Biomedical subjects

E O Sanya

Publications and source records attributed to E O Sanya.

11 recordsLinked to original sources

PubMed2007

Systolic hypertension in adult Nigerians with hypertension.

OBJECTIVE: To determine the prevalence of both systolic and diastolic hypertensions in relation to age and their impacts on target organ among adult Nigerians with hypertension. DESIGN: Observational study. PLACE AND DURATION OF STUDY: The Cardiovascular Clinic of the University of Ilorin Teaching Hospital, Nigeria, from July 2002 to June 2003. PATIENTS AND METHODS: Newly diagnosed adult hypertensives, with blood pressure >or= 140/90mmHg, taken twice with mercury column sphygmomanometer at 3 weeks interval, were studied. The total number of hypertensive patients treated over this period was also taken into consideration. The newly diagnosed hypertensives were classified using JNC VI classification. The frequency of occurrence of target organ damage such as Left Ventricular Hypertrophy (LVH), heart failure, renal impairment etc. was charted according to systolic and or diastolic pressures. The occurrence of systolic or diastolic blood pressure was also related with the age of the patients. Blood metabolic parameters were compared in both systolic and diastolic blood pressures for their possible contributory role. RESULTS: Two thousand seven hundred and ninety-two adult hypertensive patients were managed over the study period. Of them, 218 (7.8%) were newly diagnosed and studied. There were 94 males and 124 females. Seventy-seven (35.3%) were aged 60 years and above with equal frequency in the gender. One hundred and seventy-eight (81.7%) cases had combined systolic and diastolic pressures. Twenty-nine (13.3%) patients had systolic hypertension. Twenty-five (86.2%) of these 29 were aged 50 years and above and 20 (69.0%) were aged 60 years and above. Eleven (5.0%) patients had isolated diastolic hypertension and they were all in the age bracket 40-49 years. Systolic blood pressure was found to be rising with advancing age while diastolic blood pressure peaked at mid 40's and declined. Target organ damage occurred more frequently with systolic hypertension and advancing age than with diastolic hypertension. CONCLUSION: Systolic hypertension occurred more frequently in this series of adult Nigerians with hypertension. It was higher with advancing age and associated with more target organ damage than the diastolic hypertension.

Adult↗

PubMed2006

Prevalence and determinants of erectile dysfunction among people with type 2 diabetes in Ilorin, Nigeria.

STUDY OBJECTIVES: To determine the prevalence and determinants of Erectile Dysfunction (ED) among men with Type 2 diabetes mellitus. MATERIALS AND METHODS: Seventy-seven adult men with Type 2 Diabetes Mellitus were assessed for Erectile Dysfunction using the 'IIEF-5' questionnaire. They were also assessed for the presence of certain clinical factors in other to determine their degree of correlation with ED. RESULTS: The mean age of the study subjects was 56.8(+/-2.4) years. Almost all (96.1%) were married. Forty-four (56.4%) men volunteered a history of Erectile Dysfunction. When assessed with the 'IIEF - 5' questionnaire, the prevalence of any degree of ED was 74% while moderate to severe ED was found in 39(51%) of the patients. The only clinical variables that had statistically significant correlation with ED were the age of the patients (p=0.04) as well as the duration of diabetes (p=0.04). CONCLUSION: - Erectile Dysfunction is a very common condition among men with Type 2 Diabetes mellitus in Ilorin, Nigeria and should therefore be routinely sought for by the clinicians. The two clinical factors that confer significant risk to development of ED, from this study are non-modifiable. More emphasis should therefore be placed on treatment rather than the prevention of this condition.

Age Factors↗

PubMed2005

Impairment of parasympathetic baroreflex responses in migraine patients.

