Professor, physician - scientist, cardiovascular physician - clinical Pharmacologist, MD, PhD , Fellow British Pharmacological Society, Fellow West African College of Physicians, Merck Fellow, Wellcome Trust Fellow, Young Investigator Award : American Society of Clinical investigation, The Outstanding Young Person Award for Academic accomplishments Nigeria, by Junior Chamber international, University Scholar, Faculty prize winner and Deans Medalist, Author of Diaspora Medicine, Immigration and Health text books and more than 180 peer reviewed journal articles , Book chapters , conference proceedings and abstracts.
Austin Journal of Pharmacology and Therapeutics, 2021
The pharmacology of anti-SARS-CoV-2 drugs, Molnupiravir (M) and repurposed Ivermectin (IV) were c... more The pharmacology of anti-SARS-CoV-2 drugs, Molnupiravir (M) and repurposed Ivermectin (IV) were compared. The IC50 for the inhibition of viral replication were 0.3μM for M and 2.8μM for IV. Both drugs have good oral absorption, with M achieving peak plasma concentrations by 2 hours and IV by 5 hours. The plasma half life were 7 hours for M and 81-91 hours for IV. M inhibits viral replication inducing viral mutagenesis in RdRp, causing viral error catastrophe and viral extinction. IV affects viral cell entry, nuclear transport and inhibits replication via RdRp. IV has additional effect to suppress cytokine production through STAT-3 inhibition. M is a more potent antiviral drug and IV has a longer residence in the body. Their effects on RdRp and cytokine inhibition are potentially complimentary for anti-COVID-19 activity. Both IV and M should be compared in randomized controlled clinical trials, and the possibility of their combination for anti-SARS-CoV-2 antiviral actions, explored f...
The efficacy of ivermectin (IVM) against SARS-CoV-2 has been demonstrated in vitro, while several... more The efficacy of ivermectin (IVM) against SARS-CoV-2 has been demonstrated in vitro, while several clinical studies suggest that it is efficacious and safe in reducing morbidity and mortality. Hydroxychloroquine HCQ, IVM and azithromycin AZM (HIA therapy) are being used in several low- and middle-income countries (LMICs) where more expensive medications such as remdesivir are out of reach. In this study, we set out to compare the efficacy of IVM monotherapy with HIA combination therapy. Methods: This was a single-blind, randomized control trial of 2 parallel groups of COVID-19-positive Nigerians. Thirty patients received ivermectin 200 mcg/kg daily for five days, while 31 patients received HIA triple therapy. The viral cycle threshold (Ct) at pretreatment baseline and days 2, 5 14 and 21 were measured for the E- and N-genes. SPO2 was assessed on a daily basis, while inflammatory markers erythrocyte sedimentation rate (ESR), C-reactive protein, and D-dimer and neutrophil/lymphocyte ra...
International journal of dermatology, Jan 26, 2018
Chloroquine (CQ) is an antimalarial drug that elicits severe pruritus in black Africans with mala... more Chloroquine (CQ) is an antimalarial drug that elicits severe pruritus in black Africans with malaria fever. This acute itching (2-7 days duration) exhibits age dependency and a racial and genetic predilection. CQ itch is non-histaminergic, which makes it both a good model and a tool to probe the mechanisms of chronic itch. This review focuses on recently discovered mechanisms, neuroscience, mediators, and receptors that are implicated in molecular studies of CQ pruritus. CQ pruritus mechanisms are also compared to that of itching following other systemic diseases, such as chronic kidney disease, chronic liver disease, skin disorders, and burns. There are striking similarities between CQ itching pathways and other chronic itch secondary to systemic disease with or without skin lesions, which have not been previously highlighted. Prominent among these are the shared roles of skin, neural and spinal μ opiate receptors, kappa opiate receptor, nitric oxide, serotonin via 5HT1B/D receptor...
