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Biomedical subjects

B N Okeahialam

Publications and source records attributed to B N Okeahialam.

15 recordsLinked to original sources
PubMed2004

Prolongation of electrocardiographic intervals in women on Norplant contraceptive: what dangers?

This study used electrocardiography to determine any inherent cardiovascular dangers with the use of Norplant, an implant contraceptive among Nigerian females using the device. As part of a major study of metabolic, physical and cardiovascular changes consequent upon the use of Norplant implant contraceptive, all subjects underwent serial electrocardiograms at pre-insertion, 3, 6, and 12 months of use. Given the observed prolongation ofelectrocardiographic intervals, the ECG of all the study subjects were secondarily analysed for QT and corrected QT (QTc) dispersions. QT intervals was measured from the ECG of each of the 21 subjects who were available at pre-insertion and 12 months post-insertion; from the onset of QRS to the end of T wave or nadir of the curve between T and U waves as the case may be. Corrected QT intervals was calculated by determining the RR interval and using the Bazett's formula. The difference of the lowest and highest QT intervals and QTc intervals over the 12 leads determined their respective dispersions. These were then analysed. The subjects whose ages ranged from 25-45 years weighed between 43 and 87.2 kg. The mean QT dispersion increased with time but did not reach statistical significance by the twelve month visit (ANOVA - QT dispersion 0 month vs 12 months: F=0.98, p=0.48). However the mean QTc dispersion increased and reached statistical significance by 12 months (0 month vs 12 months: F=5.49, p=0.006). QT and QTc dispersion increases are known to predict cardiovascular death in health and disease. With the use of this device, these indices rose gradually with time reaching statistical significance by 12 months only with the QTc dispersion. The use of this device may increase the tendency to cardiovascular morbidity and mortality. Whether this translates into real risk will require a long-term study to determine. For now, application of the device on patients with cardiovascular disease or tendency thereof should still attract caution.

Adult↗
PubMed2000

Lacidipine in the treatment of hypertension in black African people: antihypertensive, biochemical and haematological effects.

This is an open trial investigating the efficacy and metabolic effects of 3 months' treatment with lacidipine in 25 Nigerian Africans with mild to moderate hypertension. There was a significant fall in sitting diastolic blood pressure, with treatment (p = 0.01). There were no significant weight changes. The heart rate initially rose significantly with the drug but this normalised with time. All biochemical and haematological indices remained essentially unchanged during therapy. Lacidipine therefore proved an efficacious and metabolically neutral antihypertensive in mild to moderate hypertension in Africa.

Antihypertensive Agents↗
PubMed1998

Non-dilated cardiomyopathy in Nigerians evaluated by echocardiography.

Non-dilated cardiomyopathy (NDCM), a condition said to be uncommon, has been found to occur in 4.6% of cases undergoing echocardiography in our centre. Its echocardiographic features have been given (normal cavity dimensions, reduced contractility, thick walls) and clinical implications highlighted. Since it is not an entirely innocuous state, patients should, when discovered, be followed up closely. This would afford clinicians the opportunity to determine factors that lead to stability or deterioration of DCM.

Adult↗
PubMed1997

alpha-receptor blockade for benign prostatic hyperplasia: uses and problems in a developing country.

OBJECTIVE: To evaluate the use and problems of alpha-receptor blockade with prazosin among patients in Nigeria with benign prostatic hyperplasia (BPH) who face a prolonged wait for a prostatectomy. PATIENTS AND METHODS: The study comprised 31 patients (mean age 64.4 years, range 55-89) facing a prolonged wait for prostatectomy: in group 1, 14 patients presented in acute urinary retention and had an indwelling urethral catheter; in group 2, six patients had indwelling catheters but removal was deemed necessary to control urinary tract infection: in group 3, 11 patients had troublesome symptoms from BPH but no retention. Some of the patients were also hypertensive. After receiving I mg of prazosin twice daily, the catheters were removed at various intervals and the effect on symptom scores and residual urine volume determined after one week and 2 months. RESULTS: Prazosin allowed the catheters to be removed, improved the symptoms of prostatism and/or controlled high blood pressure in seven, five and nine patients in each group, respectively. CONCLUSION: The use of this alpha blocker for BPH in the absence of facilities to measure urinary flow rate, intravesical pressure and serum prostate specific antigen can be justified for short periods. However, a large default rate among these patients raises additional questions about long-term safety and underlines the importance of selecting patients carefully.

Adrenergic alpha-Antagonists↗
PubMed1995

Behaviour of blood pressure in dilated cardiomyopathy patients suspected significantly hypertensive at echocardiography.

