A. Ogunniyi - Academia.edu (original) (raw)
Papers by A. Ogunniyi
West African journal of medicine, 2019
OBJECTIVE There is paucity of information on delirium in sub-Saharan Africa (SSA) particularly in... more OBJECTIVE There is paucity of information on delirium in sub-Saharan Africa (SSA) particularly in the older persons (>60 years of age), leaving questions about the burden of the disease in an environment with lower health care standards. In this article, we set out to determine the frequency, precipitants and symptomatology of delirium in elderly patients admitted into medical wards in a teaching hospital in South-West Nigeria. METHODS This was a descriptive study involving a pre-planned sample of one hundred and fifty patients aged 60 years and over, assessed for cognitive impairment and delirium using the previously validated IDEA cognitive screen, and the Confusion Assessment Method (CAM) respectively. Diagnosis of delirium was made using the CAM and DSM-IV criteria. RESULTS Delirium was diagnosed in 32 patients giving a frequency of 21.3% (95%CI: 14.7-30.0%). Patients with delirium were significantly older (p<0.05). A quarter of the patients had dementia. Hypertension was ...
West African journal of medicine, 2015
BACKGROUND Human Immunodeficiency Virus (HIV) dementia is an important complication in persons wi... more BACKGROUND Human Immunodeficiency Virus (HIV) dementia is an important complication in persons with HIV/AIDS, manifesting as neurocognitive and functional impairments which are detectable on neuropsychological testing. OBJECTIVE To determine the profile of HIV/AIDS neurocognitive impairment and associated risk factors among adults with HIV infection in our center and determine its associative factors. METHODS A total of 87 HIV-seropositive patients, aged between 18- 59 years were studied. Eighty seven (87) age, sex and education-matched HIV-seronegative individuals were recruited as controls. Clinical assessments were done using standardized questionnaires developed by the AIDS Clinical Trial Group (ACTG A5199). The study participants were screened for HIV associated dementia using the International HIV dementia scale (IHDS) and a 5-test neuropsychological battery. The scores of the neuropsychological parameters of the control subjects provided the normative data. The scores of the ...
West African journal of medicine, 2019
BACKGROUND Sleep disordered breathing has been closely linked to pathogenesis, poor control of hy... more BACKGROUND Sleep disordered breathing has been closely linked to pathogenesis, poor control of hypertension, and progression of chronic kidney disease (CKD). Though hypertension and CKD are highly prevalent in Nigeria, the effects of sleep disorders on CKD and hypertension phenotypes have not been widely studied. This study investigated the relationship between self-reported sleep disorders, and ambulatory blood pressure phenotypes in patients with hypertension and those with or without CKD. METHODS Participants aged 18 years and above who consented were recruited into the study. Anthropometric measurements including height, weight, and waist and hip circumferences were obtained, Office/clinic hypertension was defined as SBP =140mmHg and/or DBP =90mmHg or being on pharmacological treatment for hypertension. 24-hour ambulatory blood pressure monitoring were done. Obstructive sleep apnea was assessed using Stop Bang questionnaire. Estimated GFR was calculated using CKD-EPI Creatinine ...
East African medical journal
We evaluated the effectiveness of anticonvulsant drugs in 175 Nigerians of whom 106 were males, w... more We evaluated the effectiveness of anticonvulsant drugs in 175 Nigerians of whom 106 were males, who suffer from epilepsy. The mean age at onset of seizures was 17.5 years and over 60% had seizures for more than one year before the commencement of therapy. Partial seizures were encountered in 98 (56%) subjects, and generalised seizures in 44%. One hundred and twenty six subjects were on single drug therapy and phenobarbital was the single most commonly prescribed agent. There was complete seizure control in 30 (17%), more than 50% control in another 87 (50%), and poor control in 58 (33%) of them. The factors associated with good control were infrequent seizures and monotherapy. The duration of seizure, and absence of aetiologic factor were not correlated with good control. There was no significant difference between phenobarbital and phenytoin effectiveness in seizure control. Adverse drug effects--mainly drowsiness and movement disorders--were encountered in 61 subjects. We conclude...
