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   2001| April-June  | Volume 8 | Issue 2  
    Online since November 30, 2015

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Gastric acid secretion in Helicobacter pylori positive and negative dyspeptic Nigerians.
AA Adesanya, JT daRocha-Afodu, SO Elesha, OO Oluwatowoju, KS Oyedeji, MO Kehinde, OA Afonja, AO Coker
April-June 2001, 8(2):61-68
The pathological role of Helicobacter pylori is largely unproven in our region of high incidence of infection but very low incidence of serious gastroduodenal lesions. The aim of this study was to investigate the effect of H. pylori infection on gastric acid secretion. One week after gastroduodenoscopy, basal and pentagastrin (8 micrograms/kg) stimulated gastric acid secretion were measured in 39 dyspeptic Nigerians. H. pylori status was determined using urease test, culture, histology and serology, while gastritis was assessed using the Sydney system criteria. The median maximal acid output (MAO) and peak acid output (PAO) in mmol/h were significantly higher in H. pylori positive (29.3, range 7.4-81.6 and 34.4, range 7.6-144.0) than in H. pylori negative (16.6, range 4.2-44.1 and 22.4, range 5.6-48.6) patients, p = 0.019 and p = 0.029, respectively. Stimulated gastric acid secretion was significantly higher in patients with duodenal ulcer (n = 8) than in H. pylori negative (n = 11) patients, but was similar in non-ulcer dyspeptics (n = 20) and H. pylori negative patients. The median basal acid output was not significantly different between the groups of patients. Our patients (median age 32 years) had normal mucosa (12.1%), pangastritis with corpus predominance (12.1%), antrum-only gastritis (24.3%) and pangastritis with antral predominance (51.5%). In the subset of H. pylori positive patients (n = 28, 71.8%), there were no significant correlations between grade of antral chronic inflammation, gastritis index score, anti-H. pylori IgG titre and gastric acid secretion, p > 0.05. H. pylori infection increases MAO and PAO in our relatively young patients with antral predominant chronic gastritis.
[ABSTRACT]   Full text not available   
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HIV infection: Risk of occupational exposure in a chemical pathology laboratory in Nigeria
AC Ojule, OA Ejele, HC Opurum
April-June 2001, 8(2):78-80
The prevalence of HIV/AIDS is rising globally, the worst affected area being Sub-Saharan African. In order to assess the risk of occupational exposure to HIV/AIDS in laboratory workers in Nigeria, we screened 210 consecutive serum sample sent to the Chemical Pathology Laboratory of the University of Port Harcourt Teaching Hospital, Port Harcourt, over a two-week period. 17 (8.1%) of all the sample screened tested positive. The Sero-positivity rate was 11.3% for adults and 2.6% for children. The implications of these findings with regards to the risk of occupational exposure of laboratory and health worker is discussed. The need for more attention to be paid to laboratory safety regulation in sub-saharan Africa in highlighted.
[ABSTRACT]   Full text not available   
  660 0 -
Aspirin-induced duodenal perforation in a Nigerian with sickle cell disease: A case report
L Salawu, OO Olaomi, B Paul-Odo, OS Olayinka, MA Durosinmi
April-June 2001, 8(2):90-92
A case of duodenal perforation associated with aspirin ingestion in a 21-year old male Nigerian with sickle cell anaemia is reported. He presented with a sudden onset of epigastric pain which later spread to involve other parts of the abdomen. He had previously used aspirin at a dose of 1800 mg daily for two weeks to treat bone pain. Abdominal ultrasonography and X-ray showed fluid collection in the pelvis and elevation of the diaphragm. At exploratory laparotomy, the perforation found in the first part of the duodenum anteriorly was repaired. He was discharged 11 days post-surgery. In view of the frequent usage of salicylates and non-steroidal anti-inflammatory drugs to treat painful crises in sickle cell disease, we suggest careful monitoring of patients on such drugs and those with dyspeptic symptoms must be fully investigated including the use of endoscopy, to prevent fatal outcome.
[ABSTRACT]   Full text not available   
  651 0 -
Effect of HIV infection on the clinical spectrum of leprosy in Maiduguri
AE Moses, KA Adelowo, EA Nwankwo
April-June 2001, 8(2):74-77
The clinical features associated with different classes of leprosy patients co-infected with HIV in Maiduguri was studied and the classification of leprosy was done clinically and bacteriologically using Ridley-Jopling classification and bacteriological index respectively. The cases were classified as paucibacillary (Tuberculoid--TT and Borderline Tuberculoid--BTT) and multibacillary (Borderline Borderline--BB, Borderline Lepromatous BL and Lepromatous Leprosy--LL) leprosy. Eleven (10.5%) of 105 leprosy cases were HIV-seropositive comprising of 7 males and 4 females. Age range was 15 and 62 years. Among the HIV seropositive patients, those with paucibacillary (PB) leprosy were 6 (TT-1, BT-5) while multibacillary (MB) leprosy 5 (BB-1, BL-2, LL-2). The predominant clinical features were clawing of fingers (64%), ulcerations (64%), hand muscle atrophy (55%) and clawing of toes (45%). Some clinical features of paucibacillary leprosy such as sensory and hair losses (as is also seen in HIV negative patients) occurred in increased frequency in HIV positive patients belonging to the multibacillary class. The HIV infected leprosy patients are more likely to manifest advanced stages of the disease than the HIV seronegative patients.
