The impact of current therapeutic options on the health-related quality of life of patients with relapse/refractory multiple myeloma: a systematic review of clinical studies.

Purpose: Patients with relapse and/or refractory multiple myeloma (RRMM) have a high disease burden with poor health-related quality of life (HRQoL) which worsens with each additional relapse. We aimed to review the impact of triplet, doublet, monotherapies, and salvage autologous stem cell transplantation on the HRQoL of RRMM patients.

Methods: We performed a comprehensive literature search of Medline/PubMed, Wiley Cochrane Library, EMBASE, Scopus, CINAHL, and Clinicaltrials.

Early Intervention With a Curative Intent Through an Intensive Therapy Versus Immunologic Disease Control Using a Minimal Intensity Approach in the Management of High-risk Smoldering Multiple Myeloma: A Systematic Review of Evidence From Clinical Trials.

A subset of individuals with smoldering myeloma (SMM) are at a high risk of progression to symptomatic myeloma. Current efforts are focused on identifying this high-risk group and intercepting the disease process before its progression. There is no consensus on what the goal of an intervention should be, whether to aim for a cure through a high-intensity intervention or pursue immunologic disease control using the least intense approach.

Global uptake of fertility preservation by women undergoing cancer treatment: An unmet need in low to high-income countries.

Although the incidence of cancers is on the rise globally, mortality has continued to decrease due to advances in early detection and treatment. Cancer treatments such as chemotherapy and radiotherapy can impact the reproductive capacity of survivors by inducing premature ovarian failure and subsequent infertility causing significant psychological distress with decreased quality of life. Despite the increasing need for fertility preservation services for the rising number of cancer survivors and the recent advances in assisted reproductive technology, many women with cancers in low, middle, and to a lesser extent, high-income countries have no access to these services.

The effect of intervention versus watchful waiting on disease progression and overall survival in smoldering multiple myeloma: a systematic review of randomized controlled trials.

Background: Smoldering multiple myeloma (SMM) is an intermediate pre-malignant condition with individuals having a distinct risk of progression to overt myeloma. The optimal management option has remained controversial due to the heterogeneous nature of the condition in which progression to overt diseases is variable. The question of who, when, and what to use for the treatment of SMM remains equivocal.

Quality of meta-analyses for randomized trials in the field of hypertension: a systematic review.

Objectives: Doubling on average every 6 years, hypertension-related meta-analyses are now published twice weekly and are often considered the highest level of evidence for clinical practice. However, some hypertension specialists and guideline authors view meta-analyses with skepticism. This article evaluates the quality of hypertension-related meta-analyses of clinical trials.

Maximum accuracy obesity indices for screening metabolic syndrome in Nigeria: A consolidated analysis of four cross-sectional studies.

Background: In sub-Saharan Africa, there is no precise use of metabolic syndrome (MetS) definitions and risk factors screening indices in many clinical and public health services. Methods proposed and used in Western populations are adopted without validation within the local settings. The aim of the study is to assess obesity indices and cut-off values that maximise screening of MetS and risk factors in the Nigerian population.

Assessment of stigma and discrimination experienced by people living with HIV and AIDS receiving care/treatment in University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria.

The research was designed to assess the stigma and discrimination faced by People living with HIV and AIDS (PLWHA) that are receiving treatment in UITH, Ilorin. The study was a descriptive cross-sectional survey conducted on three hundred (300) people living with HIV and AIDS receiving care at the antiretroviral therapy (ART) clinics within University of Ilorin Teaching Hospital (which was the only ART site in Kwara State as at then). A quantitative method through the use of interviewer administered questionnaire was used for data collection.

Knowledge of sickle cell disease and haemoglobin electrophoresis: a survey of students of a tertiary institution.

Background: Sickle Cell Disease (SCD) is the commonest genetic disease worldwide. Of the sickle cell control strategies, premarital genetic counselling is increasingly practised in many countries of the world. Knowledge of the citizenry of a nation about SCD constitutes an important variable that influences the acceptability, practice and success of premarital genetic counselling.

