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| 1 | Depression in patients with irritable bowel syndrome in Jos,Nigeria显示文摘AIM: To study the brain-gut interaction and the effect of behavioral or psychiatric conditions on irritable bowel syndrome (IBS) in an African population. METHODS: IBS was diagnosed using the Rome Ⅱ diagnostic criteria. The entry of each patient was confirmed following detailed explanations of the questions. Four hundred and eighteen patients were studied. Subjects satisfying the Rome Ⅱ criteria for IBS were physically examined and stool microscopy was done to identify the presence of “alarm factors”. Depression was diagnosed using the symptom-check list adapted from the Research Diagnostic Criteria (DSM-Ⅳ) of the American Psychiatric Association. RESULTS: Seventy-five (56.8%) of the 132 IBS patients were depressed whereas only 54 (20.1%) of the 268 non-IBS patients were depressed. There was a significant relationship between IBS and depression (χ2 = 54.29, Odds ratio = 5.21, 56.8 ± 8.4 vs 20.1 ± 5.2, P = 0.001). Even though constipation predominant IBS patients were more likely to be depressed, no significant relationship was found between the subtype of IBS and depression (χ2 = 0.02, OR = 0.95, P = 0.68). CONCLUSION: IBS is significantly associated with major depression but not gender and bowel subtypes of the patients. Patients with IBS need to be evaluated for depression due to the highly significant relationship between the two conditions. | Nimzing G Ladep Taiwo J Obindo Moses D Audu Edith N Okeke Abraham O Malu | 2006 | World Journal of Gastroenterology2006，12，48： | 22 |
| 2 | Incidence and mortality of primary liver cancer in England and Wales: Changing patterns and ethnic variations显示文摘AIM: To explore recent trends, modes of diagnosis, ethnic distribution and the mortality to incidence ratio of primary liver cancer by subtypes in England and Wales. METHODS: We obtained incidence(1979-2008) and mortality(1968-2008) data for primary liver cancer for England and Wales and calculated age-standardised incidence and mortality rates. Trends in age-standardised mortality(ASMR) and incidence(ASIR) rates and basis of diagnosis of primary liver cancer and subcategories: hepatocellular carcinoma, intrahepatic bile duct and unspecified liver tumours, were analysed over the study period. Changes in guidelines for the diagnosis of primary liver cancer(PLC) may impact changing trends in the rates that may be obtained. We thus explored changes in the mode of diagnosis as reported to cancer registries. Furthermore, we examined the distribution of these tumours by ethnicity. Most of the statistical manipulations of these data was carried out in Microsoft excel(Seattle, Washington, United Sttaes). Additional epidemiological statistics were done in Epi Info software(Atlanta, GA, United Sttaes). To define patterns of change over time, we evaluated trends in ASMR and ASIR of PLC and intrahepatic bile duct carcinoma(IHBD) using a least squares regression line fitted to the natural logarithm of the mortality and incidence rates. We estimated the patterns of survival over subsequent 5 and 10 years using complement of mortality to incidence ratio(1-MIR). RESULTS: Age-standardised mortality rate of primary liver cancer increased in both sexes: from 2.56 and 1.29/100000 in 1968 to 5.10 and 2.63/100000 in 2008 for men and women respectively. The use of histology for diagnostic confirmation of primary liver cancer increased from 35.7% of registered cases in 1993 to plateau at about 50% during 2005 to 2008. Reliance on cytology as a basis of diagnosis has maintained a downward trend throughout the study period. Although approximately 30% of the PLC registrations had information on ethnicity, there was a relatively higher registration of the major tumour subtypes in patients whose ethnic backgrounds were from high incident regions of the world. Survival from PLC is estimated to get poorer in 10 years(2018) relative to 2008, particularly as a result of IHBD. CONCLUSION: Incidence and mortality of PLC, and particularly IHBD, have continued to rise in England and Wales. Changes in the modes of diagnosis may be contributing. | Nimzing G Ladep Shahid A Khan Mary ME Crossey Andrew V Thillainayagam Simon D Taylor-Robinson Mireille B Toledano | 2014 | World Journal of Gastroenterology2014，20，6： | 15 |
| 3 | Gastroenterology in developing countries:Issues and advances显示文摘Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments,lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas: diarrhoeal diseases, hepatitis B, and Helicobacter pylori . Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those setting up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of 'cascades' are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries. | Kate L Mandeville Justus Krabshuis Nimzing Gwamzhi Ladep Chris JJ Mulder Eamonn MM Quigley Shahid A Khan | 2009 | World Journal of Gastroenterology2009，15，23： | 8 |
