Bappa Adamu - Academia.edu (original) (raw)

Papers by Bappa Adamu

Research paper thumbnail of A three-year review of mortality patterns in the medical wards of Aminu Kano Teaching Hospital, Kano, Nigeria

Nigerian Postgraduate Medical Journal

The pattern of morbidity and mortality reflects the burden of disease in a particular community. ... more The pattern of morbidity and mortality reflects the burden of disease in a particular community. This pattern shows geographic variations between communities and countries. The knowledge of the pattern of diseases and their contribution to mortality in a given country is very important in evaluating its health care delivery system. Such knowledge is important for health planning and for improving the healthcare services in that particular nation. We set out to study the mortality pattern in our medical wards. This is a retrospective study that reviewed the causes of death in the medical wards of Aminu Kano Teaching Hospital (AKTH) Kano between January 2001 and December 2003 (three years). The data were obtained from the admission and discharge/death register, patients' case records, the weekly as well as quarterly mortality reviews. The SPSS version 10 was used to analyse the data. A total of 3369 patients were admitted over the 3 year study period. Of these 2518 (74.7%) were discharged or referred and 851 patients died, giving an overall mortality rate of 25.3%. The male to female admission ratio was 1.6:1. Majority of deaths, 714 (83.9%) occurred after 24 hours of admission. The most important causes of death were infectious diseases other than HIV/AIDS (17.9%), cerebrovascular disease (17%), HIV/AIDS (13.6%), chronic renal failure (12.5%) and diseases of the circulatory system (11.9%). Mortality in the medical wards reflects the emerging trend of mixed disease spectrum burden comprising communicable and non communicable diseases. Public health education, raising the socio-economic status of our people as well as improving the standards of our health care facilities and personnel would prevent a large proportion of deaths from medical wards.

Research paper thumbnail of Magnitude of diabetic peripheral neuropathy in Saudi Arabia: a systematic review and meta-analysis

BMC Endocrine Disorders

Background Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and d... more Background Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and disability from foot ulcers and amputations, is increasingly becoming a source of concern in Saudi Arabia and worldwide. However, wide variability exists in the prevalence of DPN reported in previous studies in Saudi Arabia, limiting the utility of existing data in national public health policy. Therefore, the aim of this study was to systematically evaluate the magnitude of DPN in patients living with DM in Saudi Arabia in order to inform policymakers during the implementation of appropriate preventive and treatment strategies for DPN. Methods PubMed, Google Scholar, African Journals Online, Scopus, Web of Science, Embase, and Wiley Online Library were searched systematically to acquire relevant articles based on preset criteria. We evaluated heterogeneity and publication bias and employed a random-effects model to estimate the pooled prevalence of DPN from the included studies. We follo...

Research paper thumbnail of Magnitude of Diabetic Neuropathy in Saudi Arabia: A Systematic Review and Meta-Analysis

Background: Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and ... more Background: Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and disability from foot ulcers and amputations, is increasingly becoming a source of concern in Saudi Arabia and worldwide. However, wide variability exists in the prevalence of DPN reported in previous studies in Saudi Arabia, limiting the utility of existing data in national public health policy. Therefore, this study aimed to estimate the magnitude of DPN in people living with diabetes mellitus in Saudi Arabia.Methods: PubMed, Google Scholar, African Journals OnLine, Scopus, Web of Science, Embase, and Wiley Online Library were searched systematically to acquire relevant articles based on preset criteria. We evaluated heterogeneity and publication bias and employed a random-effects model to estimate the pooled prevalence of DPN from the included studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in conducting the meta-analysis. Analysis...

Research paper thumbnail of Hemorrhagic infarctive stroke in COVID-19 patients: report of two cases and review of the literature

Journal of Community Hospital Internal Medicine Perspectives, 2021

There is growing evidence in support of ischemic stroke as a manifestation of COVID-19 infection.... more There is growing evidence in support of ischemic stroke as a manifestation of COVID-19 infection. However, hemorrhagic transformation of ischemic stroke is rare. We present two cases of hemorrhagic infarction as presenting features in COVID-19 patients who did not have traditional cardiovascular risk factors for ischemic or hemorrhagic stroke. While the hemorrhagic infarct was from a large artery in one of the patients, the other patient had a small artery related hemorrhagic infarct. We highlighted the possible underlining mechanisms from the literature and the implication of hemorrhagic infarct for routine anticoagulant therapy in patients with COVID −19 related ischemic stroke.

Research paper thumbnail of Electroencephalography findings in childhood epilepsy in a Saudi population: Yield, pattern and determinants of abnormality

Journal of Taibah University Medical Sciences, 2021

Research paper thumbnail of Neurocysticercosis in people with epilepsy in Sub-Saharan Africa: A systematic review and meta-analysis of the prevalence and strength of association

Seizure, 2020

We analyzed studies on neurocysticercosis (NCC) and epilepsy across Sub-Saharan Africa (SSA) to d... more We analyzed studies on neurocysticercosis (NCC) and epilepsy across Sub-Saharan Africa (SSA) to determine the prevalence of NCC in people with epilepsy (PWE) and the strength of association of NCC with epilepsy in the region. Methods: We conducted a systematic review of the existing literature on NCC and epilepsy in SSA. Diagnostic methods for NCC in the studies selected for our analysis included one or more of the following: positive brain CT, serum ELISA and serum EITB. A common prevalence and overall odds-ratio were then estimated using metaanalysis. Results: A total of 25 (overall) and 20 (case-control) studies met the inclusion criteria for the prevalence and strength of association estimation, respectively. The overall prevalence estimate of NCC in PWE was 22 % [95 % confidence interval [CI]: 17-27.0 %). The figures were higher in the Southern and Eastern Africa sub-region (45 % and 25 % respectively) but lower in the Central and Western Africa sub-region (6 % and 15 % respectively). The prevalence of NCC estimate in PWE varied with method of diagnosis; with 29 % 18 % and 15 % in studies that used a minimum of Brain CT, ELISA and EITB respectively. The overall odds ratio was 2.4 (95 % CI 2.1-2.8), p < 0.0001. Conclusion: The overall prevalence of NCC in PWE in SSA was 22 %. The prevalence figure varied with the subregion of SSA. The odd of NCC in PWE in SSA was 2.4. In spite of the sub-regional variation in NCC prevalence, this meta-analysis suggests that neurocysticercosis contributes significantly to epilepsy in SSA.

