Ethical Issues in the Publication of Scientific Articles

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Blood transfusion practice in patients undergoing thyroidectomy in Ibadan, Nigeria

Background: The demand on the blood bank in sub-Saharan Africa for blood is huge. There is, therefore, a need for more efficient use of this precious material. This study, therefore, was carried out to assess blood transfusion practice for thyroidectomy in a sub-Saharan African country.Methods: A descriptive study of patients who had thyroidectomy over a 12 year-period was carried out. Information on clinical characteristics, blood loss and utilization were obtained prospectively. The blood utilization practice was assessed using Cross-match:Transfusion ratio (C:T), Transfusion probability (%T), and Transfusion index (TI). Maximum Surgical Blood Ordering Schedule (MSBOS) for thyroidectomy was derived.Results: The data of 265 patients aged 11 – 71 years with a mean age of 40.8 ± 12.6 years were analyzed. The surgeons requested for cross-matched blood for 255 patients. Blood cross-match was carried out for 216 (84.7%) patients. The patients had an average pre-operative haematocrit of 37% and median blood loss of 200mls. Cross-match:Transfusion ratio (C:T) was 5.53 with a %T of 17.6% and TI of 0.22. The MSBOS was 0.33.Conclusion: The routine cross-matching of blood is unnecessary for thyroidectomy in our clinical practice. The blood ordering practice for thyroidectomy should, therefore, be streamlined to reduce the cost and burden of the reservation of the units of blood to the transfusion services. The type and screen policy should be considered by the blood bank, surgeons, anaesthetists and the hospital transfusion committee

Complement factor H levels in steady state sickle cell anaemia

Objective: The red cell membrane of sickle cell anaemia is vulnerable to attack from the alternative complement pathway. The activation of the alternative complement pathway is initiated by externalization of  phosphatidylserine on red cell membrane. Serum and cell bound regulators normally prevent amplification of the cascade. However, red blood cells in sickle cell anaemia appear to be exposed and the cell lysing membrane attack complex is ubiquitous on irreversible sickle red blood cells. It is possible that there are deficiencies (either functional or quantitative) of  complement regulators. In this study the quantitative defects of the most abundant serum phase regulator,   complement factor H in sickle cell anaemia was investigated.Methods: We compared the plasma levels of complement factor H (a serum phase regulator of the alternative pathway) in 61 steady state Hb SS with 60 healthy Hb AA using an enzyme linked immunosorbent assay to analyze complement factor H level in the plasma. The full blood count parameters were estimated using flow cytometry.Results: There was no significant difference in the serum complement factor H levels between the steady state Hb SS and healthy Hb AA.  Significant inverse relationships existed between complement factor H, total white cell count, granulocyte cell count and platelet count as well as  significant direct relationships between complement factor H, haematocrit, and the haemoglobin concentration.Conclusion: Complement factor H in patients with sickle cell anaemia who are in steady state is not significantly lower than in controls.Keywords: Complement factor H, sickle cell anaemia, alternative pathwa

Chronic Suppurative Osteomyelitis of the Jaws

Sixty-four patients treated at the University College Hospital, Ibadan were analysed. The objective was to evaluate the effect of the duration and sight distribution of CSO on the out come of treatment. The commonest aetiological was dental abscess. A total of 53 (82.8%) of the teeth associated with the aetiology of CSO wee molar teeth. The duration of CSO ranged from 2 to 96months with a mean of 25.8, standard deviation 20.8 and median of 20. The mandible was involved in 59 (92.2%) and the maxilla in (5) 7.8% patients. The result suggest that the longer the duration of the lesion, the greater the segments of the jaws to be affected (

Antimicrobial Evaluation of Extracts and Fractions of Daniella oliveri Leaf on Selected Clinical Enteropathogens

