Morphometric profile of tendocalcaneus of South Africans of European ancestry using a cadaveric approach

Background: Tendocalcaneus is a strong tendon that is vital for bipedalism in humans. Despite its tremendous strength, the tendocalcaneus is prone to damage and degeneration causing mobility problems and pain. Morphometric dimension of the tendocalcaneus is of benefit to the surgical repair and reconstruction of the damaged tendon. Cadaveric approach provides a realistic method for determining tendocalcaneus morphometry and as at present only two cadaveric studies on Indian population is available. Thus this study presents data on tendocalcaneus morphometry in South Africans of European ancestry using a cadaveric approach. Materials and methods: A total of 66 lower limbs (32 left and 34 right legs) sourced from 49 male and female cadavers were used. After careful dissection of the posterior aspect of leg, the medial and lateral length, distal width, distal circumference and proximal width of the tendocalcaneus were measured. Results: The data showed a high degree of reproducibility indicating that the measurements obtained using cadaveric approach were precise and accurate. There was no difference in measurements between the sides. Measurements in the males were generally higher than in the females. Strong associations were observed between the paired measurements of the medial and lateral tendon length and between the distal width and distal circumference. Conclusions: The data obtained will be useful in predicting tendocalcaneus size during the surgical reconstruction of the tendocalcaneus

Morphometric profile of tendocalcaneus of South Africans of European ancestry using a cadaveric approach.

Tendocalcaneus is a strong tendon that is vital for bipedalism in humans. Despite its tremendous strength, the tendocalcaneus is prone to damage and degeneration causing mobility problems and pain. Morphometric dimension of the tendocalcaneus is of benefit to the surgical repair and reconstruction of the damaged tendon. Cadaveric approach provides a realistic method for determining tendocalcaneus morphometry and as at present only two cadaveric studies on Indian population is available. Thus this study presents data on tendocalcaneus morphometry in South Africans of European ancestry using a cadaveric approach. A total of 66 lower limbs (32 left and 34 right legs) sourced from 49 male and female cadavers were used. After careful dissection of the posterior aspect of leg, the medial and lateral length, distal width, distal circumference and proximal width of the tendocalcaneus were measured. The data showed a high degree of reproducibility indicating that the measurements obtained using cadaveric approach were precise and accurate. There was no difference in measurements between the sides. Measurements in the males were generally higher than in the females. Strong associations were observed between the paired measurements of the medial and lateral tendon length and between the distal width and distal circumference. The data obtained will be useful in predicting tendocalcaneus size during the surgical reconstruction of the tendocalcaneus

Ophthalmic manifestations in patients with intracranial tumours

Introduction L’étude a pour but d’apprécier les manifestations ophtalmologiques des patients présentant des tumeurs cérébrales au Nigéria dans un hôpital tertiaire. Méthode Il s’agit d’une étude rétrospective avec une revue des tumeurs cérébrales dans le Neurosurgical Unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile- Ife de janvier 2003 à décembre 2007. L’analyse des données, diagnostique, acuité visuelle, et prise en charge, ont été analysées selon la fréquence en utilisant avec la version 1 11 SPCS . L’acuité visuelle a été classifiée selon celle de l’OMS. Résultat Sur un total de 94 patients, 88 patients ont été revus. Il s’agissait de 53 patients de sexe masculin et 35 de sexe féminin. La moyenne d’âge était de 36.2 plus ou moins 20 ans. 14 patients ont été pris en charge par les ophtalmologistes. La répartition des tumeurs était la suivante: méningiomes, 36,4 %, craniopharyngiomes, 13,6 % et gliomes, 9,1 %. 67,9 % des patients se plaignaient de troubles visuels à l’admission dont 46,6 % avec une baisse importante et 12,5 % une vision double. Il a été objectivé une artrophie optique dans 23,9 % . 46 malades (52 %) étaient aveugles et 14 (16 %) avaient un trouble visuelimportant. Conclusion Les troubles visuels sont des manifestations cliniques fréquentes de présentation des tumeurs cérébrales. Une information médicale précoce est requise

