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Medical Morbidity Profile of Adults in a Rural Community in Enugu, Southeast Nigeria: A Cross Sectional Survey

Health 2023年第7期15卷 711-727页

作者： Nkeiruka Chigekwu Mbadiwe Birinus Adikaibe Ezeala-Adikaibe Celestine Chibuzor Okwara monday umeh nwobodo Fintan C. Ekochin Casmir Orjioke Nkiruka P. Onodugo Titus Okpara Denise Paul Okoli Uzoma C. Okechukwu Mark Ezeme Obumneme B. Anyim Grace O. Eneh Obinna Donatus Onodugo Innocent Okoye Uchenna N. Ijoma Department of Medicine Enugu State University Teaching Hospital Enugu Nigeria Department of Medicine University of Nigeria Teaching Hospital Enugu Nigeria Memfys Hospital for Neurosurgery Enugu Nigeria Anambra State University Teaching Hospital Awka Nigeria

Introduction: People in rural communities are exposed to the risk factors for non-communicable disease as those in urban areas. Correct interpretation and management of symptoms are important in primary care especially in rural communities where diagnostic facilities are not readily available. Materials and Methods: This was a cross-sectional study carried out in a village in Enugu South Local Government area of Enugu State. Thorough medical history was taken from all eligible participants who gave their consent. Data were analyzed using SPSS version 26. Results: Data from a total of 1019 (64.7%) out of 1576 participants were analysed. Fever was by far the most common presenting complaint 580 (56.9%) of all participants and 67.9% of medical complaints seen in the clinic. This was followed remotely by musculoskeletal problems and neurological problems 15.6% and 3.8% of the participants respectively. Across all age groups, febrile illness was more than non-febrile illness except in those 65 years. Generalized body pains 74 (7.3%), back pains 55 (5.1), headache 33 (3.2%) and abdominal pains 24 (2.4%) were the commonest symptoms presented by the participants. About 15 (1.5%) of the population surveyed had had trauma/surgery in the past. This was twice the number who presented to the clinic with symptoms related to injury and trauma 7 (0.7%). Conclusions: Fever and musculoskeletal pains are the dominant medical complaints presented by adults in a rural community clinic. This may be related to the season of the year and the occupation of the population studied.

关键词： Symptoms Infectious Diseases Non-Communicable Diseases Rural Community Southeast Nigeria

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Persistent Hiccups Following Use of Oral Dexamethasone: A Report of Two Cases from Abakaliki, Nigeria

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Case Reports in Clinical Medicine 2020年第9期9卷 282-287页

作者： Chukwuemeka O. Eze Thomas O. Nnaji monday U. nwobodo Internal Medicine Department Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) Ebonyi State Nigeria

Hiccups are common, usually mild with no obvious cause and often resolve spontaneously. They are classified as transient, persistent and intractable depending on the duration. Drug induced hiccups have been reported in medical literature but not common and corticosteroids are often cited. This report involved 2 male patients who developed persistent hiccups following use of oral dexamethasone for inflammatory conditions. The hiccups were severe and intolerable and could not stop despite use of metoclopramide and chlorpromazine. The hiccups only stopped following discontinuation of the dexamethasone. It should be noted that low dose of dexamethasone was used. Management of dexamethasone induced hiccups involves discontinuation of the drug, steroid rotation if the patient is steroid dependent and use of metoclopramide and chlorpromazine. Clinicians should be aware of this known but rare adverse effect of dexamethasone as it could be severe, distressful and negatively impart patients care. There is a need for a high index of suspicion whenever a patient develops hiccups while taking dexamethasone.

关键词： Persistent Hiccups Following Use of Oral Dexamethasone: A Report of Two Cases from Abakaliki Nigeria

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Mortality Pattern in Intensive Care Unit: Experience at Abakaliki Southeastern Nigeria

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World Journal of Cardiovascular Diseases 2020年第7期10卷 473-482页

作者： Chukwuemeka O. Eze Francis C. Okoro Thomas Nnaji monday nwobodo Uma Kalu Richard Ewah Internal Medicine Department Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) Ebonyi State Nigeria Anaesthesia Department Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) Ebonyi State Nigeria

Background: An intensive care unit (ICU) is a special unit of a hospital that provides intensive treatment for patients with severe or life-threatening illnesses and injuries, which require constant care and close monitoring with life support equipment. The mortality rate is still very high in most ICUs especially in the developing countries due to late presentation of patients, unavailability of well trained staff and lack of life support equipment. There has not been any previous study on the mortality pattern in ICU of Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA). It is against this background that we embarked on this retrospective descriptive hospital based study of the mortality pattern in ICU of a Tertiary Hospital in Abakaliki, South-eastern Nigeria. Method: This is a retrospective descriptive hospital based study. The admission and discharge registers of the ICU ward were used to extract information on biodata, diagnosis, duration and outcome of all admissions from January to December 2019 (12 months). Results: A total of 174 (male 113, female 71) patients were admitted over the 12 months period with mean age of 46.31 ± 12.28 years. Seventy-

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Impact of COVID-19 Pandemic on Haemodialysis Care at a Tertiary Centre in South East Nigeria

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Open Journal of Nephrology 2020年第4期10卷 383-387页

