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1. Systemic lupus erythematosus: A possible cause of non-alcoholic Wernicke's encephalopathy

Author

Nyo, M T L, Magazi, D, and Ally, M M T M

Subjects
immune system diseases, skin and connective tissue diseases
Abstract

We report a young woman with systemic lupus erythematosus (SLE) and an acute cerebellar ataxia. A history of poor appetite and vomiting preceded the inco-ordination. Ataxia in SLE has been well described, but is nevertheless uncommon. The clinical triad of mild confusion, ataxia and ophthalmoplegia also raised the possibility of Wernicke's encephalopathy (WE). The diagnosis of WE was further supported by the magnetic resonance imaging features. Owing to overlapping causal factors, this case illustrates the complexity of diagnosing and managing neuropsychiatric syndromes in a patient with SLE. The limited published literature on SLE-related cerebellar syndromes adds to the challenge. Gastrointestinal manifestations of SLE are described as being common in SLE, with nausea and vomiting occurring in >50% of cases in some series. Poor eating habits and vomiting are well-described causes of non-alcoholic WE. This is the first description of gastrointestinal SLE as a possible cause of WE.

Published
2017

3. Practice patterns and outcomes after stroke across countries at different economic levels (INTERSTROKE): an international observational study

Author

Langhorne, Peter, primary, O'Donnell, Martin J, additional, Chin, Siu Lim, additional, Zhang, Hongye, additional, Xavier, Denis, additional, Avezum, Alvaro, additional, Mathur, Nandini, additional, Turner, Melanie, additional, MacLeod, Mary Joan, additional, Lopez-Jaramillo, Patricio, additional, Damasceno, Albertino, additional, Hankey, Graeme J, additional, Dans, Antonio L, additional, Elsayed, Ahmed, additional, Mondo, Charles, additional, Wasay, Mohammad, additional, Czlonkowska, Anna, additional, Weimar, Christian, additional, Yusufali, Afzal Hussein, additional, Hussain, Fawaz Al, additional, Lisheng, Liu, additional, Diener, Hans-Christoph, additional, Ryglewicz, Danuta, additional, Pogosova, Nana, additional, Iqbal, Romana, additional, Diaz, Rafael, additional, Yusoff, Khalid, additional, Oguz, Aytekin, additional, Wang, Xingyu, additional, Penaherrera, Ernesto, additional, Lanas, Fernando, additional, Ogah, Okechukwu S, additional, Ogunniyi, Adesola, additional, Iversen, Helle K, additional, Malaga, German, additional, Rumboldt, Zvonko, additional, Magazi, Daliwonga, additional, Nilanont, Yongchai, additional, Rosengren, Annika, additional, Oveisgharan, Shahram, additional, Yusuf, Salim, additional, O'Donnell, M., additional, Yusuf, S., additional, Rangarajan, S., additional, Rao-Melacini, P., additional, Zhang, X. Michelle, additional, Islam, S., additional, Kabali, C., additional, Casanova, A., additional, Chin, S.L., additional, DeJesus, J., additional, Dehghan, M., additional, Agapay, S., additional, McQueen, M., additional, Hall, K., additional, Keys, J., additional, Wang, X., additional, Devanath, A., additional, Gupta, R., additional, Prabhakaran, D., additional, Diaz, R., additional, Schygiel, P., additional, Garrote, M., additional, Rodriguez, M.A., additional, Caccavo, A., additional, Duran, R.G., additional, Sposato, L., additional, Molinos, J., additional, Valdez, P., additional, Cedrolla, C.M., additional, Nofal, P.G., additional, Huerta, M.F., additional, Desmery, P.M., additional, Zurru, M.C., additional, Della Vedova, B., additional, Varigos, J., additional, Hankey, G., additional, Kraemer, T., additional, Gates, P., additional, Bladin, C., additional, Herkes, G., additional, Avezum, A., additional, Pereira, M.P., additional, Minuzzo, L., additional, Oliveira, L., additional, Teixeira, M., additional, Reis, H., additional, Carvalho, A., additional, Ouriques