Adult Nigerians Research Articles

Examining traditional methods of handling domestic violence in a Southeastern Nigerian state: the imperative for social workers’ involvement

ABSTRACT This study investigates the conventional methods used to combat domestic violence within cultural contexts in a local council in Nigeria’s Southeastern state. The study aims first to promote the use of traditional methods of resolving domestic violence that aim at ensuring family unity and second, the need for social workers’ engagement in conventional means of resolving domestic violence. A qualitative study methodology was employed, using in-depth interviews to elicit data from twelve adult Nigerians residing in a local council of a southeastern state. Thematic analysis was adopted to analyze the data. The study discovered significant factors, including poverty, anger, and patriarchal structures, as predictors of domestic violence with substantial repercussions on family cohesion and the mental health of those affected. The findings revealed that people in the study area are well-versed in traditional methods for handling domestic violence, with family elders and traditional and religious leaders playing a crucial role. The study reveals that people are unaware of social work professionals’ involvement in domestic violence management, mainly due to the relatively new and emerging nature of formal social work practice. We suggest the inclusion of social workers for effective and efficient use of traditional approaches in handling domestic violence. Their engagement becomes essential in propagating awareness about better system trust to encourage the use of conventional methods to ensure family protection, preservation, and reunification, unlike the formal legal system. The study, however, indicated that effective collaboration among social workers, policymakers, and community stakeholders is essential to develop comprehensive policies that effectively tackle the issue of domestic violence. Overall, the study recommends a collaborative effort by social workers and community stakeholders to develop strategies and identify adequate linkages to prevent possible social injustice resulting from patriarchal norms within the cultural context that may affect their intervention.

Prevalence and Pattern of Labial Frenal Attachments in Adult Nigerians - a Pilot Study

Introduction The frenum is a band of mucous membrane which connects the lips and cheeks to the alveolar mucosa, underlying periosteum, or the gingiva with a primary function of stabilizing the lips and tongue. There are variations of frenal attachment and morphologies, some associated with health, others resulting to loss of periodontium. This study therefore aims to assess the various attachments and morphologies within our study population. Materials and Methods This was a descriptive cross-sectional study conducted at the Oral Diagnosis and Periodontology clinics of the Lagos University Teaching Hospital Idi-Araba among participants who reported to both clinics. Convenience sampling method was employed in participants’ selection, and interviewer-administered questionnaires were used for data collection and documentation of socio-demographic variables, and findings of intra-oral examination. Ethical approval was obtained from the institutional Health Research Ethics Committee and informed consent was obtained from each participant. Data was analyzed using the Statistical Product and Service Solutions (SPSS) version 27. P values < 0.05 were statistically significant. Results The study comprised 337 participants, 203 (60.2%) were females. Mean age was 34.6±15.2 years. The frenal attachment distribution in the maxilla was mucosal 204 (60.5%), gingival 105 (31.2%), papillary 23 (6.8%), and papillary penetrating 5 (1.5%);while in the mandible, 233 (69.1%), 92 (27.3%), 9 (2.7%) and 3 (0.9%) presented with mucosal, gingival, papillary, and papillary penetrating frenal attachment respectively. Simple frenum was the most prevalent frenum morphology in the maxilla [328 (97.3%)] and the mandible [321 (95.2%)], followed by trifid frenum in both maxilla [5 (1.5%)] and mandible [4 (1.2%)]. Diastema was present in 27.6% in maxilla and 11.0% in the mandible. Conclusion In this study, mucosal type was predominant among all age groups. Males presented more with gingival and mucosal type of frenal insertion, while females presented more with papillary type of frenal insertion. Papillary and/or papillary penetrating were significantly associated with the presence of diastema.

