Browsing by Author "Otegbayo, J. A."

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Clinicoradiologic and sonographic patterns of metastasis in hepatocellular carcinoma
(2006) Otegbayo, J. A.; Atalabi, O. M.; Yakubu, A.
Hepatocellular carcinoma(HCC) is usually diagnosed at an advanced stage, when little remedy could be offered. There is a need for relatively affordable, available and non- invasive tests for diagonsis, staging and detection of metastasis among individuals at risk. A clinical, chest radiographic (CXR) and abdominal ultrasonographic examination was carried out to detect and evaluate the pattern of metastasis among 53 untreated patients. One patients had clinical paraparesis with no outward evidence of metastasis. CXR revealed lund metastasis in 11(20.8%), with multifocal deposit in one. Two (3.8%) patients had perihilar lymphadenopathy and consolidation, respectively, while 18 (34%) patients had elevated right hemidiaphragm and four (7.5%) had pleural effusion. One right hemidiaphragm and four (7.5%) had pleural effusion. One had right basal pneumonitis, multiple cavitatory lesions in the lungs fields and soft-tissue wasting. No abnormality was seen in 17 (32.1%) cases. Abdominal ultrasonograph showed probe tenderness in 22(41.5%), hepatomegaly in 49(92.5%), with 33(62.3%) of these having nodularities of varying sizes. The spleen was enlarged in 10(18.9%) cases, with para-aortic lymphadenopathy. Portal hepatic lymphadenopathy was demostrated in two (3.8%) cases, while pleural effusion was detected in seven (13.2%). Metastasis is common in HCC at presentation, the lung is the commonest site of spread. Clinically visible metastasis appears uncommon in HCC.
Correlation of cag-A serological status with histological parameters of chronic gastritis among dyspeptic patients in south western Nigeria
(2012) Oluwasola, A. O.; Otegbayo, J. A.; Ola, S.O.; Ebili, H. O.; Afplabi, A. O.; Odaibo, G. N.
"BACKGROUND:The aim of this study was to determine the sero-prevalence of Cag-A strains of Helicobacter pylori in both dyspeptic and non-dyspeptic individuals and also correlate the serological status of Gag-A strain of H. pylori with the various graded histological variables of chronic gastritis in the dyspeptic patients. METHODS:Using helicobacter p120 Cag-A enzyme linked immunosorbent assay, Cag-A serology test was carried out on 65 dyspeptic patients and 65 age and sex matched non-dyspeptic controls. The gastric biopsies of the patients were also histologically examined to ascertain the presence, nature and degree of the following histological variables of gastritis: colonisation by H. pylori; inflammation, intestinal metaplasia and mucosal atrophy. The CagA serological status was then correlated with the graded variables. RESULTS:A prevalence of 46.2% and 58.8% seropositivity for Cag-A strain of H. pylori was found among dyspeptic patients and control individuals respectively. Cag-A seropositive patients accounted for nine(81.8%) of the 11 cases with moderate to severe activity and 75% of both cases with mucosal atrophy and cases with intestinal metaplasia. CONCLUSION:Infection with Cag-A positive Helicobacter pylori was equally prevalent among both dyspeptic patients and control subjects studied. CagA seropositivity, however, appeared to be associated with higher inflammatory activity in the mucosa of patients with chronic gastritis and may be associated with intestinal metaplasia and mucosal atrophy in H. pylori-induced chronic gastritis."
Demographic factors in HIV infected patients seen at UCH, Ibadan, Nigeria.
(2005) Ola, S. O.; Ladipo, M. M. A.; Otegbayo, J. A.; Odaibo, G. N.; Bamgboye, E. A.; Nwaorgu, O. G. B.; Shokunbi, W.; Olaleye, O. D.
