Cervical spondylosis in South West Nigerian farmers and female traders

Background: Neck pain is a common pain syndrome in the clinical practice. It may or may not be associated with the radiculopathy or myelopathy. Load carrying on the head is believed to be associated with an increased incidence of cervical spondylosis. Radiographic spondylosis is noticeable in 25-50% of people of 50 years of age and in 75-90% by the age of 65 years.Materials and Methods: Plain cervical radiograph were obtained in all farmers and female traders above 45 years of age who complained of neck pain. Those who met the radiological diagnostic criteria were enlisted in the study. The study was carried out over a 3 year period (July 2009-June 2012) in a private rheumatology clinic.Results: Thirty six cases of cervical spondylosis were seen, representing 10.7% of a total rheumatology cases seen over the study period. There were 23 males (63.9%) and 13 females (36.1%), giving a male: Female ratio of 1.8:1. There were 18 male farmers, 5 female farmers, and 5 female traders. Eight males and 6 females showed severe degenerative changes in the cervical spine. Mostly affected were C4-C7 cervical spine levels.Conclusion: Load carrying, as earlier documented in literature may be a significant contributory factor to the degenerative process of the cervical spine.Keywords: Cervical spondylosis, farmers and traders, Nigeria, south wes

Takayasu's disease in a young black boy

Takayusu's disease is a rare disease affecting women predominantly during the child- bearing age. It is a primary vasculitis condition of large-vessels that responds well to steroid therapy. Immunosuppressives and vascular reconstruction may be needed as necessary. Reference was made to the case note of this young boy who was being co-managed by cardiology and vascular clinics. The diagnosis of Takayasu's disease was confirmed by the rheumatology unit and appropriate literature search was done.Takayusu's disease responds well to steroid therapy as exemplified by this patient. There was no relapse of the active inflammation after six months of steroid therapy. Ahigh index of suspicion must be exercise in diagnosing Takayasu's disease. It could be difficult to have a clue early in the disease process because of non-specific presentations. Appropriate referral shouldhowever be made to Rheumatologist when the diagnosis is suspected. This will go a long way in delaying the morbidity that is associated with this rare disease

Systemic sclerosis (Scleroderma) Among Adults Attending the Rheumatology Clinic of a Tertiary Institution

Background: Systemic sclerosis is a multi-systemic autoimmune disorder characterised by the generation of autoantibodies, massive deposition of collagen and other matrix substances in the connective tissues and alterations of the microvasculature. Methods: This was a prospective study of all the cases of scleroderma seen between January 2012 and June 2015 at the Rheumatology Clinic of the Olabisi Onabanjo University Teaching Hospital. All the patients with the diagnosis of scleroderma were included. Excluded from the study were patients with other skin lesions not typical of scleroderma. Results: Six hundred and six patients with rheumatologic disorders were seen over the study period but eight of them had scleroderma. All the eight cases of scleroderma were females. The age range was 36-52 years with a mean age of 45 years (SD ± 11.4 years). All the cases had arthritis and diffuse skin lesions. Other features included sclerodactyly, microstomia and salt and pepper skin appearance in all the eight cases while Raynaud’s phenomenon and leg ulcers were not frequent. Inflammatory marker (erythrocyte sedimentation rate) was significantly elevated in all the cases. Renal and cardiovascular complications were the leading causes of death. Conclusion: Diffuse systemic sclerosis is a more serious disease than the limited form. Early referral of patients with skin lesions suggestive of scleroderma to a specialist centre is recommended as symptomatic treatment helps to improve the quality of life

Recurrent renal stone – a case report and review of literature

No Abstract.Tropical Journal of Health Sciences Vol. 15 (2) 2008: pp. 53-5

Incidence of non-steroidal anti-infl ammatory drugs induced gastric discomfort in patients with knee osteoarthritis

Background: Osteoarthritis is an age related degenerative disease seen predominantly in the elderly. Non-steroidal anti-inflammatory drug (NSAID) is a major therapeutic component in the management of osteoarthritis. Selective NSAID was developed to reduce the incidence of gastric irritation and erosion caused by the regular NSAIDS. Methods: All elderly patients with clinical and radiographic features of osteoarthritis were included in the study. Some patients were placed on regular NSAIDS while others were placed on selective NSAIDS, being randomly selected. The trial was carried out in a private clinic over three years. Proton pump inhibitor was added as soon as patients complain of abdominal discomfort. Results: Osteoarthritis was made up of 30.9 % of the total rheumatology cases seen over the three years period. Both patients on non-selective and selective NSAIDS presented with gastric discomfort. Symptoms were more noticeable in patients on non-selective NSAIDS. Females were more affected. Only two patients (2.1%) presented with symptomless gastrointestinal bleeding. Proton pump inhibitor was helpful in majority of patients. Conclusion: Gastric discomfort is very common in elderly patients on NSAIDS. Selective NSAIDS is not an exception though better than non-selective NSAIDS. Contributory factors may be co-intake of low dose aspirin and few others on corticosteroid and anticoagulant. Key words: NSAIDS, Gastric discomfort, Osteoarthritis, Elderly

