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Papers by Mustapha Danesi

Research paper thumbnail of Plasma magnesium in adult Nigerian patients with epilepsy

Nigerian Postgraduate Medical Journal

The objective of this study was to determine the relationship between plasma magnesium levels and... more The objective of this study was to determine the relationship between plasma magnesium levels and epilepsy. The study was carried out at the Lagos University Teaching Hospital. Plasma magnesium was estimated using the calmigite dye colorimetric method in 45 adults with epilepsy and 35 healthy controls. Plasma concentrations of calcium, phosphorus and albumin were also estimated. The mean plasma magnesium in the patients was 0.98 mm0l/L (0.05) while that in the controls was 1.15 mmol/L (0.28). The mean plasma magnesium in the epileptics was significantly lower than that obtained in the controls (p < 0.001). Age of onset of seizures, seizure frequency and duration of treatment did not influence the plasma magnesium levels. Low plasma magnesium is associated with epilepsy, further studies may determine the influence of anti-epileptic drug therapy on plasma magnesium levels. magnesium, seizures, Nigeria.

Research paper thumbnail of Contents Vol. 28, 2007

Neuroepidemiology, 2007

Access to full text and tables of contents, including tentative ones for forthcoming issues: www.... more Access to full text and tables of contents, including tentative ones for forthcoming issues: www.karger.com/ned_issues

Research paper thumbnail of Neurological complications of sickle cell anemia

Journal of Pediatric Hematology/Oncology, 1982

o r i g i n a l c o m m u n i c a t i o n IntroductIon S ickle cell anemia (SCA) has widespread c... more o r i g i n a l c o m m u n i c a t i o n IntroductIon S ickle cell anemia (SCA) has widespread clinical manifestations that involve nearly all the systems in the body, including the central nervous system. 1,2 The occurrence of neurological complications in patients with sickle cell disease was known for decades, but the explanations for the clinical variability are not well known. SCA results from one-point mutation that causes vasculopathy of large and small vessels. There is evidence of small vessel sludging, and relative deficiency of nitric oxide in the vessels further reduces compensatory vasodilatations. These result in both ischemia and infarcts, which may be silent and affect motor and cognitive functions. 3 SCA is an important health problem in Nigeria, which has one of the highest concentrations of patients with this disorder in the world. 4 In Nigeria, unlike some other parts of the world, 3,5,6 no specific studies have addressed the neurological complications of sickle cell anemia and their contribution to morbidity. This study evaluated the neurological complications of patients with SCA attending the outpatient clinics of Lagos University Teaching Hospital (LUTH), Lagos, Nigeria, to determine their contributions to overall morbidity of the patients with SCA. The findings in this preliminary study will provide the direction for future detailed studies on individual specific neurological complications in patients with SCA. Methodology The study was carried out from July 2004 to June 2005 at the sickle cell outpatients clinics of LUTH, Idi-Araba, Lagos. Patients Inclusion criteria. All the patients with SCA were in the steady state of their disease. Adult subjects. All consecutive patients were ≥20 years old with hemoglobin electrophoretic pattern SS and gave informed consent. Adolescent subjects. All consecutive patients were 15-19 years old with hemoglobin electrophoretic pattern SS and gave informed consent Child subjects. All consecutive children were 4-14 years old with hemoglobin electrophoretic pattern SS and had written consent from their parents, guardians or wards.

Research paper thumbnail of Effect of cervical traction on cardiovascular and selected ECG variables of cervical spondylosis patients using various weights

The Nigerian postgraduate medical journal, 2006

There is currently no consensus among the clinicians regarding the tractive force to be employed ... more There is currently no consensus among the clinicians regarding the tractive force to be employed during cervical traction (CT) that will correlate precisely with the percentage body weight of the patient and reduce the side effects associated with CT therapy. This study therefore aimed to investigate the response of cervical spondylosis (CS) patients to different CT weights and to establish the effect of CT on the cardiovascular system of patients with cervical spondylosis (CS). Sixty out of 78 subjects participated in the study. They were randomly assigned into three experimental groups A, B and C. Their systolic and diastolic blood pressures (SBP and DBP) and heart rates (HR) were measured. Rate pressure product (RPP) was calculated using standard equation18 and ECG recorded using the KENZ, 201 machine. Subjects' cardiovascular and ECG responses were monitored in a supine resting position (baseline) and under three experimental conditions using the subjects' 7.5% kg total ...

Research paper thumbnail of Clinical governance: Quality Health-Care System for 21st Century

The Nigerian Journal of General Practice, 2019

Clinical governance is a system through which all organizations in the health system are accounta... more Clinical governance is a system through which all organizations in the health system are accountable for continuously improving the quality of their clinical services and ensuring high standard of care by creating a facilitative environment in which excellence flourishes. Clinical governance has not been an important component of healthcare delivery in Nigeria. Clinical Governance has become the most important component of health care system for the 21st century. The aim is that, health care should be safe, effective, patient centered, timely, efficient and equitable.

