Tuberculous Ileal Perforation In A HiV Positive Patient A Case Report And Review Of Literature

Tuberculosis is prevalent worldwide. Even in developed countries there is a resurgence of tuberculosis mainly due to increasing HIV infection. Tuberculous ileal perforation is uncommon. It is, however, a potentially fatal complication of intestinal tuberculosis especially inHIV/AIDS patient. To highlight tuberculous ileal perforation as an underestimated complication of intestinal tuberculosis in anHIVpatient presentingwith acute abdomen. A 42 year old HIV positive long distance truck driver with tuberculous ileal perforation is presented and related literatures reviewed. Intestinal perforation due to abdominal tuberculosis is an aetiological factor in acute HIV abdomen.High index of suspicion remains the key to diagnosis.Keywords: Tuberculosis, Ileal Perforation,HIV Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 386-38

Outcome of surgery for toxic goitres in maiduguri: A single teaching hospital’s perspective

Background: Thyrotoxicosis a common endocrine disorder of the thyroid gland in Nigeria is commonly treated surgically. The outcome of thyroidectomy for toxic goiters in Maiduguri Nigeria is evaluated.Materials and Methods: Over the last 5 years (Jan 2005-July 2010), in a prospective review, the demographic, and clinical data of patients operated for toxic goiters in our department was entered, into a predesigned proforma and analyzed. The objective of the study is to review our experience with subtotal and near-total thyroidectomy as treatment for benign toxic goiters.Results: Seventy-eight patients, 11 males (14.1%) and 67 females (85.9%), with male: female ratio of 1:6.1 and the mean age of 30 ± 10.9 (range, 17-65 years), underwent thyroidectomy for toxic goiters. The mean duration of symptoms was 41.9 (range 3-126 months). There were 53 patients with toxic diffuse goiters (Grave’s disease) with their mean age of 27.6 ± 6.93 (range 17-38 years), 23 with toxic multinodular goiters, the mean age of 43.7 ± 15.68 (range 17-65 years) and two with toxic nodule. There was no case of permanent recurrent laryngeal nerve palsy or permanent hypocalcemia. Transient hypocalcemia occurred in 9 (11.5%) patients and hemorrhage with hematoma, requiring exploration in 4 (5.1%). There were two cases of wound infection and no postoperative mortality. The mean hospital stay was 7.6 ± 2.34 (range 5-15 days). There was no disease recurrence over a mean follow-up of 20.7 (range 2-48) months.Conclusion: Subtotal thyroidectomy is an effective procedure for the treatment of thyrotoxicosis with few postoperative complications and majority of patients being euthyroid after long follow-up

PREVALENCE OF GASTROINTESTINAL PARASITES OF HORSES AND ASSOCIATED RISK FACTORS IN PLATEAU STATE, NIGERIA.

Horses are companion animals and highly resourceful in sports, national and traditional ceremonies, military and paramilitary involvements hence they play an important part in the economics of Nigeria. Gastrointestinal parasites are known to be deleterious to horses thus affecting the health, productivity and working capacity. In order to determine the prevalence of Gastrointestinal parasites and associated risk factors, fecal samples were collected from 107 horses comprising 58 females and 49 males from 3 local government areas including Jos North, Jos South and Riyom in Plateau State, samples were carefully examined using floatation and sedimentation techniques. The overall prevalence of gastrointestinal helminths was 46.7% out of which 11.2% were mixed infections. 7 different gastrointestinal parasites were observed in the animals studied: Ascaris equorum (12.1%), Eimeria spp (8.4%), Fasciola spp (3.7%), Gastrodiscus aegyptiacus (2.8%), Strongyloides spp (7.5%), Strongylus spp (11.2%) and Trichomena spp (14%). No significant differences (p>0.05) in the prevalence of gastrointestinal parasites were observed in relation to age, sex and breed but there was significant variation (p<0.05) in relation to location. The study reveals that gastrointestinal helminths are still a major constraint to the overall working and productivity of horses in the study areas hence the need for improved management practices

