Amoebic liver abscess: a diagnostic dilemma in the elderly

A 63-year old man presented with a 2-year history of progressive abdominal swelling with non-specific symptoms and signs. He visited several hospitals, where no diagnosis could be made for about 2 years and all therapeutic options given were ineffective. The appearance of an elevated right hemi diaphragm on chest X-ray, a single well defined area of Sonolucency with a thin edged border on ultrasound and a positive amoebic precipitin led to a diagnosis of amoebic liver abscess. Radiological intervention through ultrasound guided aspiration combined with medical therapy using metronidazole, led to rapid recovery and near complete resolution. This case typifies a not very uncommon but atypical presentation of amoebic liver abscess seen in practice characterized by intra abdominal space occupying lesion with non-specific symptoms and signs. Effective use of imaging techniques should help in the diagnosis. Ultrasound guided aspiration combined with medical therapy is effective treatment. Keywords: Amoebic liver abscess, atypical presentation, imaging Annals of African Medicine Vol.2(1) 2003: 33-3

Respiratory symptoms and ventilatory function impairment among wood workers in the savannah belt of Northern Nigeria

Background:Exposure to wood dust and substances connected to wood processing have been associated with a variety of health hazzards. Both upper and lower respiratory tract diseaes have been noticed and described. Several publications are found in the literature on these but no such report has come from the Savannah belt with its peculiar climatic conditions. Methods: One hundred and forty (140) workers in a wood furniture factory in Kaduna, a city within the Savannah belt of Northern Nigeria, were studied for presence of respiratory symptoms and /or ventilatory function impairment using the MRC questionnaire on respiratory symptoms and an electronic Spirometer. The workers were classified into five working groups according to their nature of work in the factory, such as Machine shop, Assembling, Spray room, Upholstery and Administration. Results:Forty eight (48) out of the one hundred and forty (140) workers (34.3%) had respiratory symptoms. Prevalent symptoms identified were chronic cough, corrhiza, breathlessness and wheeze. The workers in the machine shop and the spray room had higher prevalence of respiratory symptoms of 60.5% (

Outcome of pregnancy related acute kidney injury requiring haemodialysis in a Nigerian teaching hospital

Background: Pregnancy related acute kidney injury (AKI) severe enough to require dialysis is now rare in developed countries but is still a significant cause of maternal mortality in many resource constrained countries. However, there is scanty information from many sub-Saharan countries about outcomes of patient who undergo haemodialysis. The aim of this study was to review the outcomes of women dialyzed for Pregnancy related AKI at Ahmadu Bello University Teaching Hospital Zaria, Nigeria.Methods: Retrospective 5 year audit of patients dialyzed from 2008 to 2012.Results: Eight (5.5%) of 150 women dialyzed within the period under review had Pregnancy related AKI. They presented 4 to 21 days after delivery with reduced urine output of 1 to 10 days (median 5 days). Only 3 (37.5%) of the 8 patients received antenatal care; 5 (62.5%) had severe haemorrhage, 4 (50%) had sepsis (2 post abortal), and 3 (37.5%) had eclampsia. Two patients died, one patient regained normal renal function and another had partial recovery of renal function. The remaining 4 (50%) were dialysis dependent at discharge but could not afford more dialysis. Foetal loss was 87.5%.Conclusion: Peripartum haemorrhage, Sepsis and Eclampsia were the factors associated with AKI and foetal loss in our patients. Delayed recognition, late presentation, and financial constraints contributed to maternal morbidity and mortality. Lack of antenatal care may have also contributed significantly. There is urgent need to increase awareness among birth attendants (medical/traditional) and the general public about the importance of monitoring urine output after delivery and referring patients early.Keywords: Acute Kidney Injury, Pregnancy, Haemodialysis, Renal Outcom