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Biomedical subjects

I Mohammed

Publications and source records attributed to I Mohammed.

At least 19 recordsLinked to original sources

Genetic influences in gastro-oesophageal reflux disease: a twin study.

BACKGROUND: A number of families have been described which include multiple members with symptomatic, endoscopic, or complicated gastro-oesophageal reflux disease (GORD). First degree relatives of patients with GORD are more likely to suffer with GORD symptoms. These observations raise the possibility of a genetic contribution to the aetiology of GORD. AIMS: To determine the relative contribution of genetic factors to GORD by evaluating GORD symptoms in monozygotic (MZ) and dizygotic (DZ) twins. METHODS: A total of 4480 unselected twin pairs, identified from a national volunteer twin register, were asked to complete a validated symptom questionnaire. GORD was defined as symptoms of heartburn or acid regurgitation at least weekly during the past year. RESULTS: Replies were obtained from 5032 subjects (56% response rate). A total of 1960 twin pairs were evaluable: 928 MZ pairs (86 male pairs, mean (SD) age 52 (13) (range 19-81) years) and 1032 DZ pairs (71 male pairs, mean age 52 (13) (20-82) years). The prevalence of GORD among both groups of twins was 18%. Casewise concordance rates were significantly higher for MZ than DZ twins (42% v 26%; p<0.001). Multifactorial liability threshold modelling suggests that additive genetic effects combined with unique environmental factors provide the best model for GORD. Heritability estimates suggest that 43% (95% confidence interval 32-55%) of the variance in liability to GORD is due to additive genetic factors. CONCLUSIONS: There is a substantial genetic contribution to the aetiology of GORD.

Adult↗

Tuberculosis myocarditis: a case report.

A 35-year old man presented with fever, weight loss, drenching night sweats and symptoms of cardiac failure for three months. Examination revealed wasting, peripheral oedema, bilateral pleural effusion and constrictive pericarditis. A diagnosis of constrictive pericarditis with bilateral pleural effusion probably due to tuberculosis was made. Human immunodeficiency virus antibodies and six sputum for acidfast bacilli were negative. Electrocardiograph revealed low voltages globally and echocardiography showed global myocardial hypokinesia. He had pericardiectomy, pericardial and pleural histology was non-specific inflammatory reaction but myocardial histology showed granulomatous changes of tuberculous myocarditis. We suggest that in experienced hands myocardial biopsy could be useful in making the diagnosis.

Adult↗

Pseudomyxoma peritonei manifesting as intestinal obstruction.

Pseudomyxoma peritonei is an appendiceal tumor with distinct clinical and pathologic features. It frequently presents a problem in diagnosis and management. We report a case of pseudomyxoma peritonei, which initially appeared with intestinal obstruction. This is a rare initial manifestation in patients who have not had multiple surgical procedures. We review the literature and discuss the unique clinical features and misconceptions surrounding pseudomyxoma peritonei.

Adenocarcinoma↗

Clostridium difficile colitis associated with treatment of Helicobacter pylori infection.

Helicobacter pylori infection of the stomach is being detected and treated more often now than ever before. This is likely to result in an increase in complications such as antibiotic-associated diarrhea. However, there is no literature on the incidence of such diarrhea, particularly Clostridium difficile colitis, in patients treated for Helicobacter pylori infection. We report the case of a patient who developed Clostridium difficile colitis after treatment for Helicobacter pylori infection with metronidazole, amoxicillin, H2 blockers, and bismuth subsalicylate. This patient presented with severe diarrhea that responded to a course of metronidazole with rapid disappearance of symptoms. The incidence of Clostridium difficile colitis in patients treated for Helicobacter pylori infection has not been studied. This unique association, although not unexpected, has not yet been reported in the literature. The increasing number of patients being diagnosed and treated for this infection requires a heightened awareness on the part of physicians, to assure early diagnosis and treatment of this treatable, yet potentially dangerous, complication.

Aged↗

Prognostic scores for use in African meningococcal epidemics.

Current WHO guidelines for the case management of meningococcal infections during epidemics in developing countries often cannot be applied, largely because of the limited health resources in such countries. Several scoring scales based on clinical and laboratory features in numerous combinations have been developed for the management of meningococcal infections in developed countries, and these have facilitated early identification of patients with fulminant disease and thus early intervention and reduction in mortality. Unfortunately such scoring scales are not appropriate for use in developing countries. We identified hypotension, tachycardia, tachypnoea, delay in capillary refill time, coma, absence of neck stiffness and petechiae and/or purpura as simple prognostic factors of meningococcal disease. Two scores were developed: score I, which includes all seven prognostic factors, had a sensitivity and specificity of 80% and 94%, respectively. Score II, which excluded hypotension, had a sensitivity and specificity of 73.3% and 89.7%, respectively. Quick and simple scoring scales are therefore not only applicable but useful for the case management of patients in meningococcal epidemics in developing countries.

