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- ItemOpen AccessThe ACT and the ATAQ are useful surrogates for asthma control in resource-poor countries with inadequate spirometric facilities.(Taylor and Francis Online, 2012-12) Ozoh, O.B.; Okubadejo, N.U.; Chukwu, C.C.; Bandele, E.O.; Irusen, E.M.OBJECTIVE: The objective of this study is to determine the utility of simple asthma control questionnaires in assessing the asthma control in our practice setting. METHODS: The Asthma Control Test (ACT), Asthma Therapy Assessment Questionnaire (ATAQ), and mini Asthma Quality of Life Questionnaire (mini AQLQ) were administered to previously diagnosed asthma patients. Spirometry was performed to obtain the prebronchodilator forced expiratory volume in 1 second (FEV1). The relationship between test scores (ACT and ATAQ) and the FEV1 and mini AQLQ scores, respectively, was explored. RESULTS: A total of 106 patients (mean age 41 ± 15.3 years, 61 (57.5%) females) participated in the study. The mean ACT score was 17 ± 5.3 and the mean ATAQ score was 1.46 ± 1.34. There was a significant positive correlation between the ACT score and FEV1% predicted indicating the improvement in asthma control when FEV1% predicted increases (Pearson's correlation = 0.518, R² = 0.268, p < .0001) and a negative correlation between the ATAQ score and FEV1% predicted also indicating the improvement in asthma control when FEV1% predicted increases (Pearson's correlation = -0.516, R² = 0.266, p < .0001). The ACT score was significantly and positively related to the mini AQLQ score signifying an improvement in quality of life with increasing ACT score (Pearson's correlation = 0.691, R² = 0.461, p < .0001).The ATAQ score was significantly and negatively related to the mini AQLQ score indicating an improvement in quality of life with decreasing ATAQ score (Pearson's correlation = -0.654, R² = 0.428, p ≤ .0001). The FEV1% predicted and the mini AQLQ score were the only significant determinants of both the ACT score and the ATAQ score. CONCLUSION: The ACT and ATAQ are the objective and reliable tools in determining asthma control due to their strong correlation with the FEV1 and the asthma-specific health-related quality of life. Use of either questionnaire routinely will identify more patients with poor asthma control even when spirometry services are not readily available.
- ItemOpen AccessAdmission blood pressure of stroke patients and its relationship to one-week case fatality-a preliminary study.(Lagos University Medical Society (LUMS), 2002-01) Ojini, F.I.; Okubadejo, N.U.; Ogun, S.A.; Akokhia, S.I.; Danesi, M.A.Background: High blood pressure is often said to be associated with poor outcome in stroke. However, there remains some uncertainly about the relationship of blood pressure to mortality in stroke. Objective: This study seeks to determine the influence of admission blood pressure on early mortality of stroke patients at the Lagos University Teaching Hospital (LUTH). Methods: Clinical and laboratory data were collected prospectively according to a standardized protocol, from stroke patients admitted to LUTH in 1999 and 2000, and information obtained about the time of onset of stroke, history of hypertension, level of consciousness, admission blood pressure, ECG findings of left ventricular hypertrophy, and one-week outcome. Results: hypertension was present in 87.3% of strokes on presentation. Strokes with mild to moderate hypertension had the lowest case fatality of 5.6%, while those with isolated systolic hypertension had the highest fatality of 40%. There was a u-shaped relationship between admission blood pressure and one-week case fatality, with strokes that had mild to moderate hypertension having a significantly lower one-week case fatality than strokes with normal blood pressure and severe hypertension Conclusion: Most patients with stroke have hypertension on presentation. It appears that mild to moderate hypertension on presentation is associated with a significantly better one-week outcome for stroke patients than other categories of blood pressure.
