Kolawole Wahab | University of Ilorin (original) (raw)

Papers by Kolawole Wahab

International Archives of Medicine, 2011

Background: Obesity is assuming an epidemic dimension globally. It is important to appreciate fac... more Background: Obesity is assuming an epidemic dimension globally. It is important to appreciate factors associated with the disease so that a holistic approach can be taken in tackling the rising burden. The objective of this study was to determine the prevalence of overweight and obesity and the factors independently associated with obesity in an urban Nigerian population. Methods: A cross-sectional study of 300 healthy adult subjects was conducted in the urban city of Katsina, northern Nigeria. Relevant sociodemographic and clinical information were obtained. Screening for obesity was done using the Body Mass Index while relevant laboratory investigations were conducted. Univariate and multivariate logistic regression analyses were performed to determine the predictors of obesity. Results: Overweight and obesity was found in 53.3% and 21.0% respectively with a significantly higher prevalence in females compared to males (overweight: 62.0% vs 41.9%, p < 0.001; obesity: 29.8% vs 9.3%, p < 0.001). In univariate analysis, the odds of obesity were higher in women and in the presence of hypertension, hypercholesterolaemia and hyperuricaemia. However, in multivariate analysis, factors independently associated with obesity were female sex (OR 6.119, 95% CI 2.705-13.842, p < 0.001), hypercholesterolaemia (OR 2.138, 95% CI 1.109-4.119, p = 0.023) and hyperuricaemia (OR 2.906, 95% CI 1.444-5.847, p = 0.003). Conclusion: There is a high prevalence of obesity in northern Nigeria and women are significantly more affected. The high prevalence is independently associated with female sex, hypercholesterolaemia and hyperuricaemia. Public health education is urgently needed in order to reduce this burden and prevent other non-communicable cardiovascular disorders.

European Archives of Oto-Rhino-Laryngology, 2010

exact test while level of significance was set at pϽ0.05. RESULTS: Out of the 37 confirmed cases ... more exact test while level of significance was set at pϽ0.05. RESULTS: Out of the 37 confirmed cases of LF, 5(13.5%) and none (0%) of the control developed Early-onset SNHL (pϭ0.03). Forty percent of the cases studied had negative IgM. The audiograms ranged from 65-85dB and the speech discrimination 20-40%. Overall case fatality rate was 27%, and for Early-SNHL cases 60% (pϾ0.05). CONCLUSION: The incidence of sensorineural hearing loss in Lassa fever infection is about 13.5% and could be a reflection of a worse disease process. There is possibility of direct viral invasion aside immunological reaction as a causative mechanism.

BMC Research Notes, 2010

Objectives This report provides the first comprehensive and standardized assessment of the distri... more Objectives This report provides the first comprehensive and standardized assessment of the distribution of cardiovascular disease (CVD) risk factors in Syria, where such data are still scarce. Methods A population-based household survey was conducted in Aleppo (population [2.5 million), involving 1,168 subjects C25 years old (47.7% men; mean age 44.7 ± 12.7 years). Information about socio-demographics, personal behavior, and other CVD risk factors was collected. Anthropometric measurements and fasting blood samples were obtained. Results The prevalence of clinical risk factors of CVD (ClinRFs) was 45.6% for hypertension, 43.2% for obesity, 21.9% for hypercholesterolemia and 15.6% for diabetes. The prevalence of behavioral risk factors (BehRFs) was 82.3% for physical inactivity, 39.0% for smoking, and 33.4% for unhealthy diet. All ClinRFs increased with age, while gender was associated only with obesity and smoking. Education was associated with obesity and diabetes (P \ 0.05 for all). Conclusions Adults in Syria have some of the world's highest prevalence of CVD risk factors. Unhealthy behaviors and social norms unfavorable to women may explain some of such risk profiles.