77th EAGE Conference and Exhibition 2015
West African journal of medicine
We documented the pattern of medical illnesses in 613 elderly Nigerians (398 females and 215 male... more We documented the pattern of medical illnesses in 613 elderly Nigerians (398 females and 215 males) resident in Idikan community in Ibadan city. Their ages ranged from 65 to 110 years with a mean of 76.2 years. Medical disorders diagnosed either singly or in combinations were diagnosed in 364 (59.4%) subjects and there was no gender association. Cardiovascular problems were the commonest and high blood pressure (27.8%) was the most frequent diagnosis. Only 5 of the hypertensive subjects were aware of that diagnosis and were on regular medications. The complications presented with included heart failure and stroke. Visual impairment (12.1%) mainly due to cataracts and osteoarthritis (6.7%) in that order were next in frequency. The most frequent neurological disorders were hearing impairment and movement disorders. The other conditions encountered were similar to the findings in previous studies in this environment, and the usual findings in studies focusing on this age-group in other...
West African journal of medicine
We evaluated CT findings in 75 Nigerians who suffer from epilepsy aged 12 years and over to deter... more We evaluated CT findings in 75 Nigerians who suffer from epilepsy aged 12 years and over to determine factors associated with positive yield for judicious utilisation of CT. There were 48 males and 27 females with a mean age of 36 +/- 15 years. CT was normal in 41 subjects (54.7%). The commonest CT abnormality was cortical atrophy encountered in 16 subjects. The other abnormalities were occupying lesions (13) comprising 11 neoplasms and 2 subdural haematoma, vascular lesions (4) and poroencephaly (1). The presence of CT abnormality was statistically significantly associated with neurologic deficit, partial seizure type and EEG abnormalities (P < 0.05). The decision on when to request CT scan in epileptics could therefore be influenced by our findings.
East African medical journal, 1991
We developed a new instrument for the assessment of cognitive functions in elderly Nigerians as a... more We developed a new instrument for the assessment of cognitive functions in elderly Nigerians as a preliminary step towards the determination of the burden of dementia in Nigerian Communities. The instrument was pilot tested on 250 cognitively-normal Nigerians and their scores compared with those of 15 subjects with clinically-diagnosed dementia. The cognitively normal subjects had a mean score of 24 (SD 2.3) while the cognitively-impaired subjects had a mean of 35 (SD 3.0) and p less than 0.01). Of those with normal cognition, subjects with at least 6 years of education had significantly lower mean scores than illiterates (p less than 0.005). The instrument was completed in 4 minutes in normal subjects as against 7 minutes in those with cognitive impairment. The 19 item instrument had a sensitivity of 80% and a specificity of 72% at a cut-off value of 27. With the elimination of 3 items related to information, the sensitivity and specificity increased to 93% and 83% respectively. We...
Nigerian Journal of Medicine, 2006
Myasthenia gravis is an autoimmune disease condition caused by the generation of antibodies again... more Myasthenia gravis is an autoimmune disease condition caused by the generation of antibodies against the acetylcholine receptor sites at the neuromuscular junction. The treatment modalities include anticholinesterase drugs, corticosteroids, immunotherapy, thymectomy and plasmapheresis. However, because of the poor financial state of our patients and the dearth of appropriate equipment in our centres modifications are made to standard treatment modalities including plasmapharesis. We report a case of myasthenia gravis who was on various occasions on neostigmine, pyridostigmine and prednisolone. After about 18 months of treatment, he developed myasthenic crises on two occasions. He was admitted in the ICU for respiratory support where he also had modified plasmapheresis. The patient had remarkable improvement following the modified plasmapheresis with reversal of symptoms of the myasthenic crises. In the absence of facilities for standard plasmapheresis in this environment, the use of modified plasmapheresis is hereby recommended.
West African Journal of Medicine, 2004
Parkinsonism & Related Disorders, 2007
Neurology, 1994
We assessed the interobserver agreement on the clinical diagnosis of dementia syndrome and dement... more We assessed the interobserver agreement on the clinical diagnosis of dementia syndrome and dementia subtypes as part of a cross-national project on the prevalence of dementia. Fourteen clinicians from the participating countries (Canada, Chile, Malta, Nigeria, Spain, and the United States) independently assessed the diagnosis of 51 patients whose clinical information was in standard records written in English. We used the DSM-III-R and ICD-10 criteria for dementia syndrome, the NINCDS-ADRDA criteria for Alzheimer&amp;#39;s disease (AD), and the ICD-10 criteria for other dementing diseases, and measured interobserver agreement. We found comparable levels of agreement on the diagnosis of dementia using the DSM-III-R (kappa = 0.67) as well as the ICD-10 criteria (kappa = 0.69). Cognitive impairment without dementia was a major source of disagreement (kappa = 0.10). The kappa values were 0.58 for probable AD, 0.12 for possible AD, and rose to 0.72 when the two categories were merged. The interrater reproducibility of the diagnosis of vascular dementia was 0.66 in terms of kappa index; the diagnoses of other dementing disorders as a whole reached a kappa value of 0.40. This study suggests that clinicians from different cultures and medical traditions can use the DSM-III-R and the ICD-10 criteria for dementia effectively and thus reliably identify dementia cases in cross-national research. The interrater agreement on the diagnosis of dementia might be improved if clear-cut guidelines in the definition of cognitive impairment are provided. To improve the reliability of AD diagnosis in epidemiologic studies, we suggest that the NINCDS-ADRDA &amp;quot;probable&amp;quot; and &amp;quot;possible&amp;quot; categories be merged.
