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Glycemic Control among Medical Outpatients in Enugu: A Cross Sectional Survey

Journal of Diabetes Mellitus 2019年第2期9卷 50-61页

作者： Obinna Donatus Onodugo Birinus Adikaibe Ezeala-Adikaibe Obumneme Benneth Anyim Pascaline Onodugo Ijeoma Nnene Anyim nkeiruka Chigekwu mbadiwe Ekenechukwu Young Michael Abonyi Gideon Anigbo Ifeomai Ulas Uzoma Chukwunonso Okechukwu 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

Background: Diabetes in Nigeria presents a rising public health challenge and many cases are probably undetected. Poor glycemic control is a risk factor to both micro and macro vascular complications of diabetes and a major factor in the burden of the disease world-wide. The aim of the present study was to determine the pattern of glycemic control among adult diabetes patients attending a medical outpatient clinic in Enugu. Methods: Using a semi-structured questionnaire, we conducted a cross sectional descriptive study of patients with diabetes attending the medical out-patient clinic of one of the tertiary Hospitals in Enugu, Nigeria. Good glycemic control was defined as fasting blood glucose of less than 100 mg/dl. Study duration was 6 months. Statistical analyses were done using SPSS software. Results: A total of 119 participants were recruited for the study: 74 (62.2%) females and 45 males (37.8%) with a mean age of 62.2 (11.7) years. The mean systolic and diastolic blood pressure was 138.4 (24.3) mmHg and 81.2 (12.9) mmHg respectively. Eight (6.7%) had a docu-mented history of diabetes-related coma in the past. The mean fasting blood glucose was 127.9 (22.4) mg/dl. Good, fair and poor glycemic control was achieved in 16.8%, 30.3% and 63% (52.9%) respectively. Correlation statistics showed that low level of adherence and abstaining from alcohol/tobacco are correlated with poor glycemic control. Conclusion: Majority (52.9%) of patients with diabetes attending a tertiary health center in Enugu, Nigeria has poor glycemic control status. Medication adherence and substance use are correlated with poor control.

关键词： Diabetes Glycemic Control Enugu Nigeria

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Correlates of Tobacco and Marijuana Use among Urban Dwellers in Enugu, Nigeria

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Open Journal of Preventive Medicine 2019年第7期9卷 80-94页

作者： Onodugo Obinna Donatus Orjioke Casmir Obumneme Bennett Anyim Ezeala-Adikaibe Birinus Adikaibe Chime Peter Onodugo Pauline Nkiruka mbadiwe nkeiruka Obumneme-Anyim Ijeoma Nnenne Ekochin Fintan Achor Justin Ezeala-Adikaibe Ngozi Praise Department of Medicine University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Enugu State University of Science and Technology Teaching Hospital Enugu Nigeria Department of Pediatrics University of Nigeria Teaching Hospital Enugu Nigeria Federal Neuropsychiatric Hospital Enugu Enugu Nigeria Department of Community Medicine University of Nigeria Teaching Hospital Enugu Nigeria

Introduction: Tobacco and marijuana use is a public health challenge all over the world and especially in Sub Saharan Africa. The combination of low socioeconomic status and substance use can be described as a social and economic disaster for many poor families of Africa. While majority of studies concentrated on cigarette smoking, few studies in Nigeria has been conducted on non-smoke forms of tobacco. The burden of marijuana abuse is also rising in the Nigeria. Similar to cigarette smoking, cannabis use is more common among males. Knowledge of the pattern of tobacco and cannabis use in the community is important considering the public health implications. The aim of this study was to determine the prevalence of tobacco (cigarette smoking and snuff) and cannabis use among adults in an urban communities Enugu, southeast Nigeria. Methods: This was a cross-sectional descriptive study conducted in urban slum settlements in Enugu, the capital of Enugu State, southeast Nigeria. Using a semi structured questionnaire, we collected data selected socio-demographic characteristics, including tobacco use and cannabis use in the last 30 days. The study was conducted between August and December 2013. For database management and statistical analyses, we used the SPSS version 23. Results: The total number of individuals recruited in the study was 1572;844 (52.8%) females and 728 (45.5%) males with a male to female ratio of 0.9:1. Tobacco was used by a total of 270 (17.2%) individuals within the last 4 weeks and marijuana by 23 (1.5%) of the population. Overall, 280 (17.8%) used either one or both tobacco and marijuana. While snuff was predominately used from 60 years and above, cigarette smoking peaked at 30 - 39 years and marijuana use peaked at a younger age of 20 - 29 years. Cigarette smoking positively correlated with male gender (male 1, female 0) and alcohol use (Yes 1, No 0). P Conclusion: The prevalence of cigarette smoking (5.5%), snuff (11.6%) and marijuana use (1.6%) wa

