Chronic osteoyelitis in patients with sickle cell disease

Objective: To determine the baseline pattern and audit management modalities of chronic osteomyelitis in patients with sickle cell disease.Design: A retrospective study.Setting: Jos University Teaching Hospital, Jos, Nigeria from August 1993 to July 1997.Patients: Twenty four patients with concomitant chronic sickle cell disease.Interventions: Fifteen patients had operations; eleven had sequestrectomy and curettage while four had incision and drainage. Eight patients were treated with antibiotics alone and one patient refused surgery.Main outcome measures: The demographic data of patients, aetiological agents, culture and sensitivity patterns, aetiopathogenesis, treatment modalities and outcome were analysed.Results: Twenty four (36.9%) out of 65 patients who had chronic osteomyelitis also had sickle cell disease. Male:female ratio was 1.2:1. The peak age incidence (37.5%) was in the first decade of life. Seventy five per cent of infections were haematogenous. The most frequentlyisolated organism was Staphylococcus aureus (58.8%) while the rest were Gram negative organisms. There was no case of Salmonella osteomyelitis. The most sensitive antibiotics were gentamicin and the third generation cephalosporins. Twelve patients (50%) had good results while eight (33.3%) were still undergoing treatment. Complications recorded were persistent discharging sinuses in two cases, recurrence of symptoms in one and pathological fracture with non-union in one patient.Conclusion: Though the incidence of Gram negative organisms in causation of chronic osteomyelitis in patients who have sickle cell disease is high (41.2%), Salmonella osteomyelitis may be related to endemicity of the organism in a given locality

Thyroidectomy under local anaesthesia: how safe?

In order to compliment the inadequate health facilities in the rural areas in Nigeria, nongovernmental organisations provide adhoc outreach health camps that offer treatment in various medical specialties including surgery. Rural outreach health camps. To evaluate the safety of thyroidectomy under local anaesthesia at rural outreach setting with inadequate facilities for general anaesthesia. This was a prospective descriptive study of 33 consecutive cases of thyroidectomy performed using field block with 1% lignocaine and adrenaline 1: 200,000 dilution during two free medical outreaches that held at Jos,Nigeria inMarch andOctober 2005 respectively, lasting twoweeks each. : A total of 33 primary thyroid operations were performed consisting of 30 subtotal thyroidectomies (91%), 2 lobectomies (6%) and one total thyroidectomy (3%), The patientswere aged between 23 and 62 years with a mean age of 45.8years. There were 3males and 30 females with a male: female ratio of 1:10. There was no mortality butmorbidity was 2/33 (6%) Two complications were recorded in 2 patients and were superficial surgical site infection (3%) and reactionary haemorrhage (3%). We conclude that thyroidectomy under local anaesthesia is a safe procedure in experienced hands at rural settingswith inadequate facilities for general anaesthesia. Keywords: Thyroidectomy; Local anaesthesia; Safety;Rural outreach;Nigeria Nigerian Journal of Clinical Practice Vol. 11 (1) 2008: pp.37-4

Ghrelin axis reveals the interacting influence of central obesity and hypertension

201902 bcmaVersion of RecordPublishe

One year of yoga training alters ghrelin axis in centrally obese adults with metabolic syndrome

201902 bcmaVersion of RecordPublishe