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Article: Does preoperative chemical depilation make any difference in postoperative wound infection?

Okoli, C C / Anyanwu, S N / Emegoakor, C D / Chianakwana, G U / Ihekwoaba, E / Ughasoro, M D / Egwuonwu, O A / Nzeako, H

Nigerian journal of clinical practice

2020 Volume 23, Issue 9, Page(s) 1318–1323

Abstract: Background: Preparation for surgery has traditionally included the removal of body hair from the intended surgical wound site. The effect of this practice on postoperative wound infection is yet to be fully elucidated.: Aims: This study sought to ... ...

Abstract	Background: Preparation for surgery has traditionally included the removal of body hair from the intended surgical wound site. The effect of this practice on postoperative wound infection is yet to be fully elucidated. Aims: This study sought to determine if preoperative chemical depilation reduces the risk of surgical site infection (SSI). Methodology: Two methods of preoperative hair removal: razor shaving and depilatory cream were compared. The eligible patients were randomized into two groups and the presence of postoperative wound infection was evaluated using the Southampton wound grading system. Data were analyzed using SPSS version 21 Chicago-Illinois, statistical significance was inferred at Pvalue ≤ 0.05. Results: In total 100 patients were analyzed with 20 patients excluded due to co-morbidities and noncompletion of the study. The overall prevalence of SSI was 18.0% (7 (14.0%) and 11 (22.0%) in the depilatory cream and razor shaving groups, respectively). The difference in the rate of SSI was not statistically significant (P = 0.436). Hair was completely removed in 47 (94.0%) compared to 38 (76.0%) patients in the razor shaving group (P = 0.012) while skin injuries were noted in 21 (42.0%) vs 1 (2.0%) patients who had razor shaving and chemical depilation(P = <0.0001), respectively. Conclusion: There was no significant difference in SSI rates in patients that had preoperative chemical depilation when compared with razor shaving.
MeSH term(s)	Adult ; Female ; Hair Removal/adverse effects ; Hair Removal/methods ; Humans ; Male ; Middle Aged ; Preoperative Care/methods ; Prevalence ; Restraint, Physical ; Soft Tissue Injuries/complications ; Soft Tissue Injuries/epidemiology ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/prevention & control ; Wound Healing/physiology ; Young Adult
Language	English
Publishing date	2020-07-18
Publishing country	India
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1458330-6
ISSN	1119-3077
ISSN	1119-3077
DOI	10.4103/njcp.njcp_149_20
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Article ; Online: Assessing the Quality of Life of Patients with Breast Cancer Treated in a Tertiary Hospital in a Resource-Poor Country.

Okoli, Chinedu / Anyanwu, S N C / Ochomma, Amobi O / Emegoakor, Chiemelu D / Chianakwana, Gabriel U / Nzeako, Henry / Ihekwoaba, Eric

World journal of surgery

2018 Volume 43, Issue 1, Page(s) 44–51

Abstract: Background: Very few studies have assessed the quality of life (QoL) of patients living with breast cancer in a resource-poor setting like Nigeria. The aim of our study was to comprehensively examine the measures of QoL in breast cancer patients using ... ...

Abstract	Background: Very few studies have assessed the quality of life (QoL) of patients living with breast cancer in a resource-poor setting like Nigeria. The aim of our study was to comprehensively examine the measures of QoL in breast cancer patients using the Functional Assessment of Cancer Therapy-Breast (FACT-B) version 4 in order to deepen the literature on QoL among breast cancer patients to include non-Western/northern patient populations. Patients and methods: Purposive sampling of stable patients who attended general surgery clinics with histopathologically diagnosed breast cancer was done. Eligible patients were assessed using five domains of the FACT-B questionnaire including: the breast cancer-specific symptoms (BCS), emotional well-being (EWB), functional well-being (FWB), physical well-being (PWB), and social & family well-being (SWB). The questionnaire was administered in a face-to-face interview by trained research assistants. In addition, the five domains were compared among three different age categories, pre-menopausal and post-menopausal, and patients who have had surgery and chemotherapy alone. The SPSS (IBM Corp. Released in 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.) and the Microsoft Excel (11. Corporation Microsoft, Redmond, WA, USA) were used for statistical analysis. Statistical significance was inferred when p <0.05. Results: Among the 60 enrolled participants, total score of the five domains (n = 144) was 74.59 ± 17.72, FACT-G score (n = 108) was 53.49 ± 12.56, Trial outcome index (n = 112) was 49.20 ± 13.13, PWB (n = 28) was 10.95 ± 6.37, SWB (n = 28) was 18.41 ± 6.48, EWB (n = 24) was 6.98 ± 4.15, FWB (n = 28) was 17.15 ± 7.12, and the BCS (n = 36) was 21.10 ± 8.93. EWB was significantly less in post-mastectomy patients on adjuvant chemotherapy (p = 0.031) and pre-menopausal women (p = 0.041) as well as in patients less than 40 years when compared with patients more 50 years (p = 0.049). Conclusions: Breast cancer patients in resource-poor countries have a profoundly impaired quality of life. This study showed significantly lower emotional well-being domain scores in post-mastectomy patients on adjuvant chemotherapy, pre-menopausal women having breast cancer and in younger female patients. There is need to address this anomaly.
MeSH term(s)	Adult ; Age Factors ; Aged ; Breast Neoplasms/complications ; Breast Neoplasms/therapy ; Chemotherapy, Adjuvant ; Developing Countries ; Emotions ; Female ; Health Status ; Humans ; Mastectomy ; Middle Aged ; Nigeria ; Premenopause ; Quality of Life/psychology ; Surveys and Questionnaires ; Tertiary Care Centers
Language	English
Publishing date	2018-08-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-018-4772-x
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Article: Etiologic factors and clinical presentation of hepatocellular carcinoma: differences between cirrhotic and noncirrhotic Italian patients.

