African Journals Online
Journal of Medicine and Biomedical Research

Volume 1 Number 2 December 2002
ABSTRACTS

Ophthalmic surgical procedures in children at the University of Benin Teaching Hospital, Benin City

Adesuwa I Osahon and Oseluese A Dawodu

Department of Optometry, University of Benin Teaching Hospital, Ugbowo, Benin City, Nigeria

ABSTRACT

A retrospective study of paediatric eye surgeries at the University of Benin Teaching Hospital was carried out to determine the frequency and pattern of eye surgeries in children in order to provide a database for such operations. During the study period, January 1996 to December 2000, a total of 757 ophthalmic surgeries were performed, out of which 113 (14.9%) were children. There were 75 males and 38 females, giving a male to female ratio of approximately 2:1. Eye surgery was most frequent in the age group 0–4 years (46.9%). The commonest indication for surgery was ocular trauma (25.7%). The second commonest indication for surgery was cataract (23.0%), while eyeball removal (9% of cases) due to tumours or infection was the third commonest surgical procedure. Strabismus and pterygium surgery were infrequently performed (0.9%). Late presentation for eye surgery was the pattern in most of the cases. Majority of the cases were carried out under general anaesthesia (80.5%) and the others under local anaesthesia (14.5%).             Recommendations are made regarding provision of adequate ophthalmic surgical facilities, health education of the populace on the need for early presentation of patients to hospital and inclusion of rubella (German measles) immunisation in the National Programme on Immunization.

Key Words: Ophthalmic surgery, children, Benin City

Correspondence: Dr A.I. Osahon, Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Nigeria.

Management of penetrating colorectal injuries in civilian practice

OO Oludiran^a and U Osime^a

Department of Surgery, College of Medical Sciences, University of Benin, Benin City, Nigeria.

ABSTRACT

The changing trend in the management of penetrating colorectal trauma favouring primary repair without faecal diversion has generated a lot of interest among surgeons. In West Africa, surgeons face peculiar challenges of inadequate facilities, late presentation, delay to surgery and faecal loading of the colon. This study was carried out to determine the place of this trend in our practice. There were seventeen consecutive patients (aged 15 to 50 years) with injuries at 21 different anatomic sites: five in the right colon and 16 in the left. Twelve (75%) patients had primary repair without faecal diversion, two of which had colon related complications. The median duration of hospitalisation was shorter in patients managed without faecal diversion. Two patients died in the immediate peri-operative period and could not be included in the study. From our experience and from a review of literature we conclude that primary repair without faecal diversion should be favoured in good surgical risk patients.

Key Words: Colon, rectum, injury, primary repair, colostomy

Correspondence: Oludiran O.O., Department of Surgery, College of Medical Sciences, University of Benin, Benin City, Nigeria. E-mail: [email protected]

Intra-operative blood transfusion among adult surgical patients in a tertiary hospital in Benin City, Nigeria

CO Imarengiaye^a, ME Enosolease^b and PE Iribhogbe^c

Departments of Anaesthesiology^a, Haematology^b and Surgery^c, University of Benin Teaching Hospital, P.M.B. 1111, Benin City, Nigeria.

ABSTRACT

This retrospective study was designed to audit the pattern of intra-operative whole blood transfusion among adult surgical patients over a two-year period. Data were collected on the rate of intra-operative transfusion, estimated blood loss, units of donor blood transfused, pattern of use of autologous blood and circumstances of the surgery. Fifteen per cent of the surgical population had blood transfusion in the intra-operative period. Over half of the patients (52.3%) received single unit transfusion. Preoperative anaemia was seen in 14.9% of the population. There was no intra-operative estimation of haemoglobin level prior to transfusion. Estimated blood loss of over 500mL was a likely trigger for intra-operative whole blood transfusion. There is need for specific guidelines on the management of intra-operative haemotherapy. Such management strategy may reduce exposure to donor blood, improve safety and save cost for surgical patients.

Key Words: Audit, blood transfusion, intra-operative

Correspondence: Dr C.O. Imarengiaye, Department of Anaesthesiology, University of Benin Teaching Hospital, P.M.B. 1111, Benin City, Nigeria. E-mail: [email protected]

Childhood urinary tract infection in Benin City: pathogens and antimicrobial sensitivity pattern