Martins, S., additional, Carvalho, J.J., additional, Gebara, O., additional, Minelli, C., additional, Oliveira, D.C., additional, Sobral Sousa, A.C., additional, Ferraz de Almeida, A.C., additional, Hernandez, M.E., additional, Friedrich, M., additional, Mota, D.M., additional, Ritt, L.E., additional, Correa Vila Nova, D., additional, Teal, P., additional, Gladstone, D., additional, Shuaib, A., additional, Silver, F., additional, Dowlatshahi, D., additional, Lanas, F., additional, Carcamo, D., additional, Santibañez, C., additional, Garces, E., additional, Liu, L.S., additional, Zhang, H.Y., additional, Fang, H.P., additional, Lian, M.F., additional, Shen, F., additional, Luo, F.X., additional, Wen, X.X., additional, Xu, Z.Q., additional, Liu, Z.Z., additional, Yan, W., additional, Yu, J.F., additional, Wang, W.K., additional, Liu, L.H., additional, Sun, Y.H., additional, Zhou, L.C., additional, Zhang, Z.F., additional, LV, J., additional, Zhang, C.S., additional, Chen, G., additional, Wang, H.L., additional, Chen, Y., additional, Zheng, H., additional, Huang, J.J., additional, Li, W.Z., additional, Wang, L.J., additional, Shi, J.X., additional, Hu, C.Y., additional, Song, H.F., additional, Ji, R.Y., additional, Wang, D.L., additional, Meng, L.H., additional, Meng, Q.W., additional, Duan, L.J., additional, Liu, H.F., additional, Luo, Y.C., additional, Zhang, Q.Y., additional, Wu, Y.B., additional, Wang, C.R., additional, Zhao, J.G., additional, Liu, S.G., additional, Shi, C.L., additional, Wang, X.Y., additional, Lopez-Jaramillo, P., additional, Martinez, A., additional, Sanchez-Vallejo, G., additional, Molina, D.I., additional, Espinosa, T., additional, Garcia Lozada, H., additional, Gomez-Arbelaez, D., additional, Camacho, P.A., additional, Rumboldt, Z., additional, Lusic, I., additional, Iversen, H.K., additional, Truelsen, T., additional, Back, C., additional, Pedersen, M.M., additional, Peñaherrera, E., additional, Duarte, Y.C., additional, Cevallos, S., additional, Tettamanti, D., additional, Caceres, S., additional, Diener, H.C., additional, Weimar, C., additional, Grau, A., additional, Rother, J., additional, Ritter, M., additional, Back, T., additional, Winter, Y., additional, Pais, P., additional, Xavier, D., additional, Sigamani, A., additional, Mathur, N., additional, Rahul, P., additional, Murali, A., additional, Roy, A.K., additional, Sarma, G.R.K., additional, Matthew, T., additional, Kusumkar, G., additional, Salam, K.A., additional, Karadan, U., additional, Achambat, L., additional, Singh, Y., additional, Pandian, J.D., additional, Verma, R., additional, Atam, V., additional, Agarwal, A., additional, Chidambaram, N., additional, Umarani, R., additional, Ghanta, S., additional, Babu, G.K., additional, Sathyanarayana, G., additional, Sarada, G., additional, Navya Vani, S., additional, Sundararajan, R., additional, Sivakumar, S.S., additional, Wadia, R.S., additional, Bandishti, S., additional, Agarwal, R.R., additional, Mohan, I., additional, Joshi, S., additional, Kulkarni, S., additional, Partha