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BackgroundThe diagnosis of Marked First Degree Atrioventricular Block is made with electrocardiogram when PR interval ≥0.30 s. A PR interval of up to 0.48 s had been reported in literature. Data is sparse on an extremely prolonged PR interval associated with Atrioventricular Dissociation and Pseudo-Pacemaker Syndrome. Electrocardiogram with this type of uncommon features poses diagnostic and management challenges in clinical practice.Case presentationWe report a case of a 22 year old Nigerian male from Igbo ethnic group who presented himself for medical screening with a history of exercise intolerance, occasional palpitation and fainting spells. He has no history of cough, orthopnoea, paroxysmal nocturnal dyspnoea nor body swelling. A physical examination revealed that the patient has a pulse rate of 64 beats per minute, blood pressure of 110/70 mmHg and soft heart sounds. Standard 12-lead electrocardiogram showed an uncommon Marked First Degree Atrioventricular Block with an extremely prolonged PR interval of 0.56 s. Long rhythm strips of the electrocardiogram showed extremely prolonged PR interval associated with Atrioventricular Dissociation and variable degrees of Atrioventricular Block (Mobitz type I and II).ConclusionsAn extremely prolonged PR interval may occur in First Degree Atrioventricular Block and it may be associated with Atrioventricular Dissociation and Pseudo-Pacemaker Syndrome which may pose diagnostic and management challenges. This suggests that not all cases of First Degree Atrioventricular Block are benign and so should be sub-classified based on degree of PR interval prolongation and associated electrical abnormalities.

Out of the 4 ECG criteria, Araoye code system, Cornell and Sokolow-Lyon criteria compared favorably well with echocardiography and may be used in the initial assessment of LVH in adult hypertensive subjects. However, a combination of any of the 3 criteria with Gubner-Ungerleider criterion will be more clinically useful.

Background: Cardiovascular disease (CVD) is the leading cause of mortality in patients with chronic kidney disease (CKD). Carotid intima-media thickness (CIMT) is a measure of atherosclerotic vascular disease and considered a comprehensive picture of all alterations caused by multiple cardiovascular risk factors over time on the arterial walls. We therefore sought to determine the CIMT of the common carotid artery in patients with CKD and to evaluate the clinical pattern and prevalence of CVD in CKD patients. Methods: A case-control study involving 100 subjects made of 50 patients with CKD stages 2 to 4 and 50 age and sex matched apparently normal individuals. Carotid intima-media thickness of the common carotid artery was considered thickened if it measured greater than 0.8 mm. All subjects had laboratory investigations, 12-lead electrocardiogram, transthoracic echocardiography, and ankle-brachial index. Results: The mean CIMT was higher in CKD population compared with controls ( P < .001). Eighty-four percent of the study population was found to have thickened CIMT compared with 18% of controls ( P < .001). Patients with CKD had significantly higher blood pressure and heart rate than controls. Cardiovascular disease was also more prevalent among patients with CKD as compared with controls. Carotid intima-media thickness positively correlated with age, blood pressure, and random blood sugar. Conclusions: As CIMT was well correlated with many cardiovascular risk factors among CKD patients, it may serve as a surrogate marker for CVD and its early assessment may target patients who may need more aggressive therapy to retard the progression of kidney disease and improve outcome.

Body mass index (BMI) is an important cardiometabolic parameter. This study determined the mean BMI, pattern and prevalence of underweight, overweight and obesity among young adult Nigerians. It also examined the effect of sex on pattern of distribution of BMI classes. This was cross-sectional study conducted among students of a tertiary institution. Seven hundred and two (702) students (412 males and 290 females) with age range between 18-40years participated in the study. The participants had their weights and heights recorded by standardized techniques and BMI was calculated from the weight and height. BMI was classified according to WHO reference values. Data was analyzed using SPSS version 17 software. A p-value of less than 0.05 was considered as statistically significant. The mean BMI was 21.89±3.07 (kg/m 2). Age was positively correlated with BMI(r = 0.298, p <0.001).Significant sex differences in anthropometry were demonstrated in terms of height (t=17.880, p <0.001), weight (t =7.595, p<0.001), BMI (t =-2.483, p =0.013) and BSA (t=12.716, p <0.001). There was a significant sex difference in BMI classes recorded in this study (χ 2 = 12.255, p = 0.007).The prevalence of overweight and obesity among the total participants were 14.8% and 1.3% respectively. Among the males, the prevalence of underweight, overweight and obesity were 9.2%, 11.2% and 1.2% respectively while among the females, the prevalence of underweight, overweight and obesity were 11.0%, 20.0% and 1.4% respectively. More than a quarter of the apparently healthy young adults had abnormal BMI. The study also showed that abnormal BMI (underweight, overweight and obesity) were more frequent in female than male young adult Nigerians. Health education focusing on weight adjustment measures including exercise and dietary strategies will be beneficial among young adult population.