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Owolabi LF, Alghamdi M, Adamu B, Taura MG, Jibo A, Almansour M, Alaklabi SN, Alghamdi MA, Alotaibi YA, Imam IA, Abdelrazak R, Rafaat A, Aliyu MH. Magnitude of diabetic peripheral neuropathy in Saudi Arabia: a systematic review and meta-analysis. BMC Endocr Disord 2022; 22:266. [PMID: 36319996 PMCID: PMC9628018 DOI: 10.1186/s12902-022-01167-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 09/02/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and disability from foot ulcers and amputations, is increasingly becoming a source of concern in Saudi Arabia and worldwide. However, wide variability exists in the prevalence of DPN reported in previous studies in Saudi Arabia, limiting the utility of existing data in national public health policy. Therefore, the aim of this study was to systematically evaluate the magnitude of DPN in patients living with DM in Saudi Arabia in order to inform policymakers during the implementation of appropriate preventive and treatment strategies for DPN. METHODS PubMed, Google Scholar, African Journals Online, Scopus, Web of Science, Embase, and Wiley Online Library were searched systematically to acquire relevant articles based on preset criteria. We evaluated heterogeneity and publication bias and employed a random-effects model to estimate the pooled prevalence of DPN from the included studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in conducting the meta-analysis. Analysis was performed using the STATA Version 12 software. RESULTS Twelve studies with a total of 4,556 participants living with DM, of whom 2,081 were identified as having DPN were included in the meta-analysis. The overall prevalence of DPN was 39% (95% CI [30%, 49%]). Subgroup analysis based on diagnostic method showed that prevalence estimates for DPN using screening questionnaires and clinical examination were 48% (95% CI [46%, 50%]) and 40% (95% CI: [38%, 42%]), respectively, while the estimated prevalence using nerve conduction studies was 26% (95% CI [15%, 36%]). CONCLUSION This study showed a high magnitude of DPN in Saudi Arabia (39%), thus highlighting the need for sustained efforts to reduce the prevalence of diabetes mellitus and DPN in the kingdom.
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Affiliation(s)
| | - Mushabab Alghamdi
- University of Bisha Medical College, Bisha, Aseer region, Saudi Arabia
| | - Bappa Adamu
- University of Bisha Medical College, Bisha, Aseer region, Saudi Arabia
| | | | - Abubakar Jibo
- University of Bisha Medical College, Bisha, Aseer region, Saudi Arabia
| | | | | | | | | | - Isa Adamu Imam
- University of Bisha Medical College, Bisha, Aseer region, Saudi Arabia
| | - Reda Abdelrazak
- University of Bisha Medical College, Bisha, Aseer region, Saudi Arabia
| | - Ahmad Rafaat
- King Abdullah Hospital, Bisha, Anseer region, Saudi Arabia
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Alghamdi M, Owolabi LF, Adamu B, Taura MG, Jibo A, Almansour M, Alaklabi SN, Alghamdi MA, Imam IA, Abdelrazak R, Rafaat A, Aliyu MH. Disease-specific quality of life in patients with diabetic neuropathy. Saudi Med J 2022; 43:408-417. [PMID: 35414620 PMCID: PMC9998049 DOI: 10.15537/smj.2022.43.4.20210861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 03/01/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To compare health-related quality of life (HRQoL) among patients with diabetes mellitus (DM) and diabetic neuropathy (DN) (D+N) with patients with DM without DN (D-DN) and healthy participants. To evaluate factors associated with poor HRQoL in patients with DN. METHODS This study included 306 participants residing in Bisha, Saudi Arabia. Patients with DM were screened for DN using the Michigan Neuropathy Screening Instrument. Neuropathy severity, disability and HRQoL were determined using the Neuropathy Severity Scale (NSS), the Neuropathy Disability Score (NDS), and the Norfolk Quality of Life-Diabetic Neuropathy (QOL-DN) tool, respectively. Nerve conduction studies (NCSs) were also performed. RESULTS The D+DN group had poorer overall and domain HRQoL scores compared to the D-DN group (p<0.001). There was a strong correlation between overall HRQoL score and both NDS and NSS scores in the D+DN group (ρ= -0.71 and p<0.0001; ρ= -0.81 and p<0.0001, respectively). There was also a significant difference in all mean HRQoL domain scores between D+DN participants with normal and abnormal NCS. Physical inactivity (p=0.043), duration of DM (p<0.0001), abnormal NCS, NSS (p<0.0001), and NDS (p<0.0001) predicted HRQoL in the D+DN group. CONCLUSION D+DN participants had a worse HRQoL compared with D-DN and healthy counterparts. NDS, NNS, physical inactivity, abnormal NCS, and duration of DM independently predicted poor HRQoL in D+DN participants.
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Affiliation(s)
- Mushabab Alghamdi
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Lukman F. Owolabi
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Bappa Adamu
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Magaji G. Taura
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Abubakar Jibo
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Mohammed Almansour
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Saeed N. Alaklabi
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Mohammed A. Alghamdi
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Isa A. Imam
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Reda Abdelrazak
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Ahmad Rafaat
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
| | - Muktar H. Aliyu
- From the Departmentof Internal Medicine (Alghamdi M, Owolabi, Adamu, Taura, Jibo, Alaklabi, Alghamdi MA, Imam, Abdelrazak), University of Bisha Medical College; from the Departmentof Internal Medicine(Rafaat), King Abdullah Hospital, Bisha; from the Departmentof Internal Medicine (Almansour), King Fahad Medical City, Riyadh; from the Department of Health Policy (Aliyu), Vanderbilt University Medical Center, Nashville, United States of America.
