Endocarditis is of the inner layer of the , the. It usually involves the. Other structures that m... more Endocarditis is of the inner layer of the , the. It usually involves the. Other structures that may be involved include the , the , the mural endocardium or the surfaces of intracardiac devices. Infective endocarditis is a form of endocarditis caused by infectious agents, which are usually bacterial (other organisms can also be responsible). Before the age of modern antibiotics it was almost universally fatal. Although the epidemiology of infective endocarditis has changed over the last 50 years, with rheumatic heart disease becoming less common and degenerative valve disease more frequent, its incidence and associated mortality have remained relatively constant.
Background: Prostate cancer is the commonest cancer among men in Nigeria and early detection is k... more Background: Prostate cancer is the commonest cancer among men in Nigeria and early detection is key to cure and survival but its screening through prostate specific antigen (PSA) has remain controversial in literature. Screening with prostate specific antigen (PSA) has led to more men diagnosed with prostate cancer than in previous years with potential for negative effects from overdiagnosis and overtreatment. Method: This is a review article on the controversies and recommendations regarding prostate cancer screening following detailed search of literature and online databases such as Pubmed and Google using PSA, DRE, prostate cancer, screening as key words. Conclusion: Prostate cancer screening is fraught with a lot of controversies therefore it should be individualised through discussion between the physician and informed client using appropriate guidelines and recommendations.
Journal of BioMedical Research and Clinical Practice, 2021
HIV/AIDS is an increasingly important cause of cardiovascular (CVD) morbidity world-wide. We soug... more HIV/AIDS is an increasingly important cause of cardiovascular (CVD) morbidity world-wide. We sought to evaluate the prevalence of CVD risk factors in HIV positive (HIV+) adults and assessment of these risks using the Framingham risk score (FRS). A cross-sectional study of adult clients of the HIV clinic at Jos University Teaching Hospital. One hundred and fifty HIV+ selected randomly with 50 (age and sex matched) HIV negative (HIV-) participants were enrolled. Relevant history, physical examination and biochemical investigations and 12-lead electrocardiography were performed. Data was analyzed using Epi-info 7.2 statistical software and P value < 0.05 was considered significant. The prevalent major CVD risk factors were dyslipidaemia (30.0% versus 6.0%), hypertension (34.0% versus 10.0%) and diabetes mellitus (10.0% versus 2.0%) among the HIV+ and HIV- participants respectively. The FRS of the HIV+, 3 (IQR 3-28) were statistically significantly higher than that of the HIV- partic...
l' unclic.ll1:tl d i.l!>.' i ur q LmH t~• c.1 L Ilk. f lencL!. wtl b ~m,;: ':!~l't.:ptruns. I)L•n... more l' unclic.ll1:tl d i.l!>.' i ur q LmH t~• c.1 L Ilk. f lencL!. wtl b ~m,;: ':!~l't.:ptruns. I)L•ncan.hn•LoUl)' i:lhc l l'cat mt!'nt n l d 1mt:"c f," '>' m (ltLl ma• i c l:ltnstric l i\ c; pen t~11 d 1tjs .
Background : Holter monitoring is a cardiovascular test available in few centres in Nigeria. It i... more Background : Holter monitoring is a cardiovascular test available in few centres in Nigeria. It is indicated when cardiac rhythm disorders are suspected and standard electrocardiogram is not helpful. A simple overview of this test could give an idea of what cardiovascular complications are common. We evaluated the indications and simple results of outcome of Holter monitoring in a teaching hospital. Methods : This descriptive cross-sectional study evaluated the indications and findings of patients that had a 24 hour Holter recording at the Jos University Teaching Hospital over a four year period between January 2011 to December 2014, utilizing routinely collected hospital data. Results : A total of 113 subject hah Holter monitoring over the study period. The population had an age range 4-90 years, consisting of consisting of 60 (53%) male and 7 (6%) children. The main indications for Holter monitoring were palpitation (28%) and hypertensive heart disease (26%). Common findings follo...
