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Search Results: 1 - 10 of 171788 matches for " Henry E. Okafor "
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Characterization of Genome-Wide Association-Identified Variants for Atrial Fibrillation in African Americans
Jessica T. Delaney, Janina M. Jeff, Nancy J. Brown, Mias Pretorius, Henry E. Okafor, Dawood Darbar, Dan M. Roden, Dana C. Crawford
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0032338
Abstract: Background Despite a greater burden of risk factors, atrial fibrillation (AF) is less common among African Americans than European-descent populations. Genome-wide association studies (GWAS) for AF in European-descent populations have identified three predominant genomic regions associated with increased risk (1q21, 4q25, and 16q22). The contribution of these loci to AF risk in African American is unknown. Methodology/Principal Findings We studied 73 African Americans with AF from the Vanderbilt-Meharry AF registry and 71 African American controls, with no history of AF including after cardiac surgery. Tests of association were performed for 148 SNPs across the three regions associated with AF, and 22 SNPs were significantly associated with AF (P<0.05). The SNPs with the strongest associations in African Americans were both different from the index SNPs identified in European-descent populations and independent from the index European-descent population SNPs (r2<0.40 in HapMap CEU): 1q21 rs4845396 (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.13–0.67, P = 0.003), 4q25 rs4631108 (OR 3.43, 95% CI 1.59–7.42, P = 0.002), and 16q22 rs16971547 (OR 8.1, 95% CI 1.46–45.4, P = 0.016). Estimates of European ancestry were similar among cases (23.6%) and controls (23.8%). Accordingly, the probability of having two copies of the European derived chromosomes at each region did not differ between cases and controls. Conclusions/Significance Variable European admixture at known AF loci does not explain decreased AF susceptibility in African Americans. These data support the role of 1q21, 4q25, and 16q22 variants in AF risk for African Americans, although the index SNPs differ from those identified in European-descent populations.
Determination of nitrate, nitrite, N- nitrosamines, cyanide and ascorbic acid contents of fruit juices marketed in Nigeria
PN Okafor, E Nwogbo
African Journal of Biotechnology , 2005,
Abstract: The nitrate, nitrite, N- nitrosamines and ascorbic acid content as well as the levels of cyanide in eight brands of fruit juices and twelve brands of sachet water commonly marketed and consumed in Nigeria were estimated. The mean values of nitrate ranged from 2.29±0.05 to 16.50±1.21 mg/L for the juices and 0.64±0.21 to 7.56±3.10 mg/L for sachet water. While the mean concentration of nitrite ranged from 6.84±0.47 to 12.03±1.07 and 0.12±0.02 to 4.42±0.33 mg/L for juices and sachet water, respectively. Four out of the eight brands of juices analyzed contained detectable levels of nitrosamines (2.75±0.47 to 45.70±3.07 ìg/L) while none of the samples contained any detectable amount of cyanide. Ascorbic acid concentrations of the samples varied from 100 to 400 mg/L. The results are discussed from nutritional and toxicological points of view.
Pattern of Mortalities among Orthopaedic and Trauma Admissions in Irrua  [PDF]
E. O. Edomwonyi, R. E. Enemudo, I. A. Okafor
Open Journal of Orthopedics (OJO) , 2015, DOI: 10.4236/ojo.2015.57024
Abstract: Background: There are many reports from different parts of the world addressing different aspects of surgical mortality. However, none has been done in this centre as it relates to orthopaedics and trauma admissions. Such data are invaluable to health planning and epidemiological monitoring. Objective: To retrospectively review all mortalities arising from orthopaedics and trauma admission as they present to Irrua specialist Teaching Hospital (ISTH) Irrua from Jan 2005-Dec 2014. Method: Medical records of case mortalities among orthopaedic and trauma admissions over ten years (Jan 2005-Dec 2014) were retrospectively reviewed. Results: Over this period, 2129 admissions and 45 deaths were recorded, with an overall crude mortality rate of 2.11%. No death was recorded among the paediatric age group. Thirty-four patients (75.56%) died from trauma (fracture) related diagnosis, majority of which were from head injury followed by infection 5 (11.11%), tumours 4, (8.89%) and disc herniation 2 (4.44%). Males were more affected 77.78% and median age at death was 44 years. Medical co-morbidities were found in 37.77% of the deceased patients. Conclusion: Patients with trauma related cases particularly head injuries, topped the list of mortalities. Young and middle aged adult males were most affected. Need for manpower development, investment in diagnostic and therapeutic facilities and preventive measures is emphasised.