Neuroepidemiology, 1991
Cognitive function was assessed in 930 elderly Nigerians living in an urban community by trained ... more Cognitive function was assessed in 930 elderly Nigerians living in an urban community by trained medical students who were blinded to the educational status of the subjects. They used a pretested and validated questionnaire. The subjects were later evaluated for the presence of dementia according to DSM-IIIR criteria by neurologists who then determined the educational status of the subjects. There were 361 males and 569 females with a mean age of 58.5 years (SD = 14.8). One hundred and sixty-one subjects (17%) with at least 6 years of education performed better on all aspects of cognition assessed (p less than 0.001). The differences in performance were statistically significant on assessment of general knowledge, intelligence, abstract thinking, depth of information and immediate recall (p less than 0.001) but not for calculation, orientation, attention and language comprehension. Our findings confirm the confounding effect of education on cognitive assessment and suggest the possibility of developing a short culture-free and educationally unbiased instrument for assessing cognitive functions in Nigerians.
Journal of the Neurological Sciences, 2009
Acta Neurologica Scandinavica, 2013
Objectives-There is paucity of information about the association of seizure severity and quality ... more Objectives-There is paucity of information about the association of seizure severity and quality of life in people with epilepsy (PWE) in sub-Saharan Africa. We evaluated the relationship of seizure severity to health-related quality of life of patients with epilepsy being followed up in an outpatient neurology clinic in southwestern Nigeria. Materials and methods-Eighty-eight consecutive patients with epilepsy who met the recruitment criteria completed the study questionnaire in company of an eyewitness. The study questionnaire comprised of the National Hospital Seizure Severity Scale (NHS3), the Quality of Life Inventory in Epilepsy (QOLIE-31), and the Beck's Depression Inventory-II (BDI-II). Results-We found a minute association between seizure severity and QOLIE-31 total score (r = À0.262, P = 0.014). Increased seizure severity predicted a worse QOLIE-31 seizure worry (R 2 = 0.311, b = À0.289; P = 0.003). Of the seven seizure severity items, generalization of seizures and presence of falls were items that predicted a worse QOLIE-31 seizure worry score and time to recover predicted a worse QOLIE-31 total score. Conclusions-Reducing seizure severity may be an alternate endpoint in epilepsy care in Nigeria (particularly difficult to control seizures) because of its practical clinical relevance in view of the fact that stateof-the-art epilepsy care is still farfetched.
Acta Neurologica Scandinavica, 2013
The treatment gap of epilepsy in developing countries is high, and data on the magnitude and caus... more The treatment gap of epilepsy in developing countries is high, and data on the magnitude and causes of epilepsy treatment gap in Africa are sparse. We aimed to determine the prevalence and causes of epilepsy treatment gap among people with epilepsy in a Suburban community in Southeast Nigeria. The direct method was used to determine epilepsy treatment gap in a two-phase cross-sectional study. Those with probable epilepsy were identified in a door-to-door survey using a modification of World Health Organization (WHO) protocol in the first phase. In the second phase, an epilepsy-specific questionnaire that was further designed to determine the magnitude and causes of epilepsy treatment gap was used. The overall treatment gap of epilepsy was 76% (n = 22/29). The major contributors to the overall treatment gap were people who were never diagnosed accounting for a diagnostic gap of 38% (n = 11/29) and those who were diagnosed but discontinued antiepileptic drug (AED) treatment of their own volition accounting for a therapeutic gap of 38% (n = 11/29). Epilepsy treatment gap in Southeast Nigeria is comparable to that in many developing countries. Fifty percent of the overall treatment gap was caused by patients discontinuing AED treatment of their own volition despite continuing fits. This result may indicate that perhaps with appropriate education on the need to adhere to therapy, the treatment gap in the community may be narrowed.