OBJECTIVES: The aim of this study was to assess baroreflex regulation of the heart rate and blood vessels in migraine patients in comparison with healthy controls. METHODS: In 30 migraine patients who were in a headache-free phase, aged 34 +/- 2 years, and 30 healthy controls, aged 34 +/- 3 years, we applied oscillatory neck suction at 0.1 Hz to assess the sympathetic modulation of the heart and blood vessels and at 0.2 Hz to assess the effect of parasympathetic stimulation on the heart. Breathing was paced at 0.25 Hz. Electrocardiographic RR-intervals, blood pressure and respiration were continuously recorded. Responses to the baroreflex stimulations were assessed as the changes in power of the RR-interval and blood pressure fluctuations at the relevant stimulating frequency from the baseline values. RESULTS: Systolic and diastolic blood pressure responses to the 0.1 Hz neck suction pressure were not significantly different between the patients and controls. The RR-interval oscillatory response to 0.2 Hz neck suction was significantly less (P < 0.05) in the migraine patients (4.45 +/- 0.27 ln ms2) compared with the controls (5.48 +/- 0.36 ln ms2). CONCLUSION: These results suggest that baroreflex-mediated cardiovagal responses are reduced in migraine patients. However, the sympathetic-mediated baroreflex control of the blood vessels is intact in the migraine patients. The autonomic nervous system may have a role in the pathophysiology of migraine.

Adult↗

PubMed2005

Perception and attitude to epilepsy among teachers in primary, secondary and tertiary educational institutions in middle belt Nigeria.

Compared with the disability associated with repeated seizures or side-effects of antiepileptic medications, the social stigma associated with epilepsy is often a major handicap to people living with this condition. This study therefore looked at the knowledge, attitude and perception of teachers who see a lot of epileptics, relates on daily bases and have a high influence on students with epilepsy.Self-administered questionnaires were used to obtain information from 460 randomly selected teachers in primary, secondary and tertiary educational institutions in Kwara State-middle belt of Nigeria. The response rate was 75%. Almost all of the teachers had heard about epilepsy, but their awareness does not equate with the acceptance and understanding of epilepsy. About 30.5% believed that it could be contracted through the saliva of an epileptic, 27.7% thought it was synonymous with possession with evil spirit, while 10% misunderstood epilepsy for insanity. Close to one-fifth of the teachers were of the opinion that epileptic students have a below average mental capacity compared with other students and so cannot attainment the highest possible education. Negative attitude and bias towards epilepsy is still deeply ingrained among teachers in Nigeria. Apart from formal education, teachers need to have health education courses on common disease conditions such as epilepsy that are prevalent in school age. This might help to reduce prejudice and increase the acceptance of epileptic individuals into the classroom.

Adolescent↗

PubMed2005

The determinants of seizure severity in Nigerian epileptics.

BACKGROUND: Epilepsy is a chronic disease and the control of seizures is central to its management. While seizure frequency has been the traditional index of epilepsy control. severity of seizures is probably as important as seizure frequency in this regard. Seizure severity scales have therefore been developed to assess the impact of antiepileptic drugs on seizure control. The eight items of the national hospital seizure severity scale were applied in this study to Nigerian subjects with epilepsy to determine which aspects of seizure severity were considered relevant from the patients' perspective. MATERIALS AND METHODS: Twenty-eight confirmed subjects with epilepsy at the University College Hospital, Ibadan, were studied. The National Hospital seizure severity scale questionnaire was administered to all subjects. This assesses generalisation of seizures, falls, injuries, urinary incontinence, warning interval before loss of consciousness, automatisms and time of recovery on a graded scale. RESULTS: The most frequent indices of seizure severity in Nigerian epileptics is the generalisation of seizures in 85.7% of subjects, incontinence of urine in 78.6%, absence of protective warning time in 75% and occurrence of serious injuries in 71.5%. Occurrence of falls and disruptive automatisms were less frequent. Seizure severity scores were worse in subjects with longer duration of epilepsy and in those on monotherapy. CONCLUSIONS: The indices of seizure severity that occurred most frequently in Nigerian subjects with epilepsy were generalisation of seizures, incontinence of urine, absence of protective warning time and serious injuries. These may need to be addressed in the management of epilepsy patients. Subjects on monotherapy in this study had worse seizure severity scores and this may indicate the need to consider early rational polytherapy in order to improve seizure control.