BMC Neurology, 2008

Background: Although stroke is a leading cause of morbidity and mortality in Nigeria, there is no... more Background: Although stroke is a leading cause of morbidity and mortality in Nigeria, there is no information on awareness of its warning signs. This study was designed to assess awareness of stroke warning signs in Nigerians at increased risk. Methods: A hospital-based cross-sectional study conducted at Irrua Specialist Teaching Hospital, in southern Nigeria. Patients with a diagnosis of hypertension, diabetes or both were interviewed for the warning signs of stroke in the outpatient clinic by trained interviewers. The main outcome measure was ability to identify at least one stroke warning sign. Results: There were 225 respondents with a mean age of 58.0 ± 11.7 years. Only 39.6% could identify at least one stroke warning sign while the commonest sign identified was sudden unilateral limb weakness (24.4%). On multivariate logistic regression analysis, male sex (β = 0.26, 95% CI = 0.14-0.39, p < 0.001) and 11 or more years of education (β = 0.16, 95% CI = 0.03-0.29, p = 0.02) emerged the independent predictors of ability to identify at least one warning sign. Conclusion: Awareness of stroke warning signs is poor among Nigerians at increased risk for the disease. Efforts should be made to improve on the level of awareness through aggressive health education.

The Theory and Practice of Legislation

Neurology, 2015

OBJECTIVE: To determine the short-term functional outcome and its predictors in a cohort of Niger... more OBJECTIVE: To determine the short-term functional outcome and its predictors in a cohort of Nigerians with first-ever acute stroke. BACKGROUND: In spite of remaining a leading cause of death and disability worldwide, there is a paucity of information on stroke functional outcome and its predictors in many developing countries which have a disproportionately higher disease burden compared to developed countries. DESIGN/METHOD: This was a prospective study conducted over a period of 3 years at the Neurology Unit of University of Ilorin Teaching Hospital, Ilorin, Nigeria. Stroke confirmation was with brain computed tomogram while stroke severity was assessed on admission using the NIHSS. The outcome measure was functional outcome at 30 days using the modified Rankin Score (mRS); poor functional outcome was defined as mRS score >2. Binary logistic regression analysis was done to determine the predictors of functional outcome. RESULTS: The mean age of the 150 patients studied was 59.4...

Stroke, 2020

Background: There is paucity of data on the epidemiology of post-stroke cognitive impairment amon... more Background: There is paucity of data on the epidemiology of post-stroke cognitive impairment among African stroke survivors. The aim of this study is to report the profile and risk factors of post- stroke cognitive impairment among stroke survivors participating in the Stroke Investigative Research and Education Network (SIREN) Study. Methods: 1566 were evaluated with the Montreal Cognitive Assessment (MoCA) tool, the Community Screening Instrument for Dementia (CSID) and the Stick Design Test three months after the index stroke. Domain scores were derived for executive function, language memory and visuo-constructive/visuospatial domains. Cut off scores were derived from normative cognitive data obtained from comparable healthy stroke-free control subjects. We used conditional logistic regression to estimate odds ratios (OR) with 95% CIs. Results: Of 1566 stroke survivors [mean age 57.7 (13.4) years] who were assessed 3 months after stroke, 37% were impaired in global cognition and...

Nigerian Medical Journal, 2007

Background: There is a lot of controversy on the prognostic value of admission blood pressures in... more Background: There is a lot of controversy on the prognostic value of admission blood pressures in acute ischaemic stroke, but in Nigeria, there is no information on this. Objective: The objective of this study was to correlate the effect of blood pressures measured on admission with 30-day mortality and neurological handicap in Nigerians with acute ischaemic stroke. Methods: This was a prospective observational study carried out between February, 2003 and May, 2004 at the Lagos University Teaching Hospital, Lagos, Nigeria. All eligible consecutively consenting ischaemic stroke patients were recruited. Systolic (SBP) and diastolic blood pressures (DBP) were measured on admission while pulse pressure (PP) and mean arterial pressure (MAP) were derived. Patients were periodically evaluated for progress and/or development of complications. Primary outcome was mortality within 30 days while secondary outcome was level of handicap on the modified Rankin Scale. Results: 100 patients were st...

Stroke, 2021

Background: Pre-diabetes and diabetes mellitus (DM) are dysglycemic states associated with stroke... more Background: Pre-diabetes and diabetes mellitus (DM) are dysglycemic states associated with stroke occurrence. However, there is limited data from sub-Saharan Africa on the burden and associations b...

Stroke, 2020

Background: The risk factors associated with the occurrence of the distinct pathophysiologic subt... more Background: The risk factors associated with the occurrence of the distinct pathophysiologic subtypes of ischemic stroke are unknown among indigenous Africans. Objective: To identify and quantify the contributions of risk factors for occurrence of ischemic stroke and its etiologic subtypes among West Africans. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Nigeria and Ghana. Cases included adults aged >18 years with CT/MRI confirmed stroke and ischemic strokes were etiologically subtyped using the TOAST protocol. Controls were age-and-gender matched stroke-free adults recruited from the communities in catchment areas of cases. Comprehensive evaluation for vascular, lifestyle and psychosocial factors was performed using standard instruments. We used conditional logistic regression to estimate odds ratios (OR) with 95% CIs. Results: There were 1,721 ischemic stroke cases with a mean age of 62.19 ...

