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Papers by B EZEALA-ADIKAIBE

West African journal of medicine, Aug 31, 2022

Annals of Medical and Health Sciences Research, 2021

Background: Alcohol holds an important role in social engagement in southeast Nigeria. It is cons... more Background: Alcohol holds an important role in social engagement in southeast Nigeria. It is considered pleasurable by many who drink it in mild or moderate quantities. Studies show an increasing trend in alcohol consumption, including among adolescents. Aim: The aim of the study is to determine the prevalence and pattern of alcohol use among adolescents living in urban settlements in Enugu Urban, Southeast Nigeria. Materials & Methods: A cross sectional descriptive study was conducted, using purposive sampling method. Using semi-structured questionnaires, we obtained information on their biodata, medical history, alcohol consumption profiles and a few other lifestyle behaviors. Statistical analysis was carried out using SPSS version 23. Results: A total of 473 youngsters aged 10 yeras-19 years were recruited from the two settlements. Females (mean age 15.4 years) were also older than males (mean age 14.8 years) p=0.02. The prevalence of current alcohol use within the preceding 4 weeks was 23.7% (112/473). Males drank alcohol more frequently than females (31.8% vs. 17.8%). p<0.01) and local brew (palm wine) was the commonest alcoholic consumed 40 (35.7%). The amount of alcohol consumed (in grams) rose sharply after the age of 15 years with a steeper gradient being observed among the males. Conclusion: This study shows that there was a moderate rate of alcohol use among adolescents in the study population which increased sharply after 15 years of age. There is therefore a need for public health enlightenment targeted at adolescents both in school and in the community, to highlight the dangers of excessive alcohol use thereby preventing future alcoholism and consequent heart, vascular, brain and liver diseases that may ensue.

International Journal of Medicine and Health Development, 2009

Background: Strokes account for a large number of medical admissions and neurological admissions ... more Background: Strokes account for a large number of medical admissions and neurological admissions in Nigeria. The frequency of the different types of stroke is difficult to ascertain because clinical diagnosis is not always correct. Non-contrast cranial computed tomography (CT) scan reliably distinguishes between ischemic stroke (IS) and hemorrhagic strokes (HS) and will provide a reliable characterization of stroke types in the developing countries. Aims: To examine stroke types based on CT Imaging studies and the differences in stroke types based on age. Methodology: A retrospective study of CT register of Memfys Hospital for Neurosurgery was done covering a period of four and half years. Results: One hundred and six cases which met the criteria were reviewed. Seventy two (67.9%) were males and 34 (32.1%) were females, with a male female ratio of 2.1:1. The proportion of ischemic stroke (IS), Intracerebral hemorrhage (ICH) and Subarachnoid hemorrhage(SAH) was 66.7%, 22.6%, 16.1% re...

Epilepsia Open, 2017

Objective: EpiNet was established to encourage epilepsy research. EpiNet is used for multicenter ... more Objective: EpiNet was established to encourage epilepsy research. EpiNet is used for multicenter cohort studies and investigator-led trials. Physicians must be accredited to recruit patients into trials. Here, we describe the accreditation process for the EpiNet-First trials. Methods: Physicians with an interest in epilepsy were invited to assess 30 case scenarios to determine the following: whether patients have epilepsy; the nature of the seizures (generalized, focal); and the etiology. Information was presented in two steps for 23 cases. The EpiNet steering committee determined that 21 cases had epilepsy. The steering committee determined by consensus which responses were acceptable for each case. We chose a subset of 18 cases to accredit investigators for the EpiNet-First trials. We initially focused on 12 cases; to be accredited, investigators could not diagnose epilepsy in any case that the steering committee determined did not have epilepsy. If investigators were not accredited after assessing 12 cases, 6 further cases were considered. When assessing the 18 cases, investigators could be accredited if they diagnosed one of six nonepilepsy patients as having possible epilepsy but could make no other false-positive errors and could make only one error regarding seizure classification. Results: Between December 2013 and December 2014, 189 physicians assessed the 30 cases. Agreement with the steering committee regarding the diagnosis at step 1 ranged from 47% to 100%, and improved when information regarding tests was provided at step 2. One hundred five of the 189 physicians (55%) were accredited for the EpiNet-First trials. The kappa value for diagnosis of epilepsy across all 30 cases for accredited physicians was 0.70. Significance: We have established criteria for accrediting physicians using EpiNet. New investigators can be accredited by assessing 18 case scenarios. We encourage physicians with an interest in epilepsy to become EpiNet-accredited and to participate in these investigator-led clinical trials.