Adolescent↗

Prevalence of transmissible blood infections among blood donors at the University of Maiducuri Teaching Hospital, Maiduguri, Nigeria.

Before the advent of the Acquired Immune Deficiency Syndrome (AIDS), many countries of the world transfused blood without seriously considering the potential risks of transmission of infectious agents. Even after it was shown that the Human Immunodeficiency virus(HIV) could be transmitted through blood and blood products, many hospitals and clinics in Nigeria still continue to transfuse unscreened blood. This study was therefore initiated to highlight the risks of transmitting infectious agents through blood transfusion and the category of infectious agents which could be transfused in blood in this area. A total of 364 healthy blood donors were counselled, bled and screened for HIV-1, HIV-2, HBsAg, Treponema pallidum, Plasmodium falciparum and microfilaria. The results show that the three most common infections transmissible through blood transfusion are Hepatitis B(14.9%), HIV-1 (5.8%) and P.falciparum (4.1%). Thirteen of the 364 blood donors (3.6%) and antibodies to T. pallidum. There were no donors with HIV-2 or filarial infection. Infection of donors by hepatitis B virus (HBV), T. pallidum and HIV-1 was not significant dependent on promiscuity, polygamy, previous blood transfusion or local surgery. However, there was a significant difference between donors with no risk factors and those with risk factors with regard to seroprevalence to HBV, T. pallidum and HIV-1 (p = 0.0053). The results confirm that transfusion of unscreened blood carries severe risks of transmitting serious infectious agents and that is a need to enforce laws for transfusing blood in Nigeria. Meanwhile, in the absence of screening facilities, proper counselling of blood donors in order to ascertain their risk behaviour should be used to select donors and reduce this risk.

Adult↗

IgG2 associated hypergammaglobulinaemia in some Nigerians with HIV infection.

Concentrations of immunoglobulins (IgA, IgG and IgM) were measured in Nigerians with (HIV) infection. Considerable elevations up to two-fold the reference values were observed for IgG and IgM in the patient group as a whole but elevations in IgA concentration were least marked albeit significantly different from the healthy subjects. Elevation of a particular isotype was not always concomitant with elevation of the other major classes in the same patient. Overall, these elevations were observed in both symptomatic and asymptomatic infected subjects. Further analysis of IgG hyperglobulinemia showed that increases in this major class may be due to increased IgG2 subclass concentrations. It is suggested that elevation of IgG2 subclass in Nigerians with HIV infection and not IgG1 or IgG3 may be due to genetic and environmental factors rather than variation in the strain of the virus.

Case-Control Studies↗

Meningioma resembling an epidermoid tumor.

A case of retro-orbital meningioma who presented to the Department of Surgery, Neuro-surgery Unit of Tikur Anbessa Hospital in June 1993 with a progressive right eye proptosis is described. Exploration through a right frontal craniotomy showed a well circumscribed and encapsulated thickened bony tumor that had a cavity containing a cheesy-yellowish oily material. The lesion was successfully shelled-out. The preoperative diagnosis was meningioma. However, based on its intraoperative macroscopic appearance, mode of presentation, and location of the lesion an impression of an epidermoid tumor (cholesteatoma) was made. The result of histologic examination turned out to be meningioma (psammomatous type). Literature review on both conditions, the pathologic characteristics and clinical features are discussed briefly.

Adult↗

Seroepidemiology of human immunodeficiency virus infection in Borno State of Nigeria by sentinel surveillance.

A serosurvey for human immunodeficiency virus (HIV) infection was carried out in three well-separated population centers in Borno State of Nigeria in 1989-1990. The study subjects were 1,259 made up of sexually transmitted disease (STD) clinic attenders, pregnant women, female prostitutes, and blood donors. Sera were screened by enzyme-linked immunosorbent assay and confirmation was done by Western blotting. The overall seroprevalence was 1.67% (21/1,259), with no significant differences from one population center to another. There were, however, significant differences among the population groups studied: prostitutes, 4.24%; STD clinic attenders, 1.67%; blood donors, 0.71%; and pregnant women, 0.24%. Of the 21 seropositives, 18 were positive for HIV-1 only; 1 was positive for HIV-2 only; and 2 were positive for both HIV-1 and HIV-2. All three HIV-2-positive sera were from prostitutes. Prevalence rates found in this study showed marked increases from 2 to 3 years earlier. There is therefore the need for a vigorous and sustained intervention program.

Adolescent↗

Determination by Widal agglutination of the baseline titre for the diagnosis of typhoid fever in two Nigerian states.