Neurology, 2018

Objective: We report a case of stroke occurring after a venomoussnakebite in an adult Nigerian. B... more Objective: We report a case of stroke occurring after a venomoussnakebite in an adult Nigerian. Background: In spite of remaining a significant public healthproblem, especially in rural Africa, there is paucity of information oncerebrovascular manifestations of snake bite. Design/Methods: Not applicable. Results: A 27-year-old Nigerian pastoralist presented to the accident and emergency department of our hospital with a two-day history of severe, generalized headache, vomiting and convulsions after being bitten by a snake identified to be a carpet viper. There was associated minimal spontaneous bleeding from the right foot but no bleeding from anycraniofacial orifices and no evident bleeding from elsewhere. He had two episodes of spontaneously-aborting right-sided focal seizures with secondary generalization on the day of presentation. No history of abnormal sensations over the body, no difficulty in swallowing or breathing and no diplopia. The nervous system examination revealed a ...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2008

OBJECTIVE To determine the predictors of 30-day intra-hospital case fatality rate in patients wit... more OBJECTIVE To determine the predictors of 30-day intra-hospital case fatality rate in patients with first-ever acute ischaemic stroke, attending a tertiary care hospital in Western Nigeria. STUDY DESIGN A cross-sectional observational study. PLACE AND DURATION OF STUDY This study was conducted at the Lagos University Teaching Hospital, Lagos, Nigeria between February 2003 and May 2004 (16 months). METHODOLOGY One hundred consecutively consenting patients admitted within 72 hours of onset of first-ever acute ischaemic stroke were studied. Uniform information was obtained using a standard format documenting demographic information, stroke-related symptoms and signs, risk factor profile, admission Glasgow Coma Score (GCS), stroke severity, admission Random Blood Glucose (RBG) and presence of complications. All patients were closely followed-up to monitor progress and document any complications. The end point was mortality or survival at 30 days from stroke onset. RESULTS The 30-day case...

Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascul... more Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascular risk factor acquisition. In sub-Saharan Africa, the effect sizes of vascular risk factors for str...

Background: Patients who suffer intracerebral hemorrhage (ICH) are at very high risk of recurrent... more Background: Patients who suffer intracerebral hemorrhage (ICH) are at very high risk of recurrent ICH and other serious cardiovascular events. A single-pill combination (SPC) of blood pressure (BP) lowering drugs offers a potentially powerful but simple strategy to optimize secondary prevention. Objectives: The Triple Therapy Prevention of Recurrent Intracerebral Disease Events Trial (TRIDENT) aims to determine the effects of a novel SPC “Triple Pill,” three generic antihypertensive drugs with demonstrated efficacy and complementary mechanisms of action at half standard dose (telmisartan 20 mg, amlodipine 2.5 mg, and indapamide 1.25 mg), with placebo for the prevention of recurrent stroke, cardiovascular events, and cognitive impairment after ICH. Design: An international, double-blind, placebo-controlled, randomized trial in adults with ICH and mild-moderate hypertension (systolic BP: 130–160 mmHg), who are not taking any Triple Pill component drug at greater than half-dose. A total of 1500 randomized patients provide 90% power to detect a hazard ratio of 0.5, over an average follow-up of 3 years, according to a total primary event rate (any stroke) of 12% in the control arm and other assumptions. Secondary outcomes include recurrent ICH, cardiovascular events, and safety. Results: Recruitment started 28 September 2017. Up to 31 October 2021, 821 patients were randomized at 54 active sites in 10 countries. Triple Pill adherence after 30 months is 86%. The required sample size should be achieved by 2024. Conclusion: Low-dose Triple Pill BP lowering could improve long-term outcome from ICH.