MO Ibadin

ABSTRACT

Anti-microbial sensitivity pattern of bacterial isolates implicated in urinary tract infection (UTI) amongst children was studied using the disc diffusion method. The prospective study was carried out in 65 children managed for urinary tract infection in the paediatric facilities of the University of Benin Teaching Hospital, Benin City, Nigeria, between October 1, 1997, and September 30, 2002. The subjects were made up of 26 (40.0%) males and 39 (60.0%) females. UTI was commoner in females and young children. Amongst older children it was found mainly in those with primary renal morbidities. Escherichia coli (49.2%), Staphylococcus aureus (24.6%) and Klebsiella pneumoniae (20.0%) were the commonest isolates. In vitro sensitivity of the common isolates to gentamycin, clavulanic acid potentiated amoxycillin, ofloxacin, and ciprofloxacin was moderate to high; and against ceftazidime and azithromycin, it was low to moderate. It was, however, low to cotrimoxazole and ampicillin. The rampant recommendation and use of cotrimoxazole as first choice drug in UTI in children does not seem to enjoy scientific backing, at least for now. There is also an emerging resistance of common pathogens to azithromycin and ceftazidime. Though rare, other urinary pathogens with acknowledged virulence are being encountered. It is recommended that clavulanic acid potentiated amoxicillin, gentamycin or ceftriaxone be used for the treatment of UTI in the study locale, particularly when cultural evidences of causative organisms are not immediately available.

Key Words: Urinary pathogens, antibiotic susceptibility, children

Correspondence: Dr M.O. Ibadin, Senior Lecturer/Consultant, University of Benin Teaching Hospital, Benin City

Screening for microalbuminuria amongst medical students in University of Benin, Nigeria: a pilot study

Evelyn I Unuigbe^a, Ahbor D Ighoroje^b, Frank A Imariagbe^a, Ogechika K Alozie^a

Departments of ^aMedicine and ^bPhysiology, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria.

ABSTRACT

Microalbuminuria, a predictive tool in both diabetics and hypertensive, is associated with an increase in vascular mortality and morbidity in the healthy population. A cohort of apparently healthy medical students was screened for microalbuminuria using micral test strips. Data on history of hypertension, diabetes mellitus, renal disease and smoking were collected using a self-administered structured questionnaire. Blood pressure and body mass index (BMI) were recorded in all subjects. Microalbuminuria was present in 61% of the students. It was commonly encountered in students who are smokers, have a family history of diabetes mellitus and hypertension. BMI of students with normoalbuminuria was significantly lower than in students with MA (p = 0.012). MA positively correlated with BMI (r = 0.13, p = 0.40). Microalbuminuria is alarmingly prevalent in the group of students studied and may probably predate clinical diagnosis of diabetes mellitus and hypertension. There is need for follow-up and close monitoring of students who have been identified to have MA, as early preventive strategies may be useful.

Key Words: Screening, microalbuminuria, healthy students

Correspondence: Dr Evelyn I. Unuigbe, P.O. Box 10112, Ugbowo, Benin City, Nigeria.

Knowledge and practice of universal precautions among doctors and laboratory workers in Central Hospital, Benin City, Nigeria

AN Ofili^a, MC Asuzu^b and OH Okojie^a

^aDepartment of Community Health, School of Medicine, University of Benin, P.M.B. 1154, Benin City, Nigeria. ^bDepartment of Community Medicine, University College Hospital, P.M.B. 5116, Ibadan, Oyo State, Nigeria.

ABSTRACT

A total of 87 health workers at the Central Hospital, Benin City, participated in this study aimed at finding out the knowledge and practice of universal precautions in 1999. All participants had worked for at least six months in the hospital and included all doctors and laboratory workers. All the respondents completed a self-administered structured questionnaire. The mean ages of the doctors and laboratory workers were 37.5 ± 9.11 and 41.56 ± 7.19 respectively. There were more males in the study (73.4%) than females (26.4%). The respondents had poor knowledge of universal precautions, as only 31 (35.6%) of them had heard about it. There was also poor adherence to the precautions by those who knew of it. We recommend that seminars/workshops be organised for health workers on the universal precautions.

Key Words: Knowledge, practice, universal precautions, doctors, laboratory workers

Correspondence: Dr (Mrs.) A.N. Ofili, Department of Community Health, School of Medicine, University of Benin, P.M.B. 1154, Benin City, Nigeria.

CASE REPORT

Treatment of unerupted maxillary incisors — a case report

AA Umweni^a and MA Ojo^b

^aDepartment of Preventive Dentistry, ^bDepartment of Oral Surgery and Oral Pathology, School of Dentistry, University of Benin, P.M.B 1154, Benin City, Nigeria

ABSTRACT

A case of unerupted maxillary left central incisor due to impedance from an odontome is presented. The problems associated with various modalities of management are highlighted in the light of current practical possibilities to achieve good aesthetics. Surgical removal of the impeding pathologic agent and orthodontic traction of the unerupted tooth remain the most viable advocated methods of treatment.

Correspondence: Dr A.A. Umweni, Department of Preventive Dentistry, College of Medical Sciences, University of Benin, P.M.B.1154, Benin City, Nigeria.

LABORATORY REPORTS

Studies on the nutritional value and anti-tumour property of the bark of Spondias mombin L.