CASE REPORT A 51-year-old woman presented to the Cardiology Clinic with a 2-week history of dyspn... more CASE REPORT A 51-year-old woman presented to the Cardiology Clinic with a 2-week history of dyspnoea which initially occurred on moderate exertion but had progressed to occur at rest. This was associated with recurrent cough, palpitations, chest pain, orthopnoea, paroxysmal nocturnal dyspnoea and progressively increasing bilateral leg swelling. There was also an associated history of recurrent right upper quadrant abdominal pain and swelling which was associated with anorexia and early satiety.
Cardiovascular disease (CVD) is a common cause of morbidity/mortality in patients with type 2 dia... more Cardiovascular disease (CVD) is a common cause of morbidity/mortality in patients with type 2 diabetes mellitus (T2DM). Echocardiography can detect changes in cardiac geometry/function before overt CVD symptoms. This study aimed to evaluate left ventricular (LV) geometry and function in normotensive/hypertensive patients with T2DM without overt cardiac symptoms. A cross-sectional study in which fifty normotensives and fifty hypertensive adults with DM without overt cardiac symptoms were enrolled from the cardiology/diabetes clinics of Jos University Teaching Hospital (JUTH) in a simple random manner. Relevant history, physical examination and biochemical investigations were performed. 12-lead electrocardiography and echocardiograph assessment of LV geometry and function were also performed. Data was analyzed using Epi-info 7 statistical software; p value < 0.05 was considered significant. There were 27 females and 29 females in both groups. The prevalence of abnormal LV geometry ...
Background: Multidrug resistant tuberculosis (MDR-TB) which is TB that is resistant to at least i... more Background: Multidrug resistant tuberculosis (MDR-TB) which is TB that is resistant to at least isoniazid and rifampicin. Making a diagnosis of MDR-TB is a challenge in our environment as the access to facilities for diagnosis is difficult. This study tries to look at the pattern and possible determinants of MDR-TB and the challenges in making a diagnosis Method: This was a prospective study to identify pattern and possible determinants of MDR TB among MDR TB suspects managed in the Tuberculosis clinic of Jos University Teaching Hospital (JUTH) between January 2008 and October 2010. Sputum samples for patients that met the criteria were taken for culture and Drug susceptibility testing. All tests were confirmed using MGIT BACTEC. Results: Nine patients met study criteria. 77.7% were male. The mean age (SD) of the subjects was 42.55 (14.51); there was no significant difference between the mean age of the males and females. Two (22.2%) of study participants were HIV Seropositive. Four...
Background and Purpose: To identify the qualitative and quantitative contributions of conventiona... more Background and Purpose: To identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans. Methods: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection. Controls were age- and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle, and psychosocial factors were performed. We used conditional logistic regression to estimate adjusted odds ratios with 95% CI. Results: There were 2431 ischemic stroke case and stroke-free control pairs with respective mean ages of 62.2±14.0 versus 60.9±13.7 years. There were 1024 (42.1%) small vessel occlusions, 4...
Introduction human immunodeficiency virus (HIV) is evolving into a leading cause of cardiovascula... more Introduction human immunodeficiency virus (HIV) is evolving into a leading cause of cardiovascular diseases (CVD) in sub-Saharan Africa (SSA) where the burden of HIV remains high. Atherosclerosis underlie progression to CVD. We therefore examined the prevalence of subclinical atherosclerosis and its association with traditional and non-traditional risk factors for CVD in Nigerian HIV-infected adults. Methods this was a cross-sectional study involving randomly selected stable HIV-infected patients with undetectable viral load attending HIV clinics at the Jos University Teaching Hospital and Faith Alive Foundation in Jos, Nigeria. Demographic data, biophysical measurements, cardiovascular risk factors and information regarding HIV-related factors, fasting serum lipid profile, fasting plasma glucose, high-sensitivity C-reactive protein and Carotid-Intima-Media-Thickness (CIMT) were assessed. Subclinical atherosclerosis was defined using a cut-off value of mean CIMT ≥ 0.78 mm. Data were analyzed with the Statistical Package for Social Sciences® (SPSS) software version 23.0 (IBM Corp., Chicago, Illinois, USA). Bivariate