Neurology, 2012

Objective: To determine the knowledge of stroke risk factors among patients with hypertension and... more Objective: To determine the knowledge of stroke risk factors among patients with hypertension and diabetes attending the outpatient clinics of a Nigerian tertiary hospital. Background Although the first step towards effective prevention of stroke is awareness of its risk factors, there is limited information on knowledge of these risk factors especially among Nigerians at increased risk. Design/Methods: Using a cross-sectional design, patients with a diagnosis of hypertension, diabetes or both attending the outpatient clinics of the University of Ilorin Teaching Hospital were interviewed using an interviewer-administered semi-structured questionnaire. Respondents were requested to mention all the risk factors for stroke they knew. Outcome measure was ability to mention at least hypertension or diabetes as a risk factor; binary logistic regression analysis was used to determine factors associated with the outcome measure. Results: There were 314 respondents (mean age 56.3 years, male 47.1%). The risk factors mentioned by the respondents were: hypertension (34.7%), diabetes (7.3%), alcohol intake (4.5%), smoking (3.8%), overweight and obesity (1.9%) and heart disease (0.6%). Almost half (48.1%) did not know any risk factor. Factors associated with ability to mention at least hypertension or diabetes as risk factors were age (OR 0.980, 95% CI 0.961-0.998; p=0.034), >12 years of formal education (OR 2.492, 95% CI 1.537-4.040; p Conclusions: Despite being on follow up for hypertension and diabetes which are well-documented stroke risk factors, knowledge of these as stroke risk factors is very poor in our respondents. A younger age, good formal education, urban residence and previous health education on stroke were associated with ability to identify hypertension and diabetes as stroke risk factors. Intensive health education is needed in order to improve on this poor knowledge. Disclosure: Dr. Wahab has nothing to disclose. Dr. Kayode has nothing to disclose. Dr. Musa has nothing to disclose.

Tropical Journal of Health Sciences, 2016

Stroke

Background and Purpose: To identify the qualitative and quantitative contributions of conventiona... more Background and Purpose: To identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans. Methods: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection. Controls were age- and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle, and psychosocial factors were performed. We used conditional logistic regression to estimate adjusted odds ratios with 95% CI. Results: There were 2431 ischemic stroke case and stroke-free control pairs with respective mean ages of 62.2±14.0 versus 60.9±13.7 years. There were 1024 (42.1%) small vessel occlusions, 4...

Movement Disorders Clinical Practice

International Archives of Medicine, 2011

Background: Obesity is assuming an epidemic dimension globally. It is important to appreciate fac... more Background: Obesity is assuming an epidemic dimension globally. It is important to appreciate factors associated with the disease so that a holistic approach can be taken in tackling the rising burden. The objective of this study was to determine the prevalence of overweight and obesity and the factors independently associated with obesity in an urban Nigerian population. Methods: A cross-sectional study of 300 healthy adult subjects was conducted in the urban city of Katsina, northern Nigeria. Relevant sociodemographic and clinical information were obtained. Screening for obesity was done using the Body Mass Index while relevant laboratory investigations were conducted. Univariate and multivariate logistic regression analyses were performed to determine the predictors of obesity. Results: Overweight and obesity was found in 53.3% and 21.0% respectively with a significantly higher prevalence in females compared to males (overweight: 62.0% vs 41.9%, p < 0.001; obesity: 29.8% vs 9.3%, p < 0.001). In univariate analysis, the odds of obesity were higher in women and in the presence of hypertension, hypercholesterolaemia and hyperuricaemia. However, in multivariate analysis, factors independently associated with obesity were female sex (OR 6.119, 95% CI 2.705-13.842, p < 0.001), hypercholesterolaemia (OR 2.138, 95% CI 1.109-4.119, p = 0.023) and hyperuricaemia (OR 2.906, 95% CI 1.444-5.847, p = 0.003). Conclusion: There is a high prevalence of obesity in northern Nigeria and women are significantly more affected. The high prevalence is independently associated with female sex, hypercholesterolaemia and hyperuricaemia. Public health education is urgently needed in order to reduce this burden and prevent other non-communicable cardiovascular disorders.

European Archives of Oto-Rhino-Laryngology, 2010

exact test while level of significance was set at pϽ0.05. RESULTS: Out of the 37 confirmed cases ... more exact test while level of significance was set at pϽ0.05. RESULTS: Out of the 37 confirmed cases of LF, 5(13.5%) and none (0%) of the control developed Early-onset SNHL (pϭ0.03). Forty percent of the cases studied had negative IgM. The audiograms ranged from 65-85dB and the speech discrimination 20-40%. Overall case fatality rate was 27%, and for Early-SNHL cases 60% (pϾ0.05). CONCLUSION: The incidence of sensorineural hearing loss in Lassa fever infection is about 13.5% and could be a reflection of a worse disease process. There is possibility of direct viral invasion aside immunological reaction as a causative mechanism.