Low-Noise Ku-Band Receiver Frontend with Switchable SIW Filters for Cubesat Applications

This paper proposes a low-noise receiver frontend for nanosatellite and Cubesat platforms. The frontend is composed by a Low-Noise Amplifier (LNA) and two Substrate Integrated Waveguide (SIW) filters, providing a frequency reconfigurability to the system. The two filters operate in the 13 and in the 14 GHz uplink bands, and are selected by means of a pair of solid-state SPDT switches. As a results, 15.5 dB gain with 2.4 dB noise figure for the 13 GHz configuration and 17.8 dB gain with 2.3 dB noise figure for the 14 GHz configuration are obtained. This work is important since demonstrates a low-cost solution for satellite radio apparatuses based on commercial components on a standard PCB

Gastric Outlet Obstruction at Bugando Medical Centre in Northwestern Tanzania: A Prospective Review of 184 Cases.

Gastric outlet obstruction poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. There is a paucity of published data on this subject in our setting. This study was undertaken to highlight the etiological spectrum and treatment outcome of gastric outlet obstruction in our setting and to identify prognostic factors for morbidity and mortality. This was a descriptive prospective study which was conducted at Bugando Medical Centre between March 2009 and February 2013. All patients with a clinical diagnosis of gastric outlet obstruction were, after informed consent for the study, consecutively enrolled into the study. Statistical data analysis was done using SPSS computer software version 17.0. A total of 184 patients were studied. More than two-third of patients were males. Patients with malignant gastric outlet obstruction were older than those of benign type. This difference was statistically significant (p < 0.001). Gastric cancer was the commonest malignant cause of gastric outlet obstruction where as peptic ulcer disease was the commonest benign cause. In children, the commonest cause of gastric outlet obstruction was congenital pyloric stenosis (13.0%). Non-bilious vomiting (100%) and weight loss (93.5%) were the most frequent symptoms. Eighteen (9.8%) patients were HIV positive with the median CD 4+ count of 282 cells/μl. A total of 168 (91.3%) patients underwent surgery. Of these, gastro-jejunostomy (61.9%) was the most common surgical procedure performed. The complication rate was 32.1 % mainly surgical site infections (38.2%). The median hospital stay and mortality rate were 14 days and 18.5% respectively. The presence of postoperative complication was the main predictor of hospital stay (p = 0.002), whereas the age > 60 years, co-existing medical illness, malignant cause, HIV positivity, low CD 4 count (<200 cells/μl), high ASA class and presence of surgical site infection significantly predicted mortality ( p< 0.001). The follow up of patients was generally poor as more than 60% of patients were lost to follow up. Gastric outlet obstruction in our setting is more prevalent in males and the cause is mostly malignant. The majority of patients present late with poor general condition. Early recognition of the diagnosis, aggressive resuscitation and early institution of surgical management is of paramount importance if morbidity and mortality associated with gastric outlet obstruction are to be avoided

A five-year review of burn injuries in Irrua

<p>Abstract</p> <p>Background</p> <p>The management of burns remains a challenge in developing countries. Few data exist to document the extent of the problem. This study provides data from a suburban setting by documenting the epidemiology of burn injury and ascertaining outcome of management. This will help in planning strategies for prevention of burns and reducing severity of complications.</p> <p>Methods</p> <p>A total of 72 patients admitted for burns between January 1st, 2002 and December 31st, 2006 at the Irrua specialist teaching hospital were studied retrospectively. Sources of information were the case notes and operation registers. Data extracted included demographics as well as treatment methods and outcome</p> <p>Results</p> <p>The results revealed male to female ratio of 2.1:1. Over 50% of the injuries occurred at home. There was a seasonal variation with over 40% of injuries occurring between November and January. The commonest etiologic agent was flame burn from kerosene explosion. There were 7 deaths in the series.</p> <p>Conclusion</p> <p>Burns are preventable. We recommend adequate supply of unadulterated petroleum products and establishment of burn centers.</p

Declines in Pediatric Bacterial Meningitis in the Republic of Benin Following Introduction of Pneumococcal Conjugate Vaccine: Epidemiological and Etiological Findings, 2011-2016.

