West African Journal Of Medicine[JOURNAL]
Sun
200 papers
Assessment of the Initial Acquisition of Streptococcus mutans in Infants Born to Pregnant Women Attending the Lagos University Teaching Hospital.
Ashaolu O, Orenuga OO, Oredugba FA … +1 more , Nwaokorie FO
West Afr J Med · 2025 Jul · PMID 41370185
AIM: Streptococcus mutans has been strongly associated with dental caries. The mother, the primary caregiver in the first year of life is the most significant source of the bacteria. The presence of S. mutans in infants...
AIM: Streptococcus mutans has been strongly associated with dental caries. The mother, the primary caregiver in the first year of life is the most significant source of the bacteria. The presence of S. mutans in infants from birth to 6 weeks of life was assessed. METHODOLOGY: Prospective study of 24 women enrolled during their third trimester. Socio-demographic characteristics, oral hygiene, dietary practices and obstetric characteristics obtained using investigator-administered questionnaire. Saliva samples collection from neonates at birth and six weeks, investigated by cultural microbial analysis and polymerase chain reaction to detect S. mutans specific species genes. RESULTS: Total of 24 mother-child pairs assessed. Mothers mean age; 31.29 (+/- 4.6) years. Neonates' mean gestational age; 38.79 (+/-1.4) weeks, with 14 (58.3%) females and 10 (41.7) males. Microbiological culture analysis of the saliva sample of the neonates showed that 25% of the neonates had S. mutans at birth and 25% had it at 6 weeks post-delivery. Approximately 25% of salivary samples from the neonates showed S. mutans upon cultural analysis and correlated with the presence of the bacteria in 41.7% of the samples using Polymerase chain reaction. Streptococcus mutans detected at birth in 60% of neonates were identical to that of the mothers. CONCLUSION: Maternal transmission is the primary source of S. mutans acquisition. Culture analysis of oral fluid revealed presence of viable and cultivable S. mutans in neonates asserting the acquisition of these species at birth and their presence before tooth eruption.
Assessing the Correlation of Protein C and Protein S Levels with Stroke Severity and Functional Outcomes in Adults with Ischaemic Stroke.
Idowu AO, Fawale MB, Bolarinwa RA … +6 more , Sanusi AA, Ogunmodede AF, Lawal SO, Asifat OA, Adebowale AA, Komolafe MA
West Afr J Med · 2025 Jul · PMID 41370113
BACKGROUND: Protein C, a vitamin K-dependent anticoagulant, regulates thrombin generation with its cofactor, protein S. Deficiencies in these proteins predispose individuals to thrombophilia, which may contribute to isch...
BACKGROUND: Protein C, a vitamin K-dependent anticoagulant, regulates thrombin generation with its cofactor, protein S. Deficiencies in these proteins predispose individuals to thrombophilia, which may contribute to ischemic stroke. However, data on their role in Nigerian populations remain limited. OBJECTIVES: To compare serum levels of protein C and protein S between adults with acute ischemic stroke and matched healthy controls; to assess associations between these deficiencies and stroke severity; and to evaluate their relationship with functional outcomes. METHODS: A hospital-based, cross-sectional case-control study was conducted involving 100 ischemic stroke patients and 100 age- and sex-matched healthy controls. Serum protein C and S levels were measured using enzyme-linked immunosorbent assay (ELISA). Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), while functional outcomes were measured using the Barthel Index and Modified Rankin Scale (mRS) on days 7, 14, and 30. Statistical analysis was performed using SPSS version 25, with significance set at p < 0.05. RESULTS: Among 200 participants (59 males, 41 females per group), the mean age of stroke patients was 61.24 ± 13.30 years. Median time to presentation was 48 hours. Protein C levels were significantly lower in stroke patients, while Protein S showed no significant difference. A weak positive correlation was observed between Protein C levels and stroke severity (rs = 0.201, p = 0.045), whereas Protein S did not show such a correlation. The functional outcome showed no significant association with either protein. CONCLUSION: Protein C deficiency may serve as a marker for stroke severity but has limited predictive value for functional outcomes. Further research is needed to clarify its pathophysiological role in ischemic stroke.
Remarks on the Correlation between the EU-TIRADS Score and the Definitive Histology of Thyroid Nodules Operated on in Lomé.
Sengul I, Sengul D
West Afr J Med · 2025 Jul · PMID 41369989
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Antioxidant Depletion in Asphyxiated Neonates, Neuropsychiatric Burden in Parkinson's Disease, and Public Health Vulnerabilities: The Need for Proactive Healthcare Delivery.
