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Biomedical subjects

E A Bamgboye

Publications and source records attributed to E A Bamgboye.

At least 19 recordsLinked to original sources

Demographic factors in HIV infected patients seen at UCH, Ibadan, Nigeria.

There is a rising rate of Human Immunodeficiency Virus (HIV) infection in Nigeria. Good knowledge of the demographic characteristics of the patients with HIV/AIDS may be of great importance in understanding its epidemiology in Nigeria and could facilitate efforts at curtailing the spread of the infection. The study was planned to determine the demographic factors in Nigerian patients with HIV infection. The study was conducted at the University College Hospital (U.C.H), Ibadan, located in the South West of Nigeria. It was a retrospective study of patients with HIV infection attending the U.C.H. from 1988 to 2002. The data collected from the clinical records of the patients with HIV infection included age, sex, marital status, number of spouses, tribe, occupation, education and their religious affiliation. A total of 460 patients aged 1-76 years with peak at 30-34 years were studied. The male/female ratio was 1.06 and the males were the older group. Traders accounted for 40% with female preponderance while the artisans (19.9%) and the military (2.9%) were mostly males. The patients were of Yoruba (70.6%), Igbo (20.0%) and Hausa (9.1%) races. Among the patients with marital status, majority (71.4%) were married while those separated and widowed accounted for 3.5% and 2.6% respectively. Also, a higher proportion of the female HIV patients were Christians whereas the majority of the males were of Islamic religion. Although, there was a low frequency of records on education, the males had better formal education. In conclusion, the study shows that HIV infection is presently an adult disease affecting the most productive segment of the Nigerian population regardless of the individual occupation, educational status, tribe and religious affiliation. Also, it shows that the infection could be associated with heterosexual intercourse.

Adolescent↗

Outcome of patients with systemic lupus erythematosus in intensive care unit.

The objective of the study was to identify the causes, outcome and prognosis of severe illness in patients with systemic lupus erythematosus (SLE) requiring intensive care unit (ICU) care in a University Hospital over a five-year period. The design was a cohort study. Forty-eight SLE patients requiring ICU management over a five-year period (January 1997-December 2001) were studied prospectively. Of 48 patients, 14 (29.2%) died, predominantly with multiorgan dysfunction syndrome (MODS). Patients whose APACHE II score was equal to or greater than 20 had higher mortality than those with APACHE score below 20 (60 versus 7.1%; and P < 0.01). All the 18 patients whose health status rated as 'good' survived, while 46.7% of 30 patients whose health rated as 'poor' died (P < 0.01). Patients who had thrombocytopenia associated with sepsis and/or disseminated intravascular coagulopathy (DIC) had the highest mortality (75%, five-year survival). In conclusion, SLE patients admitted to the ICU had a lower mortality rate than some of the previous reports. Patients with SLE with high APACHE score, > or =20, poor health status, thrombocytopenia and multiorgan dysfunction syndrome had poor prognosis in the ICU.

APACHE↗

Factors associated with growth faltering in children from rural Saudi Arabia.

Recent studies on the growth of children in Saudi Arabia have revealed that children under two years of age suffer from faltering growth when compared with the American reference population. The present study aims to identify parental and child characteristics associated with faltering growth among the children in a rural area of Saudi Arabia. A cross-sectional study of all women with a child less than three years of age in a rural community in NorthWestern part of Saudi Arabia was undertaken. Anthropometric measurements, socio-demographic and fertility variables were collected using a structured questionnaire. The indicators of growth were derived from the data and univariate and logistic models fitted to determine potential risk factors. There were 332 children, sex ratio 1.35 and 94.3% were less than 2 years of age. A low frequency (1.5%) had low weight for height, 11.4% low weight for age and 36.1% low height for age when compared with the American NCHS reference population. Multiple logistic regression suggested birth space > 2 years (OR = 0.44, 95% CI = 0.25 - 0.77), father's with primary or intermediate education (OR = 0.45, 95% CI = 0.25-0.90), birth weight > 2500 gms. (OR = 0.8, 95% CI = 0.03-0.75), male birth (OR = 2.60, 95%. CI = 1.54-4.59) were variables statistically and independently associated with faltering growth. The pattern of growth of children under 2 years deviated negatively from their NCHS-WHO reference. This is similar to the previous findings from urban communities in Saudi Arabia. This growth faltering could be attributed partly to the inadequacy of the reference to compare growth pattern of children in all geographical areas, of the world. While the effects of different dietary habits may not be ruled out, it may be important to develop a different anthropometrics and nutrients growth chart that could be more appropriate to compare variation of infant growth in all nations of the world.

