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Papers by Solomon Danbauchi
Studies on the nutrient composition of commonly used complementary foods in North Western Nigeria... more Studies on the nutrient composition of commonly used complementary foods in North Western Nigeria were carried out using Kaduna, Kebbi and Niger states as case studies. Ready to eat complementary food samples were collected from mothers with children older than 6 months but younger than 24 months and evaluated for its nutrient components using standard procedures. Results obtained showed that
Ethnicity & Disease, 2008
In acromegaly, specific structural and functional changes in the heart appear to contribute to th... more In acromegaly, specific structural and functional changes in the heart appear to contribute to the increased mortality in this disease. This disease is uncommon in Nigeria, West Africa and little has been published about it; also rare is clinically evident heart failure. We are therefore highlighting a late presentation of acromegaly as heart failure. A 45-year-old woman presented with a 4-year history of progressive increase in body size, lactation and amenorrhoea, and a six-week history of worsening symptoms of heart failure. Physical examination showed coarse facial features, spade like hands and feet, pitting pedal edema, galactorrhoea, and features of congestive cardiac failure. Chest radiograph showed gross cardiomegaly. On skull radiograph, destruction of the floor of the pituitary fossa was noted, with erosion of the clinoid processes. She had hyperprolactinamia. Fasting and post-glucose growth hormones values were elevated. Echocardiography revealed features of both diastol...
African Journal of Biotechnology, 2009
Studies on the nutrient composition of commonly used complementary foods in North Western Nigeria... more Studies on the nutrient composition of commonly used complementary foods in North Western Nigeria were carried out using Kaduna, Kebbi and Niger states as case studies. Ready to eat complementary food samples were collected from mothers with children older than 6 months but younger than 24 months and evaluated for its nutrient components using standard procedures. Results obtained showed that guinea corn and millet paps were the first foods introduced to children in the zone. The ash content ranged from 0.63±0.01 to 1.21±0.20 g/100 g with the crude protein ranging from 1.38±0.30 to 3.15±0.01 g/100 g and crude fat 0.07±0.01 to 2.56±0.06 g/100 g. Levels of lysine (1.55 to 3.11 g/100 g protein) and methionine (0.70 to 1.15 g/100 g protein) were below the international reference values of 4.2 and 2.2 for lysine and methionine, respectively. Zinc content ranged from 4.16 to 7.47 mg/100 g and iron content was between 17.82 and 33.88 mg/100 g. Phytates (0.04±0.01 to 0.12±0.02 mg/100 g), ta...
Journal of The National Medical Association, 2005
Annals of African Medicine, 2004
Background: Rheumatic heart disease (RHD) is a disease that is still prevalent in the developing ... more Background: Rheumatic heart disease (RHD) is a disease that is still prevalent in the developing countries and still poses a major medical and cardio-thoracic surgery challenge in Nigeria. Method: A study of data from echocardiography laboratory from October 1999 – September 2002. Results: Forty-seven (47) out of 600 echocardiography scans had a diagnosis of rheumatic heart disease from October 1999 to September 2002. They were made up of 32 females and 16 males (female/male ratio of 2:1). The ages of the patients ranged from 5 to 52 years with a mean of 19.51 +/- 1.4. There was no statistically significant difference in the mean age of female and male patients. Nearly 90 % of the referring Physician made the correct diagnosis of rheumatic heart disease. Forty eight percent of the patients had depressed left ventricular function (EF Conclusion: The mitral and the aortic valves are most commonly affected valves. Patients with critical mitral stenosis have a favourable anatomy for PTM...
Background: Patients with pre-eclampsia and eclampsia constitute a special high risk group for fu... more Background: Patients with pre-eclampsia and eclampsia constitute a special high risk group for future hypertension. They require a long term follow up to be able to detect and treat emerging hypertension early enough to prevent complications. Unfortunately, this is not so. This study was undertaken to find out the incidence of history of pre-eclamptic toxaemia (PET) in our female hypertensive patients attending cardiac clinic and to also determine the incidence of complications of hypertension in those with previous history of PET. Methods: Fifty consecutive female hypertensive patients seen in cardiac clinic were recruited. Detailed history including full obstetric and family history was taken. A full clinical examination was done including blood pressure and a search for complications of hypertension. Findings were then analyzed and various frequencies determined. Results: Forty-nine patients were studied. The mean age was 47.29 ± 11.46 years. The mean SBP, DBP and MAP were 143.18...