Journal of Pharmacology and Pharmacotherapeutics, 2017
To assess the effects of hydrochlorothiazide (HCT) given alone and in combination with an angiote... more To assess the effects of hydrochlorothiazide (HCT) given alone and in combination with an angiotensin-converting enzyme inhibitor (ACEI) on beta-cell function in a negroid population to further explore possible ethnic differences in the effect of antihypertensive drugs on homeostasis model assessment - insulin resistance (HOMA-IR). A total of 80 newly diagnosed Nigerian essential hypertensive patients were assigned to receive either HCT 25 mg daily or both HCT and lisinopril (Lis; 25/10 mg daily) in an open-label study for 12 weeks. The treatment groups were well matched in clinical and demographic baseline features. Changes in HOMA-IR from baseline to end of study (week 12), fasting plasma glucose (FPG), serum potassium, serum insulin, and blood pressure over the same period were also evaluated. After 12 weeks, mean delta HOMA-IR (and %) was higher in the HCT monotherapy group; although, this change did not reach statistical significance in both groups -0.1 ± 7.1, P = 0.538 (HCT) and 0.6 ± 4.2 P = 0.913 (HCT + Lis); an insignificant increase was observed in FPG and serum insulin in both groups, whereas serum potassium decreased in similar fashion. Blood pressure reduction was similar in both groups. Analysis of HOMA-IR change according to gender in response to HCT mono- or combination therapy with Lis showed no significant difference. HCT monotherapy in hypertensive indigenous Nigerians, was not associated with worse metabolic effects when compared with combination therapy using Lis, an ACEI after 12 weeks. Low-dose thiazide diuretic as first-line antihypertensive medication may be safe in the short-term, further larger and long-term studies are needed to corroborate this finding.
The Journal of pharmacology and experimental therapeutics, 2001
Many vasoactive agents produce qualitatively similar effects on blood flow in the renal cortex an... more Many vasoactive agents produce qualitatively similar effects on blood flow in the renal cortex and medulla, evoking reductions or increases in blood flow in both regions. We demonstrated previously that endothelin-1 (ET-1) is an exception because it evoked an increase in medullary perfusion despite a potent cortical vasoconstriction ( Hercule and Oyekan 2000). We report here that U46619 (11,9 epoxymethano-prostaglandin H2), a selective agonist of prostaglandin H2 (PGH2)/thromboxane A2 (TxA2) (TP) receptor, evokes similar effects as ET-1. In the pentobarbital-anesthetized (60 mg/kg) rat, 1, 3, and 5 microg/kg U46619 dose dependently reduced mean arterial blood pressure by -2 +/- 4, -8 +/- 10, and -31 +/- 10 mm Hg, respectively; renal cortical blood flow (CBF) by -50 +/- 11, -174 +/- 45, and -349 +/- 43 perfusion units (PU), respectively; but increased medullary blood flow (MBF) by 42 +/- 16, 51 +/- 18, and 61 +/- 21 PU, respectively. Prostaglandin F2alpha, a TxA2 mimetic, produced si...
A five-year prospective study of chloramphenicol induced aplastic anaemia in Nigerians was undert... more A five-year prospective study of chloramphenicol induced aplastic anaemia in Nigerians was undertaken. Five proven cases were seen, representing 45.5% of all cases of aplastic anaemia diagnosed during the period of study and 1.0 cases per year. Chloramphenicol induced aplastic anaemia is rare (only 0.002% of all new non-obstetric patients seen in the hospital during the period of study) but preventable. Restriction of the drug or its total withdrawal is recommended.