Psychiatric Diagnoses of Patients Presenting with Functional Somatic Symptoms in a Primary Care Clinic at a University Teaching Hospital in Nigeria  [PDF]
Chidi J. Okafor, Owoidoho Udofia, Essien E. Ekpe
Open Journal of Depression (OJD) , 2015, DOI: 10.4236/ojd.2015.43004
Abstract: Background: A number of patients that attend primary care medical settings present with distressing bodily complaints which are not attributable to organic (physical) pathology. The difficulties in diagnosing and treating such patients have been observed by many Health Care Practitioners. This study assesses the presence of psychological conditions and attempts to make psychiatric diagnoses (using a standardized diagnostic instrument) in patients presenting with Functional Somatic Symptoms (FSS) in a primary care clinic at the University of Calabar Teaching Hospital. Method: The study was carried out at the General Out Patients Clinic (GOPC) of the University of Calabar Teaching Hospital (UCTH). It was a cross-sectional study of a convenience sample of 100 randomly selected patients presenting with Functional Somatic Symptoms. Those who consented filled the modified version of the Enugu Somatization Scale and were interviewed with the Schedule for Clinical Assessments in Neuropsychiatry (SCAN) for possible psychiatric diagnoses. Results: While 41 of the selected patients were males, 59 were females. Their mean age was 38.5 (SD = 12.2). Frequent headaches and body heat (internal heat) were the most prevalent symptoms in the patients. ICD-10 psychiatry diagnoses using the SCAN were made in 79% of the patients studied. Depressive disorders (diagnosed in 48% of the patients) and anxiety disorders (in 21%) were the most common diagnoses. Older patients were mainly diagnosed of depressive disorders (p = 0.016) whereas younger patients tended to receive diagnoses of anxiety disorders (p = 0.039). Conclusion: Patients presenting with FSS may have diagnosable psychiatric disorders which if not recognized would go untreated. Psychiatric referral may therefore reduce the sufferings of the patients.
Assessment of the Knowledge and Practice of Fitness to Drive among Commercial Long Distance Drivers in Benin City  [PDF]
K. C. Okafor, E. C. Azuike, O. H. Okojie
Advances in Physical Education (APE) , 2018, DOI: 10.4236/ape.2018.82019
Abstract: Commercial long distance driving is progressively growing and accounts for significant part of the socio-economic life of the populace as individuals and families travel from one destination to another. Driver’s role in road safety is attracting global attention as a component of the tripod system consisting of the road user, road environment and vehicle system. Unfortunately, most drivers are unaware of the need to have regular driver’s fitness assessment. This study aimed at assessing the drivers’ knowledge and practice of fitness to drive among commercial long distance drivers in Benin City, Edo State. A descriptive cross sectional study design was used, and data were collected from 315 commercial long distance drivers and their vehicles. Study was done from January to October, 2013. Respondents were recruited using systematic random sampling technique. Study instruments included structured interviewer administered questionnaires and focus group discussion guide. The results showed that 114 (36.2%) were within the age group of 31 - 40 years. Ninety-one (28.9%) were in the 41 - 50 years age group and almost all the respondents 311 (98.7%) were males while 4 (1.3%) were surprisingly females. Of the 315 respondents, 177 (56.2%) were aware of “medical examination for drivers”. More than half (54.3%) of commercial drivers had poor knowledge of fitness to drive. Over three quarters (79.7%) had poor practice of fitness to drive. The respondents who were not seeing a doctor for treatment were less likely (B = -0.845) to have good knowledge of fitness to drive compared to those who were being treated by a doctor with odds of 0.446. This was statistically significant (p = 0.038). Of all the predictors of good practice of fitness to drive, good knowledge of fitness to drive and history of occurrence of RTA were statistically significant predictors. Most commercial drivers had poor knowledge and practice of fitness to drive. It is recommended that health education and enlightenment should be done by transport park management. Fitness to drive should be enforced among drivers by road safety and drivers licensing agencies.
