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Biomedical subjects

E O Adeyemi

Publications and source records attributed to E O Adeyemi.

At least 19 recordsLinked to original sources
PubMed2006

Hypoglycaemic and hypolipidaemic effects of fractions from kolaviron, a biflavonoid complex from Garcinia Kola in streptozotocin-induced diabetes mellitus rats.

In the search for natural hypoglycaemic agents as alternatives to synthetic ones that are expensive and not easily accessible, and to justify the use of Garcinia kola seeds in traditional African medicine to treat diabetes, the hypoglycaemic and hypolipidaemic effects of fractions from kolaviron (KV) (a Garcinia kola seed extract) were investigated in normal and streptozotocin (STZ)-diabetic rats. KV, a biflavonoid complex from Garcinia kola seed, was separated by thin-layer chromatography into three fractions; Fraction I (FI), Fraction II (FII) and Fraction III (FIII) with RF values of 0.48, 0.71 and 0.76, respectively. In normoglycaemic rats, KV, FI and FII administered at a dose of 100 mg kg(-1) body weight elicited significant (P < 0.05) hypoglycaemic activity within 4 h of oral administration. Precisely, KV, FI and FII decreased blood glucose levels of normoglycaemic rats by 66%, 50% and 61%, respectively, when compared with controls 30 min after oral administration of the extracts. In hyperglycaemic rats, KV, FI and FII significantly (P < 0.05) reduced blood sugar levels in STZ-diabetic rats within 4 h of oral administration. Furthermore, KV alone produced a significant (P < 0.05) anti-diabetic effect from day 3 to day 7 of oral intubation of STZ-diabetic rats. In addition, the extracts showed favourable effect on the plasma lipid profile of STZ-diabetic rats, and also decreased significantly (P < 0.05) the STZ-induced increase in the activity of microsomal glucose-6-phosphatase and lipid peroxidation (LPO) products. This study confirms the anti-diabetic and hypolipidaemic effects of KV in STZ-diabetic rats. These observed effects of KV are attributed to two of its fractions, FI and FII, with RF values of 0.48 and 0.71, respectively.

Animals↗
PubMed2001

The performance profile of medical students in the mock objective structured clinical examination.

OBJECTIVE: Acquisition of clinical skills, after completing a course in the basic sciences, is an essential aspect of undergraduate training in any medical school. These skills are usually divided into 3 broad categories: namely, history taking, physical examination and selection of the appropriate laboratory investigations. At the end of the clerkship, the students' clinical skills have to be assessed. The main objective was to describe the performance profile of a group of medical students while examing a distended abdomen in the United Arab Emirates. METHODS: This paper describes the performance profile of 24 randomly selected medical students in a mock objective structured clinical examination of a patient with distended abdomen in the hospital environment. Marks were allotted according to the checklist of the performance expectations. For the assessment used in this paper, ability to perform a step of the clinical examination was rated positive and documented. RESULTS: The performance profile of the students was very good to excellent, corresponding to 9 out of 10 marks. All students identified or excluded the common signs of clinical ascites. The signs uncommonly seen in this area, such as Dupytren's contractures, were excluded by 20 of 24 (83%) students. CONCLUSION: The excellent performance is attributed to a greater exposure to patients with mainly gastrointestinal disorders during the clerkship. The main advantage of an objective structured clinical abdominal examination, which is set up in a hospital environment, is that it reflects the real life situation of a practising physician, as opposed to using simulated patients. Although, a structured clinical examination is labor-intensive and costly, the advantages outweigh the work and cost of setting it up.

Adult↗
PubMed1999

The outcome of a 2-week treatment of Helicobacter pylori-positive duodenal ulcer with omeprazole-based antibiotic regimen in a region with high metronidazole resistance rate.