Journal of BioMedical Research and Clinical Practice, 2020
Epilepsy is one of the most prevalent chronic non-communicable neurological disorder. Persons wit... more Epilepsy is one of the most prevalent chronic non-communicable neurological disorder. Persons with epilepsy (PWE) have unique characteristics that have social impacts on the affected individuals and their family. This study sought to describe the profile of patients with epilepsy attending the out-patient neurology clinic in a tertiary health care centre in North West Nigeria. The study was carried out at Neurology clinic of Ahmadu Bello University Teaching Hospital Kaduna State, Nigeria from August 2013 to October 2014. Consecutively presenting PWE on follow-up were recruited after obtaining ethical approval and informed consent. Those recruited were at least 18 years and have been on routine follow-up for at least 1 year. Patients with clinical and electroencephalography (EEG) features suggestive of non-epileptic seizures, acute metabolic or febrile illness precipitating seizures were excluded. A structured questionnaire was used to obtain all relevant information. The data was an...
South African Family Practice, 2019
Background: Biomarkers, shock index and modified early warning score (MEWS) are of public health ... more Background: Biomarkers, shock index and modified early warning score (MEWS) are of public health importance because identification and prompt attention to them have been found to reduce mortality among older patients on admission. Objectives: A study was undertaken to determine the biomarkers, shock index and MEWS that predict mortality on admission among older medical hospital inpatients. Methods: This was a prospective study of 450 patients (≥ 60 years) on the medical wards of University College Hospital, Ibadan. Biomarkers recommended by the National Institute on Aging such as blood pressure, heart rate and pulse rate (cardiovascular functioning); cholesterol and triglycerides (metabolic processes); T-cell counts (immune system status) and weight, body mass index and waist-to-hip ratio (indicators of obesity, chronic metabolic disorders and fat deposits) were assessed. Vital signs were recorded on admission and used to calculate the shock index and MEWS. Multivariate and survival analyses were carried out at p < 0.05. Results: Baseline temperature ≥ 39.0°c (p = 0.049), pulse rate ≥ 100 beats/minute (p = 0.034), systolic blood pressure (SBP) < 120 mmHg (p = 0.048), shock index ≥1.0 (p = 0.041), age shock index (p = 0.032) and critical illness score (MEWS ≥5) p = 0.019 were significantly associated with mortality. Independent predictors of mortality on Cox regression analysis were temperature ≥ 39.0°C (HR = 3.317 [1.281-8.590]) and SBP < 120 mmHg (HR = 1.845 [1.025-3.322]). Conclusion: Prompt identification and management of fever and low blood pressure should improve the survival of older medical hospital inpatients.
Annals of Saudi Medicine, 1999
150 Annals of Saudi Medicine, Vol 19, No 2, 1999 PRELIMINARY ASSESSMENT OF AN ARABIC VERSION OF T... more 150 Annals of Saudi Medicine, Vol 19, No 2, 1999 PRELIMINARY ASSESSMENT OF AN ARABIC VERSION OF THE MINI-MENTAL STATE EXAMINATION Saad Al-Rajeh, MD, FAAN; Adesola Ogunniyi, MD; Adnan Awada, MD; Abdulkader Daif, MD; Radwan Zaidan, MD, PhD ...
West African journal of ultrasound
The development of transcranial colour-coded duplex sonography (TCCS) has resurrected the hope of... more The development of transcranial colour-coded duplex sonography (TCCS) has resurrected the hope of safe, real time bedside brain imaging beyond childhood. This review article provides an overview of the role of TCCS in the management of patients with stroke. The objective is to stimulate interest in the field of neurosonology as a potential means of improving neurological outcome for stroke patients and a area for stroke research endeavors in Africa. Literature search was done on MEDLINE, Cochrane library, and Google Scholar databases with the following keywords: transcranial colour Doppler, Transcranial duplex sonography, transcranial colour-coded Doppler sonography, stroke, infarct and haemorrhage. We also identified relevant articles from the references section of studies produced by our literature search. We discussed the roles of TCCS to discriminate ischaemic from haemorrhagic forms; unravel the mechanism of stroke; monitor temporal evolution of stroke and predictors of stroke ...