Quite a number of dramatic interventional advances in the treatment of cardiac arrhythmias such a... more Quite a number of dramatic interventional advances in the treatment of cardiac arrhythmias such as catheter ablation and implantable cardiac defibrillators for serious ventricular arrhythmias have held the limelight over the last few years. The treatment of atrial fibrillation (AF), which remains the commonest arrhythmia affecting 0.5% of people aged 50-59 years increasing to 12% at age above 74years, has received relatively little attention. There is however, a recent resurgence of interest following some important experimental and therapeutic advances. This article reviews the current understanding of the nature of atrial fibrillation (AF) and some recent developments in the pharmacological and alternative therapeutic approaches. Key Words: Atrial fibrillation, treatment Annals of African Medicine Vol.3(2) 2004: 98-108
Blood
Pulmonary hypertension has a prevalence of 30% in patients with sickle cell disease (SCD) in the ... more Pulmonary hypertension has a prevalence of 30% in patients with sickle cell disease (SCD) in the United States with mortality rates of 40% at 40 months after diagnosis. The global burden of SCD is highest in sub-Saharan Africa where more than 200,000 children are born with the disease annually. The prevalence of pulmonary hypertension among individuals with SCD in Africa has not been previously reported. We performed Doppler echocardiographic assessments of pulmonary-artery systolic pressure in 206 consecutive hydroxyurea sickle cell patients at steady state in Nigeria, West Africa (101 males and 105 females; age range 10–52, mean [+/−SD] age, 21.5 +/− 7.7 years; 196 homozygous sickle cell and 10 compound heterozygotes SC). A control group consisted of 93 healthy Nigerians. Hemoglobin gentotype was determined by electrophoresis and DNA sequencing. Pulmonary hypertension was defined prospectively as a tricuspid regurgitant jet velocity (TRV) of at least 2.5 m per second. We collected...
International Medicine
Background: To evaluate the relations of B-type natriuretic peptide (BNP) to tissue Doppler (TD) ... more Background: To evaluate the relations of B-type natriuretic peptide (BNP) to tissue Doppler (TD) E/e ́, left ventricular systolic functions and BNP’s predictors as well as determine plasma BNP levels in African heart failure (HF) subjects in comparison to healthy controls as there is paucity of data on these in black African population. Methods: A cross-sectional analytical study done on 184 subjects: 109 decompensated HF patients at the Ahmadu Bello University Teaching Hospital, Nigeria and 75 healthy controls. Simultaneous BNP assessment and echocardiographic determination of systolic function and TD E/e ́ were done. Pearson’s Correlation and Binary Logistic Regression analysis determined BNP’s association with parameters. Mann-Whitney U test determined the difference in BNP levels between patients and controls. Results: Log-transformed (Ln10) BNP inversely correlated with Ln10Ejection fraction (EF) in patients (p=0.005, r = -0.27) and all subjects combined (p<0.001, r = -0.55) with similar trend for Ln10Fractional shortening (FS). BNP significantly (p < 0.001) positively correlated with TD E/e ́ in patients (r = 0.46) and all subjects (r = 0.61) respectively. Tissue-Doppler E/e ́ > 15 was associated (p=0.01) with higher BNP levels in the unadjusted and adjusted age, sex, body mass index and glomerular filtration rate models of patients with about four times Odd. EF < 40% and FS < 19% as well as EF < 50% and FS < 29% were significantly (p<0.001) associated with higher BNP levels in the unadjusted patient-control model. BNP levels were significantly (p<0.001) higher in patients (median, 412.5 pg/mL) than controls (median, 237.5 pg/mL). Conclusions: BNP levels can predict systolic dysfunction and independently predict elevated left ventricular filling pressure (LVFP) amidst confounders. BNP levels of Nigerian-Africans are significantly higher in HF patients than controls. BNP and E/e ́ provide a better assessment of HF in African HF patients with both systolic and diastolic dysfunctions.
![Research paper thumbnail of B-Type Natriuretic Peptides (BNP) and Tissue Doppler E/e´ Before and After 4 Weeks Standard Treatment of African Heart Failure Subjects: The ABU-BNP Longitudinal Survey [Corrigendum]](https://attachments.academia-assets.com/82314324/thumbnails/1.jpg)
](Vascular Health and Risk Management
Vascular Health and Risk Management
Background: The study aimed at determining the response of BNP and tissue Doppler (TD) E/e´to sta... more Background: The study aimed at determining the response of BNP and tissue Doppler (TD) E/e´to standard heart failure (HF) therapy in an African black population as data on these are lacking in Africa. BNP assessment in relation to HF severity and its association with its predictors were also determined. Methods: It was a longitudinal-analytical study with a one month follow-up among 100 HF patients seen at
Nigerian Journal of Cardiology
Situs inversus with dextrocardia refers to complete inversion of the position of the thoracic and... more Situs inversus with dextrocardia refers to complete inversion of the position of the thoracic and abdominal viscera. Dextrocardia occurs when the heart is located in the right side of the thoracic cavity with its base-to-apex axis directed to the right and inferiorly. It may be isolated or associated with cardiac or alimentary malformations. Our patient had dextrocardia with situs inversus. The patient is a 32-year-old woman that presented with recurrent respiratory symptoms but no cardiac symptoms. Dextrocardia with situs inversus was confirmed by chest radiograph, electrocardiography, and abdominal ultrasound. Echocardiography established atrioventricular great arteries and ventricular concordance with no valvular abnormalities.
