FACULTY OF CLINICAL SCIENCES

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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.
Bronchial asthma: a risk factor for hypertension?
(2000) Salako, B.L.; Ajayi, S.O.
Several attempts have been made to improve primary prevention of essential hypertension and many of these have been directed at avoiding the well known risk factors. Both asthma and hypertension are spastic disorders of smooth muscle, also asthmatics and hypertensives have been found to be salt sensitive. There is a suspicion that the similarities between these two diseases may predispose the individuals with one disease to the other, as pulmonary hypertension has been described during exercise- induced bronchoconstriction. We therefore, studied the blood pressure pattern during and after acute severe asthma (ASA) along with the frequency of hypertension in stable asthmatic patients. Two groups of patients were studied. Group 1 consisted of 12 patients with ASA (2 males, 10 females) with a mean age of 30 ± 9,9.years. The mean blood pressure during attack of ASA (147±16.9/ 100±8.2 mmHg) was higher than the mean BP (132±8.3/82±7 mmHg) 2 weeks after discharge from hospital without treatment in all patients (P < 0.05). Group 2 included 134 asthmatic subjects in stable state (54 males, 80 females) with a mean age of 45 ± 15 years and a range of 15-90 years. The overall frequency of hypertension was 37% with a proportion of 39% in males and 35% in females. Hypertension was defined as systolic blood pressure of £ 140mmHg and or diastolic blood pressure of £ 90mmHg. There was no difference between the frequency of attack of ASA in hypertensives (5.7 ±5.6 per year) and nonhypertensives (5.5 ± 3.8 per year), P < 0.05. We concluded that transient elevation of blood pressure may occur during ASA. The frequency of hypertension among asthmatics is quite high and concurrent family history of hypertension and frequency of attack of ASA did not seem to determine the status of blood pressure. Patients with asthma should have regular blood pressure check during follow-up visits.
Hypertensive patient in the surgical ward - what the Surgeon should do
(2004) Akute, O. 0; Olubowale, 0. 0|; Aghahowa, M. E; Afolabi., A. 0
Two cases of hypertension are presented to emphasize the need for the surgeons to pay adequate attention to these purely medical conditions that may have a devastating adverse effect on the outcome of surgery. The article also highlights the serious constraints that still characterize the management of these patients in this part of the world. The ideal situation is a multi-disciplinary approach involving the Surgeon, the Physician and the Anaesthetist. The surgeon must not confine himself to the technical aspect of the surgery alone. The hypertension must be controlled whether the patient presents with an elective or emergent surgical condition and anti-hypertensive medication must be continued up till the time ofsurgery and at times intra-operatively. It is not only unnecessary hut also potentially dangerous to withdraw anti-hypertensives before anaesthesia. The main goal of the surgically amenable secondary hypertension is to remove the cause ofter adequate control of the hypertension in preparation for surgery. Patient however must be made to understand that the hypertension may not be "cured" and the anti-hypertensive medication may have to be continued post-operatively particularly if the hypertension is long established before patient presents. Local and/or regional blocks are to be preferred to general anaesthesiafor peripheral lesions and even then it is still preferable to have the hypertension controlled.
The challenges of single-short spinal anaesthesia for caesarean section in a morbidly obese patient: a case report
(2005-10) Danladi, K. Y.; Sotunmbi, P. T.; Awolude, O. A.; Obisesan, K. A.
An unusual case of morbid obesity, severe hypertension and twin gestation at 36weeks in an unbooked multigravid patient was presented for cesarean section. She was referred from a private clinic to the obstetric emergency unit of the University College Hospital, Ibadan with history of hypertension in pregnancy. She was a known hypertensive for ten years and her blood pressure was poorly controlled due to non-compliance with medications and medical check-up. She had been having progressive visual loss over the ten year period and had lost three, previous pregnancies. Following comprehensive clinical and radiological evaluation, she had a carefully planned single-shot spinal anaesthesia for cesarean delivery of a set of twin which was performed on a double operation table. She remained stable throughout the procedure and post operative period.

FACULTY OF CLINICAL SCIENCES

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