E O Agbedana

University of Ibadan, Ibadan, Oyo State, Nigeria

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Publications (59)77.66 Total impact

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    ABSTRACT: Aim: To assess the prevalent components of metabolic syndrome (MSC) and their related determinants of lipid metabolism in the Nigerian for early diagnosis, prevention and management of the metabolic syndrome (MS) and its associated diseases. Study Design: Cohort study. Place and Duration of Study: Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan between March and August 2010. Methodology: 534 apparently healthy Nigerian traders aged 18–105 years were participants of a cohort study. The IDF (2005) criteria was used for MS diagnosis. Anthropometric indices and blood pressure (BP) were obtained by standard methods. Fasting plasma glucose, total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDLC) were determined by enzymatic methods while low density lipoprotein cholesterol (LDLC) was calculated. Data analysed were statistically significant at P<0.05. Results: 60.1% of traders had 2 and 3MSC. 0.6%, 1.1% and 9.6% of traders had all 5MSC, ≥3MSC without elevated waist circumference (WC) and zero MSC respectively. Elevated WC, reduced HDLC and high BP were more frequent MSC representing 70.2%, 63.1% and 47.9% while FPG and TG were less frequent representing 11.2% and 2.2% of traders respectively. This pattern was similar in MS and non-MS groups. 25.3% of males and only 2.2% of females had no MSC. Reduced HDLC and elevated WC were the most frequent MSC in males and females respectively. All metabolic risk factors (MRF) except TC were significantly different in comparison between MS and non-MS groups as well as among traders with 0-5 MSC. WHR was the only parameter that correlated significantly with all MRF. Conclusion: Elevated waist circumference, reduced high density lipoprotein cholesterol, and high blood pressure may be prevalent metabolic syndrome components and important in managing metabolic syndrome in Nigeria. Regional specific cut-offs for these components for the African population is needed.
    International Journal of TROPICAL DISEASE & Health. 05/2014; 4(7):740-752.
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    ABSTRACT: Metabolic syndrome (MS) amplifies hypertension (HTN) associated with increased risk of cardiovascular disease (CVD). MS components and other CVD risk measures were investigated in different stages of hypertension. 534 apparently healthy Nigerian traders aged 18-105 years were participants of a cohort study. The International Diabetes Federation (2005) and the National High Blood Pressure Education Program Coordinating Committee criteria were used for MS and HTN classifications, respectively. Anthropometric indices were obtained by standard methods. Levels of fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDLC) were determined by enzymatic methods, while low-density lipoprotein cholesterol (LDLC) was calculated. Data analysed statistically were significant at P < 0.05. 143 (26.8%), 197 (36.9%), and 194 (36.3%) of the traders had normotension, pre-HTN and HTN (stages 1 and 2), respectively. All indices tested except HDLC were significantly different among BP groups (P < 0.05). Waist to hip (WHR) and waist to height (WHT) ratios were significantly different between HTN groups (P < 0.05). HTN was associated with MS and female gender (P < 0.05). Metabolic alterations and significant HTN were observed. Treatment of the individual components of the syndrome and improvement of modifiable metabolic factors may be necessary to reduce MS and high BP.
    International journal of hypertension. 01/2013; 2013:351357.