Erhabor GE
West Afr J Med · 2025 Jul · PMID 41369921
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Prevalence, Mortality Rate and Risk Factors of Obstetrics-Related Venous Thromboembolism in Africa: A Systematic Review.
Nwagha TU, Ojukwu CP, Nweke M … +1 more , Nwagha UI
West Afr J Med · 2025 Jun · PMID 41252748
BACKGROUND: Obstetric-related venous thromboembolism (VTE) is common in Africa. However, management has remained suboptimal. Evaluating its epidemiology will aid policy decisions. AIM: To evaluate the prevalence, mortali...
BACKGROUND: Obstetric-related venous thromboembolism (VTE) is common in Africa. However, management has remained suboptimal. Evaluating its epidemiology will aid policy decisions. AIM: To evaluate the prevalence, mortality rate and risk factors of obstetrics-related venous thromboembolism in Africa. SEARCH STRATEGY: We searched four databases namely MEDLINE, PubMed, CINAHL, and Academic Search Complete. DATA COLLECTION AND SELECTION: We undertook independent screening to identify relevant articles. Only peer-reviewed articles written and published in English were included. DATA ANALYSIS: We fitted a random-effect model to estimate the pooled prevalence and mortality rates, with I2 computed to estimate the degree of heterogeneity. RESULT: Prevalence of obstetrics-related VTE varied between 2 (per 100,000 deliveries) in 2000 and 248 (per 100,000 births) in 2020. The pooled prevalence was 17 per 100,000 births (95% CI 6-480/100,000 births). Two most important risk factors were immobilization/prolonged travel (OR=2.5 [95% CI 1.4 - 4.5] to 18 (95% CI 2.3-137) and oral contraceptive (OR=15.9, [95% CI 1.9-133.1]). VTE-related maternal mortality ranged from 33 to 286 per 100,000 live births. CONCLUSION: Moving from 2000 to 2020, there is an increasing trend in the prevalence of obstetrics-related VTE and associated maternal mortality in Africa. The strength of risk factors of obstetrics-related VTE in Africa may not follow a global risk stratification pattern.
The Relationship Between Nonalcoholic Fatty Liver Disease and Hepatitis B: Ameliorating or Aggravating? A Systematic Review.
Abere S, Oyan B, Okeke UF
West Afr J Med · 2025 Jun · PMID 41252740
BACKGROUND/PURPOSE: Chronic Hepatitis B is a global health challenge which has persisted despite universal vaccination against Hepatitis B. The relationship between hepatitis B virus infection and Non-alcoholic Fatty dis...
BACKGROUND/PURPOSE: Chronic Hepatitis B is a global health challenge which has persisted despite universal vaccination against Hepatitis B. The relationship between hepatitis B virus infection and Non-alcoholic Fatty disease (NAFLD) remains unclear thus, a review was carried out to elucidate the nature of the relationship existing between them and the risk factors for this interrelation. DATA SOURCE AND SELECTION: The accepted guideline for a systematic review was followed. English language-based studies on hepatitis B and NAFLD in adult populations between 2010 -2021 were sourced from CINHAL, PubMed, Medline, Scopus, google scholar and ScienceDirect database. DATA EXTRACTION: Following the PICO format, studies which met the inclusion criteria were identified and selected on a Prisma chart. They were further assessed using the modified Newcastle-Ottawa score for the assessment of non-randomized studies. RESULT: 11 out of 12,380 studies obtained from multiple databases were included in the review comprising of 128,566 controls and 5177 cases. The relationship between exposure to hepatitis B infection and NAFLD outcome was aggravating, ameliorating and non-existent in six, four and one study respectively. Risk factors for NAFLD identified include metabolic factors such as increased body mass index, hyperglycaemia, raised triglycerides, metabolic syndrome, hyperuricemia and the presence of hepatitis B HBx protein. CONCLUSION: NAFLD is most likely to occur in HBV patients in the presence of host metabolic factors.
Artificial Intelligence in Medical Practice: Time to Join the Global Participants' Train.
Akanbi AG, Akanbi OO, Adejumo AA … +4 more , Ilori OS, Oyedepo VO, Aina I, Olalere AA
West Afr J Med · 2025 Jun · PMID 41252731
BACKGROUND: The application of artificial intelligence (AI) in medical practice is attracting attention in various aspects of disease management. Currently, many doctors lack a basic understanding of this data-driven inn...