BACKGROUND/OBJECTIVE: Metronidazole resistance is a major problem in many developing countries. Our main objective was to study the outcome of a non-metronidazole and omeprazole-based antibiotic regimen in eradicating Helicobacter pylori in patients with duodenal ulcer. DESIGN: A prospective study of 50 consecutive patients with proven peptic ulcer (mean age 36.6 +/- 10.5 years, range 17-60, male:female = 2), referred from the primary health centres. MAIN OUTCOME MEASURE: The primary outcome of the study was H. pylori eradication, at least 4 weeks after stopping antibiotic treatment. METHODS: Patients were considered eligible for the study if they had endoscopic evidence or a past medical history of peptic ulcer and had not received any antibiotics for at least 4 weeks prior to admission into the study. H. pylori infection was confirmed by serology, histology, a rapid urease test (RUT) and culture. After an initial oesophago-gastroduodenoscopy (OGD), each patient received a 2-week course of omeprazole (20 mg twice daily), and each of amoxycillin capsules (500 mg) and clarithromycin tablets (250 mg) thrice daily after food. The follow-up OGDs were performed after a mean period of 10.04 weeks (range 4-48) and at 10.4 +/- 2.5 months (range 6-14 months) after stopping treatment. RESULTS: All 50 patients completed the study. The sensitivity values for serology, RUT and histopathology were 98, 96 and 100%, respectively. H. pylori culture was positive in only 15 of 50 patients (30% sensitivity). H. pylori was eradicated in 47 (94%) patients. There was no evidence of H. pylori infection in the 27 of 35 (77%) patients, who returned for a third OGD. At the time of the second OGD, there was a significant reduction of pain-days (from 5.47 to 1.16), and antral (from 1.95 to 0.78) and corpus (from 1.8 to 0.6) mucosal cellular infiltrate scores, when compared with the first OGD (P < 0.001 in each case). CONCLUSION: Exclusion of metronidazole from the treatment regimen of patients with H. pylori-positive duodenal ulcer in a region with metronidazole resistance yielded an excellent H. pylori eradication rate of 94%, when omeprazole, amoxicillin and clarithromycin were used.

Adolescent↗
PubMed1999

Characterization of autonomic dysfunction in patients with irritable bowel syndrome by means of heart rate variability studies.

OBJECTIVE: Our aim was to characterize autonomic dysfunction in patients with irritable bowel syndrome (IBS) using heart rate variability (HRV) studies. METHODS: EKG signals were obtained from 35 patients (mean age, 39.1 +/- 9.5 yr, M:F ratio = 2.9:1) and 18 healthy controls (mean age, 38.2 +/- 6.5 yr, M:F ratio = 2:1) in supine, standing, and deep-breathing modes. Fast Fourier transformation and autoregressive techniques were used to analyze the HRV power spectra in very low (VLF, 0.0078-0.04 Hz), low (LF, 0.04-0.14 Hz), and high (HF, 0.14-0.4 Hz) frequency bands. RESULTS: In the supine position, the VLF power spectral density (PSD) in IBS was significantly higher than normal (3 vs 1.3 beats per minute [bpm]2/Hz, p < 0.01). On changing from the supine to standing position, the normals (NC) had raised median PSDs in the VLF (1.3 vs 12.8 bpm2/Hz, p < 0.01) and LF (1.6 vs 6.1 bpm2/Hz, p < 0.01) bands, as a sign of increased sympathetic tone, whereas the median HF PSDs (parasympathetic tone) remained unchanged (1.8 bpm2/Hz each, p = 0.8). Similarly, the IBS patients had increased VLF (3.04 vs 14.93 bpm2/Hz, p < 0.01) and LF (2.8 vs 8.7 bpm2/Hz, p < 0.01) PSDs on standing up, but the HF PSD was also raised (from 2.4 to 5.7 bpm2/Hz, p = 0.04). On changing from standing to the deep-breathing mode, the normals had a significant increase in the HF (from 1.8 to 10.3 bpm2/Hz, p < 0.001) and a significant reduction of the VLF (from 12.8 to 2.2 bpm2/Hz, p < 0.01) PSDs. The reduction of the LF PSD was not significant (from 6.1 to 5.6 bpm2/Hz, p = 0.6). In IBS, HF PSD remained constant (5.7 bpm2/Hz each, p = 0.6), whereas the LF PSD increased from 8.7 to 24.2 bpm2/Hz (p < 0.0001). The VLF PSD was reduced (from 14.9 to 4.1 bpm2/Hz, p < 0.0001). In IBS, the median sympathovagal outflow ratio was significantly lower in the standing position (1.4 vs 2.8, p < 0.02) and higher in the deep-breathing mode (7.33 vs 0.42, p < 0.0001) than normal. CONCLUSIONS: IBS patients have reduced sympathetic influence on the heart period in response to orthostatic stress and diminished parasympathetic modulation during deep breathing.