Background: Diarrhoea is one of the major health threats to the populace in the tropics, and also one of the killer diseases in children under 5 years of age. Antimicrobial resistance and its spread pose serious public health threats, hence the need for development of safer and more effective antibacterial agents. Daniella oliveri Hutch and Dalz is used in ethnomedicine for the treatment of diarrhoea and other gastrointestinal disturbances. Objective: To investigate the antimicrobial activity of Daniella oliveri leaves on diarrhoeal pathogens. Methods: Successive plant extraction was carried out with hexane, ethylacetate and methanol using soxhlet apparatus. Methanol extract was fractionated using vacuum liquid chromatography (VLC). Phytochemical screening was done using standard chemical assays. Antibiogram of test isolates was carried out using disc diffusion assay. Antimicrobial activity of plant extract and fractions against strains of diarrhoeagenic Escherichia coli, Salmonella cholerae-suis, Shigella dysenteriae, Proteus mirabilis and Acinetobacter baumannii was determined by agar well diffusion and MIC by agar dilution methods. Kill-kinetics study was carried out using viable count technique. Results: Terpenoids, steroids and anthraquinones were detected in fractions of D. oliveri. Antibiogram assay showed that 66% of isolates were MDR. Extract and fractions produced appreciable zones of inhibition on all challenge organisms except Acinetobacter baumannii. MICs ranged between 6.25-25 mg/ml. Kill kinetics studies showed total kill on susceptible pathogens after 24 hours. Conclusion: This research has shown D. oliveri is a promising drug candidate for the management and treatment of diarrhoea.&nbsp

Evaluation of causes and predictors of non-attendance at review appointments following treatment of Maxillofacial injuries

Background: Causes and rate of non attendance at review appointment in the outpatient clinics vary widely among various clinics and different  regions all over the world. Solving the problem of non-attendance may therefore require different and individualized approaches tailored to the peculiarity of the clinic and the locality in focus. The aims of this study were to evaluate the causes and the predictors of nonattendance at review appointments following treatment for maxillofacial injuries at a sub Saharan tertiary health facility. Materials and Methods: A prospective, cohort descriptive hospital based study was carried out in a tertiary health facility in South Western Nigeria. Sixty three consecutive adult patients treated for maxillofacial injuries during the study period who met the inclusion criteria were included in the study. The demographic and clinical data of these patients were prospectively collected and analysed. Results: The mean age of the study participants was 34 (range of 17-83) years with a male to female ratio of 5.3:1. Only 17(27.0%) of the patients attended all four clinic review appointments giving an overall default rate of 73.0%. One hundred percent and 30.8% of the patients with mandibular fractures and soft tissue injuries alone respectively attended the first review appointment. The non-attendance rate at the first outpatient review clinic appointment was 28.6% and this progressively increased to 41.3%, 61.9% and 71.4% at the second, third and fourth review clinic appointments respectively. Out of the 18 patients that missed the 1st review appointment, only 1(5.6%) subsequently attended any of the other appointments. Significant factors that are associated with non-attendance at the follow up review clinic appointments following maxillofacial injuries were age of the patients and types of maxillofacial injury. Commonest reasons cited by study participants for default were 'feeling okay', relocation and financial reasons. Conclusion: The most significant factors predicting non-attendance at review appointment following treatment for maxillofacial injuries are type of injuries and age of the patient while the most common reason cited by patient for non attendance was feeling okay. Motivating patients adequately  before discharge by letting them know the advantages of attending and possible implications of not attending post-op review may be a way to improve attendance. Key words: Non-attendance, maxillofacial injuries, treatment, review appointmen

Orofacial cancers: pattern and management in Ibadan, Nigeria

Background: Orofacial cancers remain a significant health burden globally, especially in the developing countries where the incidence is higher and appears to be increasing. This study aims to document the pattern, management and survivorship of patients with orofacial cancers as seen at a tertiary healthcare facilityin Nigeria.Materials and Methods: This is a retrospective study of patients who presented at our centre with orofacial cancers in the period between January 2010 and December. Patients' demographics, location of lesion, histopathological diagnosis, treatment given and follow-up events were extracted from the records. Patient with insufficient data for analysis were excluded. Data was analysed using IBM SPSS version 21.Results: 21,090 patients were seen during the study period and 228 of the 1,029 biopsies done were malignant. The study included 213 patients (121 males and 92 females. mean age 48.2 years) with orofacial cancers. The commonest sites were the jaws (48.8%), palate (13.1%) and the tongue (7.5%).Carcinomas constituted 71.8% and were the commonest malignancies. All patients presented in stages III (34.6%) or IV (65.4%). 39.4% of patients  had no treatment instituted and surgery alone (21.9%) was the commonest treatment provided. The mean interval between treatment and recurrence was 3.0 months while mean expiration period was 13.5 months.Conclusion: Treatment conferred a higher probability of survival. Patients treated with surgery (and radiotherapy/chemotherapy) survived better than those treated non-aggressively. In general, about a third (30.8%) of orofacial cancer patients were alive at 5 years post presentation and about 50% of these survivors were living with the disease.Keywords: Orofacial cancer; outcome; survival; Nigeri