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Background: Cardiovascular diseases are major contributors to morbidity and mortality. It is generally recognized that cardiac markers are of particular benefit in the evaluation of patients with suspected Acute Coronary Syndrome (ACS). Tertiary hospitals, mainly teaching hospitals, are expected to be optimally equipped to offer these services. The study therefore aimed at determining the central laboratory and point-of-care cardiac marker testing capacity of tertiary hospitals in Nigeria., Method: A cross-sectional survey was carried out in government-owned tertiary hospitals in Nigeria. Data were collected using semi-structured self-administered questionnaires, and analyzed using Stata version 13 (Stata Corp., USA)., Results: A total of 34 hospitals participated in the study. The mean (SD) age of respondents was 43.68 (5.2) years. A total of 19 (55.88%) hospitals were found to have a functional cardiac marker testing facility, either in the form of point-of-care, central laboratory testing or both. Of those without a facility, lack of funds to procure equipment was the major reason given. In hospitals with a testing facility, most testing devices were located in the Central laboratory., Conclusion: Cardiac marker testing capacity of tertiary hospitals in Nigeria, both in the form of point-of-care and central laboratory testing, was found to be barely adequate. Improvement is needed in this area for better diagnosis and evaluation of patients who need the tests., (© 2022 Meka IA et al.)

Introduction: Problem-based learning (PBL) method which was introduced about 50 years ago in Canada is beginning to gain acceptance over conventional teaching method (CTM) worldwide in medical education but still remains unpopular in Nigeria. This study aims to determine the perception of clinical medical students to the use of both learning methods in pathology courses., Methods: A cross-sectional quantitative survey was conducted in four Nigerian universities drawn from four regions of the country. Data were collected using pretested semi-structured self-administered questionnaires., Results: The study included 310 respondents, 182(58.7%) males and 128(41.3%) females. Of all the participants, 257(82.9%) had heard of PBL prior to the study and 260(83.9%) thought it suitable for teaching and learning Pathology. Majority of participants, 221(71.3%) preferred a combination of both PBL and CTM while 238(76.8%) thought PBL suitable for all medical students. Some identified factors capable of enhancing adaptation of PBL into medical curriculum include conducive quiet spaces for learning and availability of computers with internet facilities for students' use., Conclusion: Participants demonstrated high level of awareness of PBL and thought it suitable for all medical students. Availability of computers and up-to-date libraries with internet and audio-visual facilities could enhance adaptation of PBL into medical curriculum in Nigeria., Competing Interests: The authors declare no competing interests., (© Helen Chioma Okoye et al.)

The study aimed to determine if selenium deficiency, serum ceruloplasmin and traditional birth practices are risk factors for peripartum cardiomyopathy (PPCM), in Kano, Nigeria. This is a case-control study carried out in three hospitals, and PPCM patients were followed up for six months. Critically low serum selenium concentration was defined as <70 µg/L. A total of 39 PPCM patients and 50 controls were consecutively recruited after satisfying the inclusion criteria. Mean serum selenium in patients (61.7 ± 14.9 µg/L) was significantly lower than in controls (118.4 ± 45.6 µg/L) (p < 0.001). The prevalence of serum selenium <70 µg/L was significantly higher among patients (76.9%) than controls (22.0%) (p < 0.001). The mean ceruloplasmin and prevalence of socio-economic indices, multiparity, pregnancy-induced hypertension, obesity and twin pregnancy were not different between the groups (p > 0.05). Logistic regression showed that rural residency significantly increased the odds for serum selenium <70 µg/L by 2.773-fold (p = 0.037). Baseline serum levels of selenium and ceruloplasmin were not associated with six-month mortality. This study has shown that selenium deficiency is a risk factor for PPCM in Kano, Nigeria, and is related to rural residency. However, serum ceruloplasmin, customary birth practices and some other characteristics were not associated with PPCM in the study area.

Microalbuminuria has been reported to be a precursor of HIV related renal disease, which if detected early and coupled with appropriate intervention may slow or retard the progress of the disease. One hundred and seventy-eight HIV infected children aged 15 years and below were recruited from the Paediatric Infectious Disease Clinic of Aminu Kano Teaching Hospital (AKTH), Kano, to determine the prevalence of persistent microalbuminuria using the albumin creatinine ratio (ACR). Early morning urine samples and spot urine samples were analyzed using a dipstick specific for microalbumin. Those who tested positive had their samples reanalyzed in the laboratory using immunometric assay and Jaffe reaction method for albumin and creatinine, respectively. Patients that had ACR of 30-300 mg/g were said to have microalbuminuria and had their urine samples retested after 6 to 8 weeks. Twelve children (6.7%) had persistent microalbuminuria and had a mean age of 7.5 ± 3.3 years, with a male to female ratio of 1 : 1. There was no significant relationship between the finding of microalbuminuria and age, sex, duration of infection, and the use of highly active antiretroviral therapy. Periodic screening for microalbuminuria using albumin specific dipstick should be considered for children with HIV infection.