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    ABSTRACT: Background: Metabolic Syndrome (MS) increases the risk of developing type-2 diabetes (DM2) and cardiovascular diseases (CVD) and it is thought to be prevalent in Nigeria. This study aims at determining the prevalence of MS and its component risk factors among apparently healthy traders in a local market in Ibadan, Nigeria. Methods: 534 apparently healthy traders from a local market in Bodija, Ibadan, Nigeria aged (18–105) years with neither DM2 nor CVD were participants of a cohort study on risk assessment of type 2 diabetes and dementia in Nigerians with metabolic syndrome. The International Diabetes Federation (2005) and the World Health Organisation (1998) criteria were used for MS and BMI respectively. Anthropometric indices (weight, height, body mass index (BMI), percentage body fat (PBF), waist and hip circumferences (WC & HC) and their ratio (WHR), waist circumference to height ratio (WHT)) and blood pressure (BP) were obtained by standard methods. Blood samples (6 ml) were obtained for the determination of glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) by enzymatic methods while low density lipoprotein cholesterol (LDL-C) was calculated. Descriptive statistics, Chi-square test and ANOVA were among the analyses conducted. Results: 301 (56.4%) of traders studied were overweight (176, 33.0%) or obese (125, 23.4%) while 17 (3.4%) and 125 (40.4%) were underweight and normal weight respectively. The prevalence of MS and obesity were 87 (16.3%) and 125 (23.4%) respectively. There was significant association between obesity and MS (p < 0.05). Both MS and obesity were significantly associated with gender (p < 0.05). The prevalence of MS and obesity was higher in female (20.9%; 31.0%) than male traders (6.5%; 7.1%) respectively. The prevalence of MS increased from normal weight (8.3%) to overweight (18.8%) to obesity (28.8%). There were significantly higher differences in age, BP(systolic and diastolic), weight, BMI, WC, HC, WHT, WHR, and PBF but lower difference in height when overweight/obese groups were compared with normal weight group (p < 0.05). TC and LDL-C were significantly higher in only obese than normal weight traders. However, FPG, TG and HDL-C were similar in all groups (p > 0.05). Conclusion: There is high prevalence of MS and obesity among Nigerian traders. Female gender, hypercholesterolemia, hypertension, increasing age, general and abdominal obesity appear to be important metabolic risk factors of CVD and not DM2 among Nigerian traders. Health care strategies for effective modulation of diet and lifestyle are needed urgently. In addition, screening programs for indices of MS in all Nigerians irrespective of BMI could be considered.
    Journal of US-China Medical Science. 02/2012; 9(,No. 2 (Serial No. 87)-ISSN 1548-6648, USA):91–100.
  • Journal of US-China Medical Science. 01/2012; 8:493-500.
  • A.S. Adekunle, E.O. Agbedana, A.O. Oyewopo
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    ABSTRACT: Artemether has been shown to be a very reliable antimalarial drug particularly because of its potency against multidrug resistant strain of malaria parasite; however, there is concern about its potential toxic effects. This study was designed to evaluate the neurotoxic effect of artemether using a mouse model. The photomicrographs of brains of the mice in the different artemether treated groups showed neurodegeneration. This observation is an indication that artemether may be neurotoxic in mice.
    Toxicological and Environmental Chemistry 01/2010; 92(1):197-204.
  • A.S. Adekunle, E.O. Agbedana, B.E. Egbewale
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    ABSTRACT: Effects of artemether administration on liver and selected biochemical parameters were evaluated. Eighty albino mice were divided into four equal groups. Group 1 was given water which served as control, while groups 2, 3, and 4 were given 1.2, 2.4, or 4.8 mg kg−1 body weight artemether intramuscularly for five consecutive days. On day 6 all mice were sacrificed by cervical dislocation and blood was collected for analysis of alanine and aspartate transaminases, alkaline phosphatase, copper, and total proteins. Liver tissues were prepared for histological studies. It was found that the serum alanine and aspartate transaminase and alkaline phosphatase activities were higher in groups treated with artemether compared to control. The serum concentrations of copper and total proteins were lower than control. The histological features of liver tissues after administration of artemether showed histopathological alterations. These findings showed that artemether administration may have reversible adverse effects on mouse hepatocytes.
    Toxicological and Environmental Chemistry 06/2009; 91(4):699-705.
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    ABSTRACT: Various antimalarial drugs have been shown to exert different adverse effects; however, scanty information is available for artemether-induced potential side effects. The present study assessed effects of artemether on lipid profile, sperm count, and histological features of testes in an animal model. The mean total cholesterol, high-density lipoproteins, low-density lipoproteins, triglyceride, and total proteins in mice-administered artemether were higher compared with controls. The mean sperm counts in mice treated with artemether were reduced when compared with controls. In addition, it was observed that artemether affected the histopathology of seminiferous epithelia and Leydig cells. Evidence indicates that artemether exerts adverse effects in mice testes.
    Toxicological and Environmental Chemistry 04/2009; 91(3):511-519.
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    Adekunle AS, Falade CO, Agbedana EO, Egbe A
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    ABSTRACT: In animal in-vivo study, we have reported some significant changes such as reduced sperm counts, degeneration ofseminiferous epithelium and interstitial leydig cells in the testicle. Therefore human study was designed to assess theeffects of artemether on some biochemical parameters in individuals treated with artemether. Moderate and transientside effects were observed after administration. This implies that administration of artemether is still tolerated and themoderate side effects are not comparable with the debilitating effects of malaria infection it is meant to cure.Artemisinine is still a tolerable antimalaria drug with no major side effects on human.