Saradhi, S., additional, Joshi, P., additional, Pandharipande, M., additional, Badnerkar, N., additional, Joshi, R., additional, Kalantri, S.P., additional, Somkumar, S., additional, Chauhan, S., additional, Singh, H., additional, Varma, S., additional, Sidhu, G.K., additional, Singh, R., additional, Bansal, K.L., additional, Bharani, A., additional, Pagare, S., additional, Chouhan, A., additional, Mahanta, B.N., additional, Mahanta, T.G., additional, Rajkonwar, G., additional, Diwan, S.K., additional, Mahajan, S.N., additional, Shaikh, P., additional, Devendrappa, H.R., additional, Agrawal, B.K., additional, Agrawal, A., additional, Khurana, D., additional, Thakur, S., additional, Jain, V., additional, Oveisgharan, S., additional, Bahonar, A., additional, Kelishadi, R., additional, Hossienzadeh, A., additional, Raeisidehkordi, M., additional, Akhavan, H., additional, Walsh, T., additional, Albaker, O., additional, Yusoff, K., additional, Chandramouli, A., additional, Shahadan, S., additional, Ibrahim, Z., additional, Husin, A., additional, Damasceno, A., additional, Lobo, V., additional, Loureiro, S., additional, Govo, V.A., additional, Ogah, O.S., additional, Ogunniyi, A., additional, Akinyemi, R.O., additional, Owolabi, M.O., additional, Sani, M.U., additional, Owolabi, L.F., additional, Iqbal, R., additional, Wasay, M., additional, Raza, A., additional, Malaga, G.G., additional, Lazo-Porras, M., additional, Loza-Herrera, J.D., additional, Acuña-Villaorduña, A., additional, Cardenas-Montero, D., additional, Dans, A., additional, Collantes, E., additional, Morales, D., additional, Roxas, A., additional, Villarruz-Sulit, M.V.C., additional, Czlonkowska, A., additional, Ryglewicz, D., additional, Skowronska, M., additional, Restel, M., additional, Bochynska, A., additional, Chwojnicki, K., additional, Kubach, M., additional, Stowik, A., additional, Wnuk, M., additional, Pogosova, N., additional, Ausheva, A., additional, Karpova, A., additional, Pshenichnikova, V., additional, Vertkin, A., additional, Kursakov, A., additional, Boytsov, S., additional, Al-Hussain, F., additional, DeVilliers, L., additional, Magazi, D., additional, Mayosi, B., additional, Elsayed, A.S.A., additional, Bikhari, A., additional, Sawaraldahab, Z., additional, Hamad, H., additional, ElTaher, M., additional, Abdelhameed, A., additional, Alawad, M., additional, Alkabashi, D., additional, Alsir, H., additional, Rosengren, A., additional, Andreasson, M., additional, Kembro Johansson, J., additional, Cederin, B., additional, Schander, C., additional, Elgasen, A.C., additional, Bertholds, E., additional, Boström Bengtsson, K., additional, Nilanont, Y., additional, Nidhinandana, S., additional, Tatsanavivat, P., additional, Paryoonwiwat, N., additional, Poungvarin, N., additional, Suwanwela, N.C., additional, Tiamkao, S., additional, Tulyapornchote, R., additional, Boonyakarnkul, S., additional, Hanchaiphiboolkul, S., additional, Muengtaweepongsa, S., additional, Watcharasaksilp, K., additional, Sathirapanya, P., additional, Pleumpanupat, P., additional, Oguz, A., additional, Akalin, A.A., additional, Caklili, O.T., additional, Isik, N., additional, Caliskan, B., additional, Sanlisoy, B., additional, Balkuv, E., additional, Tireli, H., additional, Yayla, V., additional, Cabalar, M., additional, Culha, A., additional, Senadim, S., additional, Arpaci, B., additional, Dayan, C., additional, Argun, T., additional, Yilmaz, S., additional, Celiker, S., additional, Kocer, A., additional, Asil, T., additional, Eryigit, G., additional, Mondo, C., additional, Kayima, J., additional, Nakisige, M., additional, Kitoleeko, S., additional, Yusufali, A.M., additional, Zuberi, B.J., additional, Mirza, H.Z., additional, Saleh, A.A., additional, BinAdi, J.M., additional, Hussain, F., additional, Langhorne, P., additional, Muir, K., additional, Walters, M., additional, McAlpine, C., additional, Ghosh, S., additional, Doney, A., additional, Johnston, S., additional, Mudd, P., additional, Black, T., additional, Murphy, P., additional, Jenkinson, D., additional, Kelly, D., additional, Whiting, R., additional, Dutta, D., additional, Shaw, L., additional, Mcfarlane, C., additional, Ronald, E., additional, and McBurnie, K., additional