BMC Research Notes, 2010

Objectives This report provides the first comprehensive and standardized assessment of the distri... more Objectives This report provides the first comprehensive and standardized assessment of the distribution of cardiovascular disease (CVD) risk factors in Syria, where such data are still scarce. Methods A population-based household survey was conducted in Aleppo (population [2.5 million), involving 1,168 subjects C25 years old (47.7% men; mean age 44.7 ± 12.7 years). Information about socio-demographics, personal behavior, and other CVD risk factors was collected. Anthropometric measurements and fasting blood samples were obtained. Results The prevalence of clinical risk factors of CVD (ClinRFs) was 45.6% for hypertension, 43.2% for obesity, 21.9% for hypercholesterolemia and 15.6% for diabetes. The prevalence of behavioral risk factors (BehRFs) was 82.3% for physical inactivity, 39.0% for smoking, and 33.4% for unhealthy diet. All ClinRFs increased with age, while gender was associated only with obesity and smoking. Education was associated with obesity and diabetes (P \ 0.05 for all). Conclusions Adults in Syria have some of the world's highest prevalence of CVD risk factors. Unhealthy behaviors and social norms unfavorable to women may explain some of such risk profiles.

BMC Neurology, 2008

Background: Although stroke is a leading cause of morbidity and mortality in Nigeria, there is no... more Background: Although stroke is a leading cause of morbidity and mortality in Nigeria, there is no information on awareness of its warning signs. This study was designed to assess awareness of stroke warning signs in Nigerians at increased risk. Methods: A hospital-based cross-sectional study conducted at Irrua Specialist Teaching Hospital, in southern Nigeria. Patients with a diagnosis of hypertension, diabetes or both were interviewed for the warning signs of stroke in the outpatient clinic by trained interviewers. The main outcome measure was ability to identify at least one stroke warning sign. Results: There were 225 respondents with a mean age of 58.0 ± 11.7 years. Only 39.6% could identify at least one stroke warning sign while the commonest sign identified was sudden unilateral limb weakness (24.4%). On multivariate logistic regression analysis, male sex (β = 0.26, 95% CI = 0.14-0.39, p < 0.001) and 11 or more years of education (β = 0.16, 95% CI = 0.03-0.29, p = 0.02) emerged the independent predictors of ability to identify at least one warning sign. Conclusion: Awareness of stroke warning signs is poor among Nigerians at increased risk for the disease. Efforts should be made to improve on the level of awareness through aggressive health education.

The Theory and Practice of Legislation

Neurology, 2015

OBJECTIVE: To determine the short-term functional outcome and its predictors in a cohort of Niger... more OBJECTIVE: To determine the short-term functional outcome and its predictors in a cohort of Nigerians with first-ever acute stroke. BACKGROUND: In spite of remaining a leading cause of death and disability worldwide, there is a paucity of information on stroke functional outcome and its predictors in many developing countries which have a disproportionately higher disease burden compared to developed countries. DESIGN/METHOD: This was a prospective study conducted over a period of 3 years at the Neurology Unit of University of Ilorin Teaching Hospital, Ilorin, Nigeria. Stroke confirmation was with brain computed tomogram while stroke severity was assessed on admission using the NIHSS. The outcome measure was functional outcome at 30 days using the modified Rankin Score (mRS); poor functional outcome was defined as mRS score >2. Binary logistic regression analysis was done to determine the predictors of functional outcome. RESULTS: The mean age of the 150 patients studied was 59.4...

Stroke, 2020

Background: There is paucity of data on the epidemiology of post-stroke cognitive impairment amon... more Background: There is paucity of data on the epidemiology of post-stroke cognitive impairment among African stroke survivors. The aim of this study is to report the profile and risk factors of post- stroke cognitive impairment among stroke survivors participating in the Stroke Investigative Research and Education Network (SIREN) Study. Methods: 1566 were evaluated with the Montreal Cognitive Assessment (MoCA) tool, the Community Screening Instrument for Dementia (CSID) and the Stick Design Test three months after the index stroke. Domain scores were derived for executive function, language memory and visuo-constructive/visuospatial domains. Cut off scores were derived from normative cognitive data obtained from comparable healthy stroke-free control subjects. We used conditional logistic regression to estimate odds ratios (OR) with 95% CIs. Results: Of 1566 stroke survivors [mean age 57.7 (13.4) years] who were assessed 3 months after stroke, 37% were impaired in global cognition and...