Research paper thumbnail of Prevalence of active epilepsy, lifetime epilepsy prevalence, and burden of epilepsy in Sub-Saharan Africa from meta-analysis of door-to-door population-based surveys

Epilepsy & Behavior, 2020

Background: There is marked variation in the prevalence of epilepsy across Sub-Saharan Africa (SS... more Background: There is marked variation in the prevalence of epilepsy across Sub-Saharan Africa (SSA). In order to accurately estimate the clinical and public health impacts of epilepsy in the region, robust and reliable epidemiological data are required for appropriate estimation of logistical, economical, and social impacts of epilepsy including policy formulation and intervention in the region. Objective: We sought to evaluate the prevalence of active epilepsy (AE) and lifetime epilepsy prevalence in SSA using available data collected at community level. Methods: We carefully searched online databases and identified the required articles using prespecified criteria. Random-effects model (REM) was used to estimate the active and lifetime prevalence from data generated from studies in SSA.. The burden of epilepsy, in terms of the number of people with the disease, was also obtained. Heterogeneity in the analysis was further explored using subgroup analysis and meta-regression techniques. Result: A total of 39 and 12 community-based door-to-door surveys addressing AE and lifetime epilepsy, respectively, from different countries of SSA met the inclusion criteria for the study. Random-effects model estimates of overall prevalence of epilepsy were 9 per 1000 persons (95% confidence interval (CI): 8.0-9.9 per 1000 persons) for AE and 16 per 1000 persons (95% CI: 12.3-19.7 per 1000 persons) for lifetime epilepsy. The prevalence was highest in the Central Africa subregion with 30.2 per 1000 persons (95% CI: 6.2 to 66.7 per 1000 persons). The prevalence of AE in the rural settlement was twice that of the urban settlements.

Research paper thumbnail of Treatment of Light Chain Deposition Disease Using Bortezomib-Based Regimen Followed by Thalidomide-Based Regimen in a Saudi Male

Case Reports in Nephrology, 2016

Light chain deposition disease (LCDD) is a rare illness with, as yet, no clear evidence-based gui... more Light chain deposition disease (LCDD) is a rare illness with, as yet, no clear evidence-based guidelines for its treatment. To the best of our knowledge, LCDD has not been previously reported from Saudi Arabia. We present in this report, a 38-year-old Saudi male who presented with clinical features suggestive of hypertensive nephropathy but kidney biopsy later revealed the diagnosis of LCDD. His serum creatinine at presentation was 297 μmol/L which came down to 194 μmol/L on treatment with Bortezomib, Cyclophosphamide and Dexamethasone. His 24-hour protein excretion at presentation was 6 g/L which also came down to less than 1 g/day. He was later placed on Cyclophosphamide, Thalidomide, and Dexamethasone regimen because of persistent high titres of serum free light chains. He went into remission with undetectable serum free light chains and remained so for three years at the time of writing this report. We conclude that LCDD, though rare, does occur in Saudi population. The treatmen...

Research paper thumbnail of Pattern of urinary bladder sonographic findings in patients evaluated for urinary schistosomiasis

West African Journal of Radiology, 2015

Background: Urinary schistosomiasis is one of the neglected tropical diseases. Of the 239 million... more Background: Urinary schistosomiasis is one of the neglected tropical diseases. Of the 239 million people with active Schistosoma infections in 2009, 85% lived in sub-Saharan Africa. The urinary bladder is the main site of pathologic damage in patients with urinary schistosomiasis. Objectives: The objectives were to study the prevalence and pattern of sonographic bladder abnormalities in patients evaluated for urinary schistosomiasis. Materials and Methods: All consecutive patients being evaluated for urinary schistosomiasis at the Usmanu Danfodiyo University, Teaching Hospital Sokoto and Federal Medical Centre Birnin Kebbi were prospectively scanned at radiology departments of the two centers. All the patients were scanned with Apogee 800 plus (Japan 2002) and Concept D (Dynamic Imaging Scotland) ultrasound scanners with a variable frequency probes at 3.5–5 MHz. Doppler was used to assess the vascularity of urinary bladder masses, and to differentiate between masses and blood clots which is a diagnostic challenge when using brightness mode (B-mode) sonography alone. The gain was set correctly to allow good visualization of the bladder and adjacent structures. Transverse images are obtained in the true axial plane and angled caudal to show the bladder base. Longitudinal and oblique sagittal images are obtained to complete the examination. All the ultrasound findings and images were recorded as hard copies, and the films were reviewed by a qualified radiologist. The results were analyzed using statistical software SPSS 17.0 for windows. Results: We evaluated a total of 107 patients. The mean age of the patients was 42.9 ± standard deviation 16.8 years, with a range between 7 and 86 years. There were 84 males accounting for 78.5% and 23 females accounting for 21.5%. Abnormal sonographic findings were seen in 101 (94.4%) of patients evaluated. Urinary bladder stone with wall thickening was the most common finding accounting for 37 (36.4%), followed by bladder wall thickening with internal echoes accounting for 32 (21.5%) of the patients. The incidence of irregular bladder mass was 15 (14.0%) while polypoidal mass accounted for 4 (3.7%). Contracted bladder with wall calcification was seen in 7 (6.5%) while no abnormalities were seen in the urinary bladder in 6 (5.6%) of the patients. Conclusion: Abnormal bladder sonographic findings are common in patients evaluated for signs and symptoms of urinary schistosomiasis in North-Western Nigeria, with a prevalence of 94.4% in this current study. Urinary bladder stone with wall thickening followed by bladder wall thickening with internal echoes were the most common findings accounting for 58% of the findings. These sonographic abnormalities should raise the suspicion of urinary schistosomiasis in an endemic region.