BACKGROUND: The application of artificial intelligence (AI) in medical practice is attracting attention in various aspects of disease management. Currently, many doctors lack a basic understanding of this data-driven innovation and are unaware of its potential applications in the field of medicine. This review thus aims to provide an introductory insight into AI, the basic concepts of AI and how it is applicable to medical practice. METHODS: We reviewed the concept of AI by elucidating its fundamental principles and applications in medical practice. Literature searches were conducted on AI using PubMed, Scopus, Google Scholar, and MEDLINE. The search keywords included artificial intelligence, machine learning, AI algorithm, medical application of AI, and the future of AI in medical practice. RESULTS: Ninety-four articles were initially reviewed, but only 71 met the inclusion criteria. The application of AI in medicine is growing across various aspects of disease management for cancerous and non-cancerous conditions. It has been used for complex procedures, such as robot-assisted surgery, in managing medical information and data, in predictive and precision medicine, and in clinical research. CONCLUSION: AI is rapidly transforming the future of human endeavours, and the healthcare community is no exception, with its potential to revolutionise medicine. Incorporating AI into healthcare should be considered a necessity, not just an option. We cannot afford to be passive observers, waiting for others to take the lead.
Management Challenges of Chronic Suppurative Otitis Media in Sub-Saharan Africa: A Call for Urgent Action.
Adedeji TO, Tobih JE, Adegbosin BA
West Afr J Med · 2025 Jun · PMID 41252692
BACKGROUND: Chronic suppurative otitis media is a serious health care concern in sub-Saharan Africa. Poverty, ignorance, and non-availability of surgical treatment techniques militate against its effective management. ME...
BACKGROUND: Chronic suppurative otitis media is a serious health care concern in sub-Saharan Africa. Poverty, ignorance, and non-availability of surgical treatment techniques militate against its effective management. METHODS: A retrospective descriptive study conducted at UNIOSUN Teaching Hospital, Osogbo on patients with CSOM over five years. RESULTS: A total of 428 patients consisting of 232 males and 196 females with age ranged from 1 - 83 years. Children 1-15 years constituted the largest (54.2%) proportion. RCSOM (37.4%), LCSOM (29.9%) and bilateral CSOM (32.7%). Majority (51.4%) had discharge for more than 2 years. Most patients 208 (48.6%) had moderate size perforations and majority (93.5%) were central perforations. Culture results showed pseudomonas 24.3% and staphylococcus aureus 24.3% as the most common organisms isolated. PTA of 152 patients (reviewed) showed that 36.8% had moderate degree of HL and severe degree HL in 26.3%. Ninety four (61.8%) had conductive hearing loss. Hearing loss was significantly associated with the size of perforation (p = 0.001) and duration of ear discharge (p = 0.022). About 99% of patients were managed conservatively with topical ear drops/ dressing with wick gauze impregnated with ciprofloxacin ear drops. Five patients (1.17 %) had tympanoplasty, six (1.40%) had cortical mastoidectomy and 2 (0.47%) patients died secondary to intracranial complications. CONCLUSION: Challenges militating against effective management of CSOM in Nigeria include poverty, delayed presentation, few tympanomastoid surgical experts and poor attitude toward surgical procedures. Public enlightenment including early presentation of patients, provision of adequate equipment and focused attention on appropriate surgical techniques should be embarked upon urgently.
Serum Glial Fibrillary Acidic Protein (GFAP) as an Index of Severity and Predictor of Functional Outcome in Acute Stroke.
Sanusi AA, Fawale MB, Idowu AO … +4 more , Ogunmodede AF, Eke UC, Adebowale AA, Komolafe MA
West Afr J Med · 2025 Jun · PMID 41252688
BACKGROUND: Serum biomarkers, such as glial fibrillary acidic protein (GFAP), have been proposed to accurately assess stroke severity and prognosis. However, there is limited published data on their potential role in res...