Outcome and Challenges of Kidney Transplant in Patients with Sickle Cell Disease
U. H. Okafor,E. Aneke
Journal of Transplantation , 2013, DOI: 10.1155/2013/614610
Abstract: Sickle cell nephropathy is a common presentation in patients with sickle cell disease. End-stage kidney disease is the most severe presentation of sickle cell nephropathy in terms of morbidity and mortality. Sickle cell disease patients with end-stage kidney disease are amenable to renal replacement therapy including kidney transplant. Kidney transplant in these patients has been associated with variable outcome with recent studies reporting short- and long-term outcomes comparable to that of patients with HbAA. Sickle cell disease patients are predisposed to various haematological, cardiorespiratory, and immunological challenges. These challenges have the potential to limit, delay, or prevent kidney transplant in patients with sickle cell disease. There are few reports on the outcome and challenges of kidney transplant in this group of patients. The aim of this review is to highlight the outcome and challenges of kidney transplant in patients with sickle cell disease. 1. Introduction Sickle cell disease (SCD) is a haematological disorder associated with multisystemic complications and manifestations [1]. There had been significant improvement in the outlook of adults with sickle cell disease. The Cooperative Study of Sickle Cell Disease (CSSCD) and other observational studies had helped to define the prognosis and common complications that occur as the patient ages. Improvement in management of infections and central nervous system (CNS) complications in childhood, active health maintenance for adults, new interventions, and improved psychosocial support have all contributed to a reduction in morbidity and mortality. More than 90 percent of patients of all phenotypes will survive for more than 20 years, and significant numbers are older than age of 50 years [1]. Thus, chronic and long-term complications associated with SCD including sickle cell nephropathy/end stage renal disease (ESRD) are becoming common. Treatment of sickle cell nephropathy is fraught with many challenges and has variable outcome. Renal replacement therapy is required in patients with uraemia, circulatory overload, pulmonary oedema, and ESRD. Kidney transplant is the treatment of choice for eligible patients with ESRD. However, kidney transplant is not readily available in most of the developing countries because of cost, poverty, few transplant centres, and lack of donors [2]. SCD and prevailing complications worsen these challenges, further limiting kidney transplant in these patients. The aim of this study is to review the available literature highlighting the outcome and
Biventricular Noncompaction Cardiomyopathy in a Patient Presenting with New Onset Seizure: Case Report
Oghenerukevwe Odiete,Ramanna Nagendra,Mark A. Lawson,Henry Okafor
Case Reports in Cardiology , 2012, DOI: 10.1155/2012/924865
Abstract: Ventricular noncompaction (VNC) of the myocardium is a rare genetic cardiomyopathy caused by a disorder during endocardial morphogenesis and could be accompanied by life-threatening complications. The major clinical manifestations of VNC are heart failure, arrhythmias, and embolic events. The left ventricle is the most commonly reported affected site, but a few cases of right ventricular involvement have also been reported. We report a case of biventricular noncompaction cardiomyopathy in a 31-year-old woman presenting with a new onset seizure. On the second day of her telemetry-monitored hospitalization, she suffered a witnessed ventricular fibrillation arrest requiring emergency direct-current cardioversion and induced hypothermia. Transthoracic echocardiography (TTE) showed isolated left ventricular (LV) noncompaction and depressed LV systolic function. Subsequent cardiac magnetic resonance imaging (MRI) revealed both left and right ventricular noncompaction. This unusual presentation highlights the importance of a complete and thorough evaluation of patients even when presenting with apparently noncardiac symptom(s).
Biventricular Noncompaction Cardiomyopathy in a Patient Presenting with New Onset Seizure: Case Report
Oghenerukevwe Odiete,Ramanna Nagendra,Mark A. Lawson,Henry Okafor
Case Reports in Cardiology , 2012, DOI: 10.1155/2012/924865
Abstract: Ventricular noncompaction (VNC) of the myocardium is a rare genetic cardiomyopathy caused by a disorder during endocardial morphogenesis and could be accompanied by life-threatening complications. The major clinical manifestations of VNC are heart failure, arrhythmias, and embolic events. The left ventricle is the most commonly reported affected site, but a few cases of right ventricular involvement have also been reported. We report a case of biventricular noncompaction cardiomyopathy in a 31-year-old woman presenting with a new onset seizure. On the second day of her telemetry-monitored hospitalization, she suffered a witnessed ventricular fibrillation arrest requiring emergency direct-current cardioversion and induced hypothermia. Transthoracic echocardiography (TTE) showed isolated left ventricular (LV) noncompaction and depressed LV systolic function. Subsequent cardiac magnetic resonance imaging (MRI) revealed both left and right ventricular noncompaction. This unusual presentation highlights the importance of a complete and thorough evaluation of patients even when presenting with apparently noncardiac symptom(s). 