The global spread of hepatitis B virus (HBV) and hepatitis C virus (HCV), their high chronicity r... more The global spread of hepatitis B virus (HBV) and hepatitis C virus (HCV), their high chronicity rates and their progression to cirrhosis and hepatocellular carcinoma, are major public health problems. Research and intervention programmes for special population groups are needed in order to assess their infection risk and set up suitable prevention and control strategies. Aim of this paper is to give health care professionals information on HBV and HCV infections amongst migrants, drug users and prison inmates. The manuscript is an official Position Paper on behalf of the following Scientific Societies: Italian Association for the Study of the Liver (A.I.S.F.), Italian Society of Infectious and Tropical Diseases (S.I.M.I.T.), Italian Federation Department's Operators and Addiction Services (FederSerD), Italian Prison Medicine and Healthcare Society (S.I.M.S.Pe.). The considered population groups, having a high prevalence HBV and HCV infections, require specific interventions. In this context, the expression "special population" refers to specific vulnerable groups at risk of social exclusion, such as migrants, prison inmates, and intravenous drug users. When dealing with special population groups, social, environmental and clinical factors should be considered when selecting candidates for therapy as indicated by national and international guidelines.
Background The incidence of thrombotic cardiovascular disease is greater in men than in premenopa... more Background The incidence of thrombotic cardiovascular disease is greater in men than in premenopausal women. Testosterone has been implicated as a significant risk factor for cardiovascular disease and for acute myocardial infarctions and strokes in young male athletes who abuse anabolic steroids. Thromboxane A 2 (TXA 2 ) is a vasoconstrictor and platelet proaggregatory agent that has been implicated in the pathogenesis of cardiovascular disease. We therefore tested the hypothesis that testosterone regulates the expression of human platelet TXA 2 receptors. Methods and Results In a double-blind, placebo-controlled, randomized, parallel-group study, we determined the effects of testosterone cypionate 200 mg IM given twice, 2 weeks apart, or saline placebo in 16 healthy men. Platelet TXA 2 receptor density (B max ) and dissociation constant ( K d ) were measured by use of the TXA 2 mimetic 125 I-BOP. Platelet aggregation responses to I-BOP and to thrombin and plasma testosterone conce...
Congestive heart failure is also a major source of morbidity and mortality in Nigerians as it is ... more Congestive heart failure is also a major source of morbidity and mortality in Nigerians as it is in the rest of the world. Hypertension is the commonest cause and the incidence of coronary artery disease, though not as common as in Western countries, may be on the increase. The etiological spectrum in Nigeria and probably Africa differs from the rest of the world and we paid special attention to peripartum cardiomyopathy and endomyocardial fibrosis. Sadly no large-scale trials of mortality reducing drugs have taken place here but a few small scale trials suggest that angiotensin converting enzyme inhibitors and beta blockers may also have clinical benefit. The side effect profiles of these drugs are largely similar in Nigeria and Western countries though, Nigerians may have a lower incidence of angioedema in relation to ACE inhibitors than is expected in a black population. Sadly cardiac resynchronization therapy, left ventricular assist devices and transplantation are not widely available at this time in Nigeria so the emphasis on mortality reduction remains prevention, early detection and treatment of high blood pressure.
Conventional unfractionated heparin substantially enhances spontaneous platelet aggregation in pr... more Conventional unfractionated heparin substantially enhances spontaneous platelet aggregation in pregnancy in vitro, and may cause platelet activation in healthy volunteers in vivo. It is unknown, however, whether therapeutically administered heparin affects platelet behavior during pregnancy. In a parallel group ex vivo study, 8 third trimester pregnant patients requiring anticoagulation with heparin exhibited a trend to a greater spontaneous platelet aggregation, in comparison to 11 age-matched healthy third trimester pregnant controls. This is consistent with heparin-induced platelet activation in vivo during therapeutic anticoagulation. Peak aggregation in the heparin-treated group was 48 +/- 4% compared to 37 +/- 5% in the healthy controls, (P = 0.086 ANOVA): and significant time treatment interaction (P = 0.03 ANOVA). There was also a weak positive correlation (r = 0.54) between the peak % spontaneous platelet aggregation and the activated partial thromboplastin time ratio durin...
