Pattern of aganglionic megacolon in Calabar, Nigeria

Birschsprung's disease, a congenital condition resulting in functional intestinal obstruction, was seen in 21  children at the University of Calabar Teaching Hospital (UCTH) between January 1996 and December 1998. Late presentation of patients to hospital was ()bserved and was attributed to ignorance and poverty. Patients   presented only  then repeated herbal enemas no longer of£ered relief. The main complaints were abdominal  distension, constipation, wasting, diarrhoea and  growth retardation. Surgical resection of .the aganglionic segment and anastomosis is the treatment of choice and this procedure decreases mortality and  morbidity. Palliative transverse colostomy was considered essential as it protects the anastomosis. Early diagnosis of this disease in our environment can only be  achieved by means of a public awareness campaign. This will prevent many of the fatal complications associated with this condition

Synthetic beta cells for fusion-mediated dynamic insulin secretion

Generating artificial pancreatic beta cells by using synthetic materials to mimic glucose-responsive insulin secretion in a robust manner holds promise for improving clinical outcomes in people with diabetes. Here, we describe the construction of artificial beta cells (AβCs) with a multicompartmental 'vesicles-in-vesicle' superstructure equipped with a glucose-metabolism system and membrane-fusion machinery. Through a sequential cascade of glucose uptake, enzymatic oxidation and proton efflux, the AβCs can effectively distinguish between high and normal glucose levels. Under hyperglycemic conditions, high glucose uptake and oxidation generate a low pH (<5.6), which then induces steric deshielding of peptides tethered to the insulin-loaded inner small liposomal vesicles. The peptides on the small vesicles then form coiled coils with the complementary peptides anchored on the inner surfaces of large vesicles, thus bringing the membranes of the inner and outer vesicles together and triggering their fusion and insulin 'exocytosis'

Appendicitis in children: The need for careful assessment

No Abstract.Global Journal of Medical Sciences Vol. 6 (2) 2007 pp. 47-5

INJURIES AND DEATHS FROM VEHICULAR ACCIDENTS IN CALABAR

Four thousand five hundred and sixty (4560) accident cases that were reported to the traffic section of the Nigerian Police in Calabar were studied. Of this number, 1051 23%) were fatal and post mortem examinations were carried out at the University of Calabar, Teaching Hospital (UCTH). Six hundred and eighty-Two (682) were males while 369 were female victims. Head injury and ruptured abdominal viscera were the commonest causes of death. Lack of good roads, indiscipline on the part of drivers/motorcycle riders and absence of good law enforcement measures by the relevant ities all combine to render vehicular movements unsafe. It is hoped that the reinvigoration of the Federal Road Safety Commission and the reactivation of the Marine police will help reduce vehicular accident-related deaths. (Global J Med Sci: 2002 1(1): 61-63

Surgical procedure to improve on continence in children

Operational repair of anorectal malformations frequently present with, faecal soilage as the dominant complication. Series of operations have been attempted but none fully satisfies the criteria for continence. A child that present with faecal soilage is a societal problem especially when he is away from the home environment. Several authors have adopted very expensive procedures such as microsurgical interpositioning of skeletal muscle fibres but these are largely beyond the scope of developing countries. Therefore the search for cheaper but equally effective method is imperative. The surgical procedure that narrows the ano-rectal junction which was adopted in this series was able to improve on continence in this group of patients, and is best carried out when the child is 6 years and above. Key Words: Faecal, Incontinence, Anorectal Operation Global Jnl Medical Sciences Vol.2(2) 2003:131-13

Typhoid Enteric Perforation in Children in Calabar, Nigeria

Typhoid enteric perforation, a severely debilitating illness with a high mortality rate in children was studied in Calabar. The aim of the study was to determine the role that ingestion of herbal preparations, laxatives and enemas has on perforation and whether there is a relationship between the observed perforation and its occurrence within the first week of illness. Fifty-two patients with typhoid enteric perforations were selected from a pool of 178 cases of acute abdomen in children. Clinical, laboratory and radiological assessments were used to diagnose the condition and confirmation obtained intra-operatively. Results showed a male: female ratio of 3:1; with delayed presentation after 6 hours being a common feature in all patients with perforations. Sixty-three percent of the patients who were perforated had either consulted a traditional healer or chemist and had ingested a herbal concoction, a laxative or had an enema administered to them. Mortality was also higher within this group. Early resuscitation and surgical intervention within 24 hours of onset of illness led to a significant reduction in mortality. Seasonal variation was noted in the occurrence of typhoid fever. It was rampant during the dry season but rare during the rainy season. Key words: typhoid perforation, traditional healers, late presentation, seasonal variation Journal of Medical Laboratory Sciences Vol.12(1) 2003: 41-4

Traumatic transection of the ileum in a neonate: Case Report (With review of the literature)

Paediatric abdominal injury especially in the neonatal period is rarely seen in paediatric surgical practice. The home environment in a typical African setting is comparatively safe as adult and specially paid individual take care of the young ones. This case of abdominal trauma with transection of the ileum is therefore a rare occurrence. KEYWORDS : Trauma, Ileum, transection. Global Jnl Medical Sciences Vol.2(2) 2003: 187-18

Motorcycle Related Abdominal Trauma in Children in Calabar – Nigeria

Between January 1998 and December 2001, 38 children aged between 1-15 years were admitted to the UCTH with the history of motorcycle related abdominal trauma. A male preponderance was observed and incidence of trauma increases with age. It was lowest at preschool age under five years (16%) but peaked at post elementary school age of 11-14 years (45%). Children were injured as passengers (61%) and as pedestrians (38%). Majority of the children presented with blunt abdominal injury (79%) while 21% sustained penetrating abdominal injury. Laporatomy was carried out in all cases of penetrating injury while increasing abdominal tenderness; haemodynamic instability or a positive abdominal paracentesis was considered in blunt abdominal injuries. With blunt injuries, the solid viscera were commonly injured, whereas penetrating injuries involve hollow organs. Motorcycle related injuries are preventable conditions and require the enforcement of traffic regulations, provision of basic but necessary footpaths and public enlightenment on the dangers of child abuse as pedestrian child hawker. Mary Slessor Journal of Medicine Vol.3(2) 2003: 47-5