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Biomedical subjects

E A Ayoola

Publications and source records attributed to E A Ayoola.

At least 19 recordsLinked to original sources
PubMed2004

Isoniazid acetylation phenotyping in Saudi Arabs.

AIMS: The present study is designed to investigate the acetylator status in Saudi Arabs. METHODS: Isoniazid (INH) acetylation phenotyping was studied in 136 Saudi Arabs in Riyadh, Saudi Arabia, using a single plasma sample taken 3 h post-INH oral dose of 200 mg. Metabolic ratio (MR) of plasma acetyl-INH (Ac-INH) to INH was used to determine the acetylation phenotype. RESULTS: The MR had a bimodal distribution with an antimode of 1.0. The frequency distribution of slow acetylators (MR < 1.0) was 94.9% (n = 129). Using Hardy-Weinberg Law, the gene frequency (q) of the recessive allele determining slow acetylator phenotype was found to be 0.97. CONCLUSION: INH phenotyping suggests a high frequency of slow acetylators among Saudi Arabs. There was no association between the MR of plasma Ac-INH/INH and age or gender.

Acetylation↗
PubMed2002

Hepatitis E virus infection in haemodialysis patients: a case-control study in Saudi Arabia.

To determine the prevalence of antibody to hepatitis E virus (IgM anti-HEV) among haemodialysis patients and evaluate whether there was an increased risk of infection and exposure to HEV in an area of endemic viral hepatitis, serum samples obtained from 83 Saudi patients on chronic haemodialysis (group 1), 400 sex- and age-matched healthy subjects (group 2) and hospital patients (group 3) were tested for the IgM anti-HEV and IgG anti-HEV. The prevalence of anti-HEV among the patients (group 1) and the healthy controls were 4.8% and 0.3%, respectively. The difference (4.5%) was statistically significant, with a calculated odds ratio (OR) of 20.2 (95% CI = 2.1-481.0; P = 0.0002). In contrast, there was no significant difference in the prevalence rates of IgG anti-HEV (7.2% vs 10.8%) in both groups. In nonhaemodialysis patients with various diseases, 1.6% (1 of 64) of outpatients (group 3) and none (0 of 113) of the ward patients (group 4) was positive for IgM anti-HEV. Thus, the prevalence (4 of 83) of IgM anti-HEV in the haemodialysis patients was significantly higher than the rate (1 of 177) in the combined groups of nonhaemodialysis hospital patients. The calculated OR was 8.9 (95% CI = 0.92, 212.8; P = 0.037). IgM antibody to hepatitis A virus (IgM anti-HAV) was not detected in any subjects, and the prevalence rates of IgG anti-HAV were similar in the patients and controls (72.3% and 74.3% in groups 1 and 2, respectively, and 75.7% combined groups 3 and 4). The study indicated a significantly higher risk of acute HEV infection among patients on chronic haemodialysis. It is possible that these were nosocomial infections acquired by person-to-person transmission in the haemodialysis unit. However, it is more probable that the infections were community acquired, a conclusion supported albeit indirectly by the lack of a significant difference between the prevalence in haemodialysis patients (4.8%) and outpatients (1.6%). In areas of endemic HEV, appropriate strategies should be adopted to prevent the risk of HEV among haemodialysis patients.

Adolescent↗
PubMed1995

Profile of hepatitis C virus and the possible modes of transmission of the virus in the Gizan area of Saudi Arabia: a community-based study.

The seroprevalence of antibody to hepatitis C virus (anti-HCV) and the possible modes of transmission of HCV were investigated in Gizan, southern Saudi Arabia. The sample size chosen to give an adequate estimate of the seroprevalence, about 1500, was based on the assumption that 5% of the population in Gizan were anti-HCV-positive. Sera from 1482 subjects (705 males, 777 females; aged > or = 10 years) were initially screened for anti-HCV using a commercial, ubiquitin-based enzyme immunoassay. Repeatedly reactive sera were confirmed positive using second-generation immunoassays. Serum samples were also tested by ELISA for hepatitis B surface antigen (HbsAg) and antibodies to this antigen and to the hepatitis B core antigen. Of the subjects tested, 27 (1.8%) were anti-HCV-positive. Exposure to HCV was generally similar in both sexes, age-prevalence curves for anti-HCV peaking in males aged > 49 years (6.2%) and in females aged 40-49 years (5.0%). In the youngest subjects, those aged 10-19 years, the HbsAg carrier rate was significantly higher in males (10.4%) than in females (3.6%). Exposure to the hepatitis B virus was similar in both sexes (31.0% in males v. 28.6% in females). Some 7.4% and 14.8% of the 27 anti-HCV-positive cases had histories of schistosomiasis and blood transfusion, respectively. The corresponding values for the 1455 anti-HCV-negative cases investigated, 1.1% for schistosomiasis and 3.5% for blood transfusion, were much lower. The spouses and other family members of eight anti-HCV-positive index cases were investigated but none was anti-HCV-positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

The diagnostic utility of serum ferritin. Estimation in patients with primary hepatocellular carcinoma.

