African
Journals Online
Sahel Medical
Journal
Volume 6 No.3 July-September
2003
ABSTRACTS
Appendicitis: A Study of
Negative Appendicectomies
*J Kpolugbo, FMCS., T Njoku, FMCS. and U Osime,
FRCS.
Department
of Surgery, University of Benin Teaching Hospital, Benin City, Edo State,
Nigeria.
Summary
This is a fifteen-month
prospective study to assess the diagnostic accuracy of appendicitis. One
hundred and fifty nine patients were diagnosed on clinical basis as having
acute appendicitis and subsequently had appendicectomy. 52.8% were confirmed on
histology. The diagnostic error (negative appendicectomy) was 47.2%. the error
was lower in males (35%) compared with females. The reason for the high
negative appendicectomy in women is pelvic inflammatory diseases, which mimics
acute appendicitis.
Post-operative complications were noted in 3% of the
negative appendicectomy group but in the positive appendicectomy group
complications were much more common particularly when the appendix was
ruptured.
(Key Words: Negative
appendicectomy, perforated appendix and postoperative complications.)
Childhood and Adolescent Sexual Abuse: Incidence, Complications and
Management
*IF Abdul, FWACS.
Department
of Obstetrics and Gynaecology, Maternity Hospital, P.M.B. 1339, Ilorin,
Nigeria.
Summary
Sexual
abuse in children and adolescents is a silent epidemic because despite the fact
that close to 20% of children and adolescents (1 out 5) are affected, less than
10% of the cases get reported to law enforcement agents or medical
practitioners.
Sexual
abuse is associated with physical injuries such as bruises and lacerations to
the neck, back, buttocks, extremities, vulva and the vagina. Other
complications relate to sexually transmitted diseases, unwanted pregnancy and
psychological pathologies such as intense anxiety, anger, depression, mood
swings, nightmares, phobias and somatisation. This review discusses the
apparent low incidence and of sexual abuse in children and adolescents,
complications as well as management. The aim is to increase the level of
awareness of sexual abuse among medical practitioners and improve the care of
victims.
(Key word: Sexual abuse;
Childhood and Adolescence; Incidence; Complications; Management).
Chronic Suppurative Otitis
Media: A Clinical Profile in Sokoto, Nigeria
*KR Iseh, FWACS., TS Abubakar, MBBS.
Department
of ENT, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
Summary
This is a retrospective study of
sixty eight cases of chronic suppurative otitis media seen in the Ear, Nose and
Throat (ENT) Department of Usmanu Danfodiyo University Teaching Hospital Sokoto
from June 1998 to May 1999. It was commonest in the paediatric age group
(68.82%).
The
commonest symptom at presentation was ear discharge (100%), ear ache (26.47%),
hearing loss (22.46%) and itchiness (10.29%). The commonest signs were ear
discharge (100%) and tympanic membrane perforation (100%). All patients had the
tubotympanic type of chronic suppurative otitis media.
Pseudomonas
aeruginosa and staphylococcus aureus were the most commonly cultured organisms
(28.5% each). Cultures were sensitive to gentamicin and peflacine in most
cases.
Chronic
suppurative otitis media is a public health problem affecting mainly the
paediatrics age group with attendant learning impairment, caused by some degree
of hearing loss and frequent hospital visitation for treatment. Therefore,
prevention is stressed to reduce the morbidity of the disease.
Key words: Chronic suppurative otitis media,
pseudomonas aerugi nosa, hearing loss.
Knowledge, Attitude and
Practice about the Traditional Bone Setters among Health Workersi n Federal
Medical Centre, Owo, Nigeria.
*AA Olasinde, FWACS., **KS Oluwadiya, FMCS (ortho),
*AO Olawoye, FMCS (ortho.), ***Late OS Badru, FMCS (ortho), ***LM Oginni, FMCS
(ortho), and OO Adegbehingbe, MB, CH.B.
*Departments
of Orthopaedics and Traumatology, Federal Medical Center, Owo, Ondo State.
**Surgery,
Ladoke Akintola University, Ogbomosho, ***Orthopaedics and Traumatology,
Obafemi Awolowo University, Ile-Ife, Osun State.
Summary
The
practice of traditional bone setters can no longer be denied in this
environment as some of the complications resulting from their treatment are
still seen commonly in orthopaedic surgical practice.
This
study was undertaken at the Federal Medical Centre, Owo, Ondo State, Nigeria to
find out about knowledge, attitude and practice about the traditional bone
setters (TBS) among health workers. A pre-tested questionnaire was distributed
among the health workers through their heads of departments for ease of
collection. The response rate was 88.2% with a male to female ratio of 1:1.7.
88.1%
were aware of the TBS practice in our environment and 32.7% got to know about
them through the mass media; constituting the greatest percentage proportion.
Only 19.6% of the respondents claimed the knowledge of how traditional bone
setters acquired their skills, 73.6% of these responded that it was innately
acquired. While most of the respondents assessed their care as inadequate and
that they should not be allowed to treat patients with fractures; 12.9%
believed that the TBS possessed special powers to treat fractures that is
lacking in orthopaedic surgeons. Health assistants were the most likely to be
believe in the possession of such powers.
