IntroductionProstate cancer (CaP) is the most commonly diagnosed cancer among Nigerian men but CaP screening is not a common practice. The true burden of the disease in Nigeria is not known. The study was aimed at studying the community burden of CaP in Lagos.MethodsDuring a community-based prostate cancer awareness program in 13 local government areas of Lagos, men aged >40 years had serum total PSA (tPSA) test and digital rectal examination (DRE). Those with abnormal DRE or tPSA >95th percentile of the cohort or both were selected for prostate biopsy (TRPB).Results4172 men were screened and complete data was available for 4110 (98.5%). The mean age was 60.8 years. DRE was abnormal in 410 men and was significantly correlated with the age of the patient and tPSA (p<0.001). The tPSA ranged from 0 to 438.3ng/ml with a median, mean and 95th percentile of 1.5, 2.5 and 10.0ng/ml respectively. 341 out of the 438(78%) men selected were subjected to TRBP. Forty-three men had histological diagnosis of CaP, giving an estimated prevalence rate of at least 1.046% or 1046 per 100,000 men of age ≥40. Only 11 (26%) had organ-confined disease while 17 (40%) had locally advanced disease and 15 (35%) men had metastatic disease. The majority of the men, 32 (74%) were reported to have Gleason's score of ≥7.ConclusionThe prevalence rate of CaP among men aged ≥40 years in Lagos is higher than previously reported in hospital-based study. Majority have advanced and high-grade disease.

Increasing concern has been expressed about the declining sperm count of humans and the potential environmental effects of both synthetic and natural estrogenic endocrine disruptors (EEDs) on human reproductive health in the last few decades. However, due to paucity of knowledge, we evaluate the chronic reproductive toxicity of sesame phytoestrogenic lignans on the male Sprague Dawley (SD) rats' testis. Thirty adult male SD rats weighing 150-200g were divided into three groups. Two treated groups received a daily dose of aqueous leaves extract of Sesamum radiatum at 14.0 mg/kg bw and 28.0mg /kg bw respectively via gastric gavage, while equal volume of normal saline was administered to the control group for six weeks. Seminal analysis and hormonal assay study were analyzed using SPSS software and P< 0.05 was considered statistically significant. The results showed significant (P< 0.05) body weight gains observed in all the animals with significant (P< 0.05) weight increase in their raw testicular weights compared to control. The relative testicular weight per 100g bw was significantly (P< 0.05) higher in control than treated. However, theweight gain was dose related with a reversal in their relative testicular weight. The cauda sperm count including the motility and morphology of the treated were significantly (P< 0.05) higher than control in a dose related manner. In addition, significant (P > 0.05) increases in testosterone and a significant decrease in FSH in the high dose (treated) compared to control. Sesame phytoestrogenic lignans improves spermatozoa quality in a dose related manner.

Morbidity due to dracunculiasis (guinea worm disease) and diarrhoea in persons of all ages, and nutritional status of young children, were used as health impact indicators in the evaluation of the Imo State Drinking Water Supply and Sanitation Project in south-eastern Nigeria. Data were collected using repeated cross-sectional surveys and longitudinal follow-up. The study area was found to have a low level of endemicity of dracunculiasis. While no impact could be demonstrated on overall period or point prevalence rates in the cross-sectional surveys, a prospective longitudinal survey showed a significant reduction in the percentage of person-fortnights positive for dracunculiasis in areas served by the project, while the control areas showed no such change. In the cross-sectional surveys it was found that, in the project villages, those persons drinking only borehole water had significantly lower period prevalence rates one year later than others. Moreover, those living further from the nearest borehole had higher rates of dracunculiasis. An impact of the project on diarrhoea morbidity was found only in limited sub-groups of the population. A greater association with water availability rather than quality was suggested for rates in young children. The prevalence of wasting (less than 80% weight-for-height) among children aged less than 3 years decreased significantly over time in all 3 intervention villages; there was no such decline in the control villages.

A health impact evaluation was conducted in conjunction with the Imo State Drinking Water Supply and Sanitation Project in Nigeria. The project consisted of a package of water supply, sanitation, and health and hygiene education given by village-based workers. The evaluation was a quasi-experimental study covering pre-, peri- and post-intervention periods. Data were collected from 3 intervention and 2 control villages. Baseline surveys indicated that the intervention and control areas were similar with respect to most socio-demographic variables. Use of the improved water supply was high, although this was influenced by borehole-to-population ratios and household-to-borehole distances. Water collection time was consequently greatly reduced. Data from a small sample of households showed that borehole water became heavily contaminated during collection and storage, and that there was no significant change in consumption of water per person. Adults in 46% of household units in the intervention area were using ventilated improved pit latrines by the end of the study period. Use by young children (2-5 years old), however, was low. Limitations in the success of the health education component of the project were found. Although changes were found in knowledge, attitudes and practices related to water and sanitation, and in management of childhood diarrhoea, this occurred in both the intervention and control areas.