Adolescent↗

The Ibadan glaucoma study.

To obtain epidemiological data on the prevalence and risk factors for open angle glaucoma in hospital workers of African origin, and investigate appropriate methods of a rapid, cost-effective screening procedure for glaucoma. A cross-sectional study of workers in the University College Hospital (UCH) Ibadan, using a structured questionnaire for data collection. The variables available for data analysis include workers demographic characteristics, visual acuity, pupil status, intraocular pressure, cup-disc ratio, central visual fields, family history of glaucoma, chronic diseases such as hypertension and diabetes. The data was analysed with EPI-INFO version 6.02 for simple analysis, while the SPSS package was used for multivariate analysis. A total of two thousand, one hundred and nine (2,109) UCH workers participated in the screening exercise for glaucoma. A high majority of the workers 1794 (85.1%) were negative to the diagnosis of glaucoma, while the remaining 315 (14.9%) were suspected to have glaucoma out of which 57 (2.7%) were confirmed as definite glaucoma cases. The prevalence of glaucoma among UCH workers was 27 per 1000, 95%, confidence interval = 20 per 1000, 35 per 1000. Factors associated with glaucoma were relative afferent pupillary defect, cup-disc ratio greater than 0.7, intraocular pressure, family history of glaucoma and the presence of chronic diseases such as diabetes. The left eye appears to have a higher probability of ocular problems compared with the right eye. The prevalence of glaucoma among hospital workers was 2.7% The cup-disc ratio appears to be a better diagnostic tool for glaucoma since it gives the best positive predictive value (with a cut-off point of 0.7) than all other variables.

Adult↗

Open fractures of the lower limb in Nigeria.

During an 18-month period we studied prospectively 63 consecutive patients (42 males, 21 females) with an open fracture of the lower limb. Their mean age was 32 years (range: 4-78 years) and 58 patients with 59 fractures were available until the conclusion of the study. Forty-seven had tibial fractures, 12 had femoral fractures and the majority of the patients were either students or traders. According to Gustilo and Anderson's grading, 21 fractures were of type II and 16 of type IIIA. On arrival all the wounds were irrigated and debrided and the patients also received tetanus prophylaxis and intravenous antibiotics. Of the 47 tibial fractures 39 were managed with an above-knee plaster of Paris cast which was windowed so as to allow wound care. Of the 12 femoral fractures ten were treated with skeletal traction on a Bohler frame. The time taken for soft tissue healing was not significantly different between the tibial and femoral fractures. There were, however, significant differences with respect to (1) the time interval between injury and debridement, (2) the incidence of wound infection, (3) the occurrence of osteomyelitis, (4) fracture union time, and (5) time spent in hospital. The most common complications were wound infections (27 cases) and delayed union (26 cases). The time interval between injury and wound debridement was a major prognostic factor.

Adolescent↗

Double-blind, placebo-controlled, randomised cross-over clinical trial of NIPRISAN in patients with Sickle Cell Disorder.

The study was undertaken to determine the safety and efficacy of NIPRISAN, a phytomedicine, developed for the management of patients with Sickle Cell Disorder (SCD). The study design is a placebo-controlled double blind cross-over trial. Eighty-two (82) patients with SCD were recruited and randomised into two groups. An initial 4 month pre-trial study was undertaken to determine the similarity of the groups. The main study was conducted over a twelve-month period with crossover at six months. Safety of the drug was assessed clinically and biochemically. NIPRISAN significantly (P < 0.01) reduced the frequency of SCD crisis associated with severe pains. Acute toxicity to the liver assessed by the activities of liver enzymes, indicate that NIPRISAN is safe. Renal function assessed by the serum levels of creatinine and blood urea nitrogen remained normal. Both the clinical and laboratory results of the present phase IIB (pivot) clinical study suggest that NIPRISAN is a safe and efficacious phytomedicine for the management of patients with Sickle Cell Disorder.