West African journal of medicine, 2019
OBJECTIVE There is paucity of information on delirium in sub-Saharan Africa (SSA) particularly in... more OBJECTIVE There is paucity of information on delirium in sub-Saharan Africa (SSA) particularly in the older persons (>60 years of age), leaving questions about the burden of the disease in an environment with lower health care standards. In this article, we set out to determine the frequency, precipitants and symptomatology of delirium in elderly patients admitted into medical wards in a teaching hospital in South-West Nigeria. METHODS This was a descriptive study involving a pre-planned sample of one hundred and fifty patients aged 60 years and over, assessed for cognitive impairment and delirium using the previously validated IDEA cognitive screen, and the Confusion Assessment Method (CAM) respectively. Diagnosis of delirium was made using the CAM and DSM-IV criteria. RESULTS Delirium was diagnosed in 32 patients giving a frequency of 21.3% (95%CI: 14.7-30.0%). Patients with delirium were significantly older (p<0.05). A quarter of the patients had dementia. Hypertension was ...
West African journal of medicine, 2015
BACKGROUND Human Immunodeficiency Virus (HIV) dementia is an important complication in persons wi... more BACKGROUND Human Immunodeficiency Virus (HIV) dementia is an important complication in persons with HIV/AIDS, manifesting as neurocognitive and functional impairments which are detectable on neuropsychological testing. OBJECTIVE To determine the profile of HIV/AIDS neurocognitive impairment and associated risk factors among adults with HIV infection in our center and determine its associative factors. METHODS A total of 87 HIV-seropositive patients, aged between 18- 59 years were studied. Eighty seven (87) age, sex and education-matched HIV-seronegative individuals were recruited as controls. Clinical assessments were done using standardized questionnaires developed by the AIDS Clinical Trial Group (ACTG A5199). The study participants were screened for HIV associated dementia using the International HIV dementia scale (IHDS) and a 5-test neuropsychological battery. The scores of the neuropsychological parameters of the control subjects provided the normative data. The scores of the ...
West African journal of medicine, 2019
BACKGROUND Sleep disordered breathing has been closely linked to pathogenesis, poor control of hy... more BACKGROUND Sleep disordered breathing has been closely linked to pathogenesis, poor control of hypertension, and progression of chronic kidney disease (CKD). Though hypertension and CKD are highly prevalent in Nigeria, the effects of sleep disorders on CKD and hypertension phenotypes have not been widely studied. This study investigated the relationship between self-reported sleep disorders, and ambulatory blood pressure phenotypes in patients with hypertension and those with or without CKD. METHODS Participants aged 18 years and above who consented were recruited into the study. Anthropometric measurements including height, weight, and waist and hip circumferences were obtained, Office/clinic hypertension was defined as SBP =140mmHg and/or DBP =90mmHg or being on pharmacological treatment for hypertension. 24-hour ambulatory blood pressure monitoring were done. Obstructive sleep apnea was assessed using Stop Bang questionnaire. Estimated GFR was calculated using CKD-EPI Creatinine ...
East African medical journal
We evaluated the effectiveness of anticonvulsant drugs in 175 Nigerians of whom 106 were males, w... more We evaluated the effectiveness of anticonvulsant drugs in 175 Nigerians of whom 106 were males, who suffer from epilepsy. The mean age at onset of seizures was 17.5 years and over 60% had seizures for more than one year before the commencement of therapy. Partial seizures were encountered in 98 (56%) subjects, and generalised seizures in 44%. One hundred and twenty six subjects were on single drug therapy and phenobarbital was the single most commonly prescribed agent. There was complete seizure control in 30 (17%), more than 50% control in another 87 (50%), and poor control in 58 (33%) of them. The factors associated with good control were infrequent seizures and monotherapy. The duration of seizure, and absence of aetiologic factor were not correlated with good control. There was no significant difference between phenobarbital and phenytoin effectiveness in seizure control. Adverse drug effects--mainly drowsiness and movement disorders--were encountered in 61 subjects. We conclude...