Distomolars – Exploring the Rare Clinical Entity in a Northern Nigerian Population

Background: Distomolars are supernumerary teeth erupting distal to the maxillary or mandibular third molars. This present study explored the clinical significance of distomolars in a Nigerian population. Objectives: The aim of the present study was to estimate the prevalence, clinical significance, and pathologies associated with distomolars in a population of Northern Nigerian adults using dental pantomograms. Materials and Methods: This retrospective cross-sectional study was conducted in the Department of Oral Diagnostic Sciences, Aminu Kano Teaching Hospital, Kano State, Nigeria, and it included the extraction of images from the central computer attached to the Planmeca Promax machine. The sampling frame included patients who had dental pantomograms during the two-year period under review. The images were viewed on Planmeca Romexis 4.3.0 R software to identify relevant study variables. Results: Of 4,932 pantomograms reviewed, 107 distomolars were identified. The prevalence of distomolars was 2.17%. The mean age of subjects with a distomolars was 36.25 years, with a male-to-female ratio of 1:1.6. Majority of the distomolars were identified in the maxilla (60.75%) and had typical forms (67.3%) and 72.9% of them were seen unerupted. Conclusion: Distomolars occurred more frequently in females in the Nigerian population, commoner in the maxilla, and were predominantly unerupted and smaller in size than the normal adjacent teeth.

Colorectal Cancer: aggressive presentations among young Nigerian adults

Colorectal Cancer (CRC) is the fourth most common cancer contributing to high morbidity and mortality worldwide. CRC is very common in the Western world with typical peculiarities how- ever, the black population has a different pattern of presentations since polyps and other pre-malignant lesions are relatively uncom- mon as compared to the Caucasians. This is a cross-sectional descriptive study of patients referred for colonoscopy evaluation at Aminu Kano Teaching Hospital, Kano, Nigeria. Sixty patients with colonic diseases were consecutively recruited during the study period. Colorectal cancer accounted for 11.7% of the study population with a M:F ratio of 2.5:1. Significantly, 57.14% of the patients were within 50 years of age. Over 70% of the patients were diagnosed with aggressive variant CRC. Constipation, fatigue, and weight loss were the dominant presenting symptoms, and predominantly left-sided colonic tumours were seen in 85% of the study population. For reasons that require further investiga- tions, the African population develops more aggressive variants of CRC at younger ages and it has a worse prognosis.

Blood biomarkers of trans-fatty acid intake among Nigerian adults in the Federal Capital Territory: a cross-sectional study

BackgroundIntake of trans-fatty acids (TFAs) is an established risk factor for cardiovascular disease. In April 2023, Nigeria passed regulations limiting TFA content in foods, fats, and oils, but the current level of TFA exposure in the Nigerian population is unknown. We assessed TFA biomarkers in dried blood spots from Nigerian adults in the Federal Capital Territory before policy enforcement to establish a baseline for future evaluation. MethodsWe used gas chromatography to measure TFA content in dried blood spots from adults participating in a cross-sectional household survey using a representative sampling frame. Individual TFA (t-16:1, t-18:1, and t- 18:2) and their total were expressed as percentage of total fatty acids. We assessed differences in TFA levels between subgroups based on sex, age, body mass index (BMI), education, income, and local government area using multivariable-adjusted linear regression models. Mean TFA levels were compared with samples from individuals in 30 countries. ResultsIn 213 adults (62% females; mean age: 36 y, mean BMI: 25.9 kg/m2), the mean TFA level in dried blood spots was 0.61% of total fatty acids (range: 0.23%–1.31%). In multivariable-adjusted models, TFA levels were higher in younger adults {<30 y compared with ≥42 y, 0.07% [95% confidence interval (CI): 0.00, 0.15], P = 0.047}, those without a high school degree [compared with higher education, 0.08% (95% CI: 0.01, 0.16), P = 0.023], and residents of Abuja Municipal Area Council [compared with residents in Gwagwalada, 0.12% (95% CI: 0.05, 0.20), P = 0.001]. Total TFA levels were comparable with international samples, but t-16:1 and t-18:1 appeared lower, whereas t-18:2 appeared greater (52% of all TFA), in the Nigerian samples. ConclusionsThese results provide a baseline assessment of TFA exposure in Nigerian adults to evaluate implementation and effect of national regulation passed in 2023. The observed subgroup differences may help identify subpopulations for targeted interventions to reduce TFA intake.

