L. Abdur-rahman, O. Awolaran, A. Nasir, K. Bamigbola, Nurudeen T. Abdulraheem, A. Oyinloye, J. Adeniran
Background: Lymphangiomas are the developmental defects of the lymphatic channels, and they are most commonly found in the head and neck regions. Late presentation, rejection of surgery, and traditional scarification result in fatal complications. Surgical excision often thought to give immediate relief and aesthetic results is associated with damage to contiguous structures and recurrence, hence, the need for less invasive treatment modality. Objective: To assess the effectiveness of bleomycin sclerotherapy of cervical lymphangiomas. Materials and Methods: This is a prospective study of patients with cervical lymphangioma treated with sclerosant injection between January 2008 and December 2016. Preinjection ultrasound scan and initial ultrasound-guided aspiration of the fluid in the swelling (which many times is multiloculated) using a 20G cannula into a 10 ml syringe were performed. The cannula tip is retained in the space and intralesional injection of double-diluted bleomycin 0.5 i.u./kg body weight was given as outpatient at 2–4-weekly interval. Postinjection events were documented. The clinical assessment of the pre- and postinjection of sclerosant was performed. Result: A total of 23 patients were recruited, and six were females and 17 were males. All swellings were noticed at birth but median time at presentation was 17 days. All patients but one (95.8%) had complete clinical resolution after 1–4 courses of sclerotherapy for 4–16 weeks. Only one patient had residual nodule that required surgical excision. Redundant skin and hyperpigmentation from skin wrinkle were the early effects noticed in three patients; however, these were cosmetically acceptable to the parents. No recurrence was recorded. Conclusion: The treatment of cervical lymphangiomas with intralesional bleomycin injection is shown to be effective. It is safe and associated with no complication. This treatment modality and outcome was found to be acceptable to the parents of these children.
背景:淋巴管瘤是淋巴通道的发育缺陷，最常见于头颈部。延迟出现、手术排斥和传统的割伤导致致命的并发症。手术切除通常被认为能立即缓解和达到美观效果，但与相邻结构的损伤和复发有关，因此需要侵入性较小的治疗方式。目的:评价博来霉素硬化治疗颈淋巴管瘤的疗效。材料与方法:本研究是一项前瞻性研究，研究对象为2008年1月至2016年12月间接受硬化剂注射治疗的颈部淋巴管瘤患者。注射前超声扫描和超声引导下用20G套管将肿胀处的液体(多次为多室)吸入10ml注射器。留置导管尖端，局部注射双稀释博来霉素0.5 iu /kg体重，门诊每2 - 4周注射一次。记录了注射后事件。对注射前和注射后的硬化剂进行临床评价。结果:共纳入23例患者，其中女性6例，男性17例。所有的肿胀都是在出生时发现的，但分娩时的中位时间是17天。除1例(95.8%)患者外，其余患者经1-4个疗程的硬化治疗后，临床症状完全缓解。只有一名患者有残余结节，需要手术切除。3例患者早期出现皮肤赘肉和皮肤皱纹引起的色素沉着;然而，这些都是父母可以接受的。无复发记录。结论:病变内注射博来霉素治疗颈部淋巴管瘤疗效确切。它是安全的，没有并发症。这种治疗方式和结果被发现为这些儿童的父母所接受。
{"title":"Efficacy of bleomycin for non-operative treatment of cervical lymphangioma in University of Ilorin Teaching Hospital, Nigeria","authors":"L. Abdur-rahman, O. Awolaran, A. Nasir, K. Bamigbola, Nurudeen T. Abdulraheem, A. Oyinloye, J. Adeniran","doi":"10.4103/JOMT.JOMT_14_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_14_17","url":null,"abstract":"Background: Lymphangiomas are the developmental defects of the lymphatic channels, and they are most commonly found in the head and neck regions. Late presentation, rejection of surgery, and traditional scarification result in fatal complications. Surgical excision often thought to give immediate relief and aesthetic results is associated with damage to contiguous structures and recurrence, hence, the need for less invasive treatment modality. Objective: To assess the effectiveness of bleomycin sclerotherapy of cervical lymphangiomas. Materials and Methods: This is a prospective study of patients with cervical lymphangioma treated with sclerosant injection between January 2008 and December 2016. Preinjection ultrasound scan and initial ultrasound-guided aspiration of the fluid in the swelling (which many times is multiloculated) using a 20G cannula into a 10 ml syringe were performed. The cannula tip is retained in the space and intralesional injection of double-diluted