关键词： Tobacco Cigarette Snuff Alcohol Marijuana Nigeria

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Diabetes and Pre-Diabetes among Adults in an Urban Slum in South East Nigeria

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Journal of Diabetes Mellitus 2018年第4期8卷 131-144页

作者： Birinus Adikaibe Ezeala-Adikaibe nkeiruka mbadiwe Celestine Okwara Obinna Onodugo Chinwe Onyekonwu Uchenna Ijoma Oluchi Stella Ekenze Casmir Orjioke Peter Chime Eddy Aneke Chidimma Brenda Nwatu Ekenechukwu Young Obumneme Anyim Department of Medicine University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Enugu State University Teaching Hospital Enugu Nigeria

Background: Despite the rising prevalence of diabetes in Nigeria and sub-Saharan Africa, few studies have assessed the prevalence of prediabetes and diabetes in people with low socioeconomic status or urban slums. Methods: Using the WHO STEP-wise approach to surveillance of noncommunicable diseases, we estimated the prevalence of diabetes and prediabetes among adults 20 years and older living in two urban slums in Enugu south east Nigeria. Diabetes was defined as previous history of diabetes, use of hypoglycemic agents and fasting blood glucose within the diabetes range on two occasions during the survey period. Study duration was 5 months. Results: Out of the 811 individuals invited to the clinic, 605 (74.6%) participants had their fasting blood glucose measured based on the study protocol. The prevalence of diabetes and prediabetes in the population was 11.7% (95% CI;9.2 - 14.3) and 7.6% (95% CI;5.0 - 9.7) respectively. About 54.9% were newly detected and 28.1% of them had normal control. The prevalence of diabetes peaked at 55 - 64 years. The odds ratio for diabetes was significantly higher in participants ≥ 45 years (1.033, 95% CI;1.208 - 3.420), participants with hypertension (0.442, 95% CI;0.257 - 0.762) and stroke (1.638, 95% CI;0.459 - 5.848). Conclusion: There is a relatively high prevalence of diabetes among adults in two urban slums in Enugu. Public health educational measures promoting prevention and early detection of diabetes should be encouraged. Efforts should be made to educate the populace on the need for early detection and treatment.

关键词： Diabetes Nigeria Obesity Prediabetes Epidemiology Urban Dwellers

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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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The Prevalence of Stroke Survivors in Urban Slums in Enugu, Nigeria

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Open Journal of Preventive Medicine 2019年第6期9卷 51-67页

作者： Oluchi Stella Ekenze Ezeala-Adikaibe Birinus Adikaibe Onodugo Obinna Chime Peter Orjioke Casmir Onodugo Pauline Nkiruka mbadiwe nkeiruka Onyekonwu Chinwe Ijoma Nkemdilim Uchenna Okoye Julius Uwabunkeonye Obumneme-Anyim Ijeoma Nnenne Ekochin Fintan Ernest Okwundu Nwazor Emmanuel Uzodimma Iwuozo Department of Medicine University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Enugu State University of Science and Technology Teaching Hospital Enugu Nigeria Department of Pediatrics University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Federal Medical Center Owerri Nigeria Federal Medical Center Makurdi Nigeria

Background: Stroke is one of the commonest non-communicable diseases and the commonest cause of death in adult neurology wards. Stroke preva-lence in sub Saharan Africa has dramatically increased over the past decades possibly due to changing life styles, poverty, poor health infrastructures which had led to increased risk factors for stroke. Poor nutrition and lack of access to standard medical care, predispose to high rates of stroke morbidity and mor-tality hence possible low prevalence. Little is known about the prevalence of stroke in people with low socio-economic status in Nigeria. Objectives: The main objective of this study was to determine the prevalence of stroke in two urban slums in south east Nigeria. Materials and Methods: This was a cross sectional descriptive study carried out in two slums in Enugu, South East Nige-ria. Participants were screened using a stroke specific questionnaire and further examined by two independent neurologists for evidence of focal neurological deficits. Analysis was done by SPSS version 22. Results: A total of 1440 par-ticipants were surveyed in the study;769 (53.4) females and 671 (46.6%) males. About 22.3% (321) screened positive for various neurological diseases out of which 17 (5.3%) had evidence for stroke giving an overall prevalence of 1.2% (males 9 (1.3%) vs females 8 (1%) p = 0.6). The mean age of stroke sur-vivors was 60.1 years, similar in males and females (p = 0.6). The odds ratio for stroke from 40 years showed progress increment doubling between 60 and 70 years and tripled between 40 and 70 years. Age, lower level of education, positive history of hypertension, sickle cell disease, leg swelling and use of snuff positively are correlated with clinical diagnosis of stroke. Conclusion: The prevalence of stroke in two urban slums in Enugu metropolis was 12/1000. Hypertension, diabetes, use of snuff, and low levels of education were signifi-cant risk factors for stroke. Public health educational measures, promoti

