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O Akinyanju

Publications and source records attributed to O Akinyanju.

16 recordsLinked to original sources
PubMed2002

Priapism in sickle-cell disease; incidence, risk factors and complications - an international multicentre study.

OBJECTIVE: To define the incidence, risk factors and complications of priapism in a large population of patients with sickle-cell anaemia in five centres in the UK and Nigeria, as priapism is common among these patients, but the precise characteristics of the condition in this population are poorly documented. PATIENTS AND METHODS: A questionnaire was developed and administered to patients with sickle-cell disease. Questions were designed to define the incidence, nature, precipitants, duration, treatment and complications of priapism. A distinction was made between acute (severe) priapism and the recurrent, 'stuttering' type. RESULTS: The questionnaire was completed by 130 patients (mean age 25 years, sd 11, range 4-66) from the five centres; 102 (78%) were homozygous Hb SS genotype, 19 (15%) were Hb SC genotype and two (1.5%) were Hb Salpha-thalassaemia. Of the patients, 46 (35%) reported a history of priapism, and of these, 33 (72%) had a history of stuttering priapism, while 24 (52%) had had an acute episode of priapism. The mean age of onset of priapism was 15 years, with 75% of patients having the first episode before their 20th birthday. Sexual activity was the most frequent precipitating factor, with fever and/or dehydration being the next most common. Of the 46 patients, 10 (21%) with a history of priapism reported having erectile dysfunction. A similar proportion reported dissatisfaction with sexual intercourse, including a fear of engaging in sexual activity. CONCLUSION: The incidence of priapism among patients with sickle-cell anaemia is high (35%). The implications of priapism for erectile and sexual function are significant and documented in this large series. The treatment of this condition in these patients remains unstandardised. This study highlights the need for an increased awareness of the problems associated with priapism among patients, families and medical professionals.

Adolescent↗
PubMed1994

Sickle cell anaemia in Nigeria: a comparison between Benin and Lagos.

The clinical and haematological features of 77 patients of Bini and 107 patients of Yoruba origin with homozygous sickle cell (SS) disease have been compared. The Bini population were generally younger and had a slightly lower incidence of alpha thalassaemia but even after correction for age and alpha thalassaemia status, this group had significantly lower HbA2 and higher HbF and MCV values. Clinically the Bini group had significantly less dactylitis and more acute chest syndrome. The decreased frequency of dactylitis is consistent with the higher HbF level in the Bini population and the mechanism of the other effects are discussed.

Adolescent↗
PubMed1989

Enuresis in sickle cell disease. I. Prevalence studies.

The prevalence of enuresis was determined by parental interview in Nigerian children with sickle cell anaemia and in age-matched controls without sickle haemoglobinopathy. There were a total of 209 subjects with sickle cell anaemia (SCA) in steady state and 200 controls of both sexes aged from 2 to 20 years. The prevalence of enuresis was 41.6 per cent in those with SCA and 18.5 per cent in the controls. In subjects who were 4 years or more the prevalences were 36.8 and 21 per cent, respectively. These differences were highly significant (P less than 0.001). There was a significant preponderance of males among enuretic control subjects (2.6 to 1) who were aged 4 years or more (P less than 0.05) which was not apparent in the sickle cell subjects at any age or in the controls below the age of 4 years.

Adolescent↗
PubMed1988

The anaerobic and aerobic bacterial flora of leg ulcers in patients with sickle-cell disease.

Leg ulcers in 26 patients with sickle-cell disease (SCD) were studied bacteriologically over a period of 6 months. The average age of the patients was 20.92 years and the mean duration of the ulcers was 3.43 years. In order of frequency, Staphylococcus aureus, Pseudomonas aeruginosa, and Bacteroides melaninogenicus were the predominant organisms. Anaerobes were isolated from 14 (54%) of 26 patients and represent 21% of the total 77 isolates. The presence of anaerobes correlated well with odorous ulcers. Isolation of anaerobes from leg ulcers of patients with SCD has added to knowledge of bacterial infection in SCD.

Adolescent↗
PubMed1987

Acute illness in Nigerian children with sickle cell anaemia.