bleomycin 0.5 i.u./kg body weight was given as outpatient at 2–4-weekly interval. Postinjection events were documented. The clinical assessment of the pre- and postinjection of sclerosant was performed. Result: A total of 23 patients were recruited, and six were females and 17 were males. All swellings were noticed at birth but median time at presentation was 17 days. All patients but one (95.8%) had complete clinical resolution after 1–4 courses of sclerotherapy for 4–16 weeks. Only one patient had residual nodule that required surgical excision. Redundant skin and hyperpigmentation from skin wrinkle were the early effects noticed in three patients; however, these were cosmetically acceptable to the parents. No recurrence was recorded. Conclusion: The treatment of cervical lymphangiomas with intralesional bleomycin injection is shown to be effective. It is safe and associated with no complication. This treatment modality and outcome was found to be acceptable to the parents of these children.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"9 1","pages":"93 - 97"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91544598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Nasir, Jessy Thomas Medugu, H. Shuwa, Fatima Yahaya
{"title":"Chikungunya virus-associated arthralgia could have been misdiagnosed by healthcare providers in Nigeria","authors":"I. Nasir, Jessy Thomas Medugu, H. Shuwa, Fatima Yahaya","doi":"10.4103/JOMT.JOMT_3_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_3_17","url":null,"abstract":"","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"24 1 1","pages":"139 - 140"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79302452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Oyefabi, E. Adetiba, Emmanuel Leeshak, Olufemi Adesigbin
Introduction: Tuberculosis (TB) kills, worldwide, about 1.5 million people infected by the disease per year according to the 2015 World Health Organization (WHO) Global TB report. In sub-Saharan Africa, Nigeria accounts for the highest absolute number of TB morbidity and the 4th among the six high-TB burden countries, which account for about 60% of all TB cases globally. Materials and Methods: This study is a retrospective, descriptive cross-sectional review of the facility TB registers of 4054 patients who accessed TB healthcare services at the 25 directly observed treatment short course (DOTS) Primary Health Care facilities in Zaria, Northwestern Nigeria, between January 1, 2007 and December 31, 2015. Results: Majority of the patients were males (2601; 64.2%), belonging to the age group <40 years (2837; 70%) The patients presented mainly with pulmonary TB (3591; 88.6%). Only half the number of patients (50.3%) had smear-positive results before the commencement of short-course chemotherapy with either 2RHZE/6EH or 2SRHZE/IRHZE/5RHE (1, 2 = 1 or 2 months intensive phase, 5 = 5 months continuation phase, R = rifampicin, H = isoniazid, Z= pyrazinamide, E = ethambutol, S = streptomycin). Human immunodeficiency virus (HIV) coinfection was reported in 774 (19.1%) patients. The treatment success rate was 80.2% (3253 patients); 278 (6.9%) of the patients were lost to follow-up, 176 (4.3%) were transferred out, and 235 (5.8%) died. The determinants of the unsuccessful treatment outcome were being a male, aged >40 years, TB and HIV coinfection, a greater degree of sputum smear positivity before treatment, located at far distances from DOTS centers, and being on retreatment or second-line regimen. Conclusion: The treatment success rate falls below the recommended 85% by the WHO. Recommendations: There is a need for the Nigeria government in collaboration with international agencies to intensify effort at TB surveillance, monitoring, and control activities in Nigeria. Effort should be directed at promoting TB/HIV awareness, the early recognition and diagnosis of TB, and strategies to expand and improve DOTS service at community level.