BACKGROUND: Serum biomarkers, such as glial fibrillary acidic protein (GFAP), have been proposed to accurately assess stroke severity and prognosis. However, there is limited published data on their potential role in resource-limited settings where the stroke burden is highest. OBJECTIVE: The study aims to determine the predictive value of the serum level of GFAP in assessing the severity and functional outcome of acute stroke. METHOD: This prospective cohort study recruited forty consecutively presenting stroke subjects each for both ischaemic stroke and intracerebral haemorrhage at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife with forty apparently healthy controls. Serum concentrations of GFAP were measured using Enzyme-Linked Immunoassays, and the data were analyzed using Statistical Package for the Social Sciences software with significance at p<0.05. RESULT: The median serum GFAP levels among apparently healthy controls, ischaemic stroke group and the ICH group at admission were 18.04 pg/ml, 24.10 pg/ml, and 33.33 pg/ml respectively. At admission, there was a significant difference in the median serum GFAP level in the ICH and apparently healthy control group as well as in the ischaemic stroke group and apparently healthy control group (p = 0.001). The study found no significant correlation between admission NIHSS and serum GFAP levels in both the ischaemic stroke group and the ICH group. In the ICH group, there was an inverse correlation between median serum GFAP level at day 7 and Barthel index at day 7 (p = 0.021) and day 30 (p = 0.001), but a positive correlation with modified Rankin score at day 30 (p = 0.001). CONCLUSION: The study found that routine screening for serum GFAP level at admission in ischaemic stroke and ICH does not predict acute stroke severity and does not correlate with functional outcomes. However, Serum GFAP level at day 7 correlated with 30-day functional outcomes for ICH and its usefulness may be explored further in larger studies.
Payment Methods and Coping Strategies for Health Care Costs by Patients with Chronic Diseases in a Low-Middle Income Country.
Mariere UI, Ogaji DS, Obikeze OO … +2 more , Adesina AD, Babatunde S
West Afr J Med · 2025 Jun · PMID 41252669
BACKGROUND: Chronic diseases contribute the highest to disease burden and deaths worldwide and require long-term access to health care. This study identified the payment methods and coping strategies for healthcare costs...
BACKGROUND: Chronic diseases contribute the highest to disease burden and deaths worldwide and require long-term access to health care. This study identified the payment methods and coping strategies for healthcare costs by patients with chronic diseases using public health facilities in Yenagoa, Bayelsa State, Nigeria. METHODS: Three hundred and thirty-nine (339) adult patients, being managed for chronic conditions (Hypertension, Diabetes mellitus, Tuberculosis & HIV), were randomly selected from three specialist hospitals that are the major providers of specialized care for patients with chronic diseases in the State. Data on sociodemographic characteristics, morbidity patterns, household financing and coping with health expenditure were collected. Chi-squared test was used to identify significant associations. A p-value 0.05 was considered significant. RESULTS: Majority were females 211(62%) and about a third were not working 113(33.3%). To pay for their chronic disease healthcare expenses, 268 (79.1%) paid out-of-pocket while 71 (20.9%) used social health insurance. Among the 120 (35.4%) patients who subscribed to a health insurance program, about 2 in 5 still paid out-of-pocket. Missing a clinic visit 145(42.8%) was the common coping strategy followed by patients having to forfeit necessities 113(33.3%) to cope with their healthcare costs. The type of chronic disease was statistically associated with payment methods adopted by patients (p<0.01). CONCLUSIONS: Most patients with chronic diseases rely on out-of-pocket payments for healthcare expenditures including patients with health insurance coverage. This has necessitated households to adopt coping strategies, found to be economically distressing, to source funds for healthcare needs. Targeted programmes are needed for patients with chronic diseases to enhance financial risk protection.
Limitations to the Implementation of a Robotic Rehabilitation Programme for Stroke Survivors in Nigeria.
Sanusi AA, Ogunmodede AF, Bello A … +9 more , Idowu AO, Olorunmoteni OE, Eke UC, Fawale MB, Adebowale AA, Ayenowowon S, Ayodele KP, Olaogun MO, Komolafe MA
West Afr J Med · 2025 Jun · PMID 41252638
BACKGROUND: Stroke remains one of the leading causes of disability worldwide. Arm function recovery is essential for stroke survivors' ability to perform activities associated with daily living. Consequently, impairment...