Prospective Study on the Effects of Marijuana Smoking on Lipase and Amylase Activities among Adult Nigerians

Marijuana consumption is prevalent among young adults in Nigeria, and its effects on various physiological systems are of growing concern. This study investigates the impact of marijuana use on digestive enzymes, specifically serum amylase and lipase, to understand its potential implications on digestive health. This cross-sectional study was conducted in 120 participants comprising of 60 marijuana smokers and 60 non-smokers. Sociodemographic and lifestyle data were collected through structured questionnaires. Serum amylase and lipase activity levels were measured by spectrophotometric method and compared between the two groups. Statistical analysis was performed to assess differences and correlations. The study revealed that marijuana smokers had significantly higher serum amylase and lipase activities compared to non-smokers. Lipase activity correlated positively (r=0.425, p=0.019) with duration of marijuana use. Amylase activity was higher among males than females (r=-0.40, p=0.028). No significant correlation was found between the quantity of marijuana consumed and enzyme activities. Chronic marijuana consumption was associated with increased serum amylase and lipase activities, indicating potential alterations in pancreatic function. These findings suggest that marijuana use may have adverse effects on digestive health, warranting further investigation into the long-term implications. It is recommended that healthcare providers monitor digestive enzyme activities in marijuana users to detect early signs of pancreatic dysfunction.

Comparing Skin Tones to Shades of Upper Anterior Teeth: An Observational Study among Nigerian Adults.

Skin tones may be predictive of anterior tooth shade. An analysis of the relationship of skin tone to anterior tooth shade within a population may facilitate the prescription of complete dentures with optimal esthetics and realism. This study aimed to assess the relationship between skin tones and shades of upper anterior teeth among a diverse Nigerian adult population. The study was conducted between February and December 2022 among consecutive healthy adults recruited from dental clinics of five teaching hospitals in four cities located across four geopolitical zones of Nigeria. Skin tones were recorded using the National Immigration Service (NIS) Skin Color scale. The Vitapan Classic® shade guide was used to record the tooth shade of the upper central incisors and canines. Bivariate and multivariate tests of associations were performed, and predictive probabilities were developed. A total of 1070 adults with a mean age of 30.8 ± 10 years participated in the study. NIS skin tones 6 (29.8%) and 5 (27.7%) were the most common, while hues A (48.7% in incisors and 48.4 % in canines) and B (41.1% in incisors and 40.1% in canines) were predominant. The values of the incisors and canines were positively related to skin tone (P = 0.001) and age (P = 0.001 for incisors and P = 0.003 for canines). Hue was also significantly associated with skin tone for canines (P = 0.01) and gender (P = 0.001). Regression models showed increasingly darker skin tones were positively related to duller values for incisor teeth (β = 0.173, OR =1.19, P < 0.001). The values for canines were more likely to be >2 (β = 0.118, OR =1.12, P = 0.01), but without significant positive relationship to increasingly darker skin tones (β = -0.99, OR =0.91, P = 0.22). Skin tones were associated with upper anterior tooth shade. There was a positive relationship between skin tones and the shades of upper anterior teeth. Skin tones could guide the clinician in shade selection during complete denture prescriptions.

Assessment of Healthiness of Food Consumption by Nigerian Adults Using the Global Diet Quality Score

Assessment of Healthiness of Food Consumption by Nigerian Adults Using the Global Diet Quality Score

A Comparative Analysis on the Histomorphometric Pattern of Various Segments of Adult Male Long Bones: Forensic Implication

Abstract Background: Human bone analysis is a useful tool in assessing and identifying skeletal remains. To make this easier, newer and modified approaches have often being documented. Aims and Objectives: The aim of this study is to analyze the histomorphometric features of various bone segments and its relevance in forensic case diagnosis. Materials and Methods: The human bones used were that of cadaveric bone samples harvested from three adult male Nigerians. The proximal, midshaft and distal segments of the femur, tibia, and humerus were utilized for the study. The bone sections were subjected to processing using Frost’s rapid manual preparation of ground sections techniques. Histomorphometric evaluation studied the number of primary osteons, secondary osteons, and osteon fragments, as well as the Haversian canal diameter (HCD). Results: The primary osteons, secondary osteons, osteon fragments, and HCD in each of the segments of the long bones show that the F values are less than the F critical for an alpha level of 0.05. This shows that there is no statistically significant (P &gt; 0.05) variation in the histomorphometric pattern for the various segments of the bones studied. Again differences in the haversian canal diameter of the various segments of the long bones shows statistically significant variation (P&lt; 0.05) among the long bones investigated. Conclusion: These findings have laid to rest the challenges with using the only available bone fragment for forensic case investigation as no notable variations exist across various segments.