Nzeako, U C

Cancer

1995 Volume 76, Issue 5, Page(s) 915

MeSH term(s)	Carcinoma, Hepatocellular/etiology ; Carcinoma, Hepatocellular/pathology ; Humans ; Liver Cirrhosis/complications ; Liver Neoplasms/etiology ; Liver Neoplasms/pathology ; Risk Factors
Language	English
Publishing date	1995-09-01
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	1429-1
ISSN	1097-0142 ; 0008-543X ; 1934-662X
ISSN (online)	1097-0142
ISSN	0008-543X ; 1934-662X
DOI	10.1002/1097-0142(19950901)76:5<915::aid-cncr2820760529>3.0.co;2-b
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Article ; Online: Anthropometric variables in relation to risk of breast cancer in Nigerian women

Chinedu C Okoli / Uzoamaka R Ebubedike / Stanley N C Anyanwu / Chinemelum D Emegoakor / Gabriel U Chianakwana / Eric Ihekwoaba / Ochomma A Egwuonwu / Henry Nzeako

International Journal of Medicine and Health Development, Vol 25, Iss 2, Pp 132-

2020 Volume 137

Abstract: Background: Breast cancer is the most prevalent cancer and the second leading cause of cancer death among women, and understanding how obesity impacts this disease has important public health implications. Materials and Methods: This study was a ... ...

Abstract	Background: Breast cancer is the most prevalent cancer and the second leading cause of cancer death among women, and understanding how obesity impacts this disease has important public health implications. Materials and Methods: This study was a prospective study that involved 100 participants managed for breast diseases from May 2015 to April 2017 at Nnamdi Azikiwe University Teaching Hospital, Nnewi (NAUTH). All the participants were formally diagnosed using clinical evaluation and core tissue biopsy. Waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), height and weight were measured, subsequently body-mass index was estimated as a ratio of an individual’s weight (kg)/height (m2). Results: The mean age (SD) of the subjects was 41.6 (9.3) years; all the participants were women. The mean (SD) body-mass index, WC and WHR of all the participants were 27.57 (6.85) kg/m2; 87.70 (16.36)cm and 0.87 (0.07) respectively. The mean (SD) body-mass index of pre-menopausal and post-menopausal were 26.52 (6.62) kg/m2 and 30.60 (6.71) kg/m2 respectively. The mean (SD) WHR of pre-menopausal and post-menopausal were 0.87 (0.06) and 0.90 (0.08) respectively, whereas the mean (SD) WC of pre-menopausal and post-menopausal were 85 (15.0) cm and 94.85 (17.97) respectively, thus individuals who were older were more likely to be overweight or obese than younger persons. Conclusion: This study findings emphasize the importance of considering wide WC and high WHR while implementing risk reduction strategies of breast cancer in younger women. Future studies to elucidate the significance of this findings in larger cohorts are needed.
Keywords	breast cancer ; height ; obesity ; waist circumference ; waist- hip ratio ; weight ; Medicine ; R
Subject code	610
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article: An evaluation of the clinical implications of acid breakthrough in patients on proton pump inhibitor therapy.