Austin Journal of Pharmacology and Therapeutics, 2021
The pharmacology of anti-SARS-CoV-2 drugs, Molnupiravir (M) and repurposed Ivermectin (IV) were c... more The pharmacology of anti-SARS-CoV-2 drugs, Molnupiravir (M) and repurposed Ivermectin (IV) were compared. The IC50 for the inhibition of viral replication were 0.3μM for M and 2.8μM for IV. Both drugs have good oral absorption, with M achieving peak plasma concentrations by 2 hours and IV by 5 hours. The plasma half life were 7 hours for M and 81-91 hours for IV. M inhibits viral replication inducing viral mutagenesis in RdRp, causing viral error catastrophe and viral extinction. IV affects viral cell entry, nuclear transport and inhibits replication via RdRp. IV has additional effect to suppress cytokine production through STAT-3 inhibition. M is a more potent antiviral drug and IV has a longer residence in the body. Their effects on RdRp and cytokine inhibition are potentially complimentary for anti-COVID-19 activity. Both IV and M should be compared in randomized controlled clinical trials, and the possibility of their combination for anti-SARS-CoV-2 antiviral actions, explored f...
The efficacy of ivermectin (IVM) against SARS-CoV-2 has been demonstrated in vitro, while several... more The efficacy of ivermectin (IVM) against SARS-CoV-2 has been demonstrated in vitro, while several clinical studies suggest that it is efficacious and safe in reducing morbidity and mortality. Hydroxychloroquine HCQ, IVM and azithromycin AZM (HIA therapy) are being used in several low- and middle-income countries (LMICs) where more expensive medications such as remdesivir are out of reach. In this study, we set out to compare the efficacy of IVM monotherapy with HIA combination therapy. Methods: This was a single-blind, randomized control trial of 2 parallel groups of COVID-19-positive Nigerians. Thirty patients received ivermectin 200 mcg/kg daily for five days, while 31 patients received HIA triple therapy. The viral cycle threshold (Ct) at pretreatment baseline and days 2, 5 14 and 21 were measured for the E- and N-genes. SPO2 was assessed on a daily basis, while inflammatory markers erythrocyte sedimentation rate (ESR), C-reactive protein, and D-dimer and neutrophil/lymphocyte ra...
International journal of dermatology, Jan 26, 2018
Chloroquine (CQ) is an antimalarial drug that elicits severe pruritus in black Africans with mala... more Chloroquine (CQ) is an antimalarial drug that elicits severe pruritus in black Africans with malaria fever. This acute itching (2-7 days duration) exhibits age dependency and a racial and genetic predilection. CQ itch is non-histaminergic, which makes it both a good model and a tool to probe the mechanisms of chronic itch. This review focuses on recently discovered mechanisms, neuroscience, mediators, and receptors that are implicated in molecular studies of CQ pruritus. CQ pruritus mechanisms are also compared to that of itching following other systemic diseases, such as chronic kidney disease, chronic liver disease, skin disorders, and burns. There are striking similarities between CQ itching pathways and other chronic itch secondary to systemic disease with or without skin lesions, which have not been previously highlighted. Prominent among these are the shared roles of skin, neural and spinal μ opiate receptors, kappa opiate receptor, nitric oxide, serotonin via 5HT1B/D receptor...