77th EAGE Conference and Exhibition 2015
West African journal of medicine
We documented the pattern of medical illnesses in 613 elderly Nigerians (398 females and 215 male... more We documented the pattern of medical illnesses in 613 elderly Nigerians (398 females and 215 males) resident in Idikan community in Ibadan city. Their ages ranged from 65 to 110 years with a mean of 76.2 years. Medical disorders diagnosed either singly or in combinations were diagnosed in 364 (59.4%) subjects and there was no gender association. Cardiovascular problems were the commonest and high blood pressure (27.8%) was the most frequent diagnosis. Only 5 of the hypertensive subjects were aware of that diagnosis and were on regular medications. The complications presented with included heart failure and stroke. Visual impairment (12.1%) mainly due to cataracts and osteoarthritis (6.7%) in that order were next in frequency. The most frequent neurological disorders were hearing impairment and movement disorders. The other conditions encountered were similar to the findings in previous studies in this environment, and the usual findings in studies focusing on this age-group in other...
West African journal of medicine
We evaluated CT findings in 75 Nigerians who suffer from epilepsy aged 12 years and over to deter... more We evaluated CT findings in 75 Nigerians who suffer from epilepsy aged 12 years and over to determine factors associated with positive yield for judicious utilisation of CT. There were 48 males and 27 females with a mean age of 36 +/- 15 years. CT was normal in 41 subjects (54.7%). The commonest CT abnormality was cortical atrophy encountered in 16 subjects. The other abnormalities were occupying lesions (13) comprising 11 neoplasms and 2 subdural haematoma, vascular lesions (4) and poroencephaly (1). The presence of CT abnormality was statistically significantly associated with neurologic deficit, partial seizure type and EEG abnormalities (P < 0.05). The decision on when to request CT scan in epileptics could therefore be influenced by our findings.
East African medical journal, 1991
We developed a new instrument for the assessment of cognitive functions in elderly Nigerians as a... more We developed a new instrument for the assessment of cognitive functions in elderly Nigerians as a preliminary step towards the determination of the burden of dementia in Nigerian Communities. The instrument was pilot tested on 250 cognitively-normal Nigerians and their scores compared with those of 15 subjects with clinically-diagnosed dementia. The cognitively normal subjects had a mean score of 24 (SD 2.3) while the cognitively-impaired subjects had a mean of 35 (SD 3.0) and p less than 0.01). Of those with normal cognition, subjects with at least 6 years of education had significantly lower mean scores than illiterates (p less than 0.005). The instrument was completed in 4 minutes in normal subjects as against 7 minutes in those with cognitive impairment. The 19 item instrument had a sensitivity of 80% and a specificity of 72% at a cut-off value of 27. With the elimination of 3 items related to information, the sensitivity and specificity increased to 93% and 83% respectively. We...
Nigerian Journal of Medicine, 2006
Myasthenia gravis is an autoimmune disease condition caused by the generation of antibodies again... more Myasthenia gravis is an autoimmune disease condition caused by the generation of antibodies against the acetylcholine receptor sites at the neuromuscular junction. The treatment modalities include anticholinesterase drugs, corticosteroids, immunotherapy, thymectomy and plasmapheresis. However, because of the poor financial state of our patients and the dearth of appropriate equipment in our centres modifications are made to standard treatment modalities including plasmapharesis. We report a case of myasthenia gravis who was on various occasions on neostigmine, pyridostigmine and prednisolone. After about 18 months of treatment, he developed myasthenic crises on two occasions. He was admitted in the ICU for respiratory support where he also had modified plasmapheresis. The patient had remarkable improvement following the modified plasmapheresis with reversal of symptoms of the myasthenic crises. In the absence of facilities for standard plasmapheresis in this environment, the use of modified plasmapheresis is hereby recommended.
West African Journal of Medicine, 2004
Parkinsonism & Related Disorders, 2007
Neurology, 1994
We assessed the interobserver agreement on the clinical diagnosis of dementia syndrome and dement... more We assessed the interobserver agreement on the clinical diagnosis of dementia syndrome and dementia subtypes as part of a cross-national project on the prevalence of dementia. Fourteen clinicians from the participating countries (Canada, Chile, Malta, Nigeria, Spain, and the United States) independently assessed the diagnosis of 51 patients whose clinical information was in standard records written in English. We used the DSM-III-R and ICD-10 criteria for dementia syndrome, the NINCDS-ADRDA criteria for Alzheimer&amp;#39;s disease (AD), and the ICD-10 criteria for other dementing diseases, and measured interobserver agreement. We found comparable levels of agreement on the diagnosis of dementia using the DSM-III-R (kappa = 0.67) as well as the ICD-10 criteria (kappa = 0.69). Cognitive impairment without dementia was a major source of disagreement (kappa = 0.10). The kappa values were 0.58 for probable AD, 0.12 for possible AD, and rose to 0.72 when the two categories were merged. The interrater reproducibility of the diagnosis of vascular dementia was 0.66 in terms of kappa index; the diagnoses of other dementing disorders as a whole reached a kappa value of 0.40. This study suggests that clinicians from different cultures and medical traditions can use the DSM-III-R and the ICD-10 criteria for dementia effectively and thus reliably identify dementia cases in cross-national research. The interrater agreement on the diagnosis of dementia might be improved if clear-cut guidelines in the definition of cognitive impairment are provided. To improve the reliability of AD diagnosis in epidemiologic studies, we suggest that the NINCDS-ADRDA &amp;quot;probable&amp;quot; and &amp;quot;possible&amp;quot; categories be merged.
