Showing papers in "Tropical Doctor in 2005"
TL;DR: This study attempts to determine the anaesthetic death rate, the causes of deaths and the avoidable mortality rate (AMR) in consecutive cases.
Abstract: This study attempts to determine the anaesthetic death rate, the causes of deaths and the avoidable mortality rate (AMR) in consecutive cases. The number of anaesthetics given was 1464: 30 cases died within 24 h. The incidence of 24-h perioperative deaths per 100 anaesthetics was 2.57. In all, 50% of deaths were observed in obstetric surgery; 47% of deaths were associated with cardiovascular management, 30% with respiratory management; 93% of deaths were identified as avoidable. The AMR was 1.5% (anaesthetic AMR: 0.75%, administrative AMR: 0.68%, surgical AMR: 0.07%). Insufficient or no blood available is the only factor for administrative AMR.
163 citations
TL;DR: Women of childbearing age in a rural community in Kano state were interviewed to ascertain the determinants of utilization of antenatal care services in the village, and a majority (86%) of those who attained secondary school education, all of those with post-secondary education and 83% of those whose husbands had post- secondary education utilized antenatal Care services.
Abstract: Women of childbearing age in a rural community in Kano state were interviewed to ascertain the determinants of utilization of antenatal care services in the village. Of the 200 women studied, 118 (59%) utilized antenatal care services during pregnancy. A majority (86%) of those who attained secondary school education, all of those with post-secondary education and 83% of those whose husbands had post-secondary education utilized antenatal care services.
73 citations
TL;DR: Teachers in Nigeria need to have health education courses on common disease conditions such as epilepsy that are prevalent in school age to reduce prejudice and increase the acceptance of epileptic individuals into the classroom.
Abstract: Compared with the disability associated with repeated seizures or side-effects of antiepileptic medications, the social stigma associated with epilepsy is often a major handicap to people living wi...
66 citations
TL;DR: A community-based study was done on 5923 rural Bangladeshi children aged 5-15 years to determine the prevalence of rheumatic fever (RF) and rhematic heart disease (RHD).
Abstract: A community-based study was done on 5923 rural Bangladeshi children aged 5-15 years to determine the prevalence of rheumatic fever (RF) and rheumatic heart disease (RHD). The prevalence was found to be 1.2 (95% confidence interval 0.3-2.1) per 1000 for RF defined by revised Jones criteria and 1.3 (0.4-2.2) per 1000 for Doppler echocardiography-confirmed RHD.
49 citations
TL;DR: The improvement in locoregional control of head and neck cancers over the last decades does not appear to modify the final survival of patients, and it is crucial to understand as accurately as possible the risk factors for these malignancies in order to improve primary prevention.
Abstract: Eighty-nine cases of head and neck cancers were studied over a 5-year period (1997--2001) at the University of Ilorin Teaching Hospital, Nigeria. The most common cancer affecting the head and neck region was carcinoma which constituted 70.8% of all the cases studied. It was followed by the lymphomas and blastomas which accounted for 20.2% and 9%, respectively. The nose/paranasal sinuses were the most common site of primary cancer (18%) followed by thyroid (12.4%), nasopharynx (11.3%) and larynx (4.5%). Other sites include a hypopharynx (3.4%), eye (2.2%), palate (2.2%), tongue (2.2%), skin (1.1%), lip (1.1%), salivary gland (1.1%), oropharynx (1.1%). Cervical lymph node metastasis with unknown primary lesion was seen in 10.1%. The peak age incidence was in the fifth decade of life. The improvement in locoregional control of head and neck cancers over the last decades does not appear to modify the final survival of these patients. It is crucial to understand as accurately as possible the risk factors for these malignancies in order to improve primary prevention.
45 citations
TL;DR: This is a study of 295 patients (23.1% of 1278 patients with long bone fractures) who had visited the traditional bonesetter (TBS) and the initial idea of visiting TBS was mooted by an external person in 75% of cases.
