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B O Onadeko

Publications and source records attributed to B O Onadeko.

63 records · Page 4Linked to original sources
PubMedDate not supplied

Prognostic factors in the management of exacerbation of chronic obstructive pulmonary disease in Kuwait.

OBJECTIVE: To evaluate the clinical presentation and the factors of prognostic importance in the management of exacerbation of chronic obstructive pulmonary disease (COPD). SUBJECTS AND METHODS: One hundred and four patients who were hospitalized because of exacerbation of COPD between 1996 and 2000 were selected for further evaluation. Only patients who fulfilled the American Thoracic Society criteria for diagnosis of COPD were included. The factors examined included age, clinical features, duration of symptoms of exacerbation, severity of underlying disease, comorbid diseases, level of consciousness, previous hospitalization, intubation and assisted ventilation, hypercapnia, degree of acidemia and complications. RESULTS: Seventy-four of 104 (71%) hospitalized patients reviewed met the inclusion criteria for COPD. The mean age was 63.68 +/- 12.6 years. There was a male:female ratio of 3:1. Fifty-eight patients (78%) had a baseline FEV1 <50% before hospitalization and 45 (64%) had previous hospitalization. Comorbid disease was found in 50% of the cases, while 78% had acidemia and 70% hypercapnia. Fourteen (19%) died on admission. Risk factors identified included severity of disease (p < 0.05); presence of comorbid disease (p < 0.01); acidemia (p < 0.0001); hypercapnia (p < 0.0001); previous hospitalization (p < 0.01), and assisted ventilation (p < 0.001). CONCLUSION: This study revealed that the presence of comorbid disease, acidemia, previous hospitalization and assisted ventilation significantly contributed to mortality in patients with exacerbation of COPD.

Aged↗
PubMedDate not supplied

Relationship of the ECG with ventilatory function tests in chronic obstructive lung disease (COLD) in Nigerians.

Although the most objective assessment of the severity of COLD is done by spirometer, this is not as readily available in Nigeria as the electrocardiograph, thus the ECG is often used to assess it. This study examines the relationship between the ECG findings and FEV 1 obtained by spirometry and expressed as a proportion predicted for age and sex in 92 Nigerians with COLD of which 39 had associated pulmonate. There was an inverse relationship between the mean electrical axis of the P wave on the ECG and the FEV 1 of predicted. The axis was more positive (82 +/- 12 degrees) among those with FEV 1 less than 50% of predicted (group 1) and this decreased progressively with increasing FEV 1 to 72 +/- 14 degrees in those with FEV 1 between 50-70% (group 2) and 67 +/- 16 degrees in those with FEV 1 greater than 70% (group 3). There was also a significant relationship between FEV 1 and the development of cor pulmonale and 71.4% of those who had the lowest FEV 1 (group 1) had cor pulmonale while the proportion decreased with the reduction in the severity of airway obstruction. A rightward P wave axis greater than 80% was statistically significant associated with development of cor pulmonale (X2 = 29.5 (P < 0.001) of those with COLD and cor pulmonale, 72.2% had a P wave axis greater than 80%. Only 13.2% of those with COLD alone had a P wave axis greater than 80 degrees. Cardiac arrhythmias were present in 28 patients, ventricular (VA) in 23 cases, and atrial (AA) in 7 cases. Both AA and VA were associated with more severe airway obstruction. All 3 patients who had atrial fibrillation (AF) and FEV 1 below 50% of predicted (group 1) and had cor pulmonale while 2 of the remaining 4 with AA also were in group 1 and the remaining 2 in group 2. The distribution of ventricular arrhythmias (VA) showed that 10 (43.5%) were in group 1, 9 (39.1%) in group 2, and 2 (8.7%) in group 3. Both VA and AA were also significantly related to the development of cor pulmonale. A P wave amplitude greater than 2.5 mm was significantly related to the development of clinical cor pulmonale X2 = 24.6 P < 0.001. The results show that ECG findings correlate well with spirometric assessments of FEV 1 and clinical severity in Nigerians with COLD and are, therefore, useful where spirometry is unavailable.

Adult↗
PubMedDate not supplied

The clinicopathological pattern of carcinoma of bronchus and lung in Africa: a 20-year clinical, histopathological, and autopsy study in Ibadan, Nigeria.

The clinicopathological pattern of carcinoma of the bronchus at the University College Hospital, Ibadan over a 20-year period, 1971-1990, was studied. An increased incidence of this disease was observed when compared to the study that was carried out in the sixties in the same environment. The reasons for the increase in incidence and the pattern of clinical presentation are discussed. The findings suggest that increasing industrialization and increased acquisition of modern diagnostic facilities are responsible for the increased incidence. The factors responsible for the poor response to treatment in the series are also discussed.

