Multi-system failure in Plasmodium vivax malaria: report of a case.
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Humans↗
Biomedical subjects
O Modebe
Publications and source records attributed to O Modebe.
Is there increased fertility in adult males with the sickle cell trait?
Different proposals have been offered to explain the polymorphism of the sickle cell hemoglobin gene. One of these proposals (Eaton and Mucha 1971) suggested that differential fertility of male subjects with the sickle cell trait contributes to the persistence and stability of the sickle cell gene frequency. Eaton and Mucha claimed that oligospermia, induced by hyperpyrexia, is a less common problem in these subjects because they probably have milder and shorter episodes of fever from malaria infection than subjects with a normal genotype. We have looked for evidence to support this hypothesis by comparing the testicular function, testicular size, and serum concentrations of the reproductive hormones in adult male subjects with the sickle cell trait and in an age-matched group of subjects with normal hemoglobin genotype. The mean serum concentration of testosterone, luteinizing hormone, follicle-stimulating hormone, and prolactin of both groups, measured by radio-immunoassay, were not statistically different from each other. Also, there was no detectable difference in any of the common indexes of semen quality between the two groups. The testicular volume index and several anthropometric indexes of subjects with the sickle cell trait and subjects with the normal hemoglobin genotype were also statistically similar. The results suggest that gonadal function is similar in adult males with the normal genotype and those with the sickle cell trait. Any increase in fertility observed in the latter group is probably due to extragonadal factors.
Adult↗
Effect of age on testicular function in adult males with sickle cell anemia.
OBJECTIVES: To determine the effect of age on testicular function and fertility profile of adult males with homozygous sickle cell disease. DESIGN: A comparative cross-sectional study. SETTING: A university teaching hospital in Nigeria. PARTICIPANTS: Twenty-two adult males with homozygous sickle cell disease and 20 healthy adult males with normal hemoglobin genotype. MAIN OUTCOME MEASURES: Seminal indexes, serum concentration of reproductive hormones, body mass index (BMI), testicular volume index, and span-height difference of patients with homozygous sickle cell disease and normal subjects were compared. Also significant differences were sought between two age groups among patients and control subjects: those < or = 25 years old and those > 25 years of age. RESULTS: The mean BMI, testicular volume index, serum T concentration, and indexes of semen quality of the patients with homozygous sickle cell disease were significantly lower than the values for the control subjects. In contrast, there was no significant difference in the mean concentration of FSH, LH, PRL, and mean span-height difference between both groups. Also, although no significant age-related effect on serum T concentration, testicular volume index, and sperm density was found in the subjects 18 to 40 years of age with normal hemoglobin genotype, patients > 25 years old with homozygous sickle cell disease had significantly higher mean serum T concentration and mean testicular volume index than those < or = 25 years old; their sperm density was also substantially higher. CONCLUSION: Fertility is impaired in adult males with homozygous sickle cell disease probably as a result of abnormal hypothalamic or pituitary function. There is a significant amelioration of the hypogonadism, abnormal sexual function, and poor semen profile with increasing age.
Adolescent↗
Experience with carbimazole in the treatment of the hyperthyroidism of Graves' disease in Nigerian patients.
To estimate the rate of remission and relapse in patients with thyrotoxic Graves' disease following therapy with thionamides, the course of 49 patients who were treated with carbimazole and followed for a mean (+/-S.D.) of 22.0 +/- 17.8 months, was analysed. A remission rate of 61% was obtained. Remissions were more common in patients with small goiters and those with a short duration of illness. Relapse occurred most commonly within the first few months following the discontinuation of the drug. Thirty-two per cent of the patients left the clinic either before or soon after achieving euthyroidism. It is concluded that the thionamides are quite efficacious in the induction of remission in newly diagnosed Nigerian patients with toxic Graves' disease and probably should presently be the principal treatment modality for these patients, rather than subtotal thyroidectomy. Efforts should be made to reduce the frequent drop-out of our patients from the clinic during follow-up.
Adolescent↗
Growth retardation in homozygous sickle cell disease: role of calorie intake and possible gender-related differences.
To evaluate the possible role of inadequate food intake in the pathogenesis of the growth retardation of patients with sickle cell anemia, we determined the daily intake of calories and macronutrients and measured several anthropometric indices in 20 patients with sickle cell anemia aged 17-35 years and in 15 of their normal siblings of similar age. Compared to the control groups, the male patients, but not the females, had a significantly lower mean weight, body mass index, midarm circumference, and triceps and subscapular skinfold thicknesses. Also, while the male patients consumed significantly less total calories, proteins, carbohydrates, and fats per day than their control group, no difference was noted between the daily intake of calories or macronutrients in the female patients and their control group. However, when the intake of calories and macronutrients was corrected for body weight, there was no statistically significant difference between the intake of nutrients in the male patients and their control subjects or between the female patients and their control group. These results suggest a sex-related difference in the somatic growth of adolescent and adult patients with sickle cell anemia and also suggest that, although an inadequate food intake may be partly responsible for the impaired somatic growth in sickle cell anemia, other factors are also probably important.