Head & Face Medicine, 2014

International Journal of Medicine and Public Health, 2012

Transactions of the Royal Society of Tropical Medicine and Hygiene, 2009

One-quarter of the 40 million individuals estimated to have epilepsy in the developing world live... more One-quarter of the 40 million individuals estimated to have epilepsy in the developing world live in Africa. Data on epilepsy in Nigeria are scanty. The disease is associated with significant socioeconomic effects. This study reviewed the pattern of presentation of epilepsy in Enugu, southeast Nigeria. A retrospective study was performed of adult epilepsy patients who presented to the medical clinic at the University of Nigeria Teaching Hospital, Enugu, from January 2002 to December 2006. Case records were reviewed and data were extracted using a pro forma and analysed. A total of 207 patients were studied (113 males and 94 females). Most affected were those aged 15-34 years. Approximately 22% had childhood seizures and approximately 88% had generalised convulsive seizures. Electroencephalography was not performed in 85% of cases. Alcohol use and head injury were seizure risks in 12% and 20% of patients, respectively. More than 25% reported socioeconomic effects, including stigmatisation and job loss. Monotherapy was used in 89% of patients, with 71% having good control. Epilepsy is a considerable source of stigma and misery for sufferers in Nigeria. There is a need for greater public health education as well as training and re-training of specialists in its management.

Journal of Human Hypertension, 2013

To address the epidemic of hypertension in blacks born and living in sub-Saharan Africa, we compa... more To address the epidemic of hypertension in blacks born and living in sub-Saharan Africa, we compared in a randomised clinical trial (NCT01030458) single-pill combinations of old and new antihypertensive drugs in patients (30-69 years) with uncomplicated hypertension (140-179/90-109 mm Hg). After X4 weeks off treatment, 183 of 294 screened patients were assigned to once daily bisoprolol/hydrochlorothiazide 5/6.25 mg (n ¼ 89; R) or amlodipine/valsartan 5/160 mg (n ¼ 94; E) and followed up for 6 months. To control blood pressure (o140/o90 mm Hg), bisoprolol and amlodipine could be doubled (10 mg per day) and a-methyldopa (0.5-2 g per day) added. Sitting blood pressure fell by 19.5/12.0 mm Hg in R patients and by 24.8/13.2 mm Hg in E patients and heart rate decreased by 9.7 beats per minute in R patients with no change in E patients (-0.2 beats per minute). The between-group differences (R minus E) were 5.2 mm Hg (Po0.0001) systolic, 1.3 mm Hg (P ¼ 0.12) diastolic, and 9.6 beats per minute (Po0.0001). In 57 R and 67 E patients with data available at all visits, these estimates were 5.5 mm Hg (Po0.0001) systolic, 1.8 mm Hg (P ¼ 0.07) diastolic and 9.8 beats per minute (Po0.0001). In R compared with E patients, 45 vs 37% (P ¼ 0.13) proceeded to the higher dose of randomised treatment and 33 vs 9% (Po0.0001) had a-methyldopa added. There were no between-group differences in symptoms except for ankle oedema in E patients (P ¼ 0.012). In conclusion, new compared with old drugs lowered systolic blood pressure more and therefore controlled hypertension better in native African black patients.