This study was carried out in Borno and Plateau States of Nigeria to determine the baseline titre for the diagnosis of typhoid fever using a single Widal test. Of 172 patients with symptoms and signs of typhoid fever, 92.4% and 90.7% had reciprocal O and H antibody titres respectively of 160 or above. On the other hand, 95.3% and 66.3% of the 937 healthy control subjects had reciprocal O and H antibody titres respectively of 80 or less. The results of this study suggest that in Borno and Plateau States of Nigeria a reciprocal O antibody titre of 160 and above in persons with illness whose symptoms and signs are compatible with typhoid fever could be considered diagnostic using the single Widal test.

Adolescent↗

Prevalence of human immunodeficiency virus-infection among pregnant women attending ante-natal clinic in Maiduguri, north-eastern Nigeria.

A seroepidemiological survey conducted among 1,059 pregnant women in Maiduguri, North-eastern Nigeria from September, 1988 to April, 1990 showed that 5 women or 0.47% were positive for HIV antibodies. Three of the women (0.28%) were positive for HIV-1 while 2 others (0.19%) were positive for HIV-2; this is consistent with the known fact that both viruses are active in West Africa, a sub-region of which Nigeria is part. Detailed information available on 4 of the 5 seropositive women and their husbands did not reveal any known risk factor favouring HIV-infection. In addition to the 5 confirmed seropositive women, 10 others (0.94%) gave Western blot patterns that were neither HIV-1 nor HIV-2. The significance of this observation, if any, needs to be clarified.

Adolescent↗

Human immunodeficiency virus (HIV) infection in patients attending a sexually transmitted diseases clinic in Borno State of Nigeria.

Results of a study to determine if patients attending sexually transmitted diseases (STD) clinics are at high risk to human immunodeficiency virus (HIV) infection are presented. The 206 patients who attended the STD clinic at the Maiduguri General Hospital consisted of 200 males and 6 females, most of whom were aged between 20 and 29 years and were single. Only one of the 206 serum samples (0.49%) was confirmed seropositive for HIV-1 antibodies. However, cultures from 143 of 174 swabs taken from the subjects yielded significant growth of which Staphylococcus aureus was the predominant isolate followed by Neisseria gonorrhoea. Antibodies to Treponema pallidum were also detected in 3.9% of the serum samples. This study shows that HIV-1 infection is relatively rare in Borno state of Nigeria. In spite of this, a well-planned health education campaign for STD patients is indicated if HIV infection is to be effectively controlled.

Adolescent↗

Comparison of commercial kits for the detection of antibody to human immunodeficiency virus type 1 (HIV-1) in Nigeria.

Four commercial kits for the detection of antibodies to HIV-1 were compared with regard to their sensitivity, specificity and positive predictive value. The Wellcozyme competitive enzyme immunoassay was the least sensitive (62.5%), while Roche EIA, was the most sensitive (100%). All the commercial kits gave false negative results except the Roche EIA system. The Serodia particle agglutination test had the least positive predictive value of 26.9% while Roche EIA had the highest (88.9%). Our results show that commercial HIV-I antibody test kits are not equally sensitive in detecting positive sera. The practice of using Wellcozyme EIA alone for screening blood meant for transfusion should be discouraged because it does not detect all positive sera and might therefore increase the chances of transfusing HIV-I positive blood. The Roche EIA system appears to be the most reliable for screening blood. Test systems which detect HIV-2 should also be used for screening blood meant for transfusion.

Enzyme-Linked Immunosorbent Assay↗

Blood group, secretor status and susceptibility to bacterial meningitis.

Epidemiological evidence is summarized for associations of ABO blood group and secretor status with susceptibility to invasive disease due to capsulate organisms responsible for the majority of bacterial meningitis. Host-parasite interactions that might underly these findings are proposed and evidence to support or refute them provided.

Bacterial Infections↗

Human immunodeficiency virus type 1 (HIV-1) infection among female prostitutes in Borno State of Nigeria: one year follow-up.

Serological investigations on female prostitutes resident in Borno State in northeastern Nigeria have shown that the seroprevalence of HIV-1 infection has increased 9.81%--fold in one year. The highest sero-prevalence rates were found amongst prostitutes who had not benefited from previous health education campaigns. Prostitution appears to be on the increase in spite of AIDS probably because of the difficulty in finding alternative means of making a living. Attempts to halt the spread of HIV infection are hampered by the fact that most prostitutes are indifferent to the use of condoms and do not appreciate the importance of protecting themselves from the risks of HIV infection. Their frequent mobility also poses a problem as it makes it difficult for them to benefit from health education campaigns. The prevalence of HIV-1 infection among female prostitutes in Borno State (as indeed in other States in Nigeria) is likely to rise sharply in the next few years unless serious efforts are made to intensify health education campaigns targeted at the high risk groups.

Acquired Immunodeficiency Syndrome↗