BACKGROUND: Stroke remains one of the leading causes of disability worldwide. Arm function recovery is essential for stroke survivors' ability to perform activities associated with daily living. Consequently, impairment in arm function is a significant target for stroke survivors' physical or robotic rehabilitation. This study aims to explore the barriers and facilitators to the implementation of a robotic rehabilitation programme for stroke survivors in a resource-poor setting. METHODS: A cross-sectional design with a qualitative approach was chosen. A semi-structured, interview-based questionnaire was administered and data were collected from stroke survivors presenting at the adult neurology clinic of two tertiary institutions in Nigeria. Data from the interview-based questionnaire were analyzed using descriptive statistics. RESULTS: A total of 52 stroke survivors participated and were interviewed. More than half (55.8%) of the respondents were elderly, with a male-to-female ratio of 1.6:1. Majority of respondents (58%) had no idea about the use of robotics for stroke rehabilitation. About 44% of the respondents believe that the major determinant of interest in robotics will be favourable outcome after trials on other participants. Lack of financial support and transportation aid constitute barriers, while creation of awareness and the availability of transportation aid from home to hospital were the major facilitators to participation. CONCLUSION: These findings highlight the fact that most stroke survivors in the resource-poor setting were not aware of the usefulness of robotics in stroke rehabilitation. Hence, increasing knowledge and creating awareness about robotic rehabilitation will make it more readily acceptable for stroke survivors. KEYWORDS: Barrier, Facilitator, Robotic rehabilitation, Stroke survivors, Implementation.
Burnout Without Borders: Exploring Burnout and the Validity of the Maslach Burnout Inventory Among Medical Students Across Four Countries in Africa.
Oluwadiya KS, Adeoti AO, Usman MI … +4 more , Maison POM, Rahman GA, Olasinde AA, Mensah S
West Afr J Med · 2025 Jun · PMID 41252609
BACKGROUND: There has been little or no cross-cultural validation study of the Maslach Burnout Inventory (MBI) from sub-Saharan Africa (SSA). This study aims to test three hypotheses among medical students in four select...
BACKGROUND: There has been little or no cross-cultural validation study of the Maslach Burnout Inventory (MBI) from sub-Saharan Africa (SSA). This study aims to test three hypotheses among medical students in four selected countries - Ghana, Nigeria, Sierra Leone and Uganda in sub-Saharan Africa (SSA). METHOD: This research utilized a cross-sectional design and employed an online self-administered questionnaire. The measurement of burnout was conducted utilizing the Maslach Burnout Inventory General Survey for Students (MBI-GS (S) on Google Form. The survey was distributed via WhatsApp to medical students enrolled in six medical schools across four countries. The statistical analysis was conducted using SPSS AMOS version 24 for Confirmatory Factor Analysis (CFA) with Structural Equation Modelling (SEM). RESULT: The prevalence of burnout varied among the medical students in the four countries with Ghana (72.1%) and Nigeria (61.2%) higher than Sierra Leone (59.2%) and Uganda (47.7%). Confirmatory factor analysis showed that the 3-factor structure of the MBI-GS(S) fits both the overall sample and the samples from each of the four individual countries albeit after correlating error terms in the analysis. However, hypothesis 2, which posited structural invariance across the samples from the four countries, was only partially met as the model demonstrated configural invariance across the samples but not metric invariance. CONCLUSION: The results of our study provide empirical evidence supporting the presence of burnout among medical students, revealing significant disparities across the participating countries. While the MBI-GS (S) proved to be a useful tool for this assessment, our findings also highlight the challenges of achieving measurement invariance in cross-cultural research, underscoring the need for culturally adaptable methodologies.
Pattern of Morbidities, Mortality and Healthcare Financing of Hospitalised Medical Patients (MOHOPA): The Study Protocol.
Karaye KM, Umuerri EM, Onwuekwe I … +9 more , Daiyab AM, Sani RN, Anjorin C, Iheonye HO, Habib ZG, Onunu A, Habib AG, Ogunniyi A, MOHOPA Study Investigators
West Afr J Med · 2025 Jun · PMID 41252495
MOHOPA (Pattern of Morbidities, Mortality and Healthcare Financing of Hospitalised Medical Patients) Study aimed to determine the pattern of morbidities among patients admitted to the medical wards of 7 Teaching and Spec...
MOHOPA (Pattern of Morbidities, Mortality and Healthcare Financing of Hospitalised Medical Patients) Study aimed to determine the pattern of morbidities among patients admitted to the medical wards of 7 Teaching and Specialised Hospitals across Nigeria, the short-term outcomes of admissions and their determinants, challenges of managing the patients, and the pattern of healthcare financing for their care. The primary study outcomes were all-cause mortality (in-hospital and at 12 weeks post-discharge), duration of hospitalisation and rehospitalisation rate. 705 patients were recruited consecutively between May 2023 and March 2024, from Aminu Kano Teaching Hospital, University of Maiduguri Teaching Hospital, Federal Medical Centre Lokoja, University College Hospital, Ibadan, University of Nigeria, Ituku-Ozalla Campus, Enugu, Delta State University Teaching Hospital, Oghara, and University of Abuja Teaching Hospital. Each patient was followed up for 12 weeks or until his/her demise or referral to another facility. We hereby present the detailed study protocol. MOTS-CLÉS: Morbidités, Mortalités, Financement des Soins de Santé, Hospitalisation, MOHOPA.
