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   Table of Contents - Current issue
Coverpage
July-December 2021
Volume 18 | Issue 2
Page Nos. 35-65

Online since Saturday, December 10, 2022

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ORIGINAL ARTICLES  

Cardiac disease and associated comorbidities seen among children in Niger Delta region of Nigeria during a cardiac screening program p. 35
Queennette Obby Daniels, Frances Sam Okpokowuruk, Chika O Duru, Olukemi O Ige, Efe E Abolodje, Patience A Udo, Christopher S Yilgwan, Olawale Olabiyi
DOI:10.4103/njc.njc_34_20  
Background: There are few studies on the pattern of cardiac diseases (CD) among children in the Niger Delta region of Nigeria. This study examines the pattern of cardiac disease and associated comorbidities among children living in the Niger Delta region of Nigeria during a cardiac mission. Materials and Methods: This was a descriptive cross-sectional study which involved all children with prior diagnosis of CD referred from all the states of Niger Delta region of Nigeria. All children had echocardiogram and electrocardiogram performed by a team of Paediatric cardiologists. Results: Out of a total of 155 children who presented for the cardiac screening exercise, 145 (75 males and 70 females) children had CD. Their ages ranged from 0.2 to 180 months with a mean age of 45.5 ± 44.3 months which was significantly higher than their mean age at first diagnosis of 12.2 ± 22.9 months (P = 0.0072). Of the 145 children with cardiac disease, 128 (88.3%) of the patients had congenital heart disease and 17 (11.7%) had acquired heart disease and arrhythmias. Ventricular septal defect, Tetralogy of Fallot, and Rheumatic heart disease were the commonest acyanotic, cyanotic and acquired heart diseases respectively. Solitary lesions accounted for 91 (62.8%) of cases while multiple lesions accounted for 54 (37.2%) with as many as 35 (24.1%) children having complex heart diseases. Sixty-nine (47.6%) children presented with comorbidity. Conclusion: The burden of cardiac disease and complex heart disease in the Niger Delta region of Nigeria remains high. Early detection and prompt intervention would help to reduce the morbidity.
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Diagnostic usefulness of NT-proBNP in asymptomatic left ventricular dysunction in black hypertensive patients p. 44
Atinuke O K Richard, Folasade Adeola Daniel, Phillip Alaba Adebola, Olayinka O Ogunleye, Ayodele O Ekun
DOI:10.4103/njc.njc_40_20  
Background: Hypertensive patients with left ventricular (LV) dysfunction, may be asymptomatic early in the disease process but tend to develop overt heart failure later on. While the usefulness of NT-proBNP in the early detection of LV dysfunction has been well studied among the Western population, there remains a relative paucity of information about its usefulness among black hypertensive patients. The aim of this study was to determine the diagnostic usefulness of NT-proBNP in the early detection of asymptomatic LV dysfunction in black hypertensive patients. Methodology: The LV function of 134 patients with hypertension who were never in heart failure and 89 age- and sex-matched normotensive individuals were assessed using echocardiography and serum NT-proBNP assay. However, due to various factors (such as drop out and abnormal laboratory results), 131 hypertensives and 79 controls were eventually analyzed. Echocardiography was used as gold standard in determining LV functions. NT-proBNP levels were measured using enzyme-linked immunosorbent assay. Data obtained were summarized with appropriate descriptive and inferential statistics at a 5% level of significance using the Statistical Package for the Social Science (SPSS) Version 22.0 software. Results: Asymptomatic LV dysfunction was present in 107 hypertensive individuals (81.7%): 102 (77.9%) had isolated diastolic dysfunction and 5 (3.8%) had combined diastolic and systolic dysfunction; whereas the remaining 24 patients (18.3%) had normal LV function. NT-proBNP were 175.21 ± 227.75 and 430.13 ± 491.88 pg/ml, P = 0.017, in hypertensive individuals without and with asymptomatic LV dysfunction, respectively. Using the NT-proBNP level of 56 pg/ml obtained among the controls, NT-proBNP level had a sensitivity of 62.8% and specificity of 60.9%. NT-proBNP level also had a positive predictive value of 88.0% and negative predictive value of 26.4%. Conclusion: NT-pro-BNP could be incorporated as a screening tool for early detection of asymptomatic LV dysfunction and possibly, stratify patients for further evaluation and treatment.
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Prevalence of obesity, hypertension, and diabetes among patients attending outpatient clinic at a tertiary health institution in Southwestern Nigeria p. 51
Adeola Beatrice Adetola, Ime Ani, Jeremiah Eti-Inyene Matthew, Grace Bosede Abodunde
DOI:10.4103/njc.njc_14_21  
Background: The prevalence of noncommunicable diseases such as obesity, hypertension, diabetes, etc., has been on the increase globally. The study assessed the prevalence and association between obesity, hypertension, and diabetes among patients visiting the dietetics outpatient clinic of Babcock University Teaching Hospital. Methodology: The prevalence and association between obesity, hypertension, and diabetes were assessed in this retrospective study. The study was conducted at the outpatient clinic of the Dietetics Department, Babcock University Teaching Hospital Ilisan-Remo Ogun State. Age, gender, height, weight, and diagnosed diseases were extracted from the record of individuals who presented at the clinic for 75 months. Data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20. Result: A total of 1059 patient's record was used in the study. The prevalence of obesity, hypertension, and diabetes were 58.9%, 37.4%, and 18.9%, respectively. Obesity and diabetes were prevalent among females than males (m = 20.4%, f = 38.5%), (m = 8.8%, f = 10.1%), while hypertension was prevalent among males (m = 19%, f = 18.4%). Diabetes was prevalent among older adults, while obesity and hypertension were prevalent among adolescents and young adults (23.9%). Obesity was significantly associated with hypertension (P < 0.05), and diabetes (P < 0.05). Conclusion: The prevalence of obesity, hypertension, and diabetes in this study was high. Obesity and hypertension were prevalent among adolescents and young adults.
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Factors associated with low adherence to medications in heart failure p. 57
Ehi J Ogbemudia, Eunice Aghimien, OD Aghimien, Austine O Obasohan
DOI:10.4103/njc.njc_7_21  
Background: Medical therapy is fundamental in the management of heart failure (HF), and it is associated with favorable outcomes. These outcomes are attainable with good adherence to medications. However, the level of adherence to HF medications and the associated factors have not been well documented in Nigeria. Aim: The aim of the study is to determine the level of adherence to HF medications and the associated factors in HF patients. Materials and Methods: This was a cross-sectional study of HF patients in a tertiary health facility. A researcher-administered questionnaire was used to obtain demographic variables, assess adherence to HF medications with the Morisky medication adherence (MA) scale, and determine barriers to adherence. The proportions of respondents with a high and low adherence were derived, and the associated factors were investigated with Chi-square tests and multiple logistic regression. Results: They were 168 respondents with a median age of 63 years, and 94 (56%) were females. The median MA score was 4.13. Forty eight (28.6%) and 120 (71.4%) had high and low MA, respectively. The associations of comorbidities, method of payment, and alternative medicines with the level of adherence gave p values of 0.000, 0.002, and 0.000, respectively. Barriers to adherence were financial 43 (35.8%), forgetfulness 38 (31.7), and others constituted 44 (36.7%). Conclusions: Adherence to HF medications is suboptimal. It is associated with out-of-pocket payment, comorbidities, and usage of alternative medicines. Financial constraint and forgetfulness are the common self-reported barriers to adherence. Interventions to address these factors should be initiated.
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CASE REPORT Top