Adolescent↗
Experience with carbimazole in the drug treatment of the hyperthyroidism of Graves' diseases in Nigerians.
To estimate the rate of remission of relapse in patients with thyrotoxic Graves' disease following therapy with thionamides, the course of 49 patients who were treated with carbimazole and followed personally for a mean (+/- SD) of 22.0 +/- 17.8 months, was analysed. A remission rate of 61% was obtained. Remissions were more common in patients with small goitres and those with a short duration of illness. Relapse, which was infrequent, occurred mostly within a few months following the discontinuation of the drug. 32% of the patients left the clinic either before or soon after achieving euthyroidism. It is concluded that carbimazole is quite efficacious in the induction or remission in newly diagnosed Nigerian patients with toxic Graves' disease and, at the present time, should probably be the principal treatment modality for these patients rather than subtotal thyroidectomy. Efforts should be made to reduce the frequent drop-out of our patients from the clinic during follow-up.
Adolescent↗
Erectile failure among medical clinic patients.
Erectile failure is commonly overlooked by most doctors while conducting clinical interviews. This is probably, in part, explained by the widespread belief within the medical profession that the disorder is mostly psychogenic and probably uncommon in a variety of patient populations. In order to define the frequency and pattern of this disorder in our local clinic population, the present study has determined the incidence of erectile failure in 227 adult male medical out-patients of the University of Nigeria Teaching Hospital, Enugu. Seventy-seven (34%) of the patients were impotent and the incidence increased progressively with age. Only 26% of the impotent patients volunteered information on the disorder without specific questioning. Diabetics had a significantly higher incidence of impotence than the non-diabetics (58% vs. 29%; P less than 0.0001). Among the hypertensives, drug therapy increased the frequency from 8 to 61%. These data suggest that impotence is very common among our male medical out-patients, particularly the elderly and middle-aged, the hypertensives on drug therapy and the diabetics. The disorder should be actively sought out since most affected patients do not complain about it.
Adult↗
Metoclopramide-mediated prolactin secretion in patients with idiopathic hypogonadotropic hypogonadism: effect of testosterone therapy.
The secretion of prolactin (PRL) after intravenous metoclopramide was evaluated in six prepubertal subjects with idiopathic isolated hypogonadotropic hypogonadism before and after repeated testosterone (T) injections. The PRL response to metoclopramide was markedly blunted before T treatment, but both the basal and metoclopramide-stimulated PRL secretion became normal after 4 to 15 months of intramuscular T enanthate, although in three of the subjects, serum T was low at the time of the repeat study. These results confirm that the pituitary lactotrophs are normal in this disorder and suggest that the attenuated response observed in the untreated patients is due to the chronic and persistent exposure of the lactotrophs to an environment low in T. The effect of exogenous T on the lactotrophs persists for several weeks after T is discontinued.
Adolescent↗
Autoimmune thyroid disease with ulcerative colitis.
Two cases of co-existing thyroid disease and ulcerative colitis are reported. Thyroid disorder preceded ulcerative colitis in each case. The presence of acute colitis delayed and obscured the clinical diagnosis of thyrotoxicosis in one case and the colitis could not be controlled until her thyrotoxicosis was treated. Although the specific factors involved in this relationship are now known, an interplay of immunological factors is most probable.
Adult↗
Ullrich-Turner syndrome associated with interstitial deletion of Xp11.4 leads to p22.31.
The full phenotype of the Ullrich-Turner syndrome (UTS) is thought to be due to loss of the short arm of X. We report a 16-year-old girl with lack of secondary sexual development, amenorrhea, and short stature. She had thyroiditis and numerous other UTS manifestations and was found to have a non-mosaic 46,X,del(Xp) chromosome abnormality. Breakpoints occurred at p11.4 and p22.31, with a loss of the intervening segment.
Adolescent↗
Inhibition of L-dopa-induced growth hormone stimulation by pyridoxine and chlorpromazine.
One gram of L-dopa was administered orally to 12 male control subjects and induced an increase of growth hormone (GH) secretion. The L-dopa-induced GH response was inhibited by an intravenous infusion of pyridoxine, but pyridoxine did not inhibit the GH response to hypoglycemia. Chlorpromazine also inhibited L-dopa-induced GH stimulation. Glucose concentrations were unaffected by L-dopa, chlorpromazine, and pyridoxine administration in these subjects. The mechanism of the suppressed L-dopa-induced GH response by pyridoxine appears to be mediated by peripheral accleration of the conversion of L-dopa to dopamine, while that of chlorpromazine appears to be mediated through hypothalamic centers. Pyridoxine and chlorpromazine should be added to the list of other factors affecting the response to L-dopa-induced GH stimulation
Adult↗
The effect of homozygous sickle cell disease on the age at menarche in Nigerian schoolgirls.