Research paper thumbnail of Secondary Hyperparathyroidism and Hypocalcaemia in Dialysis Patients in AKTH

The Aminu Kano Teaching Hospital (AKTH) is one of the tertiary health institutions in Nigeria whe... more The Aminu Kano Teaching Hospital (AKTH) is one of the tertiary health institutions in Nigeria where dialysis is provided to patients with chronic renal disease, but there had been no reported study on the prevalence of biochemical indicators of bone and mineral metabolism in these patients. We measured serum parathyroid hormone (PTH), total calcium (Ca), albumin (ALB) and phosphate (P) and calculated calcium-phosphate (CaP) ion product in order to evaluate parathyroid function and bone mineral status in dialysis patients seen at the AKTH, Kano. Forty five patients and fourty-five healthy age matched hospital staff who served as controls were studied. Intact PTH was measured with a commercial kit which is based on immunoassay (DRG International Incorp, USA) while serum calcium, phosphate and albumin were estimated also with commercial kits (Randox Laboratories, UK). Calcium was corrected for albumin.The mean PTH of 194 pg/mL in dialysis patients was significantly higher (P< 0.001) than 28 pg/mL found in controls. The corrected calcium was 1.81 mmol/L, phosphate 2.26 mrnol/L, albumin 27.09 g/L and CaP product 3.35 mmoF/U in dialysis patients compared to calcium of 2.46 mmol/L, phosphate 1.04 mmol/L, albumin 42.78 glL and CaP product of 2.55 mmoF/U in controls. Fourty eight percent of the patients had secondary hyperparathyroidism, 89% hypocalcaemia, 53% hyperphosphataernia, 82% hypoalbuminaemia and 29% elevated CaP product. This study has demonstrated significant abnormality of calcium, phosphate and parathyroid homeostasis in patients undergoing dialysis in Kano. As persistent elevations of PTH, phosphate, CaP product and co-existing hypocalcaemia are known to contribute to morbidity and mortality in dialysis patients, it is recommended that pharmacological correction and routine measurement ofthese biochemical indicators be instituted for management of haemodialysis patients in our hospitals.

Research paper thumbnail of Concurrent Kaposi's sarcoma, tuberculosis, and allograft dysfunction in a renal transplant patient

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2009

The major long-term complications of renal transplantation (RT) include cardio-vascular disease, ... more The major long-term complications of renal transplantation (RT) include cardio-vascular disease, opportunistic infections, malignancies, and chronic allograft nephropathy. Long-term complications are generally considered as those occurring more than 1 year post trans-plantation; however, some of the complications can occur earlier. We present a 58-year-old man who presented with multiple complications of RT concurrently and relatively early post trans-plantation including Kaposi's sarcoma, tuberculosis and allograft dysfunction.

Research paper thumbnail of AIDS mortality in a tertiary health institution: A four-year review

Journal of the National Medical Association, 2006

Africa contains 70% of adults and 80% of children living with AIDS in the world and has buried 75... more Africa contains 70% of adults and 80% of children living with AIDS in the world and has buried 75% of the 21.8 million worldwide who have died of AIDS since the epidemic began. Nigeria, the most populous country in Africa, has 5.8% of her adult population having HIV infection at the end of 2003. We reviewed the causes of death among AIDS patients in Aminu Kano Teaching Hospital Kano, Nigeria over four years. Four-hundred-fifty-five (9.9%) of the 4,574 adult medical admissions were due to HIV/AIDS-related diagnosis. HIV/AIDS admissions increased progressively from 45 cases in 2001 to 174 in 2004. HIV/AIDS caused 176 deaths over the period giving an HIV-related mortality of 38.7%. This also showed a gradual increase from 24 deaths in 2001 to 61 deaths in 2004. The most common causes of death were tuberculosis (33.4%), septicemia (23.8%), advanced HIV disease (9.1%), meningitis (7.4%), other pulmonary infections (5.1%) and Kaposi's sarcoma (4.5%). The present dismal situation of pa...

Research paper thumbnail of Prevalence, risk factors, and histological pattern of kidney disease in patients with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome at Aminu Kano Teaching Hospital: A clinicopathologic study

Annals of Nigerian Medicine, 2014

Background: Renal disease in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV... more Background: Renal disease in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) contributes significantly to morbidity and mortality associated with HIV infection worldwide. Aim: To determine the prevalence, risk factors, and histological pattern of kidney disease in HIV-positive patients in Kano, Nigeria. Materials and Methods: Four hundred consecutive treatment naοve HIV-positive patients with no other condition known to cause kidney disease were screened for proteinuria and reduced glomerular filtration rate (GFR). Kidney disease was defined as the presence of persistent microalbuminuria/proteinuria or decreased GFR (<60 ml/min/1.73 m 2 ). Kidney biopsy was performed on 20 patients. Data were analyzed using SPSS version 17. Results: The mean ± standard deviation age of the study population was 34.03 ± 10.23 years with 240 (60%) being females. Kidney disease was found in 227 patients (56.8%), with a higher prevalence seen in males (odds ratio = 1.9305, 95% confidence interval = 1.2760-2.9207, P = 0.0018). Proteinuria including persistent microalbuminuria was found in 211 (52.8%) and reduced GFR was found in 64 (16.0%). The risk factors for developing kidney disease were age >40 years, male gender, low CD4 cell count, cigarette smoking, low body mass index, and low serum cholesterol. Logistic regression identified low CD4 cell count as an independent risk factor for kidney disease. Collapsing focal segmental glomerulosclerosis (FSGS) was the predominant histological pattern seen. Conclusion: The prevalence of renal disease in HIV-positive patients was high in Kano, Nigeria; and microalbuminuria was a manifestation of collapsing FSGS.

Research paper thumbnail of Blood Pressure Control among Treated Hypertensives in a Tertiary Health Institution

Nigerian Journal of Medicine, 2008

Background: Goal blood pressure (BP) was defined by the JNC VI and the World Health Organization-... more Background: Goal blood pressure (BP) was defined by the JNC VI and the World Health Organization-International Society of Hypertension (WHO/ISH) as <140 mm Hg systolic and <90 mm Hg diastolic for the general and <130 mm Hg systolic and <85 mm Hg diastolic for special high-risk populations. It is well established that adequate BP control characterizes only a fraction of treated hypertensive patients. The importance of tight BP control has been established in preventing cardiovascular morbidity and mortality. Methods: We performed cross-sectional studies on the current status of BP control among treated hypertensive in our center. One hundred consecutive patients with essential hypertension who have been attending the out patient hypertension clinic and have been on treatment for at least 6 months were recruited. The pre treatment BP and BP records in the previous 2 visits were noted. Patients were said to have good BP control if their BPs are < 140/90 mmHg (<130/80 mmHg for high risk patients) at the time of the study and in the last visit. Results: There were 49 males and 51 female (M: F; 1:1), aged 26 to 85 (mean 52.33 +/-12.29) years. The duration of hypertension ranged 6 months to 30 (mean 7.37 +/-7.1) years. The duration of treatment in our centre was 6 months to 10 (mean 3.22 +/-2.23) years. Blood pressure was controlled in 33 (33%) of the patients. Pre-treatment mean blood pressure was significantly higher than the BP value at the time of the study (155.87 +/-26.02/97.81 +/-11.89 mmHg versus 143.40 +/-24.14/86.53 +/-12.71 mmHg) (p<0.05). Diuretics were the commonest antihypertensive prescribed either alone or in combination (69%), followed by a calcium antagonist (56%) and centrally acting drugs (38%). Twenty seven were on single antihypertensive, 43 (43%) on 2, 25 (25%) on 3 and 5 (5%) on 4 classes of antihypertensive. Blood pressure control was associated with taking more than one antihypertensive medication and compliance. Conclusion: Control of BP in patients receiving antihypertensive drugs is still far from optimal in the study population in Nigeria just as in other countries. Many patients had multiple cardiovascular risk factors. Adherence to medication should be encouraged.