Infective endocarditis due to Acinetobacter baumannii in an infant with complex congenital heart disease p. 62
Ibrahim Ahmadu, Nuhu Abubakar Garba, Muhammad Shakur Abubakar, Halima Kabir, Peter David Igoche, Apollos Daniel, Ismail Mohammed Inuwa, Ibrahim Aliyu, Mustafa O Asani
DOI:10.4103/njc.njc_1_21  
Infective endocarditis (IE) due to Acinetobacter baumannii is rare in children, however associated with significant morbidity and mortality. Congenital heart diseases are among the major risk factors for IE. We report a case of IE in an infant caused by A. baumannii. The patient is a 2-month-old infant with complaints of recurrent cough and breathlessness since birth which worsened 2 days before admission, associated with fever. There is difficulty in breastfeeding and occasional forehead sweating with associated darkening of the lips, palms and soles. She has been failing to thrive since birth. Significant findings on physical examination include respiratory distress with hypoxia, pyrexia, severe wasting, tachycardia, tachypnea, tender hepatomegaly, widespread coarse crepitation, displaced apex beat and a pan-systolic murmur. Full blood count was suggestive of sepsis, blood culture yielded A. baumannii, chest X-ray revealed dextrocardia with cardiomegaly and increased vascular markings while transthoracic echocardiography showed complex congenital heart disease with vegetation. The patient was commenced on intravenous antibiotics and supportive managements, however died while on admission.
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