Serum hepatitis B surface antigen (HBsAg) status and ferritin levels were measured in 3 groups of subjects: Group A (n = 14) with chronic non-neoplastic liver disease (CNLD), Group B (n = 14) with primary hepatocellular carcinoma (PHC) and Group C (n = 14) comprising healthy matched controls without liver disease. Serum ferritin values were lowest in Group C, intermediate in Group A and highest in the Group B patients (all p < 0.05). About 79% of the patients with PHC, 43% of those with CNLD and none (0%) of the healthy controls, had hyperferritinaemia (serum ferritin > 400 ng/ml). Hyperferritinaemia and HBsAg positivity coexisted in 15% and 73% of the patients with CNLD and PHC, respectively. Hyperferritinaemia and HBsAg were significantly positively related in the patients with PHC (chi 2 5.09, p < 0.05). The predictive indices of hyperferritinaemia in chronic liver disease appeared superior for PHC than for CNLD, and became somewhat enhanced with coexisting HBsAg positivity. These results suggest that serum ferritin could be useful as a tumour marker for PHC in patients with established chronic liver disease.

Adult↗
PubMed1994

Serum alphafoetoprotein, hepatitis B virus infection and primary hepatocellular carcinoma in Nigerians.

Serum alphafoetoprotein and hepatitis B antigen were estimated by radioimmuno-assay and haemagglutination methods respectively in 42 Nigerian adults comprising 14 subjects in each of three groups, viz, controls, liver cirrhosis and primary hepatocellular carcinoma. At an abnormal concentration of serum alphafoetoprotein greater than 200 micrograms/L, a correct diagnosis of primary liver cancer was made in 64.3% of the patients at a specificity of 100%. However, no correlation was found between serum concentrations of alphafoeto-protein and status of hepatitis B surface antigen in the patients with primary liver cancer. It may be concluded that serum alphafoeto-protein is useful in the diagnosis of primary hepatocellular carcinoma in Nigerians and secretion of the onco-foetal protein by neoplastic hepatocytes is unlikely to be influenced by hepatitis B virus infection.

Adult↗
PubMed1994

Cardiovascular systemic invasion by hepatocellular carcinoma: incidence and pattern in a west African population.

To determine the frequency of cardiovascular systemic invasion by hepatocellular carcinoma (HCC). Eighty-one Nigerian patients who had autopsy examinations were studied. Of these, 36 (44%) had tumour thrombi within the cardiovascular system (CVS) or metastases to the heart itself. Compared with the patients without CVS invasion, no clinicopathologic findings distinguished these two groups from each other. Furthermore, CVS invasion did not worsen the generally bad prognosis of these patients with liver cancer. It is concluded that CVS invasion is frequent and difficult to diagnose by clinical examination. Patients who are selected to undergo hepatic resection must be assessed by imaging techniques to exclude CVS invasion. However, it is unlikely that frequent and routine imaging procedures will affect the generally bad prognosis of the majority of the patients.

Adolescent↗
PubMed1992

Seroepidemiology of hepatitis B virus infection in Saudi Arabian children: a baseline survey for mass vaccination against hepatitis B.

Saudi Arabia is considered to be an area of endemic hepatitis B virus (HBV) infection. By adult age, 7% persons have hepatitis B surface antigen (HBsAg) and about 70% have one or more HBV markers. In order to provide a baseline for the integration of hepatitis B vaccine into the extended programme of immunisation (EPI), a population-based survey of HBV markers was made among Saudi children. The overall prevalence of HBsAg was 6.7%, with at least one HBV marker being positive in 19.7% persons tested. Two peaks of HBV prevalence were observed in the 7- and 10-year-old children respectively. The prevalence of HBsAg was steady in all age groups with identifiable but insignificant peaks in children aged 4 and 7 years respectively. Despite the apparent homogeneity of the Saudi population, the prevalence rates of HBV varied among the regions and were higher in urban dwellers. There was no significant difference in the HBsAg prevalence for the sexes (7.3% for males and 6.0% for females). Socioeconomic factors and family size did not significantly influence the prevalence of HBV among children. Of 307 HBsAg-positive children, 55 (17.9%) were positive for HBeAg. The early acquisition of HBV in the Saudi population is confirmed. The most effective strategy for HBV control, therefore, is by mass vaccination of all Saudi infants. An extension of the immunisation programme so as to include all pre-school children should further reduce the reservoir of HBV in Saudi Arabia. A repetition of a similar survey after 5 and 10 years should be made in order to measure this reduction.

Child↗
PubMed1992

Helicobacter pylori and dyspepsia in an Arab population.