Eleven DCM patients who were found to have significant background hypertension from an echocardiographic assessment of the role of hypertension in DCM form the subject of this follow-up study. This was to test the reliability or otherwise of this investigative method which is supposed to identify DCM patients who would be expected to manifest hypertension with traditional anti-heart failure treatment. Results suggest a sensitivity of about 73% and specificity of 36%. It has a false positive potential in young females with the "Zaria-type" peripartum cardiomyopathy where fluid overload and not intrinsic myocardial failure is responsible.

Adult↗
PubMed1989

Chloroquine-resistant malaria in Jos, Nigeria.

A 16-year-old Nigerian boy who had lived all his life in a malaria endemic region presented with continuing fever after what would ordinarily be accepted as adequate treatment for malaria. He went on to develop cerebral malaria, recovering only after administration of quinine.

Adolescent↗
PubMedDate not supplied

Effect of lisnopril, an angiotensin converting enzyme (ACE) inhibitor on spermatogenesis in rats.

The role of ACE inhibitors (Lisinopril) in reproductive function remains controversial. Some benefits seem to be derivable even in non-hypertensive males with low doses. This study was done using rat model to establish this fact. Male rats were divided into different groups to receive different doses of lisinopril. A control group received no drugs. The mean arterial pressure fell the most with 5 mg of lisinopril. The greatest increase in sperm count and motility was recorded for this same group. This response was dose dependent, falling as the drug dose fell. Lisinopril appeared to, in a dose dependent manner, improve sperm count and motility. In low doses, there is no significant change in arterial pressure. Infertile males with poor quality semen could benefit from a low dose of ACE inhibition. Where they are also hypertensive, ACE inhibition would be an appropriate first line treatment.

Angiotensin-Converting Enzyme Inhibitors↗
PubMedDate not supplied

Familial polycystic kidney disease in Nigeria: a report of two cases.

A case of familial polycystic kidney disease is reported. Although isolated cases of adult polycystic kidney disease have been reported in our environment, no case to our knowledge has been reported with a familial link. Polycystic kidney disease is said to be rare in Africans. Although it commonly terminates in chronic renal failure, it hardly features in the aetiopathogenesis of end stage renal disease requiring some form of renal replacement therapy in African series. This, some workers believe may be due to misdiagnosis and under reporting. This report is to show that it may not be as rare as suspected, and that the familial link shown in the advanced countries is also applicable here. Case 1 was diagnosed in the course of evaluation of her clinical disease. Case 2, an aunt of Case 1, was diagnosed following investigation of a casual complaint of a painless abdominal mass in the wake of her senior brother's death from haemorrhagic stroke.

Adult↗
PubMedDate not supplied

Hypertension and primary myocardial disease in congestive cardiac failure.

This study has tried to use end diastolic diameter the index of chamber dilatation to discriminate between hypertensive heart failure and diluted cardiomyopathy as both conditions are known to overlap in cases of congestive cardiac failure. The sensitivity, specificity and positive predictive value was 66.7%, 68% and 66.7% respectively. This means that alone, end diastolic diameter is not a very acute discriminator in cases where an overlap as shown in the figure occurs. It is therefore necessary to use all discriminatory indices in combination to get better accuracy.

Blood Pressure↗
PubMedDate not supplied

A randomised trial to compare the efficacy and safety of Felodipine (Plendil) and Nifedipine (Adalat) retard in patients with mild-to-moderate hypertension.

The efficacy and tolerability of Felodipine extended-release was compared with Nifedipine retard in the management of patients with mild-to-moderate hypertension. A total of one hundred and thirty three patients were screened out of which one hundred and twenty-one patients were enrolled in a 9-week multicentre open, randomised rising-dose trial to receive either Felodipine 5-10 mg once daily or Nifedipine 10-20 mg twice daily. Blood pressure was measured at the end of the dosing interval that is 24 hours and 12 hours after Felodipine and Nifedipine respectively. Both drugs, Felodipine and Nifedipine were found to lower blood pressure significantly compared with baseline. After three weeks of treatment, seated blood pressure was reduced by 20/14 mmHg (systolic/diastolic) and by 24/16 mmHg after 6 weeks in the felodipine group. Corresponding values in the Nifedipine group were 16/09 mmHg and 24/13mmHg. Pulse rate was not significantly affected by either drugs. The percentage of patients who had satisfactory control after 3 weeks treatment was 57.6% for Felodipine and 33.3% for Nifedipine (significant). After dose titration (where necessary), at the end of the study the response rates were 76.3% (n=45) and 79.6% (n=43) for Felodipine and Nifedipine respectively (non significant). Both drugs were metabolically inert and did not derange the haematologic and biochemical profile of patients. They produced no significant weight changes. The pattern of side effects were similar in both groups but tended to be more severe with Nifedipine necessitating withdrawal of two patients in this group. In conclusion, Felodipine ER 5mg - 10mg once daily, and Nifedipine Retard, 20mg twice daily were equally effective medications for mild-to-moderate hypertension but Felodipine was better tolerated.