Assessment of shoulder joint derangements with magnetic resonance imaging in adult Nigerians.

Shoulder pain secondary to various aetiologies is a common musculoskeletal complaint worldwide, and Magnetic Resonance Imaging (MRI) is the most accurate imaging method for evaluating shoulder pain in all age groups. While the patterns of shoulder MRI abnormalities in various demographics have been reported, data on sub-Sahara African populations are still sparse. This study aims to describe the imaging features and spectrum of shoulder joint pathologies on MRI in adult Nigerians. This was a retrospective review of the shoulder MRI of 100 adult Nigerians (with and without trauma) from September 2020 to December 2021. Their clinical data and shoulder MRI findings were extracted and analysed. Statistical significance was set at P ≤ 0.05. There were 64 males and 36 females aged 18-82 years. Right shoulder MRI was done in 53 subjects (53%), while the left shoulder was studied in 47 (47%). Supraspinatus tendinopathy (73%), acromioclavicular joint arthropathy (68%), and subacromial-subdeltoid (SASD) bursitis (64%) were the most frequently detected pathologies. Other demonstrated derangements include glenohumeral joint effusion (24%), long head of biceps tendon sheath effusion (18%), labral abnormalities (16%), subcoracoid bursitis (4%), Hill Sach's deformity (3%), anterior glenohumeral dislocation (2%), fatty degeneration of the supraspinatus/infraspinatus muscles (2%), adhesive capsulitis (1%), and other bony abnormalities (contusion, erosion, subchondral cysts). There was no significant difference in the frequency of shoulder abnormalities between the male and female subjects. Acromioclavicular joint arthropathy, SASD bursitis, and rotator cuff disorders were the dominant pathologies in the participants' shoulders.

The stability of life script and life story events of Nigerian young adults across religion and gender

ABSTRACT The cultural life scripts are shared semantic knowledge of the expected life course in a given culture characterised by a bump for positive events in the second and third life decades, but none for negative events [Berntsen, D., & Rubin, D. C. (2004). Cultural life scripts structure recall from autobiographical memory. Memory & Cognition, 32, 427-442. https://doi.org/10.3758/BF03195836]. We investigated the stability of Nigerian young adults' life scripts and life stories across religion and gender. One-hundred-and-seventy-four participants completed the life script and life story tasks, and the revised religious orientation scale. We found that the life scripts and life stories consisted of mainly positive events with a reminiscence bump located in the 10s and 20s; however, we also found a small bump for negative events. There was a high mention rate of religion-specific events in both the life scripts and life stories of participants across religion and gender. The level of religiosity had effects on the importance ratings of the life scripts and life stories. In sum, despite minor variations, the life scripts and life stories were consistent across religion and gender.

Exploring the relationship between dietary patterns and obesity among Nigerian adults: a cross-sectional study