Abstract: This is a study of 295 patients (23.1% of 1278 patients with long bone fractures) who had visited the traditional bonesetter (TBS). The initial idea of visiting TBS was mooted by an external person in 75% of cases, whereas to discharge from TBS was usually the patient's idea. The reasons for a patient to opt for aTBS are explored.
44 citations
TL;DR: The use of combination therapy of ofloxacin plus rifampicin for 6 weeks was found to be as effective as DR and DS, and the side-effects of therapy in OR and DS groups was less severe than in the DR group.
Abstract: The efficacy and tolerability of three different combination treatment regimens in human brucellosis were compared in 118 uncomplicated patients enrolled in a prospective study between May 1997 and December 2002. Brucellosis was diagnosed using standard clinical and microbiological findings. Patients with central nervous system involvement, spondylitis, endocarditis or children under 16 years of age were excluded from the study. Patients were randomly assigned to receive 400 mg of ofloxacin plus 600 mg of rifampicin (OR, n = 41), 200 mg of doxycycline plus 600 mg of rifampicin (DR, n = 45) or 1g intramuscularly streptomycin (administered for three weeks) plus 200 mg doxycycline (DS, n = 32) daily for 6 weeks. All patients were followed up at least 6 months after cessation of therapy. There was no statistical difference between the groups on relapse rates and clinical response to the treatment (P>0.05). Five patients in OR (12.8%), six patients in DR (14.3%) and three patients in DS groups (9.7%) suffered relapse. The side-effects were seen in eight (19.5%), 21 (46.7%) and eight (25.0%) patients of OR, DR and DS groups, respectively. The use of combination therapy of ofloxacin plus rifampicin for 6 weeks was found to be as effective as DR and DS. The side-effects of therapy in OR and DS groups was less severe than in the DR group.
42 citations
TL;DR: Ectopic pregnancy still remains a leading cause of maternal mortality and morbidity in the first trimester of pregnancy and also a significant cause of reproductive failure in Nigeria, a descriptive review of 211 consecutive cases of ectopic gestation over an 11-year period found.
Abstract: Ectopic pregnancy still remains a leading cause of maternal mortality and morbidity in the first trimester of pregnancy and also a significant cause of reproductive failure in Nigeria. A descriptive review of 211 consecutive cases of ectopic gestation over an 11-year period was undertaken. Ectopic pregnancy constituted 9.5% of gynaecological admissions. In all, 86% were nulliparous and 62.6% were married. Abdominal pain and tenderness were the most consistent modes of presentation. Also, 95.3% presented as ruptured ectopic pregnancy. Induced abortion (72%) was the most common factor associated with ectopic pregnancy. Anaemia was the most common post-operative complication. In all, 21% had prior dilatation and curettage as a result of misdiagnoses. The case fatality rate was 2.5%.Ectopic pregnancy presents a major public health challenge among women of reproductive age in this region. Community-based comprehensive health education programme focusing on contraception, sex education, prevention and treatment...
40 citations
TL;DR: It is concluded that measures to prevent induced abortions and their subsequent problems will yield major results if directed at women in their early 20s with at least primary education, no children, low economic potential, not in a stable relationship and who have had a previous induced abortion.
Abstract: A cross-sectional study of 150 women was performed at the gynaecology department of the Korle-BuTeaching Hospital to describe the characteristics of patients with complications of induced or spontaneous abortions, and to find out the reasons behind induced abortions. In all, 31% of the study sample presented with complications of induced abortions. This group was younger, of lower parity, more educated, with lower economic potential, in less stable relationships and with a higher knowledge of modern contraceptive methods than the group with spontaneous abortions. The chief reason for procuring an induced abortion was the presence of relationship problems with the subject's partner. We conclude that measures to prevent induced abortions and their subsequent problems will yield major results if directed at women in their early 20s with at least primary education, no children, low economic potential, not in a stable relationship and who have had a previous induced abortion.
39 citations
TL;DR: It is concluded that the use of the licit and 'socially' acceptable drugs may pave the way for the abuse of illicit ones.