analysis and multivariate logistic regression were used to examine the association between risk factors of CVD and subclinical atherosclerosis. The statistical significance level was set at p ≤ 0.05. Results a total of 148 HIV adults (70.9% being females) on Anti-Retroviral Therapy (ART) were included in this study. The prevalence of subclinical atherosclerosis was 7.4%. Among subjects with subclinical atherosclerosis (SCA), 63.6% were males and 81.8% were hypertensive. Elevated blood glucose, lipids and high-sensitivity C-reactive protein, body mass index (BMI), HIV-related parameters (duration of HIV infection, antiretroviral regimen, CD4+ cell count), current smoking status, alcohol use, were not significantly associated with subclinical atherosclerosis (p>0.05). Male gender [OR(95%CI=4.91(1.36-17.77)], age [OR(95%CI)=1.14(1.06-1.23)], hypertension [OR(95%CI=14.4(3.03-71.86)] and metabolic syndrome [OR(95%CI=8.34(1.73-40.18)] were significantly associated with SCA at bivariate analysis. After adjusting for age, sex and antiretroviral regimen, only increasing age [Adjusted Odds Ratio (AOR) (95% confidence interval (CI)] = 1.12(1.01-1.25)] and hypertension [AOR (95%CI)=10.67 (1.31-87.18)], remained as independent predictors of subclinical atherosclerosis (SCA). Conclusion the prevalence of subclinical atherosclerosis among HIV-infected adults is high in Nigeria. It is significantly associated with increasing age and hypertension. Traditional CVD risk factors such as dyslipidaemia, diabetes mellitus and obesity were not associated with subclinical atherosclerosis in this population.
ObjectiveTo characterize risk factors for spontaneous intracerebral hemorrhage (sICH) occurrence ... more ObjectiveTo characterize risk factors for spontaneous intracerebral hemorrhage (sICH) occurrence and severity among West Africans.MethodsThe Stroke Investigative Research and Educational Network (SIREN) study is a multicenter case-control study involving 15 sites in Ghana and Nigeria. Patients were adults ≥18 years old with CT-confirmed sICH with age-, sex-, and ethnicity-matched stroke-free community controls. Standard instruments were used to assess vascular, lifestyle, and psychosocial factors. Factors associated with sICH and its severity were assessed using conditional logistic regression to estimate odds ratios (ORs) and population-attributable risks (PARs) with 95% confidence intervals (CIs) for factors.ResultsOf 2,944 adjudicated stroke cases, 854 were intracerebral hemorrhage (ICH). Mean age of patients with ICH was 54.7 ± 13.9 years, with a male preponderance (63.1%), and 77.3% were nonlobar. Etiologic subtypes of sICH included hypertension (80.9%), structural vascular ano...
Background Little is known about the relationship between echocardiographic abnormalities and out... more Background Little is known about the relationship between echocardiographic abnormalities and outcome among patients with acute stroke. We investigated the pattern and association of baseline echocardiographic variables with 1‐month disability and mortality among patients with stroke in the SIREN (Stroke Investigative Research and Education Network) study. Methods and Results We enrolled and followed up consecutive 1020 adult patients with acute stroke with baseline transthoracic echocardiography from west Africa. To explore the relationship between echocardiographic variables and 1‐month disability (using modified Rankin scale >3) and fatality, regression models were fitted. Relative risks were computed with 95% CIs. The participants comprised 60% men with a mean age of 59.2±14.6 years. Ischemic stroke was associated with smaller aortic root diameter (30.2 versus 32.5, P =0.018) and septal (16.8 versus 19.1, P <0.001) and posterior wall thickness at systole (18.9 versus 21.5,...
Journal of Advances in Medicine and Medical Research, 2018
Aim: To determine prevalence of T 2 DM and risk factors among rural farmers of Panyam in Plateau ... more Aim: To determine prevalence of T 2 DM and risk factors among rural farmers of Panyam in Plateau Central, Nigeria. Background: Diabetes mellitus is one of the commonest metabolic disorder characterized by persistent hyperglycemia due to lack of insulin secretion or inactivity of insulin resulting in risk of microangiopathy and macroangiopathy [1,2]. Many lifestyle factors affect the incidence of Type II Diabetes Mellitus, which includes cigarette smoking, inactivity and heavy alcohol consumption that could cause hyperuriceamia. Other risk factors include obesity, age, family history. Materials and Methods: The study population consisted of 200 adults above 40 years mainly farmers. Both females and males were recruited into the study.