Research paper thumbnail of VII epilepsy and the secondary schools in Nigeria

Tropical and Geographical Medicine, 1994

Research paper thumbnail of Neurologic Disease

Tropical Infectious Diseases: Principles, Pathogens and Practice, 2011

Research paper thumbnail of Effects of different cervical traction weights on neck pain and mobility

The Nigerian postgraduate medical journal, 2006

This study investigated the effects of 3 different traction weights on neck pain and range of mot... more This study investigated the effects of 3 different traction weights on neck pain and range of motion/mobility. Ninety subjects, 42 men and 48 women, with neck pain due to cervical spondylosis participated in the study. They were assigned into three groups, each of which was subjected to a different cervical traction(CT) weight namely: group A = 7.5% total body weight(TBW), group B = 10%TBW, and group C =15%TBW CT respectively. Pain intensity and neck mobility, pre-treatment and post-treatment, were assessed using visual analogue scale(VAS) and universal goniometer respectively. There was no significant difference(p < 0.05) pre-treatment, but existed post-treatment (p < 0.05) between the groups for neck pain and mobility. Nineteen subjects had reactions due to the CT application: 3,5 and 11 in groups A,B and C respectively. The least reactions were recorded with the use of 7.5% TBW traction and the highest with the 15% TBW traction. The 10%TBW CT recorded the most significant p...

Research paper thumbnail of Facial neuralgias: analysis of the different types seen at Lagos University Teaching Hospital, (Luth)

Nigerian journal of clinical practice, 2005

To highlight the presentations, characteristics. the difficulties in diagnosis, treatment and res... more To highlight the presentations, characteristics. the difficulties in diagnosis, treatment and response to treatment types of facial neuralgias seen at Lagos University Teaching Hospital. Twelve patients with facial neuralgias diagnosed and treated in dental clinic of the Lagos University Teaching Hospital were studies. Using strict for diagnosis, patients were categorized into: trigeminal, glosspharyngeal and post herpetic neuralgias. Eight patients had trigeminal neuralgia; three patients had post -herpetic neuralgia and one patient had glossopharyeal neuralgia. In six patients with Trigeminal neuralgia. mandibular branch was affected, while in the two patients maxillary branch was affected. Six patients with Trigeminal neuralgia responded to carbamazepine alone and 2 had additional drugs. The only patients with glosspharyngeal neuralgia responded to carbamazepine. One patient with post herpetic neuralgia tested positive for HIV. All the post herpetic neuralgia responded poorly to ...

Research paper thumbnail of Frequency and predictors of autonomic dysfunction in Parkinson's disease: a study of African patients in Lagos, Nigeria

The Nigerian postgraduate medical journal, 2004

The degenerative changes in PD also affect the autonomic nervous system. The frequency and predic... more The degenerative changes in PD also affect the autonomic nervous system. The frequency and predictors of such involvement in Africans with PD has not been reported. i) To determine the frequency and type of autonomic dysfunction in Nigerians with idiopathic Parkinson's disease (PD). ii) To determine the predictors of autonomic dysfunction in PD. Cardiovascular autonomic function assessed in 33 study subjects with PD and 33 age-matched controls, utilising heart rate variability to deep breathing, standing and the Valsalva manoeuvre, and the blood pressure (BP) response to standing. The results were compared based on treatment category, grade of severity on the Columbia scale of Hoehn and Yahr, duration of PD, age at onset of PD, present age and occurrence of autonomic symptoms. Parasympathetic function was abnormal in 51.5% of PD subjects, significantly higher than controls (P<0.001). Of these, 76.5% had early parasympathetic involvement and 23.5% definite parasympathetic invo...

Research paper thumbnail of Diagnostic issues in cerebral malaria: a study of 112 adolescents and adults in Lagos, Nigeria

The Nigerian postgraduate medical journal, 2004

To determine the accuracy of initial diagnosis of cerebral malaria in adolescents and adults pres... more To determine the accuracy of initial diagnosis of cerebral malaria in adolescents and adults presenting at our tertiary centre and identify the clinical and laboratory parameters helpful in distinguishing cerebral malaria from other differential diagnosis. A retrospective review of 112 adolescents and adults initially diagnosed as having cerebral malaria was carried out. Clinical features (risk factors, mode of presentation, clinical course and final diagnosis) and laboratory parameters (level of parasitaemia, haematologic and biochemical values) were documented. A correct diagnosis was made in 52 patients (46.4%), with septicaemia (20.5%) and meningitis (15.2%) accounting for most misdiagnosis. The majority of correctly diagnosed were aged 11-25 years (92.3%), and a predisposing factor was identifiable in 46.2%. Parasitaemia was predominantly moderate to heavy in correctly diagnosed cases, compared to those misdiagnosed in whom it was mild to moderate. Case fatality was higher for ...

Research paper thumbnail of Risk of Seizures in First Degree Relatives of Probands with Epilepsy

Nigerian Quarterly Journal of Hospital Medicine, 2004

ABSTRACT Objective: To determine the risk of seizures in first degree relatives of epileptic pati... more ABSTRACT Objective: To determine the risk of seizures in first degree relatives of epileptic patients. To relate the risk to several clinical characteristics in the probands. Such information is useful for genetic counselling. Methods: A prospective case-control study of 648 FDR of 88 probands attending the neurology out-patient clinic of a tertiary hospital in Lagos, Nigeria, and 308 FDR of 44 age and sex-matched controls was carried out. History of seizures in all FDR was sought using a survey questionnaire either directly filled by the FDR, probands or both. The risk of seizures in FDR was related to some clinical variables in the probands. Results: Overall risk of seizures was slightly but insignificantly higher (3.6%) in FDR of probands with epilepsy compared to controls (2.3%) (chitest; p &gt; 0.05). Risk of seizures was highest in offspring of probands (4.3%), and FDR of female probands (4.0% compared to 3.1% in males), probands with seizure onset below 10 years (5.1% compared to 3.1% &gt;10years) and probands with complex partial seizures (4.9% compared to 3.9% for generalized tonic-clonic seizures). The differences did not however reach statistical significance in comparison to the control group (chitest; p &gt; 0.05). Conclusion: The risk of seizures in FDR of Nigerian probands with epilepsy has a similar profile with that in other environments such as Europe and North America in that it is marginally higher but not significantly different from the risk in the normal population. Nig. Qt. J. Hosp. Med. Vol.12(1-4) 2002: 66-70