    Biology and Medicine. 01/2009;
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    ABSTRACT: Elevated plasma lipoprotein (a) (Lp(a)) and total homocysteine (tHcy) concentrations, as well as fat distributions, are associated with cardiovascular disease (CVD) risk. The purpose of this study was to evaluate plasma Lp(a), tHcy, percentage body fat, anthropometric indices, and blood pressure (BP) and their relationships with each other in well-defined, hospital-based, CVD patients in a Nigerian African community. One hundred seventy patients suffering from hypertensive heart disease, hypertension, ischaemic heart disease, and myocardial infraction with the mean age of 45.3 +/- 1.3 years and 58 apparently healthy volunteers with the mean age of 44.8 +/-1.2 years were selected. Anthropometric indices and BP were measured. Percentage body fat, body mass index, and waist-to-hip ratio (WHR) were calculated. Plasma Lp(a) and tHcy concentrations were determined. The results showed significant increases in BP, skinfold thickness (SFT) variables, and WHR in all of the CVD patients. Plasma Lp(a) was also significantly increased (p < 0.001), whereas the slight increase in the mean tHcy was not statistically significant. Positive significant correlations were found between systolic BP, triceps, SFT, and percentage body fat (p < 0.01), whereas significant correlations were found between some body composition variables, tHcy, and systolic BP (p < 0.05). Our findings provide supportive evidence for altered plasma Lp(a) concentration in addition to some other traditional CVD risk factors in Nigerians. The role of homocysteine is not well defined.
    Applied Physiology Nutrition and Metabolism 04/2008; 33(2):282-9. · 2.01 Impact Factor
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    ABSTRACT: We have examined the cumulative effects of the protoberberine alkaloidal fraction (AF) of the stein bark ethanolic extracts of Enantia chlorantha on some body tissues and organs as well as on certain biochemical and metabolic parameters in mice. Acute and sub-chronic toxicity studies of the alkaloidal fractions of Enantia chlorantha were carried out in 120 mice using oral and intraperitoneal administrations. Fatality was not recorded in mice injected intraperitonealy with 100 mg kg(-1) and 150 mg kg(-1) dose level but larger doses resulted in death and the mean lethal dose (LD50) toxicity studies showed neither behavioural/untoward reactions nor death in any of the animals. The histopathological examination of the test animals when compared with the control revealed that, the sub-chronic use of the alkaloidal fractions does not have any pathological effects (lesion) on the organs examined (the stomach, the kidney, the oesophagus and the liver) except the lungs which showed mild and moderate oedema. The biochemical and metabolic analysis of the mice plasma did not show any significant difference when the corresponding values for the test mice were compared with the control mice (P > 0.05) at the end of the 14 days treatment using both 20 mg kg(-1) and 2 mg kg(-1) dose levels. The results obtained in this study suggest the relative safety of short-term use of preparations containing E. chlorantha, a very popular antimalarial herbal remedy in Southern Nigeria.
    African journal of medicine and medical sciences 12/2007; 36(4):317-23.
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    ABSTRACT: Conflicting reports on the mechanism of action of ascorbic acid level in male reproductive system exist and very little is known about the ascorbic acid status in Nigerian males with weak fertility. Ascorbate that accumulates preferentially in the testis, the lipid and lipoprotein levels were determined in the plasma of Nigerian males. Twenty-seven (27) male with inadequate spermatogenesis (36+/-1.0) years, with mean value of 15.6+/-6.90 million/cm3 sperm count and fourteen (14) controls (34+/-0.6) years, with mean value of 108.0+/-25.42 million/cm3 sperm count were selected for this study. The anthropometric indices were also determined. There were highly significant decreases in sperm cell count, percentage motility and percentage vitality (p<0.001) in each case, while percentage morphologically abnormal sperm cells was significantly elevated (p<0.001) compared with the control values. There were significant decreases in the seminal and plasma ascorbic acid concentrations (p<0.001) in the males who had inadequate spermatogenesis compared with the control values. The plasma total cholesterol (TC) and body mass index (BMI) were not significantly different from the corresponding control values, but the plasma low density lipoprotein (LDLC) (p<0.001) and triglyceride (TG)(p<0.01) concentrations were significantly increased in all the patients. While the plasma high density lipoprotein cholesterol (HDLC)(p<0.001) was significantly decreased compared with the controls. The plasma lipid and lipoprotein levels did not demonstrate any definite pattern with the sperm characteristics. The decreased semen ascorbate level may play a significant role in the reduced sperm characteristics in these patients.