Neuroepidemiology, 1991
Cognitive function was assessed in 930 elderly Nigerians living in an urban community by trained ... more Cognitive function was assessed in 930 elderly Nigerians living in an urban community by trained medical students who were blinded to the educational status of the subjects. They used a pretested and validated questionnaire. The subjects were later evaluated for the presence of dementia according to DSM-IIIR criteria by neurologists who then determined the educational status of the subjects. There were 361 males and 569 females with a mean age of 58.5 years (SD = 14.8). One hundred and sixty-one subjects (17%) with at least 6 years of education performed better on all aspects of cognition assessed (p less than 0.001). The differences in performance were statistically significant on assessment of general knowledge, intelligence, abstract thinking, depth of information and immediate recall (p less than 0.001) but not for calculation, orientation, attention and language comprehension. Our findings confirm the confounding effect of education on cognitive assessment and suggest the possibility of developing a short culture-free and educationally unbiased instrument for assessing cognitive functions in Nigerians.
Journal of the Neurological Sciences, 2009
Acta Neurologica Scandinavica, 2013
Objectives-There is paucity of information about the association of seizure severity and quality ... more Objectives-There is paucity of information about the association of seizure severity and quality of life in people with epilepsy (PWE) in sub-Saharan Africa. We evaluated the relationship of seizure severity to health-related quality of life of patients with epilepsy being followed up in an outpatient neurology clinic in southwestern Nigeria. Materials and methods-Eighty-eight consecutive patients with epilepsy who met the recruitment criteria completed the study questionnaire in company of an eyewitness. The study questionnaire comprised of the National Hospital Seizure Severity Scale (NHS3), the Quality of Life Inventory in Epilepsy (QOLIE-31), and the Beck's Depression Inventory-II (BDI-II). Results-We found a minute association between seizure severity and QOLIE-31 total score (r = À0.262, P = 0.014). Increased seizure severity predicted a worse QOLIE-31 seizure worry (R 2 = 0.311, b = À0.289; P = 0.003). Of the seven seizure severity items, generalization of seizures and presence of falls were items that predicted a worse QOLIE-31 seizure worry score and time to recover predicted a worse QOLIE-31 total score. Conclusions-Reducing seizure severity may be an alternate endpoint in epilepsy care in Nigeria (particularly difficult to control seizures) because of its practical clinical relevance in view of the fact that stateof-the-art epilepsy care is still farfetched.
Acta Neurologica Scandinavica, 2013
The treatment gap of epilepsy in developing countries is high, and data on the magnitude and caus... more The treatment gap of epilepsy in developing countries is high, and data on the magnitude and causes of epilepsy treatment gap in Africa are sparse. We aimed to determine the prevalence and causes of epilepsy treatment gap among people with epilepsy in a Suburban community in Southeast Nigeria. The direct method was used to determine epilepsy treatment gap in a two-phase cross-sectional study. Those with probable epilepsy were identified in a door-to-door survey using a modification of World Health Organization (WHO) protocol in the first phase. In the second phase, an epilepsy-specific questionnaire that was further designed to determine the magnitude and causes of epilepsy treatment gap was used. The overall treatment gap of epilepsy was 76% (n = 22/29). The major contributors to the overall treatment gap were people who were never diagnosed accounting for a diagnostic gap of 38% (n = 11/29) and those who were diagnosed but discontinued antiepileptic drug (AED) treatment of their own volition accounting for a therapeutic gap of 38% (n = 11/29). Epilepsy treatment gap in Southeast Nigeria is comparable to that in many developing countries. Fifty percent of the overall treatment gap was caused by patients discontinuing AED treatment of their own volition despite continuing fits. This result may indicate that perhaps with appropriate education on the need to adhere to therapy, the treatment gap in the community may be narrowed.
