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Biomedical subjects

B O Osuntokun

Publications and source records attributed to B O Osuntokun.

At least 19 recordsLinked to original sources
PubMed1992

Alzheimer's disease in Nigeria.

The age-related dementias of the elderly (those aged 65 years or more) are of major public health importance in developed countries. Developing countries, most of which are undergoing epidemiological transition and greying of population, currently contain more than half of the world's population of elderly, a proportion that would reach 75% by 2020. Apart from reports from China, there is little or no information on the dementias of the elderly in developing countries. Alzheimer's disease, which accounts for two-thirds of dementia of the elderly in Caucasian population, is under-documented and believed to be rare in black Africans. But black Americans who are of black African lineage commonly suffer from Alzheimer's disease. A recent autopsy survey of the brains of elderly Nigerians showed absence of senile plaques and neurofibrillary tangles, the pathognomonic histologic lesions of Alzheimer's disease and ageing found in 25% to 80% of normal undemented elderly Caucasians and Japanese. In a community-based door-to-door survey of a population of 9000, including 932 elderly Nigerians, no subject with dementia as defined by DSM-IIIR was found, although there was significant decline of cognition with age, female sex and less than 6 years of formal education. The distribution of cognitive scores is a highly skewed unimodal curve. We emphasize the potential value of cross-cultural epidemiological studies of ethnic groups in different environments and with different prevalence ratios of Alzheimer's disease, in identifying putative environmental factors for this disease.

Adult↗
PubMed1992

Cross-cultural studies in Alzheimer's disease.

The search for risk factors for Alzheimer's disease would be greatly enhanced by identification of populations with significantly different prevalence rates, particularly if these populations consisted of ethnic groups now living in different environments and cultures. Evidence is presented that two such groups are worthy of further study: subjects of African origin living in Africa and in the West and Native Americans living on and off reserves.

Black or African American↗
PubMed1992

Rarity of dementia (by DSM-III-R) in an urban community in Nigeria.

Dementia of the elderly, a public health problem world-wide, is underdocumented in black Africa. We carried out a door-to-door survey in Idikan in NW3 ward, a political and administrative unit, with a population of 9000: in Ibadan city, Nigeria, to determine the burden of dementia. Census and demographic listing was done by trained clinical students who concurrently administered a modified Mini Mental State Examination as a screening instrument to those aged 40 years or more. Only 2 out of 932 subjects refused: 293 (31%) were aged 65 years or more. Those who were positive to the screening test and 20% of negatives were investigated by neurologists. Decline in cognitive function significantly correlated with age, female sex and low level of education. Impaired cognition was present in 41 (4.4%) but was due to depressive disorders in 7 (0.6%) patients. In none of the remaining 34 (3.8%) subjects could a diagnosis of dementia as defined by DSM-III-R be justified.

Adult↗
PubMed1979

Treatment of epilepsy: with special reference to developing countries.

1. Epilepsy, a common chronic neurological disorder, constitutes an important medical problem especially as in the developing countries there is a great dearth and shortage of health personnel, especially trained ones, in clinical neurosciences. The prevalence of epilepsy in developing countries is probably higher than in the Caucasians although accurate epidemiological data are lacking. 2. Epilepsy is discussed with special regard to the need for accurate diagnosis, and the difficulties encountered in developing countries. 3. Pharmacotherapy should be as simple as possible and suggestions are made on the essential drugs useful in the control of epilepsy with special reference to developing countries and in the context of economics and ready availability. Grand mal and focal epilepsies could be controlled by phenobarbitone, with phenytoin, sulthiame and carbamazepine kept as reserves or adjuncts. Minor (generalised) epilepsies could be controlled by ethosuximide, with clonazepam and sodium valproate (sodium dipropylacetate) as reserve drugs and adjuncts. For status epilepticus, diazepam is effective and readily available, with clonazepam and phenytoin as alternatives. 4. The problems in the management of epilepsy in the developing countries include lack of facilities and personnel to ensure accurate diagnosis and treatment, inadequate supply or non-availability of drugs, high defaulting rate of patients, the adverse and often pernicious social stigmatisation of the epileptic. 5. Possible solutions to some of these problems include integration of management (in simple terms) of convulsive disorders into the basic health system of delivery of health care in developing countries, aggressive pursuit of health education of the public by governmental and non-governmental agencies, active, intensive and sustained promotion of training of health personnel in clinical neurosciences and research aimed at producing long-acting anticonvulsants.