The pattern of illness in 60 consecutive children with homozygous sickle cell disease who attended the Paediatric Emergency Room of a busy Lagos hospital with acute illness was studied prospectively. Their ages ranged from 3 months to 13 years with a peak in the 2nd year. There were twice as many boys as girls. The commonest symptoms were fever, limb or abdominal pain and cough, and the commonest signs were pallor and hepatomegaly. Painful crises occurred in 27, anaemic crises in 11, and a combination of these in 12 children. Infection was detected in 76% of subjects in crises. Infection was found in 82% of all the children and was mainly bacterial. The commonest infections were pneumonia (35%), bacteraemia (32%), tonsillitis/pharyngitis (17%) and osteomyelitis (8%). The predominant bacteria isolated were Klebsiella spp (38%), E. coli (23%), Staph. aureus (23%), Staph. albus (23%) and Pseudomonas spp (23%). Some children had multiple isolates. Bacterial infection was a major cause of morbidity in very young children and merits appropriate control and preventive measures in this age group. The spectrum of bacteria isolated makes it unlikely that the specific anti-pneumococcal measures widely advocated in Europe and America for young children with SCA would be appropriate in Nigeria.

Acute Disease↗
PubMed1979

Cholelithiasis and biliary tract disease in sickle-cell disease in Nigerians.

The incidence of biliary tract disease was investigated by oral cholecystography and/or intravenous cholangiography in 77 unselected Nigerians with homozygous sickle-cell disease (SCD). They included 32 males and 45 females with ages ranging from 8 to 31 years. The prevalence of cholelithiasis was 9% with equal sex incidence. The stones were always multiple and 71.4% of them were radio opaque. Visualization and contractility of all gall bladders examined were normal. The only patient with symptoms and signs which suggested biliary tract disease had no radiographic evidence of cholelithiasis and it was impossible to predict the presence of cholelithiasis from the incidence of abdominal crises in the patients. The prevalence of cholelithiasis is significantly less than that reported in American patients with SCD (35%) and different dietary habits are probably responsible for this.

Adolescent↗
PubMed1979

Leg ulceration in sickle cell disease in Nigeria.

Leg ulceration was found in only 14 of 834 (1.7%) sickle cell patients seen in a Lagos Hospital. Ulcers were seen only in patients above the age of 12 years in whom the prevalence was 5.4%. Affected males outnumbered females 6 to 1. The aetiology was traumatic in 12 patients, spontaneous in three and due to furuncle in one. The commonest sites were around the ankles. Ulceration was not commoner in patients with low socioeconomic status. The simplest forms of aseptic treatment resulted in as variable a healing time as more complex forms of treatment, but a high recurrence rate of ulceration (71.4%) was the major problem. There remains no acceptable reason for the lower prevalence of leg ulceration in Africans with sickle cell disease, but the role of zinc in susceptibility to the ulcers deserves further investigation.

Adolescent↗
PubMedDate not supplied

The pattern of sickle cell disease in pregnancy in Lagos, Nigeria.

The outcome of pregnancy and labour in patients with sickle cell disease delivered at the Lagos University Teaching Hospital (LUTH) under one obstetrician between 1st January 1985 and 31st December, 1989 is analysed. There were 31 pregnancies in 28 patients with sickle cell anaemia (HbSS) and 10 pregnancies in seven patients with sickle cell haemoglobin C disease (HbSc). Six pregnancies in HbSS patients and two in HbSC were in patients who had not had specialized preconceptual care. There was one abortion in a patient with HbSC and one pair of twins in a patient with HbSS. The complication rate was high in HbSC patients as compared to a previous series but not as high as in patients with HbSS. The perinatal mortality rates were 233 and 111 per 1000 deliveries in HbSS and HbSC patients respectively. The maternal mortality rates were 129 and 111 per 1000 deliveries in HbSS and HbSC patients respectively. Two of the maternal deaths and four of the perinatal deaths occurred in HbSS patients who had had no preconceptual specialist care as opposed to those receiving specialist treatment. In the case of perinatal mortality, this was found to be statistically significant (p < 0.001).

Adult↗