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Owojuyigbe, A, Adenekan A, Kawamae K, Suzuki H, Aaron O, Owojuyigbe T.  2021.  Cerebral oximetry in healthy adults: A comparison of three commercial Near-Infrared Spectrophotometers, 2021/02/01. 28:37-44. Abstract
Owojuyigbe, A, Adenekan A, Ijarotimi A, Io A, Owojuyigbe T, Ibraheem A, Sowemimo O.  2020.  Cardiac diseases in pregnancy: A 10-year review in a tertiary hospital in South-west Nigeria, 2020/05/18. 6:151-157. Abstract

Background: The superimposition of the morbidity of cardiac diseases on the physiological demands of pregnancy could impact adversely on pregnancy outcomes. Therefore, contemporary information is for appropriate clinical management.Objective: To determine the management outcomes of cardiac diseases in pregnancy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife.
Methods: A retrospective review of the hospital records of patients with cardiac diseases in pregnancy between January 2006 and December 2015 was conducted. The age, parity, gestational age at admission, NYHA class, clinical diagnosis, the results of investigations, complications of cardiac diseases, and maternal and foetal outcomes were recorded.
Results: There were 33 women with cardiac diseases in pregnancy and 11,352 deliveries within the period, giving an incidence of 2.9 per 1000. Further analysis was based on 24 women with complete records. The mean age of the patients was 29.2±5.5 years. Twenty (83%) of the women were Para 2 or less, while 13 (54%) presented postpartum. The majority of the women (15; 62.5%) had peripartum cardiomyopathy, while 17 (71%) had NYHA Class III or IV disease. Thirteen (54%) women had vaginal delivery. There were four perinatal and two maternal deaths, with a perinatal mortality rate of 166/1,000 total births and maternal mortality ratio of 8,333/100,000 live births.
Conclusion: Cardiac diseases in pregnancy are associated with high perinatal and maternal mortality rates at the OAUTHC, Ile-Ife. However, with early diagnosis and appropriate care, the majority of the patients had a satisfactory clinical outcome. Early presentation and advocacy to improve health-seeking behaviour are recommended.

Owojuyigbe, T, Durosinmi M, Bolarinwa R, Salawu L, Akinola N, Ademosun A, Bosede O.  2020.  Distribution of BCR–ABL1 Transcript Variants in Nigerians with Chronic Myeloid Leukemia, 2020/02/25. 36 Abstract

The distribution of BCR–ABL1 transcript variants e13a2 (“b2a2”) and e14a2 (“b3a2”) in Nigerians with chronic myeloid leukemia (CML) had not been previously studied. In addition, there is paucity of data on the impact of BCR–ABL1 transcript variants on clinical presentation and survival in CML patients in Nigeria. The BCR–ABL1 transcript variants were analyzed in 230 Imatinib-treated CML patients at diagnosis. Patients with incomplete data (n = 28), e19a2 (n = 3) and e1a2 (n = 1) were excluded from analysis of transcript variant on disease presentation and survival leaving only 198. The frequencies of BCR–ABL1 transcript variants were 30 (13.0%), 114 (49.6%), 82 (35.7%), three (1.3%) and one (0.4%) for e13a2, e14a2, co-expression of e13a2/e14a2, e19a2 and e1a2, respectively. A significantly higher platelet count was found in patients with e13a2 variant (531.1 ± 563.4 × 109/L) than in those expressing e14a2 (488.2 ± 560.3 × 109/L) or e13a2/e14a2 (320.7 ± 215.8 × 109/L); p = 0.03. No significant differences were found between the variants with regards to gender, age, phase of disease at diagnosis, total white blood cell count, neutrophil percentage, hematocrit, splenomegaly or hepatomegaly. Overall survival was higher but not statistically significant (p = 0.4) in patients with e14a2 variant (134 months) than in e13a2 (119 months) and co-expression of e13a2/e14a2 (115 months). Nigerian CML patients have the highest incidence of co-expression of e13a2 and e14a2. Distinct disease characteristics which contrast with findings from the Western countries were also identified in Nigerians which may be due to genetic factors.

