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Item Increased urinary sodium excretion is associated with systolic blood pressure in first degree relatives of hypertensive patients in Ibadan, Southwestern Nigeria.(2018) Ajayi, S.O.; Adebiyi, A.; Kadiri, S.Introduction: Understanding the risk factors of hypertension has led to a better understanding of the pathogenesis, prevention and reduction in morbidity of hypertension. It is well known that offsprings of hypertensive parents have an increased risk of developing hypertension. It is therefore necessary to explore the physiological differences between normotensive patients with and without a positive family history of hypertension with respect to their urinary excretion of sodium. Methods: This study was carried out at the University College Hospital, Ibadan Nigeria, to determine if normotensive patients with a positive family history of hypertension are different with respect to their urinary excretion of electrolytes and blood pressure. It examined the relationship between 24-hour urinary excretion of sodium, chloride and potassium, urea and creatinine and blood pressure in subjects with and without family history of hypertension. It was a case-control study of sixty-two subjects: normotensive patients’ first degree relatives of primary hypertensive patients and normotensive patients without positive family history. Results: The mean (SD) systolic blood pressures for subjects with and without family history of hypertension were significantly different: 120.0(22.25) and 105.0(17.50) respectively, (p=0.001). The mean arterial blood pressures were significantly different: 86.4(10.2) mmHg and 80.1(8.1) mmHg respectively (p=0.010). The mean (SD) 24-hour urinary excretion of sodium for normotensive patients with and without positive family history of hypertension were 180.5 (45.50) mEq/L, and 156.0(36.25) mEq/L respectively. Systolic blood pressure and 24-hour urinary excretion of sodium was also higher in normotensive subjects with a positive family history of hypertension. Conclusion: Systolic blood pressure and twenty-four hour urinary excretion of sodium were higher in normotensive subjects with a positive family history of hypertension than in those without a family history of hypertension.Item Decreased dose requirement of antihypertensive agents with age.(2001) SalakoB.L.; Ajayi, S.O.; Kadiri, S.; Arije, A.Hypertension is very prevalent in the elderly and treatment has been shown to be beneficial. However, inappropriate doses of drugs may impair the quality of life in this group of patients. In an attempt to assess the role of advancing age on therapy and doses of antihypertensives, the authors studied the antihypertensive dose/response pattern as hypertensive subjects on regular treatment move from the young to the elderly age group. Forty-nine hypertensives who were still being followed up at the medical outpatient clinic. University College Hospital, Ibadan were recruited into the study. The patients were extensively inter viewed and information relating to age, sex, year, age of diagnosis, as well as blood pressure at diagnosis, 6 months and 5 years of therapy were noted. There were HI males and 39 females with mean ages of 66.5 ± 6.6 and 64.5 ± 4.5 years respectively. The mean ages at diagnosis for both male and female groups were 52 ± 9.3 and 50 ± 7.5 years respectively. At diagnosis, 22 (44.8%) patients were started on single (antihypertensive) drug therapy, 23 (46.9%) on two drags while 4 (8.3%) were on 3 drugs. By 5 years of fairly consistent therapy, there were 33 (67.3%) patients on single drug and 16 (32.7%) patients on 2 drugs. No patient was on 3 drugs regimen. The mean blood pressure at diagnosis of 174 ± 24/105 ± 9 mmHg dropped significantly and was maintained at 6 months of therapy at (139 ± 20 / 87 ± 13 mmHg) p < 0.001. After 5 years of therapy the mean was (139 ±24/81 ±8 mmHg) inspite of dose reduction in these patients (p < 0.001). The authors concluded that, in a hypertensive patient who is un regular treatment, consistent and gradual reduction of antihypertensive doses may be carried out with blood pressure