To determine the incidence and significance of the detection of Helicobacter pylori in an Arab population, 116 patients with dyspepsia were studied. 89 percent of these patients had H. pylori detected by culture or/and histological definition of Campylobacter-like organisms. By the modified rapid urease test (RUT) 80% of the patients had H. pylori (sensitivity of 91%, specificity of 75%). Irrespective of the endoscopic diagnosis, the presence of H. pylori was associated with histologic evidence of gastritis. A heavy growth of H. pylori on culture was associated with active gastritis. There was no difference in the incidence rates of H. pylori with regard to various diagnoses by endoscopy. It is suggested that H. pylori may be hyperendemic among Arab patients with dyspepsia. Its presence is associated with varying severity of gastritis with or without additional endoscopically recognised findings.

Chronic Disease↗
PubMed1992

Prevalence of antibodies to hepatitis C virus among Saudi patients with chronic liver diseases.

The prevalence of antibodies against hepatitis C virus (anti-HCV) was determined in 55 patients with chronic liver diseases including liver cirrhosis (42 patients), liver cirrhosis and hepatocellular carcinoma (8 patients), and chronic active hepatitis (4 patients). A total of 63.6% of these patients were positive for anti-HCV, a significantly higher prevalence than the rate of 3.9% observed in 488 asymptomatic volunteers. Of the 42 patients with liver cirrhosis 16 (38.1%) had positive anti-HCV without any markers of hepatitis B virus (HBV), while 12 (28.6%) had markers of neither HCV nor HBV infection. Our findings suggest that HCV infection may play a significant role in the pathogenesis of chronic liver disease in Saudi Arabia, which is an area of endemic HBV infection. Screening for anti HCV should be considered mandatory in patients with chronic liver disease (CLD) especially where the etiology appears obscure.

Adult↗
PubMed1991

Prevalence and significance of antibodies to hepatitis C virus among Saudi haemodialysis patients.

Seventy-four patients who were maintained on chronic haemodialysis in King Khalid University Hospital, Riyadh, Saudi Arabia were tested using the recently available ELISA to determine the prevalence of antibodies to hepatitis C virus (anti-HCV) in a haemodialysis unit. The prevalence rate of anti-HCV antibodies of 41.9% in the haemodialysis patients was significantly higher than the rate of 3.9% detected in 488 asymptomatic blood donors who were similarly tested. In the haemodialysis patients, anti-HCV positivity was related to previous blood transfusion (greater than 5 units of blood) and to the duration of haemodialysis (greater than 4 years); but was unrelated to sex, age, positive HBV markers or to past or current elevation of serum ALT. The results indicate a relatively higher prevalence of anti-HCV antibodies in our patients compared to rates of 1-20% reported from Europe and the U.S.A. An effective control strategy for HCV infection in this high risk group is urgently indicated.

Adolescent↗
PubMed1991

Prevalence of antibody to hepatitis C virus among Saudi Arabian children: a community-based study.

In a population-based survey, 39 (0.90%) of 4,496 Saudi Arabian children (ages 1 to 10) were positive for antibody to hepatitis C virus. No significant difference was seen between the prevalence rate in males (0.9%) and females (0.8%) or between urban (0.7%) and rural dwellers (1.0%). A significant variation of rates (0% to 5.7%) was seen from one region to another. The Gizan population, noted for hyperendemic hepatitis B virus infection, had the highest prevalence of antibody to hepatitis C virus despite its cultural and socioeconomic similarities to other regions. In some regions of Saudi Arabia the prevalence of antibody to hepatitis C virus among children was 0% despite endemic rates for both hepatitis B virus and hepatitis A virus infections. An inverse relationship between age and antibody to hepatitis C virus positivity was noted, suggesting an early acquisition of infection in the population studied. Although the overall prevalence of antibody to hepatitis C virus in Saudi children appears low, endemic foci exist where transmission of infection appears to occur early in childhood. The significance of this characteristic for the incidence of chronic sequelae of hepatitis C virus infection needs further evaluation.

Age Factors↗
PubMed1989

Hepatitis B surface antigen and immunoglobulin M complexes in chronic carriers and patients with acute and chronic liver diseases.

To determine the incidence and significance of circulating complexes between hepatitis B surface antigen (HBsAg) and immunoglobulin M (IgM), a total of 152 Nigerian adults with acute or chronic liver diseases were studied. They were compared with 100 chronic HBsAg carriers and 20 healthy volunteers. In HBsAg carriers HBsAg-IgM complexes persisted in 10% over a period of 6 months. In 53 cases of acute hepatitis B, 79% acute phase sera had detectable complexes. This initial incidence fell to 15% at 6 months. In the group of chronic liver diseases, the detection of HBsAg-IgM complexes occurred relatively infrequently. Circulating HBsAg-IgM complexes were associated with the presence of hepatitis B e antigen and a higher predisposition to chronicity after acute hepatitis. It is concluded that the presence of these complexes is specific to hepatitis B virus infections and may predict evolution to chronic liver diseases in Nigerians.