Abimbola, J, Adenekan A, Owojuyigbe A, Orji E, Owojuyigbe T, Aaron O.  2020.  Opioid sparing effect of post induction intramuscular midazolam following myomectomy, 10. Middle East journal of anaesthesiology. 27:187-195. Abstract
Osukoya, A, Adeyemo A, Owojuyigbe T, Ohuche A, Ejiofor O, Amusa Y.  2019.  Clinicopathological Determinants of Treatment Outcomes of Nasal Polyps in a Black African Cohort, 2019/12/28. 7:17-21. Abstract
Adenekan, A, Owojuyigbe A, Aaron O, Adetoye A, Olorunmoteni O, Owojuyigbe T, Olateju S, Faponle AF, James Y, Igharo C, Akanbi R, Moronkeji O, Egbetunde L.  2019.  Impact of Pain Management Workshop on the Knowledge and Attitude of Healthcare Workers and Opioid Utilization in a Nigerian Teaching Hospital, 2019/09/01. 36:232-238. Abstract

Background:Pain is a public health problem requiring serious attention. One major barrier to the provision of quality pain treatment in many countries is lack of training for healthcare workers. The aim of this study was to evaluate the impact of pain education on the knowledge and attitude of healthcare workers, and opioid utilization in a university teaching hospital.
Pain management workshops were conducted for healthcare workers over a 12-month period. The modified "Knowledge and Attitudes Survey Regarding Pain" questionnaire was administered to participants pre- and post- training for each of the workshops. The total mark by each participant was entered into the Statistical Package for Social Sciences (SPSS) software version 16 software for windows (SPSS Inc., Chicago, Illinois, USA) for comparison of means for pre- and post-test. Changes in opioid utilization were evaluated.
The pre-test and post-test questionnaires were filled by 715 and 700 participants respectively. The mean post-test score was significantly higher than the pre-test score (68% versus 49% respectively, p = 0.00001). The doctors scored significantly higher than the other groups (p < 0.0001) in the pre-test. The mean post-test scores were significantly higher than the corresponding mean pre-test scores for the various groups (p < 0.0001). Sustained increase (up to 60.4%) in total morphine utilization was observed during the training.
There is a wide knowledge gap requiring regular training and re-training to achieve improved pain management and opioid utilization among healthcare workers. Inclusion of robust pain curricula in medical training programs will significantly improve pain management.

Eilander, A, Olumakaiye M, Moretti D, Zimmermann M, Owojuyigbe T, Blonk C, Murray P, Duchateau G.  2019.  High Bioavailability from Ferric Pyrophosphate-Fortified Bouillon Cubes in Meals is Not Increased by Sodium Pyrophosphate: a Stable Iron Isotope Study in Young Nigerian Women, 2019/05/01. 149:723-729. Abstract

BackgroundIt is challenging to find an iron compound that combines good bioavailability with minimal sensory changes when added to seasonings or condiments. Ferric pyrophosphate (FePP) is currently used to fortify bouillon cubes, but its bioavailability is generally low. Previously, the addition of a stabilizer, sodium pyrophosphate (NaPP), improved iron bioavailability from a bouillon drink.
We assessed whether there is a dose-response effect of added NaPP on iron bioavailability from local meals prepared with intrinsically labeled FePP-fortified bouillon cubes in young Nigerian women using iron stable isotope techniques.
In a double-blind, randomized, cross-over trial, women (n = 24; aged 18–40 y; mean BMI 20.5 kg/m²) consumed a Nigerian breakfast and lunch for 5 d prepared with bouillon cubes containing 2.5 mg ⁵⁷Fe (as FePP) and 3 different molar ratios of NaPP: ⁵⁷Fe (0:1, 3:1, and 6:1). Iron bioavailability was assessed by measuring ⁵⁷Fe incorporation into erythrocytes 16 d after each 5 d NaPP: ⁵⁷Fe feeding period. Data were analyzed using a linear regression model of log iron absorption on NaPP ratio, with body weight and baseline body iron stores as covariates and subject as a random intercept.
Of the women included, 46% were anemic and 26% were iron deficient. Iron bioavailability was 10.8, 9.8, and 11.0% for the 0:1, 3:1, and 6:1 NaPP:⁵⁷Fe treatments, respectively. There was no dose-response effect of an increasing NaPP:⁵⁷Fe ratio (β ± SE: 0.003 ± 0.028, P = 0.45).
In this study, the addition of NaPP did not increase iron bioavailability from FePP-fortified bouillon cubes. However, iron bioavailability from the Nigerian meals prepared with FePP-fortified bouillon cubes was higher than expected. These results are encouraging for the potential of bouillon cubes as a fortification vehicle. Further studies are needed to assess the effect of FePP-fortified bouillon cubes on improving iron status in low-income populations. This trial was registered at as NCT02815449.