Adolescent↗

Spinal tuberculosis: a 15 year review at OAUTHC Ile-Ife.

A review of the hospital records over 15 years was made. The objective of the study was to describe the clinical presentation, management and outcome of spinal tuberculosis. Thirty-four patients were studied. There were 15(44.16%) males and 19 (55. 9%) females. Their age range was 2-80 years with mean (+/- SD) of 25.28 +/- 22.33 years. The occupations most commonly affected are Students (44.1%), Pre-school Children (17.6%) and Traders (14.7%). Back pain (100%), weight loss (47.1%), paraparesis (47.1%), kyphotic spinal deformity (32.4%) and night sweats (29.4%) were common features. Only 26.5% patients had active pulmonary tuberculosis. All the vertebral segments were involved. The Lumbar spine was the most involved vertebral segment in 50% patients. Using the Westergren method the mean (+/- SD) Erythrocyte Sedimentation Rate (ESR) mm/hour at the initial diagnosis was 83.58 +/- 31.11 mm/hour whereas three months after the commencement of antituberculosis chemotherapy it was 30.06 +/- 11.96 mm/hour. All the patients were given multiple antituberculosis drugs therapy and spinal traction. Spinal support was offered when the patients became ambulant. At the end of two years follow-up, 94.1% patients were alive, while 5.9% patients died during the course of treatment due to overwhelming sepsis. Among the patients that were alive, 14.7% still had persistence of their neurological deficit ie. paraparesis. Ten percent of the patients were mobilised on crutches while 5.96% were confined to wheelchair. This study shows that in tuberculosis endemic areas, symptom of back pain especially in the younger age group should be thoroughly investigated as this group constituted the largest affected population.

Adolescent↗

Students admission grades and their performance at Ibadan University pre-clinical MBBS examinations.

OBJECTIVE: The main objective of this study was to examine the admission grades in Senior School Certificate Examinations (SSCE) and Joint Admission Matriculation Board (JAMB) Examinations in relation to their performance at the pre-clinical class, at the University of Ibadan medical school. A descriptive, cross sectional study was carried out from December 1998-April 1999. Records of students' admitted into the medical school in 1991/92 session were studied. The results showed a stronger correlation in the performance of the students at the 100 level examination and the Part 1 MBBS examination with the SSCE grades than their JAMB scores. Students admitted on merit according to JAMB scores performed averagely better than their other counterpart with lower JAMB scores. This result demonstrated that the SSCE scores are a better predictor of performance at preclinical MBBS examination than the JAMB scores. More attention needs to be placed on the quality of SSCE scores during admission into the medical school.

Adolescent↗

Appraisal of clinical, psychosocial, and environmental health of elderly in Saudi Arabia: a household survey.

This was a cross-sectional national survey of the elderly population of Saudi Arabia conducted between January 1994 and December 1995. The participants' physical, mental, social, and environmental health status were assessed in a personal interview during which a structured data form was completed by a trained research team. Data on 6,139 elderly participants have been analyzed: 64.2 percent were males mean age: 69.2 +/- 7.8 years which was higher than females 68.0 +/- 7.6 years (P < 0.0001). The widowhood (46.7%) status was also higher than the widowerhood (4.1%) and 9.3 percent of the participants were never married. The proportion of female illiterates (95.8%) was higher than the males (71.4%). The proportion of participants with definite psychopathology was 33.8 percent and this increased with age and higher among females than males. Overall, 18.8 percent were dependent on others for ADL. Other clinical findings included visual impairment (46.1%) and difficulty in hearing (19.9%). However, a sizeable majority (72.2%) enjoyed good health. Only 3.7 percent lived alone. The proportion of the elderly taking part in any recreational exercise was 14.7 percent and only 4.3 percent had any experience of physical therapy. There were no special hospital wards for the elderly patients, and they were treated by general internists. There is a need for a national cost-effective program for the care of the elderly. The present widespread primary health care centers can be upgraded to coordinate the proposed services.