Nzeako, U C / Murray, J A

Alimentary pharmacology & therapeutics

2002 Volume 16, Issue 7, Page(s) 1309–1316

Abstract: Background: Some patients with gastro-oesophageal reflux disease continue to experience symptoms despite therapy with proton pump inhibitors. One recently proposed cause is the occurrence of nocturnal acid breakthrough.: Aim: : To investigate the ... ...

Abstract	Background: Some patients with gastro-oesophageal reflux disease continue to experience symptoms despite therapy with proton pump inhibitors. One recently proposed cause is the occurrence of nocturnal acid breakthrough. Aim: : To investigate the relationship between acid breakthrough occurrence (nocturnal and daytime) and refractory symptoms among patients with gastro-oesophageal reflux disease on proton pump inhibitors. Methods: Fifty-two consecutive patients with persistent symptoms of gastro-oesophageal reflux disease despite proton pump inhibitor therapy underwent 24-h pH study at the Mayo Clinic between January 1 and November 10, 1999. Relevant data were extracted and analysed. Results: Fifty-two patients, 18 males and 34 females, were eligible for the study. The mean age was 53 +/- 2.2 years. Thirty-seven patients (71%) had nocturnal acid breakthrough, and 36 (69%) had daytime acid breakthrough. Sixty per cent of patients experienced both nocturnal and daytime acid breakthrough, whereas 19% had neither. Among those with nocturnal and daytime acid breakthrough, only 36% and 33% of symptoms, respectively, were associated with gastro-oesophageal reflux episodes. The proportion of patients with symptoms and the mean symptom scores were not significantly different between those with and without acid breakthrough. Conclusions: Gastric acid breakthrough occurs nocturnally and during the daytime in patients on proton pump inhibitor therapy. With less than 36% of refractory symptoms associated with gastro-oesophageal reflux, gastric acid breakthrough cannot explain symptom refractoriness to proton pump inhibitor therapy in a significant majority of patients evaluated by 24-h pH study.
MeSH term(s)	2-Pyridinylmethylsulfinylbenzimidazoles ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Ulcer Agents/therapeutic use ; Circadian Rhythm ; Drug Administration Schedule ; Enzyme Inhibitors/therapeutic use ; Female ; Gastric Acid/metabolism ; Gastric Acidity Determination ; Gastroesophageal Reflux/drug therapy ; Gastroesophageal Reflux/metabolism ; Humans ; Hydrogen-Ion Concentration/drug effects ; Lansoprazole ; Male ; Middle Aged ; Omeprazole/analogs & derivatives ; Omeprazole/therapeutic use ; Proton Pump Inhibitors ; Treatment Failure
Chemical Substances	2-Pyridinylmethylsulfinylbenzimidazoles ; Anti-Ulcer Agents ; Enzyme Inhibitors ; Proton Pump Inhibitors ; Lansoprazole (0K5C5T2QPG) ; Omeprazole (KG60484QX9)
Language	English
Publishing date	2002-08-01
Publishing country	England
Document type	Journal Article
ZDB-ID	639012-2
ISSN	1365-2036 ; 0269-2813 ; 0953-0673
ISSN (online)	1365-2036
ISSN	0269-2813 ; 0953-0673
DOI	10.1046/j.1365-2036.2002.t01-1-01281.x
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Zs.A 2206: Show issues

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Article: Intestinal involvement by metastatic malignant melanoma.

Nzeako, U C / Sobin, L H

Gastrointestinal endoscopy

2001 Volume 53, Issue 3, Page(s) 403

MeSH term(s)	Colonic Neoplasms/epidemiology ; Colonic Neoplasms/secondary ; Female ; Humans ; Incidence ; Intestinal Neoplasms/epidemiology ; Intestinal Neoplasms/secondary ; Male ; Melanoma/epidemiology ; Melanoma/secondary ; Prognosis ; Retrospective Studies ; Risk Factors ; Skin Neoplasms/epidemiology ; Skin Neoplasms/pathology ; Survival Rate
Language	English
Publishing date	2001-03
Publishing country	United States
Document type	Case Reports ; Comment ; Letter
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/s0016-5107(01)70436-1
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Article ; Online: Anthropometric Measurement of Infraorbital Foramen in South-East And South-South Nigeria

Ukoha Ukoha Ukoha / Kosisochukwu Emmanuel Umeasalugo / Onochie Okwudili Udemezue / Henry C Nzeako / Godwin U Ndukwe / Perpetua C Nwankwo

National Journal of Medical Research, Vol 4, Iss 3, Pp 225-

2014 Volume 227

Abstract: Introduction: The study aimed to determine a more precise location of the infraorbital foramen (IOF) in relation to the piriform aperture (PA), infraorbital margin (IOM) and the anterior nasal spine (ANS) with the aim of improving the efficiency in ... ...