关键词： Stroke Prevalence Nigeria

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Factors Associated with Overweight and Obesity in an Urban Area of South East Nigeria

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Food and Nutrition Sciences 2019年第7期10卷 735-749页

作者： Uchenna Nkemdilim Ijoma Peter Chime Chinwe Onyekonwu Birinus Adikaibe Ezeala-Adikaibe Casmir Orjioke Obumneme Benneth Anyim Obinna Donatus Onodugo Eddy Aneke Chidimma Brenda Nwatu Ekenechukwu Young nkeiruka mbadiwe Oluchi Stella Ekenze Julius Uwabunkeonye Okoye Michael Abonyi Ifeoma Isabella Ulasi Anthony Mbah Pauline Nkiruka Onodugo Department of Medicine University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Enugu State University Teaching Hospital Enugu Nigeria

Background: Overweight and obesity present a growing health problem among Africans from all socioeconomic status. In Sub Saharan African, obesity is not only a consequence of overnutrition but possibly from excessive consumption of unbalanced diet dominated by carbohydrates and saturated fats. Characteristics of the distribution of obesity/overweight in Nigeria include its high prevalence along with socioeconomic class and in mid-life. Methods: Using the WHO STEP-wise approach to surveillance of noncommunicable diseases, we conducted a cross-sectional descriptive study of the adult population living in two urban slums in Enugu. The study was carried out in 2013. Statistical analysis was done using SPSS version. Results: A total of 605 (414 women (68.4%) and 191 (31.6%) men were recruited and analysed. The mean body mass index was 25.8 kg/m2 higher in females (26.7 kg/m2) than males (24 kg/m2) p is 29.4% (178/605) and 19.5% (118/605) respectively. There also a modest prevalence of underweight 4% (24/605) among the population. All classes of obesity were significantly more prevalent in females. Significant positive correlates of BMI were: female sex (r = 0.21, p < 0.001), systolic blood pressure (0.25, p < 0.001), DBP (0.27, p < 0.001), fasting blood glucose (0.19, p < 0,001) and positive history of hypertension (0.23, P < 0.001). Negative correlates were physical activity and use of tobacco (0.2 (<0.001) and -0.16 (Conclusion: The prevalence of obesity is relatively high in two urban slums in Enugu and co-exists with a modest rate of underweight. Public health and community-based approaches should be used to tackle these two-opposing social/health problems.

关键词： Obesity Overweight Hypertension Diabetes Nigeria

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

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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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Screening of ethyl acetate extract of Bridelia micrantha for hepatoprotective and anti-oxidant activities on Wistar rats

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Asian Pacific Journal of Tropical Medicine 2011年第10期4卷 796-798页

作者： Nwaehujor Chinaka O Udeh nkeiruka E Department of Veterinary Physiology and Pharmacology University of NigeriaNsukkaEnugu StateNigeria Department of Veterinary Physiology and Pharmacology Michael Okpara University of AgricultureUmudikeAbia StateNigeria