Activities of Daily Living↗

A comparative study of students' performance in preclinical physiology assessed by short and long essays.

The performance of 540 medical (MBBS) and 55 dental (BDS) students in short essay questions (SEQs) in preclinical physiology was compared with their performance in long essay questions (LEQs). The cohort was made up of 88 repeating and 452 non-repeating MBBS students and 12 repeating and 43 non-repeating BDS students. The SEQs and LEQs used for the study were those administered to the students in the paper II of the Part I MBBS/BDS examination. The results showed that all the students did significantly better in LEQs than in SEQs. When the students were sub-divided into repeaters and non-repeaters, performance in LEQs was still significantly better in all cases, except in the BDS repeaters where the difference was not significant. The study also showed that the BDS students did significantly better than the MBBS students in LEQs. Further analysis showed that the latter was due to a much better performance in LEQ 4 by the BDS students. In the SEQs, MBBS non-repeaters did better than repeaters while the situation was reversed with the BDS students. For all categories of students, on no occasion was the mean score in the LEQs or the SEQs up to 20.0, which is the 50% score and pass mark in this examination. The likely reasons for the better performance of the students in LEQs than in SEQs were discussed. The better performance of the BDS students in LEQs is believed to be due to the double exposure time of the BDS students to the topics from which LEQ 4 is drawn. From our results, it was concluded that LEQs are more useful than SEQs in assessing these students. In addition, the highly significant cross-correlation between scores in questions 1, 2, 3 and 4 suggested that the inherent problem of examiners' subjective judgement in essay marking could be minimized in both SEQs and LEQs. Finally, failure to achieve a mean score of 50% (pass mark) in both SEQs and LEQs suggested that the students are weak in essay writing. Possible reasons for this were suggested.

Education, Dental↗

Pregnancy trends after abortion.

A series of women who aborted their pregnancies at King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia, over a period of 12 months (1 January 1992 to 3 December 1992), were followed up for 6-48 months afterwards to examine their pregnancy trends. Descriptive statistics for data presentation with Kaplan-Meier survivorship function estimates time from abortion to the next pregnancy and Cox proportional hazard regression analysis were used to identify prognostic factors. Eighty-one per cent of the women achieved pregnancy over a 4-year follow-up. The median time to pregnancy was 7.6 months, with a 95% confidence interval of 6.4-10.0 months. Age and nationality were found to be significant prognostic factors related to time to achieve a pregnancy. Furthermore, the outcome of the subsequent pregnancy was found to be statistically related to the number of previous abortions. There is a high chance of fertility after an abortion, with 75.2% of these occurring within the first 12 months of the post-abortion follow-up period and dwindling to only 4.1% by the end of 36 months. Using multivariate regression analysis, only age seemed to be an important determinant factor.

Journal Article↗

Overweight and obesity in Saudi Arabian adult population, role of socio-demographic variables.

The objectives of this Community-based National Epidemiological Household Survey, conducted between 1990-1993, were to estimate the prevalence of overweight and obesity in Saudi Arabia and to examine its association with the socio-demographic characteristics of the adult population. A sample of Saudis 20 years and over was selected using a multistage stratified cluster sampling technique with probability proportionate to size. The selected subjects were requested to visit primary health care centers in their localities. Physicians in these clinics took measurements of heights and weights and collected other relevant data. Obesity was measured by the Body Mass Index, using the Quetelet Index. The results showed the sample of 10,651 subjects of which 50.8% were males, had a mean age of 35.8 years (SD = 14.27 years). The prevalence of overweight was 31.2% (95% confidence interval: 30.3%, 32.1%); 33.1% for males and 29.4% for females. For obesity, the overall prevalence was 22.1%; males 17.8% and females 26.6%. The study design suggested that these estimates could be closer to the true values. The multiple logistic regression analysis showed that age, residential area, region, income, gender, and education are statistically significant predictors of obesity. The prevalence of obesity was higher in females than males, lower in subjects living in rural areas with traditional lifestyles than those in more urbanized environments, and increased with increasing age. The observed prevalence and pattern of overweight and obesity with age and gender is similar to those observed in the Arab community and some Western nations. There is a need for increased physical activity and better nutrition education programs to reduce the extent of obesity and to prevent the serious health consequences, especially, in the middle age group.

