FACULTY OF CLINICAL SCIENCES

Permanent URI for this communityhttps://repository.ui.edu.ng/handle/123456789/265

Browse

Author: search.filters.author.Otegbayo, J. A.

Search Results

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    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
  • Thumbnail Image
    Item
    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.
  • Thumbnail Image
    Item
    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."