Neuropeptide Y (NPY) is the most powerful appetite stimulant known, and rates of synthesis and release in the hypothalamus correlate closely with nutritional status. Pregnancy and lactation provide an excellent model of physiological hyperphagia. In this study the authors measured food intake, plasma glucose, insulin and luteinizing hormone (LH) and hypothalamic NPY mRNA in rats during pregnancy and in early and late lactation. The effect of food restriction (to 80% of control) during lactation was also studied. Pregnancy resulted in a modest increase in daily food intake over non-lactating controls (controls: 15.6 +/- 0.6 g, pregnant: 19.8 +/- 1.1 g, P < 0.01). During lactation food intake increased dramatically to 355% of non-lactating levels by the 12th day. Insulin and glucose levels were unchanged in lactation, except in the food-restricted animals, when insulin levels were reduced to 49.5 +/- 18.4 pmol/l compared with 215 +/- 55 pmol/l (P < 0.01) in lactating, non-restricted animals, and glucose was reduced to 3.7 +/- 0.2 mmol/l compared with 5.1 +/- 0.2 mmol/l in non-restricted lactating animals. Hypothalamic NPY mRNA was unchanged in pregnancy, moderately increased after 5 days lactation (130 +/- 6.2% of control, P < 0.01) and increased further at 14 days lactation (179 +/- 14%, P < 0.001). The greatest changes occurred in the animals who were food-deprived during lactation, when hypothalamic NPY mRNA levels reached 324 +/- 44% (P < 0.001) of non-lactating levels. Increases in hypothalamic NPY synthesis may be partly responsible for the increase in food intake seen in lactation, but unlike in food deprivation, the increase is not related to circulating insulin, suggesting involvement of other regulatory factors.

Renal failure is accompanied by oxidative stress, which is caused by enhanced production of reactive oxygen species (ROS) and an impaired antioxidant defense. We studied 73 hemodialysis (HD) patients (39 males and 34 females) aged 24-75 years; the patients were randomized into two subgroups according to the type of hemodialysis membrane (35 patients were dialyzed on cellulose and 38 patients on polysulfone F7/F9 membrane dialyzers) and we assessed their antioxidant and lipid peroxidation status levels. The total antioxidant status (TAS) levels including whole blood levels of malondialdehyde (MDA) and glutathione (GSH); glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), and catalase (CAT) activities were measured, before and after hemodialysis. The MDA levels significantly increased 52.0% and 16.9% post dialysis among the cellulose and the polysulfone dialyzer users, respectively, (P<0.05). The TAS levels significantly decreased, 22.0 and 16.5% in the cellulose and polysulfone dialyzer users, respectively, (P<0.05). The erythrocyte SOD activity decreased 25.1 and 19.1% in the cellulose and the polysulfone dialyzer users, respectively, (P<0.05). The GSH concentrations, post dialysis, decreased 49.9 and 6.8% in the cellulose and polysulfone dialyzer users, respectively, (P<0.05). In contrast, the erythrocyte activity of CAT, post dialysis, increased 15.0 and 37.3% in the polysulfone and the cellulose dialyzer users, respectively, (P<0.05). We conclude that the type of the dialysis membrane affects the oxidative status after HD with possible consequences on patient morbidity and mortality.

Introduction:Serum prostate specific antigen (PSA) levels increase with age and varies among different races and communities. The study was aimed at defining the age-specific reference ranges of serum PSA in our environment.Methods:We evaluated the relationship between age and serum PSA levels and the age-specific reference ranges of serum PSA among civil servants in Lagos, who underwent routine medical checkups. Criteria for inclusion were men who have no lower urinary tract symptoms, normal digital rectal examination and serum PSA ≤ 20 ng/ml. SPSS Statistic 21 was used for data evaluation and the mean, median, 95th percentile PSA levels were estimated. Pearson's correlation was used to examine the relationship, and P < 0.05 was considered significant.Results:4032 men met the criteria for inclusion in the evaluation. The mean age was 51.6 (range 40–70) years, and there was a strong correlation between serum PSA levels and age (r = 0.097, P < 0.001). PSA ranges of 0–2.5, >2.5–4.0, >4.0–10, and >10 ng/ml were found in 3218 (80%), 481 (12%), 284 (7%), and 52 (1%) men, respectively. The mean, median and the 95th percentile PSA for the overall group were 1.84, 1.33, and 5.2 ng/ml respectively. However the 95th percentile PSA levels for men aged 40–49, 50–59, and 60–70 years were 4.78, 5.47, and 8.93 ng/ml respectively.Conclusion:The age-specific PSA levels among Nigerian men for each age group is higher than what was described for men in the Western world. These reference ranges of serum PSA should be considered for men aged ≥40 years in our environment.

Objective:To determine the usefulness of CD4 count in predicting adrenocortical insufficiency (AI) in persons with HIV infection.Design:Experimental study involving people with HIV infection and healthy people.Participants:The participants were recruited from the Lagos University Teaching Hospital. Forty-three newly diagnosed, treatment naive persons with HIV (23 males and 20 females) and 70 (35 males and 35 females) HIV negative subjects completed the study.Intervention:One microgram Synacthen® was given intravenously to stimulate the adrenal glands.Main Outcome Measures:Blood was collected for cortisol at 0 and 30 min after the injection of adrenocorticotropic hormone (ACTH) and CD4 count.Results:Mean basal cortisol was 154.9 ± 27.2 nmol/L and 239.9 ± 31.6 nmol/L (P < 0.001); the 30-min post ACTH test, cortisol level was 354.8 ± 19.9 nmol/L and 870.9 ± 163.5 nmol/L (P < 0.001); the increment was 100.0 ± 17.2 nmol/L and 588.8 ± 143.4 nmol/L (P < 0.001) in HIV and healthy subject group; respectively. Using the diagnostic criteria for diagnosis of AI in this study, fifteen (34.8%) persons with HIV had AI. There was no significant correlation between basal cortisol levels and CD4 count in patients with HIV infection (r = -0.2, P = 0.198). There was no significant correlation between stimulated cortisol level and CD4 count in patients with HIV infection (r = -0.09, P = 0.516).Conclusion:CD4 count does not predict the presence or absence of AI. ACTH stimulation of the adrenal gland remains the acceptable standard.