- ItemOpen AccessThe adrenal gland and the patient with pulmonary tuberculosis infected with human immunodeficiency virus(Medknow, 2017) Odeniyi, I.A; Fasanmade, O.A; Ogbera, A.O; Ohwovoriole, A.EBackground: The adrenal gland is not spared from the involvement by tuberculosis. One of the recognized causes of adrenal insufficiency (AI) is tuberculosis. AI, mostly at the subclinical level, is common in persons with pulmonary tuberculosis (PTB) infection, occurring in about 23% of patients. Coinfection with PTB and human immunodeficiency virus (HIV) may compromise adrenocortical function and produce significant adrenocortical insufficiency. Objective: To determine if coinfection with tuberculosis and HIV have a compound effect on adrenocortical function in persons with HIV and PTB coinfection. Materials and Methods: Persons with sputum‐positive PTB, treatment naive, who met our inclusion criteria, were selected. All the recruited patients were screened for HIV and those positive for HIV infection had confirmatory test. A baseline blood samples for cortisol, fasting plasma glucose, full blood count, and electrolytes were collected between 8.00 h and 9.00 h immediately before administration of adrenocorticotropic hormone (ACTH). The persons received an intravenous bolus injection of 1 μg ACTH (Alliance Pharmaceuticals Ltd., Chippenham, Wiltshire SN15 2BB) and blood sample was drawn for cortisol level at 30 min. Results: Forty‐four people with PTB infection and forty people with PTB and HIV coinfection met the inclusion criteria of the study. The adrenal response to 1 μg ACTH stimulation in participants with PTB and PTB and HIV coinfection showed that the mean basal cortisol level in the 2 groups was not statistically significant; however, 30‐min post‐ACTH stimulation cortisol level was 630.84 ± 372.17 and 980.36 ± 344.82 nmol/L (P < 0.001) and increment was 367.79 ± 334.87 and 740.77 ± 317.97 nmol/L (P < 0.001), respectively. Fourteen persons (31.8%) with PTB has subnormal adrenal response to ACTH stimulation while only 2 (5%) persons with PTB and HIV coinfection has subnormal response. Conclusion: AI, at subclinical level, was less frequent in those with PTB and HIV co‐infection.
- ItemOpen AccessThe adrenal gland and the patient with pulmonary tuberculosis infected with human immunodeficiency virus(2017) Odeniyi, I.A; Fasanmade, O.A; Ogbera, A.O; Ohwovoriole, A.EBackground: The adrenal gland is not spared from the involvement by tuberculosis. One of the recognized causes of adrenal insufficiency (AI) is tuberculosis. AI, mostly at the subclinical level, is common in persons with pulmonary tuberculosis (PTB) infection, occurring in about 23% of patients. Coinfection with PTB and human immunodeficiency virus (HIV) may compromise adrenocortical function and produce significant adrenocortical insufficiency. Objective: To determine if coinfection with tuberculosis and HIV have a compound effect on adrenocortical function in persons with HIV and PTB coinfection. Materials and Methods: Persons with sputum-positive PTB, treatment naive, who met our inclusion criteria, were selected. All the recruited patients were screened for HIV and those positive for HIV infection had confirmatory test. A baseline blood samples for cortisol, fasting plasma glucose, full blood count, and electrolytes were collected between 8.00 h and 9.00 h immediately before administration of adrenocorticotropic hormone (ACTH). The persons received an intravenous bolus injection of 1 μg ACTH (Alliance Pharmaceuticals Ltd., Chippenham, Wiltshire SN15 2BB) and blood sample was drawn for cortisol level at 30 min. Results: Forty-four people with PTB infection and forty people with PTB and HIV coinfection met the inclusion criteria of the study. The adrenal response to 1 μg ACTH stimulation in participants with PTB and PTB and HIV coinfection showed that the mean basal cortisol level in the 2 groups was not statistically significant; however, 30-min post-ACTH stimulation cortisol level was 630.84 ± 372.17 and 980.36 ± 344.82 nmol/L (P < 0.001) and increment was 367.79 ± 334.87 and 740.77 ± 317.97 nmol/L (P < 0.001), respectively. Fourteen persons (31.8%) with PTB has subnormal adrenal response to ACTH stimulation while only 2 (5%) persons with PTB and HIV coinfection has subnormal response. Conclusion: AI, at subclinical level, was less frequent in those with PTB and HIV co-infection.