Adolescent↗
PubMedDate not supplied

Serum calcium levels in patients with active pulmonary tuberculosis.

One hundred and two consecutively diagnosed pulmonary tuberculosis patients were recruited and followed up to ascertain the occurrence of hypercalcaemia before and during treatment with the modified short course antituberculosis therapy. Forty-five patients had hypocalcaemia at presentation, four of whom had hypoalbuminaemia. All those with hypocalcaemia had moderate to extensive radiographic disease on enrollment with BMI of less than 20. On commencement of treatment with the modified short course therapy, two of those with extensive cavitary radiographic disease developed transient asymptomatic hypercalcaemia. Although the hypoalbuminaemia and the hypocalcaemia seem to be related to the extent of radiographic disease and the poor nutritional status of the patients at presentation, no specific cause for the transient hypercalcaemia was found.

Adolescent↗
PubMedDate not supplied

An open study to evaluate the safety and efficacy of zafirlukast ("Accolate") in patients with mild to moderate asthma in Ibadan, Nigeria.

An open study to evaluate the safety and efficacy of Zafirlukast (oral leukotriene-receptor antagonist) in patients with mild to moderate asthma was conducted at the out-patient department of the University College Hospital (UCH), Ibadan. A total of 30 patients aged 16-70 years were screened into the trial but 20 patients that fulfilled the inclusion and exclusion criteria were enrolled in a 7-week open study to receive 20mg b.i.d. of "Accolate". Efficacy of treatment was assessed by changes in symptoms, beta-agonist use and pulmonary function tests (PEFR and FEV1). Safety was assessed by adverse experiences, laboratory test results, results of physical examination and chest-x-ray (when necessary). Zafirlukast (Accolate) significantly decreased daytime asthma symptoms scores (28.8%), night-time awakenings (80.76%), morning with asthma (36.4%) and beta-agonist use (31.3%) and significantly increased the mean PEFR values (11.3%); FEV, (17.4%) at end point from their baseline values. Changes in symptoms, beta-agonist use, and pulmonary function occurred within the first week of zafirlukast treatment and continued throughout the trial. Zafirlukast was well tolerated. Headache was reported in two patients. No significant changes were observed in laboratory test results, findings on physical examination. I concluded that zafirlukast produces early and sustained effects in the treatment of mild-to-moderate asthma.

Adolescent↗
PubMedDate not supplied

Ventilatory function in normal Nigerian school children.

Lung function studies were performed on 522 school children in Ibadan to determine normal values among Nigerian School children. From four schools 257 boys and 265 girls aged 7 - 18 with different socio-economic background were selected. The forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) wee estimated using the wedge bellows vitalograph. It was observed from the results that the mean FVC and FEV1, values were lower than the predicted mean values matched for age, sex, height and weight. It was further observed that the values obtained were lower than those of the caucasian children. However, it was observed that the FVC values correlate significantly with age, weight and height (P less than 0.01).

Adolescent↗
PubMedDate not supplied

Clinical trial of sulbactam/ampicillin in the treatment of typhoid fever, and in-vitro sensitivity of isolates to sulbactam/ampicillin and chloramphenicol.

A trial of Sulbactam/Ampicillin in treatment of typhoid fever was carried out while in-vitro sensitivity of the drug was compared with chloramphenicol. Sulbactam/Ampicillin was found to be effective in 11 out of 12 patients who received the drug. The 1 patient who failed to respond had intestinal perforation with peritonitis. No side effects were encountered. The in-vitro study showed that 91.7% of the isolates were sensitive to sulbactam/ampicillin compared to 75% sensitivity to chloramphenicol. The difference was however not statistically significant (P < 0.05). It is concluded that sulbactam/ampicillin is effective and safe in the treatment of typhoid infection.

Adolescent↗
PubMedDate not supplied

Peak expiratory flow rate in normal Nigerian children.

Peak expiratory flow rate was estimated in 569 school children in Ibadan to determine normal values in Nigerians. Two hundred and seventy-six boys and 293 girls, aged 6-18 without antecedent history of respiratory disease, from different socio-economic backgrounds were selected. The peak expiratory flow rate (PFR) was estimated using the Wright peak flowmeter. The results indicated that the mean values of Nigerian children were lower than those of Caucasians of the same height, sex and age. The possible reasons for this are discussed. The PFR values were found to correlate highly (P less than 0.01) with age, weight and height, and also with FVC and FEV1. In this study, PFR correlated more closely with weight than height, contrary to the results observed in Caucasian children. Since there is a positive correlation between PFR and FVC or FEV1, PFR can therefore be used in assessment of respiratory function in clinical practice, particularly in younger children, who cannot adequately cooperate when the spirometer is used for lung-function studies.

Adolescent↗