Research paper thumbnail of Classification of the Epilepsies: An Investigation of 945 Patients in a Developing Country

Epilepsia, 1985

The present study classified epilepsies in Nigerians and compared them with the profile of epilep... more The present study classified epilepsies in Nigerians and compared them with the profile of epilepsies as found in other countries: India, France, and Denmark. Partial epilepsy formed the largest group (76.6%) in this study and in that in India (80%), but these incidences were higher than that found in France (62%), owing to a higher frequency of birth injury, CNS infections, and childhood febrile convulsions in developing countries. In contrast to our study and that in France, where partial epilepsy with complex symptomatology formed the largest subgroup, partial epilepsy with elementary symptomatology formed the largest subgroup in India. The reason for this is not totally clear, though etiological factors and criteria for categorization are contributory. The incidence of partial epilepsy was lower in children than in adults owing to a relatively lower incidence of partial epilepsy with elementary symptomatology in children in the present series and a lower incidence of complex symptomatology in children in France and Denmark. Nigerian children seem more vulnerable to complex symptomatology owing to a high incidence of febrile illness (e.g., from malaria) and febrile convulsions. The incidence of generalized epilepsies in children was higher than in adults. Grand mal formed the largest subgroup of generalized epilepsies in children in this series and in Denmark, whereas petit mal formed the largest subgroup in France and India. Petit mal was relatively rare in children in our series (2.5%) compared with children in the French study (17.5%). Secondary generalized epilepsy was peculiar to children in all the series.(ABSTRACT TRUNCATED AT 250 WORDS)

Research paper thumbnail of Patient Perspectives on Epilepsy in a Developing Country

Epilepsia, 1984

Adolescent and adult epileptic patients attending the Neurological Clinics at the Lagos Universit... more Adolescent and adult epileptic patients attending the Neurological Clinics at the Lagos University Teaching Hospital were interviewed to assess patient perspectives of epilepsy. Although all of them admitted to having recurrent seizures, 35.9% did not accept that they had epilepsy. Among those who accepted the diagnosis, only 34.5% were willing to disclose it to other people. The majority thought that people generally fear epilepsy and avoid contact with epileptic patients. Most of the patients did not know the causes of epilepsy. The majority, however, had many positive views on epilepsy and favorable attitudes toward other epileptic patients. Although many of them rated epileptic persons lower than nonepileptic persons with respect to contribution to society, hard work, temperament, and ability to make close friends, a majority thought that epileptic patients were not disabled and had the same intelligence, ambition, and ability to be educated as nonepileptic persons. Only 50.4% of them thought epileptic persons should not drive motor vehicles, and 19.7% thought epilepsy should be reported to the licensing authority. On their treatment 62.4% were satisfied with medical treatment alone, whereas 32.5% combined medical treatment with &quot;native medicine&quot; or spiritual church healing.

Research paper thumbnail of Electroencephalographic Manifestations of Grand Mai Epilepsy in Africans: Observation of Relative Rarity of Interictal Abnormalities

Epilepsia, 1988

Interictal EEG records of Nigerian epileptic patients living in Lagos and clearly diagnosed as ha... more Interictal EEG records of Nigerian epileptic patients living in Lagos and clearly diagnosed as having grand mal epilepsy were compared with those of British epileptic patients with a similar diagnosis. Interictal EEG abnormalities (spike and wave discharges, (SW), photoparoxysmal discharges (PPD), and nonspecific changes) were significantly less common in Nigerian patients (incidence 15.7%) compared with British patients (incidence 52.9%) irrespective of age or sex of the patients. These findings may be related to ethnic or geographical factors. Rarity of PPD in Africans has previously been attributed to ethnic factors. Other studies have demonstrated an influence of geographical factors, specifically sunshine. In papio papio, such a geographical factor was shown to influence occurrence of PPD. In human epileptic subjects, environmental sunshine has been found to inversely influence the occurrence of PPD as well as SW. Besides possible ethnic factors, the relative rarity of interictal EEG abnormalities in Africans with grand mal epilepsy may be related to the larger amount of sunshine in the tropics.

Research paper thumbnail of Re - Appraisal Of Risk Factors For Stroke In Nigerian Africans - A Prospective Case - Control Study

