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Biomedical subjects

M A Durosinmi

Publications and source records attributed to M A Durosinmi.

At least 19 recordsLinked to original sources
PubMed2006

Clinical and prognostic features of Nigerians with chronic myeloid leukemia.

AIMS AND OBJECTIVES: Chronic myeloid leukemia (CML). PATIENTS AND METHODS: CML patients confirmed at the OAUTHC, Ile-Ife between June 1986 and December 1999 were studied prospectively until death or the last visit to the clinic. Stages of the disease at diagnosis, presenting clinical features and laboratory parameters, as well as the drug history were noted for each patient. Survival of each patient was computed from the date of diagnosis until the date of death. Kaplan-Meier statistical technique was used for analysis of survival. Factors were compared with log rank test. Student's t-test was used for comparing means of presenting clinical and laboratory parameters between groups. P-value of <0.05 was considered significant. SPSS for windows Release 10 (Real Stats, Real Easy, 1989-1999) was used for all calculations. RESULTS AND CONCLUSION: There were 42 patients (27 males and 15 females, ratio of 1.8:1) with ages ranging from 12-74 (median=38.0) years. Philadelphia chromosome was positive in the five patients (12.0%) that underwent cytogenetic analysis. Thirty-three of the patients (78.6%) presented in treatable chronic phase and the other 9 (21.4%) were seen in advanced stages (7 in accelerated & 2 in blastic phase). The median survival of patients that presented in chronic phase was 31.7 months compared to 0.16 months in patients presenting in advanced stages, the difference was statistically significant (log rank=7.8, p-value=0.005). Significant positive correlation was obtained between spleen size and total white cell count at diagnosis (r=0.36, p=0.02). Univariate regression analysis showed negative relationship between survival and ages of patients at diagnosis, haematocrit value, spleen and liver sizes, and blast count. The relationships were statistically significant for only liver and spleen (b=-0.63, p=0.004 and b=-0.51, p=0.026, respectively). Regression of both the liver and spleen with survival, still confirms the significant negative relationship between hepatomegaly and survival.

Adolescent↗
PubMed2006

AIDS-associated Kaposi's sarcoma in Northeastern Nigeria.

INTRODUCTION: Kaposi's sarcoma is an acquired immunodeficiency syndrome (AIDS)-defining illness, and with the size of the human immunodeficiency virus (HIV)/AIDS pandemic in sub-Saharan Africa, AIDS-related Kaposi's sarcoma (KS) are now being diagnosed more frequently, although the true incidence of HIV-associated KS is not known. The clinical presentations of AIDS-related KS varied markedly across the African continent. This article reports a series of unusual clinical presentations of the tumour in Northeastern Nigeria. METHODS: This is a prospective study carried out from September 2003 to August 2005, at the University of Maiduguri Teaching Hospital, Borno State, Northeastern Nigeria. RESULTS: 20 cases of histologically-confirmed KS were prospectively studied. There were 17 (85 percent) men and three (15 percent) women, giving a male to female ratio of 5.7:1. Their ages ranged from 21-45 (median 37) years. 18 (90 percent) of the patients were anaemic. Mean haematocrit value, CD4+ cell count and duration of symptoms for all the patients were 29.5 +/- 7.5 percent, 119.0 +/- 91.4 cells per microlitre and 3.5 +/-1.7 months, respectively. Multiple lesions were a common presentation affecting sites such as lower limbs, trunk, conjunctiva, upper limbs and rectum as well as penis, lymph node, scrotum and oropharynx. CONCLUSION: Contrary to other reports that KS is not associated with HIV infection, our study has demonstrated otherwise. This study also showed that both sexes are affected but with a male preponderance. KS is also a late presentation of the HIV/AIDS disease spectrum in our environment and has varied clinical manifestations. There is an urgent need to develop health education programmes to enhance the understanding of this disease and how it spreads, particularly among the young generation.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Liver cirrhosis: Child-Pugh grading of cases seen in Nigeria.

Child-Pugh grading is an important determinant of treatment options, surgical interventions and prognosis in chronic liver disease. Sixty-four liver cirrhosis patients (49 men, 15 women) seen at Ile-Ife, Nigeria were graded according to the Child-Pugh parameters. Only one (1.6%) was in Class A, while 21 (32.8%) and 42 (65.6%) were in Classes B and C, respectively. Thirty-four either had coagulopathy or were already in encephalopathy at the time of presentation. Hepatitis B virus-associated disease was present in 64% of the patients. Most Nigerian cirrhosis patients present with very advanced disease; they are thus poor-risk candidates for diagnostic procedures and surgery. Efforts should be intensified at making the diagnosis at a much earlier stage and universal immunization with the hepatitis B vaccine should be commenced to reduce the incidence of HBV-related chronic liver disease in Nigeria.

