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Biomedical subjects

M O Balogun

Publications and source records attributed to M O Balogun.

At least 19 recordsLinked to original sources
PubMed2003

Exudative retinal detachment occurring in a patient with pyogenic liver abscess.

This is a report of a rare case of bilateral exudative retinal detachment occurring in a young Nigerian male with pyogenic liver abscess. Detailed ocular and clinical examination with biochemical, haematological and microbiological studies of the blood and liver aspirate were done. Ocular and abdominal scan plus surgical drainage of abscess were also done. The main features were febrile illness with hepatomegaly and sudden loss of eyesight. Visual acuity was light perception in both eyes. The cardiovascular and renal systems were normal. Ocular scan showed bilateral bullous retinal detachment while abdominal ultrasound revealed multiple liver abscess cavities. HIV and HBsAg tests were negative. Pyogenic liver abscess should be regarded as possible cause of exudative retinal detachment and has a potential blinding complication.

Adult↗
PubMed1996

Concurrent alpha 1 adrenergic blockade and angiotensin converting enzyme inhibition in the treatment of congestive heart failure.

We tested the hypothesis that concurrent inhibition of the renin angiotensin system by enalapril (5 mg) and the sympathetic nervous system by alpha 1 adrenergic blockade (prazosin 1 mg) will be superior to enalapril alone in 17 patients with heart failure on standard therapy, in a single blind, placebo-controlled, randomized parallel group study for 4 weeks. Enalapril alone induced a significant increase in exercise time from 499 +/- 412 s to 707 +/- 608 s (P < 0.05, ANOVA), but the increase induced by the enalapril + prazosin combination was significantly greater (P < 0.025, MANOVA) from 214 +/- 271 to 1007 +/- 784 s as was the increase in creatinine clearance (P < 0.05).

Administration, Oral↗
PubMed1996

Oral therapy with combined enalapril, prazosin and hydrochlorothiazide in the acute treatment of severe hypertension in Nigerians.

OBJECTIVE: The efficacy, safety, tolerability and speed of onset of the hypotensive action of the combination of oral enalapril (10 mg) prazosin (1 mg) and hydrochlorothiazide (50 mg) has been assessed in 12 Nigerians with severe hypertension (Diastolic BP > or = 115 mmHg). PATIENTS: The ages of the patients ranged from 30-60 years, and the serum creatinine from 52-732 mumol.l-1. The initial blood pressure was 200/130 mmHg. RESULTS: The combination significantly reduced systolic and diastolic blood pressure respectively. The hypotensive action appeared within 0.5 h and led to a fall in BP to 175/120 mmHg, and the peak action occurred at 4 h, when the BP was 138/99 mmHg, and it persisted upto 24 h (160/101 mmHg). Despite the significant fall in blood pressure, no reflex tachycardia was observed. Transient dizziness was seen in 2 patients, but otherwise all claimed improvement in clinical status and a clearer sensorium. CONCLUSION: The combination may be a useful oral treatment for the rapid control of severe hypertension in Blacks.

Administration, Oral↗
PubMed1996

Left ventricular hypertrophy as a risk factor in hypertension.

Hypertension is established as one of the major risk factors for congestive heart failure, renal failure, cerebrovascular accident and coronary artery disease. Left ventricular hypertrophy (LVH) is an adaptive response to the increased afterload in hypertension, and therefore serves to normalize wall stress. However, LVH has been established as an independent risk factor for adverse cardiovascular events and death in hypertension. For this reason, considerable attention has been directed towards a better understanding of LVH as a risk factor. As recognition of the risk associated with LVH has grown, investigators have increasingly focused attention on improving methods for the detection of LVH, assessing its effects on cardiac function, defining its relationship with myocardial ischaemia and sudden death, evaluating the role of antihypertensive treatment in the regression of LVH and assessing whether such regression is beneficial in the long term.

Death, Sudden, Cardiac↗
PubMed1996

A three year clinical review of the impact of angiotensin converting enzyme inhibitors on the intra hospital mortality of congestive heart failure in Nigerians.