"There is a rising rate of Human Immunodeficiency Virus (HIV) infection in Nigeria. Good knowledge of the demographic characteristics of the patients with HIV/AIDS may be of great importance in understanding its epidemiology in Nigeria and could facilitate efforts at curtailing the spread of the infection. The study was planned to determine the demographic factors in Nigerian patients with HIV infection. The study was conducted at the University College Hospital (U.C.H), Ibadan, located in the South West of Nigeria. It was a retrospective study of patients with HIV infection attending the U.C.H. from 1988 to 2002. The data collected from the clinical records of the patients with HIV infection included age, sex, marital status, number of spouses, tribe, occupation, education and their religious affiliation. A total of 460 patients aged 1-76 years with peak at 30-34 years were studied. The male/female ratio was 1.06 and the males were the older group. Traders accounted for 40% with female preponderance while the artisans (19.9%) and the military (2.9%) were mostly males. The patients were of Yoruba (70.6%), Igbo (20.0%) and Hausa (9.1%) races. Among the patients with marital status, majority (71.4%) were married while those separated and widowed accounted for 3.5% and 2.6% respectively. Also, a higher proportion of the female HIV patients were Christians whereas the majority of the males were of Islamic religion. Although, there was a low frequency of records on education, the males had better formal education. In conclusion, the study shows that HIV infection is presently an adult disease affecting the most productive segment of the Nigerian population regardless of the individual occupation, educational status, tribe and religious affiliation. Also, it shows that the infection could be associated with heterosexual intercourse."
Detection of p53 codon 249 mutation in Nigerian patients with hepatocellular carcinoma using a novel evaluation of cell-free DNA
(Mexican Association Hepatology, Medica Sur Clinic and Foundation, 2008) Igetei, R.; Otegbayo, J. A.; Ndububa, D. A.; Lesi, O. A.; Anumudu, C. I.; Hainaut, P.; Gorrnally, E.
Objectives: This case-control study was done to determine the association and prevalence of p53 codon 249 mutation using cell-free DNA in the plasma of patients with hepatocellular carcinoma (HCC) in South-Western Nigeria. Method: Eighty-five adults with HCC and seventy-seven age and gender matched controls without evidence of liver disease or malignancy involving any part of the body, were recruited. Plasma DNA was analyzed for p53 codon 249 by restriction fragment length polymorphism. Patient evaluation was done by means questionnaire interview, clinical examination, laboratory and radiological tests. The prevalence of the p53 codon 249 mutation was expressed as a percentage amplifiable DNA samples analyzed from HCC patients while that of controls was expressed in the same way. Fisher’s exact test or the student t-test where appropriate were used to assess statistical significance of prevalence between both groups as well as comparison of some characteristics in the HCC cases between those who had codon 249 mutation and those who did not. Associations between the various parameters assessed were determined by odds ratio and significant difference was specified at p < 0.05. Results: p53 codon 249 mutation was present in 6 (7.6%) of the 79 samples from the HCC patients with amplifiable plasma DNA while none (i.e. 0%) of the 73 samples with amplifiable plasma DNA from the controls had this mutation. This prevalence is significantly higher among HCC patients than controls (0.029). The mutation was also found to be significantly associated with HCC (odds ratio = 2.00; 95% C I: 1.70 – 2.35). Conclusion: The prevalence of the p53 codon 249 mutation from plasma DNA of hepatocellular carcinoma patients is significantly higher than among controls in South-Western Nigeria and the presence of this mutation is significantly associated with HCC in this region.
Helicobacter pylori serology and evaluation of gastroduodenal disease in Nigerias with dyspepsia
(2004) Otegbayo, J. A.; Oluwasola, O. A.; Yakubu, A.; Odaibo, G. N.; Olaleye, O. D.
Helicobacter pylori (H. pylori) has been strongly associated with various gastroduodenal diseases worldwide with only a few studies emanating from developing countries. The objectives of this study were to determine the prevalence of serum immunoglobulin G (lgG) and underlying gastroduodenal pathology in Nigerian patients with dyspepsia and ascertain the usefulness of H.pylori lgG screening in decreasing endoscopic workload in dyspeptics in Nigeria. fifty-five patients with dyspepsia and 55 age and sex-matched apparently normal control were screened for H.pylori lgG using ImmunocombrII kits. Each of the 55 patients were also examined endoscopically with biopsies taken appropriately. Serology was positive in 94.5% and 92.7% of dyspeptic patients and controls respectivley. Gastroduodenal inflammation was the commonest endoscopic finding, 43 (78.18%). Other findings were malignant gastric tumour 6(10.9%), reflux oesophagitis 3(5.45%), gastric ulcer 2(3.64%), and duodenal ulcer in 1(1.82%). chronic gastritis was the main histopathologic finding in the dyspeptic patients. It is concluded that serum H. pylori lgG cannot be used as a screening procedure to reduce endoscopic workload in Nigerian patients with dyspepsia.