| 4 | Endoscopic papillary large balloon dilatation with sphincterotomy is safe and effective for biliary stone removal independent of timing and size of sphincterotomy显示文摘AIM To describe the efficacy and safety of endoscopic papillary large balloon dilatation(EPLBD) in the management of bile duct stones in a Western population. METHODS Data was collected from the endoscopic retrograde cholangiopancreatography(ERCP) and Radiology electronic database along with a review of case notes over a period of six years from 1 st August 2009 to 31 st July 2015 and incorporated into Microsoft excel. Statistical analyses were performed using Med Calc for Windows,version 12.5(Med Calc Software,Ostend,Belgium). Simple statistical applications were applied in order to determine whether significant differences exist in comparison groups. We initially used simple proportions to describe the study populations. Furthermore,we used chi-square test to compare proportions and categorical variables. Non-parametric Mann-Whitney U-test was applied in order to compare continuous variables. All comparisons were deemed to be statistically significant if P values were less than 0.05.RESULTS EPLBD was performed in 229 patients(46 females) with mean age of 68 ± 14.3 years. 115/229(50%) patients had failed duct clearance at previous ERCP referred from elsewhere with standard techniques. Duct clearance at the Index* ERCP(1 st ERCP at our centre) was 72.5%. Final duct clearance rate was 98%. EPLBD after fresh sphincterotomy was performed in 81(35.4%). Median balloon size was 13.5 mm(10-18). In addition to EPLBD,per-oral cholangioscopy(POC) and electrohydraulic lithotripsy(EHL) was performed in 35(15%) patients at index* ERCP. 63(27.5%) required repeat ERCP for stone clearance. 28(44.5%) required POC and EHL and 11(17.4%) had repeat EPLBD for complete duct clearance. Larger stone size(12.4 mm vs 17.4 mm,P < 0.000001),multiple stones(2,range(1-13) vs 3,range(1-12),P < 0.006) and dilated common bile duct(CBD)(12.4 mm vs 18.3 mm,P < 0.001) were significant predictors of failed duct clearance at index ERCP. 47 patients(20%) had ampullary or peri-ampullary diverticula. Procedure related adverse events included 2 cases of bleeding and pancreatitis(0.87%) each.CONCLUSION EPLBD is a safe and effective technique for CBDS removal. There is no difference in outcomes whether it is performed at the time of sphincterotomy or at a later procedure or whether there is a full or limited sphincterotomy. | Usman Iqbal Aujla Nimzing Ladep Laura Dwyer Stephen Hood Nicholas Stern Richard Sturgess | 2017 | World Journal of Gastroenterology2017，23，48： | 8 |
| 5 | Rates and impact of hepatitis on human immunodeficiency virus infection in a large African cohort显示文摘AIM:To determine the rates and impact of hepatitis B virus(HBV) and hepatitis C virus(HCV) infections on response to long-term highly active antiretroviral therapy(HAART) in a large human immunodeficiency virus(HIV) population in Nigeria.METHODS:HBV and HCV as well as HIV infections are endemic in sub Saharan Africa.This was a retrospective cohort study of 19 408 adults who were recruited between June 2004 and December 2010 in the AIDS Prevention Initiative in Nigeria in Nigeria programme at Jos University Teaching Hospital.Serological assays,including HBV surface antigen(HBsAg) and hepatitis C antibody were used to categorise hepatitis status of the patients.HBsAg was determined using enzyme immunoassay(EIA)(Monolisa HBsAg Ultra3;Bio-Rad).HCV antibody was tested using third generation EIA(DIA.PRO Diagnostic,Bioprobes srl,Milan,Italy).HIV RNA levels were measured using Roche COBAS Amplicor HIV-1 monitor test version 1.5(Roche Diagnostics,GmbH,Mannheim,Germany) with a detection limit of 400 copies/mL.Flow cytometry was used to determine CD4+ cell count(Partec,GmbH Munster,Germany).Comparison of categorical and continuous variables were achieved using Pearson's χ 2 and Kruskal Wallis tests respectively,on MedCalc for Windows,version 9.5.0.0(MedCalc Software,Mariakerke,Belgium).RESULTS:With an overall hepatitis screening rate of over 90% for each virus;HBV,HCV and HBV/HCV were detected in 3162(17.8%),1983(11.3%) and 453(2.5%) HIV infected adults respectively.The rate of liver disease was low,but highest among HIV monoinfected patients(29,0.11%),followed by HBV coinfected patients(15,0.08%).Patients with HBV coinfection and triple infection had higher log 10 HIV RNA loads(HBV:4.6 copies/mL vs HIV only:4.5 copies/mL,P<0.0001) and more severe immune suppression(HBV:645,55.4%;HBV/HCV:97,56.7%) prior to initiation