Background/ObjectiveNo previous study has investigated the association between dietary pattern and both general and abdominal obesity risk among adults in Nigeria. This study aimed to evaluate the associations between dietary patterns and the risk of obesity among adult age 18 and above in Ekiti State, Southwestern Nigeria.Methods and study designsA total of 1003 adults were included in this cross-sectional study (males = 558; females = 445). Body mass index (BMI) and waist-to-hip (WHR) were used to assess general and abdominal obesity respectively and they were categorized using WHO recommendation. Partial correlation analyses were performed to assess the associations of dietary patterns with BMI and WHR. Prevalence ratio between dietary pattern and both general and abdominal obesity were calculated using Robust Poisson Regression.ResultsThe prevalence of general obesity among adults was 15.9%, (11.6% among men and 20.2% among women); abdominal obesity was 32.3% (28.9% among males and 44.5% among females). Four dietary patterns were identified; diversified traditional pattern; typical traditional pattern; milk and bread pattern and egg and fish pattern. Diversified traditional pattern was negatively associated with BMI (PR = 0.571, 95%CI: 0.360 ~ 0.905, p = 0.017), and typical traditional pattern was positively associated with BMI (PR = 1.561, 95% CI: 1.043 ~ 2.339, p = 0.031) and WHR in females (PR = 1.849, 95% CI: 1.256 ~ 2.721, p = 0.005). In comparison to those in the lowest quartile, adults with the highest quartile of the typical traditional pattern had a higher risk for abdominal obesity (PR = 1.849, 95%CI = 1.256 ~ 2.721, p = 0.020).ConclusionThis study reports an alarming increase in Obesity prevalence among Nigeria adults which is greatly influence by their lifestyle and eating pattern. We found out that a typical traditional food pattern was associated with a higher risk of both general and abdominal obesity, but a diverse traditional food pattern was associated to a reduced risk of general obesity.

Aetiological Spectrum of Pancreaticobiliary Diseases in Adult Nigerians on Magnetic Resonance Cholangiopancreatography.

Imaging is vital for assessing pancreaticobiliary diseases. The aim of the study was to investigate the spectrum and pattern of pancreaticobiliary diseases in adult Nigerians using magnetic resonance cholangiopancreatography (MRCP). This was a retrospective, descriptive cross-sectional study. The electronic radiological records of 110 adult Nigerians who had undergone MRCP were reviewed. The MRCP images were evaluated for bile duct dilatation, intraluminal filling defects, strictures, calculi, and other abnormalities. There were 45 males (40.9%) and 65 females (59.1%) aged 18-83 years, with a mean age of 51.93 ± 15.22 years. Jaundice (59.1%) and right hypochondrial pain (31.8%) were the most common presenting complaints. Gallstones (32.7%), common bile duct strictures (15.5%), choledocholithiasis (11.8%), pancreatic head carcinoma (10.9%), and gallbladder carcinoma (2.7%) were the most frequent abnormalities. There was biliary obstruction in 56.4% of participants, mostly at the distal and proximal common bile duct. Other findings include hepatomegaly (23.6%), hepatic cysts (6.4%), hepatic steatosis (0.9%), duodenal wall thickening (1.8%), and ascites (5.5%). MRCP was normal in 25 (22.7%) participants. Gallstones were the predominant pathology of the various pancreaticobiliary diseases, while Pancreatic head and gallbladder carcinoma were the most common malignant diseases.

Amoebic liver abscess in an adult Nigerian: A case report

Background: Amoebic liver abscess (ALA) is a parasitic infection caused by Entamoeba histolytica. ALA is a significant health concern, particularly in regions with poor sanitation and hygiene practices. Radiological imaging plays a crucial role in the diagnosis and management of ALA. Methods: We present a case report of a 40-year-old male patient with ALA. The patient presented to a radio diagnostic centre in Umuahia with right upper quadrant abdominal pain, fever,diarrhea and weight loss. Radiological evaluation was performed using abdominal ultrasound and contrast-enhanced CT scan. The imaging findings were correlated with clinical presentation and laboratory investigations. Results: The radiological findings revealed a focal hypoechoic lesion in the right hepatic lobe with ill-defined margins and internal echoes suggestive of liquefaction. The contrast-enhanced CT scan confirmed the presence of a well-defined, hypodense lesion with peripheral enhancement and central hypoattenuation. No evidence of biliary ductal dilatation or vascular invasion was observed. Based on the findings, a diagnosis of ALA was made, and the patient was initiated on intravenous metronidazole therapy. Follow-up imaging demonstrated a decrease in abscess size and resolution of internal echoes, indicating a positive response to treatment. Conclusion: Radiological imaging, including ultrasound and CT scan, plays a pivotal role in the diagnosis and management of ALA. The characteristic imaging findings, such as hypoechoic lesions with internal echoes and peripheral enhancement with central hypoattenuation, aid in differentiating ALA from other hepatic lesions. Early diagnosis and prompt initiation of appropriate therapy are crucial for favorable patient outcomes. Radiological follow-up allows monitoring of treatment response and guides further management decisions.