Adult↗
PubMed2005

Haematological parameters in sickle cell anaemia patients with and without splenomegaly.

BACKGROUND: The aim is to investigate the clinical and haematologic effects of persistent splenomegaly (PS) and splenectomy in a population of Nigerians with sickle cell anaemia (SCA). MATERIALS AND METHODS: SCA patients attending the Haematology clinic of the OAUTHC, Ile-Ife, were examined physically and haematologically. Patients with PS were compared with age and sex-matched controls without splenomegaly. Foetal haemoglobin (HbF), packed cell volume (PCV), reticulocyte count and the frequency of blood transfusion were noted for both groups. The clinical effects of splenectomy were documented in three patients who underwent the procedure because of symptomatic massive splenomegaly (> or = 10 cm). RESULTS: Seventy-one patients, 40 males and 31 females, aged 16-48 (median, 21) years were studied. Nineteen (26.8%) had PS ranging from 3-22 cm (mean +/- SD = 9.4 +/- 4.4 cm; median = 7 cm). Ten of these had massive splenomegaly (spleen > or = 10 cm) varying from 10-22 cm (mean +/- SD = 12.3 +/- 3.8 cm; median = 12 cm). No significant differences were found between the mean values of HbF, PCV, reticulocyte count, frequencies of pain crisis, transfusion requirement, weights and heights in SCA with PS and age-sex matched controls without PS. Annual transfusion requirement showed a mild negative correlation with splenic size (r = -0.06), which was not statistically significant (p = 0.882). Significant haematologic improvement was confirmed in the 3 patients who underwent elective splenectomy for splenomegaly-induced hypersplenism. CONCLUSIONS: We conclude that massive persistent splenomegaly is a recognised cause of significant morbidity in SCA patients as evident in the patients that underwent splenectomy. However, where it is mild to moderate, PS may not have significant adverse effect on the overall clinical picture of the disorder.

Adolescent↗
PubMed2004

The search for a predictor of CD4 cell count continues: total lymphocyte count is not a substitute for CD4 cell count in the management of HIV-infected individuals in a resource-limited setting.

Total lymphocyte count (TLC) has been recommended as a substitute for CD4 cell count for the management of HIV-infected individuals living in resource-limited settings. To confirm this, 151 TLCs and CD4 cell counts were obtained from 109 patients who had not yet started treatment and analyzed. CD4 cell counts of <200 cells/mm3 were found in 42 cases (37.8%) with TLCs of > or =1200 cells/mm3. Thus, 1 in 3 individuals would have been deprived of needed treatment. Therefore, in this setting, TLC is not a reliable predictor of CD4 cell count in HIV-infected individuals.

Adult↗
PubMed2004

Non Burkitt's non-Hodgkin's lymphoma in Ile-Ife.

To determine the frequency, age and sex patterns of non-Burkitt's non-Hodgkin's lymphoma among cases of lymphoma seen at the histopathology department of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The records of patients with histologically diagnosed non-Burkitt's non-Hodgkin's lymphoma seen over a period of five years were studied. The classification was based on the Working Formulation. The sex and the age at diagnosis as well as the sites of the lesions were noted. Of the fifty three cases of non-Burkitt's non-Hodgkin's lymphoma seen during the study period 54.7% had intermediate grade tumours; 24.5% has low grade and 20.8% had high grade tumours. 92.5% of the cases occurred in adults over the age of 20 years. There was also a male predominance. Nodal as well as extranodal sites were involved and peripheral lymph node involvement most often affected the cervical group of lymph nodes. The results showed that non-Burkitt's non-Hodgkin's lymphoma is predominantly a disease of adults which more often affected males than females. The intermediate grade type with the possibility of cure is the type most often seen in this study. Therefore, early diagnosis and preventive measures against known risk factors in our environment, where possible, are strongly recommended.

Adolescent↗
PubMed2003

Blood transfusion related paediatric HIV/AIDS in Ile-Ife, Nigeria.