Abstract	Introduction: The study aimed to determine a more precise location of the infraorbital foramen (IOF) in relation to the piriform aperture (PA), infraorbital margin (IOM) and the anterior nasal spine (ANS) with the aim of improving the efficiency in clinical situations such as surgery and anesthetic procedures. Materials and Methods: A total of 130 skulls of unknown sex and age were used for the study; they were measured on both sides (right and left). With a vernier caliper the distances between the infraorbital foramen and the piriform aperture, infraorbital margin and anterior nasal spine were measured. The vertical orientation of the infraorbital foramen (IOF) with the upper teeth was also determined by direct visual inspection. Results: The mean distance and standard deviation (mean +/- SD) between the right IOF and the PA, right IOM and ANS were 19.36+/-3.54mm, 6.94+/-2.57mm, and 30.02+/-3.55mm, respectively, and between the left IOF and the PA, left IOM and ANS were 18.27+/-2.94mm, 7.83+/-1.86mm, and 29.01+/-3.59mm, respectively. There was significant difference (p<0.05) in the parameters between the two sides. The majority of IOF were vertically oriented to the 2nd premolar teeth (46%). Conclusion: The results may provide guidance to the maxillofacial surgeons and anesthesiologists to localize infraorbital foramen and so contribute to better outcome of diagnostic or therapeutic procedures. [Natl J Med Res 2014; 4(3.000): 225-227]
Keywords	Infraorbital Foramen ; Infraorbital Margin ; Piriform Aperture ; Anterior Nasal Spine ; Infraorbital Nerve Block ; Medicine (General) ; R5-920 ; Medicine ; R
Language	English
Publishing date	2014-09-01T00:00:00Z
Publisher	National Association for Medical Research
Document type	Article ; Online
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Article: Role of tube design and selection in occurrence of gastric lesser curvature ulceration by percutaneous gastrostomy tubes: an issue for adult patients?

Nzeako, U C / Murray, J A / Chari, S T

Digestive diseases and sciences

2001 Volume 46, Issue 9, Page(s) 1827–1832

MeSH term(s)	Adult ; Aged ; Equipment Design ; Female ; Gastrostomy/adverse effects ; Gastrostomy/instrumentation ; Humans ; Male ; Peptic Ulcer Hemorrhage/etiology ; Stomach Ulcer/complications ; Stomach Ulcer/etiology
Language	English
Publishing date	2001-09
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1023/a:1010610425776
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Article: Hereditary angioedema: a broad review for clinicians.

Nzeako, U C / Frigas, E / Tremaine, W J

Archives of internal medicine

2001 Volume 161, Issue 20, Page(s) 2417–2429

Abstract: Hereditary angioedema (HAE) is an autosomal dominant disease that afflicts 1 in 10,000 to 1 in 150,000 persons; HAE has been reported in all races, and no sex predominance has been found. It manifests as recurrent attacks of intense, massive, localized ... ...