Research paper thumbnail of Outcome and complications of permanent hemodialysis vascular access in Nigerians: a single centre experience

Annals of African medicine

It is widely accepted that autogenous arteriovenous fistula (AVF) carries less morbidity and mort... more It is widely accepted that autogenous arteriovenous fistula (AVF) carries less morbidity and mortality compared to all other forms of vascular accesses in maintenance hemodialysis patients. There is paucity of data on vascular access from sub-Saharan Africa. The aim of this study was to assess the outcome and complications of permanent vascular access in our center. The study is a prospective, hospital-based, longitudinal study. All consecutive patients on maintenance hemodialysis in Aminu Kano Teaching Hospital who were referred to the surgical unit of for creation of permanent hemodialysis vascular access were included in the study. The patient's clinical and demographic data were documented. Data about vascular access types, outcomes, and complications were obtained over a 1-year period from the time of vascular access creation. One hundred and seventy four patients were operated upon between January 2008 and December 2010 with a mean age of 46.4 years (range 18-76 years) and...

Research paper thumbnail of Post Kidney Transplant Tuberculosis in Nigeria: A Case Report

Nigerian Journal of Medicine, 2008

Tuberculosis has been reported to be one of the most serious bacterial infections after transplan... more Tuberculosis has been reported to be one of the most serious bacterial infections after transplant and occur up to 20 times more frequently in transplant recipients than in the general population. Renal transplant is available in few centers in the country and the post transplant population is increasing, but to our knowledge no case of post transplant tuberculosis has been reported in this environment. The case report of a 35 year old Nigerian who had live related kidney transplant and later developed post transplant disseminated Tuberculosis is presented and the relevant literature is reviewed. A 35 year old university graduate had a live related kidney transplant in our center. He had stable allograft function on immunosuppressive regimen consisting of Cyclosporin, Azathioprine and Prednisolone, and presented with features of disseminated tuberculosis involving the cervical lymph nodes and chest with associated deterioration of allograft function. He was successfully treated with 2 months initial phase of quadruple anti tuberculosis drugs including Isoniazid, Rifampicin, Pyrazinamide and Ethambutol and four months continuation phase with Isoniazid and Rifampicin. He showed remarkable clinical improvement and reversal of the allograft dysfunction. This case illustrates one of the post transplant infectious complications seen in our environment and its successful treatment, and highlighted the need for Tuberculosis prophylaxis in transplant recipients in countries with high incidence of tuberculosis.

Research paper thumbnail of Anaemia and its Response to Treatment with Recombinant Human Erythropoietin in Chronic Kidney Disease Patients

West African Journal of Medicine, 2010

WEST AFRICAN JOURNAL OF MEDICINE Anaemia and its Response to Treatment with Recombinant Human Ery... more WEST AFRICAN JOURNAL OF MEDICINE Anaemia and its Response to Treatment with Recombinant Human Erythropoietin in Chronic Kidney Disease Patients L'anémie et sa Réponse au Traitement avec l'Humain Recombinant Erythropoietin dans les Patients de Maladie Chroniques du Rein

Research paper thumbnail of Amyloidosis and vascular thrombosis

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2008

Amyloidosis is a rare systemic disorder of protein metabolism with progressive extra-cellular dep... more Amyloidosis is a rare systemic disorder of protein metabolism with progressive extra-cellular deposition of insoluble fibrillary protein, disorganization of tissue architecture, and subsequent organ dysfunction. Primary amyloidosis is the most common form of this disorder, however, it can develop secondary to plasma cell dyscrasias such as multiple myeloma (MM); 10-15% of MM patients may develop amyloidosis of vital organs. Amyloidosis is usually associated with bleeding, but less commonly with thrombosis. We present a 52-year-old Saudi female with amyloidosis secondary to multiple myeloma. She presented with both venous and extensive arterial thrombosis. Although relatively rare, plasma cell dyscrasias such as amyloidosis and multiple myeloma could present with thrombotic rather than hemorrhagic complications.

Research paper thumbnail of Adjunctive medical expulsive therapy for kidney and ureteral stone fragments following shock wave lithotripsy

Protocols, 2011

Stone disease of the urinary tract (variously termed kidney stones, ureteric stones, urolithiasis... more Stone disease of the urinary tract (variously termed kidney stones, ureteric stones, urolithiasis, urinary calculi, and urinary calculus disease) is very common and is reported to have increased in the last quarter of the 20th century for men and women, black and ...

Research paper thumbnail of Commercial kidney transplantation: Trends, outcomes and challenges-A single-centre experience

Annals of African Medicine, 2012

Background/Objective: Many experts believe that commercial organ transplants continue unabated de... more Background/Objective: Many experts believe that commercial organ transplants continue unabated despite international efforts to curb them. The aim was to determine the trends, outcomes and challenges of commercial living unrelated renal transplants (LURT) as seen in our institution. Materials and Methods: A retrospective study of LURT patients on follow-up at our institution. The list of all LURT patients was obtained from our renal registry. Inclusion criteria for the study were 1) Presentation to our hospital within the first month post transplant; 2) Completion of one-year follow-up OR patient or allograft losses prior to completing one-year follow-up. SPSS 17.0 was used for data analysis. Results: Forty-five patients satisfied the entry criteria; 33 males and 12 females with age range 13-68 years, and mean ± SD of 40 + 15 years. The majority (28) of the transplants were carried out in Pakistan, the remaining in Egypt, Philippines, and China. There has been a steady decline in the number of new patients with commercial transplants over a four-year period. Complications encountered included infections in 19 (42.2%) patients, biopsy-proven acute rejections in nine patients (20%), surgical complications in 10 patients (22.2%), post-transplant diabetes in seven (15.6%), delayed graft function in one (2.2%), and chronic allograft nephropathy in one (2.2%) patient. Patient survival at one year was 97.8% and allograft survival was 88.9%. Conclusions: Commercial kidney transplant is on the decline as seen in our center, likely as a result of international efforts to curb it, as well as due to a parallel increase in renal transplants in the country. One-year patient and allograft survivals are good but there is a relatively high rate of infections.