Published
2018
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7. Huntington\'s disease: Genetic heterogeneity in black African patients

Author

Magazi, D. S., Amanda Krause, Bonev, V., Moagi, M., Iqbal, Z., Dludla, M., and Meyden, C. H.

Abstract

Objective. Huntington's disease (HD) has been reported to occur rarely in black patients. A new genetic variant– Huntington's disease-like 2 (HDL2) – occurring more frequently in blacks, has recently been described. The absence of an expanded trinucleotide repeat at the chromosome 4 HD locus was previously regarded as a way of excluding classic HD. The objective of this paper is to describe a number of black patients with genetically proven HD and to review its occurrence in Africa. Methods. Eleven black families (12 subjects), with genetically proven HD, are described: 9 from the Dr George Mukhari Hospital, and 2 from private practice in Tshwane. Results. Chorea was present in all 12 patients and cognitive decline in 9. Nine had an age of onset between 30 and 50 years. Six families exhibited expansion of the trinucleotide repeat at the chromosome 4, IT 15 gene (HD), and 5 a junctophilin (JPH3) trinucleotide expansion at chromosome 16 (HDL2). The HDL2 subtype showed a tendency towards a later age of onset. Conclusions. The clinical presentation of the two genotypes (i.e. HD and HDL2) appears to be similar. The actual rate of occurrence of HD in blacks may require re-assessment. Considering the number of Huntington's chorea patients occurring in our area (Garankuwa), the possibility of clustering of the condition arises. South African Medical Journal Vol. 98 (3) 2008: pp. 200-203

Published
2008

9. The Impact of HIV on Meningitis as Seen at a South African Academic Hospital (1994 to 1998).

Author

Schutte, C. M., van der Meyden, C. H., and Magazi, D. S.

Subjects
HIV infections, MENINGITIS, HOSPITALS, CENTRAL nervous system diseases, HIV-positive persons
Abstract

Background: The increase in HIV infections in South Africa is alarming. The aim of this prospective 4-year study was to evaluate the rising incidence of HIV-related admissions due to meningitis at the Pretoria Academic Hospital (PAH) adult neurology ward and to investigate the spectrum of meningitis during this time. Patients and Methods: Adults with meningitis presenting at the PAH neurology ward from March 1994 through February 1998 were included. HIV antibody status was determined and patients were assigned to five categories: bacterial, tuberculous, viral and cryptococcal meningitis, as well as an uncertain category. Results: Over the 4-year study period 141 patients with meningitis were seen. Of these, 44 were HIV-positive (31%), with TB meningitis occurring in 16 (36%), cryptococcal meningitis in 22 (50%) and acute bacterial meningitis in three (7%). In the first 2 years of the study, 14% of patients were HIV positive; this figure rose to 44% in the 3rd year, and 57% in the final year. The spectrum of meningitis also changed: bacterial meningitis remained relatively stable at about 25% of the total;TB meningitis almost doubled from 16% in the 1st year to 31 % in the last year of the study; viral meningitis initially occurred in 8% of patients and later in 3% of cases, while cryptococcal meningitis showed the most significant increase from 6% of cases in 1994/5 to 31 and 26% respectively in the last 2 years of the study. Conclusion: Over a 4-year period the HIV epidemic was responsible for a marked shift in the spectrum of meningitis towards chronic infections such as TB and cryptococcal meningitis at the PAH. [ABSTRACT FROM AUTHOR]

Published
2000
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10. HIV infection, seasonality and younger age predicting incident Bell's palsy among black South Africans.

Author

Magazi D, Longombenza B, Mda S, Van der Meyden K, Motshwane M, Nanjoh M, and Towobola O

Subjects
Adult, Age Factors, Female, Humans, Male, Retrospective Studies, Seasons, South Africa epidemiology, Young Adult, Bell Palsy complications, Bell Palsy epidemiology, Black People statistics & numerical data, HIV Infections complications, HIV Infections epidemiology
Abstract