Objective:To explore the hepatoprotective and anti-oxidant activities of the methanolic leaf extract of Bridelia micrantha(***) on paracetamol induced liver damage in Wistar rats. Methods:Parameters were measured including alanine aminotransaminase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),bilirubin and total *** anti-oxidant effects were studied using the 1,l-Diphenynl-2-Picrylhydrazyl(DPPH) and Ferric Reducing Antioxidant Power(FRAP) assay ***:*** extract decreased the level of AST in the rats given PCM from(129.47±0.921) IU/L to(57.78±1.71) IU/L(P<0.05).This was lower than the value for Silymarin which was(59.92±1.41) IU/*** concentration was reduced from (150.18±2.23) IU/L to(79.10±2.01) IU/L(P<0.05).ALP was reduced from(49.86±0.85) IU/L to(29.64±1.53) IU/L(P<0.05).Total bilirubin was reduced from(2.14±0.10 mg/dL) to(0.18±0.07) mg/dL (P<0.05) while total protein was increased from(4.26±0.30) mg/dL to(6.20±0.19) mg/dL(P<0.05). Concentrations ranging from 10 - 400μg/mL of *** were assayed for antioxidant *** DPPH assay showed 98%antioxidant activity at concentration of 400μg/mL. The FRAP values were 0.016,0.39,0.455,0.601 and 1.382μM at 10.50,100,200 and 400μg/ mL ***:Results suggest that *** has hepatoprotective and anti oxidant ***,further work involving fractionation needs to done to isolate the active compound responsible for the hepatoprotective activity.

关键词： Bridelia micrantha Ethyl acetate leaf extract Hepatoprotective Antioxidant

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Effect of Processing Methods on the Nutrient and Phytochemical Properties of African Oil-Bean Seeds(Pentaclethra macrophylla),“Ugba”

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Journal of Food Science and Engineering 2018年第5期8卷 191-197页

作者： Oly-Alawuba nkeiruka Anunukem Deborah Department of Nutrition and Dietetics College of Health SciencesImo State UniversityOwerri23483Nigeria

The study assessed the effect of different processing methods on the phyto-chemical and nutrient properties of Africa oil-bean seeds Pentaclethra macrophylla,commonly known as *** is a traditional food,consumed by over 20 million people in *** is a rich and available source of protein for people,whose staple foods are deficient in *** ugba seeds were subjected to different processing methods,which included:boiling,soaking,drying,and fermentation at different degrees,of 24 h,48 h and 72 *** samples were dried and examined on their nutrient,anti-nutrient and phyto-chemical *** sensory properties of the samples were *** result showed significant difference(p<0.05)in the nutrients,ant-nutrient and organoleptic properties of ugba *** protein value of ugba samples,fermented for 72 h was highest(36.13%),in relation to the raw samples(29.49%).According to Ref.[1],fermentation may significantly improve the nutritive value of foods by:increasing the digestibility of protein through hydrolysis of proteins and amino *** samples that were boiled,had the highest(32.09%)fat content while the 24 h fermented samples had the least value(30.09%).The crude fiber and carbohydrate values of the raw ugba samples was highest(4.11%and 22.21%respectively).The ugba sample fermented for 72 h,recorded highest for calcium(34.13 mg/100 g),potassium(258.04 mg/100 g)and phosphorous(231.91 mg/100 g)in relation to other *** result supports the claim by Ref.[2]that fermentation is associated with microbial activities which stimulate better nutrient availability(particularly protein)and *** anti-nutrient composition of the samples *** 72 h fermented ugba had the least values for tannin(0.01 mg/100 g),phytate(0.01 mg/100 g)and oxalate(0.02 mg/100 g).Furthermore,the low level of phytate observed in this study is desirable because increased phytate level in the body,affects the availability of minerals,solubility fu

关键词： Oil-bean seed processing methods phytochemicals nutrients

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Antidiarrheal effects of hydromethanolic extract of Combretum dolichopetalum leaves in mice

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Journal of Coastal Life Medicine 2015年第11期 910-913页

作者： Samuel Okwudili Onoja nkeiruka Emmanuela Udeh Department of Veterinary Physiology PharmacologyBiochemistry and Animal Health and ProductionCollege of Veterinary MedicineMicheal Okpara University of AgriculturePMB 7267UmudikeAbia StateNigeria

Objective:To evaluate the antidiarrheal activity of the hydromethanolic extract of Combretum dolichopetalum(***)***:The antidiarrheal activity of the hydromethanolic extract of *** leaves was evaluated by inducing diarrhea with castor oil,testing small intestinal motility and establishing enteropooling models in *** groups of animals were used for each model and were treated as follows:Group A received 10 mL/kg of distilled water,and Group B received loperamide(5 mg/kg)while Groups C,D,E received 50,100 and 200 mg/kg of hydromethanolic *** extract,***:The pre-treatment of the mice with the extract(50,100 and 200 mg/kg)caused a significantly dose-dependent decrease in the mean percentage of wet faeces(P0.05),compared with the negative ***:The study shows that *** leaves possess antidiarrheal activity and validate its use in ethnomedicine for that purpose.

关键词： Antidiarrheal Loperamide Castor oil Charcoal meal Enteropooling

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