African Journal of Neurological Sciences, 2008

Stroke is one of the major challenges facing medicine with a frightening statistics of being the ... more Stroke is one of the major challenges facing medicine with a frightening statistics of being the second leading cause of death and the leading cause of physical disability worldwide. Identification and management of risk factors remains the key to reducing morbidity and mortality from stroke. Eighty patients with clinical presentation of stroke were recruited consecutively from the Emergency Departments of the University Teaching Hospital and Specialist Hospital - both situated in Benin City, Nigeria. The patients were followed up for a two year period (June 2000 - June 2002) and risk factors analysis was done on all patients. The patients were compared with eighty age and sex matched subjects without stroke (controls). Hypertension remained the dominant risk factor with an odds ratio of 2.68 (95% CI 1.29 - 5.59). Diabetes mellitus independently conferred a risk of 3.23 (95% CI 1.09 - 5.71) and in combination with hypertension enhanced stroke risk (odds ratio 7.21; 95% CI 5.79 - 13.27; p Introduction En etant la deuxieme cause de mortalite et l\'une des causes majeures de handicap dans le monde entier, les accidents vasculaires cerebraux (AVC) representent un defit medical majeur. L‘identification et la maitrise des facteurs de risque restent la cle de la reduction de la mortalite et de la morbidite. Materiel et Methode 80 patients presentant des signes vasculaires cerebraux ont ete recrutes consecutivement au niveau du service des urgences et du service de neurologie du centre hospitalier universitaire ; Benin (Nigeria). Les patients ont ete suivis pendant une periode de deux ans (juin 2000 - juin 2002) et les facteurs de risque ont ete analyses chez tous les patients . Les patients ont ete compares avec un groupe temoin de 80 personnes sains, sans notion d\'AVC. Resultat L\'hypertension arterielle reste le facteur dominant avec un odds ratio de 2,68 (95 % CI 1,29 - 5,59) le diabete sucre confere independamment un risque de 3,23 (95 % CI 1,09 - 5.71) et en combination avec l\'hypertension arterielle le risque de survenu d\'un AVC est plus eleve (odds ratio 7,21 ; 95% CI 5,79 - 13,27 ; P inferieur a 0,05, la consommation de cigarette, l\'obesite, la fibrillation auriculaire et l\'inactivite physique augmentent de maniere significative le risque d\'AVC (P inferieur a 0,05) Par ailleurs, les habitudes dietetiques, la consommation d\'alcool et l\'hypercholesterolemie n\'etait pas un facteur de risque important. Conclusion Cette etude insiste sur la necessite de controler la pression arterielle et la glycemie dans le cadre de la prevention des AVC. Il importe dans cette optique de veiller egalement au poids, a eviter la consommation de tabac avec pratique d\'un exercice physique. La pression arterielle et la glycemie devront etre controles regulierement. Keywords : Africa, Nigeria, risk factor, stroke, Afrique, Nigeria, facteur de risque, accidents cardio-vasculaires cerebraux African Journal of Neurological Sciences Vol. 24 (2) 2005: pp. 20-27

Research paper thumbnail of The effect of tens on selected symptoms in the management of patients with chronic tension type headache: A preliminary study

Nigerian Quarterly Journal of Hospital Medicine, 2009

The electron spin resonance spectra at g = 2 of the structural and soluble proteins of mouse live... more The electron spin resonance spectra at g = 2 of the structural and soluble proteins of mouse liver have been investigated separately. The structural materials have signals an order of magnitude stronger. Radicals with important similarities to those occurring in natural tissue can be induced by treating casein with methylglyoxal or crotonaldehyde. The structural proteins of cancer give little or no signal. The color of the proteins and their electron spin resonance signal seem closely related.

Research paper thumbnail of doi:10.1155/2012/581531 Clinical Study Comparison of the Minimental State Examination Scale and the International HIV Dementia Scale in Assessing Cognitive Function in Nigerian HIV Patients on Antiretroviral Therapy

Copyright © 2012 O. Olajumoke Oshinaike et al. This is an open access article distributed under t... more Copyright © 2012 O. Olajumoke Oshinaike et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. HIV-associated neurocognitive disorder (HAND) remains common despite the availability of antiretroviral therapy. Routine screening will improve early detections. Objective. To compare the performance of the minimental state examination (MMSE) and international HIV dementia scale (IHDS) in assessing neurocognitive function in HIV/AIDS patients on antiretroviral therapy. Methods. A case-control study of 208 HIV-positive and 121 HIV-negative individuals. Baseline demographic data were documented and cognitive function assessed using the two instruments. CD4 cell counts were recorded. Results. Cases

Research paper thumbnail of An investigation of the relationship of the admission hyperglycemia to severity and 30-day outcome in acute ishemic and intracerebral hemorraghic stroke: A comparative cross sectional study

Background: Hyperglycemia is implicated as deleterious in acute stroke, although the impact may v... more Background: Hyperglycemia is implicated as deleterious in acute stroke, although the impact may vary by stroke subtype. We sought to determine the frequency of admission hyperglycemia (subcategorized as diabetes related or reactive) and explore the relationship to stroke severity and functional motor outcome in acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) stroke subtypes. Methods: This cross-sectional study recruited 170 stroke patients (85 AIS, 85 ICH) presenting within 72 h of onset. Baseline characteristics including stroke severity (National Institutes of Health Stroke Scale score), random blood glucose (RBG), and glycated hemoglobin (HBA1C) were documented. The outcomes were 30-day case fatality rate (CFR) and functional motor outcome. Results: The frequency of admission hyperglycemia was 24.7% in AIS and 22.4% ICH, with 18.8%/5.9% of AIS and 9.4%/12.9% of ICH presumed diabetes related and reactive, respectively. Stroke severity and infarct size were positivel...

Research paper thumbnail of Mortality of tetanus at the Lagos University Teaching Hospital, Nigeria

Tropical Doctor, 2005

Records of 349 tetanus patients, aged 10 years and above, admitted to the Lagos University Teachi... more Records of 349 tetanus patients, aged 10 years and above, admitted to the Lagos University Teaching Hospital, Nigeria, between 1990 and 1999 were reviewed. The male:female ratio was 1.98:1, and the ages were between 10 and 88 years, with a mean age of 29.8 years. The overall case fatality rate (CFR) of tetanus was 36.96% (33.19% for men and 44.44% for women). The CFR is similar to that previously reported in the hospital, but higher than that reported from Europe and North America. The lowest CFR was in the 10-19-year age group, and there was a trend towards increasing CFR with increasing age. Tetanus patients in the intensive care unit (ICU) had a significantly higher CFR than those in the medical wards. Unlike in developed countries, where management of tetanus in ICU has resulted in a decrease in CFR, the CFR of tetanus at the Lagos University Teaching Hospital has not significantly reduced over the years.

