Nigerian Hospital Practice

Serum 25 hydroxy vitamin D level among adult black population in Lagos, Nigeria

2024-02-15T07:35:39+00:00

This is a retrospective descriptive study of serum level of 25 hydroxy vitamin D among adult black subjects in Lagos, Nigeria. Vitamin D testing is not a regular routine test request because of high cost and poor knowledge in the association of vitamin D deficiency with disease conditions. The aim of the study is to assess the prevalence of reduced level of 25 hydroxy vitamin D among the study subjects and possible correlation with age and gender. Three hundred and thirty-eight subject data were considered for this study from data between 2014 and 2017. Their serum 25 hydroxy vitamin D were assayed using COBAS 6000 Chemiluminiscence immuno-analyser under standard controlled conditions. However, only three hundred and twelve subjects had complete set of data and were used for the study. Serum level of 25 hydroxy vitamin D were studied in 312 subjects. 66% of the study population had serum vitamin D below adequacy level of 30 ng/ml (38.1% were significantly deficient). There was no correlation between serum vitamin D level and age or gender. There is significant vitamin D insufficiency and deficiency among the black subjects in Lagos irrespective of the abundance of sunlight available for de novo synthesis from the skin. Education and reviewed awareness on supplementation may help treat this deficiency.

The spectrum of renal dysfunctions in sickle cell disease: Aetiopathogenesis and management of sickle cell nephropathy and non-sickle cell nephropathies in patients with sickle cell disease

2024-02-15T07:37:56+00:00

Renal dysfunction (RD) is a common complication of sickle cell disease (SCD). Literature regarding RD in SCD is dominated by 'sickle cell nephropathy' (SCN), with little reference to 'non-sickle cell nephropathies' (NSCNs) that also affect SCD patients. This overview aims to present a comprehensive but concise narrative review of aetiopathogenesis and management of both SCN and NSCNs in SCD patients. Literature was searched using terms relevant to RD in SCD. Only articles that examined aetiology, pathogenesis, and/or management of acute and chronic RD in SCD were selected. In addition to SCN, SCD patients incur a range of acute and chronic NSCNs due to separate or combined effects of rhabdomyolysis, infection, hyperuri-cemia, analgesics, autoimmune disorders, and amyloidosis. Hence, RD in SCD patients may be caused by SCN or NSCN or both. Despite differences in aetiopathogenesis and treatment, SCN and NSCNs share similar clinical features. Thus, NSCNs can be mis-diagnosed as SCN, while SCN can mask and delay diagnosis of NSCN if the two disorders coexist. While SCN remains the prototype RD in SCD, a myriad of NSCNs also cause RD in patients with SCD. Although SCN and NSCNs share similar clinical features, the two conditions are managed differently. Therefore, SCD patients presenting with RD should always be broadly investigated for both SCN and NSCNs. This strategy will ensure accurate diagnosis and differentiation between SCN and NSCNs, which is essential for providing 'cause-specific' management of RD in patients with SCD.

Consecutive cases of uterine anomalies detected at caesarean section: A reawakening call for a critical look.

2024-02-15T07:41:27+00:00

Uterine malformations are as result of agenesis, hypoplasia, abnormal fusion, or resorption of Müllerian ducts. The causes of uterine malformations are can be said to be due to varying factors like genetic, environmental etc. Septate uterus has been found to be the commonest cause of uterine anomaly. We report a case series of uterine anomalies. These case series involves four (4) patients who had caesarean section on account of malpresentation at term and during inspection of the uterus it was observed that there was an existing uterine anomaly These case series is comprised of two (2) cases of bicornuate uterus, one (1) case of septate uterus and one (1) case of uterine didelphys. We therefore recommend strict inspection of the anatomy at caesarean section during the conduct of all caesarean sections and even more strictly in instances where there is a high index of suspicion of uterine anomalies based on the identifiable risk factors.

Time to treat the climate and nature crisis as one indivisible global health emergency

2024-02-15T07:33:47+00:00

No abstract.