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Owolabi LF, Reda AA, Raafat A, M Fares DM, Enwere OO, Mba UA, Adamu B, Alghamdi M. Nerve conduction study findings and their predictors in clinically diagnosed patients with carpal tunnel syndrome in a Saudi population. Niger J Clin Pract 2021; 24:1423-1429. [PMID: 34657005 DOI: 10.4103/njcp.njcp_459_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Despite the reports of carpal tunnel syndrome (CTS) being commonplace in Saudi Arabia, there is scarcity of cross-sectional or prospective studies detailing the profile of nerve conduction study (NCS) findings in patients with CTS. Objective The study aimed to evaluate the neurophysiologic profile of CTS with the view to finding the determinant of abnormal findings in clinically diagnosed cases of CTS in a population of Saudis. Methods Nerve conduction study was performed on consecutive patients with clinically diagnosed CTS. Median sensory, ulnar sensory, radial sensory median motor and ulnar motor nerves were assessed. The nerve conduction parameters measured were median and ulnar sensory peak latency, amplitude and velocity. Median conduction velocity, distal latency, and amplitude were also measured. Comparative median-ulnar and median-ulnar-digit 4 studies were done and the severity of CTS was determined. Data was analyzed using STATA software version 12. Results A total of 152 patients, comprising 59 males and 93 females (mean age of 42.7 years) with clinically diagnosed CTS were seen during the study period. About 72.4% patients had numbness and paresthesia in the affected fingers, 66.5% had pain in the hands, and 10.5% had weakness in the affected hands. Majority of the patients (62%) had bilateral clinical features. Carpal tunnel syndrome was confirmed with NCS in 84 (55.26%) patients. Presence of weakness in the affected hand, positive Phalen' sign, and positive Tinel's sign in patients appear to predict [6.1 (1.2-30.7), 3.9 (1.2-30.2), and 4.9 (1.4-17.0) respectively] abnormal NCS findings after adjustment for age, gender and the presence of DM. Conclusion The study revealed that over half of the patients with CTS had NCS/ Electromyography (EMG) abnormalities. Presence of hand muscles weakness, positive Phalen and Tinel's signs predict abnormal findings on NCS/EMG in patients with CTS.
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Affiliation(s)
- L F Owolabi
- Department of Medicine, University of Bisha, Bisha, Saudi Arabia
| | - A A Reda
- Department of Medicine, University of Bisha, Bisha, Saudi Arabia
| | - A Raafat
- King Abdullah Hospital, Bisha, Saudi Arabia
| | | | - O O Enwere
- King Abdullah Hospital, Bisha, Saudi Arabia
| | - U A Mba
- King Abdullah Hospital, Bisha, Saudi Arabia
| | - B Adamu
- Department of Medicine, University of Bisha, Bisha, Saudi Arabia
| | - M Alghamdi
- Department of Medicine, University of Bisha, Bisha, Saudi Arabia
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Owolabi LF, Raafat A, Enwere OO, Mustapha AF, Adamu B, AlGhamdi M. Hemorrhagic infarctive stroke in COVID-19 patients: report of two cases and review of the literature. J Community Hosp Intern Med Perspect 2021; 11:322-326. [PMID: 34191990 PMCID: PMC8108187 DOI: 10.1080/20009666.2021.1883814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
There is growing evidence in support of ischemic stroke as a manifestation of COVID-19 infection. However, hemorrhagic transformation of ischemic stroke is rare. We present two cases of hemorrhagic infarction as presenting features in COVID-19 patients who did not have traditional cardiovascular risk factors for ischemic or hemorrhagic stroke. While the hemorrhagic infarct was from a large artery in one of the patients, the other patient had a small artery related hemorrhagic infarct. We highlighted the possible underlining mechanisms from the literature and the implication of hemorrhagic infarct for routine anticoagulant therapy in patients with COVID −19 related ischemic stroke.
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Affiliation(s)
- Lukman Femi Owolabi
- Department of Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia
| | | | | | | | - Bappa Adamu
- Department of Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia
| | - Mushabab AlGhamdi
- Department of Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Owolabi LF, Adamu B, Taura MG, Isa AI, Jibo AM, Abdul-Razek R, Alharthi MM, Alghamdi M. Impact of a longitudinal faculty development program on the quality of multiple-choice question item writing in medical education. Ann Afr Med 2021; 20:46-51. [PMID: 33727512 PMCID: PMC8102895 DOI: 10.4103/aam.aam_14_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Like many other academic programs, medical education is incomplete without a robust assessment plan. Objective: The study aimed to evaluate the impact of longitudinal faculty development program (FDP) on the examination item quality (EIQ) from a cohort of medical college faculty members. Methods: Item analysis (IA) of multiple-choice questions (MCQs) from a cohort of medical tutors over a 3-year period (2017 [S1], 2018 [S2], and 2019 [S3]) before and following once-per-week FDP was conducted. The questions were from three randomly selected courses: man and his environment (MEV) from phase 1, central nervous system (CNS) from phase 2, and internal medicine (MED) from phase 3. Data assessed were 480 MCQs from the final exams in the courses. The parameters considered in IA were the difficulty index, index of discrimination, nonfunctional distractors (NFDs), distractor efficiency for each question item, and Cronbach's alpha (CA) for the test as a whole. Comparison over the 3 years was made using Fisher's exact test and repeated-measures ANOVA with Bonferroni test as post hoc test. Results: Overall, out of 480 MCQs, 272 had no NFD (52 [19.52%], 104 [38.24%], and 116 [42.65%] in 2017, 2018, and 2019, respectively) with a significant difference between S3, S2, and S1 (P < 0.0001). The mean CA for the exams in S1, S2, and S3, respectively, were 0.51, 0.77, and 0.84, P < 0.0001. Conclusion: There was an improvement in EIQ following the implementation of longitudinal FDP. Thus, the need for active training and retraining of the faculty for a better EIQ cannot be overemphasized.
