88 ± 2.98, 71.36 ± 5.69, 83.88 ± 6.04, 65.64 ± 4.12 and 73.08 ± 5.01 mg/dL respectively. There were statistically significant differences (p< 0.05) between the nadir and peak values obtained. Levels remained relatively higher during the scotophase than in the photophase. Conclusion: We conclude that blood glucose level in Sprague-Dawley rats subjected to scheduled feeding in Lagos exhibits circadian rhythm with peak at 1900h and nadir at 1100h.

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Objectives: To assess the lipid profile of Nigerian women using hormonal contraceptives and determine which of the hormone preparations significantly alter this profile. Methods: This was a cross-sectional study consisting of 50 premenopausal women who were attending the family planning clinics of the Lagos University Teaching Hospital and Planned Parenthood Federation of Nigeria. The controls were 50 age-matched women using non-hormonal contraceptive methods. Sociodemographic data of the subjects were obtained and a brief medical examination carried out. Blood samples for lipid profile were collected after an overnight fast. Results: Both groups had similar demographic statistics. The mean age of the hormone users was 35.89±5.36 Vs 35.52±4.85, p=0.78. The hormone users had a higher mean total cholesterol and low density lipoprotein cholesterol (LDL-C) than the controls; 4.23±0.30 Vs 4.06±0.34, p=0.01 and 2.50±0.30 Vs 2.33±0.28, p=0.005. There was no significant difference in the means of Triglyceride (TG) and high-density lipoprotein cholesterol (HDL-c) between the two groups. On subanalysis, Medroxy progesterone acetate had a significantly higher mean of total cholesterol and LDL-C than the controls 4.28±0.26 Vs 4.06±0.34, p<0.05 and 2.57±0.27 Vs 2.33±0.28 p<0.01. The women on Norethisterone oenanthate had a significantly higher level of TG than the controls 0.92±0.14 Vs 0.79±0.08, p<0.05. The women on implants had significantly higher levels of total cholesterol, LDL-C and TG than the controls: 4.60±0.27 Vs 4.06±0.34, P<0.001; 2.87±0.20 Vs 2.33±0.28, p<0.001 and 0.0.89±0.07 Vs 0.79±0.08, p<0.01 respectively. There was no significant difference between the lipid fractions of women on oral contraceptives and the controls. Conclusion: Based on the findings of this study, lipid profile changes still abound with the use of hormonal contraceptives. The effect is more obvious with the use of injectable progesterone, which are no longer in use in most developed countries. Newer implantable forms of hormonal contraceptives may not be as innocuous as assumed as shown by data from this study.

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Background and Objectives: Diabetes mellitus foot syndrome (DMFS) is an important cause of morbidity and mortality in Nigerian diabetics. Identification of the risk factors for foot ulceration is of paramount significance in the prevention of this all important complication of diabetes mellitus. As such, this study sets out to determine the risk factors of DMFS, of which the results are hoped to be of practical usefulness to care givers, policy makers and as well as to people living with diabetes mellitus. Subjects and Methods: This study was carried out in the Lagos University Teaching Hospital (LUTH) over a one year period. It is a case-control study in which 47 diabetic patients with past or present foot ulceration were studied. An equal number of controls who were diabetic patients with no past/present history of ulceration were studied. Relevant medical history, general physical examination neurological, vascular, ocular, metabolic and other assessments were carried out in these two groups of patients. Data were analyzed using the statistical package for social sciences SPSS version 9. The test statistic used included Student's t test, Chi squared test and logistic regression for the determination of odds ratio. Results: The risk factors that were strongly associated with foot ulceration included peripheral vascular disease, male sex, nephropathy, retinopathy, foot deformities, history of previous foot ulceration or amputation, cataract formation, poor glycaemic control, neuropathy and Tinea pedis. Weakly associated risk factors for foot ulceration were walking unshod, being of a low socio-educational status and smoking. Conclusions: The risk factors for foot ulceration are potentially preventable. As part of a comprehensive foot care program, education on foot care should be directed at the patients, family members of the patients as well as the health care providers.

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Introduction: Dyspepsia constitutes one of the most common symptoms in general medical practice. The clinical challenge in the evaluation of dyspepsia is to reliably sift out the minority of the patients with underling organic pathology who require investigation from those with functional dyspepsia who do not. Methods: Questionnaire interviews and clinical examination were conducted in 84 patients with dyspepsia. Blood samples were collected for the detection of anti-Helicobacter pylori immunoglobulin (Anti-Hp Ig). Abdominal ultrasound scan and gastroduodenal endoscopy were performed in a sub-set of the subjects. Results: The mean age of the patients with dyspepsia was 38.6 (13.3) years. There was a female preponderance with a male to female ratio of 1 to1.5. Reflux-like dyspepsia was the commonest symptom complex of dyspepsia and occurred in 38 (41.7%). Ulcer- like dyspepsia was seen in 22 (26.8%). Helicobacter pylori antibodies was detected in 88% cases and was uniformly high in all clinical sub-categories (p=0.08). Non-specific gastritis was the commonest endoscopic findings and was seen in 14/22 (56%). Duodenal ulceration was seen in only 2/25 (8%) on endoscopy. Conclusion: Dyspepsia is most often associated with a reflux-like clinical pattern. Anti-Hp was commonly detected in dyspeptic patients and may not be the best screening test in the identification of active helicobacter pylori infection and peptic ulcer disease. Most cases of dyspepsia in this environment appear to be associated with non-specific gastritis or oesophagitis.

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Full text not available  [PDF]