Nigerian Medical Journal, 2007

Background: There is a lot of controversy on the prognostic value of admission blood pressures in... more Background: There is a lot of controversy on the prognostic value of admission blood pressures in acute ischaemic stroke, but in Nigeria, there is no information on this. Objective: The objective of this study was to correlate the effect of blood pressures measured on admission with 30-day mortality and neurological handicap in Nigerians with acute ischaemic stroke. Methods: This was a prospective observational study carried out between February, 2003 and May, 2004 at the Lagos University Teaching Hospital, Lagos, Nigeria. All eligible consecutively consenting ischaemic stroke patients were recruited. Systolic (SBP) and diastolic blood pressures (DBP) were measured on admission while pulse pressure (PP) and mean arterial pressure (MAP) were derived. Patients were periodically evaluated for progress and/or development of complications. Primary outcome was mortality within 30 days while secondary outcome was level of handicap on the modified Rankin Scale. Results: 100 patients were st...

Stroke, 2021

Background: Pre-diabetes and diabetes mellitus (DM) are dysglycemic states associated with stroke... more Background: Pre-diabetes and diabetes mellitus (DM) are dysglycemic states associated with stroke occurrence. However, there is limited data from sub-Saharan Africa on the burden and associations b...

Stroke, 2020

Background: The risk factors associated with the occurrence of the distinct pathophysiologic subt... more Background: The risk factors associated with the occurrence of the distinct pathophysiologic subtypes of ischemic stroke are unknown among indigenous Africans. Objective: To identify and quantify the contributions of risk factors for occurrence of ischemic stroke and its etiologic subtypes among West Africans. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Nigeria and Ghana. Cases included adults aged >18 years with CT/MRI confirmed stroke and ischemic strokes were etiologically subtyped using the TOAST protocol. Controls were age-and-gender matched stroke-free adults recruited from the communities in catchment areas of cases. Comprehensive evaluation for vascular, lifestyle and psychosocial factors was performed using standard instruments. We used conditional logistic regression to estimate odds ratios (OR) with 95% CIs. Results: There were 1,721 ischemic stroke cases with a mean age of 62.19 ...

Neurology, 2018

Objective: We report a case of stroke occurring after a venomoussnakebite in an adult Nigerian. B... more Objective: We report a case of stroke occurring after a venomoussnakebite in an adult Nigerian. Background: In spite of remaining a significant public healthproblem, especially in rural Africa, there is paucity of information oncerebrovascular manifestations of snake bite. Design/Methods: Not applicable. Results: A 27-year-old Nigerian pastoralist presented to the accident and emergency department of our hospital with a two-day history of severe, generalized headache, vomiting and convulsions after being bitten by a snake identified to be a carpet viper. There was associated minimal spontaneous bleeding from the right foot but no bleeding from anycraniofacial orifices and no evident bleeding from elsewhere. He had two episodes of spontaneously-aborting right-sided focal seizures with secondary generalization on the day of presentation. No history of abnormal sensations over the body, no difficulty in swallowing or breathing and no diplopia. The nervous system examination revealed a ...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2008

OBJECTIVE To determine the predictors of 30-day intra-hospital case fatality rate in patients wit... more OBJECTIVE To determine the predictors of 30-day intra-hospital case fatality rate in patients with first-ever acute ischaemic stroke, attending a tertiary care hospital in Western Nigeria. STUDY DESIGN A cross-sectional observational study. PLACE AND DURATION OF STUDY This study was conducted at the Lagos University Teaching Hospital, Lagos, Nigeria between February 2003 and May 2004 (16 months). METHODOLOGY One hundred consecutively consenting patients admitted within 72 hours of onset of first-ever acute ischaemic stroke were studied. Uniform information was obtained using a standard format documenting demographic information, stroke-related symptoms and signs, risk factor profile, admission Glasgow Coma Score (GCS), stroke severity, admission Random Blood Glucose (RBG) and presence of complications. All patients were closely followed-up to monitor progress and document any complications. The end point was mortality or survival at 30 days from stroke onset. RESULTS The 30-day case...

Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascul... more Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascular risk factor acquisition. In sub-Saharan Africa, the effect sizes of vascular risk factors for str...