Africa↗
PubMed1979

Prednisolone in the treatment of pneumococcal meningitis.

The results of a steroid on 52 Nigerians (27 males, 25 females, aged 10 to 59 years) with bacteriologically proven pneumococcal meningitis are presented. Twenty-four of the patients were treated with steroids in addition to a standard regime. The clinical features on admission in the two groups were comparable and management other than steroid administration identical. Personality change with impairment of intellect was more frequent and mortality higher in the steroid-treated group although the differences wre not statistically significant. It is concluded that steroids apparently have no beneficial effect and may worsen the prognosis in pneumococcal meningitis.

Adolescent↗
PubMed1977

Stroke in the Africans.

Stroke is increasingly becoming a major cause of death and morbidity in African population among most of which the frequencies of hypertension are considerable, although hard data based on community surveys are lacking and most of the information available is from hospital data. The epidemiology of stroke in the Africans is reviewed. The frequencies in hospital populations varied from 0.9% to 4.0% and stroke accounted for 0.5% to 45% of neurological admissions. There is male predominance in published series. The main risk factors are hypertension, diabetes mellitus and homozygous sickle cell disease (in children only). Ischaemic stroke is by far the commonest clinical type encountered. These conclusions are further supported by experience at Ibadan, of over 1100 Africans seen over 18 years reported briefly in this communication. The results of the first community study over a 2-year period on the incidence of stroke in an African Urban (Ibadan) Community are presented. The study was carried out as part of a multinational multicentric study initiated and sponsored by the World Health Organization. The male to female ratio was five to two. Incidence rates reached peaks in the eighth decade in males and in seventh decade in females and were higher in males in all age groups, and the rates are comparable with those recorded in European populations, except in those under the age of 40 in Ibadan, in which age-specific incidence rates are considerably lower than in European and Japanese populations. Hypertension, diabetes mellitus constituted the main risk factors. Mortality and recurrence rates are described and are similar to experience in the Caucasians. Hypertension in the Nigerians predispose to a high frequency of cerebrovascular disease other than through mainly cerebral atherosclerosis. With increasing longevity of Nigerians and other Africans, the mortality and morbidity caused by cerebrovascular disease would probably become of enormous dimensions and adequate control of high blood pressure on a community basis may be the only way of preventing this: this would be desirable as myocardial infarction in contradistinction to hypertensive heart disease is an uncommon complication of high blood pressure in the Africans and prevention of hypertensive heart disease as shown by experience elsewhere can be achieved by control of high blood pressure, which does not seem to prevent ischaemic myocardial disease.

Adolescent↗
PubMed1976

Nutritional problems in the African region.