International journal of stroke : official journal of the International Stroke Society, Jan 24, 2018
Background It is crucial to assess genomic literacy related to stroke among Africans in preparati... more Background It is crucial to assess genomic literacy related to stroke among Africans in preparation for the ethical, legal and societal implications of the genetic revolution which has begun in Africa. Objective To assess the knowledge, attitudes and practices (KAP) of West Africans about stroke genetic studies. Methods A comparative cross-sectional study was conducted among stroke patients and stroke-free controls recruited across 15 sites in Ghana and Nigeria. Participants' knowledge of heritability of stroke, willingness to undergo genetic testing and perception of the potential benefits of stroke genetic research were assessed using interviewer-administered questionnaire. Descriptive, frequency distribution and multiple regression analyses were performed. Results Only 49% of 2029 stroke patients and 57% of 2603 stroke-free individuals knew that stroke was a heritable disorder. Among those who knew, 90% were willing to undergo genetic testing. Knowledge of stroke heritability...
Background and objectives: We examined the association of respiratory symptoms, health status, an... more Background and objectives: We examined the association of respiratory symptoms, health status, and lung function with the use of solid fuel (wood, charcoal, coal or crop residue) for cooking or heating in a predominantly non-smoking population. Methods: Using the protocol of the Burden of Obstructive Lung Diseases (BOLD) initiative, we collected representative population data using questionnaires and spirometry tests. We categorized solid fuel use into 'never user', 'ex user' and 'current user' based on responses to the survey. We developed regression models to evaluate the relation between use of solid fuel and the prevalence of respiratory symptoms, quality of life and lung function adjusting for confounding variables. Results: Out of 1147 respondents with complete information on domestic fuel type, 33% were 'neverusers', 19% were 'ex-users' while 48% reported current use of solid fuel for domestic cooking and/or indoor heating. Compared with never-users, current solid fuel users were more likely to report cough (OR: 1.7, 95% CI: 1.0, 2.9), cough or phlegm (OR: 1.6, 95% CI: 1.0, 2.5) and the association was stronger among women (OR: 3.0, 95% CI: 1.3, 7.1 and OR: 2.3, 95% CI: 1.1, 5.2, respectively). Current solid fuel users also had lower mental health status (coefficient: À1.5, 95% CI: À2.8,-0.2) compared with the group of never-users. Current or previous domestic use of solid fuels for cooking or heating was not associated with higher prevalence of chronic airflow obstruction (FEV 1 /FVC < LLN). Conclusions: Using solid fuel for domestic cooking or heating was associated with a higher risk of cough or phlegm and a lower mental quality of life. However we found no significant effect in the prevalence of chronic airflow obstruction in Ife, Nigeria.
Background-Africa has a growing burden of stroke with associated high morbidity and a 3year fatal... more Background-Africa has a growing burden of stroke with associated high morbidity and a 3year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes has not been previously characterized in Africans. We assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods-We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 hours of admission and stroke classified based on brain CT scan or MRI. Stroke severity at baseline was assessed using the Stroke levity scale (SLS), while onemonth outcome was assessed using the modified Rankin scale (mRS). Results-Patients mean age was 58.4 (±13.4) years, 490 were male (55%) and 400(45%) females, 65.5% had ischemic stroke, and 85.4% had at least one ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy (LVH) with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%, p=0.002), but more likely to have LVH (64.4% vs. 51.4%, p=0.004). Odds of severe disability or death at one month was higher with severe stroke (AOR: 2.25; 95% CI :1.44-3.50), or atrial enlargement (AOR: 1.45;
Objective: Resistant hypertension (RH) is an important challenge in hypertension management. And ... more Objective: Resistant hypertension (RH) is an important challenge in hypertension management. And adherence was reported to be very important when to diagnose a RH. There are few studies to report the prevalence of RH by refl ecting the aspect of adherence. Insurance claim database has advantage to refl ect the information on the prescription and its duration.