Background: Although South Africa (SA) is facing a high prevalence of HIV infection, there is no literature from this region on a link between Bell's palsy and HIV. The aim of this study was to identify the occurrence of Bell's palsy in relation to demographics, seasons and HIV status among black South Africans., Methods: This retrospective cohort was conducted among adult black patients, without Bell's palsy in 2003, presenting to the neurology outpatients department at Dr. George Mukhari Academic hospital, Pretoria, South Africa, between 2004 (study baseline) and 2012 (end test). Gender, age, HIV status, and seasons were potential predictors of Bell's palsy using Cox regression model and Kaplan Meier curves., Results: From the baseline of 1487 patients, 20.9% (n = 311) experienced Bell's palsy onset by the end of the study. In univariate analysis, male gender (RR = 2.1 95% CI 1.7-2.5; P <  0.0001), age less than 30 years (RR = 2.9 95% CI 2.4-3.6; P <  0.0001), HIV seropositivity (RR =2.9 95% CI 2.3-4.9; P < 0.0001). The highest incidence in winter (30.3% n = 136/450) vs. incidences during other seasons with Intermediate values during Summer (25.3% n = 136/450) and Autumn (20.7% n = 64/308) and the lowest incidence in Spring (23.7% n = 16/353) P < 0.0001) were predictors of Bell's palsy. In multivariate analysis at adjusting for gender, the most significant and independent predictors of incident Bell's palsy were HIV seropositivity (HR = 6.3 95% CI 4.8-8.3; P < 0.0001), winter (HR = 1.6 95% CI 1.2-2.1; P < 0.0001) vs. other seasons, and younger age < 30 years (HR = 7.1 95% CI 5.6-9.1; P < 0.0001) vs. older age groups., Conclusion: Seasonality, younger age and HIV positivity are important and independent risk factors of Bell's palsy. Education and awareness programs on the possible effects of HIV and seasons on the development of Bell's palsy are necessary. This would lead to a better understanding and even a possible development of avoidance measures for this condition amongst young black South Africans.

Published
2020
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11. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study.

Author

O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, Rao-Melacini P, Zhang X, Pais P, Agapay S, Lopez-Jaramillo P, Damasceno A, Langhorne P, McQueen MJ, Rosengren A, Dehghan M, Hankey GJ, Dans AL, Elsayed A, Avezum A, Mondo C, Diener HC, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Iqbal R, Diaz R, Yusoff K, Yusufali A, Oguz A, Wang X, Penaherrera E, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, Al Hussain F, Magazi D, Nilanont Y, Ferguson J, Pare G, and Yusuf S

Subjects
Adult, Africa epidemiology, Aged, Alcohol Drinking adverse effects, Alcohol Drinking epidemiology, Apolipoprotein A-I blood, Apolipoproteins B blood, Asia epidemiology, Atrial Fibrillation complications, Atrial Fibrillation epidemiology, Australia epidemiology, Biomarkers blood, Brain Ischemia blood, Brain Ischemia complications, Case-Control Studies, Cerebral Hemorrhage blood, Cerebral Hemorrhage complications, China epidemiology, Diabetes Complications epidemiology, Diabetes Complications prevention & control, Europe epidemiology, Evidence-Based Medicine, Feeding Behavior, Female, Health Behavior, Humans, Hypertension blood, International Cooperation, Male, Middle Aged, Middle East epidemiology, Motor Activity, Obesity, Abdominal complications, Obesity, Abdominal epidemiology, Odds Ratio, Risk Factors, Self Report, Smoking adverse effects, Smoking epidemiology, Stroke blood, Stroke etiology, Stroke pathology, Waist-Hip Ratio, Brain Ischemia epidemiology, Cerebral Hemorrhage epidemiology, Hypertension complications, Hypertension epidemiology, Risk Reduction Behavior, Stroke epidemiology, Stroke prevention & control
Abstract