Research paper thumbnail of A three-year review of mortality patterns in the medical wards of Aminu Kano Teaching Hospital, Kano, Nigeria

Nigerian Postgraduate Medical Journal

The pattern of morbidity and mortality reflects the burden of disease in a particular community. ... more The pattern of morbidity and mortality reflects the burden of disease in a particular community. This pattern shows geographic variations between communities and countries. The knowledge of the pattern of diseases and their contribution to mortality in a given country is very important in evaluating its health care delivery system. Such knowledge is important for health planning and for improving the healthcare services in that particular nation. We set out to study the mortality pattern in our medical wards. This is a retrospective study that reviewed the causes of death in the medical wards of Aminu Kano Teaching Hospital (AKTH) Kano between January 2001 and December 2003 (three years). The data were obtained from the admission and discharge/death register, patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; case records, the weekly as well as quarterly mortality reviews. The SPSS version 10 was used to analyse the data. A total of 3369 patients were admitted over the 3 year study period. Of these 2518 (74.7%) were discharged or referred and 851 patients died, giving an overall mortality rate of 25.3%. The male to female admission ratio was 1.6:1. Majority of deaths, 714 (83.9%) occurred after 24 hours of admission. The most important causes of death were infectious diseases other than HIV/AIDS (17.9%), cerebrovascular disease (17%), HIV/AIDS (13.6%), chronic renal failure (12.5%) and diseases of the circulatory system (11.9%). Mortality in the medical wards reflects the emerging trend of mixed disease spectrum burden comprising communicable and non communicable diseases. Public health education, raising the socio-economic status of our people as well as improving the standards of our health care facilities and personnel would prevent a large proportion of deaths from medical wards.

Research paper thumbnail of Magnitude of diabetic peripheral neuropathy in Saudi Arabia: a systematic review and meta-analysis

BMC Endocrine Disorders

Background Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and d... more Background Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and disability from foot ulcers and amputations, is increasingly becoming a source of concern in Saudi Arabia and worldwide. However, wide variability exists in the prevalence of DPN reported in previous studies in Saudi Arabia, limiting the utility of existing data in national public health policy. Therefore, the aim of this study was to systematically evaluate the magnitude of DPN in patients living with DM in Saudi Arabia in order to inform policymakers during the implementation of appropriate preventive and treatment strategies for DPN. Methods PubMed, Google Scholar, African Journals Online, Scopus, Web of Science, Embase, and Wiley Online Library were searched systematically to acquire relevant articles based on preset criteria. We evaluated heterogeneity and publication bias and employed a random-effects model to estimate the pooled prevalence of DPN from the included studies. We follo...

Research paper thumbnail of Magnitude of Diabetic Neuropathy in Saudi Arabia: A Systematic Review and Meta-Analysis

Background: Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and ... more Background: Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and disability from foot ulcers and amputations, is increasingly becoming a source of concern in Saudi Arabia and worldwide. However, wide variability exists in the prevalence of DPN reported in previous studies in Saudi Arabia, limiting the utility of existing data in national public health policy. Therefore, this study aimed to estimate the magnitude of DPN in people living with diabetes mellitus in Saudi Arabia.Methods: PubMed, Google Scholar, African Journals OnLine, Scopus, Web of Science, Embase, and Wiley Online Library were searched systematically to acquire relevant articles based on preset criteria. We evaluated heterogeneity and publication bias and employed a random-effects model to estimate the pooled prevalence of DPN from the included studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in conducting the meta-analysis. Analysis...

Research paper thumbnail of Hemorrhagic infarctive stroke in COVID-19 patients: report of two cases and review of the literature

Journal of Community Hospital Internal Medicine Perspectives, 2021

There is growing evidence in support of ischemic stroke as a manifestation of COVID-19 infection.... more There is growing evidence in support of ischemic stroke as a manifestation of COVID-19 infection. However, hemorrhagic transformation of ischemic stroke is rare. We present two cases of hemorrhagic infarction as presenting features in COVID-19 patients who did not have traditional cardiovascular risk factors for ischemic or hemorrhagic stroke. While the hemorrhagic infarct was from a large artery in one of the patients, the other patient had a small artery related hemorrhagic infarct. We highlighted the possible underlining mechanisms from the literature and the implication of hemorrhagic infarct for routine anticoagulant therapy in patients with COVID −19 related ischemic stroke.

Research paper thumbnail of Electroencephalography findings in childhood epilepsy in a Saudi population: Yield, pattern and determinants of abnormality

Journal of Taibah University Medical Sciences, 2021

Research paper thumbnail of Neurocysticercosis in people with epilepsy in Sub-Saharan Africa: A systematic review and meta-analysis of the prevalence and strength of association

Seizure, 2020

We analyzed studies on neurocysticercosis (NCC) and epilepsy across Sub-Saharan Africa (SSA) to d... more We analyzed studies on neurocysticercosis (NCC) and epilepsy across Sub-Saharan Africa (SSA) to determine the prevalence of NCC in people with epilepsy (PWE) and the strength of association of NCC with epilepsy in the region. Methods: We conducted a systematic review of the existing literature on NCC and epilepsy in SSA. Diagnostic methods for NCC in the studies selected for our analysis included one or more of the following: positive brain CT, serum ELISA and serum EITB. A common prevalence and overall odds-ratio were then estimated using metaanalysis. Results: A total of 25 (overall) and 20 (case-control) studies met the inclusion criteria for the prevalence and strength of association estimation, respectively. The overall prevalence estimate of NCC in PWE was 22 % [95 % confidence interval [CI]: 17-27.0 %). The figures were higher in the Southern and Eastern Africa sub-region (45 % and 25 % respectively) but lower in the Central and Western Africa sub-region (6 % and 15 % respectively). The prevalence of NCC estimate in PWE varied with method of diagnosis; with 29 % 18 % and 15 % in studies that used a minimum of Brain CT, ELISA and EITB respectively. The overall odds ratio was 2.4 (95 % CI 2.1-2.8), p < 0.0001. Conclusion: The overall prevalence of NCC in PWE in SSA was 22 %. The prevalence figure varied with the subregion of SSA. The odd of NCC in PWE in SSA was 2.4. In spite of the sub-regional variation in NCC prevalence, this meta-analysis suggests that neurocysticercosis contributes significantly to epilepsy in SSA.