Black or African American↗
PubMedDate not supplied

Epidemiology and pathogenesis of human immunodeficiency virus (HIV) related heart disease: a review.

BACKGROUND: There is a clear and growing body of evidence for cardiac dysfunction in a significant portion of patients with HIV disease. An increased number of HIV-infected individuals may present with cardiac complications in the future as more patients with this disease survive longer because of modern therapy. Heart involvement in AIDS may be well characterized cardiac disease occurring coincidentally in AIDS patients, a complication of the disease or its treatment or possibly a direct insult to the heart by the HIV itself. METHODS: We reviewed the literature on heart disease in HIV infection and AIDS with particular reference to epidemiology and pathogenetic mechanisms that may play a role in diagnosis, management, and therapy of these complications. The MEDLINE/PUBMED and bibliographic searches forEnglish language studies were used. RESULTS: A variety of potential aetiologies have been postulated in HIV-related heart disease, including myocardial invasion with HIV itself, opportunistic infections, viral infections, autoimmune response to viral infection, drug-related cardiac toxicity, nutritional deficiencies, and prolonged immunosuppression. CONCLUSION: An increased number of HIV-infected individuals present with cardiac complications as chronic viral infection, co-infections, drug therapy, and immunosuppression. Understanding the nature and course of cardiac illness related to HIV infection may allow appropriate monitoring, early intervention and therapy

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

The aortic width as an index of hypertension--how specific?

Primary aortic diseases are believed to be rare in our environment, the result of which is to attribute increase in aortic width to hypertension. This premise has advised certain widely held views in the past, one of which is that heart muscle diseases (dilated cardiomyopathy) is hypertensive heart disease in disguise. New trends in knowledge have led to a shift in ground. Dilated cardiomyopathy is now thought to be an end-stage situation with many factors operating. This has prompted this re-look at the main factor that advised the earlier stand, namely the aortic width on chest X-ray. 48 patients in hypertensive heart failure and 50 in heart failure from dilated cardiomyopathy were studied. Aortic root dimensions were measured on chest X-ray and echocardiography. The results point to the fact that in our adult population, aortic dimension is a poor specific index of hypertension, as there was no statistically significant difference between the groups.

Aorta↗
PubMedDate not supplied

The effect of lacidipine on patients with mild to moderate hypertension and the effect of a combination of lacidipine and hydrochlorothiazide in the treatment of hypertension uncontrolled after four weeks of lacidipine treatment: an open study.

In the treatment of hypertension, some patients may go off control while still on the drugs. This occurs especially with sympathetic inhibitors and vasodilators. Lacidipine, a new calcium antagonist acts principally by vasodilatation. After a wash out period, patients with mild to moderate hypertension received 4 mg of Lacidipine for two weeks. After evaluation at two weeks, those uncontrolled received 6 mg of Lacidipine, while those controlled continued with 4 mg of Lacidipine for another two weeks. By the next evaluation, while patients continued whatever doses they were on, any one who had gone off control had 25 mg of Hydrochlorothiazide added. They were evaluated finally after another two weeks. It was found in this study that 91.3% (21/23) were controlled by the end with only Lacidipine either in 4 mg or 6 mg doses. Another 8.7% (2/23) initially controlled on Lacidipine went off control while still on the drug, and were eventually controlled by adding Hydrochlorothiazide. Some transient side effects not warranting discontinuation were encountered. It is concluded that Lacidipine is effective as monotherapy in mildly to moderately hypertensive Nigerian Africans; with good tolerance and safety profile. Where transient control is encountered, addition of a diuretic could be beneficial.

Adult↗
PubMedDate not supplied

Lysis of left ventricular thrombus with urokinase in a patient with alcohol heart disease.

A dilated cardiomyopathy patient whose congestive cardiac failure was made refractory to treatment by a left ventricular thrombus is reported. Thrombolectomy is usually the preferred therapeutic approach over anticoagulation and thrombolysis, as the latter approaches are said to carry the risk of stroke and haermorrhage. Facilities for thrombolectomy may not be available or affordable in our setting, and in some patients not practicable. Where 2-D echo facilities are available to indicate complete lysis, thrombolysis may be a way out.

Cardiomyopathy, Alcoholic↗