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Affiliation(s)
- Lukman Femi Owolabi
- Department of Medicine, University of Bisha Medical College, Bisha, Saudi Arabia
| | - Bappa Adamu
- Department of Medicine, University of Bisha Medical College, Bisha, Saudi Arabia
| | - Magaji Garba Taura
- Department of Anatomy, University of Bisha Medical College, Bisha, Saudi Arabia
| | - Adamu Imam Isa
- Department of Physiology, University of Bisha Medical College, Bisha, Saudi Arabia
| | - Abubakar Muhammed Jibo
- Department of Community of Medicine, University of Bisha Medical College, Bisha, Saudi Arabia
| | - Reda Abdul-Razek
- Department of Medicine, University of Bisha Medical College, Bisha, Saudi Arabia
| | | | - Mushabab Alghamdi
- Department of Medicine, University of Bisha Medical College, Bisha, Saudi Arabia
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Owolabi LF, Reda AA, Ahmed RE, Enwere OO, Adamu B, AlGhamdi M. Electroencephalography findings in childhood epilepsy in a Saudi population: Yield, pattern and determinants of abnormality. J Taibah Univ Med Sci 2021; 16:86-92. [PMID: 33603636 PMCID: PMC7858024 DOI: 10.1016/j.jtumed.2020.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 10/20/2020] [Accepted: 10/25/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The study was designed to evaluate the yield, pattern, and factors that are independently associated with electroencephalography (EEG) abnormalities in childhood epilepsy in a Saudi population. METHODS We characterised the features of the first EEG and evaluated the associated factors in children with epilepsy in a Saudi population. The features of interictal epileptiform discharges (interictal epileptiform activity (IEA)) adopted by the International Federation of Societies for Electroencephalography and Clinical Neurophysiology were used in the study. RESULT A total of 756 paediatric patients, comprised of 427 men (56.5%) and 329 women (43.5%) with a clinical diagnosis of epilepsy, underwent EEG. Clinically, seizure was generalised in 619 (81.9%) patients and focal in 137 (18.1%). Among the patients, 397 (52.51%) had an abnormal EEG, while EEG was normal in 359 (47.49%) patients. Seizure frequency, gender, family history of epilepsy, and age were independent predictors of the presence of EEG abnormalities. CONCLUSION This study revealed a yield of 52% abnormal EEG findings in children with epilepsy. Age, gender, family history, and seizure frequency were independent predictors of the presence of EEG abnormalities in childhood epilepsy.
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Affiliation(s)
- Lukman F Owolabi
- Department of Medicine, College of Medicine, University of Bisha, Bisha, KSA
| | - AbdulRazeq A Reda
- Department of Medicine, College of Medicine, University of Bisha, Bisha, KSA
| | - Raafat E Ahmed
- Department of Medicine, King Abdullah Hospital, Bisha, KSA
| | | | - Bappa Adamu
- Department of Medicine, College of Medicine, University of Bisha, Bisha, KSA
| | - Mushabab AlGhamdi
- Department of Medicine, College of Medicine, University of Bisha, Bisha, KSA
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Owolabi LF, Reda AA, El Sayed R, Morsy DFM, Enwere OO, Mba UA, Adamu B, AlGhamdi M. Study of electroencephalography in people with generalized epilepsy in a Saudi population. J Community Hosp Intern Med Perspect 2020; 10:549-554. [PMID: 33194127 PMCID: PMC7599013 DOI: 10.1080/20009666.2020.1809255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Bappa Adamu
- College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Ezedunukwe IR, Adamu B, Enuh HA, Ozieh MN. Oral iron for people with chronic kidney disease. Hippokratia 2020. [DOI: 10.1002/14651858.cd011418.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Bappa Adamu
- Department of Internal Medicine; University of Bisha; Bisha Saudi Arabia
| | - Hill A Enuh
- Department of Internal Medicine; Richmond University Medical Center; Staten Island New York USA
| | - Mukoso N Ozieh
- Department of Nephrology; Medical University of South Carolina; Charleston SC USA
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Owolabi LF, Owolabi SD, Adamu B, Jibo A, Alhaji ID. Epilepsy treatment gap in Sub-Saharan Africa: Meta-analysis of community-based studies. Acta Neurol Scand 2020; 142:3-13. [PMID: 32219865 DOI: 10.1111/ane.13246] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/16/2020] [Accepted: 03/20/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the prevalence, highlight the variation and determine the trend over time, of epilepsy treatment gap (ETG) in Sub-Saharan Africa (SSA). METHODS We systematically searched PubMed, MEDLINE, Embase, ISI databases, and African Journal Online (AJOL). We determined the pooled prevalence estimate of ETG and the degree of heterogeneity in the region. Further subgroup analysis by sub-region, settlement setting, and cutoff adopted for active epilepsy in the studies was carried out. Meta-regression technique was also used to determine the trend of the ETG magnitude over time. RESULTS Twenty-three studies from SSA met the inclusion criteria. We found a high level of discordance among the studies that were included. Collectively, the estimated ETG was 68.5% (95% CI: 59.5%-77.5%). On subgroup analysis, the prevalence of the ETG was 67% (95% CI: 52%, 83%) in the Western, 68% (95% CI: 56%, 80%) in the Eastern, and 63% (95% CI: 53%, 73%) in the Southern Africa sub-regions. On stratified analysis based on 1-year, 5-year, and 2-year cutoffs for definition of active epilepsy, the prevalence figures for the ETG were 71% (95% CI: 56%, 85%), 55% (95% CI: 33%, 77%), and 57% (95% CI: 43%, 71%), respectively. Meta-regression result suggested that the prevalence of the ETG decreases by approximately by 0.006 per year. CONCLUSION The study showed a high prevalence of ETG, higher than the average for resource poor countries, and twice in rural compared with urban settlements in SSA.
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Affiliation(s)
- L. F. Owolabi
- Departments of Medicine Bayero University Kano Nigeria
| | - S. D. Owolabi
- Department of Psychiatry, Bayero University Kano Nigeria
| | - B. Adamu
- Department of Medicine University of Bisha Bisha Saudi Arabia
| | - A.M. Jibo
- Department of Community Medicine Bayero University Kano Nigeria
| | - I. D. Alhaji
- Departments of Medicine Bayero University Kano Nigeria
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Owolabi LF, Enwere OO, Ahmed Reda A, Sayed Sayd RE, Elrazek H, Adamu B, AlGhamdi M. Methanol induced stroke: report of cases occurring simultaneously in two biological brothers. J Community Hosp Intern Med Perspect 2020; 10:265-268. [PMID: 32864054 PMCID: PMC7431918 DOI: 10.1080/20009666.2020.1766840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Methanol bears semblance to ethanol in smell and taste, thus, individuals who indulge in alcohol may fall back on it in societies where alcohol consumption is illegal or difficult to come by despite the life-threatening neurologic sequelae of methanol toxicity. Stroke is an uncommon outcome of methanol poisoning. We presented two cases of methanol-induced infarctive and hemorrhagic stroke in biological brothers who were simultaneously involved in an illicit ingestion of methanol. One of them developed infarctive stroke while the other had infarctive stroke with hemorrhagic transformation. We have highlighted the differences and similarity in the course of their illnesses.