- ItemOpen AccessAdrenocortical function in Nigerian Patients with Pulmonary Tuberculosis (PTB)(2011-03) Odeniyi, I.; Fasanmade, O.; Ajala, M.; Ohwovoriole, A.Addison's disease was frequently consequent upon affectation of the glands by tuberculosis. Pulmonary Tuberculosis (PTB) is still very common in Nigeria but no report on the functional status of the adrenal cortex in patients with PTB in Nigeria exists. It is very important to note that subclinical adrenocortical failure in tuberculosis is an entity that should be considered as cortisol deficiency could be responsible for unexpected sudden death in this category of patients. This study sets out to determine the prevalence of subclinical adrenocortical failure in persons with PTB by determining the response to low-dose (1 ìg) ACTH stimulation. Forty four persons with newly diagnosed sputum-positive PTB and treatment naive, (23 males and 21 females, mean age 34.4 +/- 11.3 years, and mean body mass index (BMI) of 18.9 +/- 2.9 kg/m2) completed the study. Of the one hundred healthy volunteers recruited as control subjects, 70 persons (35 males and 35 females, mean age 38.1 +/- 12.5 years, BMI 24.1 +/- 3.7 kg/m2) completed the exercise. There was no statistically significant difference in the basal cortisol of healthy subjects and persons with PTB (239.9 vs. 229.1 nmol/L, p = 0.661). The thirty minute response to ACTH stimulation test and increment were significantly lower in persons with PTB than in healthy subjects. Adrenocortical insufficiency, mostly at the subclinical level, is common in persons with PTB infection, occurring in about 23% of patients. We therefore recommend that basal cortisol levels should not be used to detect adrenocortical insufficiency; rather stimulation tests should be used to exclude or confirm suspected adrenocortical insufficiency in patients with PTB.
- ItemOpen AccessAdrenocortical function in Nigerian patients with pulmonary tuberculosis (PTB)(University College Hospital, 2011) Odeniyi, I.A; Fasanmade, O.A; Ajala, M.O; Ohwovoriole, A.EAddison's disease was frequently consequent upon affectation of the glands by tuberculosis. Pulmonary Tuberculosis (PTB) is still very common in Nigeria but no report on the functional status of the adrenal cortex in patients with PTB in Nigeria exists. It is very important to note that subclinical adrenocortical failure in tuberculosis is an entity that should be considered as cortisol deficiency could be responsible for unexpected sudden death in this category of patients. This study sets out to determine the prevalence of subclinical adrenocortical failure in persons with PTB by determining the response to low-dose (1 ìg) ACTH stimulation. Forty four persons with newly diagnosed sputum-positive PTB and treatment naive, (23 males and 21 females, mean age 34.4 +/- 11.3 years, and mean body mass index (BMI) of 18.9 +/- 2.9 kg/m2) completed the study. Of the one hundred healthy volunteers recruited as control subjects, 70 persons (35 males and 35 females, mean age 38.1 +/- 12.5 years, BMI 24.1 +/- 3.7 kg/m2) completed the exercise. There was no statistically significant difference in the basal cortisol of healthy subjects and persons with PTB (239.9 vs. 229.1 nmol/L, p = 0.661). The thirty minute response to ACTH stimulation test and increment were significantly lower in persons with PTB than in healthy subjects. Adrenocortical insufficiency, mostly at the subclinical level, is common in persons with PTB infection, occurring in about 23% of patients. We therefore recommend that basal cortisol levels should not be used to detect adrenocortical insufficiency; rather stimulation tests should be used to exclude or confirm suspected adrenocortical insufficiency in patients with PTB.
- ItemOpen AccessAdrenocortical Function In Nigerians With Human Immunodeficiency Virus (HIV) Infection(2013) Odeniyi, I.A; Fasanmade, O.A; Ajala, M.O; Ohwovoriole, A.EOBJECTIVE: This study sets out to determine the prevalence of adrenocortical insufficiency in persons with HIV infection by determining the response to low-dose (1 µg) ACTH stimulation. DESIGN: An experimental study involving people with HIV infection and healthy people. SETTING: The study group and the controls were recruited from the Lagos University Teaching Hospital (LUTH). PARTICIPANTS: forty-three newly diagnosed and treatment naïve persons with HIV (23 males and 20 females) and 70 (35 males and 35 females) HIV negative subjects completed the study. INTERVENTION: One µg Synacthen was given intravenously to stimulate the adrenal glands. MAIN OUTCOME MEASURES: Blood was collected for basal cortisol levels and 30 minutes after the injection of ACTH. Cortisol was assayed using ELISA. RESULTS: The mean basal cortisol was 154.9 ± 27.2 nmol/L and 239.9 ± 31.6 nmol/L (p<0.001); while the 30-minute post ACTH test cortisol level was 354.8 ± 19.9 nmol/L and 870.9 ± 163.5 nmol/L (p<0.001) and 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 derived for the diagnosis of adrenocortical insufficiency in this study (30 minute cortisol level <380.2 nmol/L and increment from basal to stimulated cortisol level <158.5 nmol/L); fifteen (34.8%) persons with HIV had adrenal insufficiency. CONCLUSION: Adrenocortical insufficiency is common in persons with HIV infection, occurring in about 34.8% of patients studied. Clinically evident adrenocortical insufficiency is uncommon in persons with HIV.