of HAART compared to HIV mono-infected patients(1852,48.6%)(P<0.0001).Of 3025 patients who were 4.4 years on HAART and whose CD4 cell counts results at baseline and end of follow up were available for analyses,CD4 increase was significantly lower in those with HBV co-infection(HBV:144 cells/mm3 ;HBV/HCV:105 cells/mm3) than in those with HCV co-infection(165 cells/mm3) and HIV mono-infection(150 cells/mm3)(P=0.0008).CONCLUSION:High rates of HBV and HCV infections were found in this HIV cohort.CD4 recovery was significantly diminished in patients with HBV co-infection. | Nimzing Gwamzhi Ladep Patricia Aladi Agaba Oche Agbaji Auwal Muazu Placid Ugoagwu Godwin Imade Graham Cooke Sheena McCormack Simon David Taylor-Robinson John Idoko Phyllis Kanki | 2013 | World Journal of Gastroenterology2013，19，10： | 3 |
| 6 | Rising trends in cholangiocarcinoma: Is the ICD classification system misleading us?显示文摘 | Shahid A. Khan Shireen Emadossadaty Nimzing G. Ladep Howard C. Thomas Paul Elliott Simon D. Taylor-Robinson Mireille B. Toledano | 2011 | Journal of Hepatology2011，，4： | 2 |
| 7 | Rising trends in cholangiocarcinoma: is the ICD classification system misleading us? 显示文摘 | Khan SA Emadossadaty S Ladep N | 2012 | J Hepatol2012，56，4： | 1 |
| 8 | Rising trends in cholangiocarcinoma: Is the ICD classification system misleading us?显示文摘 | Shahid A. Khan Shireen Emadossadaty Nimzing G. Ladep Howard C. Thomas Paul Elliott Simon D. Taylor-Robinson Mireille B. Toledano | 2011 | Journal of Hepatology2011，，4： | 1 |
| 9 | Hepatocellular car- cinoma: diagnostics and screening 显示文摘 | Patel M Shariff M I Ladep N G | 2012 | J Eval Clin Pract2012，18，2： | 1 |
| 10 | Characterization of urina- ry biomarkers of hepatocellular carcinoma using magnetic reso- nance spectroscopy in a Nigerian population 显示文摘 | Shariff MIF Ladep NG Cox IJ | 2010 | J Proteome Res2010，9，2： | 1 |
| 11 | Discovery and validation of urinary metabotypes for the diagnosis of hepatocellular carcinoma in West Africans显示文摘 | Nimzing G. Ladep Anthony C. Dona Matthew R. Lewis Mary M.E. Crossey Maud Lemoine Edith Okeke Yusuke Shimakawa Mary Duguru Harr F. Njai Haddy K.S. Fye Makie Taal John Chetwood Ben Kasstan Shahid A. Khan Deborah A. Garside Anisha Wijeyesekera Andrew V. Thil | 2014 | Hepatology2014，，4： | 1 |
| 12 | Hepatocellular carci- noma: diagnostics and screening显示文摘 | Patel M Shariff MI Ladep NG | 2012 | J Eval Clin Pract2012，18，2： | 1 |
| 13 | Effects of nonplastic fines on static liquefaction of sands显示文摘 | LADEP V YAMAMURO J A | 1997 | Canadian Geoteclmical Journal1997，34，： | 1 |
| 14 | Gastroenterology in developing countrise:issues and advances显示文摘 | Mandeville KL Krabshuis J Ladep NG | | 0，，23： | 1 |
| 15 | Characterization of urinary biomarkers of hepatocellular carcinoma using magnetic resonance spectroscopy in a Nigerian population显示文摘 | Shariff M I Ladep N G Cox I J | 2010 | Journal of proteome research2010，9，： | 1 |
| 16 | Hepatocellular carcinoma: diagnostics and screening 显示文摘 | Patel M Shariff MI Ladep NG | 2012 | J Eval Clin Pract2012，18，2： | 1 |
| 17 | Hepatocellular carcinoma:diagnostics and screening显示文摘 | Patel M Shariff MI Ladep NG | 2012 | J Eval Clin Pract2012，18，： | 1 |
| 18 | WJH 6^(th) Anniversary Special Issues(2): Hepatocellular carcinoma Problem of hepatocellular carcinoma in West Africa显示文摘The incidence of hepatocellular carcinoma(HCC) isknown to be high in West Africa with an approximateyearly mortality rate of 200000. Several factors are responsible for this. Early acquisition of risk factors; with vertical or horizontal transmission of hepatitis B(HBV), environmental food contaminants(aflatoxins), poor management of predisposing risk factors and poorlymanaged strategies for health delivery. There has been a low uptake of childhood immunisation for hepatitis B in many West African countries. Owing to late presentations, most sufferers of HCC die within weeks of their diagnosis. Highlighted reasons for the specific disease pattern of HCC in West Africa include:(1) high rate of risk factors;(2) failure to identify at risk populations;(3) lack of effective treatment; and(4) scarce resources for timely diagnosis. This is contrasted to the developed world, which generally has sufficient resources to detect cases early for curative treatment. Provision of palliative care for HCC patients is limited by availability and affordability of potent analgesics. Regional efforts, as well as collaborative networking activities hold promise that could change the epidemiology of HCC in West Africa. | Nimzing G Ladep Olufunmilayo A Lesi Pantong Mark Maud Lemoine Charles Onyekwere Mary Afihene Mary ME Crossey Simon D Taylor-Robinson | 2014 | World Journal of Hepatology2014，6，11： | 0 |
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