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Affiliation(s)
| | | | | | | | - Hanem Elrazek
- Department of medicine, King Abdullah Hospital, Bisha, Saudi Arabia
| | - Bappa Adamu
- College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Owolabi LF, Adamu B, Jibo AM, Owolabi SD, Isa AI, Alhaji ID, Enwere OO. Prevalence of active epilepsy, lifetime epilepsy prevalence, and burden of epilepsy in Sub-Saharan Africa from meta-analysis of door-to-door population-based surveys. Epilepsy Behav 2020; 103:106846. [PMID: 31941583 DOI: 10.1016/j.yebeh.2019.106846] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 12/06/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is marked variation in the prevalence of epilepsy across Sub-Saharan Africa (SSA). In order to accurately estimate the clinical and public health impacts of epilepsy in the region, robust and reliable epidemiological data are required for appropriate estimation of logistical, economical, and social impacts of epilepsy including policy formulation and intervention in the region. OBJECTIVE We sought to evaluate the prevalence of active epilepsy (AE) and lifetime epilepsy prevalence in SSA using available data collected at community level. METHODS We carefully searched online databases and identified the required articles using prespecified criteria. Random-effects model (REM) was used to estimate the active and lifetime prevalence from data generated from studies in SSA.. The burden of epilepsy, in terms of the number of people with the disease, was also obtained. Heterogeneity in the analysis was further explored using subgroup analysis and meta-regression techniques. RESULT A total of 39 and 12 community-based door-to-door surveys addressing AE and lifetime epilepsy, respectively, from different countries of SSA met the inclusion criteria for the study. Random-effects model estimates of overall prevalence of epilepsy were 9 per 1000 persons (95% confidence interval (CI): 8.0-9.9 per 1000 persons) for AE and 16 per 1000 persons (95% CI: 12.3-19.7 per 1000 persons) for lifetime epilepsy. The prevalence was highest in the Central Africa subregion with 30.2 per 1000 persons (95% CI: 6.2 to 66.7 per 1000 persons). The prevalence of AE in the rural settlement was twice that of the urban settlements. About 9,596,551 (95% CI: 8,530,267-10,556,206) people with AE and 17,060,535 (95% CI: 13,115,286-21,005,784) people with lifetime epilepsy live in SSA. CONCLUSION This study estimates the active (9/1000) and lifetime (16/1000) epilepsy with a remarkable burden of the disease in SSA. However, the prevalence, which is higher in the rural setting, varies within the subregion of SSA.
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Affiliation(s)
| | - Bappa Adamu
- University of Bisha College of Medicine, University of Bisha, Saudi Arabia
| | | | | | - Adamu Imam Isa
- University of Bisha College of Medicine, University of Bisha, Saudi Arabia
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Owolabi LF, Adamu B, Jibo AM, Owolabi SD, Imam AI, Alhaji ID. Neurocysticercosis in people with epilepsy in Sub-Saharan Africa: A systematic review and meta-analysis of the prevalence and strength of association. Seizure 2020; 76:1-11. [PMID: 31935478 DOI: 10.1016/j.seizure.2020.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/01/2020] [Accepted: 01/04/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE We analyzed studies on neurocysticercosis (NCC) and epilepsy across Sub-Saharan Africa (SSA) to determine the prevalence of NCC in people with epilepsy (PWE) and the strength of association of NCC with epilepsy in the region. METHODS We conducted a systematic review of the existing literature on NCC and epilepsy in SSA. Diagnostic methods for NCC in the studies selected for our analysis included one or more of the following: positive brain CT, serum ELISA and serum EITB. A common prevalence and overall odds-ratio were then estimated using meta-analysis. RESULTS A total of 25 (overall) and 20 (case-control) studies met the inclusion criteria for the prevalence and strength of association estimation, respectively. The overall prevalence estimate of NCC in PWE was 22 % [95 % confidence interval [CI]: 17-27.0 %). The figures were higher in the Southern and Eastern Africa sub-region (45 % and 25 % respectively) but lower in the Central and Western Africa sub-region (6 % and 15 % respectively). The prevalence of NCC estimate in PWE varied with method of diagnosis; with 29 % 18 % and 15 % in studies that used a minimum of Brain CT, ELISA and EITB respectively. The overall odds ratio was 2.4 (95 % CI 2.1-2.8), p < 0.0001. CONCLUSION The overall prevalence of NCC in PWE in SSA was 22 %. The prevalence figure varied with the sub-region of SSA. The odd of NCC in PWE in SSA was 2.4. In spite of the sub-regional variation in NCC prevalence, this meta-analysis suggests that neurocysticercosis contributes significantly to epilepsy in SSA.
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Affiliation(s)
| | - Bappa Adamu
- College of Medicine, University of Bisha, Saudi Arabia
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Iliyasu G, Abdu A, Dayyab F, Tiamiyu A, Habib Z, Adamu B, Habib A. Post-renal transplant infections: single-center experience from Nigeria. Transpl Infect Dis 2016; 18:566-74. [DOI: 10.1111/tid.12548] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 08/13/2015] [Accepted: 02/14/2016] [Indexed: 11/27/2022]
Affiliation(s)
- G. Iliyasu
- Infectious Disease Unit; Department of Medicine; College of Health Science; Bayero University Kano; Kano Nigeria
| | - A. Abdu
- Nephrology Unit; Department of Medicine; College of Health Science; Bayero University Kano; Kano Nigeria
| | - F.M. Dayyab
- Department of Medicine; Aminu Kano Teaching Hospital; Kano Nigeria
| | - A.B. Tiamiyu
- Department of Medicine; Aminu Kano Teaching Hospital; Kano Nigeria
| | - Z.G. Habib
- Department of Medicine; Aminu Kano Teaching Hospital; Kano Nigeria
| | - B. Adamu
- Nephrology Unit; Department of Medicine; College of Health Science; Bayero University Kano; Kano Nigeria
| | - A.G. Habib
- Infectious Disease Unit; Department of Medicine; College of Health Science; Bayero University Kano; Kano Nigeria
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Nalado A, Abdu A, Adamu B, Aliyu MH, Arogundade FA, Sanusi AA, Wali SS, Akinsola A. Prevlaence of chronic kidney disease markers in Kumbotso rural Northern Nigeria. Afr J Med Med Sci 2016; 45:61-65. [PMID: 28686828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Data- on the epidemiology of Chronic Kidney Disease (CKD) from sub-SaharanAfrica are sparse. We investigated the prevalence of CKD and its early markers in Kumbotso, a rural community in northern Nigeria. METHODS A total of 480 individuals were randomly selected from the general population using multistage stratified random sampling. Relevant- demographic and clinical data were obtained using a structured questionnaire. Biological samples (urine and blood) were drawn for relevant investigations. RESULTS CKD (estimated glomerular filtration rate [eGFR <60 mls/min) was found in 117 participants (26%). Proteinuria was present in 106 persons (23.6%) and haematuria in 7 individuals (1.6%). The most common CKD stage was stage 1 (20%). CKD was associated with hypertension (P=0.002), diabetes (P=0.001), high cholesterol (P=0.030), smoking (P=0.015), increasing BMI (P=0.020), and increasing age (P=0.003). After adjusting for potential confounding with logistic regression modeling we found BMI, family history of hypertension, history of diabetes mellitus and family history of renal disease to be independent predictors of CKD. CONCLUSIONS Early markers of CKD are common among rural inhabitants of northern Nigeria and this call for concerted efforts towards institution of preventive measures.