Angiotensin converting enzymes inhibitors are now regarded as the cornerstone of congestive heart failure therapy owing to established reduction in mortality and the symptomatic amelioration following their use. Although the response to converting enzyme inhibitor therapy may be influenced by race, we have reported a trend to reduce intra hospital mortality, the correction of hyponatremia and shortened hospitalization in Nigerians treated with converting enzyme inhibitors. We have now conducted an extended retrospective study, to evaluate the trends in the use of enalapril or captopril and its impact on prognosis in Nigerian patients with heart failure alone, admitted between January 1992 to December 1994. The proportion of heart failure treated with (captopril or enalapril) increased from 37pc in 1992, to 50pc in 1993, to 65pc in 1994. The demographic variables and cause of heart disease were similar in patients treated with converting enzyme inhibitors (n = 55) and those treated conventionally (n = 36). The cumulative mortality among converting enzyme inhibitors treated patients, was (8/55, 14pc) compared to patients not treated (17/36, 48pc) x2 = 12.4; p < 0.0001. There was no sex predilection in mortality (M = 25pc, F = 28pc, mean 27pc). However, initial serum Na+,125mmol was significantly (x2 = 11.1; p < 0.001) more common in the dead patients, 25pc compared to the survivors discharged home 7.5pc. The median hospital stay was 17 days in captopril treated survivors (range two to 44 days) and 19 days (range four to 67 days) in conventionally treated patients. Thus converting enzyme inhibitor therapy may reduce intra hospital mortality in Black Africans hospitalized for congestive heart failure and shorten hospital stay, despite the epidemiologically low plasma renin in Blacks. Hyponatremia may be a poor prognostic index in heart failure in our patients, and its reversal by converting enzyme inhibitors may reflect neurohormonal inhibitor. Earlier and more wide spread use of angiotensin converting enzyme inhibitors in Nigerian and Black Africans with chronic heart failure is now clearly indicated.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1994

Serum albumin levels and intraethnic variations in susceptibility to a seasonal ataxia in Nigerians.

A seasonal ataxic syndrome occurs annually, predominantly among the Ijeshas of Western Nigeria, characterized by intention tremors, cerebellar ataxia, nystagmus, and varying levels of impaired consciousness. There are evidences for intraethnic variations in susceptibility to the ataxic syndrome among the Ijeshas. The reasons for such intraethnic variations in susceptibility are unclear. To test the notion that the protein nutritional status of individuals may presage susceptibility to disease, we have undertaken a controlled study of serum albumin levels as an index of protein nutriture in patients presenting with the disease. Our study shows that the mean serum albumin level in susceptible individuals on admission was significantly lower than at discharge (Mann-Whitney test: P = .0019), was significantly lower than in controls (P = .0004), and was in no single case higher than 34 g/L (laboratory reference value 35 to 50 g/L). These results imply that the protein nutriture of individuals predicts susceptibility to the seasonal ataxia.

Adult↗
PubMed1993

An audit of emergency echocardiography in a district general hospital.

Eighty patients (43 M, 37 F), aged 23-89 years who were referred for emergency echocardiography over a 12-month period were prospectively studied in order to determine the reasons for emergency echocardiography and the influence of its results on patient management. The most frequent emergency request was to clarify whether the basis for cardiomegaly in a haemodynamically unstable patient was pericardial effusion or left ventricular dilatation. Other reasons for requests were for assessment for source of systemic emboli, acute complications of myocardial infarction, endocarditis, valve dysfunction and cardiac trauma. As a consequence of the emergency echocardiography, management was immediately influenced in 19 patients. This study has provided information on the specific settings in which emergency echocardiography can be justified.

Adult↗
PubMed1993

Exercise induced bronchoconstriction in Nigerian asthmatics.

This study describes the result of free-running exercise performed on 40 asthmatic subjects and 40 age and sex matched controls. A percentage fall of more than 15% in PEFR was used for the diagnosis of exercise-induced asthma (EIA). 77.5% of our asthmatic patients had exercise-induced bronchoconstriction (EIB) while none of the control subjects exhibited EIB. Twenty-seven patients gave positive history of EIA out of which 25 (92.59%) had positive exercise testing. Conversely, 13 patients with asthma did not give history of EIA but 6 of this (46.15%) were found to have EIB on exercise. History alone is therefore insufficient to diagnose patients with exercise-induced asthma.