[ABSTRACT]   Full text not available   
  638 0 -
Features of childhood hepatic failure in Calabar, Nigeria
EE Ekanem, IS Etuk, AJ Uniga
April-June 2001, 8(2):86-89
The features in 21 patients with childhood hepatic failure studies retrospectively over a seven year period at the University of Calabar Teaching Hospital, Calabar, Nigeria are presented. Of the 21 patients, 71.4 per cent were aged three years nd below. Fulminant hepatic failure occurred in 81.0 per cent of the patients while in 19.0 per cent, the failure resulted from chronic liver disease. Hepatitis B infection alone or in association with other factors was the major cause of the condition, occurring in 76.2 per cent of the cases. The main complications were severe anaemia (23.8%), septicaemia (23.8%) and pneumonia (19.0%), renal failure (9.5%). With only one survival, the case fatality rate was 95.2 per cent. For prevention of the condition in Nigeria, universal mandatory screening of blood and blood products for hepatitis B markers before transfusion and the integration of hepatitis B vaccination into the National Expanded Programme on Immunization are strongly recommended.
[ABSTRACT]   Full text not available   
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A comparative study of induction and recovery characteristics of propofol and midazolam
NP Edomwonyi, BA Okonofua, AS Weerasinghe, F Dangnan
April-June 2001, 8(2):81-85
Propofol and midazolam were compared in 40 adult patients in A.S.A. 1 or 2 presenting for short surgical procedures (< 70 minutes) with respect to induction time, pain on injection, apnoea, heart rates, blood pressure, oxygen saturation, time to eye opening on command. The first group was induced with midazolam (0.15-0.20 mg/kg) while the second was induced with propofol (2-2.5 mg/kg) intravenously. In all other respects except for the surgery that patients had the same treatment. The mean induction time was 55.25 + 26.66 and 69.75 + 24.72 for propofol and midazolam groups respectively. In the midazolam group apnoea occurred in 10% of patients compared to 80% of patients in the propofol group. Local reaction (phlebitis) was absent in the midazolam compared with 20% incident rate observed in the midazolam group. Propofol lowered blood pressure more than midazolam after three minutes of induction at a statistically significant level (P < 0.05). Recovery was significantly more rapid following propofol (P < 0.05).
[ABSTRACT]   Full text not available   
  629 0 -
Arrhythmias: appraisal of symptoms by haemodynamic concepts
MA Araoye, GO Opadijo, AB Omotoso
April-June 2001, 8(2):95-98
Arryhthmias can afflict any heart, even in the absence of disease. Given that Cardiac Output (CO) is a product of heart rate and stroke volume, the end-result of brady- and tachy-arrhythmias is the same: low CO with symptoms of low-output state. In bradyarrhythmias, myocardial inotropy operates maximally but the product of stroke volume and slow heart rate yields a low CO. In tacharryhthmias, myocardial inotropy is redundant because the product of low stroke volume arising from low Diastolic Filling Time (DFT) and heart rate also yields a low CO. The hallmark of extrasystole is the duplex of symptoms: dizziness followed by palpitation.
[ABSTRACT]   Full text not available   
  628 0 -
Right lobar pneumonia complicated by sub-phrenic abscess in a child
EA Ameh, AA Yakubu
April-June 2001, 8(2):93-94
A 14-year old boy presented with chest and abdominal pain and fever for one week. He had been treated with several antibiotics at home and in a peripheral hospital for respiratory infection. Physical examination showed features of right lobar pneumonia and peritonitis. Chest radiograph showed consolidation in the right lower lung field and abdominal ultrasonography showed a subphrenic collection. At exploratory laparotomy, a right subphrenic abscess and general peritonitis without an intra-abdominal focus were found. The abscess was drained and broad-spectrum antibiotics given. Death, however, occurred from overwhelming infection. Subphrenic abscess complicating pneumonia is unusual but can be the cause of poor response to treatment. The diagnosis should be excluded in a child with pneumonia and persisting abdominal symptoms. Prompt treatment is necessary to avoid morbidity and mortality.
[ABSTRACT]   Full text not available   
  625 0 -
A 10-year review of venous thrombo-embolism in surgical patients seen in Jos, Nigeria.
GO Igun
April-June 2001, 8(2):69-73
A retrospective study was carried out on 42 clinically diagnosed cases of venous thrombo-embolism (VTE) seen over a 10 year period. The mean age at presentation was 41 years with a sex ratio M:F of 2.5:1. The three commonest primary surgical conditions in patients with VTE were spinal trauma (16 percent), benign prostatic hypertrophy (12 percent) and head injury (10 percent). Prostatectomy was performed in 18 percent, ventral hernia repair in 12 percent and splenectomy in 9 percent. Sudden severe dyspnoea was the clinical presentation in 60 percent of patients. Central chest pain occurred in 43 percent, loss of consciousness (38 percent), haemoptysis (7 percent), mental confusion (19 percent) and lower limb swelling (14 percent). Fifty-two percent of patients presented within 10-15 days. Oral warfarin and intravenous heparin were employed in management in 45 percent. Hospital mortality from massive pulmonary embolism was 64 percent while post thrombotic syndrome occurred in 5 percent of patients.
[ABSTRACT]   Full text not available   
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Central venous catheters for haemodialysis: A review
JA Akoh
April-June 2001, 8(2):99-103
Indications for using central venous catheters (CVC) for haemodialysis include patients with: exhausted vascular access sites, no suitable vessels, failed peritoneal dialysis or short life expectancy. Catheter design and technology have changed in recent years to address the perennial problems of poor flow and infection. Permanent CVC offer a real alternative to arteriovenous access as 11-22% of long-term haemodialysis patients use CVC as their permanent vascular access. Recent advances in catheter use including measures to avoid insertion complications are highlighted. CVC provide mean flow rates of 274-525 ml/min with a one year cumulative catheter survival of 47-93%. Tunnelled CVC provide a safe and effective long-term access for haemodialysis and are particularly suitable for use in developing countries. They are cheaper to maintain and remove the temptation to re-use disposable dialysis needles.
[ABSTRACT]   Full text not available   
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