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Pattern, Precipitants and Short Term Outcome of Heart Failure Patients Managed at Federal Medical Centre Nguru, a Tertiary Health Centre in Yobe State Northeastern Nigeria

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International Journal of Clinical Medicine 2018年第5期9卷 432-444页

作者： Musa mohammed Baba Faruk Buba mohammed abdullahi talle Habu Abdul Department of Internal Medicine Federal Medical Centre Nguru Nguru Nigeria Department of Medicine College of Medical Sciences University of Maiduguri Maiduguri Nigeria

Heart Failure (HF) is a syndrome characterized by typical symptoms (e.g. breathlessness, ankle swelling and fatigue) that may be accompanied by signs (e.g. elevated jugular venous pressure, pulmonary crackles and peripheral oedema) caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. Clinical studies investigating the aetiological patterns of heart failure in Sub-Saharan Africa (SSA) revealed that hypertension, cardiomyopathy and rheumatic heart disease account for more than two-thirds of cardiac disease cases. The objective of this study therefore is to assess the pattern, precipitating factors and short term outcome of heart failure among patients admitted into our hospital. Method: The study was a prospective cross-sectional type conducted among in patients with heart failure in the medical ward of the hospital. Results: A total of three and fifty four (354) subjects were recruited into the study, comprising one hundred and twenty nine males (36.4%) and two hundred and twenty five (63.4%) females. Majority of the patients were admitted in NYHA functional class IV. This however improved to class II at discharge though few were discharged in NYHA class III. Heart failure secondary to progressive hypertensive heart disease was the most common (39.0%) followed by peripartum cardiomyopathy (22.6%) while idiopathic dilated cardiomyopathy (11.0%) and rheumatic heart disease (7.3%) were the third and fourth causes of heart failure respectively. The most common precipitating factor for heart failure in this study was chest infection (44.9%). In conclusion, the study revealed that progressive hypertensive heart disease was the leading cause of heart failure, followed by peripartum cardiomyopathy while idiopathic dilated cardiomyopathy and rheumatic heart disease were ranked third and fourth causes of heart failure respectively. Though myocardial infarction is on

关键词： Patterns Precipitant Short Term Outcome Heart Failure

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Left Atrial Myxoma in a Woman with Postpartum Heart Failure: The Culprit or an Incidental Bystander

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Case Reports in Clinical Medicine 2018年第1期7卷 63-69页

作者： Musa mohammed Baba mohammed abdullahi talle Faruk Buba Kabir M. Fagge Department of Internal Medicine Federal Medical Centre Nguru Nguru Nigeria Department of Medicine College of Medical Sciences University of Maiduguri Maiduguri Nigeria Ma’aji Amar Muhammad Hospital Limited Hadejia Nigeria

Myxoma is a benign and the most frequent tumor of the heart, accounting for approximately 30% of all primary cardiac tumors. Seventy five percent of atrial myxomas are in the left atrium. We present a case of a 20-year-old house wife presenting with biventricular heart failure and chest infection five months after her last child birth. Transthoracic echocardiography showed a mobile left atrial echogenic mass measuring 4.6 × 4.0 cm attached to the interatrial septum. Left ventricular systolic function was mildly reduced (EF 48%) with mitral and tricuspid incompetence. A diagnosis of left atrial myxoma with biventricular heart failure with chest infection was made. She improved on antibiotics and treatment of heart failure, and referred to Aminu Kano Teaching Hospital for further management.