Journal of Pharmacology and Pharmacotherapeutics, 2017
To assess the effects of hydrochlorothiazide (HCT) given alone and in combination with an angiote... more To assess the effects of hydrochlorothiazide (HCT) given alone and in combination with an angiotensin-converting enzyme inhibitor (ACEI) on beta-cell function in a negroid population to further explore possible ethnic differences in the effect of antihypertensive drugs on homeostasis model assessment - insulin resistance (HOMA-IR). A total of 80 newly diagnosed Nigerian essential hypertensive patients were assigned to receive either HCT 25 mg daily or both HCT and lisinopril (Lis; 25/10 mg daily) in an open-label study for 12 weeks. The treatment groups were well matched in clinical and demographic baseline features. Changes in HOMA-IR from baseline to end of study (week 12), fasting plasma glucose (FPG), serum potassium, serum insulin, and blood pressure over the same period were also evaluated. After 12 weeks, mean delta HOMA-IR (and %) was higher in the HCT monotherapy group; although, this change did not reach statistical significance in both groups -0.1 ± 7.1, P = 0.538 (HCT) and 0.6 ± 4.2 P = 0.913 (HCT + Lis); an insignificant increase was observed in FPG and serum insulin in both groups, whereas serum potassium decreased in similar fashion. Blood pressure reduction was similar in both groups. Analysis of HOMA-IR change according to gender in response to HCT mono- or combination therapy with Lis showed no significant difference. HCT monotherapy in hypertensive indigenous Nigerians, was not associated with worse metabolic effects when compared with combination therapy using Lis, an ACEI after 12 weeks. Low-dose thiazide diuretic as first-line antihypertensive medication may be safe in the short-term, further larger and long-term studies are needed to corroborate this finding.
The Journal of pharmacology and experimental therapeutics, 2001
Many vasoactive agents produce qualitatively similar effects on blood flow in the renal cortex an... more Many vasoactive agents produce qualitatively similar effects on blood flow in the renal cortex and medulla, evoking reductions or increases in blood flow in both regions. We demonstrated previously that endothelin-1 (ET-1) is an exception because it evoked an increase in medullary perfusion despite a potent cortical vasoconstriction ( Hercule and Oyekan 2000). We report here that U46619 (11,9 epoxymethano-prostaglandin H2), a selective agonist of prostaglandin H2 (PGH2)/thromboxane A2 (TxA2) (TP) receptor, evokes similar effects as ET-1. In the pentobarbital-anesthetized (60 mg/kg) rat, 1, 3, and 5 microg/kg U46619 dose dependently reduced mean arterial blood pressure by -2 +/- 4, -8 +/- 10, and -31 +/- 10 mm Hg, respectively; renal cortical blood flow (CBF) by -50 +/- 11, -174 +/- 45, and -349 +/- 43 perfusion units (PU), respectively; but increased medullary blood flow (MBF) by 42 +/- 16, 51 +/- 18, and 61 +/- 21 PU, respectively. Prostaglandin F2alpha, a TxA2 mimetic, produced si...
A five-year prospective study of chloramphenicol induced aplastic anaemia in Nigerians was undert... more A five-year prospective study of chloramphenicol induced aplastic anaemia in Nigerians was undertaken. Five proven cases were seen, representing 45.5% of all cases of aplastic anaemia diagnosed during the period of study and 1.0 cases per year. Chloramphenicol induced aplastic anaemia is rare (only 0.002% of all new non-obstetric patients seen in the hospital during the period of study) but preventable. Restriction of the drug or its total withdrawal is recommended.
The global spread of hepatitis B virus (HBV) and hepatitis C virus (HCV), their high chronicity r... more The global spread of hepatitis B virus (HBV) and hepatitis C virus (HCV), their high chronicity rates and their progression to cirrhosis and hepatocellular carcinoma, are major public health problems. Research and intervention programmes for special population groups are needed in order to assess their infection risk and set up suitable prevention and control strategies. Aim of this paper is to give health care professionals information on HBV and HCV infections amongst migrants, drug users and prison inmates. The manuscript is an official Position Paper on behalf of the following Scientific Societies: Italian Association for the Study of the Liver (A.I.S.F.), Italian Society of Infectious and Tropical Diseases (S.I.M.I.T.), Italian Federation Department's Operators and Addiction Services (FederSerD), Italian Prison Medicine and Healthcare Society (S.I.M.S.Pe.). The considered population groups, having a high prevalence HBV and HCV infections, require specific interventions. In this context, the expression "special population" refers to specific vulnerable groups at risk of social exclusion, such as migrants, prison inmates, and intravenous drug users. When dealing with special population groups, social, environmental and clinical factors should be considered when selecting candidates for therapy as indicated by national and international guidelines.