remaining within acceptable limits as the patient grows old.Item Variability in the relationship between serum creatinine and creatinine clearance in hypertensives and normotensives with normal renal function(2000) Kadiri, S.; Ajayi, S.O.Variabilities exist in the relationship between serum creatinine (Se-C) and creatinine clearance (CCr) due to the influences of age, muscle mass and gender on creatinine production. We studied this variability in a group of hypertensives (n = 62, 30 male, age 44 ± 7 years) and normotensives (n = 90, 47 male, age 42 ± 1 0 years) with normal renal function (Se-C< 0.01) and females (84 ± 19mL/min Vs 96 ± 19mL/min, P < 0.01). Crude CCr was significantly higher in men than women (.P < 0.05) in the whole group but not significantly in the normotensive or hypertensive subgroups. After adjustment, the differences diminished and became insignificant in the whole group. Some subgroups had identical mean Se-C values but different adjusted CCr. A particular Se-C value did not always indicate a particular CCr. Adjustment of CCr to 1.73 m2 BSA reduced the variability between Se-C and CCr and the difference between the genders. CCr showed significant difference in renal function between subgroups where Se-C did not.Item Quinolones for short-term treatment of uncomplicated urinary tract infection.(1999) Kadiri, S.; Ajayi, S.O.; Toki, R.A.Objectives: To investigate whether quinolones produce in vivo responses comparable to reported in vitro activity against the spectrum of organisms in uncomplicated urinary tract infection (UTI) in Nigeria, Design: Equal numbers of patients with urine culture positive UTI were randomised to oral quinolone, pefloxacin 400 mg Bd and ofloxacin 200 mg Bd for 5 days. Setting: Out-patient clinics and wards at the University College Hospital. Ibadan. Subjects: Sixty patients aged sixteen years and above with uncomplicated UTI. Main outcome measures: Number of isolates, number of patients with clinical and bacteriological cure one week after commencing therapy. Relative effectiveness and side effects of the drugs. Results: Sixty four bacterial isolates were obtained with the enterobacteriaccae comprising 86%. 62 (97%) were sensitive to both drugs in vitro. Clinical cure occurred in 57 patients (95%), being 28 (93%) in those taking perfloxacin and 29 (97%) in those taking ofloxacin. Bacteriological cure occurred in 55 patients (92%), being 27 (90%) in those taking perfloxacin and 28 (93%) in those taking ofloxacin. 59 of the 64 isolates (92%) were eliminated week, 30 of 33 (91 %) in those taking pefloxacin, and 29 of 31 (94%) in those taking ofloxacin; the difference was insignificant (p=1.16). The enterobacteriaceae were generally susceptible to both drugs. Side effects were minor and infrequent. Conclusion: Quinolones were highly active against the common urinary pathogens in these Nigerian patients and can be reliably employed in treatment when culture results are unavailable.Item Blood pressure changes in haemodialysis: the nigerian experience(1998) Salako, B.L.; Ajayi, S.O.; Kadiri, S.; Arije, A.; Osoba, O.A.The blood pressure changes in haemodialysis were assessed during 59 sessions in 21 patients. Blood pressure was measured with I he corresponding pulse before and subsequently hourly during dialysis, and the patients weights were measured before and after dialysis. The mean systolic blood pressure before dialysis was 170,22 + 29.64mmHg. This showed a statistically sig nificant decrease at l hour. being 167^31.79mmHg (P < 0.002 at 2 hours, being 164.83 + 40.26mmHgwith (P < 0.001). at 3 hours, being 166.84+ 36.94mm Hg (P< 0.001) intradialysis, and immediately after 4 hours of dialysis 166.28 ±35.70mmHg t P < 001). The mean diastolic blood pressure before dialysis of 109.90 + 20.SOmmHg also showed a significant decrease at 1 hour 106.07 + 22.84mmHg (P< 001) 2 hours 105.98+ 22.10mmHg (P < 0.001) and 3 hours intradialysis 107.81 + 25.39mmHg (P< 0.001). These findings suggest that blood pressure changes in haemodialysis are affected by drop in weight that invariably occurs in haemodialysis due to the accompanying process of ultrafiltration