{"title":"Tuberculosis and the determinants of treatment outcome in Zaria, North Western Nigeria – A nine-year (2007–2015) epidemiological review","authors":"A. Oyefabi, E. Adetiba, Emmanuel Leeshak, Olufemi Adesigbin","doi":"10.4103/JOMT.JOMT_25_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_25_17","url":null,"abstract":"Introduction: Tuberculosis (TB) kills, worldwide, about 1.5 million people infected by the disease per year according to the 2015 World Health Organization (WHO) Global TB report. In sub-Saharan Africa, Nigeria accounts for the highest absolute number of TB morbidity and the 4th among the six high-TB burden countries, which account for about 60% of all TB cases globally. Materials and Methods: This study is a retrospective, descriptive cross-sectional review of the facility TB registers of 4054 patients who accessed TB healthcare services at the 25 directly observed treatment short course (DOTS) Primary Health Care facilities in Zaria, Northwestern Nigeria, between January 1, 2007 and December 31, 2015. Results: Majority of the patients were males (2601; 64.2%), belonging to the age group <40 years (2837; 70%) The patients presented mainly with pulmonary TB (3591; 88.6%). Only half the number of patients (50.3%) had smear-positive results before the commencement of short-course chemotherapy with either 2RHZE/6EH or 2SRHZE/IRHZE/5RHE (1, 2 = 1 or 2 months intensive phase, 5 = 5 months continuation phase, R = rifampicin, H = isoniazid, Z= pyrazinamide, E = ethambutol, S = streptomycin). Human immunodeficiency virus (HIV) coinfection was reported in 774 (19.1%) patients. The treatment success rate was 80.2% (3253 patients); 278 (6.9%) of the patients were lost to follow-up, 176 (4.3%) were transferred out, and 235 (5.8%) died. The determinants of the unsuccessful treatment outcome were being a male, aged >40 years, TB and HIV coinfection, a greater degree of sputum smear positivity before treatment, located at far distances from DOTS centers, and being on retreatment or second-line regimen. Conclusion: The treatment success rate falls below the recommended 85% by the WHO. Recommendations: There is a need for the Nigeria government in collaboration with international agencies to intensify effort at TB surveillance, monitoring, and control activities in Nigeria. Effort should be directed at promoting TB/HIV awareness, the early recognition and diagnosis of TB, and strategies to expand and improve DOTS service at community level.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"13 1","pages":"116 - 122"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83450045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: There was a dramatic decline of adolescents’ menarcheal age worldwide; Africa is witnessing a secular trend of this reducing menarcheal age among its black adolescents. A transition of overweight/obesity among adolescent is believed to be associated with reduced menarcheal age. Materials and Methods: It was a descriptive cross-sectional study that was conducted among female adolescent girls from January to December, 2016. Ethical approval was obtained from the management concerned. All consenting adolescents were recruited for the survey. Information was recorded on a structured, pretested questionnaire. Their respective weight and height were also measured. Body mass index (BMI) was calculated using the formula: BMI = weight (kg)/height (m2). The data obtained were analyzed using the Statistical Package for the Social Sciences version 18.0 (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Fishers’ exact test was used, and the P ≤ 0.05 was considered statistically significant. Results: Two hundred and nineteen female adolescents participated in the survey. The mean age ± SD at menarche was 12.83 ± 1.312 years. The median and modal ages were both 13 years. There was no statistically significant association between the mean age at menarche and the ethnic groups (P(Fishers’) = 0.150). However, mean age at menarche was statistically associated with their BMI (P(Fishers’) = 0.00). Obesity was associated with reduced menarcheal age. Conclusion: The median and mean ages at menarche were 13.0 and 12.8 years respectively, which were in accordance with secular trend of reduced menarcheal age among black adolescents. Our study also showed an inverse association between the age at menarche and overweight or obesity among adolescents.