Nigeria butchers and hepatitis B virus infection
(2008) Ola, S. O.; Otegbayo, J. A.; Yakubu, A.; Odaibo, G. N.; Olaleye, D. O.
Various target groups have been identified in Nigeria for studying the prevalence of hepatitis B virus infection; however there is no information on its prevalence among workers in slaughter houses. This study determined the seroprevalence of hepatitis B virus infection in Nigerian butchers at Ibadan, and comprised 360 healthy Nigerian adult subjects (180 butchers, 180 traders as controls) selected by multistage stratified sampling. A questionnaire was used to collect relevant information and included points about risk behaviour. ELISA was used to detect the hepatitis B surface antigen in the serum; the seroprevalence rate in butchers and controls was 9.4% and 3.3%, respectively (p<0.05). Risk behaviour was seen more commonly in butchers than in controls. The presence of hepatitis B surface antigen in the serum was not related to the duration of occupational exposure or the number of partners. In summary, butchers comprise a high-risk occupational group for exposure to hepatitis B virus infection. We conclude that routine screening for parenterally acquired infections in this group is thus necessary in order to identify those who will require treatment and immunisation, especially against hepatitis B virus infection.
Occult HBV infection among a cohort of Nigerian adults
(Creative Commons Attibution, 2009) Ola, S. O.; Otegbayo, J. A.; Odaibo, G. N.; Olaleye, D. O.; Summerton, C. B.; Bamgboye, E. A.
"OBJECTIVE:To determine markers of HBV infection and detect the presence of its occult infection in serum of a cohort of adult Nigerians. METHODOLOGY:The study involved 28 adult Nigerians with viral hepatitis (Group 1) and 28 apparently healthy adult Nigerians as controls (Group 2). Their sera were assayed for HBsAg, HBeAg, anti-HBe, anti-HBc, anti-HBs, and anti-HCV, while HBV DNA was determined in 15 patients with chronic hepatitis. Significance of differences between the patients and control subjects was assessed using Chi-square test at a 95% confidence level. RESULTS:Sero-detection of HBsAg, HBeAg, anti-HBe and anti-HBc was higher among the patients compared to the controls. HBV infection was diagnosed by HBsAg (89%) and a duo of HBsAg and anti-HBc (100%) among the patients. Similarly, eleven and four types of different patterns of HBV markers were observed among the respective groups. Anti-HBe (9.5%), anti-HBc (14.3%), and anti-HBs (9.5%) were detected among all the subjects who were sero-negative for HBsAg. HBV DNA was also detected in 86.7% of the 15 patients with chronic hepatitis, while occult HBV infection was observed in 7.2% of the patients and none (0%) of the controls, p < 0.05. Furthermore, HCV infection occurred among subjects with all the different patterns of HBV markers, except those with occult HBV infection and natural immunity to HBV. CONCLUSION:This study shows that occult HBV infection is present among Nigerian adults and determination of HBsAg, anti-HBc, anti-HBe, and HBV DNA will assist in its detection."
Palliative care needs evaluation in untreated patients with hepatocellular carcinoma in Ibadan, Nigeria
(2010-04) Otegbayo, J. A.; Onibokun, A. C.; Aikpokpo, V. N.; Soyannwo, O. A.