Background: Stroke is a leading cause of death and disability, especially in low-income and middle-income countries. We sought to quantify the importance of potentially modifiable risk factors for stroke in different regions of the world, and in key populations and primary pathological subtypes of stroke., Methods: We completed a standardised international case-control study in 32 countries in Asia, America, Europe, Australia, the Middle East, and Africa. Cases were patients with acute first stroke (within 5 days of symptom onset and 72 h of hospital admission). Controls were hospital-based or community-based individuals with no history of stroke, and were matched with cases, recruited in a 1:1 ratio, for age and sex. All participants completed a clinical assessment and were requested to provide blood and urine samples. Odds ratios (OR) and their population attributable risks (PARs) were calculated, with 99% confidence intervals., Findings: Between Jan 11, 2007, and Aug 8, 2015, 26 919 participants were recruited from 32 countries (13 447 cases [10 388 with ischaemic stroke and 3059 intracerebral haemorrhage] and 13 472 controls). Previous history of hypertension or blood pressure of 140/90 mm Hg or higher (OR 2·98, 99% CI 2·72-3·28; PAR 47·9%, 99% CI 45·1-50·6), regular physical activity (0·60, 0·52-0·70; 35·8%, 27·7-44·7), apolipoprotein (Apo)B/ApoA1 ratio (1·84, 1·65-2·06 for highest vs lowest tertile; 26·8%, 22·2-31·9 for top two tertiles vs lowest tertile), diet (0·60, 0·53-0·67 for highest vs lowest tertile of modified Alternative Healthy Eating Index [mAHEI]; 23·2%, 18·2-28·9 for lowest two tertiles vs highest tertile of mAHEI), waist-to-hip ratio (1·44, 1·27-1·64 for highest vs lowest tertile; 18·6%, 13·3-25·3 for top two tertiles vs lowest), psychosocial factors (2·20, 1·78-2·72; 17·4%, 13·1-22·6), current smoking (1·67, 1·49-1·87; 12·4%, 10·2-14·9), cardiac causes (3·17, 2·68-3·75; 9·1%, 8·0-10·2), alcohol consumption (2·09, 1·64-2·67 for high or heavy episodic intake vs never or former drinker; 5·8%, 3·4-9·7 for current alcohol drinker vs never or former drinker), and diabetes mellitus (1·16, 1·05-1·30; 3·9%, 1·9-7·6) were associated with all stroke. Collectively, these risk factors accounted for 90·7% of the PAR for all stroke worldwide (91·5% for ischaemic stroke, 87·1% for intracerebral haemorrhage), and were consistent across regions (ranging from 82·7% in Africa to 97·4% in southeast Asia), sex (90·6% in men and in women), and age groups (92·2% in patients aged ≤55 years, 90·0% in patients aged >55 years). We observed regional variations in the importance of individual risk factors, which were related to variations in the magnitude of ORs (rather than direction, which we observed for diet) and differences in prevalence of risk factors among regions. Hypertension was more associated with intracerebral haemorrhage than with ischaemic stroke, whereas current smoking, diabetes, apolipoproteins, and cardiac causes were more associated with ischaemic stroke (p<0·0001)., Interpretation: Ten potentially modifiable risk factors are collectively associated with about 90% of the PAR of stroke in each major region of the world, among ethnic groups, in men and women, and in all ages. However, we found important regional variations in the relative importance of most individual risk factors for stroke, which could contribute to worldwide variations in frequency and case-mix of stroke. Our findings support developing both global and region-specific programmes to prevent stroke., Funding: Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Stroke Network, Health Research Board Ireland, Swedish Research Council, Swedish Heart and Lung Foundation, The Health & Medical Care Committee of the Regional Executive Board, Region Västra Götaland (Sweden), AstraZeneca, Boehringer Ingelheim (Canada), Pfizer (Canada), MSD, Chest, Heart and Stroke Scotland, and The Stroke Association, with support from The UK Stroke Research Network., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Published
2016
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12. Post-traumatic acute disseminated encephalomyelitis.

Author

Magazi D, Wynand-Ndlovu L, Legwara P, Matlala B, Sebiloane S, and Patel J

Abstract

A 23-year-old black African male fell and bumped his head from a tackle while playing soccer. He subsequently became blind from optic neuritis. An MRI of the brain showed white-matter changes suggestive of acute disseminated encephalomyelitis (ADEM). MR spectroscopy of the brain showed a demyelination pattern. This case report brings to the fore unsettled questions about ADEM, among them being whether it can occur as a post-traumatic event.

Published
2015
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13. Amnesia after a half marathon - a case study.

Author

Magazi D

Subjects
Adult, Female, Humans, Memory, Amnesia, Transient Global etiology, Running psychology
Abstract

This is a description of a previously healthy female who developed a memory deficit after running a 21-km race for the first time in her life. The memory problem lasted a few hours, during which time she was anxious, asking the same questions repeatedly. The effects of exercise on memory are discussed. Transient global amnesia, its associations and prognosis, is reviewed.

Published
2012
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