背景:世界范围内青少年月经初潮年龄急剧下降;非洲正在目睹黑人青少年月经初潮年龄下降的长期趋势。青少年超重/肥胖的转变被认为与月经初潮年龄的降低有关。材料与方法:采用描述性横断面研究，于2016年1月- 12月对青春期女性进行调查。已获得有关管理层的伦理批准。所有同意的青少年都被招募参加调查。信息被记录在一个结构化的，预先测试的问卷上。他们各自的体重和身高也被测量。体重指数(BMI)的计算公式为:BMI =体重(kg)/身高(m2)。获得的数据使用Statistical Package for The Social Sciences version 18.0 (SPSS Inc.， SPSS Statistics for Windows, Chicago, IL, USA)进行分析。采用fisher精确检验，P≤0.05认为差异有统计学意义。结果:共有219名女性青少年参与调查。初潮平均年龄±SD为12.83±1.312岁。中位年龄和模态年龄均为13岁。月经初潮平均年龄与民族间无统计学意义(P(fisher’s) = 0.150)。然而，月经初潮的平均年龄与BMI有统计学相关性(P(fisher’s) = 0.00)。肥胖与月经初潮年龄降低有关。结论:黑人青少年月经初潮中位年龄为13.0岁，月经初潮平均年龄为12.8岁，符合黑人青少年月经初潮年龄降低的长期趋势。我们的研究还显示初潮年龄与青少年超重或肥胖呈负相关。
{"title":"Age at menarche and its association with overweight/obesity among adolescents in Kano","authors":"I. Garba, A. Rabiu, I. Abubakar","doi":"10.4103/JOMT.JOMT_5_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_5_17","url":null,"abstract":"Background: There was a dramatic decline of adolescents’ menarcheal age worldwide; Africa is witnessing a secular trend of this reducing menarcheal age among its black adolescents. A transition of overweight/obesity among adolescent is believed to be associated with reduced menarcheal age. Materials and Methods: It was a descriptive cross-sectional study that was conducted among female adolescent girls from January to December, 2016. Ethical approval was obtained from the management concerned. All consenting adolescents were recruited for the survey. Information was recorded on a structured, pretested questionnaire. Their respective weight and height were also measured. Body mass index (BMI) was calculated using the formula: BMI = weight (kg)/height (m2). The data obtained were analyzed using the Statistical Package for the Social Sciences version 18.0 (SPSS Inc., SPSS Statistics for Windows, Chicago, IL, USA). Fishers’ exact test was used, and the P ≤ 0.05 was considered statistically significant. Results: Two hundred and nineteen female adolescents participated in the survey. The mean age ± SD at menarche was 12.83 ± 1.312 years. The median and modal ages were both 13 years. There was no statistically significant association between the mean age at menarche and the ethnic groups (P(Fishers’) = 0.150). However, mean age at menarche was statistically associated with their BMI (P(Fishers’) = 0.00). Obesity was associated with reduced menarcheal age. Conclusion: The median and mean ages at menarche were 13.0 and 12.8 years respectively, which were in accordance with secular trend of reduced menarcheal age among black adolescents. Our study also showed an inverse association between the age at menarche and overweight or obesity among adolescents.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"35 1","pages":"90 - 92"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73562483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-01Epub Date: 2017-11-15DOI: 10.4103/jomt.jomt_17_17
Maxwell O Akanbi, Patricia A Agaba, Obianuju B Ozoh, Amaka N Ocheke, Zumnan M Gimba, Christiana O Ukoli, Emmanuel I Agaba
Background: The contribution of obesity to obstructive sleep apnea (OSA) is poorly described in Nigeria. We aimed to compare OSA risk between obese and nonobese adults in urban Nigeria.
Materials and methods: An analytic cross-sectional study was conducted. Participants were interviewed using the World Health Organization Non-Communicable Disease questionnaire. OSA risk assessment was performed using the STOP-BANG questionnaire. A total score of ≥3 on the STOP-BANG questionnaire indicated OSA risk, whereas a score ≥5 indicated high OSA risk. Obesity was defined as body mass index (BMI) >30 kg/m2. Relationship between obesity and OSA was tested using chi-square and logistic regression models used to control for confounding factors.
Results: There were 744 respondents, with a mean age of 44 (standard deviation 10) years. A total of 206 [27.7%, 95% confidence interval (CI) 24.46-30.9] respondents were obese (BMI ≥30 kg/m2). A total of 307 (41.3%, 95% CI 37.7-44.9) respondents scored ≥3 on the STOP-BANG questionnaire, whereas 37 (4.9%, 95% CI 3.6-6.7) scored ≥5. More number of obese than nonobese [57.8% (119/206) versus 34.9% (188/538)] respondents met the criteria for OSA risk (P < 0.001). Similarly, more obese persons [10.3% (21/206)] met the criteria for high-risk OSA compared to the nonobese [3% (16/538)]; P < 0.001. In logistic regression models adjusted for cigarette smoking and alcohol consumption, the odds for OSA risk was 15.76 (95% CI 7.44-33.9) in persons with BMI >35 kg/m2 compared to those with a BMI range of 18.5-24.99.
Conclusion: Obesity and OSA may be more prevalent in Nigeria than previously predicted. Obesity independently increased OSA risk in this population.