- ItemOpen AccessAdrenocortical function in Nigerians with human immunodeficiency virus infection(Ghana Medical Association, 2013-12) Odeniyi, I.; Fasanmade, O.; Ajala, M.O.; Ohwovoriole, A.OBJECTIVE: This study sets out to determine the prevalence of adrenocortical insufficiency in persons with HIV infection by determining the response to low-dose (1 µg) ACTH stimulation. DESIGN: An experimental study involving people with HIV infection and healthy people. SETTING: The study group and the controls were recruited from the Lagos University Teaching Hospital (LUTH). PARTICIPANTS: forty-three newly diagnosed and treatment naïve persons with HIV (23 males and 20 females) and 70 (35 males and 35 females) HIV negative subjects completed the study. INTERVENTION: One µg Synacthen was given intravenously to stimulate the adrenal glands. MAIN OUTCOME MEASURES: Blood was collected for basal cortisol levels and 30 minutes after the injection of ACTH. Cortisol was assayed using ELISA. RESULTS: The mean basal cortisol was 154.9 ± 27.2 nmol/L and 239.9 ± 31.6 nmol/L (p<0.001); while the 30-minute post ACTH test cortisol level was 354.8 ± 19.9 nmol/L and 870.9 ± 163.5 nmol/L (p<0.001) and 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 derived for the diagnosis of adrenocortical insufficiency in this study (30 minute cortisol level <380.2 nmol/L and increment from basal to stimulated cortisol level <158.5 nmol/L); fifteen (34.8%) persons with HIV had adrenal insufficiency. CONCLUSION: Adrenocortical insufficiency is common in persons with HIV infection, occurring in about 34.8% of patients studied. Clinically evident adrenocortical insufficiency is uncommon in persons with HIV.
- ItemOpen AccessAgouti-related protein promoter variant associated with leanness and decreased risk for diabetes in West Africans.(Nature Research, 2006) Bonilla, C.; Panguluri, R.K.; Taliaferro-Smith, L.; Argyropoulos, G.; Chen, G.; Adeyemo, A.A.; Amoah, A.; Owusu, S.; Acheampong, J.; Agyenim-Boateng, K.; Eghan, B.A. Jr; Oli, J.; Okafor, G.; Abbiyesuku, F.; Johnson, T.; Rufus, T.; Fasanmade, O.; Chen, Y.; Collins, F.S.; Dunston, G.M.; Rotimi, C.; Kittles, R.A.OBJECTIVE: The role of the central melanocortin system in the development of obesity has been extensively studied. Single-nucleotide polymorphisms (SNPs) within several candidate genes have been associated with food intake and obesity-related phenotypes; however, few of these associations have been replicated. SNPs in the agouti-related protein (AGRP) gene coding (Ala67Thr, 199G/A) and promoter (-38C/T) have been reported to be associated with body mass index (BMI), fat mass (FM) and percent body fat, in populations of European and African descent. In this study, we evaluated the association between the functional AGRP -38C/T promoter SNP and weight-related traits, namely BMI, FM and fat-free mass (FFM), as well as diabetes status. DESIGN: An association study of the AGRP -38C/T SNP and indices of obesity and diabetes status. SUBJECTS: A well-characterized population of 538 West Africans from Ghana and Nigeria recruited in the AADM (Africa America Diabetes Mellitus) study (mean age 52 years, 41.3% males, 71% diabetic). MEASUREMENTS: Genotyping of the AGRP -38C/T SNP, BMI, FM, FFM and fasting plasma glucose. RESULTS: Women carrying two copies of the variant T allele had significantly lower BMI (OR=0.47; 95% CI, 0.25-0.87). Also, men with at least one copy of the variant T allele were over two times less likely to be diabetic than other men (OR=0.44; 95% CI, 0.22-0.89). CONCLUSION: Our results replicate previous findings and implicate the AGRP -38C/T SNP in the regulation of body weight in West Africans.