Research paper thumbnail of Plasma magnesium in adult Nigerian patients with epilepsy

Nigerian Postgraduate Medical Journal

The objective of this study was to determine the relationship between plasma magnesium levels and... more The objective of this study was to determine the relationship between plasma magnesium levels and epilepsy. The study was carried out at the Lagos University Teaching Hospital. Plasma magnesium was estimated using the calmigite dye colorimetric method in 45 adults with epilepsy and 35 healthy controls. Plasma concentrations of calcium, phosphorus and albumin were also estimated. The mean plasma magnesium in the patients was 0.98 mm0l/L (0.05) while that in the controls was 1.15 mmol/L (0.28). The mean plasma magnesium in the epileptics was significantly lower than that obtained in the controls (p &amp;amp;lt; 0.001). Age of onset of seizures, seizure frequency and duration of treatment did not influence the plasma magnesium levels. Low plasma magnesium is associated with epilepsy, further studies may determine the influence of anti-epileptic drug therapy on plasma magnesium levels. magnesium, seizures, Nigeria.

Research paper thumbnail of Contents Vol. 28, 2007

Neuroepidemiology, 2007

Access to full text and tables of contents, including tentative ones for forthcoming issues: www.... more Access to full text and tables of contents, including tentative ones for forthcoming issues: www.karger.com/ned_issues

Research paper thumbnail of Neurological complications of sickle cell anemia

Journal of Pediatric Hematology/Oncology, 1982

o r i g i n a l c o m m u n i c a t i o n IntroductIon S ickle cell anemia (SCA) has widespread c... more o r i g i n a l c o m m u n i c a t i o n IntroductIon S ickle cell anemia (SCA) has widespread clinical manifestations that involve nearly all the systems in the body, including the central nervous system. 1,2 The occurrence of neurological complications in patients with sickle cell disease was known for decades, but the explanations for the clinical variability are not well known. SCA results from one-point mutation that causes vasculopathy of large and small vessels. There is evidence of small vessel sludging, and relative deficiency of nitric oxide in the vessels further reduces compensatory vasodilatations. These result in both ischemia and infarcts, which may be silent and affect motor and cognitive functions. 3 SCA is an important health problem in Nigeria, which has one of the highest concentrations of patients with this disorder in the world. 4 In Nigeria, unlike some other parts of the world, 3,5,6 no specific studies have addressed the neurological complications of sickle cell anemia and their contribution to morbidity. This study evaluated the neurological complications of patients with SCA attending the outpatient clinics of Lagos University Teaching Hospital (LUTH), Lagos, Nigeria, to determine their contributions to overall morbidity of the patients with SCA. The findings in this preliminary study will provide the direction for future detailed studies on individual specific neurological complications in patients with SCA. Methodology The study was carried out from July 2004 to June 2005 at the sickle cell outpatients clinics of LUTH, Idi-Araba, Lagos. Patients Inclusion criteria. All the patients with SCA were in the steady state of their disease. Adult subjects. All consecutive patients were ≥20 years old with hemoglobin electrophoretic pattern SS and gave informed consent. Adolescent subjects. All consecutive patients were 15-19 years old with hemoglobin electrophoretic pattern SS and gave informed consent Child subjects. All consecutive children were 4-14 years old with hemoglobin electrophoretic pattern SS and had written consent from their parents, guardians or wards.

Research paper thumbnail of Effect of cervical traction on cardiovascular and selected ECG variables of cervical spondylosis patients using various weights

The Nigerian postgraduate medical journal, 2006

There is currently no consensus among the clinicians regarding the tractive force to be employed ... more There is currently no consensus among the clinicians regarding the tractive force to be employed during cervical traction (CT) that will correlate precisely with the percentage body weight of the patient and reduce the side effects associated with CT therapy. This study therefore aimed to investigate the response of cervical spondylosis (CS) patients to different CT weights and to establish the effect of CT on the cardiovascular system of patients with cervical spondylosis (CS). Sixty out of 78 subjects participated in the study. They were randomly assigned into three experimental groups A, B and C. Their systolic and diastolic blood pressures (SBP and DBP) and heart rates (HR) were measured. Rate pressure product (RPP) was calculated using standard equation18 and ECG recorded using the KENZ, 201 machine. Subjects' cardiovascular and ECG responses were monitored in a supine resting position (baseline) and under three experimental conditions using the subjects' 7.5% kg total ...

Research paper thumbnail of Clinical governance: Quality Health-Care System for 21st Century

The Nigerian Journal of General Practice, 2019

Clinical governance is a system through which all organizations in the health system are accounta... more Clinical governance is a system through which all organizations in the health system are accountable for continuously improving the quality of their clinical services and ensuring high standard of care by creating a facilitative environment in which excellence flourishes. Clinical governance has not been an important component of healthcare delivery in Nigeria. Clinical Governance has become the most important component of health care system for the 21st century. The aim is that, health care should be safe, effective, patient centered, timely, efficient and equitable.