作者： Olaronke F. Afolabi monday U. nwobodo Chukwuemeka O. Eze Ugochukwu U. Nnadozie Department of Internal Medicine Alex-Ekweueme Federal University Teaching Hospital Abakaliki Nigeria African Institute for Health Policy and Health Systems Ebonyi State University Abakaliki Nigeria Division of Plastic Surgery Department of Surgery Alex-Ekweueme Federal University Teaching Hospital Abakaliki Nigeria

COVID-19 pandemic has had a significant impact on health services for patients suffering from chronic diseases. Patients suffering from kidney failure require heamodialysis and this modality of treatment is mostly offered in the hospital. Impacts of COVID-19 pandemic on haemodialysis care at a tertiary institution in South East, Nigeria include a reduction in the number of haemodialysis cases during the period of lockdown, an increase in the cost of heamodialysis, scarcity of materials used for the procedure and minor disruption of haemodialylsis care. An improvement in infection control practice at the dialysis unit is observed as a positive effect. It is advocated that the government should assist patients with kidney disease and make the procedure free to ameliorate the health and socio-economic hardships faced by the patients during the pandemic.

关键词： COVID-19 Heamodialysis Care Nigeria

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Prevalence of Carotid Atheromatous Plaques in Pre-Dialysis Chronic Kidney Disease Patients in South East, Nigeria

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World Journal of Cardiovascular Diseases 2020年第9期10卷 639-647页

作者： Olaronke F. Afolabi C. Uche Ibewuike Chukwuemeka O. Eze monday U. nwobodo Ifeoma I. Ulasi Department of Internal Medicine Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria Department of Radiation Medicine University of Nigeria Teaching Hospital Enugu Nigeria Department of Internal Medicine University of Nigeria Teaching Hospital Enugu Nigeria

Background: Chronic kidney disease (CKD) patients have considerably high atherosclerotic changes which predict cardiovascular events;hence, this study evaluated the prevalence of carotid atherosclerotic plaques in pre-dialysis CKD patients at a tertiary institution in south-east, Nigeria. Materials and Method: 107 pre-dialysis CKD patients were consecutively recruited for the study. 81 subjects who were screened and had no kidney disease served as control. The control group was sex and age matched with the CKD patients. A pre-tested questionnaire was administered to all participants and physical examination was done. Presence of atheromatous plaques was assessed using doppler ultrasound at 3 sites—distal common carotid artery (CCA), the internal carotid artery (ICA) and the carotid bulb by a single skilled radiologist specialized in doppler ultrasound. Results: Atheromatous plaques were significantly increased in CKD patients. 14.2% of CKD patients had atheromatous plaques versus 2.5% in the control group (p value Conclusions: Atheromatous plaques are prevalent in CKD patients. It is recommended that carotid doppler ultrasound should be done in CKD patients

关键词： Carotid Plaques CKD Predialysis Nigeria

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Factors Associated with Asymptomatic Proteinuria in Adult Nigerians. A Community-Based Study

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Health 2019年第6期11卷 609-620页

作者： Obinna Onodugo Adikaibe Ezeala-Adikaibe Casmir Orjioke Pauline Nkiruka Onodugo Uchenna Nkemdilim Ijoma Peter Chime Nkeiruka Mbadiwe Chinwe Onyekonwu Obumneme Benneth Anyim Ijeoma Nnenne Obumneme-Anyim Ekenechukwu Young Chidimma Brenda Nwatu Julius Uwabunkeonye Okoye monday Ume nwobodo Department of Medicine University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Enugu State University Teaching Hospital Enugu Nigeria Department of Pediatrics University of Nigeria Teaching Hospital Enugu Nigeria

Introduction: Early detection of proteinuria is early detection is a cost-effective method of assessing individuals with and without risk factors for chronic renal disease. Proteinuria is common in adults and may present a clinical challenge in the absence of obvious renal disease or risk factors especially in the tropics. Few studies in Nigeria have assessed the prevalence of proteinuria in adults using the dipstick method. The aim of this study was to document the prevalence of proteinuria among residents of a community in Enugu, south east Nigeria. Methods: This was a cross-sectional descriptive study carried out in an isolated urban slum settlement in Enugu, south east Nigeria. Dipstick testing of freshly voided early morning mid-stream urine samples was done to detect proteinuria. For database management and statistical analyses, SPSS version 23 was used. Results: A total of 262 individuals were recruited for the study, 165 (63%) females and 97 (37%) males. The participants’ age ranged from 18 to 90 years, averaging 43.7 ± 15.5. Trace amounts of protein were detected in urine samples of 225 (85.9%) individuals. Significant proteinuria was detected in 3.8% of the participants and was significantly higher 40 - 49-year-olds (6%). p = 0.02 and 0.02 respectively. Significant correlates of proteinuria were lower diastolic blood pressure and current tobacco use. Lower body mass index weakly correlated with proteinuria. Conclusion: The prevalence of significant early morning proteinuria in a community-based study in Enugu was 3.8%. Significant correlates of proteinuria included low diastolic blood pressure and tobacco use. Community based awareness programs targeted at prevention of chronic renal diseases should be incorporated in public health programs.

关键词： Proteinuria Chronic Renal Disease Risk Factors Nigeria

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