- ItemOpen AccessThe Allure of Abdominal Scarification (UDE) among the Esan Tribe in South-South Nigeria–A Prospective Analysis(International Journal of Tropical Disease & Health, 2020-09) Irekpita, E.; Emorinken, A.; Akinkugbe, A.A.; Salami, T.A.T.; Oseni, T.I.A.; Ozeigbe, O.E.; Agbebaku, F.O.Background: The practice of inflicting cuts (incisions) on the to treat splenomegaly of various causes is a very common one in some parts of Edo State, Nigeria. Such incisions may result in several complications including sepsis (especially in children who are the major targets); massive blood loss leading to symptomatic anemia that may require blood transfusions or lead to death and massive keloidal growth as sequelae in some of the patients. This practice is a long-term practice of the Esan people of the central part of Edo State Nigeria. This study aims to identify the factors that continue to make this practice attractive to members of the community, the common complications encountered, and how to develop an advocacy tool for health education and promote the health-seeking behavior of the populace. Methods: This was a prospective community based cross-sectional descriptive study that was conducted in all the 5 Esan speaking local government areas of Edo State where this practice is very common. The study was done between January 2017 and June 2018. Participants were interviewed using a structured questionnaire by previously trained researchers, after pretesting and validation. The questionnaire was administered on 700 adults, however, 500 were returned. The data obtained were summarized as frequencies and percentages. Results: The majority of the participants were middle-aged. Ninty-five percent (95%) of respondents were aware of the practice of abdominal scarification and 80% of them think it is effective. It was mainly carried out by herbalists in 95% of the respondents. Half of the respondents were unaware of any complications associated with the procedure. Conclusion: Abdominal scarification is a common practice among the Esan people of south-south Nigeria. They believe it's effective, affordable, and risk-free. This is despite the availability of effective alternatives in orthodox medicine. There is, therefore, a need for advocacy and health education considering the dangers and complications associated with the practice.
- ItemOpen AccessAn analysis of genetic studies of Parkinson's disease in Africa.(Elsevier, 2008-09-18) Okubadejo, N.U.Online databases (till April 30, 2007) revealed 12 studies describing genetics of Parkinson's disease (PD) in Africa. Two studied inheritance patterns of familial PD. Ten focused on one of three genes, i.e. parkin, PINK 1 and LRRK2 in familial PD. Most studies were from North Africa, where parkin mutations are the most common cause of autosomal recessive PD. Frequency of LRRK2 G2019S mutation is higher than North American and European populations. The LRRK2 G2019S mutation is frequent in apparently sporadic PD in North Africans. There is a need to extend research into genetics of sporadic and familial PD to more African subregions
- ItemOpen AccessAnalysis of Nigerians with apparently sporadic Parkinson disease for mutations in LRRK2, PRKN and ATXN3.(Public Library of Science (PLOS), 2008-10-17) Okubadejo, N.U.; Britton, A.; Crews, C.; Akinyemi, R.; Hardy, J.; Singleton, A.; Bras, J.Several genetic variations have been associated with Parkinson disease in different populations over the past few years. Although a considerable number of worldwide populations have been screened for these variants, results from Sub-Saharan populations are very scarce in the literature. In the present report we have screened a cohort of Parkinson disease patients (n = 57) and healthy controls (n = 51) from Nigeria for mutations in the genes PRKN, LRRK2 and ATXN3. No pathogenic mutations were found in any of the genes. Hence, common pathogenic mutations in these genes, observed in several different populations, are not a frequent cause of Parkinson disease in Nigeria.