Endocarditis is of the inner layer of the , the. It usually involves the. Other structures that m... more Endocarditis is of the inner layer of the , the. It usually involves the. Other structures that may be involved include the , the , the mural endocardium or the surfaces of intracardiac devices. Infective endocarditis is a form of endocarditis caused by infectious agents, which are usually bacterial (other organisms can also be responsible). Before the age of modern antibiotics it was almost universally fatal. Although the epidemiology of infective endocarditis has changed over the last 50 years, with rheumatic heart disease becoming less common and degenerative valve disease more frequent, its incidence and associated mortality have remained relatively constant.
Background: Prostate cancer is the commonest cancer among men in Nigeria and early detection is k... more Background: Prostate cancer is the commonest cancer among men in Nigeria and early detection is key to cure and survival but its screening through prostate specific antigen (PSA) has remain controversial in literature. Screening with prostate specific antigen (PSA) has led to more men diagnosed with prostate cancer than in previous years with potential for negative effects from overdiagnosis and overtreatment. Method: This is a review article on the controversies and recommendations regarding prostate cancer screening following detailed search of literature and online databases such as Pubmed and Google using PSA, DRE, prostate cancer, screening as key words. Conclusion: Prostate cancer screening is fraught with a lot of controversies therefore it should be individualised through discussion between the physician and informed client using appropriate guidelines and recommendations.
Journal of BioMedical Research and Clinical Practice, 2021
HIV/AIDS is an increasingly important cause of cardiovascular (CVD) morbidity world-wide. We soug... more HIV/AIDS is an increasingly important cause of cardiovascular (CVD) morbidity world-wide. We sought to evaluate the prevalence of CVD risk factors in HIV positive (HIV+) adults and assessment of these risks using the Framingham risk score (FRS). A cross-sectional study of adult clients of the HIV clinic at Jos University Teaching Hospital. One hundred and fifty HIV+ selected randomly with 50 (age and sex matched) HIV negative (HIV-) participants were enrolled. Relevant history, physical examination and biochemical investigations and 12-lead electrocardiography were performed. Data was analyzed using Epi-info 7.2 statistical software and P value < 0.05 was considered significant. The prevalent major CVD risk factors were dyslipidaemia (30.0% versus 6.0%), hypertension (34.0% versus 10.0%) and diabetes mellitus (10.0% versus 2.0%) among the HIV+ and HIV- participants respectively. The FRS of the HIV+, 3 (IQR 3-28) were statistically significantly higher than that of the HIV- partic...
l' unclic.ll1:tl d i.l!>.' i ur q LmH t~• c.1 L Ilk. f lencL!. wtl b ~m,;: ':!~l't.:ptruns. I)L•n... more l' unclic.ll1:tl d i.l!>.' i ur q LmH t~• c.1 L Ilk. f lencL!. wtl b ~m,;: ':!~l't.:ptruns. I)L•ncan.hn•LoUl)' i:lhc l l'cat mt!'nt n l d 1mt:"c f," '>' m (ltLl ma• i c l:ltnstric l i\ c; pen t~11 d 1tjs .
Background : Holter monitoring is a cardiovascular test available in few centres in Nigeria. It i... more Background : Holter monitoring is a cardiovascular test available in few centres in Nigeria. It is indicated when cardiac rhythm disorders are suspected and standard electrocardiogram is not helpful. A simple overview of this test could give an idea of what cardiovascular complications are common. We evaluated the indications and simple results of outcome of Holter monitoring in a teaching hospital. Methods : This descriptive cross-sectional study evaluated the indications and findings of patients that had a 24 hour Holter recording at the Jos University Teaching Hospital over a four year period between January 2011 to December 2014, utilizing routinely collected hospital data. Results : A total of 113 subject hah Holter monitoring over the study period. The population had an age range 4-90 years, consisting of consisting of 60 (53%) male and 7 (6%) children. The main indications for Holter monitoring were palpitation (28%) and hypertensive heart disease (26%). Common findings follo...