It
was recommended that the TBS should be banned from unvented access to the use
of the mass media. Within the hospital environment, there is need to organize
regular update or instructional lectures for health workers, especially the
health assistants who are most likely to give wrong interpretations to events
surrounding the patient treatment by the orthodox practitioners.
(Key words: Chronic suppurative otitis media,
Pseudomonas aerugi nosa, Hearing loss).
Total Glycated Serum Protein
Levels in Hyperbilirubinaemic and Normobilirubinaemic Non Diabetic Nigerians
HP Anaja, SA Usman, and HS Isah
Department of
Chemical Pathology, Ahmadu Bello University Teaching Hospital, Zaria
Summary
Serum glycated protein
concentrations as fructosamine were estimated in 30 non- diabetic patients with
hyperbilirubinaemia and 20 controls using the colorimetric nitroblue
tetrazolium reduction technique. This was aimed at assessing the effect of
hyperbilirubinaemia on serum total glycated protein concentrations
(fructosamine levels) in Nigerians. The mean serum fructosamine concentration
was significantly higher (p<0.05) in the hyperbilirubinaemic patients than
in the control subjects. Mean glucose and albumin concentrations in the
controls were similar to those of the hyperbilirubinaemic patients (p>0.05).
Conjugated bilirubin correlated significantly with serum fructosamine levels (r
= 0.37; p<0.05) in the hyperbilirubinaemic patients. There was no
significant correlation between fructosamine and total bilirubin or
unconjugated bilirubin (p>0.05).
These observations show
that hyperbilirubinaemia, especially conjugated bilirubin fraction positively
affects the concentrations of fructosamine at level probably greater than 100
umol/L. A correction factor is thus suggested.
(Key words: Fructosamine, hyperbilirubinaemia,
glycated protein).
CASE REPORT
Histoplasmosis of Paranasal
Sinuses and Orbit: A Case Report.
*KR Iseh, FWACS.
Department
of Otorhinolaryngology, Usmanu Danfodiyo University Teaching Hospital, Sokoto,
Nigeria
Summary
Fungal
sinusitis is a known cause of persistent or chronic sinusitis. Various authors
have reported various fungal organisms such as aspergillus species, candida
species and phycomycetes but not histoplasma duboisii as the cause of fungal
sinusitis. A rare case of facial deformity secondary to invasive fungal
infection by histoplasma duboisii of the left paranasal sinuses and left orbit
associated with proptosis and loss of vision is presented in a 44 year old
female trader from Usmanu Danfodiyo University Teaching Hospital (UDUTH)
Sokoto. This had defied all antifungal agents. Following computerized
tomographic (CT) scan of the brain and paranasal sinuses to ascertain the
extent of invasion, radical surgical clearance, through anterior craniofacial
resection with removal of all orbital contents except the eyelid and optic
nerve stump was carried out with no recurrence 11/2 years after
surgery. There is no place for conservative medical or surgical treatment in
invasive sinus mycosis of the paranasal sinuses and orbit.
(Key
words: Fungal sinusitis, Histoplasma duboisii, Radical surgery).
Widerspread Hypopigmentation
Secondary to the Prolonged use of Highly Potent Steroidal Cream in Lichen
Planus.
*O Onayemi, MD., MZ Hossaini, MD. and F Soyinka, MD.
Department
of Dermatology & Venereology, Faculty of Clinical Sciences, College of
Health
Sciences,
Obafemi Awolowo Univerity, Ile-Ife, Nigeria.
Summary
A
24-year old Nigerian woman presented at our clinic with extensive
hypopigmentation following the use of very potent steroidal cream in
widerspread lichen planus. She was treated with intramuscular injection of
triamcinolone acetonide and the associated secondary bacterial infection was
treated with an antibiotic. The cosmetic result at 18 months follow-up was
impressive.
(Key
words: Lichen planus, triamcinolone acetonide, hypopigmentation).
A REPEAT PUBLICATION -
ORIGINAL ARTICLE
Aspiration Pneumonia in Acute Stroke
*AK Salami and PO Oluboyo
Department
of Medicine, University of Ilorin Teaching Hospital, PMB 1459, Ilorin, Kwara
State Nigeria.
Summary
This
was a prospective study that was conducted between July 2000 and September
2001. It was designed to determine the incidence and the risk factor(s) of
aspiration pneumonia in patients with acute cerebrovascular accident.
Aspiration pneumonia was recorded
in 23.5% of the 68 patients that were recruited. The major predisposing factors
identified were disorder of swallowing which increased the risk of aspiration
pneumonia by more than 4 times. The relative risk (RR) was 4.5 and the 95%
confidence interval (95%Cl) was 1.25-16.25. Abnormal voluntary cough increased
the risk by 3 folds. RR was 3 and (95%Cl) was 0.85-10.63. And depressed level
of consciousness had 2.3 times risk with RR of 2.33 and (95%Cl) of 0.83-6.54.
Combination of abnormal gag reflex and facial palsy was another significant
risk factor; the RR was 2 and (95%Cl) was 0.71 – 5.62.
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