A Report Of Two Cases Of Uncemented Total Hip Replacement In Patients With Sickle Cell Disease

This is a report of two sickle cell patients (HbSS) with advanced osteoarthritis of the right hip. The patients were in Ficat and Arlet\'s stage 3 and 4 respectively. Both were females aged 23 and 46 years and they had uncemented hydroxyapatite coated omnifit (Stryker Howmedica Osteonics) total hip prosthetic replacement. The results so far have been quite encouraging. The procedure is technically demanding, fraught with risks and expensive but very useful. This is the first of such reports in Nigeria. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 257-25

Pattern and clinical profile of children with complex cardiac anomaly at University of Nigeria Teaching Hospital, Ituku‑Ozalla, Enugu State, Nigeria

Background: Complex congenital cardiac abnormalities are rare among children and contribute to mortality and morbidity. The prevalence and pattern of presentation vary from lace to place.Materials and Methods: The objective of this study was to determine the clinical profile and pattern of presentation of complex congenital cardiac malformations among children attending a tertiary hospital in Enugu State. A cross‑sectional retrospective study in which a review of the records of children who attended the children outpatient clinic of University of Nigeria Teaching Hospital (UNTH), Ituku‑Ozalla, Enugu State over a 5‑year period (January 2007‑June 2012) was undertaken.Results: Thirty one thousand seven hundred and ninety‑five (31,795) children attended the outpatient clinic of the hospital over the study period, of these, 65 had cardiac diseases, from which 16 were found to have congenital complex cardiac abnormalities of various types, giving a prevalence of 0.05%. Complex abnormalities seen in these children are Tricuspid atresia with various associations, cor triatriatum, single ventricle, and large ASD (atrio‑septal defect) with complete AVCD, cor triatriatum sinistrum with cardiomyopathy, DORV (double outlet right ventricle) with left sided aorta, hypoplastic tricuspid valve with a PDA (patent ductus artriosus), TOF (tetralogy of fallot), prolapse of aortic valve, and pulmonary regurgitation. One of these complex cardiac anomalies presented with Turner’s syndrome and another with VACTERAL association.Conclusions: The results of this study show that 0.05% of children who presented at cardiology clinic of a teaching hospital in Enugu State had congenital complex cardiac abnormalities and that the commonest forms seen were those with cor triatriatum and TOF.Keywords: Abnormalities, children, complex congenital cardiac, Enugu, presentationNigerian Journal of Clinical Practice • Oct-Dec 2013 • Vol 16 • Issue

Factors affecting compliance to treatment among children with epilepsy attending at a paediatric neurology clinic of a tertiary hospital in Enugu

BACKGROUND:This study aimed to determine the factors affecting compliance to treatment among children with epilepsy in Enugu,Nigeria.METHODS: Children with diagnosis of epilepsy were consecutively recruited.Their 6 months retrospective and 1 month prospective data were collected;and analyzed using SPSS version 20.0 (p < 0.05).RESULTS: Fifty six children with epilepsy (mean age= 9.7 ± 4.1 years) were studied. Generalized tonic clonic epilepsy was noted in 41.1% (23/56) of them.Thirty six (64.3%) complied strictly with the treatment regimen. Polytherapy, high cost of drugs, multiple drug dosages and drug related side effects affected compliance. Majority (79.4%, 27/34) of patients on monotherapy and a few (27.2%, 6/22) on poly-therapy had good seizure control (p<0.001).CONCLUSION: Poor drug compliance is a major constraint to adequate seizure control in children with epilepsy in our setting.Addressing the problem of poor compliance will enable them to achieve optimal seizure control.KEY WORDS: Epilepsy, Treatment Compliance, Associated Factors;Childre

Performance of oyster mushroom (Pleurotus ostreatus) in different local agricultural waste materials

The present study was conducted to evaluate different substrates for establishment of yield performance of oyster mushroom (Pleurotus ostreatus). The substrates were prepared from single or mixture of different agricultural waste materials supplemented with lime and water as additive to each substrate. A total of eight substrates labeled 1 to 8 were prepared. Substrate 4, which is a mixture of palm kernel cake and maize cob, had the highest mycelia growth rate (80%), sprouted 15 days after inoculation and yielded the highest total fresh weight for a period of 10 harvests (2957.5 g). Substrate 3, a mixture of palm kernel cake and sawdust, had 78% mycelia growth rate, sprouted 16 days after inoculation and yielded 2535.7 g fresh mushroom. Substrate 2 is a mixture of maize straw and sawdust and had 75% mycelia growth rate, sprouted 17 days after inoculation and a total of 2207.4 g fresh weight. The mushroom grown in substrates 4, 3 and 2 produced bigger and firmer fruiting bodies, which differed significantly (P < 0.05) from the other substrates. Substrates 1 and 5 which had 50% mycelia growth rate, sprouted 31 and 33 days after inoculation and 1408.8 and 1092.6 g, respectively, were recorded after a period of 10 harvests. Substrate 4, 3 or 2 is therefore recommended for cultivation of oyster mushroom.Keywords: Oyster mushroom (Pleurotus ostreatus), mycelial growth, palm kernel cake (PKC), substrate, maturit

ISOLATION OF Cryptococcus neoformans FROM ENVIRONMENTAL SAMPLES COLLECTED IN SOUTHEASTERN NIGERIA