Research paper thumbnail of Prevalence of active epilepsy, lifetime epilepsy prevalence, and burden of epilepsy in Sub-Saharan Africa from meta-analysis of door-to-door population-based surveys

Epilepsy & Behavior, 2020

Background: There is marked variation in the prevalence of epilepsy across Sub-Saharan Africa (SS... more Background: There is marked variation in the prevalence of epilepsy across Sub-Saharan Africa (SSA). In order to accurately estimate the clinical and public health impacts of epilepsy in the region, robust and reliable epidemiological data are required for appropriate estimation of logistical, economical, and social impacts of epilepsy including policy formulation and intervention in the region. Objective: We sought to evaluate the prevalence of active epilepsy (AE) and lifetime epilepsy prevalence in SSA using available data collected at community level. Methods: We carefully searched online databases and identified the required articles using prespecified criteria. Random-effects model (REM) was used to estimate the active and lifetime prevalence from data generated from studies in SSA.. The burden of epilepsy, in terms of the number of people with the disease, was also obtained. Heterogeneity in the analysis was further explored using subgroup analysis and meta-regression techniques. Result: A total of 39 and 12 community-based door-to-door surveys addressing AE and lifetime epilepsy, respectively, from different countries of SSA met the inclusion criteria for the study. Random-effects model estimates of overall prevalence of epilepsy were 9 per 1000 persons (95% confidence interval (CI): 8.0-9.9 per 1000 persons) for AE and 16 per 1000 persons (95% CI: 12.3-19.7 per 1000 persons) for lifetime epilepsy. The prevalence was highest in the Central Africa subregion with 30.2 per 1000 persons (95% CI: 6.2 to 66.7 per 1000 persons). The prevalence of AE in the rural settlement was twice that of the urban settlements.

Research paper thumbnail of Treatment of Light Chain Deposition Disease Using Bortezomib-Based Regimen Followed by Thalidomide-Based Regimen in a Saudi Male

Case Reports in Nephrology, 2016

Light chain deposition disease (LCDD) is a rare illness with, as yet, no clear evidence-based gui... more Light chain deposition disease (LCDD) is a rare illness with, as yet, no clear evidence-based guidelines for its treatment. To the best of our knowledge, LCDD has not been previously reported from Saudi Arabia. We present in this report, a 38-year-old Saudi male who presented with clinical features suggestive of hypertensive nephropathy but kidney biopsy later revealed the diagnosis of LCDD. His serum creatinine at presentation was 297 μmol/L which came down to 194 μmol/L on treatment with Bortezomib, Cyclophosphamide and Dexamethasone. His 24-hour protein excretion at presentation was 6 g/L which also came down to less than 1 g/day. He was later placed on Cyclophosphamide, Thalidomide, and Dexamethasone regimen because of persistent high titres of serum free light chains. He went into remission with undetectable serum free light chains and remained so for three years at the time of writing this report. We conclude that LCDD, though rare, does occur in Saudi population. The treatmen...

Research paper thumbnail of Pattern of urinary bladder sonographic findings in patients evaluated for urinary schistosomiasis

West African Journal of Radiology, 2015

Background: Urinary schistosomiasis is one of the neglected tropical diseases. Of the 239 million... more Background: Urinary schistosomiasis is one of the neglected tropical diseases. Of the 239 million people with active Schistosoma infections in 2009, 85% lived in sub-Saharan Africa. The urinary bladder is the main site of pathologic damage in patients with urinary schistosomiasis. Objectives: The objectives were to study the prevalence and pattern of sonographic bladder abnormalities in patients evaluated for urinary schistosomiasis. Materials and Methods: All consecutive patients being evaluated for urinary schistosomiasis at the Usmanu Danfodiyo University, Teaching Hospital Sokoto and Federal Medical Centre Birnin Kebbi were prospectively scanned at radiology departments of the two centers. All the patients were scanned with Apogee 800 plus (Japan 2002) and Concept D (Dynamic Imaging Scotland) ultrasound scanners with a variable frequency probes at 3.5–5 MHz. Doppler was used to assess the vascularity of urinary bladder masses, and to differentiate between masses and blood clots which is a diagnostic challenge when using brightness mode (B-mode) sonography alone. The gain was set correctly to allow good visualization of the bladder and adjacent structures. Transverse images are obtained in the true axial plane and angled caudal to show the bladder base. Longitudinal and oblique sagittal images are obtained to complete the examination. All the ultrasound findings and images were recorded as hard copies, and the films were reviewed by a qualified radiologist. The results were analyzed using statistical software SPSS 17.0 for windows. Results: We evaluated a total of 107 patients. The mean age of the patients was 42.9 ± standard deviation 16.8 years, with a range between 7 and 86 years. There were 84 males accounting for 78.5% and 23 females accounting for 21.5%. Abnormal sonographic findings were seen in 101 (94.4%) of patients evaluated. Urinary bladder stone with wall thickening was the most common finding accounting for 37 (36.4%), followed by bladder wall thickening with internal echoes accounting for 32 (21.5%) of the patients. The incidence of irregular bladder mass was 15 (14.0%) while polypoidal mass accounted for 4 (3.7%). Contracted bladder with wall calcification was seen in 7 (6.5%) while no abnormalities were seen in the urinary bladder in 6 (5.6%) of the patients. Conclusion: Abnormal bladder sonographic findings are common in patients evaluated for signs and symptoms of urinary schistosomiasis in North-Western Nigeria, with a prevalence of 94.4% in this current study. Urinary bladder stone with wall thickening followed by bladder wall thickening with internal echoes were the most common findings accounting for 58% of the findings. These sonographic abnormalities should raise the suspicion of urinary schistosomiasis in an endemic region.

Research paper thumbnail of Secondary Hyperparathyroidism and Hypocalcaemia in Dialysis Patients in AKTH