Research paper thumbnail of VII epilepsy and the secondary schools in Nigeria

Tropical and Geographical Medicine, 1994

Research paper thumbnail of Neurologic Disease

Tropical Infectious Diseases: Principles, Pathogens and Practice, 2011

Research paper thumbnail of Effects of different cervical traction weights on neck pain and mobility

The Nigerian postgraduate medical journal, 2006

This study investigated the effects of 3 different traction weights on neck pain and range of mot... more This study investigated the effects of 3 different traction weights on neck pain and range of motion/mobility. Ninety subjects, 42 men and 48 women, with neck pain due to cervical spondylosis participated in the study. They were assigned into three groups, each of which was subjected to a different cervical traction(CT) weight namely: group A = 7.5% total body weight(TBW), group B = 10%TBW, and group C =15%TBW CT respectively. Pain intensity and neck mobility, pre-treatment and post-treatment, were assessed using visual analogue scale(VAS) and universal goniometer respectively. There was no significant difference(p < 0.05) pre-treatment, but existed post-treatment (p < 0.05) between the groups for neck pain and mobility. Nineteen subjects had reactions due to the CT application: 3,5 and 11 in groups A,B and C respectively. The least reactions were recorded with the use of 7.5% TBW traction and the highest with the 15% TBW traction. The 10%TBW CT recorded the most significant p...

Research paper thumbnail of Facial neuralgias: analysis of the different types seen at Lagos University Teaching Hospital, (Luth)

Nigerian journal of clinical practice, 2005

To highlight the presentations, characteristics. the difficulties in diagnosis, treatment and res... more To highlight the presentations, characteristics. the difficulties in diagnosis, treatment and response to treatment types of facial neuralgias seen at Lagos University Teaching Hospital. Twelve patients with facial neuralgias diagnosed and treated in dental clinic of the Lagos University Teaching Hospital were studies. Using strict for diagnosis, patients were categorized into: trigeminal, glosspharyngeal and post herpetic neuralgias. Eight patients had trigeminal neuralgia; three patients had post -herpetic neuralgia and one patient had glossopharyeal neuralgia. In six patients with Trigeminal neuralgia. mandibular branch was affected, while in the two patients maxillary branch was affected. Six patients with Trigeminal neuralgia responded to carbamazepine alone and 2 had additional drugs. The only patients with glosspharyngeal neuralgia responded to carbamazepine. One patient with post herpetic neuralgia tested positive for HIV. All the post herpetic neuralgia responded poorly to ...

Research paper thumbnail of Frequency and predictors of autonomic dysfunction in Parkinson's disease: a study of African patients in Lagos, Nigeria

The Nigerian postgraduate medical journal, 2004

The degenerative changes in PD also affect the autonomic nervous system. The frequency and predic... more The degenerative changes in PD also affect the autonomic nervous system. The frequency and predictors of such involvement in Africans with PD has not been reported. i) To determine the frequency and type of autonomic dysfunction in Nigerians with idiopathic Parkinson's disease (PD). ii) To determine the predictors of autonomic dysfunction in PD. Cardiovascular autonomic function assessed in 33 study subjects with PD and 33 age-matched controls, utilising heart rate variability to deep breathing, standing and the Valsalva manoeuvre, and the blood pressure (BP) response to standing. The results were compared based on treatment category, grade of severity on the Columbia scale of Hoehn and Yahr, duration of PD, age at onset of PD, present age and occurrence of autonomic symptoms. Parasympathetic function was abnormal in 51.5% of PD subjects, significantly higher than controls (P<0.001). Of these, 76.5% had early parasympathetic involvement and 23.5% definite parasympathetic invo...

Research paper thumbnail of Diagnostic issues in cerebral malaria: a study of 112 adolescents and adults in Lagos, Nigeria

The Nigerian postgraduate medical journal, 2004

To determine the accuracy of initial diagnosis of cerebral malaria in adolescents and adults pres... more To determine the accuracy of initial diagnosis of cerebral malaria in adolescents and adults presenting at our tertiary centre and identify the clinical and laboratory parameters helpful in distinguishing cerebral malaria from other differential diagnosis. A retrospective review of 112 adolescents and adults initially diagnosed as having cerebral malaria was carried out. Clinical features (risk factors, mode of presentation, clinical course and final diagnosis) and laboratory parameters (level of parasitaemia, haematologic and biochemical values) were documented. A correct diagnosis was made in 52 patients (46.4%), with septicaemia (20.5%) and meningitis (15.2%) accounting for most misdiagnosis. The majority of correctly diagnosed were aged 11-25 years (92.3%), and a predisposing factor was identifiable in 46.2%. Parasitaemia was predominantly moderate to heavy in correctly diagnosed cases, compared to those misdiagnosed in whom it was mild to moderate. Case fatality was higher for ...

Research paper thumbnail of Risk of Seizures in First Degree Relatives of Probands with Epilepsy

Nigerian Quarterly Journal of Hospital Medicine, 2004

ABSTRACT Objective: To determine the risk of seizures in first degree relatives of epileptic pati... more ABSTRACT Objective: To determine the risk of seizures in first degree relatives of epileptic patients. To relate the risk to several clinical characteristics in the probands. Such information is useful for genetic counselling. Methods: A prospective case-control study of 648 FDR of 88 probands attending the neurology out-patient clinic of a tertiary hospital in Lagos, Nigeria, and 308 FDR of 44 age and sex-matched controls was carried out. History of seizures in all FDR was sought using a survey questionnaire either directly filled by the FDR, probands or both. The risk of seizures in FDR was related to some clinical variables in the probands. Results: Overall risk of seizures was slightly but insignificantly higher (3.6%) in FDR of probands with epilepsy compared to controls (2.3%) (chitest; p &gt; 0.05). Risk of seizures was highest in offspring of probands (4.3%), and FDR of female probands (4.0% compared to 3.1% in males), probands with seizure onset below 10 years (5.1% compared to 3.1% &gt;10years) and probands with complex partial seizures (4.9% compared to 3.9% for generalized tonic-clonic seizures). The differences did not however reach statistical significance in comparison to the control group (chitest; p &gt; 0.05). Conclusion: The risk of seizures in FDR of Nigerian probands with epilepsy has a similar profile with that in other environments such as Europe and North America in that it is marginally higher but not significantly different from the risk in the normal population. Nig. Qt. J. Hosp. Med. Vol.12(1-4) 2002: 66-70