Current concepts in the management of refractory cirrhotic ascites

No Abstract. Nigerian Journal of Medicine Vol. 15(3) July-September 2006: 197-20

Low back pain among patients attending rheumatology clinic in the South West Nigeria

Background: Back pain is among the common musculoskeletal complaints for patients seeking medical care. Back pain encompasses a spectrum of conditions, those with acute and short duration, to life-long disorders. Generally, causes of back pain include osteoarthritis (spondylosis), disc degeneration, osteoporotic fracture, and non-specific low back pain. Objective: To determine the pattern of low back pain among the people living in the South West Nigeria. Design: Prospective study. Methods: All the patients that presented with low back pain either with or without neuro-vascular complaints were enlisted in the study. The study was carried out over three years (January 2010-December 2012). Inclusion criterion was non-traumatic back pain. Exclusion criteria included traumatic back pain, malignancy related back pain, and inflammatory back pain. Results: Seventy three patients were seen over three years constituting 21.7% of total rheumatology cases seen over this period. There were 45 (61.6%) males, and 26 (38.4%) females with a male: female ratio of 1.6:1. Age range was 18 to 72 years, with means of 28 years. Males were generally affected with back pain more than females. Males in their active years were more affected. Non-specific back pain was the leading cause of back pain among the patients studied. Conclusion: The finding of non-specific low back pain as the leading cause of low back pain in this study agrees with earlier literatures on the same issue. Keywords: Low back pain, Musculoskeletal complaint, Hospital patients, Nigeri

Pattern of Trigger Finger among Patients Attending a Musculo-Skeletal Clinic

Background: Trigger finger is a common finger problem thought to be due to thickening of tendon sheath with or without localized tendon thickening, resulting in a narrowed tunnel for tendon excursion with ultimate restriction of tendon movement. It can be seen in anyone, it is however seen frequently in diabetic patients and in women, typically in the fifth or sixth decade of life.Objective: To determine the pattern of trigger finger among patients attending a musculo-skeletal clinic.Design: A prospective study.Setting: The study was conducted at the Olabisi Onabanjo University Teaching Hospital, a tertiary hospital located in the South west, Nigeria. The study was conducted over four years between July 2009 and June 2013.Patients and Methods: All the patients that presented with trigger finger at the outpatient clinic were enlisted for the study. Demographic and clinical information was obtained by direct interview of patients.Results: Thirty four cases of trigger finger were seen. There were 22(64.7%) females and 12(35.3%) males with a female to male ratio of 1.8:1. The age range of patients was 32 to 65 years. The mean duration of symptom was 1 year and 3 months. The ring finger (61.8%) was the commonest finger affected, and the left ring finger was predominantly affected (66.7%). The left hand (76.5%) was commonly affected. There were no cases of multiple finger involvement.Conclusion: Response to intra-lesional steroid injection was uniformly effective, surgical intervention may be un-necessary in many cases of trigger finger.Keywords: Trigger Finger, Pattern, Musculo-skeletal Clinic, Nigeri

Knee Osteoarthritis among Patients attending a Rheumatology Clinic

Background: Osteoarthritis (OA) is the most common joint disorder in the world. It is a multifactorial disease associated with pain, loss of function, and disability. Weight bearing joints like knee and hip are more commonly affected. Objective: To describe the pattern of OA in a population of rheumatology clinic attendees. Methods: The study was prospectively carried out over three years (January 2011- December 2013) in a Nigerian teaching hospital. Patients who met both the clinical and radiological diagnosis of OA were included in the study. Results: A total of 136 patients were studied. Females constituted 64.7% while men formed 35.3% of the study population. The age ranged between 40 and 84 years with the mean age of 63 years (SD ±7.91). People aged between 61and 70 years were predominantly affected. Some of the factors identified among the patients with OA included advanced age (58.1%), obesity (17.6%), sport injuries (8.1%), joint hypermobility (7.4%) and professional dancing (2.9%). Conclusion: Recognition and modification of the factors which may affect the weight bearing joints may reduce the risk of OA and prevent subsequent morbidities

Rhematological manifestations of HIV infections among Nigerians: case reports and literature

No Abstract. Nigerian Medical Practitioner Vol. 47(6) 2005: 117-12