Effect of demographic variables on cytomegalovirus antibody seropositivity among prospective blood donors in Jos, Nigeria.

Background: Cytomegalovirus, otherwise called human herpes virus type 5, is a transfusion transmissible pathogen responsible for significant morbidity and mortality among various groups of individuals with damaged or impaired host immunity. Although it has a worldwide distribution, the infection is thought to be more widespread in developing countries where certain demographic factors and living conditions are thought to be responsible for the observed increased prevalence of this infection.

Objectives: The aim of this study is to evaluate the effect of living conditions, using certain selected demographic parameters, on CMV seropositivity, among blood donors in Jos.

Relationship between left ventricular diastolic function and geometric patterns in Nigerians with newly diagnosed systemic hypertension.

Background: It is not known whether abnormalities of left ventricular diastolic function are influenced by the various cardiac geometric patterns in Nigerians with newly diagnosed systemic hypertension.

Objective: To evaluate the relationship between the parameters of left ventricular diastolic function and the geometric patterns in this group of patients.

Methods: Two-dimensional, guided M-mode echocardiography including Doppler was performed in 150 consecutive, newly diagnosed hypertensive individuals and normotensive controls aged between 35 and 74 years.

Prognostic significance of QT interval prolongation in adult Nigerians with chronic heart failure.

Background And Objectives: Prognostic survival studies for heart-rate corrected QT interval in patients with chronic heart failure are few; although these patients are known to have a high risk of sudden cardiac death. This study was aimed at determining the mortality risk associated with prolonged QTc in Nigerians with heart failure.

Materials And Method: Ninety-six consecutive patients with heart failure were recruited with 90 age and sex-matched controls.

Effect of Demographic Variables on Cytomegalovirus Antibody Seropositivity among Prospective Blood Donors in Jos, Nigeria.

Background: Cytomegalovirus, otherwise called human herpes virus type 5, is a transfusion transmissible pathogen responsible for significant morbidity and mortality among various groups of individuals with damaged or impaired host immunity. Although it has a worldwide distribution, the infection is thought to be more widespread in developing countries where certain demographic factors and living conditions are thought to be responsible for the observed increased prevalence of this infection.

Objectives: The aim of this study is to evaluate the effect of living conditions, using certain selected demographic parameters, on CMV seropositivity, among blood donors in Jos.

Prevalence of QTc prolongation in adult Nigerians with chronic heart failure.

Background: The heart rate corrected QT interval (QTc) on the electrocardiogram (ECG) has been proposed as a risk factor for ventricular arrhythmias and death in apparently healthy populations, patients with myocardial infarction and diabetes mellitus. However, data on the significance of QTc prolongation in heart failure are scarce.

Objective: Our objective was to examine the prevalence of QTc prolongation in adult Nigerians with heart failure and its association with arrhythmias.

Perception and attitude to epilepsy among teachers in primary, secondary and tertiary educational institutions in middle belt Nigeria.

Compared with the disability associated with repeated seizures or side-effects of antiepileptic medications, the social stigma associated with epilepsy is often a major handicap to people living with this condition. This study therefore looked at the knowledge, attitude and perception of teachers who see a lot of epileptics, relates on daily bases and have a high influence on students with epilepsy.Self-administered questionnaires were used to obtain information from 460 randomly selected teachers in primary, secondary and tertiary educational institutions in Kwara State-middle belt of Nigeria.

Determinants of prognosis among black Africans with hypertensive heart failure.

One hundred and seven consecutive Black Africans hypertensive heart failure patients made of 52 Gambians and 55 Nigerians (51 males + 56 females) aged 53.6 +/- 12.1 years were followed-up for 12 months or till death.

Ventricular arrhythmias: Q-T prolongation and left ventricular hypertrophy in adult Nigerians with hypertensive heart disease.

Seventy adult Nigerians with hypertensive heart disease (HHD) and 68 healthy controls were studied for ventricular arrhythmias (VA). The roles of QT prolongation and left ventricular hypertrophy in these arrhythmias were received. The mean age of the study population was 49.