背景:肥胖对阻塞性睡眠呼吸暂停(OSA)的影响在尼日利亚很少被描述。我们的目的是比较尼日利亚城市肥胖和非肥胖成年人之间的OSA风险。材料与方法:采用横断面分析研究。与会者接受了世界卫生组织非传染性疾病调查表的采访。采用STOP-BANG问卷进行OSA风险评估。STOP-BANG问卷总分≥3分表明存在OSA风险，总分≥5分表明存在OSA高风险。肥胖定义为身体质量指数(BMI) >30 kg/m2。使用卡方和逻辑回归模型检验肥胖与OSA的关系，以控制混杂因素。结果:调查对象744人，平均年龄44岁(标准差10)。共有206人(27.7%，95%可信区间(CI) 24.46 ~ 30.9)为肥胖(BMI≥30 kg/m2)。共有307人(41.3%，95% CI 37.7-44.9)在STOP-BANG问卷上得分≥3分，而37人(4.9%，95% CI 3.6-6.7)得分≥5分。肥胖者多于非肥胖者[57.8%(119/206)比34.9%(188/538)]符合OSA危险标准(P < 0.001)。同样，与非肥胖者相比，更多的肥胖者[10.3%(21/206)]符合高危OSA标准[3% (16/538)];P < 0.001。在调整吸烟和饮酒的logistic回归模型中，BMI >35 kg/m2的人与BMI在18.5-24.99之间的人相比，OSA风险的几率为15.76 (95% CI 7.44-33.9)。结论:肥胖和阻塞性睡眠呼吸暂停在尼日利亚可能比先前预测的更为普遍。肥胖单独增加了这一人群的OSA风险。
{"title":"Obesity and obstructive sleep apnea risk among Nigerians.","authors":"Maxwell O Akanbi, Patricia A Agaba, Obianuju B Ozoh, Amaka N Ocheke, Zumnan M Gimba, Christiana O Ukoli, Emmanuel I Agaba","doi":"10.4103/jomt.jomt_17_17","DOIUrl":"https://doi.org/10.4103/jomt.jomt_17_17","url":null,"abstract":"<p><strong>Background: </strong>The contribution of obesity to obstructive sleep apnea (OSA) is poorly described in Nigeria. We aimed to compare OSA risk between obese and nonobese adults in urban Nigeria.</p><p><strong>Materials and methods: </strong>An analytic cross-sectional study was conducted. Participants were interviewed using the World Health Organization Non-Communicable Disease questionnaire. OSA risk assessment was performed using the STOP-BANG questionnaire. A total score of ≥3 on the STOP-BANG questionnaire indicated OSA risk, whereas a score ≥5 indicated high OSA risk. Obesity was defined as body mass index (BMI) >30 kg/m<sup>2</sup>. Relationship between obesity and OSA was tested using chi-square and logistic regression models used to control for confounding factors.</p><p><strong>Results: </strong>There were 744 respondents, with a mean age of 44 (standard deviation 10) years. A total of 206 [27.7%, 95% confidence interval (CI) 24.46-30.9] respondents were obese (BMI ≥30 kg/m<sup>2</sup>). A total of 307 (41.3%, 95% CI 37.7-44.9) respondents scored ≥3 on the STOP-BANG questionnaire, whereas 37 (4.9%, 95% CI 3.6-6.7) scored ≥5. More number of obese than nonobese [57.8% (119/206) versus 34.9% (188/538)] respondents met the criteria for OSA risk (<i>P</i> < 0.001). Similarly, more obese persons [10.3% (21/206)] met the criteria for high-risk OSA compared to the nonobese [3% (16/538)]; <i>P</i> < 0.001. In logistic regression models adjusted for cigarette smoking and alcohol consumption, the odds for OSA risk was 15.76 (95% CI 7.44-33.9) in persons with BMI >35 kg/m<sup>2</sup> compared to those with a BMI range of 18.5-24.99.</p><p><strong>Conclusion: </strong>Obesity and OSA may be more prevalent in Nigeria than previously predicted. Obesity independently increased OSA risk in this population.</p>","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"19 2","pages":"110-115"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/67/nihms920625.PMC5701752.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35643714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Raju, Gowtham Juvva, R. Prakash, V. Pandit, D. Anandhi
Pyopericardium is an uncommon presentation of tuberculosis (TB) and has been reported in 6.98% of the cases of pyopericardium. Pyopericardium has been documented in <3% of the cases of large TB pericardial effusions, even in the high-prevalence areas of TB and human immunodeficiency virus infection. Pulmonary TB affects the pericardium in 1–2% of the cases, and pericardial TB is responsible for 7% of the cases of cardiac tamponade. Pericardial TB is usually an insidious illness and may present as acute pericarditis, chronic pericardial effusion, cardiac tamponade, or pericardial constriction; however, purulent pericarditis is rare. To the best of our knowledge, there are no previous case reports from India on acute pyopericardium with tamponade. Purulent pericarditis or pyopericardium is a rare entity and is associated with very high mortality. A 50-year-old woman was brought to the Emergency Department with respiratory distress and shock. Screening echocardiography suggested pericardial effusion with cardiac tamponade. The pericardial aspirate was frankly purulent, but she sustained a cardiac arrest, and resuscitative attempts were futile. The case is highlighted because of its rarity and fatal outcome, especially with late diagnosis and management. The following core competencies are addressed in this article: medical knowledge and patient care.
