Seizure disorder among chronic kidney disease patients in Enugu, South East Nigeria.

BACKGROUND: Seizures are the commonest neurological condition presenting in Africa. The pattern of non- epileptic seizures in systemic diseases including chronic kidney disease is unknown in South East Nigeria. OBJECTIVES: This study examined the pattern of seizures in chronic kidney disease patients in Enugu, South East Nigeria. METHODS: This was a retrospective study of chronic kidney disease patients who presented to the University of Nigeria Teaching Hospital Enugu (UNTH) from January 2007 December 2008. Data from subjects who satisfied the inclusion criteria were reviewed and analysed using Statistical Package for the Social Sciences version 13.5. Ethical clearance was obtained from the UNTH Ethics Committee. RESULTS: There were 145 patients, 95 males and 50 females. Mean age was 35 years. Only 5 patients (3,4%) had seizures (mostly generalized tonic-clonic) associated with severe hypertension. None had hypocalcaemia. Three patients (60%) received dialysis with benefit while 2 patients (40%) died before dialysis could be done. CONCLUSION: Seizures are infrequent in chronic kidney disease patients in Enugu; are commoner in males and those with severe disease. Dialysis improved survival in those with seizures. Larger multicentre studies are needed to further elucidate the spectrum of Nigeria.

Intra-cardiac masses in adults: a review of echocardiogram records at two echocardiographic laboratories in Enugu, South-East Nigeria.

BACKGROUND: Transthoracic echocardiography (TTE) is an excellent initial diagnostic technique used to evaluate and diagnose cardiac masses, even though transoesophageal echocardiography (TEE) provides superior image resolution and better visualization of cardiac masses, especially in patients with suboptimal transthoracic echocardiographic studies. TTE is the clinical procedure of choice for identification of left ventricular thrombi. TTE has greater than 90% sensitivity and greater than 85% specificity for detection of left ventricular thrombi and is probably superior to the sensitivity and specificity of TEE, especially for apical thrombi. AIMS: The study aimed to identify the common types of cardiac masses and their commonest locations in the heart. MATERIALS AND METHODS: We did a retrospective review of our echocardiogram reports from May 2003 to July 2012 to identify the frequency of intra-cardiac masses in adults, as well as the gender distribution and commonest location of these masses. RESULTS: There were 2,814 echo examinations in adults over this period, comprising 1,661 males (59.1%) and 1,153 females (40.9%). Intra-cardiac masses were found in 20 of these patients representing 0.7% of the study population. Thrombi were the commonest masses noted in our study, and there were more masses in the atria than in the ventricles. The left heart chambers also had more masses than the right heart chambers. There was no sex difference in the frequency of cardiac masses. CONCLUSION: Intra-cardiac masses are rare, and transthoracic echocardiography is still valuable in the diagnosis and initial characterization of cardiac masses.

Common echocardiographic abnormalities in Nigerians of different age groups.

BACKGROUND: Transthoracic echocardiography (TTE) is one of the most commonly performed cardiac investigations. It can provide comprehensive information about cardiac structure and function, helping to establish a diagnosis and guide therapy, and it is no longer the preserve of the specialist cardiology department. Previous studies on echocardiographic findings in our environment had documented valvular heart disease, hypertensive heart disease and congenital heart diseases as the commonest echocardiographic findings in Nigerians. AIMS: The study aimed to provide an update on the common echocardiographic findings in different age groups in this part of the world, since some of the previous similar studies were done over a decade ago. MATERIALS AND METHODS: We reviewed the echocardiogram reports of 608 consecutive patients done from July 2009 to October 2011 at a private echocardiographic laboratory in Enugu, South-East Nigeria. Data was analyzed for age, gender and echocardiographic findings. RESULTS: The age range of the patients was from 3 days to 98 years with a mean age of 46.4 ± 21.4 years. The mean age of the males was 47.6 ± 21.3 years, while the mean age of the females was 45.2 ± 21.1 years. The commonest echocardiographic abnormality in children was atrial septal defect, while rheumatic heart disease was the commonest in adolescents and young adults. Left ventricular diastolic dysfunction and degenerative valvular diseases respectively were the commonest in the middle-aged and elderly populations in this study. CONCLUSION: This study has reaffirmed rheumatic heart disease (predominantly mitral valve regurgitation) as the commonest cardiac abnormality in adolescents and young adults. Degenerative valvular diseases, left ventricular diastolic dysfunction, and atrial septal defects were the commonest abnormalities in the elderly, middle-aged population and children, respectively.