Research paper thumbnail of Classification of the Epilepsies: An Investigation of 945 Patients in a Developing Country

Epilepsia, 1985

The present study classified epilepsies in Nigerians and compared them with the profile of epilep... more The present study classified epilepsies in Nigerians and compared them with the profile of epilepsies as found in other countries: India, France, and Denmark. Partial epilepsy formed the largest group (76.6%) in this study and in that in India (80%), but these incidences were higher than that found in France (62%), owing to a higher frequency of birth injury, CNS infections, and childhood febrile convulsions in developing countries. In contrast to our study and that in France, where partial epilepsy with complex symptomatology formed the largest subgroup, partial epilepsy with elementary symptomatology formed the largest subgroup in India. The reason for this is not totally clear, though etiological factors and criteria for categorization are contributory. The incidence of partial epilepsy was lower in children than in adults owing to a relatively lower incidence of partial epilepsy with elementary symptomatology in children in the present series and a lower incidence of complex symptomatology in children in France and Denmark. Nigerian children seem more vulnerable to complex symptomatology owing to a high incidence of febrile illness (e.g., from malaria) and febrile convulsions. The incidence of generalized epilepsies in children was higher than in adults. Grand mal formed the largest subgroup of generalized epilepsies in children in this series and in Denmark, whereas petit mal formed the largest subgroup in France and India. Petit mal was relatively rare in children in our series (2.5%) compared with children in the French study (17.5%). Secondary generalized epilepsy was peculiar to children in all the series.(ABSTRACT TRUNCATED AT 250 WORDS)

Research paper thumbnail of Patient Perspectives on Epilepsy in a Developing Country

Epilepsia, 1984

Adolescent and adult epileptic patients attending the Neurological Clinics at the Lagos Universit... more Adolescent and adult epileptic patients attending the Neurological Clinics at the Lagos University Teaching Hospital were interviewed to assess patient perspectives of epilepsy. Although all of them admitted to having recurrent seizures, 35.9% did not accept that they had epilepsy. Among those who accepted the diagnosis, only 34.5% were willing to disclose it to other people. The majority thought that people generally fear epilepsy and avoid contact with epileptic patients. Most of the patients did not know the causes of epilepsy. The majority, however, had many positive views on epilepsy and favorable attitudes toward other epileptic patients. Although many of them rated epileptic persons lower than nonepileptic persons with respect to contribution to society, hard work, temperament, and ability to make close friends, a majority thought that epileptic patients were not disabled and had the same intelligence, ambition, and ability to be educated as nonepileptic persons. Only 50.4% of them thought epileptic persons should not drive motor vehicles, and 19.7% thought epilepsy should be reported to the licensing authority. On their treatment 62.4% were satisfied with medical treatment alone, whereas 32.5% combined medical treatment with &quot;native medicine&quot; or spiritual church healing.

Research paper thumbnail of Electroencephalographic Manifestations of Grand Mai Epilepsy in Africans: Observation of Relative Rarity of Interictal Abnormalities

Epilepsia, 1988

Interictal EEG records of Nigerian epileptic patients living in Lagos and clearly diagnosed as ha... more Interictal EEG records of Nigerian epileptic patients living in Lagos and clearly diagnosed as having grand mal epilepsy were compared with those of British epileptic patients with a similar diagnosis. Interictal EEG abnormalities (spike and wave discharges, (SW), photoparoxysmal discharges (PPD), and nonspecific changes) were significantly less common in Nigerian patients (incidence 15.7%) compared with British patients (incidence 52.9%) irrespective of age or sex of the patients. These findings may be related to ethnic or geographical factors. Rarity of PPD in Africans has previously been attributed to ethnic factors. Other studies have demonstrated an influence of geographical factors, specifically sunshine. In papio papio, such a geographical factor was shown to influence occurrence of PPD. In human epileptic subjects, environmental sunshine has been found to inversely influence the occurrence of PPD as well as SW. Besides possible ethnic factors, the relative rarity of interictal EEG abnormalities in Africans with grand mal epilepsy may be related to the larger amount of sunshine in the tropics.

Research paper thumbnail of Re - Appraisal Of Risk Factors For Stroke In Nigerian Africans - A Prospective Case - Control Study