Energy-calorie malnutrition (ECM) is the commonest nutritional problem in developing countries in Africa: 0.5-5% of the population under 6 years of age suffer from the severe forms and 4-40% from the moderate forms. It is possible that as many as two-thirds of the preschool children in developing countries in Africa suffer from some EPM (protein-calorie malnutrition). The recent Sahelian drought and civil wars in some countries in Africa have increased the size of the problem and the severity and prevalence of EPM in several parts of Africa. The aetiological factors of EPM in Africa include shortage of calories and protein, as well as increasing and recent tendency to abandon too early breast feeding, sensory deprivation, psychological and emotional trauma, ignorance, superstition and cultural taboos. The evidence available at the moment does not clearly indicate that effects of EPM on learning and behaviour are permanent, although the functions of the brain in the acutely malnourished child are defective. Malnutrition impairs immunological capability and surveillance, and hence augments the mortality and morbidity of infections such as measles especially by impairing cell-mediated immunity and, to a lesser extent, synthesis of immunoglobulins. Endemic goitre (prevalence varies from 2 to 90% in various age groups) in several parts of Africa is due to either iodine deficiency (Ethiopia) or to the goitrogenic effect of cassava diet (Zaire and Nigeria). Deficiencies of vitamins A, B complex and D have been reported in several parts of Africa, albeit sporadically. Dietary intoxications include: a) aflatoxins which may be important in the pathogenesis of hepatic carcinoma, one of the commonest neoplasms in developing countries in Africa; b) chronic cyanide intoxication from cassava (manihot) food derivatives, which on circumstancial evidence seems to be an important aetiological factor of a crippling neurological disease, the tropical ataxic neuropathy in Nigeria and Tanzania; c) organophosphate insecticides. The rarity of certain diseases in the Africans may be related specifically to the African diet, especially the high fibre and low animal fat content of many of the African diets. Examples of such diseases are atherosclerosis in the non-hypertensive non-diabetic population, cancer of the large bowel, varicose veins and perhaps multiple sclerosis.

Africa↗
PubMed1976

Tumours within the spinal column.

Sixty-six cases of mass lesions compressing the spinal cord are presented. The masses were neoplastic in 86.36% of the cases. Epidural masses (80.30%) remain by far the largest group, consisting chiefly of Burkitt's lymphoma and various metastatic carcinomas. Only 6.06% of the lesions were intramedullary and the glioma/paraglioma remains virtually absent.

Adolescent↗
PubMed1976

The neurology of metastatic chorion carcinoma.

Although chorion carcinoma of the uterus is the seventh commonest in the comparative frequency of malignant tumours seen at the Cancer Registry of the University College Hospital, Ibadan, Nigeria (being exceeded in order of commoness by the reticuloendothelial tumours, carcinoma of the cervix, liver, breast, stomach and ovary), it is the most frequent source of tumour deposit of the brain in this hospital. Between 1960 and 1969, 197 Nigerians with chorion cancer of the uterus were admitted to UCH; in twenty-five of them the nervous system was involved during the course of their disease. The neurological involvement presented as acute cerebrovascular accident in fourteen, encephalitis in five; as primary intracranial space-occupying lesion in three cases and in one patient, as cord compression. There were no obvious neurological features in two cases in which necropsy revealed brain metastases. Involvement of the nervous system carries a poor prognosis in chorion cancer of the uterus.

Adult↗
PubMed1975

The traditional basis of neuropsychiatric practice among the Yorubas of Nigeria.

The Nigerian, because of gross shortage of 'western-trained' health personnel, not infrequently resorts to traditional native medicine and the native herbalists. The training of these native doctors is an arduous one and lasts on the average of 8-10 years. The core of their practice is handed-down tradition learned by rote and memorised. Pharmacotherapeutics are based in part on observations tested through the ages, and not uncommonly on the cause and effect phenomena. They are excellent psychotherapists, and maintain good relationship with their patients. Neurology as practised among the Yoruba native doctors recognises several classical neurological diseases including epilepsy, cerebrovascular accidents, fever and headache, migraine and the tropical ataxic neuropathy. Several often compound prescriptions are available, but the scientific basis of most of the prescriptions is for the moment unknown to them or to modern medicine. It seems that further research into some aspects of traditional native medicine may yield some fruitful results.

Culture↗
PubMedDate not supplied

Incidence of stroke in an African City: results from the Stroke Registry at Ibadan, Nigeria, 1973-1975.

Studies based on hospital populations reported from negro communities in several countries in Africa suggest that cerebrovascular disease (CBVD) shows increasing mortality and morbidity in Africans although 2 decades ago CBVD was believed to be uncommon. We report the first study in the African to determine the incidence of stroke in an urban area, Ibadan, Nigeria.

Adolescent↗