CASE REPORT A 51-year-old woman presented to the Cardiology Clinic with a 2-week history of dyspn... more CASE REPORT A 51-year-old woman presented to the Cardiology Clinic with a 2-week history of dyspnoea which initially occurred on moderate exertion but had progressed to occur at rest. This was associated with recurrent cough, palpitations, chest pain, orthopnoea, paroxysmal nocturnal dyspnoea and progressively increasing bilateral leg swelling. There was also an associated history of recurrent right upper quadrant abdominal pain and swelling which was associated with anorexia and early satiety.
Cardiovascular disease (CVD) is a common cause of morbidity/mortality in patients with type 2 dia... more Cardiovascular disease (CVD) is a common cause of morbidity/mortality in patients with type 2 diabetes mellitus (T2DM). Echocardiography can detect changes in cardiac geometry/function before overt CVD symptoms. This study aimed to evaluate left ventricular (LV) geometry and function in normotensive/hypertensive patients with T2DM without overt cardiac symptoms. A cross-sectional study in which fifty normotensives and fifty hypertensive adults with DM without overt cardiac symptoms were enrolled from the cardiology/diabetes clinics of Jos University Teaching Hospital (JUTH) in a simple random manner. Relevant history, physical examination and biochemical investigations were performed. 12-lead electrocardiography and echocardiograph assessment of LV geometry and function were also performed. Data was analyzed using Epi-info 7 statistical software; p value < 0.05 was considered significant. There were 27 females and 29 females in both groups. The prevalence of abnormal LV geometry ...
Background: Multidrug resistant tuberculosis (MDR-TB) which is TB that is resistant to at least i... more Background: Multidrug resistant tuberculosis (MDR-TB) which is TB that is resistant to at least isoniazid and rifampicin. Making a diagnosis of MDR-TB is a challenge in our environment as the access to facilities for diagnosis is difficult. This study tries to look at the pattern and possible determinants of MDR-TB and the challenges in making a diagnosis Method: This was a prospective study to identify pattern and possible determinants of MDR TB among MDR TB suspects managed in the Tuberculosis clinic of Jos University Teaching Hospital (JUTH) between January 2008 and October 2010. Sputum samples for patients that met the criteria were taken for culture and Drug susceptibility testing. All tests were confirmed using MGIT BACTEC. Results: Nine patients met study criteria. 77.7% were male. The mean age (SD) of the subjects was 42.55 (14.51); there was no significant difference between the mean age of the males and females. Two (22.2%) of study participants were HIV Seropositive. Four...
Background and Purpose: To identify the qualitative and quantitative contributions of conventiona... more Background and Purpose: To identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans. Methods: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection. Controls were age- and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle, and psychosocial factors were performed. We used conditional logistic regression to estimate adjusted odds ratios with 95% CI. Results: There were 2431 ischemic stroke case and stroke-free control pairs with respective mean ages of 62.2±14.0 versus 60.9±13.7 years. There were 1024 (42.1%) small vessel occlusions, 4...
Introduction human immunodeficiency virus (HIV) is evolving into a leading cause of cardiovascula... more Introduction human immunodeficiency virus (HIV) is evolving into a leading cause of cardiovascular diseases (CVD) in sub-Saharan Africa (SSA) where the burden of HIV remains high. Atherosclerosis underlie progression to CVD. We therefore examined the prevalence of subclinical atherosclerosis and its association with traditional and non-traditional risk factors for CVD in Nigerian HIV-infected adults. Methods this was a cross-sectional study involving randomly selected stable HIV-infected patients with undetectable viral load attending HIV clinics at the Jos University Teaching Hospital and Faith Alive Foundation in Jos, Nigeria. Demographic data, biophysical measurements, cardiovascular risk factors and information regarding HIV-related factors, fasting serum lipid profile, fasting plasma glucose, high-sensitivity C-reactive protein and Carotid-Intima-Media-Thickness (CIMT) were assessed. Subclinical atherosclerosis was defined using a cut-off value of mean CIMT ≥ 0.78 mm. Data were analyzed with the Statistical Package for Social Sciences® (SPSS) software version 23.0 (IBM Corp., Chicago, Illinois, USA). Bivariate