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Iliyasu G, Abdu A, Dayyab F, Tiamiyu A, Habib Z, Adamu B, habib A. Post renal transplant infections: Single center experience from Nigeria. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Affiliation(s)
- Bappa Adamu
- Aminu Kano Teaching Hospital; Department of Medicine; No 1 Hospital Road Kano Kano Nigeria PMB 3452
| | - Sani Usman Alhassan
- Bayero University Kano; Department of Surgery; 1 Hospital Rd Kano Nigeria PMB 3452
| | - Emmanuel E Effa
- College of Medical Sciences, University of Calabar; Internal Medicine; PMB 1115 Calabar Cross River State Nigeria 540001
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Ezedunukwe IR, Adamu B, Enuh H, Ozieh MN. Oral iron for people with chronic kidney disease. Hippokratia 2014. [DOI: 10.1002/14651858.cd011418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Bappa Adamu
- Aminu Kano Teaching Hospital; Department of Medicine; No 1 Hospital Road Kano Kano Nigeria PMB 3452
| | - Hilary Enuh
- Richmond University Medical Center; Department of Internal Medicine; Staten Island New York USA
| | - Mukoso N Ozieh
- Medical University of South Carolina; Department of Nephrology; Charleston SC USA 29425
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Abstract
BACKGROUND Organ transplant recipients are at increased risk of infection as a result of immunosuppression caused inadvertently by medical treatment. Tuberculosis (TB) is a challenging infection to manage among organ transplant recipients that can be transmitted from infected people or triggered from latent infection. Organ transplant recipients have been reported to be up to 300 times more likely to develop TB than the general population. Consensus about the use of antibiotic prophylaxis to prevent post solid organ transplant TB has not been achieved. OBJECTIVES This review assessed the benefits and harms of antibiotic prophylaxis to prevent post solid organ transplant TB. SEARCH METHODS We searched the Cochrane Renal Group's Specialised Register up to 30 April 2013 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE and EMBASE and handsearching conference proceedings. SELECTION CRITERIA All randomised controlled trials (RCTs) and quasi-RCTs that compared antibiotic prophylaxis with a placebo or no intervention for recipients of solid organ transplants were included. DATA COLLECTION AND ANALYSIS Two authors independently assessed studies for inclusion and extracted data. We derived risk ratios (RR) for dichotomous data and mean differences (MD) for continuous data with 95% confidence intervals (CI). Methodological risk of bias was assessed using the Cochrane risk of bias tool. MAIN RESULTS We identified three studies (10 reports) that involved 558 kidney transplant recipients which met our inclusion criteria. All studies were conducted in countries that have high prevalence of TB (India and Pakistan), and investigated isoniazid, an oral antibacterial drug. Control in all studies was no antibiotic prophylaxis. Prophylactic administration of isoniazid reduced the risk of developing TB post-transplant (3 studies, RR 0.35 95% CI 0.14 to 0.89), and there was no significant effect on all-cause mortality (2 studies, RR 1.39, 95% CI 0.70 to 2.78). There was however substantial risk of liver damage (3 studies, RR 2.74, 95% CI 1.22 to 6.17).Reporting of methodological quality parameters was incomplete in all three studies. Overall, risk of bias was assessed as suboptimal. AUTHORS' CONCLUSIONS Isoniazid prophylaxis for kidney transplant recipients reduced the risk of developing TB post-transplant. Kidney transplant recipients in settings that have high prevalence of TB should receive isoniazid during the first year following transplant. There is however, significant risk of liver damage, particularly among those who are hepatitis B or C positive. Further studies are needed among recipients of other solid organ transplants and in settings with low prevalence of TB to determine the benefits and harms of anti-TB prophylaxis in those populations.
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Affiliation(s)
- Bappa Adamu
- Aminu Kano Teaching HospitalDepartment of MedicineNo 1 Hospital RoadKanoKanoNigeriaPMB 3452
| | - Aliyu Abdu
- Aminu Kano Teaching HospitalDepartment of MedicineNo 1 Hospital RoadKanoKanoNigeriaPMB 3452
| | - Abdullahi A Abba
- King Saud UniversityDepartment of MedicineRiyadhRiyadhSaudi ArabiaRiyadh 11451
| | - Musa M Borodo
- Aminu Kano Teaching HospitalDepartment of MedicineNo 1 Hospital RoadKanoKanoNigeriaPMB 3452
| | - Imad M Tleyjeh
- King Fahad Medical CityDepartment of MedicineRiyadhRiyadhSaudi ArabiaRiyadh 11525
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Sakajiki A, Abdu A, Adamu B, Arogundade F, Atanda AT, Garba B. Prevalence, risk factors, and histological pattern of kidney disease in patients with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome at Aminu Kano Teaching Hospital: A clinicopathologic study. ACTA ACUST UNITED AC 2014. [DOI: 10.4103/0331-3131.153356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Iliyasu Z, Abubakar I, Lawan U, Abubakar M, Adamu B. Predictors of public attitude toward living organ donation in Kano, northern Nigeria. Saudi J Kidney Dis Transpl 2014; 25:196-205. [DOI: 10.4103/1319-2442.124577] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Renal transplant is becoming increasingly available in developing countries. Significant advances have been made globally since the first successful kidney transplant in 1954, with the advent of newer, more effective and more selective immunosuppressants. As a result, allograft and patient survival has increased, leaving infection and malignancy as major challenges. The incidence rate of tuberculsis in renal transplant recipients is directly proportional to the prevalence in the general population with the developing countries having the highest rates. The objective of this paper is to review the existing literature on post renal transplant tuberculosis with a view to highlighting its peculiarities compared to tuberculosis in the general population. Several databases (Medline, EMBASE, Cochrane data base, Google Scholar and AJOL) were searched for articles using the key words Tuberculosis (MESH), Renal (OR Kidney), AND transplant. Hand search was also made of reference list of retrieved articles. Full text of relevant original articles were retrieved and appraised. Several studies have demonstrated increased risk of tuberculosis in renal transplant recipients, especially in developing countries. Tuberculosis in renal transplant recipients has peculiarities such as difficulty in diagnosing latent TB, atypical presentations, increased risk of dissemination, increased mortality and interactions of anti-Tb drugs with transplant medications. Clinicians managing renal transplant recipients especially in developing countries should have a high index of suspicion for TB and be aware of its peculiarities in this patient population.