BACKGROUND: Pediatric bacterial meningitis (PBM) remains an important cause of disease in children in Africa. We describe findings from sentinel site bacterial meningitis surveillance in children <5 years of age in the Republic of Benin, 2011-2016. METHODS: Cerebrospinal fluid (CSF) was collected from children admitted to Parakou, Natitingou, and Tanguieta sentinel hospitals with suspected meningitis. Identification of Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae, and Neisseria meningitidis (meningococcus) was performed by rapid diagnostic tests, microbiological culture, and/or polymerase chain reaction; where possible, serotyping/grouping was performed. RESULTS: A total of 10 919 suspected cases of meningitis were admitted to the sentinel hospitals. Most patients were 0-11 months old (4863 [44.5%]) and there were 542 (5.0%) in-hospital deaths. Overall, 4168 CSF samples were screened for pathogens and a total of 194 (4.7%) PBM cases were confirmed, predominantly caused by pneumococcus (98 [50.5%]). Following pneumococcal conjugate vaccine (PCV) introduction in 2011, annual suspected meningitis cases and deaths (case fatality rate) progressively declined from 2534 to 1359 and from 164 (6.5%) to 14 (1.0%) in 2012 and 2016, respectively (P < .001). Additionally, there was a gradual decline in the proportion of meningitis cases caused by pneumococcus, from 77.3% (17/22) in 2011 to 32.4% (11/34) in 2016 (odds ratio, 7.11 [95% confidence interval, 2.08-24.30]). Haemophilus influenzae meningitis fluctuated over the surveillance period and was the predominant pathogen (16/34 [47.1%]) by 2016. CONCLUSIONS: The observed decrease in pneumococcal meningitis after PCV introduction may be indicative of changing patterns of PBM etiology in Benin. Maintaining vigilant and effective surveillance is critical for understanding these changes and their wider public health implications

Testicular Biopsy In The Evaluation Of Male Infertility In Maiduguri North-Eastern Nigeria

Objective: To evaluate testicular biopsy in the management of male infertility in the university of Maiduguri Teaching Hospital. Method: This study reviewed retrospectively testicular biopsy in the infertile males managed at University of Maiduguri Teaching Hospital between january 1991 and December 2000. Result: Forty-six patients had testicular biopsy for infertility as part of their investigations. Mean age at presentation was 33.8 years and mean duration of marriage before presentation was 5.9 years. Forty-one (80%) had primary infertility and 5 (11%) secondary infertility. Twenty-eight (60.9%) had history suggestive of urethritis. Bacteriospermia was detected in 14 (30.4%). Thirty-three (71.4%) of the patients had azoospermia while 16 (34.8%) had severe tubular atrophy. Six (13.04%) of the patients with normal spermatogenesis but had bacteriospermia were able to achieve fertility after adequate antibiotic therapy. Conclusion: Though infertility can be caused by many factors, infection appears to be among the major contributors to infertility in this environment. Key words: Testicular biopsy, male infertility, north-eastern Nigeria. Highland Medical Research Journal Vol.2(1) 2004: 37-4

Pharyngo-oesophageal Foreign Bodies in Maiduguri

Background: Pharyngo-oesophageal impaction of foreign bodies is an otolaryngological emergency. Methods: A retrospective study of 79 patients with pharyngo-oesophageal foreign bodies managed in 5 years. Results: Children aged group 0 - 4 years were the most affected. The one Naira and 50 Kobo coins were the most common foreign bodies (45, 68.4%) encountered. Other foreign bodies seen were bone 14 (17.7%), meat 3 (3.8%), pins and needles (3.8%) and denture 1(1.3%). The miscellaneous group constituted 5%. Foreign body in the form of needle were found in some magicians. Conclusion: The need to educate parents on close monitoring of their children to avoid such accidents is stressed. (Nig J Surg Res 2001; 3: 62 – 65) KEY WORDS: Phyaryngo-oesophageal, Foreign bodies, Maiduguri