Blood Pressure, 2013

Background. Compared with Caucasians, African Americans have lower heart rate variability (HRV) i... more Background. Compared with Caucasians, African Americans have lower heart rate variability (HRV) in the high-frequency domain, but there are no studies in blacks born and living in Africa. Methods. In the Newer versus Older Antihypertensive agents in African Hypertensive patients trial (NCT01030458), patients (30-69 years) with uncomplicated hypertension (140-179/90-109 mmHg) were randomized to single-pill combinations of bisoprolol/hydrochlorothiazide (R) or amlodipine/ valsartan (E). 72 R and 84 E patients underwent 5-min ECG recordings at randomization and 8, 16 and 24 weeks. HRV was determined by fast Fourier transform and autoregressive modelling. Results. Heart rate decreased by 9.5 beats/min in R patients with no change in E patients (Ϫ 2.2 beats/min). R patients had reduced total (Ϫ 0.13 ms ² ; p ϭ 0.0038) and low-frequency power (Ϫ 3.6 nu; p ϭ 0.057), higher high-frequency (ϩ 3.3 nu; p ϭ 0.050) and a reduced low-to high-frequency ratio (Ϫ 0.08; p ϭ 0.040). With adjustment for heart rate, these differences disappeared, except for the reduced low-frequency power in the R group (Ϫ 4.67 nu; p ϭ 0.02). Analyses confi ned to 39 R and 47 E patients with HRV measurements at all visits or based on autoregressive modelling were confi rmatory. Conclusion. In native black African patients, antihypertensive drugs modulate HRV, an index of autonomous nervous tone. However, these effects were mediated by changes in heart rate except for lowfrequency variability, which was reduced on beta blockade independent of heart rate.

Epilepsy & Behavior Case Reports, 2015

Background: Levetiracetam-induced rage is a rare neurobehavioral adverse effect of levetiracetam ... more Background: Levetiracetam-induced rage is a rare neurobehavioral adverse effect of levetiracetam that is characterized by seething rage, uncontrollable anger, fits of fury, depression, violence, and suicidal tendencies. It occurs more in patients with prior mood or psychotic disturbances. No such case has been reported in Nigeria. Method: We report two cases of levetiracetam-induced rage. The first patient was a 29-year-old male with a 14year history of intractable posttraumatic epilepsy. He was initially placed on sodium valproate and phenobarbitone and later had phenobarbitone replaced with levetiracetam. Within the first week of initiating levetiracetam, he became aggressive, bursted into fits of fury, and attacked his siblings. Levetiracetam was stopped, and the seething rage ceased only to reappear when it was reintroduced; hence, the complete withdrawal of levetiracetam. Naranjo probability score for adverse drug reaction was 8. Results: The second patient was a 23-year-old lady who developed seething rage and made several attempts to kill herself with a knife following addition of levetiracetam to the clonazepam and carbamazepine that she was taking for treatment-resistant epilepsy. Withdrawal and reintroduction of levetiracetam by the relatives led to cessation and reemergence, respectively, of the rage and suicidal tendencies. Naranjo score was 8. Levetiracetam was discontinued. Conclusion: Neuropsychiatric evaluation for prior mood or psychiatric disorders in those initiating levetiracetam therapy is suggested alongside monitoring for early features of levetiracetam-induced rage by both caregivers and physicians. This will help stem the morbidity and potential mortality associated with this life-threatening adverse drug reaction.

Open Journal of Preventive Medicine, 2019

Introduction: Tobacco and marijuana use is a public health challenge all over the world and espec... more Introduction: Tobacco and marijuana use is a public health challenge all over the world and especially in Sub Saharan Africa. The combination of low socioeconomic status and substance use can be described as a social and economic disaster for many poor families of Africa. While majority of studies concentrated on cigarette smoking, few studies in Nigeria has been conducted on non-smoke forms of tobacco. The burden of marijuana abuse is also rising in the Nigeria. Similar to cigarette smoking, cannabis use is more common among males. Knowledge of the pattern of tobacco and cannabis use in the community is important considering the public health implications. The aim of this study was to determine the prevalence of tobacco (cigarette smoking and snuff) and cannabis use among adults in an urban communities Enugu, southeast Nigeria. Methods: This was a cross-sectional descriptive study conducted in urban slum settlements in Enugu, the capital of Enugu State, southeast Nigeria. Using a s...

