Background: Diabetes presents a multifaceted challenge to health systems in Nigeria and beyond. Physical activity is a cornerstone of diabetes management but is often underutilised. Despite the positive effects of physical activity on different dimensions of health to patients with diabetes, most fail to maintain long-term adherence to physical activity programmes. Objectives: This study aimed to determine the physical activity level and factors affecting exercise participation among patients with and without diabetes. Methods: This was a cross-sectional study involving 400 participants recruited by convenience sampling. International Physical Activity Questionnaire (IPAQ) and Exercise Benefit and Barrier Scale (EBBS) questionnaires were used to measure physical activity and perceived benefits and barriers to exercise, respectively. The data collected were analysed using descriptive statistics of percentages and frequency, mean and standard deviation, and independent t-test. The level of significance was set at p<0.05. Results: The majority of the patients with diabetes (71%) had low physical activity levels while 52% of the nondiabetic group were moderately active. There was a significant difference between physical activity levels of patients with diabetes and the nondiabetic group (p<0.05). Physical exertion was reported by both patients with and without diabetes as the greatest barrier to exercise participation. Conclusion: Patients with diabetes in Nigeria have a low level of physical activity and are also faced with certain barriers which limit their participation in exercise programmes. Exercise barrier identification and public awareness on the health benefits of exercise and physical activity in the prevention and management of diabetes should thus be encouraged.
Pressure ulcers remain a perennial challenge in the management of patients with spinal cord injury in developing countries due to lack of preventive facilities and trained personnel. This study assessed the prevalence and factors associated with healing outcomes of hospital-acquired pressure ulcers among patients with spinal cord injury in a Nigerian tertiary hospital. A retrospective case chart review of patients with spinal cord injury between January, 1997 and December, 2006 was carried out. Data were gleaned on gender, age, marital status, presence and number pressure ulcers per patient, worst hit body site by pressure ulcer, cause of spinal cord injury, spinal cord injury level, American spinal injury association impairment score (AIS), diabetes status, stage of worst hit body site and outcomes of healing. Data was analyzed using both descriptive and inferential statistics at α 0.05. The prevalence of pressure ulcers in the study was 51.58%. The sacrum and coccyx (56.20%) were the worst hit body sites by pressure ulcers. Gender (p = 0.00), aetiology of spinal cord injury (p = 0.01) and stage of worst hit body site by PU (p = 0.00) were associated with healing outcomes. The prevalence of pressure ulceration was high with a high majority of the ulcers not healing.
Background: There is limited information on if HIV infection induces stress in pregnancy. HIV can possibly contribute to the alterations in some fetal viability hormones thereby lead to adverse pregnancy outcome. The present study aimed to assess the possible changes in maternal cortisol, Adrenocorticotropic (ACTH), Pregnancy associated plasma protein-A (PAPP-A) and alpha-fetoprotein (AFP) hormone concentrations in HIV-infected pregnant women and their pregnancy outcomes. Methods:A cross sectional study of 80 (Eighty) volunteer pregnant women aged (18-49) years recruited during routine antenatal clinics in Nnamdi Azikiwe Teaching Hospital, Nnewi, Anambra State, Nigeria was conducted. The participants were divided into groups: 40 (forty) apparently healthy pregnant and 40 (forty) HIV-infected pregnant women. 5 ml of morning blood samples were collected from each subject in their 1 st and 2 nd trimesters for estimation of Cortisol, ACTH, AFP and PAPP-A using ELISA method. Results:The result showed that the mean systolic and diastolic blood pressures (mmHg) of HIV pregnant women were significantly higher than control (p<0.05 respectively). The mean value of cortisol (ng/ml) in HIV pregnant women was significantly higher when compared with control subjects (p<0.05). Cortisol showed inverse significant correlation with AFP in HIV-infected pregnant women. Maternal outcomes showed thatt HIV-infected pregnant women had significantly higher incidence of miscarriages and preeclampsia with higher incidence of perinatal outcomes such as low birth weight babies (LBW), preterm delivery, spontaneous abortion, still birth and low Apgar scores when compared with apparently normal pregnant women (P<0.05 respectively).Conclusion: the significantly higher cortisol level and BP in HIV pregnant women is indicative of oxidative stress due to perceived stress by HIV infection which might predispose the affected women to hypertension and preeclampsia. The highest adverse reactions observed in HIV pregnant women might be related to the damaged immune system by HIV infection however, the placental defect associated with increased placental permeability to AFP and the activity of the insulin-like growth factor (IGF) system is not related to the activity of stress thereby do not influence their birth outcomes.
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