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Affiliation(s)
- Bappa Adamu
- Department of Medicine, Bayero University/AKTH, Kano, Nigeria
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Adamu B, Uloko AE, Aliyu A, A'isha N. New-onset diabetes after renal transplantation: a case series as seen in a Nigerian kidney transplant population. Niger J Clin Pract 2013; 16:263-5. [PMID: 23563475 DOI: 10.4103/1119-3077.110134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
New-onset diabetes after transplantation (NODAT) is an important metabolic complication of transplantation because of its associated morbidity and mortality. Risk factors for NODAT include those known to cause diabetes mellitus in non-transplant patients as well as transplant-specific factors. This study was aimed at illustrating the presentation and management of NODAT in three kidney transplant recipients in our center and reviewing the literature. To our knowledge, this is the first report from Nigeria. Two of the patients were males of ages 60 and 36 years, respectively, while the third was a female aged 25 years. They were all receiving prednisolone, two were on tacrolimus, and one was on cyclosporine as part of their immunosuppressive regimens. They developed NODAT at varying times post transplant, ranging from 3 months to 6 years. Two patients were managed with oral hypoglycemic agents and one with insulin. One patient died of hemorrhagic stroke. We conclude that NODAT occurred in our kidney transplant recipients and recommend that physicians should have a high index of suspicion in order to make an early diagnosis and institute appropriate management to reduce morbidity and mortality.
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Affiliation(s)
- B Adamu
- Department of Medicine, Bayero University, Kano, Nigeria.
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Alhassan S, Adamu B, Abdu A, Aji SA. Outcome and complications of permanent hemodialysis vascular access in Nigerians: A single centre experience. Ann Afr Med 2013; 12:127-30. [DOI: 10.4103/1596-3519.112410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ma′aji SM, Adamu B. Transabdominal ultrasonographic assessment of prostate size and volume in Nigerians with clinical diagnosis of benign prostatic hyperplasia. Niger J Clin Pract 2013; 16:404. [DOI: 10.4103/1119-3077.113476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Adamu B, Ahmed M, Mushtaq R, Alshaebi F. Commercial kidney transplantation: Trends, outcomes and challenges-A single-centre experience. Ann Afr Med 2012; 11:70-4. [DOI: 10.4103/1596-3519.93527] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abdu A, Galadanci HS, Adamu B, Nalado A. A report of three consecutive pregnancies in a kidney transplant recipient and the challenges in their management in a poor resource setting. Afr J Med Med Sci 2010; 39:143-146. [PMID: 21117411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Kidney transplant recipients (KTR) have a good outcome of pregnancies. However the mother and the child are increasingly at higher risks of complications compared to the general population. The management of these pregnancies is associated with greater challenges and is better if managed by both the obstetrician and the transplant physician. Kidney transplant is available in few centres in Nigeria and the post transplant population is increasing, but to our knowledge no report on pregnancy management in KTR has been published. We present a 25 years old Nigerian who had a live related kidney transplant and later had 3 consecutive pregnancies and review the relevant literature. She was placed on oral contraceptive pills for 2 years after transplantation. She enjoyed a stable allograft function with no rejection episode, no proteinuria, had a good blood pressure control and pelvic ultrasound scan was essentially normal. She conceived her first pregnancy 26 months post transplant however she developed spontaneous abortion at 3 months gestation. She conceived her second pregnancy 33 months post transplant which was supervised by the obstetrician and the transplant physician. She had complications including urinary tract infection, anaemia and dyslipidaemia and delivered a live baby girl weighing 2.4 Kg by spontaneous vaginal delivery at 36 weeks gestation. She conceived her 3rd pregnancy 8 months later which was also carried to term and had a vaginal delivery of a live baby girl weighing 2.55 kg. This report highlights the successful management of pregnancies in KTR and the challenges faced in a poor resource setting.
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Affiliation(s)
- A Abdu
- Department of Medicine, Aminu Kano Teaching Hospital/Bayero University Kano, Nigeria.
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Abdu A, Arogundade F, Adamu B, Dutse AI, Sanusi A, Sani MU, Mijinyawa MS, Akinsola A, Borodo MM. Anaemia and its response to treatment with recombinant human erythropoietin in chronic kidney disease patients. West Afr J Med 2010; 28:295-9. [PMID: 20383832 DOI: 10.4314/wajm.v28i5.55003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The introduction of erythropoietin has transformed the management of anaemia in CKD, with considerable benefits which includes enhanced quality of life, increased exercise capacity and improved cardiac function. There is paucity of data on the beneficial effects of this treatment from this environment. OBJECTIVE The aim of this work was to study the pattern and response of anaemia and its response to treatment with recombinant human erythropoietin(r-HuEpo) in CKD patients in Nigeria. METHODS This was a prospective study in which 20 CKD patients who satisfied the inclusion criteria were recruited consecutively. Subcutaneous r-HuEpo was administered to each of the study patients, starting with a weekly dose of 50 iu per kg and titrated according to haemoglobin (Hb) response, which was monitored fortnightly throughout the study period with the aim of achieving a target Hb of 11g per dl. RESULTS The patients studied were anaemic with mean Hb of 7.36(1.05) g/dl. The anemia was normocytic normochromic in 85% of the patients. All the patients responded to treatment with r-HuEpo with the mean Hb rising from 6.74(0.70)g per dl to 11.64(0.37) g/dl and 7.64(1.19) to 11.98(0.45) g/dl in those on maintenance haemodialysis and pre-dialysis patients respectively. The patients reached the target Hb of 11g/dl within 8 weeks in predialytic CKD patients and within 10 weeks in those on maintenance haemodialysis. CONCLUSION Anaemia is mostly normocytic normochromic in CKD patients in our environment and r-HuEpo therapy is effective in correcting the anaemia.