Eilander, A, Olumakaiye M, Moretti D, Zimmermann M, Owojuyigbe T, Blonk C, Murray P, Duchateau G.  2019.  Supplemental File, 2019/05/01. Abstract
Adisa, A, Adedeji T, Bolarinwa R, Owojuyigbe T, Jeje O, Glasbey J, Akinola N.  2019.  The Inflammatory Response to Surgery in Sickle Cell Disease Patients Undergoing Cholecystectomy, 2019/04/01. 23:e2019.00027. Abstract

Background and objectives:Patients with sickle cell anemia (SCA) may have elevated inflammatory markers in health, and this may be heightened after open operations. The inflammatory response of patients with SCA after minimally invasive surgeries has not been fully explored.
Patients and methods:
Consecutive patients with SCA and with hemoglobin AA (HbAA) undergoing laparoscopic cholecystectomy for acute cholecystitis were recruited into the study. Blood samples were taken before induction of anesthesia (0-h); at 4, 12, 24, and 48 h; and on postoperative day 7. Samples were analyzed for serum C-reactive protein and interleukin (IL)-1 through IL-18.
Twenty-three patients, including 9 with SCA and 14 with HbAA, were recruited with 4 cases performed by open laparotomy. At 0-h, proinflammatory IL-1 levels (6.1 versus 4.8) and C-reactive protein levels (32.5 versus 26.6) were higher in patients with hemoglobin SS (HbSS) than in patients with HbAA, respectively. Over time, inflammatory markers were generally higher at each time-point for patients with HbSS compared with patients with HbAA for both proinflammatory and anti-inflammatory cytokines, rising immediately after surgery and up to 48 hours, then returning to baseline by postoperative day 7. There was a higher mean IL-1 level across all time-points in the HbSS group than in the HbAA group (P = .04).
This exploratory study found an enhanced inflammatory response to cholecystectomy in patients with SCA compared with patients with HbAA. Minimally invasive surgical strategies for this patient group may help to mediate this response.

Owojuyigbe, TO, Durosinmi MA.  2018.  Multiple Myeloma as a Secondary Malignancy in a 44-year old Male Nigerian with Chronic Myeloid Leukaemia: A Case Report. Nigerian Journal of Haematology. 1(2):30-35.
Bolarinwa, R, Olowookere S, Owojuyigbe T, Origbo E, Durosinmi M.  2017.  Challenges to Care and Medication Adherence of Patients With Chronic Myeloid Leukemia in a Resource Limited Setting: A Qualitative Study, 2017/12/27. Journal of Patient Experience. 5(3):195-200. Abstract

The factors related to care of patients with chronic myeloid leukemia (CML) often affects treatment outcome. We examined adherence to medication and other challenges to care in our patients on treatment of CML. This qualitative study involved in-depth interviews of 20 patients with CML receiving free imatinib (Glivec) from the Glivec International Patients’ Assistance Program. Data collected were thematically analyzed. Findings revealed that despite free drug assistance, there was relative lack of awareness resulting in inappropriate health-seeking behavior. The challenges cut across situations such as poverty, fear of the sustenance of the compassionate drug program, and living far away from the clinic. Forgetfulness was reported as the cause of poor adherence in this study. Suggested solutions include increasing community awareness, ensuring sustainability of the program and establishing more treatment centers nationwide. Strategies such as reminders and patents’ support will improve drug adherence among this cohort.

Oyekunle, A, Durosinmi M, Akinola N, Bolarinwa R, Owojuyigbe T, Salawu L.  2016.  Chronic Myeloid Leukemia in Nigerian Patients: Anemia is an Independent Predictor of Overall Survival, 2016/06/01. 9:9. Abstract

Objectives:The advent of the tyrosine kinase inhibitors has markedly changed the prognostic outlook for patients with Ph(+) and/or BCR-ABL1 (+) chronic myeloid leukemia (CML). This study was designed to assess the overall survival (OS) of Nigerian patients with CML receiving imatinib therapy and to identify the significant predictors of OS.
All patients with CML receiving imatinib from July 2003 to June 2013 were studied. The clinical and hematological parameters were studied. The Kaplan-Meier technique was used to estimate the OS and median survival. P-value of <0.05 was considered as statistically significant.
The median age of all 527 patients (male/female = 320/207) was 37 (range 10-87) years. There were 472, 47, and 7 in chronic phase (CP), accelerated phase, and blastic phase, respectively. As at June 2013, 442 patients are alive. The median survival was 105.7 months (95% confidence interval [CI], 91.5-119.9); while OS at one, two, and five years were 95%, 90%, and 75%, respectively. Multivariate Cox regression analysis revealed that OS was significantly better in patients diagnosed with CP (P = 0.001, odds ratio = 1.576, 95% CI = 1.205-2.061) or not in patients with anemia (P = 0.031, odds ratio = 1.666, 95% CI = 1.047-2.649). Combining these variables yielded three prognostic groups: CP without anemia, CP with anemia, and non-CP, with significantly different median OS of 123.3, 92.0, and 74.7 months, respectively (χ (2) = 22.042, P = 0.000016).
This study has clearly shown that for Nigerian patients with CML, the clinical phase of the disease at diagnosis and the hematocrit can be used to stratify patients into low, intermediate, and high risk groups.

