Ulceration of the foot is a major problem for people with diabetes. In a developing country like Nigeria, huge challenge is caused by diabetes foot problems. The aim of this study was to determine the impact of diabetic foot care education of patients and health care staff on the outcome of diabetic foot complications in our hospital. This was a pre and post design carried out from April 2013 to March 2014 on 155 diabetes patients. Patient education was carried out by diabetes nurses and doctors, at diagnosis and re-enforced at follow-up clinics. At the end of 1 year, the impact of education was assessed. Descriptive statistics were generated as appropriate. A total of 155 patients, 64 (41%) males and 91 (59%) females, were studied with mean age of 49 ± 3 years and mean duration of diabetes 6 ± 2.6 years. At the onset of the program, 70% of the patients had no knowledge of foot care education. Only 13.5% knew that diabetes mellitus foot ulcer could be related to long duration of diabetes, nerve damage, blood vessel blockage, foot deformity, and uncontrolled blood glucose. Ninety-two percent of the patients preferred home remedies, herbal treatment, or chemist in the event of an ulcer. After the program, 77% would seek hospital care as first option, and amputation rate decreased from 50% in 2009 to 10% by 2017. Our experience has shown that education is the cheaper option for the prevention of lower limb amputation in a resource-poor setting like ours.
Cardiac myxoma is a benign (non-malignant) neoplasm that represents the most common primary tumour of the heart. We present the case of a 36 year old woman with background hypertension who presented with features of left ventricular failure and seizures, and was found during transthoracic echocardiography to have left atrial myxoma protruding through the mitral valve orifice. She subsequently had excision of the atrial myxoma. The usefulness of early transthoracic echocardiography in any patient presenting with features of heart failure even when the aetiology seems obvious cannot be over-emphasised.
Aim: To determine the relationship between maternal serum 25(OH) D concentrations and development of preeclampsia.
Study Design: A cross sectional comparative study.
Place and Duration of Study: Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Abuja, between March 2016 and February 2017.
Methodology: We included 55 women with preeclampsia and 55 healthy women. Data obtained included sociodemographic characteristics, clothing style and duration of exposure to sun light. ELISA method was used for evaluation of serum vitamin D levels.
Results: The prevalence of VD deficiency in the population was 15%, while 16.8% and 73% of the participants had insufficient and normal levels respectively. The prevalence of VD deficiency in women with preeclampsia was 20.4% while that in healthy pregnant women was 9.4% (P=.19). The mean serum 25-OH-D level of women with pre-eclampsia was significantly lower than that of healthy women (34.5±14.9 vs. 43.5±15.1, P = .003). Preeclamptic women with vitamin D insufficiency delivered at a higher gestational age than those with vitamin D deficiency (37.67(2.77) weeks vs. 33.55(2.38) weeks respectively, P = .007). In the adjusted analysis of cases with vitamin D defficiency, the odds of developing preeclampsia was not statistically significant [odds ratio (OR) = 3.27, CI = 0.99-10.83, P =.05]. However, the odds of developing preeclampsia in women with Vitamin D insufficiency was statistically significant (OR = 3.20, CI = 1.02–10.06, = 0.046).
Conclusion: In conclusion, an association between vitamin D deficiency and preeclampsia was not demonstrated in this study. The results however suggest that maternal vitamin D insufficiency in late pregnancy is an independent risk factor for preeclampsia.
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