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Affiliation(s)
- Aliyu Abdu
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.
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Alshaebi F, Adamu B, Alghareeb W. Concurrent Kaposi's sarcoma, tuberculosis, and allograft dysfunction in a renal transplant patient. Saudi J Kidney Dis Transpl 2009; 20:270-273. [PMID: 19237817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
The major long-term complications of renal transplantation (RT) include cardio-vascular disease, opportunistic infections, malignancies, and chronic allograft nephropathy. Long-term complications are generally considered as those occurring more than 1 year post trans-plantation; however, some of the complications can occur earlier. We present a 58-year-old man who presented with multiple complications of RT concurrently and relatively early post trans-plantation including Kaposi's sarcoma, tuberculosis and allograft dysfunction.
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Affiliation(s)
- Fuad Alshaebi
- Nephrology Division, Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
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Sani MU, Mijinyawa MS, Adamu B, Abdu A, Borodo MM. Blood pressure control among treated hypertensives in a tertiary health institution. Niger J Med 2008; 17:270-4. [PMID: 18788251 DOI: 10.4314/njm.v17i3.37394] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Goal blood pressure (BP) was defined by the JNC VI and the World Health Organization-International Society of Hypertension (WHO/ISH) as <140 mm Hg systolic and <90 mm Hg diastolic for the general and <130 mm Hg systolic and <85 mm Hg diastolic for special high-risk populations. It is well established that adequate BP control characterizes only a fraction of treated hypertensive patients. The importance of tight BP control has been established in preventing cardiovascular morbidity and mortality METHODS We performed cross-sectional studies on the current status of BP control among treated hypertensive in our center. One hundred consecutive patients with essential hypertension who have been attending the out patient hypertension clinic and have been on treatment for at least 6 months were recruited. The pre treatment BP and BP records in the previous 2 visits were noted. Patients were said to have good BP control if their BPs are < 140/90 mmHg (<130/80 mmHg for high risk patients) at the time of the study and in the last visit. RESULTS There were 49 males and 51 female (M: F; 1:1), aged 26 to 85 (mean 52.33 +/- 12.29) years. The duration of hypertension ranged 6 months to 30 (mean 7.37 +/- 7.1) years. The duration of treatment in our centre was 6 months to 10 (mean 3.22 +/- 2.23) years. Blood pressure was controlled in 33 (33%) of the patients. Pre-treatment mean blood pressure was significantly higher than the BP value at the time of the study (155.87 +/- 26.02/97.81 +/- 11.89 mmHg versus 143.40 +/- 24.14/86.53 +/- 12.71 mmHg) (p<0.05). Diuretics were the commonest antihypertensive prescribed either alone or in combination (69%), followed by a calcium antagonist (56%) and centrally acting drugs (38%). Twenty seven were on single antihypertensive, 43 (43%) on 2, 25(25%) on 3 and 5 (5%) on 4 classes of antihypertensive. Blood pressure control was associated with taking more than one antihypertensive medication and compliance. CONCLUSION Control of BP in patients receiving antihypertensive drugs is still far from optimal in the study population in Nigeria just as in other countries. Many patients had multiple cardiovascular risk factors. Adherence to medication should be encouraged.
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Affiliation(s)
- M U Sani
- Department of Medicine, Bayero University Kano, Aminu Kano Teaching Hospital Kano, Nigeria
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Adamu B, Alshaebi F, Ahmed M, Beirouti B. Amyloidosis and vascular thrombosis. Saudi J Kidney Dis Transpl 2008; 19:137-141. [PMID: 18087144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Amyloidosis is a rare systemic disorder of protein metabolism with progressive extra-cellular deposition of insoluble fibrillary protein, disorganization of tissue architecture, and subsequent organ dysfunction. Primary amyloidosis is the most common form of this disorder, however, it can develop secondary to plasma cell dyscrasias such as multiple myeloma (MM); 10-15% of MM patients may develop amyloidosis of vital organs. Amyloidosis is usually associated with bleeding, but less commonly with thrombosis. We present a 52-year-old Saudi female with amyloidosis secondary to multiple myeloma. She presented with both venous and extensive arterial thrombosis. Although relatively rare, plasma cell dyscrasias such as amyloidosis and multiple myeloma could present with thrombotic rather than hemorrhagic complications.
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Affiliation(s)
- Bappa Adamu
- Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
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Abstract
Abstract
T-peel tearing of a model black-filled natural rubber tread ply vulcanizate has been carried out. Tearing alternates between slow (“stick”) and fast growth stages (“slip”). “Stick” fracture involves sideways cracking into the loading direction. This blunts the peel front, slows forward tearing, and results in rough fracture surfaces. “Slip” fracture is the sudden forward growth of a crack, leaving relatively smooth fracture surfaces. “Stick-slip” fracture is characteristic of highly reinforced rubbers; it is also seen in edge-cut tensile specimens and trouser tear specimens of black-filled NR.