African Journal of Neurological Sciences, 2008

Stroke is one of the major challenges facing medicine with a frightening statistics of being the ... more Stroke is one of the major challenges facing medicine with a frightening statistics of being the second leading cause of death and the leading cause of physical disability worldwide. Identification and management of risk factors remains the key to reducing morbidity and mortality from stroke. Eighty patients with clinical presentation of stroke were recruited consecutively from the Emergency Departments of the University Teaching Hospital and Specialist Hospital - both situated in Benin City, Nigeria. The patients were followed up for a two year period (June 2000 - June 2002) and risk factors analysis was done on all patients. The patients were compared with eighty age and sex matched subjects without stroke (controls). Hypertension remained the dominant risk factor with an odds ratio of 2.68 (95% CI 1.29 - 5.59). Diabetes mellitus independently conferred a risk of 3.23 (95% CI 1.09 - 5.71) and in combination with hypertension enhanced stroke risk (odds ratio 7.21; 95% CI 5.79 - 13.27; p Introduction En etant la deuxieme cause de mortalite et l\'une des causes majeures de handicap dans le monde entier, les accidents vasculaires cerebraux (AVC) representent un defit medical majeur. L‘identification et la maitrise des facteurs de risque restent la cle de la reduction de la mortalite et de la morbidite. Materiel et Methode 80 patients presentant des signes vasculaires cerebraux ont ete recrutes consecutivement au niveau du service des urgences et du service de neurologie du centre hospitalier universitaire ; Benin (Nigeria). Les patients ont ete suivis pendant une periode de deux ans (juin 2000 - juin 2002) et les facteurs de risque ont ete analyses chez tous les patients . Les patients ont ete compares avec un groupe temoin de 80 personnes sains, sans notion d\'AVC. Resultat L\'hypertension arterielle reste le facteur dominant avec un odds ratio de 2,68 (95 % CI 1,29 - 5,59) le diabete sucre confere independamment un risque de 3,23 (95 % CI 1,09 - 5.71) et en combination avec l\'hypertension arterielle le risque de survenu d\'un AVC est plus eleve (odds ratio 7,21 ; 95% CI 5,79 - 13,27 ; P inferieur a 0,05, la consommation de cigarette, l\'obesite, la fibrillation auriculaire et l\'inactivite physique augmentent de maniere significative le risque d\'AVC (P inferieur a 0,05) Par ailleurs, les habitudes dietetiques, la consommation d\'alcool et l\'hypercholesterolemie n\'etait pas un facteur de risque important. Conclusion Cette etude insiste sur la necessite de controler la pression arterielle et la glycemie dans le cadre de la prevention des AVC. Il importe dans cette optique de veiller egalement au poids, a eviter la consommation de tabac avec pratique d\'un exercice physique. La pression arterielle et la glycemie devront etre controles regulierement. Keywords : Africa, Nigeria, risk factor, stroke, Afrique, Nigeria, facteur de risque, accidents cardio-vasculaires cerebraux African Journal of Neurological Sciences Vol. 24 (2) 2005: pp. 20-27

Research paper thumbnail of The effect of tens on selected symptoms in the management of patients with chronic tension type headache: A preliminary study

Nigerian Quarterly Journal of Hospital Medicine, 2009

The electron spin resonance spectra at g = 2 of the structural and soluble proteins of mouse live... more The electron spin resonance spectra at g = 2 of the structural and soluble proteins of mouse liver have been investigated separately. The structural materials have signals an order of magnitude stronger. Radicals with important similarities to those occurring in natural tissue can be induced by treating casein with methylglyoxal or crotonaldehyde. The structural proteins of cancer give little or no signal. The color of the proteins and their electron spin resonance signal seem closely related.

Research paper thumbnail of doi:10.1155/2012/581531 Clinical Study Comparison of the Minimental State Examination Scale and the International HIV Dementia Scale in Assessing Cognitive Function in Nigerian HIV Patients on Antiretroviral Therapy

Copyright © 2012 O. Olajumoke Oshinaike et al. This is an open access article distributed under t... more Copyright © 2012 O. Olajumoke Oshinaike et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. HIV-associated neurocognitive disorder (HAND) remains common despite the availability of antiretroviral therapy. Routine screening will improve early detections. Objective. To compare the performance of the minimental state examination (MMSE) and international HIV dementia scale (IHDS) in assessing neurocognitive function in HIV/AIDS patients on antiretroviral therapy. Methods. A case-control study of 208 HIV-positive and 121 HIV-negative individuals. Baseline demographic data were documented and cognitive function assessed using the two instruments. CD4 cell counts were recorded. Results. Cases

Research paper thumbnail of An investigation of the relationship of the admission hyperglycemia to severity and 30-day outcome in acute ishemic and intracerebral hemorraghic stroke: A comparative cross sectional study

Background: Hyperglycemia is implicated as deleterious in acute stroke, although the impact may v... more Background: Hyperglycemia is implicated as deleterious in acute stroke, although the impact may vary by stroke subtype. We sought to determine the frequency of admission hyperglycemia (subcategorized as diabetes related or reactive) and explore the relationship to stroke severity and functional motor outcome in acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) stroke subtypes. Methods: This cross-sectional study recruited 170 stroke patients (85 AIS, 85 ICH) presenting within 72 h of onset. Baseline characteristics including stroke severity (National Institutes of Health Stroke Scale score), random blood glucose (RBG), and glycated hemoglobin (HBA1C) were documented. The outcomes were 30-day case fatality rate (CFR) and functional motor outcome. Results: The frequency of admission hyperglycemia was 24.7% in AIS and 22.4% ICH, with 18.8%/5.9% of AIS and 9.4%/12.9% of ICH presumed diabetes related and reactive, respectively. Stroke severity and infarct size were positivel...

Research paper thumbnail of Mortality of tetanus at the Lagos University Teaching Hospital, Nigeria

Tropical Doctor, 2005

Records of 349 tetanus patients, aged 10 years and above, admitted to the Lagos University Teachi... more Records of 349 tetanus patients, aged 10 years and above, admitted to the Lagos University Teaching Hospital, Nigeria, between 1990 and 1999 were reviewed. The male:female ratio was 1.98:1, and the ages were between 10 and 88 years, with a mean age of 29.8 years. The overall case fatality rate (CFR) of tetanus was 36.96% (33.19% for men and 44.44% for women). The CFR is similar to that previously reported in the hospital, but higher than that reported from Europe and North America. The lowest CFR was in the 10-19-year age group, and there was a trend towards increasing CFR with increasing age. Tetanus patients in the intensive care unit (ICU) had a significantly higher CFR than those in the medical wards. Unlike in developed countries, where management of tetanus in ICU has resulted in a decrease in CFR, the CFR of tetanus at the Lagos University Teaching Hospital has not significantly reduced over the years.