AIM This study aimed to evaluate the physical, psychosocial and spiritual needs of untreated patients with hepatocellular carcinoma, in order to determine effective palliative care approach and therefore improve their quality of life when curative therapy is elusive. METHODS The modified Needs Evaluation Questionnaire (NEQ) on pain and psychological assessments, thoughts and feelings and spiritual concerns was administered to 205 consecutive patients with recently diagnosed hepatocellular carcinoma after informed consent. The questionnaire included questions on pain, psychological state of mind, interference of disease with life, family functioning, knowledge of the disease, sexual functions and spirituality, among others. Responses were collated and analysed using simple statistics. RESULTS Abdominal pain, abdominal swelling, and weight loss were the leading clinical features, occurring in 157 (77%), 143 (70%) and 91 (44%) patients respectively. Pain characteristics varied, with 179 (87%) having it at presentation. Most of the patients (116, 57%) used NSAIDs for pain relief. Less than half (98, 48%) wanted to know the cause of the cancer, while 157 (77%) wanted to know treatment options. The majority (189, 92%) were ignorant about anyone with a similar ailment. Sexual function was not perceived as a problem but some expressed fears about sex, feeling that their partners would not find them attractive. Self-esteem was high in almost all respondents. Most (177, 86%) felt God is a “doer” while 28 (14%) felt God is a “supporter” and 162 (79%) would like a therapist or religious leader to talk to them. CONCLUSION Pain was a major concern and spiritual support by religious leaders was desired. Self-esteem of patients should be preserved and reinforced. We recommend that palliative care and end-of-life issues should be made part of multidisciplinary care of cancer patients in our setting
Pitfalls in diagnosis of hepatitis B virus infection among adults Nigerians
(2009) Ola, S. O.; Otegbayo, J. A.; Yakubu, A.; Aje, A. O.; Odaibo, G. N.; Shokunbi, W.
"OBJECTIVE:Hepatitis B virus infection is common in Nigerians and its diagnosis is necessary for effective treatment and eradication. This study is aimed at highlighting the serological factors jeopardizing the diagnosis and treatment of the infection among Nigerians adults. PATIENTS AND METHODS:Three studies were carried out. The first study involved 56 Nigerian adults and it compared the assay of HBsAg by Haemagulation Method (HMA) with Enzyme linked immunoassay (ELISA). The second study was a comparison of Glaxo Welcome HB rapid test(GWHB) with ELISA in sero-assay of HBsAg and HBeAg among 25 Nigerian subjects while the third study was on the assay of the sera of HBsAg positive patients for HBeAg and anti-HBe in forty two Nigerian patients by ELISA. RESULTS:The sero - prevalence rates of HBsAg were 41.8% and 61.8% by HM and ELISA respectively with false HBsAg sero-positives and sero-negatives by HM of 5.4% and 25.5% respectively. Similarly, there was sero-detection of HBsAg in 84% and 80% by ELISA and GWHB respectively in 25 Nigerian adults. In addition, 19% and 64% of the 42 patients with HBsAg sero-positivity were also positive for HBeAg and anti-HBe respectively, while 31% of the patients were both HBeAg and anti-HBe sero-negative. CONCLUSION:Sero-diagnosis of HBsAg and other serological markers of infectivity in patients with HBV should be carried out by ELISA rather than HMA among adult Nigerians. Furthermore, high infectivity of the virus abounds among Nigerian with HBV infection."
Prevalence of hepatitis B and C seropositivity in a Nigerian cohort of HIV-infected patients
(2008) Otegbayo, J. A.; Taiwo, B. O.; Akingbola, T. S.; Odaibo, G. N.; Adedapo, K. S.; Penugonda, S.; Adewole, I. F.; Olaleye, D. O.; Murphy, R.; Kanki, P.