Adolescent↗
PubMed1989

Dyspepsia in Ibadan.

In a prospective study between January 1982 and December 1986, 402 patients with dyspepsia were seen at the gastroenterology clinic of the University College Hospital, Ibadan. The patients were evaluated using upper gastro-intestinal fibre-optic endoscopy in addition to laboratory and radiological examination. Out of these, 374 patients were later analysed for the present study. Of the group, 14% had peptic ulcers (duodenal ulcer 10.3%; gastric ulcer 3.7%); and 26.7% had mucosal inflammation of oesophagus and gastroduodenum. 55% had no lesion as observed by endoscopy. Our observation therefore indicates that most of the dyspeptic patients at Ibadan have non-ulcer dyspepsia. The pathogenesis of dyspepsia is briefly discussed.

Adolescent↗
PubMed1987

Hepatitis B vaccine in pregnancy: immunogenicity, safety and transfer of antibodies to infants.

To determine the safety and immunogenicity of hepatitis B vaccine in pregnancy, 72 pregnant Nigerians who were negative for markers of hepatitis B virus (HBV) were given two intramuscular doses of vaccine (Heptavax, Merck) in the third trimester. One month after the second dose (at T2), 84% were anti HBs positive. No significant effect was observed in the mothers or their newborns. Passive transfer of anti HBs occurred in 59% of the newborns. The antibodies disappeared rapidly in these infants and by 3 months only 23% had detectable antibodies. No HBsAg carrier status developed in this group. In contrast, the infants born to HbsAg positive mothers had a cummulative rate of HBV events of 20%. It is concluded that HBV vaccine is safe and immunogenic in pregnant females. The passive immunity conferred on the infants is of short duration. Therefore, infants in endemic areas should be vaccinated early, preferably within 3 months of birth. Vaccination of pregnant mothers may provide adequate protection before the child is vaccinated.

Adult↗
PubMed1986

Intradermal vaccination against hepatitis B virus infection in an endemic area (Nigeria), two year results.

To determine the efficacy and safety of hepatitis B vaccine (Hevac B) given intradermally, 125 Nigerians (aged 1 year to 45 years), who were negative for hepatitis B virus markers, and randomised into two groups were vaccinated. Group 1 (64 volunteers) was given 3 monthly doses of 2 micrograms vaccine mixed with adjuvant subcutaneously (Institut Pasteur Production-Hevac B) while group 2 (61 volunteers) received 3 doses of 2 micrograms non-adjuvated vaccine intradermally given 1 month apart. A month after the third dose 83 per cent of group 1, 71 per cent of group 2 showed positive response by developing antibody to hepatitis B surface antigen. The levels of antibody were significantly higher in group 1 at each stage of the follow-up period, including a month after a booster vaccination was given. The positive response was maintained in almost all the initial responders for the 24 month duration of the study. No significant side effect was documented in any of the participants. The results suggest that population at risk in developing countries could be protected with small doses of vaccine administered intradermally.

Adolescent↗
PubMed1986

Non-ulcer dyspepsia in Nigerians clinical and therapeutic results.

To determine the role of hyperacidity non-ulcer dyspepsia, forty-five Nigerians with this diagnosis were compared with twenty patients with proven duodenal ulcer with regard to their basal, maximal and peak acid outputs. The mean basal, maximal and peak acid outputs for the duodenal ulcer group were 6.72, 21.4 and 30.6 mol/h, respectively. In contrast, the corresponding values in non ulcer dyspepsia were 3.46, 13.03 and 17.83 mol/h respectively. This value in the two groups were significantly different. The efficacy of ranitidine at 300 mg daily for the control of the symptoms of non-ulcer dyspepsia was compared with placebo in a double-blind 4-weeks clinical trial. There was no significant difference in the response of the two groups comprising twenty-three and twenty-two patients, respectively. It is concluded that hyperacidity probably plays little role in non-ulcer dyspepsia and that the newer anti-ulcer drugs may be of little benefit under these circumstances.

Adult↗
PubMed1986

Radiological and endoscopic correlation in upper gastrointestinal haemorrhage and malignancy.

Conventional barium meal and endoscopic findings were compared in 75 patients with upper gastrointestinal (UGIT) haemorrhage and 43 patients with clinically suspected UGIT malignancy. Conventional barium meal missed 3 cases of malignancy and gave a false positive haemorrhage, barium meal helped to locate the source of bleeding correctly in 38 patients only 50.7%). While efforts should continue to be made to improve radiological yield, endoscopy, where a available, should be preferred in investigating UGIT diseases.

Barium Sulfate↗