Serial C-reactive Protein and Blood Culture in the Diagnosis of Neonatal Sepsis among Babies with Risk Factors for Sepsis at Uniosun Teaching Hospital, Osogbo, Nigeria.
Omoboyeje AO, Adebami OJ, Oyedeji OA … +2 more , Ademisoye A, Kayode VO
West Afr J Med · 2025 Jun · PMID 41252431
BACKGROUND: Neonatal sepsis (NNS) contributes significantly to morbidity and mortality among newborns, especially in developing countries. Early identification of risk factors is crucial for prompt diagnosis and treatmen...
BACKGROUND: Neonatal sepsis (NNS) contributes significantly to morbidity and mortality among newborns, especially in developing countries. Early identification of risk factors is crucial for prompt diagnosis and treatment. This study aimed to investigate utility of serial C-reactive protein (CRP) and blood culture in the diagnosis of neonatal sepsis (NNS) among babies with risk factors for sepsis. METHODOLOGY: All consecutive term babies with maternal and/or neonatal risk factors for sepsis with or without initial symptoms were studied. Blood culture was done for all the participants. The CRP I was done at admission, CRP II at 48 hours and CRP III at 72 hours (a total of 3 samples). The value of CRP ≥10mg/l was considered abnormal. RESULTS: Of 106 participants, 35 (33%) had positive blood cultures, with Staphylococcus aureus being the prevalent organism. The sensitivity of CRP at the cut off ≥10mg/l was 60%, 69.7%, and 66.7% for CRP I, CRP II and CRP III, with negative predictive value (NPV) of 73.6%,72.2% and 73.8%, respectively. Abnormal temperature, respiratory distress and convulsion at presentation were significantly associated with positive blood culture (p= 0.002, 0.014 and 0.009, respectively). Logistic regression identified abnormal temperature and delivery outside the hospital facility as being significantly related to elevated CRP values (p= 0.027, 0.016). CONCLUSION: These findings highlight the importance of utilization of serial CRP tests in the early detection of sepsis in neonates with risk factors.
Emerging Technologies in Health Care: Bridging the Promise and the Gaps.
Erhabor GE
West Afr J Med · 2025 Jun · PMID 41252288
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Performance and Outcome of Pioneering Kidney Transplantation in a Resource-Constrained Setting in Southeast Nigeria.
Okwuonu CG, Achor GO, Erondu NM … +9 more , Ekwenna O, Alhassan S, Abali C, Okam E, Ralph-Iheke C, Ngwu P, Chukwuonye II, Onyebuchi A, Balogun RA
West Afr J Med · 2025 May · PMID 41052413
INTRODUCTION: Kidney transplantation is the optimal treatment for improving survival and quality of life for patients with end-stage kidney disease. There was no kidney transplant surgery and acute transplant care servic...
INTRODUCTION: Kidney transplantation is the optimal treatment for improving survival and quality of life for patients with end-stage kidney disease. There was no kidney transplant surgery and acute transplant care services in Southeast Nigeria until 2017 when our institution commenced kidney transplant surgery and acute transplant care. This study aims to share our first eight year experience including graft and patient outcome. OBJECTIVES: To obtain the transplant rate, short and long term complications and the graft and patient survival over an eight year period in a tertiary hospital in Southeast Nigeria. METHOD: A retrospective review of the transplant register for patients referred to the kidney transplant unit over an eight year period from January 2017 to January 2025. RESULT: Complete data for ninety-three patients were analyzed. Out of these, twelve were transplanted giving a transplantion rate of 13%. Financial constraint is the leading reason (40%) for failure to get a kidney transplant done. Hypertension, hyperkalemia, anemia and urinary tract infection were the leading acute complications encountered while cytomegalovirus infection, recurrence of native disease, chronic graft loss and death were the major long term complications. The three-month, one-year, three-year and five-year patient survival in our program were 100%, 90%, 80% and 80% respectively while the graft survival were 90%, 90%, 70% and 60% respectively. CONCLUSION: The transplant conversion rate is low and a review of atient selection criteria will improve access kidney transplant. Acute complications were treatable in most cases. The patient and graft outcomes appear similar with other centres in Nigeria.