"INTRODUCTION:The clinical and public health implications of the convergence of the human immunodeficiency virus (HIV) epidemic and chronic viral hepatitis in sub-Saharan Africa are poorly understood. This study was designed to determine the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV), and the impact of co-infection on baseline serum alanine transaminase (ALT), CD4+ T lymphocyte (CD4) count, and plasma HIV-RNA (viral load) in a cohort of HIV-infected Nigerians. METHODS:A retrospective study was conducted, on eligible treatment-naive patients who presented between August 2004 and February 2007 to the University College Hospital (UCH), Ibadan, Nigeria. Demographic data and pre-treatment laboratory results (hepatitis B surface antigen (HBsAg), HCV antibodies (anti-HCV), ALT, CD4 count and viral load) were retrieved from the medical records. Fisher's exact, two sample t-tests, and the Wilcoxon rank sum tests were used to compare groups. A logistic regression model was fitted to explore characteristics associated with co-infection status. RESULTS:A total of 1779 HIV-infected patients (male: female ratio, 1:2) met inclusion criteria. HBsAg was present in 11.9%, anti-HCV in 4.8% and both markers in 1%. HBsAg was more common among males than females (15.4% vs 10.1%, respectively p = 0.001) while anti-HCV was detected in a similar proportion of males and females (5.3% versus 4.6%, respectively p = 0.559). HIV-infected patients with anti-HCV alone had a lower mean baseline CD4 count compared to those without anti-HCV or HBsAg (197 cells/mm3 vs 247 cells/mm3, respectively p = 0.008). Serum ALT was higher among patients with HBsAg compared to those without HBsAg or anti-HCV (43 International Units (IU) vs. 39 IU, respectively p = 0.015). Male gender was associated with HBV co-infection on logistic regression (OR1.786; 95% CI, 1.306-2.443; p < 0.005). CONCLUSION:More HIV-infected females than males presented for care in this cohort. We identified a relatively high prevalence of HBV and HCV co-infection in general, and a higher rate of HBV co-infection among males than females. Pre-treatment CD4 count was significantly lower among those with HCV co-infection, while ALT was slightly higher among those with HBV co-infection. Triple infection with HIV, HBV and HCV was present in a small but significant proportion of patients. These findings underscore the importance of testing for HBV and HCV in all HIV-infected persons in our setting."
Prevalence of hepatitis B virus and C seropositivity in a Nigerian cohort of HIV-infected patients
(2008) Otegbayo, J. A.; Taiwo, B. O.; Akingbola, T. S.; Odaibo, G. N.; Adedapo, K. S.; Penugonda, S.; Adewole, I. F.; Olaleye, D. O.; Murphy, R.; Kanki, P.
"INTRODUCTION:The clinical and public health implications of the convergence of the human immunodeficiency virus (HIV) epidemic and chronic viral hepatitis in sub-Saharan Africa are poorly understood. This study was designed to determine the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV), and the impact of co-infection on baseline serum alanine transaminase (ALT), CD4+ T lymphocyte (CD4) count, and plasma HIV-RNA (viral load) in a cohort of HIV-infected Nigerians. METHODS:A retrospective study was conducted, on eligible treatment-naive patients who presented between August 2004 and February 2007 to the University College Hospital (UCH), Ibadan, Nigeria. Demographic data and pre-treatment laboratory results (hepatitis B surface antigen (HBsAg), HCV antibodies (anti-HCV), ALT, CD4 count and viral load) were retrieved from the medical records. Fisher's exact, two sample t-tests, and the Wilcoxon rank sum tests were used to compare groups. A logistic regression model was fitted to explore characteristics associated with co-infection status. RESULTS:A total of 1779 HIV-infected patients (male: female ratio, 1:2) met inclusion criteria. HBsAg was present in 11.9%, anti-HCV in 4.8% and both markers in 1%. HBsAg was more common among males than females (15.4% vs 10.1%, respectively p = 0.001) while anti-HCV was detected in a similar proportion of males and females (5.3% versus 4.6%, respectively p = 0.559). HIV-infected patients with anti-HCV alone had a lower mean baseline CD4 count compared to those without anti-HCV or HBsAg (197 cells/mm3 vs 247 cells/mm3, respectively p = 0.008). Serum ALT was higher among patients with HBsAg compared to those without HBsAg or anti-HCV (43 International Units (IU) vs. 39 IU, respectively p = 0.015). Male gender was associated with HBV co-infection on logistic regression (OR1.786; 95% CI, 1.306-2.443; p < 0.005). CONCLUSION:More HIV-infected females than males presented for care in this cohort. We identified a relatively high prevalence of HBV and HCV co-infection in general, and a higher rate of HBV co-infection among males than females. Pre-treatment CD4 count was significantly lower among those with HCV co-infection, while ALT was slightly higher among those with HBV co-infection. Triple infection with HIV, HBV and HCV was present in a small but significant proportion of patients. These findings underscore the importance of testing for HBV and HCV in all HIV-infected persons in our setting."