Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disorder with a poorly understood aetiology. It predominantly affects females and has a variety of clinical manifestations. In Nigeria, there are limited data on the prevalence and burden of the disease. This study aimed to determine the clinical and laboratory profiles of SLE patients seen in a new rheumatology clinic in South-South Nigeria. Material and methods: This was a retrospective cross-sectional study conducted over five years (January 2016 to December 2020). The case files of patients that satisfied the diagnosis of SLE were reviewed. The diagnosis was based on the 1997 update of the American College of Rheumatology revised criteria for the classification of SLE. The sociodemographic, clinical, and immunological data were extracted from case records. Data analysis was carried out using IBM SPSS statistics® 2012 version 21.0. Results: Fifty-two patients were diagnosed with SLE, giving a frequency of 4.7%. Forty-seven (90.4%) of the study participants were females, with a female-to-male ratio of 9.4 : 1. The mean age of the study group was 28.42 years. The mean duration of disease before diagnosis was 4.04 months with a range of 1-15 months. The patients had various organ system manifestations, with polyarthritis being the commonest (86.5%). Others included mucocutaneous (78.8%), haematological (69.2%), serositis (40.4%), renal (38.5%), and neurological (25%) manifestations. Antinuclear antibody (ANA) assay and anti-double-stranded DNA were positive in 100% and 69.2% of patients, respectively. All patients were placed on steroids, and 96.2% had hydroxychloroquine. None of the patients were on biologic disease-modifying antirheumatic drugs. Conclusions: This study's results are consistent with data from other African countries. To fully understand the burden and epidemiology of SLE in Nigeria, a larger prospective study is needed.

Systemic lupus erythematosus (SLE) is a condition that manifests in a variety of ways. Although pericarditis and pericardial effusion are frequent cardiac manifestations of SLE, cardiac tamponade is rarely reported, especially as the initial manifestation of the disease. We describe a 38-year-old Nigerian lady who presented with three months of progressive dyspnea. She had intermittent fever, tachycardia, tachypnea, hypotension, jugular vein distension, and muffled heart sounds. Echocardiography confirmed cardiac tamponade. The ANA, anti-dsDNA, and anti-Sm antibodies were positive. She had a high ESR and low levels of blood complements. The diagnosis of SLE was established based on the 2019 EULAR/ACR classification criteria. She was treated with intravenous methylprednisolone, oral prednisolone, and hydroxychloroquine after undergoing an emergency echo-guided pericardiocentesis. She responded well to treatment, and she is currently being followed up on an outpatient basis. Clinicians should consider SLE as a differential when evaluating patients with pericardial effusion, as an accurate and timely diagnosis could be lifesaving.

BACKGROUND Despite the increasing prevalence of fibromyalgia, there has been little or no attention to its diagnosis and treatment in the undergraduate medical curriculum. This study intended to assess the knowledge and awareness of fibromyalgia among undergraduate medical students in Nigeria. METHODS This was a cross-sectional, descriptive survey conducted from September to December 2021. A total of 175 clinical students participated in the survey. The questionnaire comprised sociodemographic data and questions related to fibromyalgia. A scoring system was developed to stratify knowledge of fibromyalgia into very low, low, average, high, and very high. The level of significance was set at P < 0.05. RESULTS Responses were obtained from 175 clinical students with a mean age of 25.14 ± 3.21 years. Most of the participants (38.3 %) had low fibromyalgia knowledge levels. The main sources of information on fibromyalgia were clinical postings (47.1 %) and the internet (37.1 %). Widespread pain (84.6 %), fatigue (74.9 %), sleep disturbance (73.7 %), and joint pain (69.1 %) were the most selected symptoms. About a third (32.6 %) did not know any diagnostic criteria for fibromyalgia. Physical exercise (80.0 %), NSAIDs (77.1%), and prednisolone (66.9 %) were the most selected treatment options. Age (p = 0.045), gender (p = 0.019), class level (p = 0.002), and current clinical posting (p = 0.032) were significantly associated with fibromyalgia knowledge levels. CONCLUSIONS This study revealed inadequate fibromyalgia knowledge among Nigerian medical students. This highlights the need to improve the undergraduate medical curriculum to bridge the knowledge gap.

Background Fibromyalgia is a chronic pain syndrome of unknown etiology characterized by chronic widespread musculoskeletal pain and tenderness. It affects the quality of life of patients and has been associated with the human immunodeficiency virus (HIV). The study aimed to determine the prevalence of fibromyalgia in HIV‐positive patients and assess the effect of fibromyalgia on their functional status. Methodology This was a cross‐sectional study comprising 160 treatment‐naive HIV‐positive patients and 160 age‐ and sex‐matched HIV‐negative controls. The diagnosis of fibromyalgia was based on the 2011 modification of the 2010 American College of Rheumatology diagnostic criteria by assessing the widespread pain index and symptom severity score. The severity of fibromyalgia was assessed with the revised fibromyalgia impact questionnaire. Results The prevalence of fibromyalgia in HIV‐positive individuals was found to be 10.6%, which was significantly higher compared with controls (3.1%; P = .008). There was no significant association between fibromyalgia and age, gender, or occupation. There was a significant relationship between CD4 count levels (P < .001), WHO clinical stage (P < .001), and fibromyalgia. A statistically significant higher score on the Revised FM Impact Questionnaire was found in HIV‐positive individuals with fibromyalgia (P < .001). Conclusion The study found that HIV‐positive patients had a significantly higher incidence of fibromyalgia than controls and this was related to active indices of HIV disease. Fibromyalgia had a greater clinical impact on HIV patients than in controls. As a result, fibromyalgia should be identified and treated in people living with HIV.

BACKGROUNDThe metabolic profile which includes glycated haemoglobin, insulin resistance, pancreatic beta cell function and lipid profile is frequently deranged in acute ischaemic stroke. Stroke is a leading cause of death worldwide and an emerging cause of long-term disability and mortality in Africa. Our study aimed to determine the correlation between the metabolic profile and acute ischaemic stroke in a rural Hospital in Southern Nigeria.METHODOLOGYThis was a prospective cross-sectional study. Fifty consecutive first-ever ischaemic stroke patients presenting within 72 hours of stroke were matched for age and sex with 3 control groups (49 persons with type 2 diabetes and hypertension, 49 persons with hypertension only and 57 apparently healthy individuals). Blood samples were obtained from all participants to determine glycated haemoglobin, fasting lipid profile, fasting plasma glucose, fasting insulin and C-peptide and random plasma glucose (in stroke cases at presentation). Insulin resistance and pancreatic beta-cell function were determined using the Homeostatic Model Assessment (HOMA). Data were analysed by multivariate and univariate statistics.RESULTSOne hundred and two (49.8%) males and 103 (50.2%) females participated in the study. The overall mean age of the study participants was 61.6 ± 10.1 years. Compared with the control groups, predictors of acute ischaemic stroke were Fasting insulin (hyperinsulinaemia) [OR (95%CI) = 1.108 (1.043-1.178), p= 0.001], HOMA-β% [OR (95%CI) = 0.994 (0.990-1.001) p=0.006] and total cholesterol [OR (95%CI)= 0.009 (0.001-0.012) p=0.022].CONCLUSIONIn this study, hyperinsulinaemia, impaired beta-cell secretory function (HOMA-β) and elevated total cholesterol were found to be significant risk factors of ischaemic stroke. Hence, the need for regular screening to detect abnormal metabolic profiles and prompt treatment.