This prospective study was aimed at determining the contribution of blood transfusion to paediatric HIV infection in Ile-lfe, Nigeria. It involved HIV screening of consecutive children presenting at the Obafemi Awolowo University Teaching Hospital (OAUTH), Ile-Ife, between March 1996 and March 2001, with any of the signs in the WHO clinical case definition for paediatric AIDS. The HIV serostatus of blood donors at the OAUTH was also extracted from the blood bank records. Of the 263 children who met the criteria for HIV screening, 35 (13.3%) were HIV-positive. Eighteen of the 263 children screened had a history of blood transfusion and 12 (66.7%) of the 18 were HIV-positive. Eleven (91.7%) of the 12 HIV-positive patients were transfused in private hospitals with blood collected from private laboratories. The blood with which the HIV-positive children were transfused was unscreened in three, screened in two and the HIV status unknown in the others. The sole voluntary donor was an HIV-positive father whose child received his unscreened blood. Only two (16. 7%) of the mothers of the previously transfused HIV-positive children were also HIV-positive. 'Paid'donors accounted for 94.3% of total donors in OAUTH blood bank records and cumulative HIV-positivity was statistically significantly higher in 'paid' donors than in voluntary donors (p = 0.005). Wl conclude that transfusion with unsafe blood is an important route for HIV infection in symptomatic children and that HIV-positivity is higher among paid donors. recommend the establishment of a national blood transfusion service, which is presently non-existent in Nigeria, and the enforcement of laws guiding blood transfusion. Voluntary blood donation should been encouraged and health workers in the private sectors educated on the link between blood transfusion and HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2003

A retrospective study of prevalence of antibody to HIV in blood donors at Ile-Ife, Nigeria.

Records of voluntary and remunerative blood donors bled at the OAUTHC, Ile-Ife, Nigeria between January 1993 and December 2000 were reviewed for HIV sero-positivity. With a structured questionnaire, and over a period of 2 months, the attitudes and awareness of some of the donors of HIV/AIDS epidemic in the country were also assessed. Of the 16,080 units of blood collected in the period under review, only 1073(6.7%) were obtained from voluntary donors. The cumulative HIV seroprevalence rate was 2.1% in the paid donors as against 0.3% in the voluntary donors (c2 = 16.3, df = 1, p = 0.00003). Sixty-five (805) of the donors interviewed confirmed previous knowledge of HIV/AIDS before the interview. All the respondents appreciated the roles of blood transfusion in the transmission of AIDS viruses. The majority (74%) of the respondents were unemployed. Poverty was the reason given by 61(75%) of the commercial donors for selling their blood. We conclude that there is a greater risk of transmitting AIDS viruses (and possibly other blood transmissible diseases) through remunerated blood donors.

Adult↗
PubMed2002

Autoimmune haemolytic anaemia: pattern of presentation and management outcome in a Nigerian population: a ten-year experience.

Autoimmune haemolytic anaemia (AHA) is one of the commonest autoimmune disorders of man. It is characterised by the binding of anti-erythrocyte autoantibodies to red blood cells and destruction of the coated cells in the reticulo-endothelial system. Autoimnmune disorders are said to be rare in indigenous African population, probably due to the widespread infectious diseases, which impair host's T-cell immunity. This study is therefore aimed at investigating the pattern of presentation and management outcome of patients with AHA seen over a period of 10 years (June 1988 to May 1998) at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. We retrospectively analysed the records of patients with respect to the clinical, haematological, biochemical and serological features of AHA seen within the study period. Diagnosis was based on laboratory features of haemolytic anaemia and/or a positive direct anti-human globulin (Coombs') test after excluding other causes of haemolytic anaemia. Treatment protocol and outcome were noted in all cases. We identified 13 patients with AHA (7 females, 6 males) aged 6-70 (median, 42) years. Six (42%) had secondary AHA and the remaining 8 presented with primary (idiopathic) AHA. Laboratory evidence of haemolysis (bone marrow erythroid hyperplasia and hyperbilirubinaemia) was found in all cases, while the direct Coomb's test was positive in 10 (76.9%) cases. All the patients had moderate-severe anaemia within the course of the disease, requiring blood transfusion. Remission was induced with prednisolone in all except three cases with secondary AHA who died of the primary disease before AHA could be controlled. Follow-up period post-remission ranged between 1 and 78 months. However, 2 (20%) are still being followed-up till the time of this report. This study agrees with the view that autoimmune disorders are not common in Nigerians, as documented for other Africans. It also shows that steroid therapy (prednisolone) is quite effective, especially, in idiopathic AHA, and that red cell transfusion could be useful in life-threatening anaemia.

Adolescent↗
PubMed2001

Aspirin-induced duodenal perforation in a Nigerian with sickle cell disease: a case report.