Adult↗
PubMed1996

Grading Helicobacter pylori gastritis in dyspeptic patients.

Helicobacter pylori-like organisms (Hp) and polymorphonuclear leucocytes (PMNs) in 2614 gastroduodenal biopsies from 602 patients with dyspepsia, in Al Ain, United Arab Emirates, between October 1990 and October 1992, were histologically graded to determine the prevalence of Hp gastritis and their utilization in the evaluation of treatment efficacy in these patients. Symptoms of functional dyspepsia included, in order of frequency, abdominal pain or discomfort, flatulence, burning sensation, regurgitation, fullness, nausea, vomiting, bloating and belching. The biopsies were paraffin embedded, sectioned and stained with hematoxylin and eosin (H and E) to grade the inflammation. In addition to H and E, several special stains including modified Giemsa (MG), Wharthin-Starry silver and cold Ziehl-Neelsen stains were utilized to clearly identify Hp organisms. Giemsa method was found to be superior to other special stains in visualizing the Hp organisms in paraffin sections, and was utilized in every case. Two immunohistochemical markers for B cells (CD20) and T cells (CD45RO) were utilized for labeling lymphocytes infiltrating the lamina propria of the gastroduodenal biopsies in formalin-fixed paraffin-embedded sections. H and E and MG stained sections were utilized to count PMNs and Hp, and were graded 0, 1, 2, and 3, corresponding to none, mild, moderate, and severe grades of the Sydney system for classification of gastritis, respectively. Of the total initial 2318 endoscopic biopsies, 98.8% of the patients had suitable biopsies for histologic evaluation. Unsuitable biopsies were recovered from patients with gastric carcinoma. Inflammation was seen in 98.5% of 595 patients with suitable biopsies. In 74.5% of these patients the inflammation was active; 37.5, 32.5 and 4.5% had mild, moderate and severe active inflammation, respectively. In the remaining 24% of the 595 patients, the gastritis was chronic without activity or atrophic changes. As many as 73.6% of the patients with suitable biopsies were Hp positive; 39.8, 29.1 and 4.7% had grades 1, 2 and 3 Hp, respectively. Intestinal metaplasia was found in 28.9% of the 602 patients, and was seen more often in Hp positive than Hp negative patients (34.5 vs 14%, P < 0.005, for d.f. = 1; chi 2 = 10.35). Of the Hp positive patients, 172 and 46 patients attended the first and second follow-up endoscopy visits, respectively. The triple treatment was composed of one dose of tinidazole (2gm), doxycycline, 200 mg initial dose and 100 mg daily for two weeks, and bismuth subcitrate (Gist-Brocades nv, Delft, The Netherlands), 2 tablets twice daily for 4 weeks. After triple drug treatment, eradication of Hp was accomplished, histologically, in 38.4 and 45.7% of the patients on first and second follow-up visits, respectively. Thus, the Sydney system-based grading scale provides an objective histological evaluation of Hp gastritis for accurate prevalence studies, and may prove to be of value in estimating treatment efficacy.

Adolescent↗
PubMed1993

Antibody binding to alpha 2-macroglobulin facilitates direct quantitation of elastase-alpha 2-macroglobulin complexes by a simple ELISA technique.

In order to investigate the effect which the binding of anti-alpha 2-macroglobulin (anti-A2M) antibody has on subsequent antigen-antibody reaction between the complexed elastase and the solid phase anti-elastase antibody, elastase alpha 2-macroglobulin complex (EMC) was incubated with anti-A2M antibody and then extracted by a solid-phase bound rabbit anti-elastase antibody. A doubling dilution series of EMC generated dose related absorbance values. The critical factor permitting the immunological detection of A2M-bound elastase is the pre-incubation of anti-A2M antibody with EMC in solution. The assay exhibited a lower detection limit of 0.5 ng bound elastase per ml and EMC levels in serum samples from ten volunteers were significantly higher than in plasma (28 vs. 21 ng/ml, p < 0.05, Student's t test for paired samples). The EMC levels measured with this assay were essentially identical to those obtained when phenyl methyl sulfonyl fluoride (PMSF) was added to the assay buffer solution.