Abstract: The types and frequency of drug use among 1200 students aged 10-19 years was investigated and a prevalence rate of 40.1% found; currently used drugs included mild stimulants such as kolanut and coffee 294 (26.2%), alcohol 164 (14.5%), sniffing agents 80 (7.2%), amphetamine and ephedrine 66 (6.7%), cigarette 54 (4.8%), heroin 45 (4%) cocaine 40 (3.6%) and cannabis 38 (3.4%). Multiple drug use was found among the students, with the abuse of cannabis, cocaine and heroin being significant among those who smoked cigarette (P<0.001). The relative risk (RR) for cannabis use when cigarette was smoked was 37.4 (24.1-57.8); RR for cigarette smoking when alcohol was used, 6.8, while RR for cocaine abuse when cigarette was used, 21.8 (13.9-34.5) and 52.8 (29.2-95.5) when cannabis was used. It is therefore concluded that the use of the licit and "socially" acceptable drugs may pave the way for the abuse of illicit ones.
35 citations
TL;DR: There is preference of dry sex in Malawi and a much-lubricated condom is likely to be unacceptable to those preferring drier sex and a significant number of people who would have used them may be prevented for using the condoms.
Abstract: protected ‘as clients often try to remove or even tear male condoms during sex.’ I believe this practice of removing or tearing the condom stems from the fact that some Malawian men (and women perhaps) believe that for sexual intercourse to be meaningful (an intimate social experience), there must be sharing of body fluids. Contact between mucosa to mucosa (nyama kwa nyama) is preferred and considered superior sex. Anything less than that is counterfeit. The female condom, despite being used in pilot studies and registering high acceptability rates, has not been widely accessible to the majority of the population as compared to the male condom. There were reports, as early as 1997, that UNAIDS wanted to improve the availability of the female condom in developing countries and now, almost a decade later, there seems not much progress has been made. Among the many reasons as to why the female condoms have not been readily available is the financial cost, as the female condom may cost up to 10 times as much as the male condom. The male condom continues to be sold at subsidized costs through social marketing efforts and is distributed for free to sexually transmitted infection (STI) and family planning clients in Malawi. The female condom on the other hand does not get that much attention. One of the reasons given for the lackluster promotion by social marketing organizations is that considering the gender power imbalances between men and women, it is the man who most often decides when and whether sexual intercourse is going to occur and whether a condom is going to be used or not. Promoting the male condom therefore makes much more sense than promoting the female condom, as it is deemed that the male condom target is the decisionmaker (man). Although the proportion of CSWs who perceived the female condom as unacceptable was rather small (2%), it is important that impaired sensation was mentioned as reason for unacceptability. Perception of diminished pleasure has also been mentioned as reasons for not using condoms in Indonesia. There are at least two points that can be said about this. There is some line of thought that CSWs do not mind whether sex is pleasurable or not. This thinking may not be always correct. The second idea is that if condoms (be they male or female) reduce sensation, it is possible that a significant number of people who would have used them may be prevented for using the condoms. As for CSWs, they risk losing clients and they are unlikely to accept such costs. While the perceived impairment of sensation by condoms has been mentioned in many studies, it seems there has not been a concerted effort to address this problem. For instance, while most of the condoms being promoted by social marketing organizations are the cheap ones (and although efficacious in preventing STIs), they may not be the most sexually sensitive ones. On the commercial market, there are condoms with a different thickness of latex, with ribs, with studs and other properties that could be made available widely also in order to deal with this problem of reduced ‘sweetness’ of the ‘conventional’ low-cost condoms. Yes, we may need to spend more. But we are becoming more ready to spend or ask for funding on antiretrovirals. I agree with the authors that there is preference of dry sex (as usual, for some) in Malawi and a much-lubricated condom is likely to be unacceptable to those preferring drier sex. Studies in Zimbabwe have also documented this preference for dry sex. That some of the CSWs in the study re-used the same female condom on consecutive clients would not have worried me much, had the male clients used male condoms also. It is possible these males did not use (male) condoms and that is worrying and a minus for the female condom. While I have no data to substantiate my claim, the likelihood of re-using the male condom on consecutive clients is smaller, I think. Adamson SMuula MBBSMPH
TL;DR: Assessment of the five years' incidence and pattern of cardiovascular disease in a NigerianTeaching Hospital found heart failure followed by hypertension was found to be the most prevalent.
