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  1. Article: Demographics, Cost, and Sustainability of Haemodialysis among End-Stage Kidney Disease Patients in Southern Nigeria: A Single-Center Study.

    Akpan, Effiong E / Ekrikpo, Udeme E / Effa, Emmanuel Edet / Udo, Aniema I A / Umoh, Victor A

    Nigerian medical journal : journal of the Nigeria Medical Association

    2020  Volume 61, Issue 6, Page(s) 307–311

    Abstract: Context: Access to chronic hemodialysis for patients with end-stage kidney disease has improved over the years. However, it is unclear if this has resulted in lower cost and improved dialysis vintage.: Aim: We aimed to assess the demographics, cost ... ...

    Abstract Context: Access to chronic hemodialysis for patients with end-stage kidney disease has improved over the years. However, it is unclear if this has resulted in lower cost and improved dialysis vintage.
    Aim: We aimed to assess the demographics, cost implication, and sustainability of maintenance hemodialysis in our cohort of end-stage kidney disease (ESKD) patients.
    Methods: Retrospective descriptive study of ESKD patients on maintenance HD from 2014 to 2018 using hemodialysis records. Time-to-HD discontinuation and reasons for discontinuation were recorded. Using Kaplan-Meier graphs, the time-to-dialysis discontinuation experience of the cohort was shown. Log-rank test was used to compare the experience between both genders. Univariable and multivariable Cox proportional hazard models were built to identify independent associations with time-to-dialysis discontinuation.
    Results: Over the 5-year period, 702 individuals initiated HD, males were older than females, the complete cohort contributed 65,714 person-days to the study and the median time-to-HD discontinuation was 10 days (interquartile range, 2-42). Females had a shorter time to HD discontinuation (8 days [1-32 days]) compared to males (11 days [2-48 days]). Only 28.5%, 15.3% and 8.3% of the patients had HD beyond 30, 90, and 180 days, respectively. About 128 (18.2%) had thrice-weekly HD. Most sustained the treatment for the 1
    Conclusion: Most patients cannot sustain HD beyond a few weeks for financial reasons. Several cost containment strategies need to be deployed to bring down the cost of care.
    Language English
    Publishing date 2020-12-19
    Publishing country Nigeria
    Document type Journal Article
    ZDB-ID 424429-1
    ISSN 0300-1652
    ISSN 0300-1652
    DOI 10.4103/nmj.NMJ_106_20
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4965: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Case studies of multi-disciplinary team management of atypical gastric cancer: challenges and lessons learned (about two cases).

    Kooffreh-Ada, Mbang / Iheanacho, Obinna Ebere / Nwagbara, Victor Ikechukwu / Okpebri, Komommo Okoi / Anisi, Chukwuemeka Okechukwu / Itam-Eyo, Asa / Uba-Mgbemena, Okezie / Ali, Oliver Emmanuel / Essien, Ofonime Benjamin / Akintomide, Akintunde Olusijibomi / Eyong, Michael Eteng / Effa, Emmanuel Edet / Ngim, Ngim Ewezu

    The Pan African medical journal

    2023  Volume 45, Page(s) 113

    Abstract: There is a paradigm shift towards adopting a multidisciplinary team (MDT) model in the care of cancer patients, with increasing evidence to support its effectiveness. Cancers are biologically distinct, patients present in diverse ways and require, ... ...

    Abstract There is a paradigm shift towards adopting a multidisciplinary team (MDT) model in the care of cancer patients, with increasing evidence to support its effectiveness. Cancers are biologically distinct, patients present in diverse ways and require, different therapeutic approaches in their management. Patient symptoms and treatment side-effects as well as physical and psychological impact vary according to cancer location and treatment plan. The varied clinical scenarios cancer patients present further buttress the need for MDT practice in hospitals to improve the quality of patient care, in contrast to the outdated concept of holistic treatment offered by a single physician. Unlike Europe, United States of America and Australia which have implemented successful MDT cancer care programs, Nigeria is just coming on board. We present two cases of gastric cancer (seen two months apart) with atypical presentation and the role of MDT in their evaluation and management. These case studies highlight the role of MDT in the management of cancer patients in Nigeria lending credence to the urgent need to implement this model of care in our cancer patients in a bid to improve the quality of care and outcome.
    MeSH term(s) Humans ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/therapy ; Drug-Related Side Effects and Adverse Reactions ; Hospitals ; Nigeria ; Physical Examination
    Language English
    Publishing date 2023-06-30
    Publishing country Uganda
    Document type Case Reports
    ZDB-ID 2514347-5
    ISSN 1937-8688 ; 1937-8688
    ISSN (online) 1937-8688
    ISSN 1937-8688
    DOI 10.11604/pamj.2023.45.113.38579
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Predictors of chronic kidney disease among HIV-infected patients on highly active antiretroviral therapy at the University of Calabar Teaching Hospital, Calabar, South-South Nigeria.

    Okpa, Henry Ohem / Bisong, Elvis Mbu / Enang, Ofem Egbe / Effa, Emmanuel Edet / Monjok, Emmanuel / Essien, Ekere James

    HIV/AIDS (Auckland, N.Z.)

    2019  Volume 11, Page(s) 61–67

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2019-04-05
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2520734-9
    ISSN 1179-1373
    ISSN 1179-1373
    DOI 10.2147/HIV.S189802
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Intradialysis blood pressure changes among chronic kidney disease patients on maintenance haemodialysis in a tertiary hospital south - south Nigeria: a 2 year retrospective study.

