Oluwadare Ogunlade

Evaluation of electrocardiogram as a biological signal for sex verification among fresh undergraduates in a Nigerian tertiary institution

Background: Sex verification using electrocardiogram (ECG) is a new application of the biological signal. Objective: This study aimed to determine the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of an electrocardiographic score in sex verification. Methods: A total of 2442 apparently healthy fresh undergraduates who presented for health screening in a tertiary institution were recruited for the study. The technical team documented the sex of the participants and had their resting 12-lead ECG recorded according to standard protocol. Two physicians who were blinded to the participants and the recorded sex utilized Ogunlade Sex Determination Electrocardiographic Score (OSDES) to determine the sex. The validity of OSDES was estimated using sex recorded by the technical team as the standard while the accuracy of scoring system was determined using receiver operating characteristic curve. Results: The mean (± standard deviation) of age of the participants was 20.71 ± 3.62 years. Among the male population, true positives (TPs), false positives (FPs), false negatives (FNs), and true negatives (TN) were 1131, 49, 90, and 1172, respectively. Among the females TP, FP, FN, and TN were 1172, 90, 49, and 1131, respectively. Among males, the sensitivity, specificity, PPV, and NPV were 92.63% (95% confidence interval [CI]: 91.02-94.03%), 95.99% (95% CI: 94.73-97.02%), 95.85% (95% CI: 94.55-96.91%), and 92.87% (CI: 91.31-94.23%) respectively while among the females, the sensitivity, specificity, PPV, and NPV were 95.99% (95% CI: 94.73-97.02%), 92.63% (95% CI: 91.02-94.03%), 92.87% (95% CI: 91.31-94.23%), and 95.85% (95% CI: 91.02-94.03%) respectively. The area under curve was 0.943. Conclusion: This study concluded that ECG has a reasonable level of sensitivity and specificity with excellent accuracy in verification of sex among fresh Nigerian undergraduates.

The role of electrocardiogram in the diagnosis of dextrocardia with mirror image atrial arrangement and ventricular position in a young adult Nigerian in Ile-Ife: a case report

IntroductionDextrocardia with situs inversus is a rare congenital disease. In patients with this condition, the heart is presented as a mirror image of itself with its apex pointing to the right. The pulmonary and abdominal anatomies are reversed. Dextrocardia with situs inversus occurs at birth but its diagnosis may be in adulthood. This case advances knowledge by graphically describing the unusual electrocardiographic features of dextrocardia in a young adult.Case presentationWe report a case of a 22-year-old Nigerian man of Yoruba ethnicity who presented himself for preadmission medical test. He had a standard 12-lead electrocardiogram which revealed uncommon features: inversion of P waves in leads I, aVL and aVR; dominantly negative QRS waves in leads I, V1 to V6; reverse R wave progression in chest leads; low voltage in V4 to V6; extreme QRS axis; flattened T waves in V4 to V6 and aVR; and inverted T waves in lead I and aVL. An electrocardiogram diagnosis of dextrocardia was made. The differential diagnosis considered was right ventricular hypertrophy. A cardiovascular examination showed pulse rate of 70 beats per minute, blood pressure of 119/62mmHg, visible cardiac impulse at right precordium, apex beat was located at his fifth right intercostal space mid-clavicular line. A chest X-ray (posterior anterior view) including upper abdomen showed dextrocardia; his aortic arch was located on the right. His stomach bubble was located below his right hemidiaphragm. His trachea was slightly deviated to the left. The findings in his lung fields were not remarkable. Abdominopelvic ultrasonography showed that right-sided intra-abdominal organs (liver, gallbladder) were located on the left while left-sided organs (stomach, spleen) were located on the right. His abdominal aorta was on the right while his inferior vena cava was located on the left. A diagnosis of dextrocardia with situs inversus was made ultrasonographically.ConclusionsA properly interpreted electrocardiogram was useful in suspecting the diagnosis of dextrocardia with situs inversus. So, an analysis of a relatively simple and non-invasive diagnostic tool such as an electrocardiogram allows for suspicion of a cardiovascular anomaly in a setting of scarce diagnostic resources.

Challenges of body mass index classification: New criteria for young adult Nigerians

Background: There are evidences to suggest that the World Health Organization (WHO) general cutoff points for body mass index (BMI) may not be the most appropriate for young adults globally irrespective of racial and ethnic considerations. Objective: This study assessed body anthropometric parameters in healthy population of young adult Nigerians with a view to determining race and gender-specific criteria (Ife criteria) for BMI classification. Methods: Four hundred and eighty-four (242 males and 242 females) healthy subjects aged between 18 and 41 years (inclusive) were recruited for the study. The participants were age- and sex-matched (mean age: 22.81 ± 3.83 years). The weight and height of the subjects were obtained using standard techniques while BMI was calculated as derivatives of height and weight. The BMI was classified using 5 th , 85 th , and 95 th percentiles and delineated into underweight (<5 th percentile), normal (5-85 th percentile), overweight (85-95 th percentile), and obese (>95 th percentile). Results: The result showed that the general BMI cutoff values for underweight, normal, overweight, and obesity were <17.8, 17.8-24.7, 24.8-27.8, and ≥27.9, respectively. The sex-specific BMI cutoff values for underweight, normal, overweight, and obesity in males and females were < 17.8 and < 17.8; 17.8-23.6 and 17.8-25.6; 23.7-26.8 and 25.7-28.7; and ≥26.9 and ≥28.8, respectively. Conclusions: The cutoff values for the new criteria for BMI classification were lower than the WHO defined values and sex differences were demonstrated in BMI. Therefore, WHO criteria may not be universally applicable.

Development of a Fuzzy Logic-based Model for Monitoring Cardiovascular Risk

Cardiovascular diseases CVD are top killers with heart failure as one of the most leading cause of death in both developed and developing countries. In Nigeria, the inability to consistently monitor the vital signs of patients has led to the hospitalization and untimely death of many as a result of heart failure. Fuzzy logic models have found relevance in healthcare services due to their ability to measure vagueness associated with uncertainty management in intelligent systems. This study aims to develop a fuzzy logic model for monitoring heart failure risk using risk indicators assessed from patients. Following interview with expert cardiologists, the different stages of heart failure was identified alongside their respective indicators. Triangular membership functions were used to fuzzify the input and output variables while the fuzzy inference engine was developed using rules elicited from cardiologists. The model was simulated using the MATLAB® Fuzzy Logic Toolbox.