Abstract: Epidemiological data on cardiovascular disorders are generally lacking in the developing nations. The aim of this study was to assess the five years' incidence and pattern of cardiovascular disease in a Nigerian Teaching Hospital. The records of patients diagnosed as having various cardiovascular disorders between 1997 and 2001 were scrutinized. Data such as age, sex, diagnosis, length of hospitalization and status at discharge (dead or alive) were obtained. A total number of 1104 patients were recorded. Heart failure (35%) followed by hypertension (32%) was found to be the most prevalent.
TL;DR: Tuberculosis isolated to the spleen is a rare clinical entity particularly in the non-HIV-positive patient population, and in four patients described, two presented with thrombocytopenia; in two patients the condition was diagnosed serendipitously at laparotomy undertaken for abdominal trauma.
Abstract: Tuberculosis isolated to the spleen is a rare clinical entity particularly in the non-HIV-positive patient population. In the four patients described, two presented with thrombocytopenia; in two patients the condition was diagnosed serendipitously at laparotomy undertaken for abdominal trauma.
TL;DR: This prospective study was conducted on 111 children with brucellosis, who attended the Department of Infectious Diseases, Babol, Iran, from September 1999 to March 2003, and found Fever, sweating, artheralgia, and splenomegaly were common findings.
Abstract: This prospective study was conducted on 111 children with brucellosis, who attended the Department of Infectious Diseases, Babol, Iran, from September 1999 to March 2003. Fever (73.9%), sweating (67.6%), artheralgia (49.5%) and splenomegaly (18%) were common findings. The disease was acute and sub-acute in 97.3% and chronic in 2.7% of cases. Peripheral arthritis was seen in 35 (31.5%) of cases, which was monoarticular in 29 patients, most involving the knees and hips. Sacroilitis was seen in six (5.4%) cases.
TL;DR: The CFR of tetanus at the Lagos University Teaching Hospital has not significantly reduced over the years, and patients in the intensive care unit (ICU) had a significantly higher CFR than those in the medical wards.
Abstract: Records of 349 tetanus patients, aged 10 years and above, admitted to the Lagos University Teaching Hospital, Nigeria, between 1990 and 1999 were reviewed. The male:female ratio was 1.98:1, and the ages were between 10 and 88 years, with a mean age of 29.8 years. The overall case fatality rate (CFR) of tetanus was 36.96% (33.19% for men and 44.44% for women). The CFR is similar to that previously reported in the hospital, but higher than that reported from Europe and North America. The lowest CFR was in the 10-19-year age group, and there was a trend towards increasing CFR with increasing age. Tetanus patients in the intensive care unit (ICU) had a significantly higher CFR than those in the medical wards. Unlike in developed countries, where management of tetanus in ICU has resulted in a decrease in CFR, the CFR of tetanus at the Lagos University Teaching Hospital has not significantly reduced over the years.
TL;DR: Strategies for prevention of osteomalacia should be focused on the men to encourage them to help improve the diet and lifestyle of their womenfolk, and supplementation of the diet is essential in such communities it will be difficult to initiate and maintain.