Predictors of Sleep Quality in Older Persons Attending the Outpatient Clinics in a Tertiary Hospital in Nigeria.
Akinola OA, Etukumana EA, Morgan UM
West Afr J Med · 2025 May · PMID 41052398
BACKGROUND: Good quality sleep is critical to human functioning as decline in sleep quality has been linked with health issues. One of the factors that has been identified with decline in sleep quality is increasing age,...
BACKGROUND: Good quality sleep is critical to human functioning as decline in sleep quality has been linked with health issues. One of the factors that has been identified with decline in sleep quality is increasing age, making older persons at risk of significant deleterious consequences on their physical, social, and mental spheres of well-being when they have poor sleep quality. OBJECTIVES: This study aimed at determining the predictors of sleep quality among older persons aged 60 years and above attending the outpatient clinics of a tertiary hospital in Uyo, South-South Nigeria with a view to suggesting appropriate recommendations for health improvement of participants and clinical practice, where necessary. METHODOLOGY AND METHODS: This was a cross-sectional study involving two hundred and fourteen (214) respondents. Those who met the inclusion criteria were interviewed with the aid of a semi- structured questionnaire containing items on socio-demographic characteristics, clinical data, and items from the Pittsburgh sleep quality index. Data was analysed using Epi info® version 3.5.1. RESULTS: Of the 214 respondents recruited, the prevalence of good sleep quality was 63.1% with a higher rate of poor sleep quality observed in males (57%). Factors affecting sleep quality after bivariate analysis in this study were age group (70-74 years), polygamous family type, significant stress, sleep problems, chronic medical illness, routine medication, high blood pressure, overweight and obesity. However, when multiple logistic regression was done on these factors, family type, sleep problems, and chronic medical illness were still statistically significant. CONCLUSIONS: More than one-third of the older persons had poor quality of sleep in this study, and the predictors of sleep quality were family type (polygamous), sleep problems, and chronic medical illness. Therefore, there is need for a careful routine assessment of sleep among older persons and this should include comprehensive sleep history as well as evaluation and treatment of various co-morbidities in order to improve sleep quality among them.
Prevalence of Acute Heart Failure and The Role of N-Terminal Prohormone Brain Natriuretic Peptide among Acute Dyspnoeic Patients in the Emergency Room.
Olaoye OB, Ajayi EA, Busari OA … +3 more , Ojo OE, Adeoti AO, Adewuya O
West Afr J Med · 2025 May · PMID 41052371
BACKGROUND: Acute dyspnoea (AD) is one of the most common presentations in the emergency room (ER). Its myriads of confusing differentials which include acute heart failure (AHF) has significant mortality and morbidity,...
BACKGROUND: Acute dyspnoea (AD) is one of the most common presentations in the emergency room (ER). Its myriads of confusing differentials which include acute heart failure (AHF) has significant mortality and morbidity, and specific mode of treatment. The measurement of NT-proBNP among AD patients when AHF is being suspected will aid early diagnosis, treatment and improve outcomes. OBJECTIVE: To estimate the prevalence of AHF and usefulness of NT-proBNP among AD patients at the Ekiti State University Teaching Hospital's (EKSUTH) ER. METHOD: This was a cross-sectional study. Persons aged 18 years or older with AD in the ER of the EKSUTH, Nigeria were recruited. The patients were sub-categorized into heart failure as a cause of AD (HFAD) and non-heart failure as a cause of AD (nHFAD). NT-proBNP was assayed alongside ECHO parameters for the participants. RESULTS: There were 143 cases and 72 matched controls. The mean age of patients was 56.96± 13.5yrs while that of the controls was 56.17± 14.5yrs (p=0.685). Seventy-seven patients (54%) had AHF while the remaining 46% were dyspnoea of non-cardiac origin. Pneumonia, COPD, asthma and PE accounted for 33.57%, 8.40%, 2.80% and 1.40% respectively. The median NT-proBNP level was higher (p<0.001) in the AD patients compared to controls; 592.0 vs 37.50 pg/mL. The median NT-proBNP level was higher in the HFAD group than those with nHFAD and the controls (2885.40 vs. 128.70 and 37.50 pg/mL, P<0.001). NT-proBNP levels inversely and moderately correlated with ejection fraction (EF) (ρ= 0.68, p<0.001). It directly and moderately correlated with HF severity using the NYHA functional classification (ρ=0.50, p=0.017). An age-independent NT-proBNP cut-point level of 305 pg/mL recorded 93.5%, 88.3%, 45.3% and 99.2% for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) respectively. CONCLUSION: AHF is the major cause of AD in ER. In AHF patients, NT-proBNP correlated inversely well with EF and NYHA functional classification, and has high sensitivity and NPV.