International Journal of Emergency Medicine
Purpose: In critical care situations, there are often neither the means nor the time to weigh eac... more Purpose: In critical care situations, there are often neither the means nor the time to weigh each patient before administering strict weight-based drugs/procedures. A convenient, quick and accurate method is a priority in such circumstances for safety and effectiveness in emergent interventions as none exists in adults while those available are complex and yet to be validated. We aimed to study the correlation and accuracy of a quick bedside method of weight estimation in adults using height. Method: The technique is estimated body weight-eBW(kg) = (N − 1)100, where 'N' is the measured height in metres. Adult undergraduates were enrolled 10/09/2015. Their heights and weights were measured while the formula was used to obtain the estimated weight. The SPSS version 21.0, Chicago, IL, USA was utilised for data analysis. Results: We analysed 122 participants aged 21-38 years with height = 1.55 m-1.95 m. The actual body weight range = 48.0 kg-91.0 kg, mean = 65.3 kg ± 9.7 kg and S.E. = 2.0 while eBW = 55 kg-95 kg, mean = 69.1 kg ± 8.4 kg and S.E. = 1.5. On BMI classes, a positive predictive value of 94.7% for the 'normal' category and 95.5% for 'overweight'.
Journal of Hypertension, 2016
Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfun... more Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfunction (LVD) in hypertensive versus normotensive adults without cardiac symptoms. Design and Method: A cross-sectional analytical study. Fifty consecutive hypertensive adults (HTN+) and another fifty normotensive, age and sex matched adults (HTN-) were enrolled from the medical clinics of Jos University Teaching Hospital. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, urea, creatinine and haemoglobin concentration) and electrocardiogram were obtained from the participants. Thereafter electrocardiography guided echocardiograph assessment of LV function was performed on each participant. Data was interpreted and subsequently analyzed using Epi info version 7 statistical software; p value < 0.05 was considered significant. Results: There were 27 females and 23 males in each of the two groups. The mean ages were 49 ± 8 and 47 ± 7 years respectively (p=0.48). The comparison of mean values of the systolic and diastolic parameters measured is shown (table 1). The systolic parameters showed statistically significant differences for both genders. The HTN+ group had lower mean values of systolic parameters for both genders. Similarly, the HTN+ group had a higher prevalence of LVD compared to the HTN- group (30% versus 14%, p = 0.05). In addition, the HTN+ group had worse diastolic patterns (figure 1). In the HTN+ group, duration of hypertension and left atrial diameter correlated significantly with the systolic parameters. Both further emerged as independent predictors of LVD on regression analysis. In the HTN- group, older age and left atria diameter correlated significantly with systolic and diastolic parameters. They also emerged as independent predictors on multivariate regression analysis (Data not shown). Conclusions: Left ventricular dysfunction is common in hypertensives without cardiac symptoms. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
Journal of Hypertension, 2016
To evaluate the prevalence of Hypertension and associated risk factors in HIV+ adults and assessm... more To evaluate the prevalence of Hypertension and associated risk factors in HIV+ adults and assessment of these risks using the Framingham risk score &amp;amp;amp;amp;amp;amp;amp;#39;FRS&amp;amp;amp;amp;amp;amp;amp;#39;. A cross-sectional analytical study. One hundred and fifty consecutive HIV+ adults presenting at the HIV clinic of Jos University Teaching Hospital (90 on HAART) with 50 HIV- as controls were recruited. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, CD4 count and viral load) and electrocardiogram were obtained from the participants. The prevalence of hypertension and associated risk factors was determined and the FRS for each participant was calculated and interpreted to assess cardiovascular risk. Data was analyzed using Epi info version 7 statistical software; p value &amp;amp;amp;amp;amp;amp;amp;lt; 0.05 was considered significant. There were 94 females and 30 females among the HIV+ and HIV- respectively. The mean ages of HIV+ and HIV- were 41 ± 7 and 40 ± 8 years respectively (p = 0.77).The prevalence of hypertension in the HIV+ and HIV- was 46.0% and 10.0% respectively, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.01. Among the HIV+, 123 (82%) had at least 1 risk factor while 37 (25%) had at least 4 compared to 31 (62%) and 0 (0%) respectively in the HIV-, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.01.The use of HAART was associated with higher prevalence of hypertension, dyslipidaemia, diabetes mellitus and obesity among the HIV+ (Data not shown).The mean FRS of those on HAART (4.8 ± 0.6) and those not on HAART (3.3 ± 0.6) were significantly higher than that of the controls (2.5 ± 1.0); p = 0.04. Furthermore, those on HAART had significantly higher mean FRS compared to those not on HAART, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.01. The use of protease inhibitor based regimen predisposed to higher mean FRS 7.9 ± 2.0 versus 3.2 ± 0.7, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.01. Hypertension and associated risk factors are common in HIV+ persons. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
Journal of Hypertension, 2016
Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfun... more Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfunction (LVD) in asymptomatic hypertensive patients with and without type 2 diabetes. Design and Method: A cross-sectional analytical study. Fifty consecutive hypertensive adults (HTN+) and another fifty with hypertension and type 2 diabetes mellitus (HTN+/DM+) were enrolled from the cardiology/diabetes clinics of Jos University Teaching Hospital. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, urea, creatinine and haemoglobin concentration) and electrocardiogram were obtained from the participants. Thereafter electrocardiography guided echocardiograph assessment of LV function was performed on each participant. Data was interpreted and subsequently analyzed using Epi info version 7 statistical software; p value < 0.05 was considered significant. Results: There were 27 females and 29 females in the HTN+ and HTN+/DM+ groups respectively. The mean ages were 49 ± 8 and 49 ± 7 years respectively (p = 0.95). The comparison of mean values of the systolic and diastolic parameters measured is shown (table 1). The systolic parameters showed statistically significant differences for both genders. The HTN+/DM+ group had lower mean values of systolic parameters for both genders. Similarly, the HTN+/DM+ group had a higher prevalence of LVD compared to the HTN+ group (56% versus 30%, p < 0.01) and worse diastolic patterns (figure 1). In the HTN+ group, duration of hypertension and left atrial diameter correlated significantly with the systolic parameters. Both further emerged as independent predictors on multivariate regression analysis. In the HTN+/DM+ group, duration of DM correlated significantly with systolic and diastolic parameters while duration of hypertension correlated significantly with systolic parameters. Both further emerged as independent predictor on multivariate regression analysis (Data not shown). Conclusions: Left ventricular dysfunction is common in hypertensives; co-morbid diabetes mellitus worsens it. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
World Journal of Cardiovascular Surgery, 2015
Purpose: Active heart surgery programs are few in sub Saharan Africa outside of South Africa, wit... more Purpose: Active heart surgery programs are few in sub Saharan Africa outside of South Africa, with majority being low volume centers performing small numbers annually. We reviewed our long term outcome to identify factors associated with increased morbidity and mortality, to guide future choice of prosthetic valves in our mostly indigent patients afflicted with rheumatic valvular disease. Methods: Retrospective analysis of patients who underwent heart valve replacement at Lagos State University and Ahmadu Bello University Teaching Hospitals from November 2004 to February 2009. Results: Twenty six patients, 19 (73.1%) females, age 12-47; mean 26.69 ± 9.87 years, underwent heart valve replacement. 19 (73.1%) patients had mitral and 7 (26.9%) aortic valve replacement. Mechanical valve was implanted in all except in 2 (7.7%) patients. Left ventricular ejection fraction was >50% in 14 (53.8%), 24 (92.3%) were in New York Heart Association class III/IV, 10 (38.5%) had severe pulmonary hypertension and logistic euroscore was 5.84 ± 3.81. Operative mortality was 11.5% (3/26) and morbidity 7.7% (2/26). Follow-up for survivors was 83.0 ± 27.9 months. 10-year freedom from bleeding and thromboembolism was 70.0% and survival 86.0%. Linearized rate for bleeding was 4.58 and thromboembolism 1.52. Conclusion: Late complications in survivors were primarily anticoagulant related occurring predominantly in child bearing age females especially during pregnancy. Bleeding complications were often associated with noncompliance due to poor socioeconomic status. With average life expectancy of 53 years for females, bioprosthetic valves despite higher structural failure rate, may be best suited especially in child bearing age females still desirous of childbirth to decrease valve related complications. Longer duration of follow-up and meta-analysis of future reported series from the sub
Studies on the nutrient composition of commonly used complementary foods in North Western Nigeria... more Studies on the nutrient composition of commonly used complementary foods in North Western Nigeria were carried out using Kaduna, Kebbi and Niger states as case studies. Ready to eat complementary food samples were collected from mothers with children older than 6 months but younger than 24 months and evaluated for its nutrient components using standard procedures. Results obtained showed that
Ethnicity & Disease, 2008
In acromegaly, specific structural and functional changes in the heart appear to contribute to th... more In acromegaly, specific structural and functional changes in the heart appear to contribute to the increased mortality in this disease. This disease is uncommon in Nigeria, West Africa and little has been published about it; also rare is clinically evident heart failure. We are therefore highlighting a late presentation of acromegaly as heart failure. A 45-year-old woman presented with a 4-year history of progressive increase in body size, lactation and amenorrhoea, and a six-week history of worsening symptoms of heart failure. Physical examination showed coarse facial features, spade like hands and feet, pitting pedal edema, galactorrhoea, and features of congestive cardiac failure. Chest radiograph showed gross cardiomegaly. On skull radiograph, destruction of the floor of the pituitary fossa was noted, with erosion of the clinoid processes. She had hyperprolactinamia. Fasting and post-glucose growth hormones values were elevated. Echocardiography revealed features of both diastol...