Adolescent↗
PubMed1991

A study of an outbreak of schistosomiasis in two resettlement villages near Abeokuta, Ogun State, Nigeria.

Frequent reports of haematuria among resettlers at Ibaro and Abule-titun located close to a newly constructed reservoir, 20 km north-west of Abeokuta, Ogun State, Nigeria, prompted a pre-control survey to assess age and sex distribution of urinary schistosomiasis in the communities. 210 persons were examined at Ibaro and 145 at Abule-titun between April 1988 and February 1989. Overall prevalence was about 80% in both villages, and all age and sex groups examined were affected. The pattern of infection in both villages was similar, prevalence being high in all age and sex groups, and, unlike most endemic communities, the rate of infection was not significantly higher among the 5-14 year age groups. Intensity of infection was also high in all age and sex groups with mean range egg output of between 73 +/- 73 and 2016 +/- 3875 ova/10ml urine at Ibaro and between 231 +/- 122 and 1340 +/- 1786 ova/10ml urine at Abule-titun. This is attributed to an occupation-related high rate of human water contact in both villages.

Adolescent↗
PubMed1991

Systolic and diastolic function following regression of left ventricular hypertrophy in hypertension.

Echocardiography has demonstrated that regression of left ventricular hypertrophy (LVH) can occur following control of blood pressure, although the role of individual drugs in promoting this regression remains less clear. Since LVH in hypertension is an adaptive response to the increased afterload, and therefore serves to normalize wall stress, it is important to establish the effects of hypertrophy regression on cardiac function. Assessment of these effects, however, is complicated by the contributions of alteration in loading conditions and drug therapy to left ventricular function. Since systolic function is normal in LVH, it is not surprising that regression leads to no significant change in commonly measured indices of contractile function. Abnormalities of diastolic function, on the other hand, occur as a consequence of both hypertension and LVH, and reversal of these abnormalities might, therefore, be expected to lead to an improvement in diastolic function. This is indeed the case, although not in all reported studies. Only recently has information emerged on the effects of regression of LVH on function when blood pressure is allowed to return to its pretreatment level following discontinuation of antihypertensive therapy. Such trials, although requiring careful monitoring, are the only way of providing information on the effects of regression itself on left ventricular function. The implications of LVH regression and its attendant changes in function remain to be determined.

Adaptation, Physiological↗
PubMed1990

Correlation among radiologic, echocardiographic indices and self paced-exercise capacity in heart failure.

We investigated the relationships between the cardiothoracic ratio, M-mode echocardiographic indices and symptom-limited, self-paced exercise tolerance in 8 Nigerian patients with chronic stable congestive heart failure. Left ventricular diastolic dimension was inversely related to exercise duration; thus: log exercise time (sec) = 6.142-0.057x (r2 = 0.83, P less than 0.05), but was directly correlated to an index of myocardial oxygen demand, the ratio of the pressure rate product (PRP) to the exercise time; thus: log PRP/exercise time = 0.073x-3.04 (r2 = 0.87, P less than 0.05). These preliminary findings need extensive confirmatory evidence.

Echocardiography↗
PubMed1990

Sustained beneficial effects of enalapril in Africans with congestive heart failure.

A single blind, placebo controlled, dose-ranging 3 month study of the effects of enalapril on cardiovascular parameters, clinical status and self-paced exercise capacity was undertaken in 12 Nigerians with chronic heart failure. Enalapril exerted only a modest reduction in blood pressure and heart rate but significantly improved functional capacity (P less than 0.01), and prolonged self-paced exercise time (P less than 0.05) compared to the placebo baseline. The pressure rate product and the double product corrected for exercise time, an index of myocardial oxygen demand, exhibited a significant and sustained reduction on enalapril treatment (P less than 0.01). Concentration of sodium in the serum was significantly increased (P less than 0.05) but concentrations of potassium and creatinine were unaltered. These results demonstrate the sustained efficacy of enalapril in black Africans with heart failure and indicate no important racial difference in the response to inhibition of angiotensin converting enzyme in congestive heart failure.