Background The incidence of thrombotic cardiovascular disease is greater in men than in premenopa... more Background The incidence of thrombotic cardiovascular disease is greater in men than in premenopausal women. Testosterone has been implicated as a significant risk factor for cardiovascular disease and for acute myocardial infarctions and strokes in young male athletes who abuse anabolic steroids. Thromboxane A 2 (TXA 2 ) is a vasoconstrictor and platelet proaggregatory agent that has been implicated in the pathogenesis of cardiovascular disease. We therefore tested the hypothesis that testosterone regulates the expression of human platelet TXA 2 receptors. Methods and Results In a double-blind, placebo-controlled, randomized, parallel-group study, we determined the effects of testosterone cypionate 200 mg IM given twice, 2 weeks apart, or saline placebo in 16 healthy men. Platelet TXA 2 receptor density (B max ) and dissociation constant ( K d ) were measured by use of the TXA 2 mimetic 125 I-BOP. Platelet aggregation responses to I-BOP and to thrombin and plasma testosterone conce...
Congestive heart failure is also a major source of morbidity and mortality in Nigerians as it is ... more Congestive heart failure is also a major source of morbidity and mortality in Nigerians as it is in the rest of the world. Hypertension is the commonest cause and the incidence of coronary artery disease, though not as common as in Western countries, may be on the increase. The etiological spectrum in Nigeria and probably Africa differs from the rest of the world and we paid special attention to peripartum cardiomyopathy and endomyocardial fibrosis. Sadly no large-scale trials of mortality reducing drugs have taken place here but a few small scale trials suggest that angiotensin converting enzyme inhibitors and beta blockers may also have clinical benefit. The side effect profiles of these drugs are largely similar in Nigeria and Western countries though, Nigerians may have a lower incidence of angioedema in relation to ACE inhibitors than is expected in a black population. Sadly cardiac resynchronization therapy, left ventricular assist devices and transplantation are not widely available at this time in Nigeria so the emphasis on mortality reduction remains prevention, early detection and treatment of high blood pressure.
Conventional unfractionated heparin substantially enhances spontaneous platelet aggregation in pr... more Conventional unfractionated heparin substantially enhances spontaneous platelet aggregation in pregnancy in vitro, and may cause platelet activation in healthy volunteers in vivo. It is unknown, however, whether therapeutically administered heparin affects platelet behavior during pregnancy. In a parallel group ex vivo study, 8 third trimester pregnant patients requiring anticoagulation with heparin exhibited a trend to a greater spontaneous platelet aggregation, in comparison to 11 age-matched healthy third trimester pregnant controls. This is consistent with heparin-induced platelet activation in vivo during therapeutic anticoagulation. Peak aggregation in the heparin-treated group was 48 +/- 4% compared to 37 +/- 5% in the healthy controls, (P = 0.086 ANOVA): and significant time treatment interaction (P = 0.03 ANOVA). There was also a weak positive correlation (r = 0.54) between the peak % spontaneous platelet aggregation and the activated partial thromboplastin time ratio durin...