African Journal of Biotechnology, 2009
Studies on the nutrient composition of commonly used complementary foods in North Western Nigeria... more Studies on the nutrient composition of commonly used complementary foods in North Western Nigeria were carried out using Kaduna, Kebbi and Niger states as case studies. Ready to eat complementary food samples were collected from mothers with children older than 6 months but younger than 24 months and evaluated for its nutrient components using standard procedures. Results obtained showed that guinea corn and millet paps were the first foods introduced to children in the zone. The ash content ranged from 0.63±0.01 to 1.21±0.20 g/100 g with the crude protein ranging from 1.38±0.30 to 3.15±0.01 g/100 g and crude fat 0.07±0.01 to 2.56±0.06 g/100 g. Levels of lysine (1.55 to 3.11 g/100 g protein) and methionine (0.70 to 1.15 g/100 g protein) were below the international reference values of 4.2 and 2.2 for lysine and methionine, respectively. Zinc content ranged from 4.16 to 7.47 mg/100 g and iron content was between 17.82 and 33.88 mg/100 g. Phytates (0.04±0.01 to 0.12±0.02 mg/100 g), ta...
Journal of The National Medical Association, 2005
Annals of African Medicine, 2004
Background: Rheumatic heart disease (RHD) is a disease that is still prevalent in the developing ... more Background: Rheumatic heart disease (RHD) is a disease that is still prevalent in the developing countries and still poses a major medical and cardio-thoracic surgery challenge in Nigeria. Method: A study of data from echocardiography laboratory from October 1999 – September 2002. Results: Forty-seven (47) out of 600 echocardiography scans had a diagnosis of rheumatic heart disease from October 1999 to September 2002. They were made up of 32 females and 16 males (female/male ratio of 2:1). The ages of the patients ranged from 5 to 52 years with a mean of 19.51 +/- 1.4. There was no statistically significant difference in the mean age of female and male patients. Nearly 90 % of the referring Physician made the correct diagnosis of rheumatic heart disease. Forty eight percent of the patients had depressed left ventricular function (EF Conclusion: The mitral and the aortic valves are most commonly affected valves. Patients with critical mitral stenosis have a favourable anatomy for PTM...
Background: Patients with pre-eclampsia and eclampsia constitute a special high risk group for fu... more Background: Patients with pre-eclampsia and eclampsia constitute a special high risk group for future hypertension. They require a long term follow up to be able to detect and treat emerging hypertension early enough to prevent complications. Unfortunately, this is not so. This study was undertaken to find out the incidence of history of pre-eclamptic toxaemia (PET) in our female hypertensive patients attending cardiac clinic and to also determine the incidence of complications of hypertension in those with previous history of PET. Methods: Fifty consecutive female hypertensive patients seen in cardiac clinic were recruited. Detailed history including full obstetric and family history was taken. A full clinical examination was done including blood pressure and a search for complications of hypertension. Findings were then analyzed and various frequencies determined. Results: Forty-nine patients were studied. The mean age was 47.29 ± 11.46 years. The mean SBP, DBP and MAP were 143.18...