    West African journal of medicine 01/2005; 23(4):290-3.
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    ABSTRACT: Blount's disease or congenital tibia vara is a clinical entity characterized by tibia bowing, tibia torsion, and beaking of the medial tibia metaphysis on plain radiograph. In our environment, burnt-out rickets patients with biochemical and radiological diagnosis of rickets who after treatment still have residual bone changes despite normal bone biochemistry) can also present with similar clinical and radiological features as Blount's disease. However, certain biochemical variations, including antioxidants, may serve as a basis for differentiation between these two disorders. The serum levels of calcium, inorganic phosphate, zinc, copper, and alkaline phosphatase in 15 patients (10 females and five males) aged between two- and five years (mean 3.8 +/- 1.1 (SD)) with clinical and radiological features of Blount's disease were determined. The mean weight of the patients with Blount's disease was 14.0 +/- 2.4 kg (range: 11.5-16.3 kg). Fifteen subjects (nine females and six males) matched for age and sex without clinical features of any metabolic bone and/or nutritional diseases who were attending the surgical outpatient clinic served as control subjects. The serum concentrations of inorganic phosphate and calcium, though lower in patients with Blount's disease compared with controls, did not reach statistical significance. Alkaline phosphatase activity was increased in the serum of all patients with Blount's disease. In addition, there was an observed significant reduction in serum concentration of zinc (P < 0.03) compared to the control subjects. As for calcium level, the concentration of serum copper in Blount's patients was reduced, but this was not statistically significant. These biochemical observations, especially those of the antioxidant micronuent zinc, may serve as a basis for the differentiaion of the sometimes clinically inseparable disorders of Blount's and rckets and may aid in early differential diagnosis, appropriate treatment as well as prevention of complications.
    Journal of the National Medical Association 10/2004; 96(9):1203-7. · 0.91 Impact Factor
  • M O Ebesunun, E O Agbedana, G O Taylor
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    ABSTRACT: Plasma and tissue lipids were determined in twenty-four rats fed on locally prepared 'Ogi' diet containing palm kernel oil (PKO), red palm oil (RPO) and mixture of both oils. Fasting blood sample was obtained from each animal by cardiac puncture under light ether anesthesia after feeding on different diets for twelve weeks. There were significant variations in the mean liver, kidney, spleen (p < 0.001, p < 0.03, p < 0.002) tissue weights in the different dietary groups compared with the corresponding control values. The plasma total cholesterol, triglyceride and lipoprotein cholesterol concentrations in the dietary group showed no significant changes when compared with the corresponding control values. The liver, spleen and heart total cholesterol concentrations were not significantly different from the corresponding values in the control group, but within group analysis showed significantly elevated total cholesterol in the kidney tissue of rats consuming PKO diet (p < 0.001). The total cholesterol level in rats consuming PKO diet was significantly higher than the corresponding concentration in those consuming the diet containing a mixture of PKO + RPO [p < 0.02] and control (p < 0.02) diets. There was also a significant increased in the kidney tissue cholesterol of rats fed RPO diet when compared with the corresponding control value (p < 0.05). The histological findings revealed no abnormality except in rats fed on PKO and RPO diets where nephrocalcinosis was found.
    African journal of medicine and medical sciences 03/2003; 32(1):41-7.