Abstract	Hereditary angioedema (HAE) is an autosomal dominant disease that afflicts 1 in 10,000 to 1 in 150,000 persons; HAE has been reported in all races, and no sex predominance has been found. It manifests as recurrent attacks of intense, massive, localized edema without concomitant pruritus, often resulting from one of several known triggers. However, attacks can occur in the absence of any identifiable initiating event. Historically, 2 types of HAE have been described. However, a variant, possibly X-linked, inherited angioedema has recently been described, and tentatively it has been named "type 3" HAE. Signs and symptoms are identical in all types of HAE. Skin and visceral organs may be involved by the typically massive local edema. The most commonly involved viscera are the respiratory and gastrointestinal systems. Involvement of the upper airways can result in severe life-threatening symptoms, including the risk of asphyxiation, unless appropriate interventions are taken. Quantitative and functional analyses of C1 esterase inhibitor and complement components C4 and C1q should be performed when HAE is suspected. Acute exacerbations of the disease should be treated with intravenous purified C1 esterase inhibitor concentrate, where available. Intravenous administration of fresh frozen plasma is also useful in acute HAE; however, it occasionally exacerbates symptoms. Corticosteroids, antihistamines, and epinephrine can be useful adjuncts but typically are not efficacious in aborting acute attacks. Prophylactic management involves long-term use of attenuated androgens or antifibrinolytic agents. Clinicians should keep this disorder in their differential diagnosis of unexplained, episodic cutaneous angioedema or abdominal pain.
MeSH term(s)	Acute Disease ; Androgens/therapeutic use ; Angioedema/diagnosis ; Angioedema/epidemiology ; Angioedema/etiology ; Angioedema/metabolism ; Angioedema/therapy ; Anti-Inflammatory Agents/therapeutic use ; Antifibrinolytic Agents/therapeutic use ; Chronic Disease ; Complement Activation/immunology ; Complement C1 Inactivator Proteins/immunology ; Complement C1 Inactivator Proteins/metabolism ; Complement C1 Inactivator Proteins/therapeutic use ; Complement C1q/immunology ; Complement C1q/metabolism ; Complement C4/immunology ; Complement C4/metabolism ; Diagnosis, Differential ; Epinephrine/therapeutic use ; Genes, Dominant/genetics ; Genetic Diseases, Inborn/diagnosis ; Genetic Diseases, Inborn/epidemiology ; Genetic Diseases, Inborn/etiology ; Genetic Diseases, Inborn/metabolism ; Genetic Diseases, Inborn/therapy ; Histamine H1 Antagonists/therapeutic use ; Humans ; Plasma ; Risk Factors ; Steroids
Chemical Substances	Androgens ; Anti-Inflammatory Agents ; Antifibrinolytic Agents ; Complement C1 Inactivator Proteins ; Complement C4 ; Histamine H1 Antagonists ; Steroids ; Complement C1q (80295-33-6) ; Epinephrine (YKH834O4BH)
Language	English
Publishing date	2001-11-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	211575-x
ISSN	1538-3679 ; 0003-9926 ; 0888-2479 ; 0730-188X
ISSN (online)	1538-3679
ISSN	0003-9926 ; 0888-2479 ; 0730-188X
DOI	10.1001/archinte.161.20.2417
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Article: Clear cell carcinoma of the liver: a comparative immunohistochemical study with renal clear cell carcinoma.

Murakata, L A / Ishak, K G / Nzeako, U C

Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

2000 Volume 13, Issue 8, Page(s) 874–881

Abstract: Morphologic differentiation of clear cell hepatocellular carcinoma (HCC-CC) from clear cell renal carcinoma (RCC-CC) may not be possible without the aid of immunohistochemical stains. We performed a battery of immunohistochemical stains on 10 previously ... ...

Abstract	Morphologic differentiation of clear cell hepatocellular carcinoma (HCC-CC) from clear cell renal carcinoma (RCC-CC) may not be possible without the aid of immunohistochemical stains. We performed a battery of immunohistochemical stains on 10 previously diagnosed HCC-CCs, and 10 RCC-CCs, in order to determine which single or combination of immunostains would be most useful in diagnosis. We concluded that a positive Hepatocyte immunostain (DAKO) is sufficient for a diagnosis of HCC-CC if enough tissue is available. This immunostain distinguishes HCC-CC from other clear cell malignancies with sensitivity of 90% and specificity of 100%, when biopsy material is adequate. Other tests were much less sensitive, although several had specificity of 100%. A negative immunostain does not exclude the diagnosis of HCC-CC (negative predictive value 91%, especially in small biopsy material) and should be followed by additional immunostains such as pCEA for demonstration of tumor canaliculi, ubiquitin for Mallory bodies, and several epithelial cell markers that are typically positive in RCC-CC (epithelial membrane antigen, Leu M-1, pancytokeratin) and negative in HCC-CC.
MeSH term(s)	Adenocarcinoma, Clear Cell/chemistry ; Adenocarcinoma, Clear Cell/pathology ; Antigens, Neoplasm/analysis ; Biomarkers/analysis ; Carcinoma, Hepatocellular/chemistry ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Renal Cell/chemistry ; Carcinoma, Renal Cell/pathology ; Fluorescent Antibody Technique, Direct ; Hepatocytes/chemistry ; Hepatocytes/pathology ; Humans ; Kidney Neoplasms/chemistry ; Kidney Neoplasms/pathology ; Liver Neoplasms/chemistry ; Liver Neoplasms/pathology ; Sensitivity and Specificity
Chemical Substances	Antigens, Neoplasm ; Biomarkers
Language	English
Publishing date	2000-08
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	645073-8
ISSN	1530-0285 ; 0893-3952
ISSN (online)	1530-0285
ISSN	0893-3952
DOI	10.1038/modpathol.3880156
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