    Okpa, Henry Ohem / Effa, Emmanuel Edet / Oparah, Sidney Kelechi / Chikezie, John Austin / Bisong, Elvis Mbu / Mbu, Patrick Ntui / Otokpa, Daniel Emmanuel

    The Pan African medical journal

    2019  Volume 33, Page(s) 91

    Abstract: Introduction: Haemodialysis (HD) which is a form of renal replacement therapy commonly prescribed for patients with chronic kidney disease (CKD). However, it is not without deleterious haemodynamic responses which may occur either during or immediately ... ...

    Abstract Introduction: Haemodialysis (HD) which is a form of renal replacement therapy commonly prescribed for patients with chronic kidney disease (CKD). However, it is not without deleterious haemodynamic responses which may occur either during or immediately after the termination of the procedure. These may include hypotension or hypertension.
    Methods: This was a retrospective study that reviewed chronic kidney disease (CKD) patients on maintenance haemodialysis at the renal unit of University of Calabar Teaching Hospital, Calabar, Nigeria. In all, 71 patients were reviewed but only 64 patients had complete data for analysis. Socio-demographic, clinical and biochemical data were obtained from the records in the dialysis unit.
    Results: There were more males 38 (59.4%) than females 26 (40.6%) in the study. The mean age was 51.71±15.43 years and 43.04±14.03years for males and females respectively. The prevalence of intradialysis hypertension 29 (45.3%) was higher than that of intradialysis hypotension 20 (31.3%) and the commonest cause of CKD requiring haemodialysis was diabetic nephropathy. The factors associated with intradialysis hypotension were lower post-dialysis systolic blood pressure (PDSBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and less number of antihypertensive medications; while the factors associated with intradialysis hypertension were higher post-dialysis systolic blood pressure (SBP), MAP, greater number of antihypertensive medications and longer duration of haemodialysis.
    Conclusion: Our study shows that there are several modifiable factors associated with blood pressure fluctuations among CKD patients on maintenance haemodialysis in the renal unit of the University of Calabar Teaching Hospital, Calabar.
    MeSH term(s) Adolescent ; Adult ; Aged ; Antihypertensive Agents/administration & dosage ; Blood Pressure ; Female ; Hospitals, Teaching ; Humans ; Hypertension/epidemiology ; Hypertension/etiology ; Hypotension/epidemiology ; Hypotension/etiology ; Male ; Middle Aged ; Nigeria ; Prevalence ; Renal Dialysis/methods ; Renal Insufficiency, Chronic/therapy ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers ; Time Factors ; Young Adult
    Chemical Substances Antihypertensive Agents
    Language English
    Publishing date 2019-06-06
    Publishing country Uganda
    Document type Journal Article
    ZDB-ID 2514347-5
    ISSN 1937-8688 ; 1937-8688
    ISSN (online) 1937-8688
    ISSN 1937-8688
    DOI 10.11604/pamj.2019.33.91.17000
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Assessment of dyslipidemia in pre-dialysis patients in south-west Nigeria.

    Akpan, Effiong Ekong / Ekrikpo, Udeme Ekpenyong / Effa, Emmanuel Edet / Udo, Aniema Isaac Assam / Kadiri, Solomon

    Nigerian medical journal : journal of the Nigeria Medical Association

    2014  Volume 55, Issue 3, Page(s) 214–219

    Abstract: Background: Majority of chronic kidney disease (CKD) patients are more likely to die of cardiovascular complications before reaching end stage renal disease. The Kidney Disease Outcomes Quality Initiative (K/DOQI) recommends that all CKD patients should ...

    Abstract Background: Majority of chronic kidney disease (CKD) patients are more likely to die of cardiovascular complications before reaching end stage renal disease. The Kidney Disease Outcomes Quality Initiative (K/DOQI) recommends that all CKD patients should be evaluated for dyslipidemia and for treatment to reduce the risk of cardiovascular events.
    Patients and methods: A cross-sectional case control study to determine the frequency of occurrence of lipid abnormalities in patients with CKD and compare these abnormalities with that of normal controls. A total of 100 patients and 100 controls were recruited for the study. Demographic and clinical data were obtained using structured questionnaire. Weight, height and waist circumference, body mass index (BMI) and blood pressure were also obtained. Subjects had their fasting lipid profile and fasting plasma glucose assayed after overnight fast of 8-14 hours. Low-density lipoprotein (LDL) was obtained using Friedwald formula.
    Result: The study revealed that total cholesterol (TC) was elevated above normal levels in 44% of cases compared with 6% in controls (P < 0.001), with the mean (SD) value of 5.82 ± 3.28 mmol/l for cases compared with 3.9 ± 1.0 mmol/l (P < 0.001) in controls. Low density lipoprotein was elevated in 48% of cases compared with 14% in controls (P < 0.001), with the mean (SD) values of 4.15 ± 2.74 mmol/l and 2.57 ± 0.95 mmol/l for cases and controls, respectively, (P < 0.001). Triglyceride (TG) was elevated above normal level in 26% of cases compared with none in the controls (P < 0.001), with the mean (SD) values of 1.41 ± 1.10 mmol/l and 0.64 ± 0.24 mmol/l for cases and controls, respectively (P < 0.001). All Lipid fractions except HDL also correlated significantly with levels of proteinuria TC (r = 0.345, P = 0.001), TG (r = 0.268, P = 0.011) LDL (r = 0.366, P = 0.001).
    Conclusion: Dyslipidemia is common among patients with CKD. Regular evaluation of all CKD patients for dyslipidemia and treatment need be instituted.
    Language English
    Publishing date 2014-06-11
    Publishing country Nigeria
    Document type Journal Article
    ZDB-ID 424429-1
    ISSN 0300-1652
    ISSN 0300-1652
    DOI 10.4103/0300-1652.132043
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4965: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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