  • J I Anetor, A Senjobi, O A Ajose, E O Agbedana
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    ABSTRACT: Serum magnesium, zinc and total cholesterol were evaluated in 40 Nigerian patients suffering from type-2 diabetes mellitus (21M, 19F) and 20 (14M, 6F) apparently normal non diabetic control subjects. The mean age of the diabetic patients was similar to that of controls (p > 0.05). The mean duration of the disease was (4.7 + 0.7 SEM) in these patients. Fasting blood glucose and total cholesterol were significantly higher in diabetics than in non diabetic control subjects (p > 0.001). The serum total cholesterol showed inter-group variation when the patients were classified into four different age groups. In contrast, the serum level of magnesium (Mg) and zinc (Zn) were significantly lower in diabetics than in controls (p > 0.001). There were no significant correlation between glucose and the minerals, Mg. and Zn. Serum total cholesterol showed a significant positive correlation with magnesium (r = 0.6: p > 0.001), while the correlation with zinc was not significant. In type-2 diabetic mellitus the concentration of both Mg and Zn levels were significantly reduced, probably suggesting lower antioxidant status in this condition. The implication is the greater susceptibility to LDL-cholesterol oxidation. The attendant risk of development of premature Coronary Heart Disease is discussed. Magnesium and zinc are nutritional minerals that play crucial roles in the regulation of carbohydrate and lipid metabolism.
    Nutrition and health (Berkhamsted, Hertfordshire) 01/2002; 16(4):291-300.
  • A J Onuegbu, E O Agbedana
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    ABSTRACT: The changes in total serum cholestrol, serum triglyceride, HDL-cholesterol and LDL-cholesterol after twenty eight (28) days of consumption of moderate quantity of a commercial coffee preparation (NESCAFE brand) were studied in 30 human subjects consisting of 20 male and 10 female healthy adults. Significant increases in the mean total serum cholesterol concentration (110.8-126.5 mg/100 mls) and LDL- cholesterol concentration (78.4-94.5 mg/100 ml) were observed in the subjects. No significant differences were obtained in the mean HDL cholesterol concentration and in the mean serum triglyceride levels. The differences observed in the mean total serum cholesterol, LDL cholesterol, HDL- cholesterol and triglyceride concentrations in the individual male and female groups studied were not statistically significant. The results from this study suggest that short-term consumption of coffee may increase the total serum cholesterol and LDL cholesterol levels. It is therefore possible that long-term consumption of coffee may lead to clinically significant alterations in serum lipid profile and could be important in the aetiology of atherosclerotic vascular diseases such as coronary heart disease.
    African journal of medicine and medical sciences 01/2001; 30(1-2):43-5.
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    ABSTRACT: Golden and Ramdath proposed the free radical theory of kwashiorkor, suggesting that the changes seen in kwashiorkor may be the result of an imbalance between the production and safe disposal of free radicals. In malnourished children, mineral metabolism and antioxidant status need renewed attention especially in relation to cause and functional significance of the changes in concentration of these substances. In the present study, the modified Wellcome classification was used to classify the protein energy malnourished children into kwashiorkor marasmic-kwashiorkor, marasmus and underweight. Twenty-six healthy and normal children were used as controls. Standard procedures were used for the analyses of the biochemical parameters. Our results showed that plasma total cholesterol, sodium, potassium and bicarbonate, beta-carotene, retinol and uric acid were significantly lower in the malnourished group than the control group (P < 0.05), while transaminases were significantly increased in the malnourished group (P < 0.05). These findings suggest an altered electrolyte and antioxidant status in protein energy malnutrition.
    African journal of medicine and medical sciences 01/1999; 28(1-2):81-5.
  • M O Adigun, E O Agbedana, S Kadiri, G O Taylor
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    ABSTRACT: Forty-eight adult subjects consisting of 28 patients with nephrotic syndrome and 20 control subjects were studied. The plasma levels of high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and very low density lipoprotein (VLDL) cholesterol were all significantly elevated in the patients with nephrotic syndrome. The elevations in plasma total cholesterol and triglyceride concentrations and the ratio of LDL cholesterol/HDL cholesterol were also significant. On the other hand, there was a significant reduction in the ratio of HDL cholesterol to total cholesterol in the nephrotics. Our results suggest altered lipid and lipoprotein metabolism in adult nephrotic syndrome. The significant increase in low density lipoprotein cholesterol and the reduction in the ratio of HDL cholesterol to total cholesterol, despite the high HDL cholesterol, probably suggests an increased risk for developing coronary heart disease in Nigerian adults suffering from nephrotic syndrome. It is therefore suggested that patient-management strategies for nephrotic syndrome should include lowering of cholesterol by dietary and/or pharmacological therapies.
    African journal of medicine and medical sciences 01/1999; 28(1-2):97-100.
