Browsing by Author "Mamven M.H."

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Crossed fused renal ectopia presenting as recurrent lower abdominal pain and urinary tract infection
(2013) Ajayi S.O.; Mamven M.H.; Tabari, A.; Ojji D.B.; Ibrahim A.
Background: Crossed fused renal ectopia is a relatively rare condition which may remain undiagnosed for a long time. Renal function is usually preserved. It usually involves the left kidney. It is usually associated with mal-rotation, and may be a cause of urinary tract infection, hydronephrosis and renal calculi. Material and method: We report a case of a 15- year old boy who was referred to our clinic with complaints of abdominal pain, and an ultrasound report of “absent right kidney”. Results: Urine examination indicated a partially treated infection, but the tests of kidney functions were normal. Intravenous urography confirmed crossed fused renal ectopia, and a flush aortogram showed two anomalous right renal arteries arising from the left side of aorta. Conclusion: An “absent” kidney in its normal location should prompt further investigations. Recurrent chronic lower abdominal pain and urinary tract infection in a young person may be due to congenital renal abnormality. Evaluation of persistent urinary abnormalities in a child should include screening for congenital abnormalities.
eGFR and chronic kidney disease stages among newly diagnosed asymptomatic hypertensives and diabetics seen in a tertiary health centre in Nigeria.
(2014) Ajayi S.O.; Mamven M.H.; Ojji. D.
Objectives: Moderate to severe CKD, may be symptomless and therefore may be undetected if effort is not made to assess kidney function. The aim of this study was to determine the eGFR of asymptomatic newly diagnosed hypertensives and diabetics with a view to creating awareness for early screening, evalu ation and intervention especially in resource poor settings where kidney replacement therapy is prohibitive. Design, Setting, Participants: This is a retrospective study. Records of all hypertensive and diabetic patients referred to the medical clinic were included in the study for analysis. They were considered newly diagnosed if they were just being referred and were not on antihypertensive therapy or had been on therapy only in the last one month. The diagnosis of diabetes mellitus was made according to the guideline of the American Diabetes Association. We included in the analysis patients who had anthropometric measurements and serum creatinine from which we calculated the eGFR. Main Outcome Measures: Use of eGFR and CKD stage in asymptomatic newly diagnosed hypertensives and diabetics. Results: Six hundred and twenty-eight patients were included in the study. The mean age (SD) for men and women were 50.19 (12.41) and 48.63 (14.43) respectively. A total of 242 (38.5%) had stage CKD stages 3a, 3b and 4 with a predominance of females: 184 (29.6%) vs 58 (9.2%). There was an association between CKD stage, sex (x25135.56, P,.001) and age (x2530.83, P5.01). Conclusion: A substantial number of asymptomatic patients with hypertension and diabetes have CKD stages 3 and 4, associated with age and sex, but not with the BP stage. Without a proper evaluation, which includes determination of GFR, significant deterioration of kidney function may be missed and an appropriate intervention may not be instituted
Pattern of prescription of anti-hypertensive medications in a tertiary health care facility in Abuja, Nigeria.
(2013) Ojji D.B.; Ajayi S.O.; Mamven M.H.; Alfa J.; Albertino D.
Introduction: Marked changes have been made in the pharmacotherapy of hypertension over the years. In sub-Saharan Africa, hypertension pharmacotherapy is often thought to include only thiazide diuretics, beta blockers and centrally acting medications and, it is unclear if and how often calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers are used. Objective: To examine the anti-hypertensive prescription pattern in a tertiary health centre in Nigeria to determine how it conforms to current guidelines. Method: 590 newly diagnosed hypertensive patients presenting at the Cardiology Unit of University of Abuja Teaching Hospital over a three-year period were studied. Result: Calcium channel blockers were the most frequently prescribed anti-hypertensive medications (66.9% of all cases) and centrally acting medications were prescribed in only 5.01% of cases. Single-pill combination either alone or in combination with other antihypertensive medications were prescribed in 17.3% cases. Of these, calcium channel blocker-based combinations constituted the most frequently used multiple drug combinations. 94.6% of the patients required more than one medication for blood pressure control. Conclusion: Anti-hypertensive pharmacotherapy in Abuja, Nigeria, compares favorably with the current recommendations in the prescription pattern of anti-hypertensive medications. (Ethn Dis. 2013;23[4]:480–483)
Risk assessment of adherence in hypertensives and diabetics in a sub-saharan african outpatient clinic.
(2013) Ajayi S.O.; Mamven M.H.; Ojji, D.B.
Medication non adherence is a significant burden to health care utilization[1], in addition to poor disease control. But there is a paucity of structured adherence counselling as a thematic area of care. We have used a modified adherence tool for patients living with HIV and AIDs which incorporates social background, treatment preparation, adherence habits, disclosure of illness, the use of treatment partners, and assessment of potential barriers to adherence. This form was designed only to explore known characteristics that are important for adherence, but patients were asked to make judgement on their own level of adherence. Of the one hundred and eighty one eighty six (47.5%) were males while 95(52.5%) were females. The mean age was 50.83years (SD 12.54). Majority of the patients were married (81.8%) and had at least primary education. Most of the patients whom we interviewed were hypertensives (65%). One hundred and twelve (61.88%) were taking medications during a daily routine, such as eating. Most of the patients, 116(64.10%) had some knowledge about their illness and the medications they were taking by names. Majority of patients (72.4%) had disclosed their illness to their spouses. Many patients self-report that their adherence is good.