1. Introduction Ventricular noncompaction (VNC) of the myocardium is a rare genetic cardiomyopathy that is believed to arise from arrested endomyocardial development during embryogenesis [1]. It is a rare idiopathic cardiomyopathy with an incidence of about 0.05% [2, 3]. VNC is classified by the American Heart Association as a primary genetic cardiomyopathy [1] and is characterized by an altered myocardial wall with prominent trabeculae and deep intertrabecular recesses. This results a thickened bilayer of compacted and noncompacted myocardium [4], caused by the arrest of the normal process of endomyocardial morphogenesis. The normal process of trabeculation has been shown to be dependent upon secretion of neuregulin growth factors from the endocardium. Angiogenic factors, such as vascular endothelial growth factor and angiopoietin-1, may also be critical for normal trabeculae formation [5, 6]. The major clinical manifestations of VNC are heart failure, arrhythmias, sudden cardiac death, cardioembolic events, and syncope [7–9]. To our knowledge, seizures have not been previously reported as a manifestation of this condition. Here, we report a case of biventricular noncompaction cardiomyopathy in a young female presenting with new-onset tonic-clonic seizure. 2. Case Presentation A 31-year-old woman presented with a witnessed loss of consciousness while driving. The episode lasted for about five-to-ten minutes and was associated with
Iron, Zinc, and Copper Malnutrition among Primary School Children in Lagos, Niagara  [PDF]
Ifeoma A. Akeredolu, Babatunde E. Oguntona, Chinwe Okafor, Olufemi J. Osisanya
Food and Nutrition Sciences (FNS) , 2011, DOI: 10.4236/fns.2011.210142
Abstract: This study assessed the iron, zinc and copper status of primary school-attending children in Lagos. A sample of 200 primary School-attending children was randomly selected using a stratified 2 – stage sampling technique. Data was collected in the 2 major seasons in Nigeria; Dry and Rainy seasons using dietary intake (24 hr dietary recall protocol) venipuncture blood samples, and a self-administered questionnaire. The data were analyzed using descriptive and inferential statistics. Among ages 5 - 8 years, the main dietary intake for iron was 10.66 ± 12.44 mg/d (106% of DRI), for zinc, 7.30 ± 7.39 mg/d (92% of DRI) and for copper, 1.55 ± 1.31 mg/d (390% of DRI). For ages 9 - 13 yrs, the mean intake of micronutrients showed that iron was 11.03 ± 12.72 mg/d (138% of DRI), 3inc was 8.44 ± 7.7 mg/d (105% of DRI) and copper was 3.75 ± 15.17 mg/d (536% of DRI). Biochemical results indicated that 19.8% of the subjects had inadequate serum iron, 21% and 32.1% were zinc and copper deficient respectively prevalence of anemia was 38.1% while iron deficiency anemia was 13.06% and iron deficiency was 34.6%. Dietary intakes did not provide right amounts of micronutrients to meet body requirements. There is the need to formulate and implement nutrition education programs to correct micronutrient deficiency among primary school-attending children in Lagos, Nigeria.
Maternal outcome in eclamptic patients in abuja, nigeria a 5 year review.
E R Efetie, U V Okafor
Nigerian Journal of Clinical Practice , 2007,
Abstract: Objective: To assess the outcome of women admitted with eclampsia in the National Hospital, Abuja, Nigeria. Study Design/Setting: A retrospective analysis. The medical records register in the accident and emergency department, labour ward, maternity ward and the intensive care unit were searched to identify cases of eclampsia admitted at the National Hospital, Abuja (NHA) between 1st March 2000 and 28th February 2005. Results: The incidence of eclampsia was 7.8 per 1000 deliveries. Eclampsia significantly occured in nulliparous and unbooked mothers ( p < 0.001 & p < 0.0001 respectively). Most (71.5%) of mothers delivered by Caesarean section and the most common indication for this was an unfavourable cervix ( cervix thick, firm and closed when assessed at presentation in the labour ward). Nineteen (41.3%) of mothers developed complications with HELLP (hemolysis, elevated liver enzymes, low platelets) occurring in six patients (31.6%). There were 13 maternal deaths giving a case fatality rate of 28.3% and a maternal mortality ratio for eclampsia of 222/100,000. HELLP syndrome was responsible for 46.2% of deaths in the study. Conclusion: The maternal outcome of eclamptics in Abuja, Nigeria is poor and HELLP syndrome is a major contributor to the high fatality rate. Emphasis should be on primary preventive measures such as early, continuous, good antenatal care and improvement of intensive care facilities. More widespread use of Magnesium sulphate for anticonvulsant prophylaxis is advocated.
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