Adolescent↗

PubMed2005

Increasing awareness about sudden unexplained death in epilepsy--a review.

Sudden unexplained death in epilepsy (SUDEP) is the commonest cause of epilepsy-related death and most of the presumed risks factors associated with it are probably avoidable. In Nigeria most deaths in individuals with epilepsy occurred at home and so were never reported. Therefore, autopsies are usually not carried to determine the cause of death. This article hopes to reawaken the attention of clinicians to this important, yet not so well known phenomenon, with a view towards addressing problems highlighted Literatures and research publications on SUDEP were systematically reviewed. Case definition, criteria for diagnosis, risk factors, pathophysiology and treatment options for SUDEP and possible methods towards decreasing its incidence was discussed. Incidence of SUDEP increases with the severity of seizure, early onset epilepsy, poor seizure control, generalised tonic-clonic seizure, multiple antiepileptic medications and frequent adjustment of antiepileptic drugs (AEDs). The pathophysiology of SUDEP is not yet clearly elucidated, but it seems to involve interplay of several factors. At the centre of this, is the impaired cardio-respiratory reflexes leading to central apnoea, hypoxia and oedema along with cardiac arrhythmias. Education of patients, relatives and caregivers is crucial to reducing the incidence of SUDEP. Optimal seizure management with an effective monotherapy where possible, should be the goal of the managing physician. In cases of intractable epilepsy, vagal nerve stimulation and neurosurgery should be considered early.

Awareness↗

PubMed2003

Impaired cardiovagal and vasomotor responses to baroreceptor stimulation in type II diabetes mellitus.

BACKGROUND: In diabetic patients, impairment of the cardiovagal limb of the baroreflex has been well established. However, the role of sympathetic mediated baroreflex vasomotor control of the blood vessels is not well defined. We therefore assessed the vasomotor responses to sinusoidal baroreceptor stimulation in diabetic patients. MATERIALS AND METHODS: We studied 14 type II diabetic patients (age; 57 +/- 7 years) and 18 healthy controls (age; 59 +/- 11 years). Oscillatory neck suction was applied at 0.1 Hz to assess the sympathetic modulation of the heart and blood vessels, and at 0.2 Hz to assess the effect of parasympathetic stimulation on the heart. Breathing was paced at 0.25 Hz. Spectral analysis was used to evaluate the oscillatory responses of RR-interval and blood pressure. RESULTS: The diabetic patients showed a significantly lower RR-interval response (P < 0.05) to the 0.1 Hz neck suction (2.52 +/- 0.50-3.62 +/- 0.54 ln ms2) than the controls (4.23 +/- 0.31-6.74 +/- 0.36 ln ms2). The increase in power of 0.1 Hz systolic blood pressure oscillations during 0.1 Hz suction was also significantly smaller (P < 0.05) in the diabetics (1.17 +/- 0.44-1.69 +/- 0.44 mmHg2) than in the controls (1.60 +/- 0.29 mmHg2-5.87 +/- 1.25 mmHg2). The magnitude of the peak of the 0.2 Hz oscillation in the RR-interval in response to 0.2 Hz neck stimulation was significantly greater (P < 0.05) in the controls (3.42 +/- 0.46 ln ms2) than in the diabetics (1.58 +/- 0.44 ln ms2). CONCLUSION: In addition to cardiovagal dysfunction, baroreflex-mediated sympathetic modulation of the blood vessels is impaired in type II diabetic patients.

Aged↗

PubMed2003

The quality of life of chronic epileptic patients in Ibadan, Nigeria.