Annals of Medical and Health Sciences Research, 2011

Background: Specialization in various areas of medicine is established in most tertiary hospitals... more Background: Specialization in various areas of medicine is established in most tertiary hospitals in Nigeria. There is thus an increasing awareness by the populace on need for specialist medical care. However, neurologists are few and unevenly spread in the country. This raises a serious concern considering the enormous burden that neurological diseases may constitute in our environment. Objective: To examine the scope of the burden of neurological disease as encountered in a typical neurological/medical clinic in a tertiary centre in the South East zone of the country. Methods: A retrospective study was carried out of all medical cases seen at the Neurology Clinic of the University of Nigeria Teaching Hospital Enugu over a 20 - month period from January 2007 to August 2008. Patients were at least 15 years of age. The final diagnosis as made in each patient's folder by the Consultant Neurologist or Neurology Senior Registrar was recorded. The data obtained was subjected to descr...

Nigerian journal of clinical practice, 2020

Background Most recent studies in Nigeria have documented high prevalence of hypertension, diabet... more Background Most recent studies in Nigeria have documented high prevalence of hypertension, diabetes, and obesity. Several mechanisms may link hypertension and obesity hence the high prevalences of both disorders in Nigeria. There are however no studies on the prevalence of hypertension among the obese in urban settings. Aims The aim of this study was to describe the prevalence and pattern of hypertension in overweight/obese individuals in a community. Methods We conducted a post-hoc analysis on obese subjects 20 years and above from two urban settlements within Enugu metropolis. For database management and statistical analyses, we used the SPSS version 22. Results Data from a total of 301 individuals with obesity who met the selection criteria were re-analyzed. A total of 198 (65.8%) individuals were found to have hypertension most of whom were newly diagnosed 110 (55.6%). The prevalence of hypertension was 65.8% and increased with age and BMI. Conclusion Individuals with overweight...

Nigerian Journal of Clinical Practice, 2017

Purpose: Though most doctors in their professional life will provide care for people with epileps... more Purpose: Though most doctors in their professional life will provide care for people with epilepsy, many will not get further training in their professional life. There may be other barriers, perceived or not, to providing care to people living with epilepsy by doctors which need to be approached in the medical undergraduate curriculum and medical continuing education. The aim of this study was to determine the knowledge gaps of medical students on basic issues regarding epilepsy that could be useful in preparing training material for the students and continuous medical education for doctors working in the community. Materials and Methods: This cross-sectional and descriptive study was carried out in one of the medical schools in Enugu metropolis. Data collection was done using a semi-structured validated questionnaire. Results: Seizure was regarded as a movement disorder by 10.3% of the students. The rank of causes of epilepsy given by respondents was brain injury (88%), brain tumo...

International Journal of Medicine and Health Development, 2017

Background: The use of anti-retroviral treatment has transformed AIDS into a chronic disease with... more Background: The use of anti-retroviral treatment has transformed AIDS into a chronic disease with a growing burden on the fragile public health system in the Nigeria. Pattern of condom use can act as a surrogate on the impact of counseling on HIV patients. Objectives: The aim of this study was to document the pattern of condom use among HIV positive patients on HARRT attending a tertiary hospital in Enugu. Methods: Consecutive consenting patients presenting at the ART-clinic of Enugu State University of Technology Teaching Hospital, Parklane were interviewed. Data was analyzed using the statistical package for social sciences (SPSS) version 22. Results: A total of 207patients were interviewed during the study. Twenty-three (11.1%) abstained from sexual intercourse after counselling, 113(61.4%) used condoms consistently while the rest 71(31%) did not use it or used it inconsistently. Patients with primary school education (85.4%) had the highest rate of consistent condom use. Condom ...