SUMMARY Cryptococcosis caused by Cryptococcus neoformans is the second most common fungal opportunistic pathogen and a lifethreatening infection with serious clinical manifestations especially in HIV/AIDS and other immunocompromised patients. In Nigeria, HIV/AIDS infection has reached an alarming level. Despite this, information on the presence of this fungus in clinical and environmental samples is very scanty in Nigeria and many other parts of Africa. We set out to evaluate the presence of Cryptococcus neoformans or C. gattii in pigeon droppings obtained from Southeastern Nigeria. One hundred and seventy-seven samples of pigeon droppings from six sample types were collected. The area covered comprised of ten cities and other locations spanning across five States in Nigeria. Using established techniques, Cryptococcus neoformans was isolated from 39 of the 177 (22.0%) samples overall. No C. gattiiwas isolated. Most of the isolates (32.4%) were recovered from dovecotes (11 of 34) followed closely by samples taken from markets (31.8%; seven of 22) and least from the church (4.0%; one of 25). The highest isolation rate (38.9%) was found in samples from Enugu-Ezike(seven of 23) while the least came from Afikpoand the other locations each with 9.1% isolation rate. This is the first large-scale screening of Cryptococcus neoformans from pigeon droppings in Nigeria. The ecological and epidemiological significance of these findings are discussed

Discrepancies between the medical record and the reports of patients with acute coronary syndrome regarding important aspects of the medical history

<p>Abstract</p> <p>Background</p> <p>Many critical treatment decisions are based on the medical history of patients with an acute coronary syndrome (ACS). Discrepancies between the medical history documented by a health professional and the patient's own report may therefore have important health consequences.</p> <p>Methods</p> <p>Medical histories of 117 patients with an ACS were documented. A questionnaire assessing the patient's health history was then completed by 62 eligible patients. Information about 13 health conditions with relevance to ACS management was obtained from the questionnaire and the medical record. Concordance between these two sources and reasons for discordance were identified.</p> <p>Results</p> <p>There was significant variation in agreement, from very poor in angina (kappa < 0) to almost perfect in diabetes (kappa = 0.94). Agreement was substantial in cerebrovascular accident (kappa = 0.76) and hypertension (kappa = 0.73); moderate in cocaine use (kappa = 0.54), smoking (kappa = 0.46), kidney disease (kappa = 0.52) and congestive heart failure (kappa = 0.54); and fair in arrhythmia (kappa = 0.37), myocardial infarction (kappa = 0.31), other cardiovascular diseases (kappa = 0.37) and bronchitis/pneumonia (kappa = 0.31). The odds of agreement was 42% higher among individuals with at least some college education (OR = 1.42; 95% CI, 1.00 - 2.01, p = 0.053). Listing of a condition in medical record but not in the questionnaire was a common cause of discordance.</p> <p>Conclusion</p> <p>Discrepancies in aspects of the medical history may have important effects on the care of ACS patients. Future research focused on identifying the most effective and efficient means to obtain accurate health information may improve ACS patient care quality and safety.</p

Structural and spectroscopic characterisation of a heme peroxidase from sorghum

A cationic class III peroxidase from Sorghum bicolor was purified to homogeneity. The enzyme contains a high-spin heme, as evidenced by UV-visible spectroscopy and EPR. Steady state oxidation of guaiacol was demonstrated and the enzyme was shown to have higher activity in the presence of calcium ions. A Fe(III)/Fe(II) reduction potential of -266 mV vs NHE was determined. Stopped-flow experiments with H2O2 showed formation of a typical peroxidase Compound I species, which converts to Compound II in the presence of calcium. A crystal structure of the enzyme is reported, the first for a sorghum peroxidase. The structure reveals an active site that is analogous to those for other class I heme peroxidase, and a substrate binding site (assigned as arising from binding of indole-3-acetic acid) at the γ-heme edge. Metal binding sites are observed in the structure on the distal (assigned as a Na(+) ion) and proximal (assigned as a Ca(2+)) sides of the heme, which is consistent with the Ca(2+)-dependence of the steady state and pre-steady state kinetics. It is probably the case that the structural integrity (and, thus, the catalytic activity) of the sorghum enzyme is dependent on metal ion incorporation at these positions

Traumatic hip dislocation; a South East Nigeria hospital experience

Background: Hip dislocation is a relatively common orthopaedic emergency. The hip is an inherently stable joint and substantial force is required for dislocation to occur. Thus hip dislocation is said to follow motor vehicle accidents with more than 90% of hip dislocations being posterior. Thompson and Epstein grade I and II are acknowledged to be the commonest grades of posterior hip dislocation. Method: This is a retrospective study involving all cases of traumatic hip dislocation seen at The National Orthopaedic Hospital, Enugu between 1st January 2004 and 31st December 2009.The records of the patients were obtained and the relevant data extracted. The data was analyzed to determine the pattern and management of hip dislocations. Results: A total of 67 patients were seen and treated within the study period. There were 48(69.6%) males and 21(30.4%) females giving a male to female ratio of 2.3:1. The mean age was 36.4 &plusmn; 14.6 years. Posterior hip dislocation was seen in 92.9% of cases. Thompson and Epstein grade I and II were seen in 63% of cases. Interval to presentation was variable and ranged from &lt;6 hours (39.1%), within 12 hours (44.9%), to &gt;13 weeks (7.2%). Associated neurological injury was present in 5.7% of patients. The commonest form of treatment was closed reduction in 76.8% of patients. Associated injuries occurred in 53.6% of patients with fractures of other bones in 23.2%. Most (88.4%) traumatic hip dislocations followed motor vehicular accident. Conclusion: Traumatic hip dislocation occurs in our environment and posterior dislocations are the commonest form. Thompson and Epstein I and II are common. Late presentation is common in our environment but closed reduction is the form of treatment in most cases. Associated injuries are frequently seen