A case of duodenal perforation associated with aspirin ingestion in a 21-year old male Nigerian with sickle cell anaemia is reported. He presented with a sudden onset of epigastric pain which later spread to involve other parts of the abdomen. He had previously used aspirin at a dose of 1800 mg daily for two weeks to treat bone pain. Abdominal ultrasonography and X-ray showed fluid collection in the pelvis and elevation of the diaphragm. At exploratory laparotomy, the perforation found in the first part of the duodenum anteriorly was repaired. He was discharged 11 days post-surgery. In view of the frequent usage of salicylates and non-steroidal anti-inflammatory drugs to treat painful crises in sickle cell disease, we suggest careful monitoring of patients on such drugs and those with dyspeptic symptoms must be fully investigated including the use of endoscopy, to prevent fatal outcome.

Adult↗
PubMed1999

Elemental analysis of blood of Nigerian hypertensive subjects.

Proton-induced X-ray emission (PIXE) has been used to obtain the concentrations of 11 elements (P, S, Cl, K, Ca, Fe, Cu, Zn, Br, Rb, and Cd) in whole-blood samples of 16 hypertensive subjects (mean age: 52.5 +/- 0.5 yr) and 18 age-matched controls (mean age: 51.5 +/- 0.5 yr) in a Nigerian population. The results of the study indicate that the hypertensive subjects have significantly higher mean concentration of Cl, Cd, Cu, and Zn when compared with the controls, and the mean concentration of P, K, and Ca was found to be significantly lower in the hypertensive group in comparison to the controls. Furthermore, the Zn:Cd ratio was found to be significantly higher in the controls than in the hypertensives, and the Cu:Zn ratio was significantly higher in the hypertensives.

Case-Control Studies↗
PubMed1999

The incidence and characteristics of some paraneoplastic syndromes of hepatocellular carcinoma in Nigerian patients.

OBJECTIVE: To determine whether paraneoplastic syndromes of hepatocellular carcinoma such as erythrocytosis, hypoglycaemia, hypercholesterolaemia and hypercalcaemia are found in Nigerian patients with this tumour, and, if present, to determine their incidence and characteristics. DESIGN: Consecutive patients with a diagnosis of hepatocellular carcinoma seen over a 10-year period at Ile-Ife, Nigeria, underwent haematocrit (100 patients), plasma glucose (65), cholesterol (65) and calcium studies (30). Shortage of laboratory reagents did not allow all the 100 patients to be tested for plasma glucose, cholesterol and calcium. METHODS: Haematocrit was determined by the microhaematocrit method, and the glucose oxidase-peroxidase, Liebermann-Burchard and O-cresolphthalein complexone methods were employed for the estimation of plasma glucose, cholesterol and calcium respectively. RESULTS: The haematocrit values ranged from 19 to 63% with a mean of 34.51% (SD 7.72). Only 1 out of 100 patients (1%) had erythrocytosis (haematocrit 63%). Sixty-five patients had their plasma glucose determined. The range of values for fasting plasma glucose (FPG) was 1-8.4 mmol/l with a mean of 4.3 (SD 1.6). Hypoglycaemia occurred in 18 patients (27.7%)(14 males, 4 females). The mean liver span for patients with FPG > 5.0 mmol/l was 16.87 cm (SD 3.03), while the value for those with FPG < 3.0 mmol/l was 22.0 cm (SD 6.14, P < 0.05). Plasma cholesterol was determined in 65 patients and the range of values was 2.1 -18.1 mmol/l with a mean of 5.65 (SD 2.42). Hypercholesterolaemia occurred in 16 patients (24.6%) (15 males, 1 female). The range of plasma calcium obtained in 30 patients was 1.6-3.15 mmol/l with a mean of 2.36 (SD 0.32). Three patients (10%) (all males) had hypercalcaemia. CONCLUSION: While erythrocytosis has a low incidence, hypoglycaemia and hypercholesterolaemia are important paraneoplastic syndromes of hepatocellular carcinoma in Nigerian patients. The study confirms that the larger the liver mass, the greater the tendency towards hypoglycaemia. Also, the paraneoplastic syndromes studied occurred predominantly in hepatocellular carcinomas with cirrhosis.

Calcium↗
PubMed1999

Burkitt's lymphoma presenting as lower lip paraesthesia in a 24 year old Nigerian. Case report.