{"title":"Pyopericardium − A fatal presentation: A case report","authors":"K. Raju, Gowtham Juvva, R. Prakash, V. Pandit, D. Anandhi","doi":"10.4103/JOMT.JOMT_4_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_4_17","url":null,"abstract":"Pyopericardium is an uncommon presentation of tuberculosis (TB) and has been reported in 6.98% of the cases of pyopericardium. Pyopericardium has been documented in <3% of the cases of large TB pericardial effusions, even in the high-prevalence areas of TB and human immunodeficiency virus infection. Pulmonary TB affects the pericardium in 1–2% of the cases, and pericardial TB is responsible for 7% of the cases of cardiac tamponade. Pericardial TB is usually an insidious illness and may present as acute pericarditis, chronic pericardial effusion, cardiac tamponade, or pericardial constriction; however, purulent pericarditis is rare. To the best of our knowledge, there are no previous case reports from India on acute pyopericardium with tamponade. Purulent pericarditis or pyopericardium is a rare entity and is associated with very high mortality. A 50-year-old woman was brought to the Emergency Department with respiratory distress and shock. Screening echocardiography suggested pericardial effusion with cardiac tamponade. The pericardial aspirate was frankly purulent, but she sustained a cardiac arrest, and resuscitative attempts were futile. The case is highlighted because of its rarity and fatal outcome, especially with late diagnosis and management. The following core competencies are addressed in this article: medical knowledge and patient care.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"93 1","pages":"129 - 132"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91376553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Koushik Bhattacharjee, S. Divyaveer, A. Banerjee, V. Tiwari, T. Bhattacharya, A. Raychaudhury, R. Pandey
Accidental exposure to chemicals and toxins is an important cause of acute kidney injury in the tropics. We report a case of a 26-year-old female who presented with acute kidney injury following a history of accidental ingestion of some white powder mistaken for table salt. Urine microscopy revealed the presence of calcium oxalate crystals. Because accidental poisoning was suspected despite normal 24-h oxalate excretion, renal biopsy was performed, which showed acute tubular injury with occasional refractile oxalate crystals. The patient improved symptomatically with conservative management and did not require haemodialysis. Subsequently, renal functioning showed an improving trend. Oxalic acid poisoning is relatively rare but is an emerging sporadic as well as epidemic poison in some regions.
{"title":"An unusual case of acute kidney injury caused by oxalic acid mistaken for common salt","authors":"Koushik Bhattacharjee, S. Divyaveer, A. Banerjee, V. Tiwari, T. Bhattacharya, A. Raychaudhury, R. Pandey","doi":"10.4103/JOMT.JOMT_10_17","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_10_17","url":null,"abstract":"Accidental exposure to chemicals and toxins is an important cause of acute kidney injury in the tropics. We report a case of a 26-year-old female who presented with acute kidney injury following a history of accidental ingestion of some white powder mistaken for table salt. Urine microscopy revealed the presence of calcium oxalate crystals. Because accidental poisoning was suspected despite normal 24-h oxalate excretion, renal biopsy was performed, which showed acute tubular injury with occasional refractile oxalate crystals. The patient improved symptomatically with conservative management and did not require haemodialysis. Subsequently, renal functioning showed an improving trend. Oxalic acid poisoning is relatively rare but is an emerging sporadic as well as epidemic poison in some regions.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"26 1","pages":"133 - 135"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87318479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To ascertain the relationship between B-mode ocular ultrasound findings and standard autorefraction results of participants with refractive errors, with the aim of using B-mode ultrasound as a complementary technique to determine the refractive state of the eye. Materials and Methods: The study population consisted of 255 adult patients with refractive errors, aged 18–40 years. The ocular dimensions were measured using MINDRAY DC-7.0 real-time ultrasound machine with frequency probe of 5 and 7–12 MHz. The ocular shapes and other biometric measurements were then correlated with the results of the standard autorefraction. Results: The sensitivity for prolate ocular shape corresponding with myopia/astigmatism was 88.6%, whereas that of oblate ocular shape corresponding with hyperopia/astigmatism was 87.4%. The Pearson’s correlation coefficient between right axial length and right spherical equivalent was negatively strong at −0.79 (P < 0.001). In addition, the Pearson’s correlation coefficient was negatively strong at −0.76 (P < 0.001) between left axial length and left spherical equivalent. Conclusion: Real-time B-mode ocular ultrasound has a high sensitivity in determining ocular shape, which corresponded well with the refractive state of the participants’ eyes. Axial length (AL) was found to correlate strongly with spherical equivalent, and, thus, a regression equation can be used to predict the spherical equivalent from the AL measurements.