Enzyme-Linked Immunosorbent Assay↗
PubMed1992

Plasma lactoferrin as a marker of infection in elderly individuals.

To assess lactoferrin as a marker of infection, plasma lactoferrin (LF) levels were determined in elderly in patients with infection and compared with age- and sex-matched healthy and hospital controls and young healthy blood donors. The median LF level in infection (800 ng/mL) was significantly higher than in healthy elderly living in old people's home (300 ng/mL) or elderly hospital controls (298 ng/mL) (p less than 0.01 in each case). Plasma LF correlated significantly with elastase alpha-1-proteinase inhibitor complex (EPIC) (Rs = 0.8, p less than 0.01) and C-reactive protein (CRP) (Rs = 0.45, p less than 0.02), but not with erythrocyte sedimentation rate (ESR) or white blood cell counts. We conclude that plasma LF, like CRP and EPIC, is a marker of infection in elderly individuals.

Adult↗
PubMed1992

Faecal elastase reflects disease activity in active ulcerative colitis.

Alpha-1-proteinase inhibitor-bound elastase (EPIC) was measured in plasma and fresh stool samples from 20 patients with Crohn's disease (CD), 16 patients with ulcerative colitis (UC), and 10 controls. Median EPIC values were significantly higher than normal in active CD and UC. EPIC was virtually undetectable in the stool samples of control subjects. Median faecal EPIC in 14 patients with active CD (478 ng/ml) or 10 patients with active UC (1159 ng/ml) was significantly higher than in quiescent disease (p less than 0.05) and in control subjects (p less than 0.001 in each case). The difference in the median values between active CD and UC was not significant (p = 0.065). The median faecal EPIC levels were identical in active UC (1159 ng/ml) and patients with large-bowel CD (LBCD) (1015 ng/ml) (p = 0.9), and each was significantly higher than the value of 168 ng/ml in small-bowel CD (SBCD) (p less than 0.01 in each case). In active LBCD but not in SBCD, faecal EPIC correlated significantly with Crohn's disease activity index (R = 0.78, p less than 0.05), plasma C-reactive protein (CRP) (R = 0.9, p less than 0.01), and erythrocyte sedimentation rate (ESR) (R = 0.74, p less than 0.05). In active UC, faecal EPIC correlated significantly with a numerical disease activity index (R = 0.9, p less than 0.01) but not with plasma EPIC and CRP, ESR, and leucocyte counts. Faecal EPIC values may be a better reflection of disease activity in active UC than plasma levels of markers of inflammation.

Biomarkers↗
PubMed1992

Clinicopathological assessment of gastric biopsy samples of patients with Helicobacter pylori infection--metronidazole resistance and compliance problems in the United Arab Emirates.

The significance of Helicobacter pylori (HP) infection was assessed prospectively in forty-two patients with dyspepsia using histological, bacteriological and biopsy urease techniques. Thirty-eight patients (90.5%) were positive for HP infection and were treated with bismuth subcitrate (De Nol), tinidazole and doxycycline. HP was present in the antrum, corpus, fundus, duodenum and gastric juice in 36, 26, 23, 2 and 2 patients respectively (p < 0.01, X2 test). Histological assessment yielded more positive identifications of HP than the urease test (36 vs 28 positive cases, p < 0.01, McNemar's X2 test), while histology and bacteriology were virtually identical (38 vs 37 of 41 pairs, p > 0.5, X2 test). There was a good correlation between bacterial and polymorphonuclear leucocyte (PMNL) counts per high power field (r = 0.8; p < 0.001; n = 34 pairs). There was resistance to metronidazole in 10 out of 16 isolates, but no resistance was recorded against tetracycline (p < 0.001, X2 test). Among the sixteen patients who attended follow-up endoscopy, there was clinical improvement and no evidence of HP in 5 individuals (31.25%). One patient had amelioration of his symptoms, 5 experienced no change and in 5 their symptoms became worse. Metronidazole resistance may be one of the important factors in the United Arab Emirates and elsewhere.