Anterior Ethmoid Roof Configuration: A Computed Tomography Scan Analysis of Adult Nigerians with Chronic Rhinosinusitis

Abstract Context: The anterior skull base has been adjudged a high-risk area in endoscopic sinus and skull base surgery. Hence, an understanding of its complex anatomy is crucial if catastrophic intra-operative complications must be avoided. Aims: To identify the anatomical configurations of the anterior skull base by radiological analysis, and to determine the prevalence of its variations among adults with chronic rhinosinusitis. Settings and Design: A retrospective study of 99 adult patients with chronic rhinosinusitis who attended the Ear Nose and Throat clinic of Aminu Kano Teaching Hospital from July 2022 to June 2023. Methods and Materials: The patient’s records were retrieved, and the basic demographic data, clinical history, and examination findings were extracted. All patients had diagnostic nasal endoscopy, and computed tomography scans of the nose and paranasal sinuses which were analyzed using a computer software program. Statistical Analysis Used: The data was analyzed with SPSS version 22.0 using frequency, mean, Pearson Chi-square tests and the results were presented in tables and figures. Results: A total of 99 patients’ CT scans were analyzed. There were 61 males (61.6%) and 38 females 38.4%) with a mean age of 31.7 years. 37 (37.4%) and 62 (62.6%) of patients had asymmetry and symmetry in the fovea ethmoidalis respectively. The anterior ethmoid artery was found coursing through the anterior ethmoidal air cells in 73 (36.9%) and along the anterior skull base in 125 patients (63.1%). Kero’s classification showed types I in 140 (70.7%), type II in 54 (27.3%) and type III in 4 (2.0%). Conclusion: This study found that a significant proportion of the study population had ethmoid roof asymmetry and the anterior ethmoid artery was found coursing through the anterior ethmoidal air cells respectively.

On-demand mobile hypertension training for primary health care workers in Nigeria: a pilot study

BackgroundOnly one out of every ten Nigerian adults with hypertension has their blood pressure controlled. Health worker training is essential to improve hypertension diagnosis and treatment. In-person training has limitations that mobile, on-demand training might address. This pilot study evaluated a self-paced, case-based, mobile-optimized online training to diagnose and manage hypertension for Nigerian health workers.MethodsTwelve hypertension training modules were developed, based on World Health Organization and Nigerian guidelines. After review by local academic and government partners, the course was piloted by Nigerian health workers at government-owned primary health centers. Primary care physician, nurse, and community health worker participants completed the course on their own smartphones. Before and after the course, hypertension knowledge was evaluated with multiple-choice questions. Learners provided feedback by responding to questions on a Likert scale.ResultsOut of 748 users who sampled the course, 574 enrolled, of whom 431 (75%) completed the course. The average pre-test score of completers was 65.4%, which increased to 78.2% on the post-test (P < 0.001, paired t-test). Health workers who were not part of existing hypertension control programs had lower pre-test scores and larger score gains. Most participants (96.1%) agreed that the training was applicable to their work, and nearly all (99.8%) agreed that they enjoyed the training.ConclusionsAn on-demand mobile digital hypertension training increases knowledge of hypertension management among Nigerian health workers. If offered at scale, such courses can be a tool to build health workforce capacity through initial and refresher training on current clinical guidelines in hypertension and other chronic diseases in Nigeria as well as other countries.