Quite a number of dramatic interventional advances in the treatment of cardiac arrhythmias such a... more Quite a number of dramatic interventional advances in the treatment of cardiac arrhythmias such as catheter ablation and implantable cardiac defibrillators for serious ventricular arrhythmias have held the limelight over the last few years. The treatment of atrial fibrillation (AF), which remains the commonest arrhythmia affecting 0.5% of people aged 50-59 years increasing to 12% at age above 74years, has received relatively little attention. There is however, a recent resurgence of interest following some important experimental and therapeutic advances. This article reviews the current understanding of the nature of atrial fibrillation (AF) and some recent developments in the pharmacological and alternative therapeutic approaches. Key Words: Atrial fibrillation, treatment Annals of African Medicine Vol.3(2) 2004: 98-108
Blood
Pulmonary hypertension has a prevalence of 30% in patients with sickle cell disease (SCD) in the ... more Pulmonary hypertension has a prevalence of 30% in patients with sickle cell disease (SCD) in the United States with mortality rates of 40% at 40 months after diagnosis. The global burden of SCD is highest in sub-Saharan Africa where more than 200,000 children are born with the disease annually. The prevalence of pulmonary hypertension among individuals with SCD in Africa has not been previously reported. We performed Doppler echocardiographic assessments of pulmonary-artery systolic pressure in 206 consecutive hydroxyurea sickle cell patients at steady state in Nigeria, West Africa (101 males and 105 females; age range 10–52, mean [+/−SD] age, 21.5 +/− 7.7 years; 196 homozygous sickle cell and 10 compound heterozygotes SC). A control group consisted of 93 healthy Nigerians. Hemoglobin gentotype was determined by electrophoresis and DNA sequencing. Pulmonary hypertension was defined prospectively as a tricuspid regurgitant jet velocity (TRV) of at least 2.5 m per second. We collected...
International Medicine
Background: To evaluate the relations of B-type natriuretic peptide (BNP) to tissue Doppler (TD) ... more Background: To evaluate the relations of B-type natriuretic peptide (BNP) to tissue Doppler (TD) E/e ́, left ventricular systolic functions and BNP’s predictors as well as determine plasma BNP levels in African heart failure (HF) subjects in comparison to healthy controls as there is paucity of data on these in black African population. Methods: A cross-sectional analytical study done on 184 subjects: 109 decompensated HF patients at the Ahmadu Bello University Teaching Hospital, Nigeria and 75 healthy controls. Simultaneous BNP assessment and echocardiographic determination of systolic function and TD E/e ́ were done. Pearson’s Correlation and Binary Logistic Regression analysis determined BNP’s association with parameters. Mann-Whitney U test determined the difference in BNP levels between patients and controls. Results: Log-transformed (Ln10) BNP inversely correlated with Ln10Ejection fraction (EF) in patients (p=0.005, r = -0.27) and all subjects combined (p<0.001, r = -0.55) with similar trend for Ln10Fractional shortening (FS). BNP significantly (p < 0.001) positively correlated with TD E/e ́ in patients (r = 0.46) and all subjects (r = 0.61) respectively. Tissue-Doppler E/e ́ > 15 was associated (p=0.01) with higher BNP levels in the unadjusted and adjusted age, sex, body mass index and glomerular filtration rate models of patients with about four times Odd. EF < 40% and FS < 19% as well as EF < 50% and FS < 29% were significantly (p<0.001) associated with higher BNP levels in the unadjusted patient-control model. BNP levels were significantly (p<0.001) higher in patients (median, 412.5 pg/mL) than controls (median, 237.5 pg/mL). Conclusions: BNP levels can predict systolic dysfunction and independently predict elevated left ventricular filling pressure (LVFP) amidst confounders. BNP levels of Nigerian-Africans are significantly higher in HF patients than controls. BNP and E/e ́ provide a better assessment of HF in African HF patients with both systolic and diastolic dysfunctions.
Vascular Health and Risk Management
Vascular Health and Risk Management
Background: The study aimed at determining the response of BNP and tissue Doppler (TD) E/e´to sta... more Background: The study aimed at determining the response of BNP and tissue Doppler (TD) E/e´to standard heart failure (HF) therapy in an African black population as data on these are lacking in Africa. BNP assessment in relation to HF severity and its association with its predictors were also determined. Methods: It was a longitudinal-analytical study with a one month follow-up among 100 HF patients seen at
Nigerian Journal of Cardiology
Situs inversus with dextrocardia refers to complete inversion of the position of the thoracic and... more Situs inversus with dextrocardia refers to complete inversion of the position of the thoracic and abdominal viscera. Dextrocardia occurs when the heart is located in the right side of the thoracic cavity with its base-to-apex axis directed to the right and inferiorly. It may be isolated or associated with cardiac or alimentary malformations. Our patient had dextrocardia with situs inversus. The patient is a 32-year-old woman that presented with recurrent respiratory symptoms but no cardiac symptoms. Dextrocardia with situs inversus was confirmed by chest radiograph, electrocardiography, and abdominal ultrasound. Echocardiography established atrioventricular great arteries and ventricular concordance with no valvular abnormalities.