{"title":"B-mode ocular ultrasound findings in adults with refractive errors at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria","authors":"Ibukun Abidoye, C. Asaleye, B. Adegbehingbe","doi":"10.4103/JOMT.JOMT_54_16","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_54_16","url":null,"abstract":"Objective: To ascertain the relationship between B-mode ocular ultrasound findings and standard autorefraction results of participants with refractive errors, with the aim of using B-mode ultrasound as a complementary technique to determine the refractive state of the eye. Materials and Methods: The study population consisted of 255 adult patients with refractive errors, aged 18–40 years. The ocular dimensions were measured using MINDRAY DC-7.0 real-time ultrasound machine with frequency probe of 5 and 7–12 MHz. The ocular shapes and other biometric measurements were then correlated with the results of the standard autorefraction. Results: The sensitivity for prolate ocular shape corresponding with myopia/astigmatism was 88.6%, whereas that of oblate ocular shape corresponding with hyperopia/astigmatism was 87.4%. The Pearson’s correlation coefficient between right axial length and right spherical equivalent was negatively strong at −0.79 (P < 0.001). In addition, the Pearson’s correlation coefficient was negatively strong at −0.76 (P < 0.001) between left axial length and left spherical equivalent. Conclusion: Real-time B-mode ocular ultrasound has a high sensitivity in determining ocular shape, which corresponded well with the refractive state of the participants’ eyes. Axial length (AL) was found to correlate strongly with spherical equivalent, and, thus, a regression equation can be used to predict the spherical equivalent from the AL measurements.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"1 1","pages":"123 - 128"},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90024652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Ibraheem, C. Ofoegbu, B. Solagberu, L. Abdur-rahman, A. Adekanye, A. Nasir
Background: Injuries pose a significant economic problem to communities in every society. Studies aimed at estimating the costs of management of injuries are very limited in this environment. Materials and Methods: The patients who presented to the emergency unit of the University Teaching Hospital, Ilorin, Nigeria, with traumatic injuries were recruited. The expenses were classified into various groups. Results: Of the 165 patients recruited, majority were young adult men. The mean direct cost per injury was N4061 ($27.1) with the cost of drugs accounting for the largest share of the costs. The costs incurred were higher with the increasing severity of injury. Conclusion: The direct costs of management of injuries from this study represent a significant economic drain to the low-income population of this environment. Extrapolating these cost estimates of medical treatment to the fatal as well as the even larger non-fatal injury burden in Nigeria exposes the immense financial drain to the individual and community.
