Background: Peripheral arterial disease is a disorder due to obstruction of blood supply to extremities. Diabetes mellitus and hypertension are predisposing factors.Objective: To determine if the presence of concurrent hypertension increases the risk of peripheral arterial disease (PAD) in Nigerians with type 2 diabetes.
Methods: This was a cross-sectional study that included 160 persons living with diabetes mellitus (60 subjects had type 2 diabetes (T2DM) while 100 subjects had concurrent diabetes and hypertension (DM-HTN)). The presence of PAD was determined by history of intermittent claudication, palpation of dorsalis pedis and posterior tibial arteries, ankle-brachial pressure indexes (ABPI), and measurement of intimal medial thickness [IMT] and spectral pattern on duplex ultrasound imaging of the femoropopliteal arteries. Fasting blood glucose (FBG), glycosylated haemoglobin (HbA1C) and some other parameters were obtained from subjects in both groups. Comparisons were drawn between patients with diabetes alone and diabetic-hypertensives.
Results: Mean age of T2DM only was 56.4±10.4 years and 59.4±8.5 years in DM-HTN. FBG (mmol/l) in T2DM only was 7.9±3.6 and 8.0±3.4 in DM-HTN; HbA1C (%) in T2DM group was 7.4±2.2 and 7.3±1.7 in DM-HTN. Prevalence of PAD was 74.9% in people with T2DM only and 70% among DM-HTN group using IMT as reference method. The prevalence of PAD in T2DM based on history of intermittent claudication, clinical palpation, ABPI and spectral pattern was 20.0, 26.7, 20.3, and 40.7% respectively while the prevalence of PAD in DM-HTN using history of intermittent claudication, clinical palpation, ABPI and spectral pattern was 26.0, 35.8, 22.0 and 50.0% respectively.
Conclusion: Prevalence of PAD is high among persons with diabetes mellitus. The presence of hypertension does not seem to confer any risk of PAD in people with T2DM only. In addition, traditional bedside methods of clinical pulse palpation and ankle-brachial pressure index of assessing PAD are still useful.

PurposeThe failure and abandonment of construction projects have proven to be insurmountable problems incessantly militating against the efficient performance of the construction industry in Nigeria. The complexity, technicality and a host of other project execution issues unique to multi-storey building projects do increase their susceptibility to failure and abandonment. Thus, the purpose of this paper is to examine the factors influencing failure and abandonment of multi-storey building projects in Nigeria. This is with a view to provide inferential empirical data that could enhance successful delivery of multi-storey building projects in Nigeria.
Design/methodology/approach
Primary data were used for the study. A structured questionnaire was administered on consultants and contractors’ personnel within Lagos State, Nigeria. A total of 180 copies of the questionnaire were administered ,and 134 copies which represent a combined response rate of 74.4 per cent were retrieved. The data were analysed using frequency distribution and percentages, Mean item score and factor analysis.
Findings
The factors most significant to the failure and abandonment of multi-storey building projects are inadequate funding by the client, improper planning at the pre-construction phase, structural failure in multi-storey building during construction, bankruptcy/business failure of the contractor, improper scheduling of the building project activities and failure to engage qualified professionals with technical expertise and experience. The rated factors clustered under human resources capability, planning and structural quality, contractor selection and variation, insecurity and variation, and force majeure and political risk.
Research limitations/implications
The study was limited to multi-storey building projects in Lagos State, Nigeria. Further studies could focus on specific resuscitation strategies for abandoned multi-storey building projects.
Practical implications
The study provided implications for effective project and contract management of multi-storey building projects which is very paramount to improve the delivery of complex, technical- and capital-intensive building projects in Nigeria.
Originality/value
The study provides specific implications for the management of multi-storey building projects, thereby enhancing the delivery of building projects.

PurposeThe continuous failure of construction projects notwithstanding appreciable increase in project management knowledge has necessitated a proactive approach of assessing early warning signs (EWS) of building projects failure. Building projects are expected to show warning signs before experiencing crises, comparable to a patient displaying symptoms of a disease. Thus, this study aims to examine the EWS that predisposed building projects to failure in Nigeria to provide empirical data for enhancing projects delivery.
Design/methodology/approach
Primary data were used for the study. Structured questionnaire was administered to consultants and contractors’ personnel within Lagos State, Nigeria. A total of 180 copies of questionnaire were administered and 134 copies (combined response rate of 74.44 per cent) were retrieved. Frequency distribution, percentages, mean item score and Mann–Whitney test were used to analyse the data.
Findings
Most construction professionals applied the EWS approach from project planning and early construction phase. The most significant EWS predisposing building projects to failure were “Management inability and incompetence to proactively detect and manage problems at early project stages”, “Actual expenditure is constantly shooting beyond cost estimates” and “Incurred costs already getting higher than the anticipated benefits”. Project/construction management-related symptoms are most significant to predisposing building projects to failure.
Practical implications
The study provided implications for effective project management of building projects through proactive approach which is very paramount to improving the delivery of building projects in Nigeria.
Originality/value
The study provides implications for proactive management of building projects, thereby enhancing the delivery of building projects.

Background: Cardiac autonomic neuropathy (CAN) resulting from seizures has been implicated in sudden unexpected death in epilepsy in persons with epilepsy (PWE), however, there are no previous studies of CAN in PWE from Nigeria. Objectives: This study sought to determine the frequency and pattern of CAN in adult PWE in a tertiary hospital in South-western Nigeria and to determine the relationship between seizure variables and CAN. Methods: A cross-sectional study of 80 adult PWE and 80 matched controls aged between 18 and 60 years was carried out between March 2012 and June 2013 at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Demographic and clinical data were obtained from all the study participants. Anxiety was excluded using the Hamilton Anxiety Scale. Those with conditions that could affect autonomic function, such as chronic renal failure, heart failure, Parkinson's disease, diabetes mellitus, anxiety, and psychiatric disorders and pregnant women were excluded. Five bedside cardiovascular reflex tests were performed on each subject after baseline heart rate and blood pressure (BP) had been recorded. Results: The mean age of onset of epilepsy was 19 ± 10 years, whereas the mean duration of epilepsy was 10 ± 8 years. The mean seizure frequency was 14 ± 30 per month (median three seizures per month). Of the 80 patients evaluated, 42 (52.5%) had CAN, whereas none of the controls had CAN. Majority (69%) of the PWE with CAN had purely parasympathetic dysfunction, whereas 3% had purely sympathetic dysfunction and 10% had combined autonomic dysfunction. The PWE in this study had significantly lower tilt ratios and diastolic BP change with Isometric Hand grip as well as significantly higher systolic BP change on standing than the controls. Patients who had more than four seizures per month had higher odds of CAN than those with less frequent seizures (odds ratio 0.275, P value 0.023). Also, patients who had received treatment for less than 10 years were found to have greater odds of CAN than those who had received treatment for a longer period (odds ratio 11.676, P value 0.046). Conclusion: CAN is common in adult PWE in South-Western Nigeria and the major predictors are short duration of treatment and frequent seizure episodes. Routine screening of these patients may help with early detection of autonomic dysfunction and provide an opportunity for intervention.