Epidemiology of infertility: social problems of the infertile couples.

Infertility is of public health importance in Nigeria and many other developing nations because of its high prevalence and especially due to its serious social implications. A review of the epidemiology of infertility in Nigeria and other parts of Sub-Saharan Africa is presented and socio-cultural issues including the social impact on couples are discussed. The major cause of infertility in Africa is infection--STDs, post-abortal and puerperal sepsis.

An evaluation of Health Workers for Change in seven settings: a useful management and health system development tool.

This paper presents the findings of a multi-centre study assessing the impact of Health Workers for Change (HWFC) workshops in seven different primary care sites, based on the common core protocol described in this paper. The paper discusses a common methodology used by the studies, consisting of a triangulation of qualitative and quantitative methods. Such methodologies are inherently complex as they require comparisons across systems, sites and procedures.

Arrhythmias: appraisal of symptoms by haemodynamic concepts.

Arryhthmias can afflict any heart, even in the absence of disease. Given that Cardiac Output (CO) is a product of heart rate and stroke volume, the end-result of brady- and tachy-arrhythmias is the same: low CO with symptoms of low-output state. In bradyarrhythmias, myocardial inotropy operates maximally but the product of stroke volume and slow heart rate yields a low CO.

Comparison of scalar with vectorial electrocardiogram in axis determination.

Axis deviation is one of the variables most commonly sought for in Electrocardiography (ECG). Although no one doubts the superiority of vector cardiography (VCG) as the most accurate in axis determination, most clinicians adopt the Hexaxial Reference System (HRS) of the 12-Lead ECG (12LS) as the most accessible for routine use. The question therefore arises: How accurate is the HRS? The 12LS and Orthogonal (Frank Lead) ECG (OLS) were recorded in 664 adult Nigerians without heart or metabolic diseases.

Contraceptive method choices among adolescents in a Nigerian tertiary institution.

This study was undertaken to describe adolescents, use of contraceptive methods and to examine factors that motivate their choice. Face-to-face interview of single, randomly selected 971 males and females aged 18-24 years in a Nigerian tertiary institution was conducted. Among sexually active males and females 72 percent and 81 percent respectively had ever used contraception.

The orthogonal and 12 lead ECG in adult negroes with systemic hypertension: comparison with age-matched control.

In a comparative ECG study of 288 hypertensive and 340 normal Nigerians, the following observations were made: a) The QRS voltage is high in normal Negroes but becomes significantly higher in hypertension (HBP). This suggests that the voltage criteria being used for LVH in Caucasians are not applicable to Negroes. b) The T wave amplitude diminishes in HBP culminating in ST-T flattening or down-sloping ST-segment with asymmetric T inversion, so called "Strain pattern" c) The Washington code for LVH (Rx amplitude > 2 mV, Rx + Rz > 3.

Sexual behaviour and condom acceptance among Nigerian drivers.

A survey of 180 randomly selected drivers was carried out in June 1994 in Ilorin, Nigeria in order to gain information about high-risk sexual behaviours, to ascertain condom use and to identify obstacles to condom acceptance so as to facilitate the design of an intervention to prevent Sexually Transmitted Diseases/Acquired Immuno-deficiency Disease in this target population. Data was collected through face-to-face interview. Three-quarters of the respondents were married.

Spatial magnitudes of instantaneous QRS and ST-T vectors in Nigerians.

Spatial magnitudes of instantaneous QRS and ST-T vectors were studied in 664 (333 male: 331 female) normal Nigerians aged 15 to 90 (Mean: 39.1 +/- 16.7) years.

The physiological basis of ST-T variations in the electrocardiogram: a review.

ST-T aberrations in the Negro involve both sexes, all age groups and all electrocardiogram (ECG) leads and are benign in the asymptomatic subject. This suggests that the variations have physiological basis and that alterations in the electrochemical processes occurring during repolarization would explain the ECG counterparts. While an isoelectric J-point suggests a temporal dissociation between phases 0 and 1 of the action potential, an elevated J-point suggests that phase 1 starts before the end of phase 0.