International Journal of Emergency Medicine
Purpose: In critical care situations, there are often neither the means nor the time to weigh eac... more Purpose: In critical care situations, there are often neither the means nor the time to weigh each patient before administering strict weight-based drugs/procedures. A convenient, quick and accurate method is a priority in such circumstances for safety and effectiveness in emergent interventions as none exists in adults while those available are complex and yet to be validated. We aimed to study the correlation and accuracy of a quick bedside method of weight estimation in adults using height. Method: The technique is estimated body weight-eBW(kg) = (N − 1)100, where 'N' is the measured height in metres. Adult undergraduates were enrolled 10/09/2015. Their heights and weights were measured while the formula was used to obtain the estimated weight. The SPSS version 21.0, Chicago, IL, USA was utilised for data analysis. Results: We analysed 122 participants aged 21-38 years with height = 1.55 m-1.95 m. The actual body weight range = 48.0 kg-91.0 kg, mean = 65.3 kg ± 9.7 kg and S.E. = 2.0 while eBW = 55 kg-95 kg, mean = 69.1 kg ± 8.4 kg and S.E. = 1.5. On BMI classes, a positive predictive value of 94.7% for the 'normal' category and 95.5% for 'overweight'.
Journal of Hypertension, 2016
Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfun... more Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfunction (LVD) in hypertensive versus normotensive adults without cardiac symptoms. Design and Method: A cross-sectional analytical study. Fifty consecutive hypertensive adults (HTN+) and another fifty normotensive, age and sex matched adults (HTN-) were enrolled from the medical clinics of Jos University Teaching Hospital. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, urea, creatinine and haemoglobin concentration) and electrocardiogram were obtained from the participants. Thereafter electrocardiography guided echocardiograph assessment of LV function was performed on each participant. Data was interpreted and subsequently analyzed using Epi info version 7 statistical software; p value < 0.05 was considered significant. Results: There were 27 females and 23 males in each of the two groups. The mean ages were 49 ± 8 and 47 ± 7 years respectively (p=0.48). The comparison of mean values of the systolic and diastolic parameters measured is shown (table 1). The systolic parameters showed statistically significant differences for both genders. The HTN+ group had lower mean values of systolic parameters for both genders. Similarly, the HTN+ group had a higher prevalence of LVD compared to the HTN- group (30% versus 14%, p = 0.05). In addition, the HTN+ group had worse diastolic patterns (figure 1). In the HTN+ group, duration of hypertension and left atrial diameter correlated significantly with the systolic parameters. Both further emerged as independent predictors of LVD on regression analysis. In the HTN- group, older age and left atria diameter correlated significantly with systolic and diastolic parameters. They also emerged as independent predictors on multivariate regression analysis (Data not shown). Conclusions: Left ventricular dysfunction is common in hypertensives without cardiac symptoms. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
Journal of Hypertension, 2016
To evaluate the prevalence of Hypertension and associated risk factors in HIV+ adults and assessm... more To evaluate the prevalence of Hypertension and associated risk factors in HIV+ adults and assessment of these risks using the Framingham risk score &amp;amp;amp;amp;amp;amp;amp;#39;FRS&amp;amp;amp;amp;amp;amp;amp;#39;. A cross-sectional analytical study. One hundred and fifty consecutive HIV+ adults presenting at the HIV clinic of Jos University Teaching Hospital (90 on HAART) with 50 HIV- as controls were recruited. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, CD4 count and viral load) and electrocardiogram were obtained from the participants. The prevalence of hypertension and associated risk factors was determined and the FRS for each participant was calculated and interpreted to assess cardiovascular risk. Data was analyzed using Epi info version 7 statistical software; p value &amp;amp;amp;amp;amp;amp;amp;lt; 0.05 was considered significant. There were 94 females and 30 females among the HIV+ and HIV- respectively. The mean ages of HIV+ and HIV- were 41 ± 7 and 40 ± 8 years respectively (p = 0.77).The prevalence of hypertension in the HIV+ and HIV- was 46.0% and 10.0% respectively, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.01. Among the HIV+, 123 (82%) had at least 1 risk factor while 37 (25%) had at least 4 compared to 31 (62%) and 0 (0%) respectively in the HIV-, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.01.The use of HAART was associated with higher prevalence of hypertension, dyslipidaemia, diabetes mellitus and obesity among the HIV+ (Data not shown).The mean FRS of those on HAART (4.8 ± 0.6) and those not on HAART (3.3 ± 0.6) were significantly higher than that of the controls (2.5 ± 1.0); p = 0.04. Furthermore, those on HAART had significantly higher mean FRS compared to those not on HAART, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.01. The use of protease inhibitor based regimen predisposed to higher mean FRS 7.9 ± 2.0 versus 3.2 ± 0.7, p &amp;amp;amp;amp;amp;amp;amp;lt; 0.01. Hypertension and associated risk factors are common in HIV+ persons. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