Abstract: Osteomalacia is most commonly seen in the remoter northern regions (Kohistan District) of Hazara District, Pakistan. Low serum calcium is common, as is tetany, but not universal. A 2% prevalence was found retrospectively in all obstetric patients from 1978--1985. Overall, there was a 12% caesarean section rate (61/annum), of which 37% (22) exhibited cranio-pelvic disproportion, nearly half of which (n=83, 46%) were thought clinically to be due to osteomalacia. Osteomalacia was found prospectively in 3.6% of all female outpatients (3600/100,000). Purdah did not appear to influence the incidence of osteomalacia, although sunlight exposure varied significantly due to place of abode (0.05 > P> 0.025); those living in the deeper, darker valleys suffered more from osteomalacia and its side effects, such as cranio-pelvic disproportion and the resulting need for caesarean sections. Diet is an important factor, showing little variety in the affected region; it lacks animal protein and is low in calories.The estimated intake of vitamin D is approximately 1 microg per day, seriously short of the daily requirement of 2.5 microg. The other main factor is higher parity in the women with osteomalacia (15/18 affected women had more than three pregnancies compared with 9/18 controls; odds ratio 13, 0.05 > P> 0.025). These all indicate that in a marginal situation added metabolic stress can precipitate the condition. While supplementation of the diet is essential in such communities it will be difficult to initiate and maintain. We therefore also recommend that strategies for prevention be focused on the men to encourage them to help improve the diet and lifestyle of their womenfolk.
TL;DR: All adolescents and adults, irrespective of age or sex, should be the target groups for community education and intervention programmes for prevention of spinal injury.
Abstract: This is a retrospective case series of 233 spinal injury patients admitted to the orthopaedic ward of BPKIHS from May 1997 to April 2001. The inpatient records were analysed. In all, 40.3% of spinal injuries resulted from falls from trees while cutting leaves for fodder, and 27.9% resulted from falls from first/second floors. More than 75% of total spinal injuries are largely preventable. Overall, 46.8% of our spinal injury patients had complete cord transection at the level of injury. All adolescents and adults, irrespective of age or sex, should be the target groups for community education and intervention programmes for prevention of spinal injury.
TL;DR: Of 460 interns from five Pakistani teaching hospitals surveyed, only 22% correctly identified the estimated number of new TB cases in Pakistan and most interns were unable to identify a single component of directly observed treatment short course (DOTS) strategy.
Abstract: Of 460 interns from five Pakistani teaching hospitals surveyed, only 22% correctly identified the estimated number of new TB cases in Pakistan. The majority (96%) knew that droplet infection was the usual mode of transmission. Only 38% considered sputum smears for acid-fast bacilli as the best test for diagnosis of pulmonary TB and 43.5% for follow-up during TB treatment. The recommended four-drug anti-TB regimen was prescribed by 56.5% in the initiation phase and the recommended two-drug combination in the continuation phase by 52%. Most interns (82%) were unable to identify a single component of directly observed treatment short course (DOTS) strategy. Our study reflects poor awareness of and low compliance to the World Health Organization/National Tuberculosis Programme guidelines among interns. For effective control of TB, immediate action to improve undergraduate and continuing medical education is essential, with special emphasis on national guidelines.
TL;DR: The inability to consider HIV in the differential diagnosis of the conditions listed above could lead to an underdiagnosis of HIV/AIDS.
Abstract: A higher prevalence of malaria has been documented among HIV-seropositive individuals and the rates increase with deteriorating immune status. Similarly, a higher incidence of anaemia is noted in patients with HIV seropositivity and the risk increases in patients with co-infection of HIV and malaria. Anaemia was the fifth leading diagnosis in our study. It is likely that some patients with malaria and anaemia had HIV infection. Finally, gastroenteritis occurs commonly in HIV-seropositive patients. It could be related to infections or malabsorption. In our study, gastro-enteritis was among the top 10 diagnoses. In conclusion, I would like to stress the fact that HIV infection and AIDS can have varied manifestations affecting different body systems. The inability to consider HIV in the differential diagnosis of the conditions listed above could lead to an underdiagnosis of HIV/AIDS. S Kumar MDDM
TL;DR: Febrile children should be investigated for the presence of bacterial infection even if the blood film for malaria parasites is positive, and consideration should be given to the use of both anti-malarial therapy and empiric antibiotic therapy in the management of febrile infants.