analysis and multivariate logistic regression were used to examine the association between risk factors of CVD and subclinical atherosclerosis. The statistical significance level was set at p ≤ 0.05. Results a total of 148 HIV adults (70.9% being females) on Anti-Retroviral Therapy (ART) were included in this study. The prevalence of subclinical atherosclerosis was 7.4%. Among subjects with subclinical atherosclerosis (SCA), 63.6% were males and 81.8% were hypertensive. Elevated blood glucose, lipids and high-sensitivity C-reactive protein, body mass index (BMI), HIV-related parameters (duration of HIV infection, antiretroviral regimen, CD4+ cell count), current smoking status, alcohol use, were not significantly associated with subclinical atherosclerosis (p>0.05). Male gender [OR(95%CI=4.91(1.36-17.77)], age [OR(95%CI)=1.14(1.06-1.23)], hypertension [OR(95%CI=14.4(3.03-71.86)] and metabolic syndrome [OR(95%CI=8.34(1.73-40.18)] were significantly associated with SCA at bivariate analysis. After adjusting for age, sex and antiretroviral regimen, only increasing age [Adjusted Odds Ratio (AOR) (95% confidence interval (CI)] = 1.12(1.01-1.25)] and hypertension [AOR (95%CI)=10.67 (1.31-87.18)], remained as independent predictors of subclinical atherosclerosis (SCA). Conclusion the prevalence of subclinical atherosclerosis among HIV-infected adults is high in Nigeria. It is significantly associated with increasing age and hypertension. Traditional CVD risk factors such as dyslipidaemia, diabetes mellitus and obesity were not associated with subclinical atherosclerosis in this population.
ObjectiveTo characterize risk factors for spontaneous intracerebral hemorrhage (sICH) occurrence ... more ObjectiveTo characterize risk factors for spontaneous intracerebral hemorrhage (sICH) occurrence and severity among West Africans.MethodsThe Stroke Investigative Research and Educational Network (SIREN) study is a multicenter case-control study involving 15 sites in Ghana and Nigeria. Patients were adults ≥18 years old with CT-confirmed sICH with age-, sex-, and ethnicity-matched stroke-free community controls. Standard instruments were used to assess vascular, lifestyle, and psychosocial factors. Factors associated with sICH and its severity were assessed using conditional logistic regression to estimate odds ratios (ORs) and population-attributable risks (PARs) with 95% confidence intervals (CIs) for factors.ResultsOf 2,944 adjudicated stroke cases, 854 were intracerebral hemorrhage (ICH). Mean age of patients with ICH was 54.7 ± 13.9 years, with a male preponderance (63.1%), and 77.3% were nonlobar. Etiologic subtypes of sICH included hypertension (80.9%), structural vascular ano...
Background Little is known about the relationship between echocardiographic abnormalities and out... more Background Little is known about the relationship between echocardiographic abnormalities and outcome among patients with acute stroke. We investigated the pattern and association of baseline echocardiographic variables with 1‐month disability and mortality among patients with stroke in the SIREN (Stroke Investigative Research and Education Network) study. Methods and Results We enrolled and followed up consecutive 1020 adult patients with acute stroke with baseline transthoracic echocardiography from west Africa. To explore the relationship between echocardiographic variables and 1‐month disability (using modified Rankin scale >3) and fatality, regression models were fitted. Relative risks were computed with 95% CIs. The participants comprised 60% men with a mean age of 59.2±14.6 years. Ischemic stroke was associated with smaller aortic root diameter (30.2 versus 32.5, P =0.018) and septal (16.8 versus 19.1, P <0.001) and posterior wall thickness at systole (18.9 versus 21.5,...
Journal of Advances in Medicine and Medical Research, 2018
Aim: To determine prevalence of T 2 DM and risk factors among rural farmers of Panyam in Plateau ... more Aim: To determine prevalence of T 2 DM and risk factors among rural farmers of Panyam in Plateau Central, Nigeria. Background: Diabetes mellitus is one of the commonest metabolic disorder characterized by persistent hyperglycemia due to lack of insulin secretion or inactivity of insulin resulting in risk of microangiopathy and macroangiopathy [1,2]. Many lifestyle factors affect the incidence of Type II Diabetes Mellitus, which includes cigarette smoking, inactivity and heavy alcohol consumption that could cause hyperuriceamia. Other risk factors include obesity, age, family history. Materials and Methods: The study population consisted of 200 adults above 40 years mainly farmers. Both females and males were recruited into the study.