Journal of BioMedical Research and Clinical Practice, 2020
Epilepsy is one of the most prevalent chronic non-communicable neurological disorder. Persons wit... more Epilepsy is one of the most prevalent chronic non-communicable neurological disorder. Persons with epilepsy (PWE) have unique characteristics that have social impacts on the affected individuals and their family. This study sought to describe the profile of patients with epilepsy attending the out-patient neurology clinic in a tertiary health care centre in North West Nigeria. The study was carried out at Neurology clinic of Ahmadu Bello University Teaching Hospital Kaduna State, Nigeria from August 2013 to October 2014. Consecutively presenting PWE on follow-up were recruited after obtaining ethical approval and informed consent. Those recruited were at least 18 years and have been on routine follow-up for at least 1 year. Patients with clinical and electroencephalography (EEG) features suggestive of non-epileptic seizures, acute metabolic or febrile illness precipitating seizures were excluded. A structured questionnaire was used to obtain all relevant information. The data was an...
South African Family Practice, 2019
Background: Biomarkers, shock index and modified early warning score (MEWS) are of public health ... more Background: Biomarkers, shock index and modified early warning score (MEWS) are of public health importance because identification and prompt attention to them have been found to reduce mortality among older patients on admission. Objectives: A study was undertaken to determine the biomarkers, shock index and MEWS that predict mortality on admission among older medical hospital inpatients. Methods: This was a prospective study of 450 patients (≥ 60 years) on the medical wards of University College Hospital, Ibadan. Biomarkers recommended by the National Institute on Aging such as blood pressure, heart rate and pulse rate (cardiovascular functioning); cholesterol and triglycerides (metabolic processes); T-cell counts (immune system status) and weight, body mass index and waist-to-hip ratio (indicators of obesity, chronic metabolic disorders and fat deposits) were assessed. Vital signs were recorded on admission and used to calculate the shock index and MEWS. Multivariate and survival analyses were carried out at p < 0.05. Results: Baseline temperature ≥ 39.0°c (p = 0.049), pulse rate ≥ 100 beats/minute (p = 0.034), systolic blood pressure (SBP) < 120 mmHg (p = 0.048), shock index ≥1.0 (p = 0.041), age shock index (p = 0.032) and critical illness score (MEWS ≥5) p = 0.019 were significantly associated with mortality. Independent predictors of mortality on Cox regression analysis were temperature ≥ 39.0°C (HR = 3.317 [1.281-8.590]) and SBP < 120 mmHg (HR = 1.845 [1.025-3.322]). Conclusion: Prompt identification and management of fever and low blood pressure should improve the survival of older medical hospital inpatients.
Annals of Saudi Medicine, 1999
150 Annals of Saudi Medicine, Vol 19, No 2, 1999 PRELIMINARY ASSESSMENT OF AN ARABIC VERSION OF T... more 150 Annals of Saudi Medicine, Vol 19, No 2, 1999 PRELIMINARY ASSESSMENT OF AN ARABIC VERSION OF THE MINI-MENTAL STATE EXAMINATION Saad Al-Rajeh, MD, FAAN; Adesola Ogunniyi, MD; Adnan Awada, MD; Abdulkader Daif, MD; Radwan Zaidan, MD, PhD ...
West African journal of ultrasound
The development of transcranial colour-coded duplex sonography (TCCS) has resurrected the hope of... more The development of transcranial colour-coded duplex sonography (TCCS) has resurrected the hope of safe, real time bedside brain imaging beyond childhood. This review article provides an overview of the role of TCCS in the management of patients with stroke. The objective is to stimulate interest in the field of neurosonology as a potential means of improving neurological outcome for stroke patients and a area for stroke research endeavors in Africa. Literature search was done on MEDLINE, Cochrane library, and Google Scholar databases with the following keywords: transcranial colour Doppler, Transcranial duplex sonography, transcranial colour-coded Doppler sonography, stroke, infarct and haemorrhage. We also identified relevant articles from the references section of studies produced by our literature search. We discussed the roles of TCCS to discriminate ischaemic from haemorrhagic forms; unravel the mechanism of stroke; monitor temporal evolution of stroke and predictors of stroke ...