- ItemOpen AccessAntihypertensive pharmacotherapy in a developing economy: pattern, acquisition costs and conformity to international guidelines in a tertiary-care setting(Nature Publishing Group, 2006-11) Amira, C.O.; Okubadejo, N.U.Acquisition cost of antihypertensive drugs may hamper blood pressure (BP) control. We evaluated prescribing pattern, acquisition cost and cost-effectiveness relationship in 225 black hypertensives attending a tertiary clinic in a developing economy. BP control was achieved in 89 (39.6%), calcium channel blockers were used most frequently (28.4%), but the most cost-effective therapy was the diuretic co-amiloride.
- ItemOpen AccessApathetic Thyrotoxicosis Presenting with Hemoptysis(Science and Education Publishing, 2014) Sheyin, O; Falade, T; Fasanmade, OIntroduction: Apathetic thyrotoxicosis is an uncommon manifestation of hyperthyroidism. We report a case of apathetic thyrotoxicosis in an elderly Nigerian woman presenting with hemoptysis. Case Presentation: An 85 year old woman with past medical history of hypertension and euthyroid goiter presented with a two-week- history of subjective weight loss, cough, hemoptysis and progressively worsening dyspnea. Examination findings included dyspnea, pallor, goiter, an irregularly irregular pulse, tachypnea, jugular venous distension, a third heart sound and rales in both lung bases. Thyroid function tests revealed elevated free triiodothyronine and free thyroxine with a suppressed thyroid stimulating hormone. Her brain natriuretic peptide was 980pg/L and her electrocardiogram revealed atrial fibrillation with rapid ventricular response. Findings on trans-thoracic echocardiogram included a dilated left atrium, mild concentric left ventricular hypertrophy with grade 1 diastolic dysfunction, but preserved left ventricular systolic function, without any significant valvular abnormalities. A diagnosis of apathetic throtoxicosis presenting with heart failure with preserved ejection fraction, precipitated by atrial fibrillation was made and treatment was instituted. The patient reverted to sinus rhythm with resolution of her hemoptysis and heart failure symptoms within one week of admission. Discussion: Apathetic thyrotoxicosis is an atypical manifestation of hyperthyroidism more commonly found in the elderly. It presents with cardiac disease, wasting or depression with only a few of the more typical clinical manifestations of thyrotoxicosis. The hemoptysis found in our patient is most likely due to pulmonary edema from left ventricular failure. Conclusion: A diagnosis of apathetic thyrotoxicosis should be considered in the elderly patient presenting with heart failure in the absence of the usual risk factors for heart failure. Early recognition and treatment can reduce the morbidity and mortality associated with this condition.
- ItemOpen AccessAppropriate use of colonoscopy in Nigeria: a retrospective study using the American Society for Gastrointestinal Endoscopy (ASGE) 2012 guidelines.(Panafrican Medical Journal, 2020) Odeghe, E.A; Oluyemi, A.O; Adeniyi, O.FIntroduction: colonoscopy is the standard investigation for assessing colonic disease, with moderate yield. The American Society of Gastrointestinal Endoscopy (ASGE) published guidelines to tailor the appropriate use of colonoscopy. The aims of this study were to determine the frequency at which colonoscopy was performed for an appropriate indication based on ASGE´s 2012 guidelines, and to determine if there was an association of appropriateness of indication with endoscopic findings. Methods: a retrospective study of colonoscopies performed in a private endoscopy centre in Lagos, Nigeria, between January 2014 and December 2016. Ethical approval was obtained before commencement. Data retrieved were basic demographics, indication of, and findings at colonoscopy. Data were analysed using SPSS 23. A p-value of <0.05 was considered significant. Results: altogether 627 colonoscopies were performed, 464 (74%) were male, mean age was 53.6 (± 14.3) years, 255 (40.7%) were younger than 50 years. Colonoscopy was appropriately indicated in 450 (71.8%). Women were nearly twice as likely to have an unnecessary procedure than men. The overall diagnostic yield of 39.6% was similar in appropriately (41.6%) and inappropriately (34.5%) indicated procedures. Older age, abdominal mass on imaging or examination, unexplained weight loss and chronic constipation were independently associated with diagnostic yield. The pooled sensitivity and specificity of the ASGE guidelines for significant endoscopy findings were 75%, and 31% respectively. Conclusion: there was a high rate of unnecessary colonoscopies, especially in women. Older patients, and those with chronic constipation, unexplained weight loss and an abdominal mass, should be referred for urgent colonoscopy.