Two thousand two hundred and four schoolgirls from four secondary schools in Enugu, the capital of Anambra State in south-eastern Nigeria, were interviewed and provided information regarding their age, menstrual status and the presence or absence of some common chronic disorders. Sickle cell disease was identified and confirmed by haemoglobin electrophoresis in 1.36% of the students. Average age at menarche, determined by probit analysis, was significantly delayed among subjects with sickle cell disease when compared with normal students (14.5 +/- 1.13 years vs. 13.3 +/- 1.09 years; P less than 0.005). Comparison of the average menarcheal age of the normal subjects in this study with previous reports of studies from southern Nigeria confirms a continuing decline of the average age at menarche at a rate of about four months per decade.
Adolescent↗
Idiopathic central precocious puberty in a Nigerian boy.
A case of idiopathic central precocious puberty, a rare condition is reported in a 2 1/2 year-old Nigerian boy. He presented with progressive genital growth, a growth spurt, advanced skeletal maturation, and inappropriately high serum concentrations of pituitary and gonadal sex homones for his age. There was no family history of precocious puberty. Physical examination and investigations revealed no identifiable cause for his precocity. Despite the overwhelming problems of malnutrition and infectious diseases in our environment, clinicians must have a high index of suspicion for endocrine disorders.
Body Constitution↗
Serum concentrations of pituitary and testicular hormones in infertile Nigerian males.
Serum concentrations of luteinising hormone, follicle stimulating hormone, prolactin, and testosterone were measured by radioimmunoassay in 384 male partners of infertile Nigerian couples in order to assess the prevalence of abnormalities of these hormones in this population of African males. Eighty-eight (23%) of the patients had hyperprolactinemia, which was associated with subnormal testosterone concentration in 38 patients. Thirteen percent had features suggesting either primary gonadal failure or germinal tubular dysfunction, while 1% had hypogonadotropic hypogonadism. The results show that a substantial proportion of our infertile males have abnormalities of the hormones measured. It is suggested that the estimation of these hormones should be an integral part of the evaluation of infertile African males, since the information so provided will be of value in the management and treatment of a large number of these patients.
Adult↗
Serum prolactin concentration in impotent African males.
Serum prolactin concentration, measured by radioimmunoassay, was significantly higher (p less than 0.005) in 49 patients with impotence than in a control population of 16 normal subjects. 26.5% of the impotent patients had hyperprolactinemia. Their serum testosterone was also significantly lower (p less than 0.05). Bromocriptine suppressed the raised prolactin, normalised testosterone in seven treated hyperprolactinemic patients, and restored potency in five of them. These results suggest a possible role for hyperprolactinemia in a substantial proportion of African patients with impotence. Further studies in more affected patients are in order.
Adult↗
Hyperprolactinemia in oligospermic Nigerian males: effect of bromocriptine treatment.
OBJECTIVE: To assess the possible etiological role of hyperprolactinemia in oligospermic African males. DESIGN: Prospective. SETTING: University teaching hospital. PATIENTS AND METHODS: Of the 52 infertile males studied, 23 had oligospermia, 11 were hyperprolactinemic, while 7 had both oligospermia and hyperprolactinemia. Mean serum testosterone concentration was lower in oligospermic than normospermic patients (3.6 +/- 1.9 ng/mL vs. 6.3 +/- 2.8 ng/mL; P < .05), and in hyperprolactinemic than normoprolactinemic patients (2.8 +/- 1.5 ng/mL vs. 5.7 +/- 2.8 ng/mL; P < .05). The patients with both oligospermia and hyperprolactinemia had the lowest mean serum testosterone (2.2 +/- 0.7 ng/mL) concentration. Oral bromocriptine was given to the seven hyperprolactinemic, oligospermic patients for 9-12 weeks. RESULTS: Serum prolactin was reduced to normal in all and increased sperm count to normal in 4/7. The wives of two of the responders became pregnant. CONCLUSIONS: The serum concentration of prolactin should be estimated in all oligospermic patients who exhibit no obvious cause of the oligospermia. Those found to be hyperprolactinemic should be given bromocriptine.
Adult↗
Antagonism of drug therapy for hypertension by nonsteroidal antiinflammatory drugs.
Three cases, in which the deterioration of blood pressure control was associated with the onset of therapy with nonsteroidal anti-inflammatory drugs (NSAIDS), are reported. It is suggested that this effect of the NSAIDs could possibly have resulted from the inhibition of the biosynthesis of the prostaglandins, some of which have vasodilatory or natriuretic properties. This interaction, hitherto unreported from our environment and therefore not commonly recognised, is of relevance in the drug treatment of hypertension since the widely used NSAIDs have the potential to impair the effectiveness of several antihypertensive drugs. It should be taken cognizance of when using both antihypertensive drugs and NSAIDs in any hypertensive patient.
Aged↗