Adolescent↗
PubMed1990

Plasma lactoferrin and neutrophil elastase in rheumatoid arthritis and systemic lupus erythematosus.

In order to assess lactoferrin (LF), stored in specific granules of neutrophils, as a marker of inflammation, LF was measured in plasma and serum samples of patients with active rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). In active RA, the median plasma LF level (800 ng/ml) was significantly higher than in normal individuals (220 ng/ml) (P less than 0.00001) and patients with active SLE (235 ng/ml) (P less than 0.00001). Median plasma elastase-proteinase inhibitor complex (EPIC) and C-reactive protein (CRP) levels were also significantly higher in patients with RA than in normal individuals (P less than 0.00001) and active SLE (P less than 0.00001 for both EPIC and CRP). Elevations of LF, EPIC and CRP in RA were independent of rheumatoid factor titres. Plasma lactoferrin in RA correlated significantly with EPIC (Rs = 0.7, P less than 0.0001), CRP (Rx = 0.72, P less than 0.0001) and absolute neutrophil counts (Rs = 0.483, P less than 0.02), but surprisingly not with the Ritchie index, with which CRP showed a weak but significant correlation (Rs = 0.27, P less than 0.05 greater than 0.025). Thus plasma LF and EPIC are markers of inflammation in RA and their levels may reflect release of mediators of inflammation into the joint space and periarticular tissue.

Adolescent↗
PubMed1990

The effect of some anti-inflammatory agents on elastase release from neutrophils in-vitro.

In view of the potential role of released polymorphonuclear leucocyte elastase in causing tissue damage, the effect of commonly used anti-inflammatory drugs on elastase release from neutrophils has been studied in-vitro. Elastase release from neutrophils exposed to the synthetic bacterial cell wall peptide N-formyl-L-methionyl-L-leucyl-L-phenylalanine (10(-6) M) was quantitated using a radiometric immunoassay and a functional assay of elastase. Prednisolone and non-steroidal anti-inflammatory drugs inhibited elastase release at concentrations from 0.1 mM-0.1 nM. No inhibition by sulphosalicylic acid, D-penicillamine or chloroquine sulphate was observed. The clinical relevance of these findings is discussed.

Adult↗
PubMed1990

Molecular distribution of elastase between its two main inhibitors: direct quantitation of elastase-alpha 2-macroglobulin complex with a novel ELISA technique.

A novel enzyme-linked immunosorbent assay for the quantitation of elastase linked to alpha 2-macroglobulin (alpha 2M) (elastase-alpha 2M complex, EMC) in body fluids is presented. The assay has a lower detection limit of 1.5 ng bound elastase per ml. The critical factor allowing immunological detection of alpha 2M-bound elastase is the addition of phenyl methyl sulphonyl fluoride (PMSF) to the assay buffer. The assay has been used to quantitate EMC in plasma and serum of healthy volunteers, and assess the distribution of elastase between its two main inhibitors, alpha 2M and alpha 1-proteinase inhibitor (API). EMC levels in serum samples from volunteers were significantly higher than in plasma (26.9 vs 21.9 ng/ml, p = 0.05, Student's t-test for paired samples). The API-bound elastase levels were 70.2 and 170.1 ng/ml in plasma and serum respectively (statistically significantly higher in serum, p less than 0.0001). The ratio of macroglobulin to alpha 1-proteinase-bound elastase levels was 0.333 in plasma and 0.168 in serum (p less than 0.0001). As alpha 2M bound elastase retains some proteolytic activity, direct measurement of circulating levels in inflammatory conditions should be of interest.

Chromatography, Gel↗
PubMed1989

Circulating neutrophil elastase in infectious diseases in geriatric patients.