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    ABSTRACT: Forty-six African patients with essential hypertension aged 40 to 65 years had plasma total cholesterol and triglyceride levels determined at four different periods during a 12-month treatment with doxazosin. The patients were classified according to their pretreatment (baseline) values into 'low', 'medium' and 'high' baseline value groups. The mean total cholesterol levels significantly decreased in the three baseline groups while mean triglyceride levels reduced only in the patients that belonged to the medium and high baseline value groups. The baseline values of total cholesterol did not influence the beneficial cholesterol changes in all the patients, while the lack of significant favorable triglyceride changes was influenced by the low baseline values of triglyceride of the patients during doxazosin treatment. A similar study involving lipoprotein fractions and sub-fractions is also in progress.
    International journal of clinical pharmacology research 02/1998; 18(4):159-63.
  • J E Ahaneku, G O Taylor, E O Agbedana
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    ABSTRACT: Forty-two Nigerian hypertensive men and women aged 40 to 60 years treated with doxazosin for 12 consecutive months were studied. Before the doxazosin therapy, all the patients had their baseline lipoprotein fractions determined and that was used to classify the patients into 'low', 'medium' and 'high' baseline values. The assays were repeated 4 times at every 3 months during the 12-month treatment with doxazosin. The mean high density lipoprotein-cholesterol (HDLC) levels were significantly reduced in the patients with high baseline values, and remained unchanged for the patients with low and medium baseline values during doxazosin therapy. Low density lipoprotein-cholesterol (LDLC) levels were apparently reduced in all the groups and this was significant for the patients with high baseline values. The mean levels of very low density lipoprotein-cholesterol (VLDLC) increased in the patients with low baseline values, and decreased in the patients with medium and high baseline values during the 12 months of doxazosin therapy. We therefore conclude that although the overall risk of developing coronary heart disease as measured by the risk predictor index LDLC/HDLC ratio was not affected by the baseline values of the patients, it is, however, important to note that adverse lipoprotein changes such as raised VLDLC and reduced HDLC may be seen in patients with low and high baseline values, respectively, during doxazosin treatment for hypertension. These observations will call for more serious monitoring of these lipoprotein fractions in patients with variable baseline values, by physicians and all health workers concerned during doxazosin treatment for hypertension.
    International journal of clinical pharmacology research 02/1998; 18(4):165-70.
  • E O Agbedana, M O Ebesunun
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    ABSTRACT: Serum total, different isoforms of both alkaline and acid phosphatases, liver function enzymes, calcium, inorganic phosphate, heamatocrit, white blood cells and platelet counts were determined in 50 female patients suffering from breast cancer. The serum total alkaline and total acid phosphatases within the breast cancer group were variable with significant elevation of both enzymes compared with the corresponding control values. The activities of alanine and aspartate transferases were higher than the control values, while the decreases in serum albumin and heamatocrit were statistically significant. In the breast cancer patients, the increases in the activities of both heat and urea labile alkaline phosphatases were significant. Similarly, in the patients, the tartrate-labile acid phosphatases activity was significantly elevated while the difference in tartrate resistant activity was not significant. In 9 patients (18%), both total alkaline and acid phosphatases were excessively raised when compared with the control. The increased activities of urea-labile and heat-labile alkaline phosphatases as well as tartrate-resistant acid phosphatases are suggestive of increased activities of osteoclast and osteoblasts associated with bone metastasis. A possible diagnostic importance of this observation deserves further investigation, using monoclonal antibody techniques.
    African journal of medicine and medical sciences 01/1998; 27(1-2):65-9.

Publication Stats

115 Citations
77.66 Total Impact Points

Institutions

  • 1978–2010
    • University of Ibadan
      • • Department of Chemical Pathology & Immunology
      • • Department of Pharmacognosy
      • • College of Medicine
      Ibadan, Oyo State, Nigeria
  • 1982–2004
    • University College Hospital Ibadan
      Ibadan, Oyo, Nigeria
  • 1999
    • The Polytechnic, Ibadan
      Ibadan, Oyo, Nigeria
  • 1992–1998
    • Nnamdi Azikiwe University, Awka
      Akwa, Anambra State, Nigeria
  • 1992–1996
    • Hyogo College of Medicine
      • Department of Internal Medicine
      Nishinomiya, Hyogo-ken, Japan