Abstract: In the tropics, febrile illnesses are often presumed to be due to malaria, because of its endemicity, and treatment can lead to delay in diagnosis or failure to detect severe infections such as bacteraemia.This study sought to determine the prevalence of bacteraemia and malaria parasitaemia in febrile post-neonatal infants (age 1-12 months) at the University College Hospital, Ibadan, Nigeria, and the bacterial aetiological agents of bacteraemia in the infants. Therefore, 102 infants aged 1-12 months who presented with fever with a negative history of antimicrobial use in the week prior to presentation were evaluated and had blood cultures done for the detection of aerobic organisms by standard methods and blood films for malaria parasites. Bacteraemia was found in 38.2% of the infants, malaria parasitaemia was found in 46.1%.The most common organisms isolated were Escherichia coli (35.9%), Staphylococcus aureus (33.3%) and Klebsiella spp. (10.3%). Febrile children should be investigated for the presence of bacterial infection even if the blood film for malaria parasites is positive. Where laboratory facilities are not available, consideration should be given to the use of both anti-malarial therapy and empiric antibiotic therapy in the management of febrile infants, depending on the clinician's judgement.
TL;DR: The attitudes, needs and priorities of adolescents in family planning, as articulated by them during focus group discussions, are presented and suggestions are provided on how community-based distributors could improve their outreach to adolescents and provide youth-friendly family planning services.
Abstract: In this article, the attitudes, needs and priorities of adolescents in family planning, as articulated by them during focus group discussions, are presented Findings indicate that: (a) Ugandan adolescents face numerous barriers to accessing family planning information and services; (b) they hold an alarming number of misconceptions about modern contraceptives; (c) they lack reliable, trusted and non-judgemental sources of information, privacy and confidentiality during family planning counselling, and (d) they don't know about contraceptive services available from the community-based distributors Suggestions are provided on how community-based distributors could improve their outreach to adolescents and provide youth-friendly family planning services
TL;DR: The object of the model is to predict the likelyhood of a pregnant woman receiving the recommended two doses of TT vaccine subject to other factors such as birth order, maternal education, prenatal care provider, household standard of living, health-care-seeking decision-maker and service availability.
Abstract: In order to increase the uptake of tetanus toxoid (TT) vaccination, we need to understand the factors that underlie the decision of the pregnant woman to undergo vaccination, especially in rural areas, where 75% of India's population resides. This paper constructs a model from a data-set of 2398 women in order to understand the determinants of TT vaccine immunization by women during their most recent pregnancy and applies it to the National Family Health Survey-2 data. The object of the model is to predict the likelyhood of a pregnant woman receiving the recommended two doses of TT vaccine subject to other factors such as birth order, maternal education, prenatal care provider, household standard of living, health-care-seeking decision-maker and service availability. Policy implications of these findings are discussed.
TL;DR: A five-year retrospective study of 32 histologically diagnosed cases of Kaposi's sarcoma in Nigerian patients who had undergone HIV antibody testing at the Jos University Teaching Hospital shows similarities with other African countries which have been affected by the HIV epidemic.
Abstract: This is a five-year retrospective study of 32 histologically diagnosed cases of Kaposi's sarcoma (KS) who had undergone HIV antibody testing at the Jos University Teaching Hospital: 13 cases (40%) were HIV-negative. Multiple lesions were more common in HIV-positive cases and affected unusual sites such as the face, oropharynx, conjuctiva, vulva and rectum in addition to the limbs and trunk, which were more frequently involved in HIV-negative cases. This pattern of KS seen in Nigerian patients shows similarities with other African countries which have been affected by the HIV epidemic.
TL;DR: It is believed that the figure reported here represents an underestimate of the frequency of malignant tumours seen in the hospital and recommend the establishment of hospital - and population-based cancer registries to ensure proper documentation ofmalignant diseases within the region.
Abstract: This study was designed to evaluate the pattern of malignant diseases seen at the University of Benin Teaching Hospital over a 20-year period (January 1980-December 1999). A total of 2258 histologically confirmed malignant diseases were seen with the predominant tumours comprising carcinoma of the cervix (20.59%), breast (18.25%), prostate (7.13%), endometrium (6.47%) and colon and rectum (5.71%). We believe that the figure reported here represents an underestimate of the frequency of malignant tumours seen in the hospital and recommend the establishment of hospital- and population-based cancer registries to ensure proper documentation of malignant diseases within the region.