Journal of Hypertension, 2016
Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfun... more Objective: To evaluate the prevalence, patterns and associated factors of left ventricular dysfunction (LVD) in asymptomatic hypertensive patients with and without type 2 diabetes. Design and Method: A cross-sectional analytical study. Fifty consecutive hypertensive adults (HTN+) and another fifty with hypertension and type 2 diabetes mellitus (HTN+/DM+) were enrolled from the cardiology/diabetes clinics of Jos University Teaching Hospital. Relevant history, physical examination (including blood pressure measured according to standard guidelines), laboratory specimen (fasting plasma sugar and lipids, urea, creatinine and haemoglobin concentration) and electrocardiogram were obtained from the participants. Thereafter electrocardiography guided echocardiograph assessment of LV function was performed on each participant. Data was interpreted and subsequently analyzed using Epi info version 7 statistical software; p value < 0.05 was considered significant. Results: There were 27 females and 29 females in the HTN+ and HTN+/DM+ groups respectively. The mean ages were 49 ± 8 and 49 ± 7 years respectively (p = 0.95). The comparison of mean values of the systolic and diastolic parameters measured is shown (table 1). The systolic parameters showed statistically significant differences for both genders. The HTN+/DM+ group had lower mean values of systolic parameters for both genders. Similarly, the HTN+/DM+ group had a higher prevalence of LVD compared to the HTN+ group (56% versus 30%, p < 0.01) and worse diastolic patterns (figure 1). In the HTN+ group, duration of hypertension and left atrial diameter correlated significantly with the systolic parameters. Both further emerged as independent predictors on multivariate regression analysis. In the HTN+/DM+ group, duration of DM correlated significantly with systolic and diastolic parameters while duration of hypertension correlated significantly with systolic parameters. Both further emerged as independent predictor on multivariate regression analysis (Data not shown). Conclusions: Left ventricular dysfunction is common in hypertensives; co-morbid diabetes mellitus worsens it. Early diagnosis with prompt treatment will significantly reduce morbidity and mortality in these patients.
World Journal of Cardiovascular Surgery, 2015
Purpose: Active heart surgery programs are few in sub Saharan Africa outside of South Africa, wit... more Purpose: Active heart surgery programs are few in sub Saharan Africa outside of South Africa, with majority being low volume centers performing small numbers annually. We reviewed our long term outcome to identify factors associated with increased morbidity and mortality, to guide future choice of prosthetic valves in our mostly indigent patients afflicted with rheumatic valvular disease. Methods: Retrospective analysis of patients who underwent heart valve replacement at Lagos State University and Ahmadu Bello University Teaching Hospitals from November 2004 to February 2009. Results: Twenty six patients, 19 (73.1%) females, age 12-47; mean 26.69 ± 9.87 years, underwent heart valve replacement. 19 (73.1%) patients had mitral and 7 (26.9%) aortic valve replacement. Mechanical valve was implanted in all except in 2 (7.7%) patients. Left ventricular ejection fraction was >50% in 14 (53.8%), 24 (92.3%) were in New York Heart Association class III/IV, 10 (38.5%) had severe pulmonary hypertension and logistic euroscore was 5.84 ± 3.81. Operative mortality was 11.5% (3/26) and morbidity 7.7% (2/26). Follow-up for survivors was 83.0 ± 27.9 months. 10-year freedom from bleeding and thromboembolism was 70.0% and survival 86.0%. Linearized rate for bleeding was 4.58 and thromboembolism 1.52. Conclusion: Late complications in survivors were primarily anticoagulant related occurring predominantly in child bearing age females especially during pregnancy. Bleeding complications were often associated with noncompliance due to poor socioeconomic status. With average life expectancy of 53 years for females, bioprosthetic valves despite higher structural failure rate, may be best suited especially in child bearing age females still desirous of childbirth to decrease valve related complications. Longer duration of follow-up and meta-analysis of future reported series from the sub