An unusual case of stage D Burkitt's lymphoma in a 24 year old Nigerian female undergraduate is reported. There was a four month history of left lower lip paraesthesia followed three months later by a slowly progressive 'pimple-sized' nodular mandibular swelling arising from the mental foramen region. A full-blown, rapidly developing abdominal mass manifested only three weeks after a biopsy of the mandibular swelling. Aspiration of the latter and a histologic report of the mandibular mass confirmed Burkitt's lymphoma. The patient responded very well to appropriate chemotherapy. Clinicians should not overlook insidious jaw swellings in any adult residing in the endemic zone of Burkitt's lymphoma, in view of the fact that successful therapy is dependent on early diagnosis. Mental nerve paraesthesia is very rarely seen in Burkitt's lymphoma.

Abdominal Neoplasms↗
PubMed1998

Hepatitis D virus antigen in HBsAg positive chronic liver disease in Nigeria.

Hepatitis B virus (HBV) is strongly associated with an aggressive type of chronic active liver disease (CALD) and hepatocellular carcinoma, which tend to present in the relatively young, in sub-Saharan Africa. It is known that co-existent infection with HDV tends to aggravate the course of HBV-associated liver disease. This study was carried out to determine the sero-prevalence of hepatitis D virus (HDV) among thirty one consecutive southwestern Nigerians with HBsAg-positive, HCV antibody-negative chronic liver disease. Alongside, we tested for HBsAg and the HDV antigen in fifty randomly selected sera each from blood donors and university freshmen undergoing pre-admission medical tests and who had no clinical evidence of liver disease. The HDV antigen (HDVAg) was found in the sera of two of 31 (6.5%) patients. Among the blood donors and university freshmen, HBsAg prevalence was twelve and eight per cent respectively, while HDVAg was present in none. In addition, liver biopsies of 28 other patients were stained for HDVAg. None of these was positive. These findings show that HDV prevalence is low in our community, and suggest that the virus might play only a minor role in the pathogenesis of HBsAg-associated chronic liver disease among our patients. A review of reports on the epidemiology of HDV in sub-Saharan Africa shows a rather complicated pattern that makes its impact on HBsAg-associated CALD difficult to assess. More studies designed to elucidate this pattern of HDV epidemiology are called for.

Blood Donors↗
PubMed1997

Emergency autologous blood transfusion in the management of ruptured ectopic pregnancy.

Thirty-three cases of ruptured ectopic pregnancies treated by emergency autologous blood transfusion were compared with 85 cases treated by homologous blood. The postoperative outcome was satisfactory and the duration of hospital stay was similar in both groups. However, the quantity of blood transfused in those who received autologous blood was significantly higher than in those transfused with homologous blood ( P 0.02). Because of this experience we advocate greater use of intra-operative blood salvage and autotransfusion, even when banked homologous blood is available, in the management of ruptured ectopic pregnancy.

Journal Article↗
PubMed1997

Familial Burkitt's lymphoma in Nigerians.

Three Nigerian sib-pairs with familial Burkitt's lymphoma (BL) seen between 1986 and 1996 are described. Their ages ranged from 4 to 20 years (median 9.5), and there were five males and one female. The mean age interval between each pair at presentation was 4 years (3-6) and the mean time interval 22 months (0.3-41). Two of the sib-pairs were sex-concordant, including a set of monozygotic twins. Five of the patients presented in stage C and one in stage A. Parental consanguinity was not found in any group. Space-clustering was confirmed in all three but time-clustering in only one. The occurrence of BL in multiple members of the same family, the presence of sex concordance and the relatively wide variation in the time of onset of disease between each pair suggest genetic predisposition as a possible additional aetiological factor for BL in the families affected.

Adolescent↗
PubMed1995

Acceptability of prenatal diagnosis of sickle cell anaemia (SCA) by female patients and parents of SCA patients in Nigeria.

The acceptability of prenatal diagnosis (PND) of sickle cell anaemia (SCA) as a means of controlling sickle cell disorder in Nigeria was examined using a structured questionnaire. The respondents were comprised of 92 adult female patients with SCA, aged 15-20 (23 +/- 6) years; 53 HbAS mothers, aged 20-61 (37 +/- 11) years and 48 HbAS fathers, aged 33-65 (46 +/- 8) years. More than 85% of the respondents would like PND to be offered in Nigeria and 92% of the HbAS mothers as well as 86% of the fathers would like to have the investigation or allow their wives to go through the procedure, respectively. Only 35% of the patients as compared to 63% of the mothers and 51% of the fathers would opt for termination of an affected pregnancy. Fear of the complications of abortion and religious convictions were the two most frequently cited reasons for opposing pregnancy termination. The high percentage of parents who would opt for termination of an affected pregnancy was associated with the societal emphasis on perfection and on previous experience in management of SCA patients. It is interesting that most of the respondents still favoured effective genetic counselling as the best means of controlling SCA.

Adolescent↗