Epilepsy is a disease that significantly impairs the quality of life of the sufferers. Measures of quality of life have been developed to assess the overall impact of management on the patients. While studies on quality of life have been previously carried out in Nigerians, a standardised and validated inventory has not been used for this purpose because these are just being developed. Thirty-two epileptics (24 males and 8 females) attending the Neurology clinic of the University College Hospital, Ibadan, were studied. Each subject had complete physical examination and elecroencephalography. A short screening quality of life questionnaire (QOLIE 10) was administered to the subjects during routine clinic visits. The commonest aspect of quality of life affected in the subjects was feeling of energy, which was impaired in 15 (46.8%) subjects. This was followed by memory problems in 11 (34.4%). Fear of experiencing the next seizure was reported by eight (25.8%) of subjects. Only five (16.7%) and three (10.3%) of the subjects respectively reported work and social limitations like attending social occasions. No subject reported difficulty with driving or operating machinery, or mental disturbances. Energy and memory deficits are the major problems affecting the quality of life of epileptics in this study. Most subjects did not consider physical and social limitations important.

Adolescent↗

PubMedDate not supplied

Cardiovascular autonomic neuropathy in non-diabetic Nigerian patients with chronic renal failure.

AIMS: To determine the frequency of cardiovascular autonomic neuropathy (CAN), its pattern and clinical predictors in Nigerians with non-diabetic chronic renal failure (CRF). METHODS: A total of 120 subjects comprising 60 pre-dialysis CRF patients and an equal number of age- and sex-matched healthy controls were studied. Five standard cardiovascular reflex (CVR) tests namely: heart rate response to deep breathing, Valsalva manoevre and posture, as well as blood pressure response to hand grip and posture were used to evaluate the cardiac autonomic functions. A pre-tested questionnaire was administered, with neurological examination and serum biochemical investigations also included in the evaluation. RESULTS: The frequency of CAN in non-diabetic CRF was 65%. Dysfunction of both the parasympathetic and sympathetic divisions of the ANS occurred in CRF patients. Significant impairment in all the heart rate reflex tests (39%) and blood pressure response to the handgrip tests (28%) occurred in patients with CAN. Symptoms of autonomic neuropathy with clinical correlation with CAN included: constipation (60%), hyposialism (51%) and hypohidrosis (33%), whilst those of peripheral neuropathy were: loss of sensation (50%) and numbness (40%). Of the biochemical parameters, serum creatinine and urea had significant correlation with autonomic neuropathy. CONCLUSION: Autonomic neuropathy is common in Nigerian patients with non-diabetic CRF, especially in those with symptoms of constipation, hypohidrosis, numbness and prickly sensations.

Adolescent↗

PubMedDate not supplied

Candida meningitis in a suspected immunosuppressive patient--a case report.

Meningitis due to fungal agents represents an AIDS-defining event and occurs typically with very low CD4+ lymphocyte count. Candida meningitis is still a rare clinical condition, although it is becoming frequently reported in the background of immune suppressive states such as: drug addicts, cancer patients, organ transplant recipients and HIV/AIDS patients. In this report we highlight a case of candida meningitis, in a 25- year old female patient. She presented with vulva swelling, vaginal discharge and fever, with rapid progression to tonic-clonic convulsions and loss of consciousness. She fully recovered after treatment with fluconazole.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Status epilepticus--a review article.

BACKGROUND: Status epilepticus is a neurological emergency associated with significant morbidity and mortality and outcome that are inversely related to duration of the condition. Any type of epileptic seizure can develop into status epilepticus (SE) but some types evolve into SE more commonly than others. METHODS: This article reviews both convulsive and non-convulsive types of SE with emphasis on generalised convulsive type the most commonly seen. The aetiology, pathophysiology, complications and drugs used in the management of SE are also discussed. RESULTS: To prevent complications resulting from the repeated seizures, prompt and aggressive management is essential and should proceed along four fronts: (a) Treatment of the SE (b) Prevention of recurrence (c) Management of potential precipitating causes and (d) Management of complication and underlying conditions. The morbidity and mortality associated with SE are often due to: (1) Injury from repetitive electrical discharge (2) Systemic stress from repeated generalised tonic-clonic seizure and (3) The damage to the central nervous system (CNS) caused by the acute insult precipitating the SE. CONCLUSION: The sequelae resulting from SE can be life threatening. Therefore prompt treatment is very crucial with the attending physician having a low threshold for intensive care management.

Humans↗