Prof Adesuyi A Leslie Ajayi MD, PhD, FWACP, FBPharmacolS
This fully referenced textbook of Medi... more Prof Adesuyi A Leslie Ajayi MD, PhD, FWACP, FBPharmacolS
This fully referenced textbook of Medicine (2,000 refeences cited) is written to integrate the art and science of history, physical diagnosis and logical deduction (section 1) with a detailed exposition of pathophysiology and systemic or organ based medicine (section 2) followed by general principles of clinical pharmacology, rational drug use and therapeutics (section 3). In all there are 22 chapters. The book possess a uniqueness in describing diseases common in Africans in Africa ( such as endomyocardial fibrosis, pueperal cardiomyopathy, sickle cell trait, Diet induced season ataxic syndromes and neuropathy, chloroquine induced itching, rarity of auto-immune disorders in indigenous Africans, but increased incidence upon migration ) as well as the general cosmopolitan global medicine. The more frequent and more severe natural history of hypertension and its target organ damage on blacks is highlighted, as is its role in sudden cardiac death (SCD). As the countries of world increasingly contain people all ethnicities, and since common diseases may manifest differently by ethnicity, this book equips all practitioners (medical, nursing, pharmacists ) with referenced information on disease variation in black people anywhere in the world, thereby enriching global medical literature. Parenthetically, the book recognizes the research labor of indigenous African medical or clinical researchers as appropriate whose work may not receive a global attention. The book serves both medical, nursing or pharmacy students and Physician Consultants who desire a quick refresher on Medicine in black Africans as well as Tropical Medicine, inclusive of virology and parasitology. The book opens vistas for mechanistic hypotheses which can be tested by medical research and further expansion and improvements and updating are envisaged for the book,
Immigration and Health USA is written to inform and assist both the recent global immigrants to t... more Immigration and Health USA is written to inform and assist both the recent global immigrants to the USA, and the host Americans and their governments in understanding health status diversity and the dynamics and impact of acculturative stress of US residence on the health of the immigrants by region of nativity and mode of departure from their origins. Immigrants arrive with a generally healthier status than host Americans with longer US residence. This is known as the Healthy immigrant paradox . The book focuses on ways to maintain and promote the physical and mental health status of the immigrants despite acculturative stress and post -immigration depression. This fully referenced book is divided into 9 chapters : Chapter 1. Who is coming from where ? 2. Consequences of leaving region of nativity (physical and mental) 3. Adverse health effects of acculturation to the American lifestyle 4. Mortality by Ethnicity and ethnic disparities in health outcomes 5. Ethnic variation in efficacy and adverse effects and safety of drug therapy 6. Impact of immigration on Women, pregnant women and their children 7. Health Maintenance and Promotion for Immigrants 8. Travel Medicine 9, Synthesis and recommendations.
This updated version ( from the 2008 print version Immigration and Health by Author house publishers Inc ) includes Affordable Care Act changes and other changes relating to recent permission and admission of HIV positive people as immigrants to the USA. Nativity region specific disease burden, condition or reason for immigration and their interaction with post immigration acculturative stress and the impact of these on mental and physical health and wellness is emphasized.
In a single blind parallel group study , treatment with either hydrochlorothiazide alone (25mg) o... more In a single blind parallel group study , treatment with either hydrochlorothiazide alone (25mg) or Hydrochlorothiazide combined with Lisinopril (20mg) did not alter the Beta cell function or HOMA-IR compared to baseline reading, but significantly lowered systolic and diastolic BP from base line