Adult↗

Attitude to aging among different groups in Nigeria.

Attitude to aging and the aged was surveyed in three groups of Nigerians, 1) caregivers living at home with the elderly, 2) various categories of hospital workers, and 3) the general public. Based on scores of an eleven-item questionnaire the best attitude was in caregivers, and the poorest in hospital workers. Years of education had an overall negative effect on attitudinal measurement. An inference from this study is that the elderly are still valued, but caregivers could be under some stress and would appreciate assistance. It is important for developing countries like Nigeria to begin to think seriously of what types of public assistance the elderly and their families would need.

Adult↗

Multivariate determinants of the need for postoperative ventilation in myasthenia gravis.

PURPOSE: Following transsternal thymectomy, up to 50% of patients may require postoperative ventilation. The aim of this study was to identify the variables most useful in predicting the myasthenic patient who needs postoperative mechanical ventilation. METHODS: We applied multivariate discriminant analysis to preoperative physical, historical, laboratory and intraoperative data of 51 myasthenic patients who underwent transcervical-transsternal thymectomy to select those variables most useful in predicting the postoperative need for mechanical ventilation. The receiver operating characteristic (ROC) curve was also used to describe the discrimination abilities and to explore the trade-offs between sensitivity and specificity of the model. RESULTS: Discriminant analysis identified seven risk factors that correlated with the need for postoperative ventilation: FVC, FEF25-75%, MEF50% and their percentages of the predicted values, as well as, sex. The model correctly predicted the actual ventilatory outcome in 88.2% of patients. The area under the ROC curve verified that our model correctly predicted the actual ventilatory outcome with a probability of 88.2%. CONCLUSIONS: This model can be used for predicting the need for postoperative mechanical ventilation in myasthenia gravis patients.

Adolescent↗

The effect of urbanization on the distribution of cord serum lipids in Riyadh, Saudi Arabia: a pilot study.

The objectives of this study were to examine the distribution and effects of sex and urbanization on cord serum lipids, and to determine the cut-off point for calculating prevalence of hypercholesterolaemia in neonates in Saudi Arabia. The study sample was 200 full-term newborns at four different hospitals selected on a quota basis from the urban and rural areas of Saudi Arabia. Total cholesterol, triglyceride and high density lipoprotein (HDL) were the serum lipids assayed. The results showed that the serum total cholesterol and HDL concentration were significantly higher in urban than in rural areas. However, there was no significant sex differential in the lipids. The cut-off points for the calculation of prevalence of hypercholesterolaemia were 1.79 mmol/l in rural areas and 2.56 mmol/l in urban areas. The study also showed that the 95th percentiles of the three lipid parameters were lower than those reported from other countries, e.g. Australia and Finland. This study provides the distributional form of total cholesterol, HDL cholesterol and triglyceride in cord blood, and may serve as a pilot for a large-scale study which incorporates the prevalence of familial hypercholesterolaemia in Saudi Arabia.

Female↗

Predictors of smoking among male junior secondary school students in Riyadh, Saudi Arabia.