A protocol for the study of environmental risk factors and candidate gene–environment interactions in neurodegenerative disorders in Nigeria (SERGEND): A cross-sectional descriptive study

Introduction: The risk of developing neurodegenerative disorders (NDDs) such as Alzheimer’s disease and related dementias (ADRD) and Parkinson’s disease and atypical parkinsonism (PDAP), has been alluded to arise predominantly from the interplay between environmental exposures and genetic variability. The contributions of these factors to NDD in Black sub-Saharan Africans are largely unknown. The broad aim of SERGEND is to investigate the effect of specific environmental exposures and genetic variability on the risk of developing ADRD and PDAP in our population. Methods: The SERGEND, a national, multi-center, cross-sectional, descriptive study, will be conducted in Nigeria, within academic hospitals located in all six geopolitical zones of the country. The study population will comprise 3000 consenting adult Nigerians aged 18 years and above, residing within the recruiting geopolitical zone in the preceding 12 months. Cases will be persons with ADRD or PDAP and age-matched healthy controls. Assessments will include dementia and parkinsonism-specific case ascertainment, disease severity, functional status, and environmental risk factors assessment. Genotyping for APOE and SNCA REP1 polymorphic variability will be conducted. Future analyses will be performed on biobanked samples. Ethics and Dissemination: The study protocol was approved by the National Health Research Ethics Committee in Nigeria, with institutional HREC concordant approval for all participating sites before enrollment of the study participants. Written informed consent was obtained from all study participants or identified proxies. The study results will be published in peer-reviewed journals and as conference abstracts. Trial Registration: International Standard Registered Clinical/soCial sTudy Number (ISRCTN) registry (www.isrctn.com). Trial registration number: ISRCTN10548575. Locator ID: https://doi.org/10.1186/ISRCTN10548575.

Effects of addition of fentanyl to lidocaine plus adrenaline during peribulbar anaesthesia for cataract surgery: A prospective study

Background: Local anaesthesia is most commonly used for cataract surgery in adult patients. Different combinations of local anesthetic agents and adjuvants have been used to provide adequate anaesthesia and analgesia. This study assessed the effect of adding 25 µg fentanyl to lidocaine with adrenaline mixture on the onset and duration of anaesthesia in adult patients undergoing cataract surgery under peribulbar anaesthesia. Methods: This was a double blind, randomized controlled study. Adult patients aged 40 years and above with American Society of Anesthesiologists Physical Status Classes 1 and 2 undergoing cataract surgery under peribulbar block (PB) were studied. Sixty-six patients were randomized into two equal groups. Group A had 25 µg fentanyl (0.5 mL) added to 6 mL of 2% lidocaine with adrenaline while Group B had sterile water 0.5 mL added to 6 mL of 2% lidocaine with adrenaline for PB. Onset and duration of lid akinesia, globe akinesia, globe anaesthesia, Numerical Rating Scale (NRS) pain score, time to analgesia request as well as patient and surgeon satisfaction were assessed. Results: The differences in the onset of lid akinesia, globe akinesia, and globe anaesthesia between the two groups were statistically significant (P ≤ 0.001, respectively). The mean duration of globe akinesia and globe anaesthesia was longer in Group A as compared to Group B (P = 0.008 and P = 0.009, respectively). Statistically significant differences in median NRS scores were found at the 4th, 5th, and 6th h (P = 0.001, respectively). The mean duration to analgesia request was 238.1 ± 65.5 min in Group A compared to 207.2 ± 49.1 min in Group B (P = 0.034). Conclusion: The addition of 25 µg fentanyl to 2% lidocaine plus adrenaline mixture improved the quality of peribulbar anaesthesia and is recommended in Nigerian adults scheduled for cataract surgery under peribulbar anaesthesia to improve their surgical experience.

Validity and Reproducibility of a Semiquantitative Food Frequency Questionnaire and Food Picture Book in Nigeria