ABSTRACT Chloroquine (CQ) induces severe generalized itching in black patients with malaria fever, and in the treatment of rheumatological diseases, globally. We previously demonstrated that the CQ-induced pruritus may involve release of endogenous opioids or interaction with the mu-opiate receptors in rats. We tested the hypothesis that Naltrexone(N) a mu opiate antagonist, will prevent or palliate severe pruritus in patients with parasitologically proven malaria fever. In a double blind, randomized parallel group study, 6 patients each, with established CQ-pruritus history in malaria, received Naltrexone 100mg tablet once or promethazine [P] 25mg tablet, concurrently with full treatment with CQ [2.1 g over 3 days] for malaria fever. Pruritus intensity was self-assessed by a categorical scale of 0-4, or by a VAS score, at 0, 6, 12, 24, 48 and 72 hours of dosing. Malaria parasite density, [median 780 /ul - N, and 240/ul-P] Areas under the pruritus -intensity time curve was calculated for each patient. Both agents attenuated itching severity with no significant difference between treatments in the pruritus intensity or AUC by 2 way -repeated measures ANOVA[p= 0.66, F=0.19] but there was a significant time effect in pruritus intensity [p = 0.001, ANOVA df5 F=4.77].One of six patients on N, and 2 of 6 on P, had total prevention of itching. Thus, N may be as efficacious in inhibiting CQ pruritus in malaria, and endogenous opiates/receptors contribute to CQ induced itching in humans.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's
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This fully referenced textbook of Medicine (2,000 refeences cited) is written to integrate the art and science of history, physical diagnosis and logical deduction (section 1) with a detailed exposition of pathophysiology and systemic or organ based medicine (section 2) followed by general principles of clinical pharmacology, rational drug use and therapeutics (section 3). In all there are 22 chapters. The book possess a uniqueness in describing diseases common in Africans in Africa ( such as endomyocardial fibrosis, pueperal cardiomyopathy, sickle cell trait, Diet induced season ataxic syndromes and neuropathy, chloroquine induced itching, rarity of auto-immune disorders in indigenous Africans, but increased incidence upon migration ) as well as the general cosmopolitan global medicine. The more frequent and more severe natural history of hypertension and its target organ damage on blacks is highlighted, as is its role in sudden cardiac death (SCD). As the countries of world increasingly contain people all ethnicities, and since common diseases may manifest differently by ethnicity, this book equips all practitioners (medical, nursing, pharmacists ) with referenced information on disease variation in black people anywhere in the world, thereby enriching global medical literature. Parenthetically, the book recognizes the research labor of indigenous African medical or clinical researchers as appropriate whose work may not receive a global attention. The book serves both medical, nursing or pharmacy students and Physician Consultants who desire a quick refresher on Medicine in black Africans as well as Tropical Medicine, inclusive of virology and parasitology. The book opens vistas for mechanistic hypotheses which can be tested by medical research and further expansion and improvements and updating are envisaged for the book,
This updated version ( from the 2008 print version Immigration and Health by Author house publishers Inc ) includes Affordable Care Act changes and other changes relating to recent permission and admission of HIV positive people as immigrants to the USA. Nativity region specific disease burden, condition or reason for immigration and their interaction with post immigration acculturative stress and the impact of these on mental and physical health and wellness is emphasized.
B. A. Kolawole
Clinical Pharmacology & Therapeutics 2004 75(2):P27-P27. DOI: 10.1016/j.clpt.2003.11.101
ABSTRACT Chloroquine (CQ) induces severe generalized itching in black patients with malaria fever, and in the treatment of rheumatological diseases, globally. We previously demonstrated that the CQ-induced pruritus may involve release of endogenous opioids or interaction with the mu-opiate receptors in rats. We tested the hypothesis that Naltrexone(N) a mu opiate antagonist, will prevent or palliate severe pruritus in patients with parasitologically proven malaria fever. In a double blind, randomized parallel group study, 6 patients each, with established CQ-pruritus history in malaria, received Naltrexone 100mg tablet once or promethazine [P] 25mg tablet, concurrently with full treatment with CQ [2.1 g over 3 days] for malaria fever. Pruritus intensity was self-assessed by a categorical scale of 0-4, or by a VAS score, at 0, 6, 12, 24, 48 and 72 hours of dosing. Malaria parasite density, [median 780 /ul - N, and 240/ul-P] Areas under the pruritus -intensity time curve was calculated for each patient. Both agents attenuated itching severity with no significant difference between treatments in the pruritus intensity or AUC by 2 way -repeated measures ANOVA[p= 0.66, F=0.19] but there was a significant time effect in pruritus intensity [p = 0.001, ANOVA df5 F=4.77].One of six patients on N, and 2 of 6 on P, had total prevention of itching. Thus, N may be as efficacious in inhibiting CQ pruritus in malaria, and endogenous opiates/receptors contribute to CQ induced itching in humans.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's
Volume 183, Issue 2, 2 July 1990, Pages 504–505
Posters
A.A. Ajayi,
O.E. Ukponmwan