Background: Patients who suffer intracerebral hemorrhage (ICH) are at very high risk of recurrent... more Background: Patients who suffer intracerebral hemorrhage (ICH) are at very high risk of recurrent ICH and other serious cardiovascular events. A single-pill combination (SPC) of blood pressure (BP) lowering drugs offers a potentially powerful but simple strategy to optimize secondary prevention. Objectives: The Triple Therapy Prevention of Recurrent Intracerebral Disease Events Trial (TRIDENT) aims to determine the effects of a novel SPC “Triple Pill,” three generic antihypertensive drugs with demonstrated efficacy and complementary mechanisms of action at half standard dose (telmisartan 20 mg, amlodipine 2.5 mg, and indapamide 1.25 mg), with placebo for the prevention of recurrent stroke, cardiovascular events, and cognitive impairment after ICH. Design: An international, double-blind, placebo-controlled, randomized trial in adults with ICH and mild-moderate hypertension (systolic BP: 130–160 mmHg), who are not taking any Triple Pill component drug at greater than half-dose. A total of 1500 randomized patients provide 90% power to detect a hazard ratio of 0.5, over an average follow-up of 3 years, according to a total primary event rate (any stroke) of 12% in the control arm and other assumptions. Secondary outcomes include recurrent ICH, cardiovascular events, and safety. Results: Recruitment started 28 September 2017. Up to 31 October 2021, 821 patients were randomized at 54 active sites in 10 countries. Triple Pill adherence after 30 months is 86%. The required sample size should be achieved by 2024. Conclusion: Low-dose Triple Pill BP lowering could improve long-term outcome from ICH.

Neurology, 2012

Objective: To determine the knowledge of stroke risk factors among patients with hypertension and... more Objective: To determine the knowledge of stroke risk factors among patients with hypertension and diabetes attending the outpatient clinics of a Nigerian tertiary hospital. Background Although the first step towards effective prevention of stroke is awareness of its risk factors, there is limited information on knowledge of these risk factors especially among Nigerians at increased risk. Design/Methods: Using a cross-sectional design, patients with a diagnosis of hypertension, diabetes or both attending the outpatient clinics of the University of Ilorin Teaching Hospital were interviewed using an interviewer-administered semi-structured questionnaire. Respondents were requested to mention all the risk factors for stroke they knew. Outcome measure was ability to mention at least hypertension or diabetes as a risk factor; binary logistic regression analysis was used to determine factors associated with the outcome measure. Results: There were 314 respondents (mean age 56.3 years, male 47.1%). The risk factors mentioned by the respondents were: hypertension (34.7%), diabetes (7.3%), alcohol intake (4.5%), smoking (3.8%), overweight and obesity (1.9%) and heart disease (0.6%). Almost half (48.1%) did not know any risk factor. Factors associated with ability to mention at least hypertension or diabetes as risk factors were age (OR 0.980, 95% CI 0.961-0.998; p=0.034), >12 years of formal education (OR 2.492, 95% CI 1.537-4.040; p Conclusions: Despite being on follow up for hypertension and diabetes which are well-documented stroke risk factors, knowledge of these as stroke risk factors is very poor in our respondents. A younger age, good formal education, urban residence and previous health education on stroke were associated with ability to identify hypertension and diabetes as stroke risk factors. Intensive health education is needed in order to improve on this poor knowledge. Disclosure: Dr. Wahab has nothing to disclose. Dr. Kayode has nothing to disclose. Dr. Musa has nothing to disclose.

Tropical Journal of Health Sciences, 2016

Stroke

Background and Purpose: To identify the qualitative and quantitative contributions of conventiona... more Background and Purpose: To identify the qualitative and quantitative contributions of conventional risk factors for occurrence of ischemic stroke and its key pathophysiologic subtypes among West Africans. Methods: The SIREN (Stroke Investigative Research and Educational Network) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with ischemic stroke who were etiologically subtyped using the A-S-C-O-D classification into atherosclerosis, small-vessel occlusion, cardiac pathology, other causes, and dissection. Controls were age- and gender-matched stroke-free adults. Detailed evaluations for vascular, lifestyle, and psychosocial factors were performed. We used conditional logistic regression to estimate adjusted odds ratios with 95% CI. Results: There were 2431 ischemic stroke case and stroke-free control pairs with respective mean ages of 62.2±14.0 versus 60.9±13.7 years. There were 1024 (42.1%) small vessel occlusions, 4...

Movement Disorders Clinical Practice