Utility of Cardiac Troponin I as a Marker of Severity in Non-Ischaemic Heart Failure.
Udosen A, Ansa VO, Umoh IO … +5 more , Shogade T, Effiong B, Akpu B, Epoke E, Udoh E
West Afr J Med · 2025 May · PMID 41051202
BACKGROUND: Biomarkers are crucial for assessing the severity of heart failure (HF) and monitoring its treatment. Cardiac troponin I (cTnI) has traditionally been used as a marker for myocardial injury but its role in no...
BACKGROUND: Biomarkers are crucial for assessing the severity of heart failure (HF) and monitoring its treatment. Cardiac troponin I (cTnI) has traditionally been used as a marker for myocardial injury but its role in non-ischemic heart failure (NIHF) remains unclear. OBJECTIVES: This study was aimed at determining the relationship between cTnI and left ventricular function and geometry in NIHF patients. METHODS: This was a cross-sectional comparative study that recruited 60 NIHF patients and 60 controls from the cardiology unit in a tertiary hospital. All participants had cTnI assay and transthoracic echocardiography done to assess left ventricular function and geometry. Data was analysed using Statistical Package for Social Sciences (SPSS) version 23. The level of statistical significance was fixed at p value < 0.05. RESULTS: The mean age of patients with NIHF was 50.0±12.6 years versus 50.3±12.0 years for controls (p=0.456). The mean serum cTnI level was 358.52±56.60ng/L in NIHF patients versus 218.54±36.01ng/L in the controls (p <0.001). Serum cTnI had a moderate negative correlation with ejection fraction (EF) in NIHF patients (R= -0.70, R2 = 0.492); and a positive correlation with left ventricular mass index (LVMI) (R= 0.12, R2 = 0.015). Mean cTnI levels increased with worsening grade of diastolic dysfunction in NIHF patients. Higher levels of serum cTnI was associated with worse New York Heart Association (NYHA) class of HF (p <0.001). CONCLUSION: Elevated serum cTnI level was associated with worsening clinical and echocardiographic indices of left ventricular function in NIHF patients suggesting that it is an important surrogate marker for worsening HF.
The Outcome of Laparoscopic Cholecystectomy at King Khalid Hospital, Hail, Saudi Arabia.
Altwiher RAS, Nwashilli NJ, Alzaid AS
West Afr J Med · 2025 May · PMID 41051177
BACKGROUND: Laparoscopic cholecystectomy has evolved to become the gold standard treatment of calculous and acalculous cholecystitis. AIM: This research aims to study the demographics, indications, types of cholecystecto...
BACKGROUND: Laparoscopic cholecystectomy has evolved to become the gold standard treatment of calculous and acalculous cholecystitis. AIM: This research aims to study the demographics, indications, types of cholecystectomies (early/interval), length of hospital stays, conversion to open surgery, use of drains, complications, and outcomes. PATIENTS AND METHODS: This was a retrospective, descriptive study of all cases of laparoscopic cholecystectomy carried out from 1st January 2023 to 31st December 2023 at King Khalid hospital Hail, Saudi Arabia. The case files of all the patients who had laparoscopic cholecystectomy were retrieved from the Oasis health information management system of the hospital. Written informed consent was obtained from each patient before surgery. Ethical approval was obtained before embarking on the study. Information regarding demographics, indications and types of cholecystectomies, length of hospital stays, conversions to open surgery, use of drains, complications and mortality were analyzed with Statistical Package for Social Sciences version 26. RESULTS: A total of 351 cases of cholecystitis had laparoscopic cholecystectomy. There were 248 (70.7%) females and 103 (29.3%) males. The mean age of the patients was 39.5 ± 1.2 years. There was conversion to open cholecystectomy in four (1.1%) cases. The average duration of hospital stay was 1.5 ± 1.5 days. There was neither a case of bile duct injury nor mortality. CONCLUSION: The outcome of laparoscopic cholecystectomy was good with no major morbidity or mortality.
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