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Affiliation(s)
- B. Adamu
- 1Rubber Research Center, The University of Akron, Akron, OH 44325-3909;
| | - G. R. Hamed
- 1Rubber Research Center, The University of Akron, Akron, OH 44325-3909;
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Abstract
BACKGROUND Physical activity results in increased exercise capacity and physical fitness, which may lead to many health benefits. Individuals who are more physically active appear to have lower rates of all-cause mortality, probably due to a decrease in chronic diseases including coronary artery disease (CAD). This may result from an improvement in cardiovascular risk factors in addition to enhanced fibrinolysis, improved endothelial function, decreased sympathetic tone, and other yet undetermined factors. METHODS We reviewed the literature on physical activity and health with particular reference to the benefits derivable by engaging in regular physical activity. The MEDLINE/PUBMED and bibliographic searches for English language studies were used. RESULTS Physical inactivity is now considered a risk factor for Cardiovascular diseases (CVD). Regular exercise results in an increase in exercise capacity and lower myocardial oxygen demand leading to cardiovascular benefits, including lower mortality rates. Physically active individuals suffer from fewer ailments than do less-active individuals. Physical activity reduces cardiovascular risk through lowering of blood pressure, improved glucose tolerance, reduced obesity, improvement in lipid profile, enhanced fibrinolysis, improved endothelial function and enhanced parasympathetic autonomic tone. CONCLUSION Physical exercise has many health benefits and the evidence for this continues to accumulate. Health care professionals should incorporate counselling to patients for physical exercise in their daily clinical practice, while health policy makers and community physicians should see to implementation of this at the community level.
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Affiliation(s)
- B Adamu
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.
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Sani MU, Adamu B, Mijinyawa MS, Abdu A, Karaye KM, Maiyaki MB, Borodo MM. Ischaemic heart disease in Aminu Kano Teaching Hospital, Kano, Nigeria: a 5 year review. Niger J Med 2006; 15:128-31. [PMID: 16805167 DOI: 10.4314/njm.v15i2.37095] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Socio-economic changes and rural urban migration have led to emergence of non-communicable disease including ischaemic heart disease (IHD) and many others. The actual prevalence of IHD in Nigeria is not known. The non communicable disease (NCD) survey sought to determine the prevalence of major risk factors, rather than the prevalence of the disease itself. The prevalence is generally considered low in Nigeria but the current impression about its importance stems mostly from anecdotal reports. We therefore set out to describe the prevalence as well as the spectrum of IHD at Aminu Kano Teaching Hospital, Kano. METHOD Between July 2000 and June 2005, we reviewed the prevalence as well as the spectrum of presentation of IHD in Aminu Kano Teaching Hospital. Information was obtained from the medical records of patients in the medical unit of the hospital. Age, sex, diagnosis, risk factors for IHD, other relevant clinical and laboratory data and outcome of patients for myocardial infarction (MI) were extracted from the records. Data was analyzed using SPSS version 10.0 software. RESULTS There were 5124 medical patients admitted over the period under review, out of which 1347 had cardiovascular diseases. Forty six patients were diagnosed to have IHD giving it a prevalence of 0.9% of medical conditions and 3.4% of all cardiovascular cases. There were 33 males and 13 females (M : F = 2.5:1). Twenty two patients (47.8%) had myocardial infarction, 14 (30.4%) had ischemic cardiomyopathy and 10 (21.7%) had angina. The patients consist of 41 (89.1%) Nigerians, 3 (6.5%) Lebanese, 1 (2.2%) Indian and 1 (2.2%) Pakistani. The risk factors found were Hypertension in 37 (80.4%) of patients, diabetes in 16 (34.8%), and Dyslipidaemia in 20 (43.5%). Others were cigarette smoking and obesity. CONCLUSION IHD is an important cause of morbidity and mortality in our population. There is need for us to be on the alert and prepare ourselves to manage these cases. Focus should be on preventive cardiology.
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Affiliation(s)
- M U Sani
- Department of Medicine, Aminu Kano Teachig Hospital, Kano, Nigeria
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Sani MU, Mohammed AZ, Adamu B, Yusuf SM, Samaila AA, Borodo MM. AIDS mortality in a tertiary health institution: A four-year review. J Natl Med Assoc 2006; 98:862-6. [PMID: 16775907 PMCID: PMC2569378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Africa contains 70% of adults and 80% of children living with AIDS in the world and has buried 75% of the 21.8 million worldwide who have died of AIDS since the epidemic began. Nigeria, the most populous country in Africa, has 5.8% of her adult population having HIV infection at the end of 2003. We reviewed the causes of death among AIDS patients in Aminu Kano Teaching Hospital Kano, Nigeria over four years. Four-hundred-fifty-five (9.9%) of the 4,574 adult medical admissions were due to HIV/AIDS-related diagnosis. HIV/AIDS admissions increased progressively from 45 cases in 2001 to 174 in 2004. HIV/AIDS caused 176 deaths over the period giving an HIV-related mortality of 38.7%. This also showed a gradual increase from 24 deaths in 2001 to 61 deaths in 2004. The most common causes of death were tuberculosis (33.4%), septicemia (23.8%), advanced HIV disease (9.1%), meningitis (7.4%), other pulmonary infections (5.1%) and Kaposi's sarcoma (4.5%). The present dismal situation of patients living with HIV/AIDS calls for enhanced strategies to decrease the mortality trend observed. With the introduction of affordable highly active antiretroviral therapy (HAART) in several centers in Nigeria, it is hoped that infected patients can be made to live longer.
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Affiliation(s)
- Mahmoud U Sani
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.
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Abdu A, Adamu B, Sani MU, Mohammed AZ, Alhassan SU, Borodo MM. Post transplant Kaposi's sarcoma among Nigerians: a report of two cases. Afr J Med Med Sci 2005; 34:395-8. [PMID: 16752672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
With the establishment of kidney transplant centres in Nigeria and increase in the number of kidney transplant recipients returning home for follow up after successful transplant abroad, an increasing number of patients with post transplant complications are likely to be seen. There is the need for physicians vested with the care of these patients to be aware of the post transplant complications so that early diagnosis and effective treatment can be instituted so as to save both the patient and the allograft. Two out of seventeen renal transplant recipients followed up in our unit had post renal transplant Kaposi's sarcoma. Both were successfully treated with withdrawal of cyclosporin, reduction of other immunosuppressives and introduction of low dose Mycophenolate Mofetil (MMF). One had a course of radiotherapy followed by weekly intravenous vincristine and the other only had vincristine with complete remission of the lesions in both patients. Post transplant Kaposi's sarcoma occurs in Nigerian transplant patients and this report highlights the need for increased awareness and high index of suspicion of post transplant Kaposi's sarcoma among kidney transplant recipients.
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Affiliation(s)
- A Abdu
- Department of Medicine, Aminu Kano Teaching Hospital, PMB 3452, Kano, Nigeria.
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