Enzyme-linked immunosorbent assay has been used to measure elastase proteinase inhibitor complex (EPIC) and C-reactive protein (CRP) in the elderly, with and without infection. Median EPIC levels in the elderly with infection, hospital controls, healthy elderly residents in old people's homes and healthy blood donors were 300, 104, 96 and 74 ng/ml respectively. Ninety-five per cent of the patients with infection had EPIC levels well above the normal range. The median EPIC level in the elderly with infection showed a statistically significant difference from that in the control groups (p less than 0.0001, Mann U test). CRP showed similar results. Elevation of EPIC or CRP did not depend on the type of infection or bacteria isolated. We would conclude that neutrophil inhibitor-bound elastase could be used as a marker of inflammation in old people.

Aged↗
PubMed1988

Augmented release of human leucocyte lactoferrin (and elastase) during coagulation.

Lactoferrin, an iron binding protein, present in specific granules of neutrophils has been shown to be released concomitantly with elastase, when neutrophils are activated in vitro. Using enzyme-linked immunosorbent assay, lactoferrin release has been studied during blood coagulation, a more physiological system for studying the in vivo neutrophil activation in vitro. The assay has a lower detection limit of 1.0 ng/ml with intra and interassay coefficients of variation of 8 and 14% respectively. Median plasma and serum lactoferrin levels were 144 and 705 ng/ml respectively. The difference was statistically significant at p less than 0.0001. The median elastase proteinase inhibitor complex (EPIC) levels in plasma and serum were 85 and 176.5 ng/ml respectively. This difference was also highly significant at p less than 0.0001. There was no correlation between these parameters in the plasma samples. However, there was a statistically significant correlation between these measurements in sera at p less than 0.001 (Kendall's rank correlation). Release of lactoferrin and elastase-A1PIC during coagulation reflects the activation of neutrophils in vivo, especially during inflammation.

Adult↗
PubMed1986

Circulating human leucocyte elastase in rheumatoid arthritis.

Elastase-inhibitor complex (EIC) levels were determined in EDTA-plasma samples of 40 patients with connective tissue disease by a double antibody immuno-assay technique. In active rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), EIC levels were significantly higher than in the normal controls (P less than 10(-8) and fell on remission. The mean EIC level in active RA was significantly greater than in inactive disease (P = 0.0001) but there was no statistically significant difference between the EIC levels in the acute and inactive disease states in SLE (P = 0.49). In active RA, there was a positive correlation between EIC levels and white blood cell count (WBC) but not with erythrocyte sedimentation rate (ESR). In SLE there was no significant correlation between EIC levels and ESR or WBC. EIC measurement may be useful in the objective assessment of activity in RA.

Arthritis, Rheumatoid↗
PubMed1985

Circulating human leucocyte elastase in patients with inflammatory bowel disease.

The plasma concentration of human leucocyte elastase (HLE), measured by enzyme immunoassay as the complex with alpha 1-proteinase inhibitor, was determined in 94 patients with active and inactive inflammatory bowel disease. In Crohn's disease and in ulcerative colitis human leucocyte elastase levels were raised significantly above normal when the disease was active, and fell on remission. The mean human leucocyte elastase level in 31 cases of active Crohn's disease was significantly greater than the mean human leucocyte elastase level in 23 patients with active ulcerative colitis (p = 0.013). The values of human leucocyte elastase correlated significantly with Crohn's disease activity index scores (p = 0.05) and with the circulating concentration of C-reactive protein (p less than 0.05 and p less than 0.01 for ulcerative colitis and Crohn's disease respectively), but not with the erythrocyte sedimentation rate. These results indicate that the concentration of human leucocyte elastase in the plasma of patients with inflammatory bowel disease reflects the activity of their intestinal disease and suggest that serial measurements of human leucocyte elastase may be useful in the assessment and clinical management of these conditions.

Adolescent↗
PubMedDate not supplied

Somatostatin inhibits neutrophil elastase release in vitro.

The influence of the long-acting somatostatin analogue, SMS 201-995, on FMLP-induced neutrophil elastase release in vitro has been investigated. Doses from 150 ng/ml upwards inhibited elastase release, with 100% inhibition by 2500 ng/ml. Inhibition was demonstrated both by an assay measuring elastase immunometrically and by an assay based on its enzyme activity. The demonstration that SMS 201-995 inhibits protease release from polymorphonuclear leukocytes may have implications for the long-term clinical use of this somatostatin analogue.

Amino Acid Sequence↗