TL;DR: A retrospective case review was made on 23 patients diagnosed as HIV seropositive with liver abscess in Bangkok, Thailand, where Gram-negative aerobes were the major abscess pathogens and Klebsiella was the most significant microorganism.
Abstract: Liver abscess is an important tropical gastrointestinal disorder. HIV seropositive patients show relative immunosuppression and are more susceptible to infection, including liver abscess. This retrospective case review was made on 23 patients who were diagnosed as HIV seropositive with liver abscess in Bangkok, Thailand. We demonstrated the high rate of amoebic liver abscess in our series (17.4%) from fresh smear with five cases of tuberculosis and one case of Nocardosis. The rates of positive bacterial culture were 17.4% from blood and 47.8% from pus. Gram-negative aerobes were the major abscess pathogens in our series. Among Gram-negative aerobes, Klebsiella was the most significant microorganism, followed by Escherichia coli and Pseudomonas aeruginosa.
TL;DR: It is important to note that ‘unsafe’ is not a synonym for ‘illegal or ‘clandestine’, for example, legal abortions may be unsafe because of poorly trained clinicians, inadequate facilities, or both.
Abstract: Unsafe abortion is defined by the World Health Organization (WHO) as a procedure to terminate an unwanted pregnancy either by persons lacking the necessary skills, or, in an environment lacking the minimum medical standards, or both. It is important to note that ‘unsafe’ is not a synonym for ‘illegal or ‘clandestine’. For example, legal abortions may be unsafe because of poorly trained clinicians, inadequate facilities, or both.
TL;DR: Of the 876 rodents caught in different parts of Ekpoma, Nigeria, and environs, 218 were Mastomys natalensis, while 658 were other rodents, 102 (46.79%) were positive for complement fixing antibody to Lassa virus.
Abstract: Of the 876 rodents caught in different parts of Ekpoma, Nigeria, and environs, 218 were Mastomys natalensis, while 658 were other rodents. Of the 218 M. natalensis caught, 102 (46.79%) were positive for complement fixing antibody to Lassa virus.
TL;DR: The guideline for active and passive immunization below is suggested in view of poor vaccination history in many cases and some portals of entry such as from snake bites among farmers and from dermatoses/erosive skin diseases.
Abstract: the three decades is the establishment of an ICU in UCH, Ibadan. Treatment of severe tetanus has been found to be improved by ICU care in the developing countries 14% was recorded from Leeds in Britain compared with a mortality for tetanus of 45 % in Nigeria about the same time, i.e. three decades ago. Clinicians sometimes overlook some portals of entry such as from snake bites among farmers and from dermatoses/erosive skin diseases. The guideline for active and passive immunization below is suggested in view of poor vaccination history in many cases:
TL;DR: The absolute numbers of skeletal TB have remained relatively constant, fluctuating between 14 and 58 per year, while the total number of cases has progressively increased from 657 in 1986 to 3469 in 2002.
Abstract: A retrospective audit of all cases of bone and joint TB registered in theTB office at Queen Elizabeth Central Hospital (QECH) from 1986 to 2002 was conducted with the aim of quantifying the proportion of bone and joint TB. The study period coincides with that of the HIV pandemic. A total of 37,075 cases were recorded with 599 (1.6%) involving the skeletal system; of the skeletal TB, 90% involved the spine. The absolute numbers of skeletal TB have remained relatively constant, fluctuating between 14 and 58 per year, while the total number of cases has progressively increased from 657 in 1986 to 3469 in 2002.
TL;DR: The spleen was the most common organ in patients with hydatid cyst over 21 years in the general surgical unit, followed by skin and soft tissues.
Abstract: Hydatid disease usually affects liver and lungs, but may affect any organ, posing a diagnostic and therapeutic dilemma. We analysed 110 patients with hydatid cyst over 21 years in our general surgical unit, which included 24 cases in unusual sites. The spleen was the most common, followed by skin and soft tissues.