Mabayoje, V, Akindele R, Akinleye C, Muhibi M, Owojuyigbe T, Fadiora S.  2013.  Epidemiological Factors and Liver Enzymes in Patients Co-Infected With HIV/AIDS in a Tertiary Teaching Hospital, 2013/12/05. 1:409-114. Abstract

Objective: HIV and HCV share routes of infection. Co-infection and its complications are therefore emerging as a major concern as patients on HAART have longer life expectancy. These complications have been well documented. It is necessary to determine in our environment what epidemiological factors are associated. This is expected to improve treatment protocols leading to increase quality of life and prolonged lifespan. Liver enzymes may be useful to monitor therapy. Materials and Methods: This is a prospective study. Seventy age and sex matched co-infected patients participated. Sera of the participants were subjected to anti-HCV antibody (IgG) screening using third generation ELISA kit from DIA.PRO, Italy. The epidemiological variables were determined and depicted using bar charts and tables. HIV was determined by detecting the antibodies using two different kits. Determine and Unigold. Results: There were 14 males and 56 females in the co-infected group. While there was a definite raise in Liver enzymes in the co-infected patients, only ALT was significantly raised in both sexes and not only the male sex. The majority of patients were above thirty years of age (mean 35.84). Among mono infected and co-infected patients age was the only statistically significant variable. Conclusion: It is vital to determine the HCV status of HIV positive patients at any point of entry into a particular health care facility. This would further improve the quality of life and life span of individuals as a result of improved treatment protocols. INTRODUCTION Human immunodeficiency virus(HIV) was first discovered by Gallo 1 . Hitherto it was described in homosexual men in California and New York in 1981 2 who presented with Pneumocystis Carinii Pneumonia (PCP). The prevalence in Africa and especially Nigeria and South Africa have become alarming over time. Sub-Saharan

Oyekunle, A, Bolarinwa R, Owojuyigbe T, Ogbe P, Salawu L, Faluyi J, Durosinmi M.  2010.  H396R, F359V and E255K mutations of the Abl kinase domain in imatinib-resistant Nigerian patients with chronic myeloid leukemia., 2010/01/01. 1:79-83. Abstract

AIM We have observed therapy failure in some Nigerian patients with chronic myeloid leukemia (CML). We therefore set out to determine the causes of imatinib resistance in these patients.METHODS From August 2003 to July 2010, we registered and commenced 266 consenting CML patients on imatinib (IM) under the Glivec International Patient Assistance Program (GIPAP). We investigated the occurrence of Abl kinase domain mutations (KDM) among a cohort of these patients, with features of imatinib resistance or intolerance. Peripheral blood samples were collected from 14 patients, after informed consent was obtained for Bcr-Abl quantitative PCR assessment and Abl KDM screening.
RESULTS The chimeric Bcr-Abl gene was detectable in all patients, (range of 0.18 - 141.9%), when compared with the Abl gene. Sequencing analysis was done in 12 out of the 14 patients and Abl KDM were identified in three of the 12 patients (one quarter). One mutant (H396R) is known to retain intermediate sensitivity to imatinib, while the other two (E255K and F359V) are insensitive; all are sensitive to nilotinib. Four of these patients have since been commenced on nilotinib and are responding well to therapy, while three have died of disease progression.
CONCLUSION An increasing number of Nigerian CML patients on imatinib are developing resistance or intolerance to the drug, and some are due to kinase domain mutations, while others may have other yet unexplained reasons for suboptimal response. Continuous monitoring is mandatory in the care of CML patients, to aid early detection of suboptimal therapy outcomes, necessitating further molecular studies. Additionally, more work needs to be done to fully understand the mechanisms for these therapy failures in Nigerian CML patients.