关键词： Myxoma Left Atrium Postpartum Heart Failure

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Sudden Cardiac Death: Clinical Perspectives from the University of Maiduguri Teaching Hospital, Nigeria

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World Journal of Cardiovascular Diseases 2015年第5期5卷 95-106页

作者： mohammed abdullahi talle Aimé Bonny Bukar Bakki Faruk Buba Charles Oladele Anjorin Haruna Yusuph Adama Kane University of Maiduguri Teaching Hospital Maiduguri Nigeria Teaching Hospital Laquintinie University of Douala Douala Cameroon Service de Cardiogie Centre Hospitalier le Dantec Dakar Senegal

Despite tremendous advances in the management of cardiovascular diseases and cardiac arrest, there is paucity of information regarding sudden cardiac death in sub-Saharan Africa. We present a two-year review of sudden cardiac death cases among patients managed at a Nigerian tertiary hospital. Patients admitted from January 2012 to December 2013 were prospectively followed-up and cases of sudden cardiac death identified. Diagnosis was based on records of events preceding death, direct interview of attending physician/nurses, and family members/eye witnesses for out-of-hospital sudden cardiac death. Causes of death were obtained from the death certificates for cases of in-hospital events. Three hundred and eighty eight (M:F = 1:1.3) patients with a mean age of 42.22 ± 19.30 years were admitted into the cardiac unit during the period, out of whom 56 (14.4%) died. Twenty three (41.1%) were classified as sudden cardiac death. The predominant etiology was ischemic cardiomyopathy (39.1%), followed by peripartum cardiomyopathy (21.7%) and dilated cardiomyopathy (17.4%). Rheumatic heart disease was diagnosed in 17.4%, while 4.3% had pulmonary hypertension. Nineteen (82.6%) of the subjects had congestive cardiac failure. Hypokalemia and hypocalcaemia were recorded in 2 (8.7%) patients who developed prolongation of the QT interval following commencement of diuretics. Chest-compression-only cardiopulmonary resuscitation was attempted in 12 (52.1%) with a success rate of 8.3%. Sudden cardiac death is common among our patients admitted with cardiovascular diseases. The most common etiology is ischemic cardiomyopathy, followed by peripartum cardiomyopathy. Most of the victims were young, and there were no optimum resuscitative measures.

关键词： Sudden Cardiac Death Nigeria Etiology Prevalence Outcome

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Seroprevalence of and Risk Factors for Cytomegalovirus among HIV-Infected Patients at University of Maiduguri Teaching Hospital, Nigeria

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Open Journal of Immunology 2014年第2期4卷 54-59页

作者： Ibrahim Musa Kida Ballah Akawu Denue Bukar Bakki Baba Goni Waru mohammed abdullahi talle Ibrahim Ummate Salisu Aliyu Kwayabura Ibrahim Shettima Kuburi Haruna Yusuph Department of Medicine College of Medical Sciences University of Maiduguri Maiduguri Nigeria Department of Obstetrics and Gynaecology College of Medical Sciences University of Maiduguri Maiduguri Nigeria.

Although the distribution of cytomegalovirus (CMV) infection has a wide regional variation, it is more common in Africa and Asia with high prevalence approaching 100% in some communities. CMV is a frequent opportunistic infection and major cause of morbidity and mortality among HIV patients with severe immunosuppression. It can be contracted from body fluid, including saliva, urine, blood, cervical secretions, and semen. CMV seropositivity is considered the best laboratory measure of past infection. We determined the prevalence of CMV and the risk factors associated with its acquisition in a population of HIV positive patients. Anti-CMV IgG seroprevalence was 100% among HIV infected subjects and 98.6% among controls. Having multiple sexual partners and traditional practices were identified as risk factors associated with risk of contracting CMV infection.

关键词： CMV Cytomegalovirus HIV Human Immunodeficiency Virus AIDS Acquired Immunodeficiency Syndrome IgG Immunoglobulin

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Arrhythmogenic Ventricular Dysplasia/Cardiomyopathy: Insights from the Rationale of Disease Nomenclature and Clinical Perspectives

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World Journal of Cardiovascular Diseases 2015年第8期5卷 218-226页

作者： Aimé Bonny mohammed A. talle Guy Fontaine Douala Cardiovascular Research Center University of Douala Douala Cameroon Clinique Paul Picquet Sens France Division of Cardiology Department of Internal Medicine University of Maiduguri Teaching Hospital/University of Maiduguri Maiduguri Nigeria Groupe Hospitalier Pitie Salpetriere Unite de Rythmologie Paris France