The Aminu Kano Teaching Hospital (AKTH) is one of the tertiary health institutions in Nigeria whe... more The Aminu Kano Teaching Hospital (AKTH) is one of the tertiary health institutions in Nigeria where dialysis is provided to patients with chronic renal disease, but there had been no reported study on the prevalence of biochemical indicators of bone and mineral metabolism in these patients. We measured serum parathyroid hormone (PTH), total calcium (Ca), albumin (ALB) and phosphate (P) and calculated calcium-phosphate (CaP) ion product in order to evaluate parathyroid function and bone mineral status in dialysis patients seen at the AKTH, Kano. Forty five patients and fourty-five healthy age matched hospital staff who served as controls were studied. Intact PTH was measured with a commercial kit which is based on immunoassay (DRG International Incorp, USA) while serum calcium, phosphate and albumin were estimated also with commercial kits (Randox Laboratories, UK). Calcium was corrected for albumin.The mean PTH of 194 pg/mL in dialysis patients was significantly higher (P< 0.001) than 28 pg/mL found in controls. The corrected calcium was 1.81 mmol/L, phosphate 2.26 mrnol/L, albumin 27.09 g/L and CaP product 3.35 mmoF/U in dialysis patients compared to calcium of 2.46 mmol/L, phosphate 1.04 mmol/L, albumin 42.78 glL and CaP product of 2.55 mmoF/U in controls. Fourty eight percent of the patients had secondary hyperparathyroidism, 89% hypocalcaemia, 53% hyperphosphataernia, 82% hypoalbuminaemia and 29% elevated CaP product. This study has demonstrated significant abnormality of calcium, phosphate and parathyroid homeostasis in patients undergoing dialysis in Kano. As persistent elevations of PTH, phosphate, CaP product and co-existing hypocalcaemia are known to contribute to morbidity and mortality in dialysis patients, it is recommended that pharmacological correction and routine measurement ofthese biochemical indicators be instituted for management of haemodialysis patients in our hospitals.

Research paper thumbnail of Concurrent Kaposi's sarcoma, tuberculosis, and allograft dysfunction in a renal transplant patient

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2009

The major long-term complications of renal transplantation (RT) include cardio-vascular disease, ... more The major long-term complications of renal transplantation (RT) include cardio-vascular disease, opportunistic infections, malignancies, and chronic allograft nephropathy. Long-term complications are generally considered as those occurring more than 1 year post trans-plantation; however, some of the complications can occur earlier. We present a 58-year-old man who presented with multiple complications of RT concurrently and relatively early post trans-plantation including Kaposi's sarcoma, tuberculosis and allograft dysfunction.

Research paper thumbnail of AIDS mortality in a tertiary health institution: A four-year review

Journal of the National Medical Association, 2006

Africa contains 70% of adults and 80% of children living with AIDS in the world and has buried 75... more Africa contains 70% of adults and 80% of children living with AIDS in the world and has buried 75% of the 21.8 million worldwide who have died of AIDS since the epidemic began. Nigeria, the most populous country in Africa, has 5.8% of her adult population having HIV infection at the end of 2003. We reviewed the causes of death among AIDS patients in Aminu Kano Teaching Hospital Kano, Nigeria over four years. Four-hundred-fifty-five (9.9%) of the 4,574 adult medical admissions were due to HIV/AIDS-related diagnosis. HIV/AIDS admissions increased progressively from 45 cases in 2001 to 174 in 2004. HIV/AIDS caused 176 deaths over the period giving an HIV-related mortality of 38.7%. This also showed a gradual increase from 24 deaths in 2001 to 61 deaths in 2004. The most common causes of death were tuberculosis (33.4%), septicemia (23.8%), advanced HIV disease (9.1%), meningitis (7.4%), other pulmonary infections (5.1%) and Kaposi's sarcoma (4.5%). The present dismal situation of pa...

Research paper thumbnail of Prevalence, risk factors, and histological pattern of kidney disease in patients with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome at Aminu Kano Teaching Hospital: A clinicopathologic study

Annals of Nigerian Medicine, 2014

Background: Renal disease in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV... more Background: Renal disease in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) contributes significantly to morbidity and mortality associated with HIV infection worldwide. Aim: To determine the prevalence, risk factors, and histological pattern of kidney disease in HIV-positive patients in Kano, Nigeria. Materials and Methods: Four hundred consecutive treatment naοve HIV-positive patients with no other condition known to cause kidney disease were screened for proteinuria and reduced glomerular filtration rate (GFR). Kidney disease was defined as the presence of persistent microalbuminuria/proteinuria or decreased GFR (<60 ml/min/1.73 m 2 ). Kidney biopsy was performed on 20 patients. Data were analyzed using SPSS version 17. Results: The mean ± standard deviation age of the study population was 34.03 ± 10.23 years with 240 (60%) being females. Kidney disease was found in 227 patients (56.8%), with a higher prevalence seen in males (odds ratio = 1.9305, 95% confidence interval = 1.2760-2.9207, P = 0.0018). Proteinuria including persistent microalbuminuria was found in 211 (52.8%) and reduced GFR was found in 64 (16.0%). The risk factors for developing kidney disease were age >40 years, male gender, low CD4 cell count, cigarette smoking, low body mass index, and low serum cholesterol. Logistic regression identified low CD4 cell count as an independent risk factor for kidney disease. Collapsing focal segmental glomerulosclerosis (FSGS) was the predominant histological pattern seen. Conclusion: The prevalence of renal disease in HIV-positive patients was high in Kano, Nigeria; and microalbuminuria was a manifestation of collapsing FSGS.

Research paper thumbnail of Blood Pressure Control among Treated Hypertensives in a Tertiary Health Institution

Nigerian Journal of Medicine, 2008

Background: Goal blood pressure (BP) was defined by the JNC VI and the World Health Organization-... more Background: Goal blood pressure (BP) was defined by the JNC VI and the World Health Organization-International Society of Hypertension (WHO/ISH) as <140 mm Hg systolic and <90 mm Hg diastolic for the general and <130 mm Hg systolic and <85 mm Hg diastolic for special high-risk populations. It is well established that adequate BP control characterizes only a fraction of treated hypertensive patients. The importance of tight BP control has been established in preventing cardiovascular morbidity and mortality. Methods: We performed cross-sectional studies on the current status of BP control among treated hypertensive in our center. One hundred consecutive patients with essential hypertension who have been attending the out patient hypertension clinic and have been on treatment for at least 6 months were recruited. The pre treatment BP and BP records in the previous 2 visits were noted. Patients were said to have good BP control if their BPs are < 140/90 mmHg (<130/80 mmHg for high risk patients) at the time of the study and in the last visit. Results: There were 49 males and 51 female (M: F; 1:1), aged 26 to 85 (mean 52.33 +/-12.29) years. The duration of hypertension ranged 6 months to 30 (mean 7.37 +/-7.1) years. The duration of treatment in our centre was 6 months to 10 (mean 3.22 +/-2.23) years. Blood pressure was controlled in 33 (33%) of the patients. Pre-treatment mean blood pressure was significantly higher than the BP value at the time of the study (155.87 +/-26.02/97.81 +/-11.89 mmHg versus 143.40 +/-24.14/86.53 +/-12.71 mmHg) (p<0.05). Diuretics were the commonest antihypertensive prescribed either alone or in combination (69%), followed by a calcium antagonist (56%) and centrally acting drugs (38%). Twenty seven were on single antihypertensive, 43 (43%) on 2, 25 (25%) on 3 and 5 (5%) on 4 classes of antihypertensive. Blood pressure control was associated with taking more than one antihypertensive medication and compliance. Conclusion: Control of BP in patients receiving antihypertensive drugs is still far from optimal in the study population in Nigeria just as in other countries. Many patients had multiple cardiovascular risk factors. Adherence to medication should be encouraged.