OBJECTIVE: To determine the prevalence and determinants of cigarette smoking among intermediate (junior secondary) schoolboys in Riyadh, Saudi Arabia. PARTICIPANTS: A sample of 1382 students (ages 12-19 years) in 45 classes randomly selected from 15 schools, using a two-stage stratified cluster sampling scheme. DESIGN: Students in the selected classes were requested to complete an anonymous questionnaire, under the supervision of trained interviewers. Univariate and multivariate statistical analyses of potential risk factors were performed. SETTING: Intermediate schools in Riyadh, Saudi Arabia. MAIN OUTCOME MEASURES: Association between current smoking and socio-demographic variables, history of smoking, age of smoking initiation, smoking behaviour among family members, knowledge of the harmful effects of smoking, and whether smoking is allowed in the presence of relatives and acquaintances. RESULTS: The prevalence of current smokers was 13.2% overall, ranging from 3.2% in those 12-13 years old to 31.1% in those aged 18-19. Some of the variables (nationality, father's education, and smoking allowed in the presence of parents or teachers) found to be associated with current smoking in a univariate analysis were no longer significantly associated with smoking in the multivariate analysis. By multivariate analysis, knowledge of the harmful effects of smoking, age, smoking allowed in the presence of friends or brothers, and previous smoking were statistically significant determinants of current smoking. CONCLUSIONS: Current health education activities against smoking should be continued and extended to the young population to further reduce the prevalence of smoking and its health consequences. Religious antipathy toward smoking should be emphasised in any local anti-smoking campaigns.

Adolescent↗

The pattern of growth and obesity in Saudi Arabian male school children.

OBJECTIVE: To determine the prevalence of overweight and obesity among male school children in Saudi Arabia and provide a growth chart for males 6-18 y old. DESIGN: Three stage stratified cluster sampling procedure. SUBJECTS: The study population was 9061 male school children, attending public schools in Saudi Arabia. Their ages ranged from 6-18 y and covered all the 12 grade levels of school. Children with evidence of chronic or acute diseases were excluded from the study. MEASUREMENT: Structured questionnaire, including: location of school, socio-demographic characteristics and age of the student. Anthropometric measurements of weight and height was done for all the study sample. Growth charts were designed through fitting the polynomial regression model of degree three. The percentage of body mass index (BMI) of expected BMI at the 50th percentile for each age group was computed. The 50th percentile of The National Center for Health Statistics/Center for Disease Control reference population was used as the expected standard population values for defining childhood overweight and obesity. RESULTS: The overall prevalence of overweight was 11.7% and obesity 15.8%. There was a statistically significant variation in the regional distribution of overweight and obesity (P < 0.01). The highest prevalence (18.0%) was recorded in Riyadh, capital of Saudi Arabia, and the lowest was in Sabea (11.1%) located in the Southern region. CONCLUSION: These findings of a high prevalence of childhood obesity when compared with the NCHS/CDC calls for an early health education program on the appropriate choice of diets for growth, health and longevity. However, because of the possible ethnic differences between the Saudi and American populations, the growth charts presented could serve as a better reference for future comparisons.

Adolescent↗

Reproductive potential after an ectopic pregnancy.

OBJECTIVE: To measure statistically how soon pregnancy can occur after an ectopic pregnancy (EP) so as to determine the cumulative pregnancy rate and the risk factors involved in nonpregnancy. DESIGN: The risk of not getting pregnant after an EP (survivorship) was estimated for 120 patients followed up for up to 60 months using the actuarial life-table technique. The risk factors involved in nonpregnancy, abortions, or live births were analyzed, using Cox regression models. SETTING: King Khalid University Hospital, Riyadh, Saudi Arabia. RESULTS: There were 68 pregnancies over the study period, with a conception rate of 56.7%. Using the actuarial life table, the cumulative probability of not achieving pregnancy in a patient decreased sharply during the first 12 months, followed by a gradual decrease up to 48 months. The Cox regression analysis showed a correlation between pregnancy and two variables, namely, age and history of prior EP. The chances of a pregnancy resulting in abortion or live birth also correlated with the presence of prior infertility, pelvic inflammatory disease (PID), or postoperative complications. CONCLUSION: Age and prior EP are important determinants in pregnancy rates after an EP. Similarly, history of PID, infertility, and postoperative complications are important risk factors in whether the pregnancy goes to term or ends in abortion.

Abortion, Spontaneous↗