IntroductionOver 80% of stroke deaths occur in low-income and middle-income regions of the world. Identification of predictors of mortality is vital so that prompt therapeutic measures could be instituted to improve outcome. Previous studies have identified factors such as stroke severity, stroke type, older age, impairment of consciousness and hyperglycaemia as predictors of mortality for acute stroke but mortality remain high among patients hospitalized for acute stroke. The study objective was to determine the association between admission serum albumin levels and short-term outcome following acute ischaemic stroke in Nigerians.MethodsConsecutive first-ever acute ischaemic stroke patients were prospectively enrolled between February 2009 and May 2010. Stroke severity at presentation was determined using National Institute of Heath Stroke Score (NIHSS). Admission serum chemistry including albumin, were measured. Patients were then followed up for 30 days and outcome measures applied at the end of the study were 30-day mortality and functional outcome using the Modified Rankin Scale (MRS) and graded as favourable(MRS 0-3) or unfavourable(MRS 4-6). Relationship between serum albumin and stroke outcome was determined.Results75 acute stroke cases were studied. Mean age was 57.68 ± 12.4 years. Outcome was favourable in 48% while 30-day case fatality was 17.3%. The mean age (61.13 years) of those with poor outcome was significantly higher than those with favourable outcome. Mean serum albumin (3.03g/dL) of those with favourable outcome was also significantly higher than (2.08g/dL) of those with unfavourable outcome (p=0.0001). Patients that died had significantly lower serum albumin (1.66g/dl) than survivors (p=0.0001).Receiver operating characteristics curve for optimal cut off point of serum albumin to predict survival or death within 30 days revealed area under the cure (AUC) of 0.870, p-value 0.0001, 95% C/I=0.759-0.982. Serum albumin of 1.55g /dL has sensitivity of 100% and specificity of 61.5%. NIHSS and serum albumin were predictors of poor outcome using multiple regression.ConclusionLow admission serum albumin was an independent determinant of poor outcome.
The prevalence of dysphagia in this cohort of stroke patients was 34.4%, and the major independent determinant of 30-day mortality was development of aspiration pneumonia.
The prevalence rates of DM and its principal risk factor obesity are low among the rural Nigerian Fulani. However, the prevalence of prediabetes is relatively high, a factor that may predispose to the future development of DM.
IntroductionThe aim of this study was to investigate the prevalence of metabolic syndrome in Sokoto metropolis of North-Western Nigeria.MethodsA cross-sectional community based study was carried out. Four hundred and ten subjects (201 males and 209 females) were recruited for the study using a multi-stage sampling technique. Demographic and the life style data was obtained from the participants. Evaluation of anthropometric variables, fasting blood sugar, lipid profiles, insulin resistance and blood pressure was performed. The classification of metabolic syndrome was based on the NCEP ATP III guidelines.ResultsThe mean (SD) age of the sample population was 39.6 (14.4) years. The mean (SD) age of the male subjects was 38.4(14.9) years and that of the females was 40.8(13.9) years (p> 0.05). The overall prevalence of metabolic syndrome was 35.1% with the females having 42.83% and the males 27.36%. The frequencies of metabolic syndrome parameters in the study subjects were low HDL (56.1%), hypertension (46.1%), dysglycemia (32.7%), central obesity (28%), and elevated triglycerides (22.4%). Most of the women had low HDL (62.2%) and central obesity elevated (49.8%).ConclusionMetabolic syndrome is common in residents of North-Western Nigeria, commoner in the females than males. Risk factors for metabolic syndrome should be detected in normal individuals for implementing effective preventive measures.
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