New onset neuromyelitis optica in a young Nigerian woman with possible antiphospholipid syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Devic's neuromyelitis optica is an inflammatory demyelinating disease that targets the optic nerves and spinal cord. It has a worldwide distribution and distinctive features that distinguish it from multiple sclerosis. There has been no previous report of neuromyelitis optica from our practice environment, and we are not aware of any case associated with antiphospholipid syndrome in an African person.</p> <p>Case presentation</p> <p>We report the case of a 28-year-old Nigerian woman who presented with neck pain, paroxysmal tonic spasms, a positive Lhermitte's sign and spastic quadriplegia. She later developed bilateral optic neuritis and had clinical and biochemical features of antiphospholipid syndrome. Her initial magnetic resonance imaging showed a central linear hyperintense focus in the intramedullary portion of C2 to C4. Repeat magnetic resonance imaging after treatment revealed resolution of the signal intensity noticed earlier.</p> <p>Conclusion</p> <p>Neuromyelitis optica should be considered in the differential diagnoses of acute myelopathy in Africans. We also highlight the unusual association with antiphospholipid syndrome. Physicians should screen such patients for autoimmune disorders.</p

The Impact of Recycled Neonatal Incubators in Nigeria: A 6-Year Follow-Up Study

Nigeria has a record of high newborn mortality as an estimated 778 babies die daily, accounting for a ratio of 48 deaths per 1000 live births. The aim of this paper was to show how a deteriorating neonatal delivery system in Nigeria may have, in part, been improved by the application of a novel recycled incubator technique (RIT). Retrospective assessment of clinical, technical, and human factors in 15 Nigerian neonatal centres was carried out to investigate how the application of RIT impacted these factors. Pre-RIT and post-RIT neonatal mortalities were compared by studying case files. Effect on neonatal nursing was studied through questionnaires that were completed by 79 nurses from 9 centres across the country. Technical performance was assessed based on 10-indices scores from clinicians and nurses. The results showed an increase in neonatal survival, nursing enthusiasm, and practice confidence. Appropriately recycled incubators are good substitutes to the less affordable modern incubators in boosting neonatal practice outcome in low-income countries

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Distributions of cadmium and lead in peri-urban wetlands as influenced by soil organic matter, clay fraction, and moisture content

Environmental distribution of cadmium (Cd) and lead (Pb) were studied in two wetlands (alluvial plain and inland depression) in Ibadan, Nigeria. Mean and median values of variables measured across the wetlands showed that soil properties varied considerably. Hydraulic conditions, soil organic matter (SOM), and particle size distribution contributed to the distribution of heavy metals recorded. Profile distribution of Cd and Pb maintained two patterns: (1) linear distribution pattern, where concentrations of Cd and Pb increase and decrease respectively, with increase in soil depth and (2) middle depth enrichment. Active carbon (AC), SOM, and clay fraction affected the surface and profile distribution of Cd and Pb. Cadmium showed significant correlation (R2 = −0.61* and 0.64*) with AC and SOM, respectively, while Pb had R2 values of 0.77* and 0.57 with SOM and clay content, respectively. The non-residual fractions of the heavy metals increased with increasing metal loading and SOM. This study is useful in assessing chemical changes for Cd and Pb in different wetlands, and their potential release to the environment

Facial Nerve palsy: the Experience at a Nigerian Teaching Hospital

Background: We observed at our center that facial nerve palsy (FNP) presented in crops at a particular season of the year and was usually associated with emotional stress on the patient. Objective: The aims of this study were to evaluate the aetiology, and the management options for patient with facial nerve palsy in our institution Materials and Methods: The medical charts of all the patients that had FNP over the 16-year period (1988-2003) were retrospectively reviewed. The demographic data, aetiology and the management outcome of each patient were noted. The data were analyzed using SPSS Version 11 software and results were presented using simple frequency, percentages and charts. Results: There were 104 patients with a male: female ratio of 1.4:1. All age groups were affected with the peak prevalence in the third decade of life. Bell's palsy accounted for 50 (48.1%), inflammatory ear diseases 23(22.1%), trauma 14(13.5%), cerebral infarction 7(6.7%) malignancies 4(3.8%) and post grand-mal seizure in 2(1.9%). Unilateral FNP was seen in 93 (90%) of cases while bilateral paralysis was seen in 4 (3.8%). All the patients were treated conservatively and had physiotherapy. Full recovery occurred in 80% of the cases, 5% had partial recovery while in 15% the outcome was unsatisfactory. Corneal ulceration was seen in 5(4.8%). Conclusion: Bell's palsy was the most common cause of FNP in our center. There was need for surgical rehabilitation procedures in the management of FNP in this environment. This will ensure satisfactory outcome in all patients. Keywords: Bell's palsy, facial nerve palsy, otitis media, corneal ulceration Nigerian Journal of Otorhinolaryngology Vol. 3 (2) 2006: pp. 72-7