International journal of stroke : official journal of the International Stroke Society, Jan 24, 2018
Background It is crucial to assess genomic literacy related to stroke among Africans in preparati... more Background It is crucial to assess genomic literacy related to stroke among Africans in preparation for the ethical, legal and societal implications of the genetic revolution which has begun in Africa. Objective To assess the knowledge, attitudes and practices (KAP) of West Africans about stroke genetic studies. Methods A comparative cross-sectional study was conducted among stroke patients and stroke-free controls recruited across 15 sites in Ghana and Nigeria. Participants' knowledge of heritability of stroke, willingness to undergo genetic testing and perception of the potential benefits of stroke genetic research were assessed using interviewer-administered questionnaire. Descriptive, frequency distribution and multiple regression analyses were performed. Results Only 49% of 2029 stroke patients and 57% of 2603 stroke-free individuals knew that stroke was a heritable disorder. Among those who knew, 90% were willing to undergo genetic testing. Knowledge of stroke heritability...
Background and objectives: We examined the association of respiratory symptoms, health status, an... more Background and objectives: We examined the association of respiratory symptoms, health status, and lung function with the use of solid fuel (wood, charcoal, coal or crop residue) for cooking or heating in a predominantly non-smoking population. Methods: Using the protocol of the Burden of Obstructive Lung Diseases (BOLD) initiative, we collected representative population data using questionnaires and spirometry tests. We categorized solid fuel use into 'never user', 'ex user' and 'current user' based on responses to the survey. We developed regression models to evaluate the relation between use of solid fuel and the prevalence of respiratory symptoms, quality of life and lung function adjusting for confounding variables. Results: Out of 1147 respondents with complete information on domestic fuel type, 33% were 'neverusers', 19% were 'ex-users' while 48% reported current use of solid fuel for domestic cooking and/or indoor heating. Compared with never-users, current solid fuel users were more likely to report cough (OR: 1.7, 95% CI: 1.0, 2.9), cough or phlegm (OR: 1.6, 95% CI: 1.0, 2.5) and the association was stronger among women (OR: 3.0, 95% CI: 1.3, 7.1 and OR: 2.3, 95% CI: 1.1, 5.2, respectively). Current solid fuel users also had lower mental health status (coefficient: À1.5, 95% CI: À2.8,-0.2) compared with the group of never-users. Current or previous domestic use of solid fuels for cooking or heating was not associated with higher prevalence of chronic airflow obstruction (FEV 1 /FVC < LLN). Conclusions: Using solid fuel for domestic cooking or heating was associated with a higher risk of cough or phlegm and a lower mental quality of life. However we found no significant effect in the prevalence of chronic airflow obstruction in Ife, Nigeria.
Background-Africa has a growing burden of stroke with associated high morbidity and a 3year fatal... more Background-Africa has a growing burden of stroke with associated high morbidity and a 3year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes has not been previously characterized in Africans. We assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods-We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 hours of admission and stroke classified based on brain CT scan or MRI. Stroke severity at baseline was assessed using the Stroke levity scale (SLS), while onemonth outcome was assessed using the modified Rankin scale (mRS). Results-Patients mean age was 58.4 (±13.4) years, 490 were male (55%) and 400(45%) females, 65.5% had ischemic stroke, and 85.4% had at least one ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy (LVH) with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%, p=0.002), but more likely to have LVH (64.4% vs. 51.4%, p=0.004). Odds of severe disability or death at one month was higher with severe stroke (AOR: 2.25; 95% CI :1.44-3.50), or atrial enlargement (AOR: 1.45;
Objective: Resistant hypertension (RH) is an important challenge in hypertension management. And ... more Objective: Resistant hypertension (RH) is an important challenge in hypertension management. And adherence was reported to be very important when to diagnose a RH. There are few studies to report the prevalence of RH by refl ecting the aspect of adherence. Insurance claim database has advantage to refl ect the information on the prescription and its duration.
Uploads
Papers by Ganiyu Amusa