International Journal of Medicine and Health Development, 2018

Background: Symptoms of anxiety disorders vary widely among physically ill patients. Early detect... more Background: Symptoms of anxiety disorders vary widely among physically ill patients. Early detection and treatment of anxiety will reduce the economic burden of common medical disorders and provide empirical data for public health educators and policy makers for the development of guidelines for health workers and care givers. Objectives: The objective of the present study was to determine the correlates and predictors of anxiety symptoms based on the Hospital anxiety and depression scores among patients attending medical outpatient clinic in a Tertiary hospital in Enugu South East Nigeria. Methods: This was a cross sectional study conducted at the Medical Outpatient Clinic of Enugu State University Teaching Hospital, Enugu Nigeria. All consecutive consenting patients were recruited. Anxiety symptoms were explored using the Hospital Anxiety Depression Scale. Study duration was 6 months. Statistical analyses were one using SPSS version 22. Results: A total of 512 (males 190(37.1%), f...

BACKGROUND Neurological disorders are a significant cause of morbidity and mortality worldwide. U... more BACKGROUND Neurological disorders are a significant cause of morbidity and mortality worldwide. Urban hospital-based studies give some perspectives on the burden of neurological disease but there are no community-based studies from South East Nigeria. AIM This study sought to screen for the scope and pattern of neurological dysfunction affecting inhabitants of two semi-urban communities in Enugu, South East Nigeria. METHODS A descriptive, cross-sectional, questionnaire-based study of inhabitants living in Alfred Camp and Udi Siding communities in Enugu was carried out in March 2008. Using a structured questionnaire, house-to-house interview of the residents was conducted by doctors trained for this purpose. Residents' knowledge and experience of clinical features that suggest neurological dysfunction were ascertained. Informed consent was obtained and ethical approval obtained from the Ethics Committee of the University of Nigeria Teaching Hospital Enugu. Data obtained was analy...

Background: The muscle diseases are frequently encountered in medical clinics in Nigeria. In many... more Background: The muscle diseases are frequently encountered in medical clinics in Nigeria. In many cases however they are not optimally managed. The ion channel diseases, ‘channelopathies', are a group of muscle disorders that share a lot of clinical similarity. Misdiagnosis can occur especially in resource poor settings with paucity of neurologists and diagnostic tools. Method: A case report of two young Nigerian siblings aged 13 and 15 years who have the clinical features of autosomal recessive myotonia congenita (Becker disease), one of the muscle channelopathies, is presented. The relevant literature is reviewed. Results: A 15 year old Nigerian male presented with a 7 year history of progressive weakness of the legs and a 4 year history of difficulty in lifting heavy loads with the arms. There are no bulbar or cardiac symptoms. He had generalized muscle hypertrophy with percussion and exercise induced myotonia. Available investigations showed no cardiac involvement. The 13 ye...

Background: Rabies is a highly contagious viral infection of the nervous system with a still as y... more Background: Rabies is a highly contagious viral infection of the nervous system with a still as yet high mortality rate even in advanced settings. Management maybe enhanced with early presentation. The incubation period usually ranges from 7 days to I year with a mean of 1 - 2 months. Method: The case report of a 34 year old Nigerian male presenting with clinical rabies is discussed. The onset of the illness comes 112 days after a dog bite. This incubation period is unusual in this environment. Result: A 34 year old male metal worker of the Igbo tribe and resident in Abakaliki, South East Nigeria was admitted into the medical ward of the University of Nigeria Teaching Hospital Enugu on the 7th of May 2008 with an 8 day history of headache and a 4 day history of involuntary spasms of facial and pharyngeal muscles associated with pain on drinking water. He also complained of fever. He recalled being bitten about mid- January 2008 by the uncle's dog which had earlier bitten another...