- ItemOpen AccessAssessment of anthropometric indices among residents of Calabar, South-East Nigeria(Medknow, 2014-05) Enang, O.E; Ohwovoriole, A.E; Essien, O.E; Otu, A.A; Fasanmade, OBackground: Obesity is a risk factor for type 2 diabetes mellitus which may be addressed by application of intensive lifestyle interventions. Thus, establishing normative values of anthropometric indices in our environment is crucial. This study aimed to determine normative values of anthropometric indices of nutrition among residents of Calabar. Materials and Methods: This cross sectional observational study recruited residents of Calabar aged between 15-79 years using a multistage sampling method. Trained research assistants collected socio-demographic data and did anthropometric measurements. Results: There were 645 (56.5%) males and 489 (43.1%) females. Males had significantly lower general adiposity and hip circumference (HC) than females while females had significantly lower waist circumference (WC) and waist hip ratio (WHR) than males. The WHR increased with age particularly among males. Body mass index (BMI) also increased with age in both males and females with a peak in the middle age bracket, followed by a decline among the elderly. The mean (SD) BMI was 27.7 (5.0) kg/m2. Males had a mean (SD) BMI of 27.0 (4.4) kg/m2, while females had a mean (SD) BMI of 28.5 (5.5) kg/m2 respectively. WC correlated positively and significantly with BMI and WHR in males and females. WHR correlated positively and significantly with BMI in males and females. Conclusion: There are positive linear inter relationships between the indices of nutrition which is strongest between WC and BMI. In view of the strong independent association of DM with indices of nutrition, it is appropriate to derive normal cut-off values for WC, WHR and BMI nationally.
- ItemOpen AccessAssessment of diabetic control:an African perspective(FSG communications, 1994-04) Ohwovoriole, A.E; Fasanmade, O.A; Johnson, T.ODiabetes mellitus, especially non-insulin dependent diabetes (NIDDM) is being increasingly recognised particularly in Africa and other parts of the developing world. The complications taking a great toll of life among African diabetics include: hyperglycaemic emergencies, hypoglycaemia, limb gangrene, strokes and infections. Recent observations indicate an increase in these complications. If this trend is halted, the management of diabetes in the region needs to be reappraised.
- ItemOpen AccessAn Assessment of the Knowledge and Attitudes of Graduating Medical Students in Lagos, Nigeria, Regarding Obstructive Sleep Apnea.(American Thoracic Society (ATS Journals), 2015-09) Ozoh, O.B.; Iwuala, S.O.; Desalu, O.O.; Ojo, O.O.; Okubadejo, N.U.RATIONALE: Symptom scores show that a significant proportion of Nigerians are at high risk of developing obstructive sleep apnea; however, the diagnosis is rarely made in this country. The knowledge of medical students regarding sleep apnea may provide insight into their future ability to recognize patients with sleep apnea and can also inform student education on this disease. OBJECTIVES: To assess the knowledge and attitudes of graduating medical students in Nigeria regarding obstructive sleep apnea using a standard validated questionnaire. METHODS: This descriptive, cross-sectional survey study was performed at the College of Medicine of the University of Lagos, Nigeria. The Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) instrument was self-administered by the subjects. This validated questionnaire consists of 18 knowledge assessment questions and 5 attitude assessment questions. MEASUREMENTS AND MAIN RESULTS: The response rate was 99%, and our final sample comprised 143 participants. The maximum achievable knowledge score was 18. Obtained scores ranged from 0 to 15; the mean ± SD score was 7.6 ± 3.2 (42.2%); and the median score was 8 (interquartile range, 6-10). Four participants (2.8%) had a score of 0, and 56 (39.2%) had a score corresponding to ≥50%. There was no significant difference in knowledge scores by sex or age. Regarding attitudes, over 80% considered obstructive sleep apnea an important disorder; 41% were confident in identifying patients with the condition; 16.1% were confident in managing the disease; and 16.8% expressed confidence in managing patients receiving continuous positive airway pressure therapy. The total attitude score ranged from 1 to 5 (mean, 2.9 ± 0.7). There was a significant correlation between the total attitude score and the total knowledge score (r = 0.22, P = 0.01) and the age of the participants (r = 0.18, P = 0.04). CONCLUSIONS: The level of knowledge of obstructive sleep apnea among medical students at the Nigerian university in our study was not optimal. This study demonstrates a need to formally incorporate evaluation of sleep disorders into the undergraduate medical curriculum with the clear objective of enabling recognition of clinical features of common sleep disorders such as sleep apnea.