“Arrhythmogenic right ventricular dysplasia” (ARVD), a heart muscle disorder characterized by the presence of fibro-fatty tissue and ventricular electrical vulnerability related to sudden death, was first described in 1977 by a French team. Since then, other terms such as “arrhythmogenic right ventricular cardiomyopathy” (ARVC), “arrhythmogenic cardiomyopathy” (AC), “left-dominant arrhythmogenic cardiomyopathy” (LDAC), and “arrhythmogenic left ventricular dysplasia” (ALVD) have been introduced. These changes in nomenclature of the same disease entity are based on different explanations of pathomorphologic patterns. The dysplasia theory claims cardiac growth “maldevelopment” whereas the cardiomyopathy has been seen as an atrophy from acquired injury (myocyte death) and repair (fibrofatty replacement). The other area of divergent opinion is with regards to involvement of both ventricles rather than being an isolated right ventricular anomaly that may result in increased likelihood of diagnosing the concealed form manifesting with pre-dominant left ventricular arrhythmias. Multiple line of evidences support common disease path-ways: Presence of fibro-fatty and superimposed myocarditis, desmosome mutations and malfunc-tion. These compelling data regarding the heart growth, and pathological, clinical, phenotype/ genotype correlates have advanced our understanding of arrhythmogenic ventricular dysplasia/ cardiomyopathy and increased the diagnostic accuracy as well as providing an avenue for future development of new mechanism-based therapies.

关键词： Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Arrhythmogenic Cardiomyopathy Ventricular Arrhythmia Sudden Cardiac Death

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Congenital Heart Diseases Diagnosed on Transthoracic Echocardiography: Perspectives from the University of Maiduguri Teaching Hospital, Nigeria

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World Journal of Cardiovascular Surgery 2017年第4期7卷 55-65页

作者： Faruk Buba mohammed A. talle Charles O. Anjorin mohammed M. Baba Bello A. Ibrahim Department of Medicine College of Medical Sciences University of Maiduguri Maiduguri Nigeria Cardiology Unit Department of Medicine University of Maiduguri Teaching Hospital Maiduguri Nigeria Federal Medical Centre Nguru Nigeria Department of Paediatrics University of Maiduguri Teaching Hospital Maiduguri Nigeria

In a retrospective study of 1224 transthoracic echocardiograms performed between January 2011 and December 2013, we evaluated the spectrum of congenital heart disease (CHD) diagnosed at a tertiary referral centre in Maiduguri, north-eastern Nigeria. Diagnosis of CHD was made in 88 (8.3%) subjects, comprising 23 (26.1%) adults and 65 (73.9%) aged less than 18 years. Forty six (52.3%) of those with CHD were females, while 42 (47.7%) were males. The frequencies of the CHD in decreasing order were: ventricular septal defect 23 (26.1%), tetralogy of Fallot (TOF) 14 (15.9%) and atrial septal defect (ASD) and atrioventricular septal defect (AVSD) were 11 (12.5%) each. One of the patients with AVSD had Ellis Van Creveldt syndrome. Six (6.8%) cases of patent ductus arteriosus (PDA) were diagnosed in those younger than 18 years, while all the 5 (5.7%) cases of Ebstein’s anomaly were diagnosed in adults. There were 6 (6.8%) cases of Eisenmenger syndrome involving three cases of AVSD, one case of ASD and two cases of Ebstein’s anomaly. Timely definitive cares for these patients are still lacking in Nigeria and many areas of sub-Saharan Africa. We recommend sensitization of all relevant clinicians to actively look for congenital heart defects. Pulse oximetry and postnatal echocardiographic new-born screening which were previously validated should be implemented at secondary and tertiary levels, and efforts should be made towards providing the needed care for patients with CHD.

关键词： Congenital Heart Disease Transthoracic Echocardiography Nigeria

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