M Idu^a, JE Ataman^b, AO Akhigbe^c, OG Ucho^d, SF Akinbo^e and FK Idu^f

Departments of ^a,dBotany, ^bAnatomy, ^cRadiology, ^eMorbid Anatomy, and ^fOptometry, University of Benin, PMB 1154, Benin City, Nigeria.

ABSTRACT

This study was conducted to investigate the anti-tumour property of the bark of Spondias mombin, commonly used traditionally for the treatment of certain malignancies. Forty wister rats of about seven weeks old were randomly sampled and grouped into three. Group A, the main control, was fed with 50g marsh only over a definite period, while the test control received 50g marsh and 5g Cycas revoluta, a carcinogenic plant. Three subgroups from the B group were fed with carcinogen-containing diet and S. mombin simultaneously at different concentrations. Group C rats had their diet changed to marsh and S. mombin at different concentrations for each subgroup after initial exposure to carcinogen-containing diet. Group B rats fed with carcinogenic feed alongside treatment with Spondias mombin bark for induced cancer showed some recovery, as the treatment suppressed some effects of the carcinogen. By contrast, group C rats, which were similarly induced with cancer and later treated at 50% level showed significant improvement compared to the test control. Most of the symptoms observed in the later such as hair loss, reduced agility, low food intake and hyperplastic nodules were reduced. Ultrasound findings showed significant tachycardia in group B rats with increased dosage of the treatment plant while the test control rats showed relative bradycardia, indicating that tachycardia is a possible side effect of the treatment plant. Histopathology of the tissues showed significant pathological differences especially in the liver, small intestine and kidney (p < 0.05) as observed in SGOT, SGPT ALP, cholesterol and bilirubin levels. Proximate analysis carried out on S. mombin bark showed a high concentration of crude fibre and calcium ion, which have been identified to have anti-tumour properties. The results obtained suggest a role for S. mombin in the treatment of certain malignancies.

Key Words: Nutritional value, anti-tumour, Spondias mombin

Correspondence: JE Ataman, Department of Anatomy, University of Benin, PMB 1154, Benin City, Nigeria

Cyanide profiles of some Nigerian edible mushrooms in the raw and processed states

NP Okolie and DA Gbuji

Department of Biochemistry, University of Benin, P.M.B 1154, Benin City, Nigeria.

ABSTRACT

Slices of eight species of Nigerian edible mushrooms, namely, Volvorella vulvacaea, Marasmius spp., Coprinus comatus, Pleurotus squarulotus, Pleurotus ostreatus, Schizophyllum commune, Rigidiporus lignosus and Ganaderma oregonense were analysed for free and bound (glycosidic) cyanide in the raw state as well as after processing. The species of mushroom were processed by soaking in water, boiling, sun drying and oven drying using a combination of gravimetric and colorimetric methods. Except for G. oregonense, all the mushrooms contained toxic levels of free cyanide (133–781mg HCN/kg dry matter) and bound cyanide (219–2711mg HCN/kg dry matter). Soaking slices in water for 24 hours led to 41–99% and 79–93% losses in free and bound cyanide respectively. After boiling for 45 minutes both forms of cyanide were reduced to innocuous levels in slices previously soaked in water for 24 hours. Oven drying was less effective than sun drying in minimising free and bound cyanide, although both processes led to significant losses of cyanide. From toxicological perspectives, edible mushrooms are safest when boiled after prolonged soaking in water.

Key Words: Mushroom, processing, cyanide

Correspondence: N. P. Okolie, Department of Biochemistry, University of Benin, P.M.B 1154, Benin City, Nigeria. E-mail: [email protected]

Chronic cyanide toxicity and urinary enzyme excretion in rabbits

NP Okolie and B Ivwighregweta

Department of Biochemistry, Faculty of Science, University of Benin, P.M.B 1154, Benin City, Nigeria.

ABSTRACT

The time-course effect of sub-acute cyanide toxicity on urinary excretion of some marker enzymes for kidney damage was studied in two groups of three-month-old New Zealand White rabbits fed for eight weeks on either pure growers mash or mash plus 640ppm potassium cyanide. Weekly assays of lactate dehydrogenase (LDH), acid phosphatase (AP) and alkaline phosphatase (ALP) were carried out in urine for both groups, and in kidney tissues on termination of feeding. Results show that LDL and ALP were detected in the urine of cyanide-treated rabbits in the second and fifth weeks respectively and up to the eighth week. AP was not detected in urine, and its activity in the kidney was unaffected by cyanide. In contrast, cyanide treatment caused significant increases in kidney LDH while kidney ALP was significantly decreased relative to controls (p < 0.05). The pattern of enzyme changes in kidney and urine suggest cyanide-induced damage to kidney tubules most probably via tissue hypoxia.

Key Words: Cyanide toxicity, enzyme excretion, urine

Correspondence: N.P. Okolie, Department of Biochemistry, Faculty of Science, University of Benin, P.M.B 1154, Benin City, Nigeria. E-mail: [email protected]