- ItemOpen AccessAssociation between periodontal diseases and systemic illnesses: A survey among internal medicine residents in Nigeria(Elsevier, 2016-01) Fasanmade, O.A; Umeizudike, K.; Iwuala, S.; Ozoh, O.B; Ayanbadejo, P.O.OBJECTIVE:To assess internal medicine residents' knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients' periodontal health. METHODS: A cross-sectional survey using a self-administered questionnaire was conducted among internal medicine residents attending the Faculty of Internal Medicine 2014 Update Course organized by the National Postgraduate Medical College of Nigeria. Participants came from all over the country. Data on respondents' demographic characteristics, periodontal disease knowledge, knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients' periodontal health were collected. Data were analyzed using Epi INFO software. The Pearson chi square test was used to measure significant association between categorical variables such as the knowledge of periodontal disease and gender, age group and designation of the participants (p ⩽ 0.05). RESULTS: Of 150 questionnaires distributed, 123 were returned (82% response rate); 109 questionnaires were completed properly and included in the analysis. The most common source of residents' information on oral health was television (59.4%). Only 11.2% of respondents were aware that gingival bleeding was the earliest sign of periodontal disease. Respondents correctly identified periodontal disease as a risk factor for coronary heart disease (45.9%), stroke (43.5%), hospital-acquired pneumonia (53.2%), diabetes mellitus (13.8%), and preterm birth (11%). Increased age (p = 0.032) and male gender (p = 0.022) were associated significantly with knowledge of periodontal disease as a risk factor for stroke. Higher designation (p = 0.002) and longer duration in residency training (p = 0.004) were associated significantly with knowledge of periodontal disease as risk factor for peripheral arterial disease. The majority (90.9%) of respondents had positive attitudes toward the referral of their patients for regular periodontal care. CONCLUSIONS: Knowledge of periodontal disease as a risk factor for systemic illnesses among medical residents in Nigeria is inadequate. These relationships should be emphasized in continuing medical education courses
- ItemOpen AccessAssociation between periodontal diseases and systemic illnesses: a survey among internal medicine residents in Nigeria.(Elsevier, 2016) Umeizudike, K.A.; Iwuala, S.O.; Ozoh, O.B.; Ayanbadejo, P.O.; Fasanmade, O.A.OBJECTIVE: To assess internal medicine residents' knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients' periodontal health. METHODS: A cross-sectional survey using a self-administered questionnaire was conducted among internal medicine residents attending the Faculty of Internal Medicine 2014 Update Course organized by the National Postgraduate Medical College of Nigeria. Participants came from all over the country. Data on respondents' demographic characteristics, periodontal disease knowledge, knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients' periodontal health were collected. Data were analyzed using Epi INFO software. The Pearson chi square test was used to measure significant association between categorical variables such as the knowledge of periodontal disease and gender, age group and designation of the participants (p ⩽ 0.05). RESULTS: Of 150 questionnaires distributed, 123 were returned (82% response rate); 109 questionnaires were completed properly and included in the analysis. The most common source of residents' information on oral health was television (59.4%). Only 11.2% of respondents were aware that gingival bleeding was the earliest sign of periodontal disease. Respondents correctly identified periodontal disease as a risk factor for coronary heart disease (45.9%), stroke (43.5%), hospital-acquired pneumonia (53.2%), diabetes mellitus (13.8%), and preterm birth (11%). Increased age (p = 0.032) and male gender (p = 0.022) were associated significantly with knowledge of periodontal disease as a risk factor for stroke. Higher designation (p = 0.002) and longer duration in residency training (p = 0.004) were associated significantly with knowledge of periodontal disease as risk factor for peripheral arterial disease. The majority (90.9%) of respondents had positive attitudes toward the referral of their patients for regular periodontal care. CONCLUSIONS: Knowledge of periodontal disease as a risk factor for systemic illnesses among medical residents in Nigeria is inadequate. These relationships should be emphasized in continuing medical education courses.