Research paper thumbnail of Outcome and complications of permanent hemodialysis vascular access in Nigerians: a single centre experience

Annals of African medicine

It is widely accepted that autogenous arteriovenous fistula (AVF) carries less morbidity and mort... more It is widely accepted that autogenous arteriovenous fistula (AVF) carries less morbidity and mortality compared to all other forms of vascular accesses in maintenance hemodialysis patients. There is paucity of data on vascular access from sub-Saharan Africa. The aim of this study was to assess the outcome and complications of permanent vascular access in our center. The study is a prospective, hospital-based, longitudinal study. All consecutive patients on maintenance hemodialysis in Aminu Kano Teaching Hospital who were referred to the surgical unit of for creation of permanent hemodialysis vascular access were included in the study. The patient's clinical and demographic data were documented. Data about vascular access types, outcomes, and complications were obtained over a 1-year period from the time of vascular access creation. One hundred and seventy four patients were operated upon between January 2008 and December 2010 with a mean age of 46.4 years (range 18-76 years) and...

Research paper thumbnail of Post Kidney Transplant Tuberculosis in Nigeria: A Case Report

Nigerian Journal of Medicine, 2008

Tuberculosis has been reported to be one of the most serious bacterial infections after transplan... more Tuberculosis has been reported to be one of the most serious bacterial infections after transplant and occur up to 20 times more frequently in transplant recipients than in the general population. Renal transplant is available in few centers in the country and the post transplant population is increasing, but to our knowledge no case of post transplant tuberculosis has been reported in this environment. The case report of a 35 year old Nigerian who had live related kidney transplant and later developed post transplant disseminated Tuberculosis is presented and the relevant literature is reviewed. A 35 year old university graduate had a live related kidney transplant in our center. He had stable allograft function on immunosuppressive regimen consisting of Cyclosporin, Azathioprine and Prednisolone, and presented with features of disseminated tuberculosis involving the cervical lymph nodes and chest with associated deterioration of allograft function. He was successfully treated with 2 months initial phase of quadruple anti tuberculosis drugs including Isoniazid, Rifampicin, Pyrazinamide and Ethambutol and four months continuation phase with Isoniazid and Rifampicin. He showed remarkable clinical improvement and reversal of the allograft dysfunction. This case illustrates one of the post transplant infectious complications seen in our environment and its successful treatment, and highlighted the need for Tuberculosis prophylaxis in transplant recipients in countries with high incidence of tuberculosis.

Research paper thumbnail of Anaemia and its Response to Treatment with Recombinant Human Erythropoietin in Chronic Kidney Disease Patients

West African Journal of Medicine, 2010

WEST AFRICAN JOURNAL OF MEDICINE Anaemia and its Response to Treatment with Recombinant Human Ery... more WEST AFRICAN JOURNAL OF MEDICINE Anaemia and its Response to Treatment with Recombinant Human Erythropoietin in Chronic Kidney Disease Patients L'anémie et sa Réponse au Traitement avec l'Humain Recombinant Erythropoietin dans les Patients de Maladie Chroniques du Rein

Research paper thumbnail of Amyloidosis and vascular thrombosis

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2008

Amyloidosis is a rare systemic disorder of protein metabolism with progressive extra-cellular dep... more Amyloidosis is a rare systemic disorder of protein metabolism with progressive extra-cellular deposition of insoluble fibrillary protein, disorganization of tissue architecture, and subsequent organ dysfunction. Primary amyloidosis is the most common form of this disorder, however, it can develop secondary to plasma cell dyscrasias such as multiple myeloma (MM); 10-15% of MM patients may develop amyloidosis of vital organs. Amyloidosis is usually associated with bleeding, but less commonly with thrombosis. We present a 52-year-old Saudi female with amyloidosis secondary to multiple myeloma. She presented with both venous and extensive arterial thrombosis. Although relatively rare, plasma cell dyscrasias such as amyloidosis and multiple myeloma could present with thrombotic rather than hemorrhagic complications.

Research paper thumbnail of Adjunctive medical expulsive therapy for kidney and ureteral stone fragments following shock wave lithotripsy

Protocols, 2011

Stone disease of the urinary tract (variously termed kidney stones, ureteric stones, urolithiasis... more Stone disease of the urinary tract (variously termed kidney stones, ureteric stones, urolithiasis, urinary calculi, and urinary calculus disease) is very common and is reported to have increased in the last quarter of the 20th century for men and women, black and ...

Research paper thumbnail of Commercial kidney transplantation: Trends, outcomes and challenges-A single-centre experience

Annals of African Medicine, 2012

Background/Objective: Many experts believe that commercial organ transplants continue unabated de... more Background/Objective: Many experts believe that commercial organ transplants continue unabated despite international efforts to curb them. The aim was to determine the trends, outcomes and challenges of commercial living unrelated renal transplants (LURT) as seen in our institution. Materials and Methods: A retrospective study of LURT patients on follow-up at our institution. The list of all LURT patients was obtained from our renal registry. Inclusion criteria for the study were 1) Presentation to our hospital within the first month post transplant; 2) Completion of one-year follow-up OR patient or allograft losses prior to completing one-year follow-up. SPSS 17.0 was used for data analysis. Results: Forty-five patients satisfied the entry criteria; 33 males and 12 females with age range 13-68 years, and mean ± SD of 40 + 15 years. The majority (28) of the transplants were carried out in Pakistan, the remaining in Egypt, Philippines, and China. There has been a steady decline in the number of new patients with commercial transplants over a four-year period. Complications encountered included infections in 19 (42.2%) patients, biopsy-proven acute rejections in nine patients (20%), surgical complications in 10 patients (22.2%), post-transplant diabetes in seven (15.6%), delayed graft function in one (2.2%), and chronic allograft nephropathy in one (2.2%) patient. Patient survival at one year was 97.8% and allograft survival was 88.9%. Conclusions: Commercial kidney transplant is on the decline as seen in our center, likely as a result of international efforts to curb it, as well as due to a parallel increase in renal transplants in the country. One-year patient and allograft survivals are good but there is a relatively high rate of infections.