Background: There is paucity of data in Africa on the prevalence of pulmonary hypertension (PHT) and its impact on morbidity and short-term mortality in heart failure (HF) patients. The aim of this study was to assess the prevalence of PHT, its clinical characteristics and in-hospital mortality among HF patients admitted to a referral hospital in Nigeria., Methods: The study was carried out on serially-admitted HF patients who satisfied the inclusion criteria, in a Nigerian tertiary health center. PHT was defined as the presence of mean pulmonary artery pressure (mPAP) of ≥25 mmHg, assessed using Doppler echocardiography and Chemla formula., Results: A total of 80 admitted HF patients were studied serially. 53 of them (66.25%) had PHT while the remaining 27 (33.75%) had normal mPAP. mPAP was 38.31 ± 12.23 mmHg and 16.39 ± 5.48 mmHg (P < 0.001) for subjects with and without PHT, respectively. The most common cause of HF was hypertensive heart disease (HHD) (28 patients; 35%). Subjects with PHT had relatively lower systolic blood pressure (SBP) (P = 0.044), and larger left atrium (P = 0.036) and left ventricle (LV) at both end-diastole and end-systole (P = 0.036 and P = 0.008, respectively), and a trend toward lower LV ejection fraction (LVEF) (P = 0.053). There was no relationship between mPAP and N-terminal pro-B type natriuretic peptide (P > 0.05). A total of 12 HF patients (15.0%) died, out of whom 8 (66.7%) had PHT. Cardiogenic shock (P = 0.044) and trans-mitral flow velocities ratio (P = 0.023) were the independent determinants of in-hospital mortality., Conclusion: PHT was common among the admitted HF patients, and was associated with worse morbidity indices, and a trend toward higher mortality. We recommend that HF patients be screened for PHT, and its presence should be taken into consideration in the management and prognostication of affected patients.

Objective: To study the seroprevalence of Hepatitis B viral (HBV), infection among patients attending Aminu Kano Teaching Hospital in Kano metropolis., Patients and Method: This is a retrospective study in which patients tested for hepatitis B virus using hepatitis B surface antigen (HBsAg) as a marker were reviewed over 3 years. A total of 6,395 patients comprising of 4,040 males and 2,355 females including adults and children were tested for HBsAg from January 2004 to December 2006. Over this period, 1509 sera were tested in 2004, 2,322 in 2005 and 2,564 in 2006., Results: Among the 6,395 patients, 703 (11.4%) comprising of 240 (10.2%) females and 490 (12.1%) males were positive for HBsAg. The highest prevalence was seen at the extremes of life in which 19.4% and 16.9% were seen among patients below 10 years and above 50 years respectively. The yearly trend of HBV surface antigenemia was 220 (14.6%) in 2004, 235 (10.1%) in 2005 and 275 (10.7%) in 2006., Conclusion: We conclude that the prevalence of HBsAg among patients attending Aminu Kano Teaching Hospital, Kano is high and highest prevalence is seen at the extremes of life.

Background: Hepatitis B virus infection has become a global public health problem. In Nigeria, several studies from different parts of the country have confirmed the endemicity of the infection. This study seeks examine the seroprevalence of Hepatitis B viral infection among patients attending Aminu Kano Teaching Hospital in Kano metropolis., Method: This is a retrospective study in which patients tested for hepatitis B virus using hepatitis B surface antigen (HBsAg) as a marker were reviewed over 3 years. A total of 6,395 patients comprising of 4,040 males and 2,355 females including adults and children were tested for HBsAg from January 2004 to December 2006. Over this period, 1,509 sera were tested in 2004, 2,322 in 2005 and 2,564 in 2006., Results: Among the 6,395 patients, 703 (11.4%) comprising of 240 (10.2%) females and 490 (12.1%) males were positive for HBsAg. The highest prevalence was seen at the extremes of life in which 19.4% and 16.9% were seen among patients below 10 years and above 50 years respectively. The yearly trend of HBV surface antigenemia was 220 (14.6%) in 2004, 235 (10.1%) in 2005 and 275 (10.7%) in 2006., Conclusion: We conclude that the prevalence of HBsAg among patients attending Aminu Kano Teaching Hospital, Kano is high and highest prevalence is seen at the extremes of life.