BackgroundIncreasing noncommunicable diseases in Nigeria are partly related to dietary factors. However, the lack of validated nutrition assessment tools hinders the conduct of nutritional epidemiology research in this population. ObjectivesTo develop a Food Frequency Questionnaire (FFQ) and Food Picture Book (FPB) for Nigerian adults, and to assess its reproducibility and validity compared with 24-h dietary recalls (24DRs) during different seasons in the year. MethodsWe compiled 202 foods for the FFQ through focus groups and consultations with local dietitians. We created an FPB with standardized food portion images to enhance the accuracy of reports of dietary intakes. We administered the FFQs to 205 purposively selected adults in Ibadan, Nigeria at ∼6 monthly intervals between November 2018 and October 2020. We evaluated the FFQ’s reproducibility and validity compared with 24DR across the dry and rainy seasons by examining the consumption of common food and mixed dishes. We computed the Spearman’s correlation coefficients (SCC), intraclass correlation coefficients (ICC), and Wilcoxon signed-rank tests, and generated Bland and Altman plots. ResultsOverall, we studied 110 women (53.7%) and 95 men (46.3%) with a mean age of 45.0 ± 13.4 y (mean ± SD). The reproducibility tests showed a mean ± SD SCC of 0.39 ± 0.14 and mean ± SD ICC of 0.32 ± 0.12. Higher mean ± SD SCC values were noted for cereal products (0.43 ± 0.09), starchy roots and tubers (0.45 ± 0.17), and soups (0.44 ± 0.20). Conversely, lower mean ± SD SCC values were observed for milk products (0.29 ± 0.02), solid fats (0.29 ± 0.26), and fish (0.22 ± 0.19). Regarding validity tests, the overall mean ± SD SCC was 0.27 ± 0.16 and mean ± SD ICC was 0.26 ± 0.16. We observed seasonal variations in intakes of fruits, cassava flour-based products, and nuts, although most foods did not show significant differences in intakes between seasons. ConclusionsOur FFQ and FPB demonstrated moderate correlations and seasonal variations in intakes of certain foods, emphasizing the need to account for seasonality in dietary intakes in nutritional studies in Nigeria and similar countries.

Untargeted metabolomic profiling reveals molecular signatures associated with type 2 diabetes in Nigerians

BackgroundType 2 diabetes (T2D) has reached epidemic proportions globally, including in Africa. However, molecular studies to understand the pathophysiology of T2D remain scarce outside Europe and North America. The aims of this study are to use an untargeted metabolomics approach to identify: (a) metabolites that are differentially expressed between individuals with and without T2D and (b) a metabolic signature associated with T2D in a population of Sub-Saharan Africa (SSA).MethodsA total of 580 adult Nigerians from the Africa America Diabetes Mellitus (AADM) study were studied. The discovery study included 310 individuals (210 without T2D, 100 with T2D). Metabolites in plasma were assessed by reverse phase, ultra-performance liquid chromatography and mass spectrometry (RP)/UPLC-MS/MS methods on the Metabolon Platform. Welch’s two-sample t-test was used to identify differentially expressed metabolites (DEMs), followed by the construction of a biomarker panel using a random forest (RF) algorithm. The biomarker panel was evaluated in a replication sample of 270 individuals (110 without T2D and 160 with T2D) from the same study.ResultsUntargeted metabolomic analyses revealed 280 DEMs between individuals with and without T2D. The DEMs predominantly belonged to the lipid (51%, 142/280), amino acid (21%, 59/280), xenobiotics (13%, 35/280), carbohydrate (4%, 10/280) and nucleotide (4%, 10/280) super pathways. At the sub-pathway level, glycolysis, free fatty acid, bile metabolism, and branched chain amino acid catabolism were altered in T2D individuals. A 10-metabolite biomarker panel including glucose, gluconate, mannose, mannonate, 1,5-anhydroglucitol, fructose, fructosyl-lysine, 1-carboxylethylleucine, metformin, and methyl-glucopyranoside predicted T2D with an area under the curve (AUC) of 0.924 (95% CI: 0.845–0.966) and a predicted accuracy of 89.3%. The panel was validated with a similar AUC (0.935, 95% CI 0.906–0.958) in the replication cohort. The 10 metabolites in the biomarker panel correlated significantly with several T2D-related glycemic indices, including Hba1C, insulin resistance (HOMA-IR), and diabetes duration.ConclusionsWe demonstrate that metabolomic dysregulation associated with T2D in Nigerians affects multiple processes, including glycolysis, free fatty acid and bile metabolism, and branched chain amino acid catabolism. Our study replicated previous findings in other populations and identified a metabolic signature that could be used as a biomarker panel of T2D risk and glycemic control thus enhancing our knowledge of molecular pathophysiologic changes in T2D. The metabolomics dataset generated in this study represents an invaluable addition to publicly available multi-omics data on understudied African ancestry populations.