Adult↗
PubMed1990

Influence of parental socioeconomic status on casual blood pressures of Nigerian school children.

The purpose of this study was to determine the effect of parental socioeconomic status on blood pressures of Nigerian school children. The weight, height, blood pressure and heart rate of 807 school children in Ile-Ife, Nigeria were measured. The subjects' ages ranged between 8 and 20 years. The subjects were classified into three (lower, middle and upper) groups based on the socioeconomic status of their parents. The findings revealed that parental socioeconomic status has no effect on the systolic and diastolic pressure, heart rate, rate pressure product and pulse pressure of Nigerian children. We found the 95th centile blood pressure to be 133/92 mm Hg. If the 95th centile is considered the diagnostic criteria for hypertension, then Nigerian children with sustained blood pressure in excess of 133/92 mm Hg should be investigated.

Adolescent↗
PubMed1990

Anthropometric determinants of resting blood pressure and heart rate of Nigerian school children.

Blood pressure, heart rate and anthropometric parameters were measured in 807 Nigerian school-age children. There was no significant difference between the blood pressure and heart rate of boys and girls after adjusting for differences in age and anthropometric parameters. The stepwise regression analysis revealed that the strong determinants of blood pressure levels were weight, Quetelet index and triceps skinfold thickness. Based on our findings, we recommend that body weight norms rather than age should be used in evaluating abnormal blood pressure levels in Nigerian children.

Adolescent↗
PubMed1990

Regression of left ventricular hypertrophy in patients with hypertension.

Left ventricular hypertrophy is an ominous prognostic factor for all the cardiovascular complications of hypertension. Treatment has undoubtedly improved the outlook, particularly in patients with congestive cardiac failure. It has recently been shown that the hypertrophy process itself can be regressed by control of hypertension. The principal factor of importance in this regression process is the fall in blood pressure. Although experimental studies suggest that the renin-angiotensin-aldosterone (RAA) system and the sympathetic nervous system (SNS) both play a role in regression, clinical studies in this regard are suggestive but not conclusive. Left ventricular function appears well preserved with the control of blood pressure and parallel reduction in pressure and left ventricular mass is likely to have no adverse effect on myocardial perfusion. The implications of regression of hypertrophy and the patient's long term prognosis have not yet been determined.

Antihypertensive Agents↗
PubMed1989

Enalapril in African patients with congestive cardiac failure.

In a preliminary double-blind study in African patients with heart failure, enalapril tended to increase treadmill exercise duration relative to placebo (95% confidence interval--11.5 to 144.3 s). This was associated with a significant improvement in NYHA functional class and subjective well being (P less than 0.05 ANOVA) with a concomitant reduction in body weight (P less than 0.05 ANOVA). It significantly increased pulse pressure during forearm isometric exercise (P less than 0.05 ANOVA), but the Valsalva's manoeuvre and the orthostatic response were unchanged.

Adult↗
PubMed1989

Cardiovascular responses to maximal treadmill exercise in healthy adult Nigerians.

Maximum treadmill exercise, using the Bruce protocol was performed on 124 healthy Nigerians (80 males and 44 females) aged 20-59 years. The mean duration of exercise (DOE) and estimated maximal oxygen uptake (VO2 max) decreased linearly with increase in age with a high correlation between age and VO2 max (r = -0.82). Males and active subjects had significantly higher values than females and sedentary subjects respectively. From this study, average values of VO2 max in healthy Nigerian men and women can be predicted from the following regression equations for VO2 max (ml of O2 per kg of body weight per min): Sedentary men = 57.2 - 0.528 (years of age) (r = -0.85), Active men = 65.0 - 0.579 (years of age) (r = -0.82), Sedentary women = 34.6 - 0.236 (years of age) (r = -0.61). The regression equation for active women is not predictive as none above the age of 29 years volunteered to participate in this study. The mean maximal heart rate (MHR) was inversely related to age (r = -0.51) and average value of MHR (beats/min) expected in healthy Nigerian men and women can be predicted from the regression equation below: MHR = 207 - 0.620 (age in years) (r = -0.51). This study presents reference data for the assessment of cardiovascular fitness of Nigerians with or without cardiovascular disease.

Adult↗