{"title":"Costs of management of injuries in emergency room patients in Ilorin","authors":"G. Ibraheem, C. Ofoegbu, B. Solagberu, L. Abdur-rahman, A. Adekanye, A. Nasir","doi":"10.4103/JOMT.JOMT_26_16","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_26_16","url":null,"abstract":"Background: Injuries pose a significant economic problem to communities in every society. Studies aimed at estimating the costs of management of injuries are very limited in this environment. Materials and Methods: The patients who presented to the emergency unit of the University Teaching Hospital, Ilorin, Nigeria, with traumatic injuries were recruited. The expenses were classified into various groups. Results: Of the 165 patients recruited, majority were young adult men. The mean direct cost per injury was N4061 ($27.1) with the cost of drugs accounting for the largest share of the costs. The costs incurred were higher with the increasing severity of injury. Conclusion: The direct costs of management of injuries from this study represent a significant economic drain to the low-income population of this environment. Extrapolating these cost estimates of medical treatment to the fatal as well as the even larger non-fatal injury burden in Nigeria exposes the immense financial drain to the individual and community.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"86 1","pages":"21 - 25"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78218273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Shwe, S. Pitmang, J. Abba, Mark Akindigh, D. Egah, S. Oguche
Background: The deployed artemether–lumefantrine (AL) and artesunate–amodiaquine (AA) medicines are known to be gametocytocidal. Continuous monitoring of their efficacies is imperative for malaria elimination interventions. To compare gametocytocidal clearance by AL versus AA. Materials and Methods: Data on demographics, anthropometry measures and gametocytes densities of 111 of 114 Human Immunodeficiency Virus (HIV) sero-negative children aged 6–59 months with uncomplicated Plasmodium falciparum malaria mono-infection, who participated in a drug therapeutic efficacy testing, were extracted. Patients who had severe malnutrition, other causes of common childhood fevers and use of antimalarial medicines in the preceding 1 week were excluded from the study. Study participants who met the enrolment criteria and gave written informed parental consent were randomized to receive AL or AA according to the manufacturer’s instructions. Clinical and parasitological evaluations were performed on D0, D1, D2, D3, D7, D14, D21 and D28. Analysis was restricted to 111 participants who completed the study. Results: Twelve (10.8%) patients had gametocytes on D0. Six (5.4%) study participants were in the AL treatment arm and 6 (5.4%) participants were in the AA treatment arm (P = 0.32). Gametocyte clearance time (GCT)AL was 104 h and (GCT)AA was 152 h (P = 0.44). Conclusion: AL and AA demonstrated comparable gametocytocidal activity in North-Central Nigeria. There is a need for continuous monitoring of the efficacies of these artemisinin-based combination therapies to keep track with the emergence of resistant Plasmodium gametocyte isolates in Nigeria.
背景:已知已部署的蒿甲醚-甲苯芳碱(AL)和青蒿琥酯-阿莫地喹(AA)药物具有杀配子体作用。持续监测其效力对于消除疟疾的干预措施至关重要。比较AL与AA的杀配子体清除能力。材料与方法:提取114例6-59月龄单纯恶性疟原虫感染的人类免疫缺陷病毒(HIV)血清阴性儿童中111例参加药物疗效试验的人口统计学、人体测量和配子体密度数据。患有严重营养不良、其他原因的常见儿童发烧和在前一周使用抗疟疾药物的患者被排除在研究之外。符合入组标准并给予书面知情父母同意的研究参与者根据制造商的说明随机接受AL或AA。对D0、D1、D2、D3、D7、D14、D21和D28进行临床和寄生虫学评价。分析仅限于111名完成研究的参与者。结果:12例(10.8%)患者在D0时出现配子体。AL治疗组6名(5.4%)，AA治疗组6名(5.4%)(P = 0.32)。配子细胞清除时间(GCT)AL为104 h, AA为152 h (P = 0.44)。结论:AL和AA在尼日利亚中北部具有相当的杀配子体活性。有必要持续监测这些以青蒿素为基础的联合疗法的疗效，以便跟踪尼日利亚出现的耐药疟原虫配子细胞分离株。
{"title":"Gametocytocidal clearance by artemether–lumefantrine versus artesunate–amodiaquine in North-Central Nigeria","authors":"D. Shwe, S. Pitmang, J. Abba, Mark Akindigh, D. Egah, S. Oguche","doi":"10.4103/JOMT.JOMT_48_16","DOIUrl":"https://doi.org/10.4103/JOMT.JOMT_48_16","url":null,"abstract":"Background: The deployed artemether–lumefantrine (AL) and artesunate–amodiaquine (AA) medicines are known to be gametocytocidal. Continuous monitoring of their efficacies is imperative for malaria elimination interventions. To compare gametocytocidal clearance by AL versus AA. Materials and Methods: Data on demographics, anthropometry measures and gametocytes densities of 111 of 114 Human Immunodeficiency Virus (HIV) sero-negative children aged 6–59 months with uncomplicated Plasmodium falciparum malaria mono-infection, who participated in a drug therapeutic efficacy testing, were extracted. Patients who had severe malnutrition, other causes of common childhood fevers and use of antimalarial medicines in the preceding 1 week were excluded from the study. Study participants who met the enrolment criteria and gave written informed parental consent were randomized to receive AL or AA according to the manufacturer’s instructions. Clinical and parasitological evaluations were performed on D0, D1, D2, D3, D7, D14, D21 and D28. Analysis was restricted to 111 participants who completed the study. Results: Twelve (10.8%) patients had gametocytes on D0. Six (5.4%) study participants were in the AL treatment arm and 6 (5.4%) participants were in the AA treatment arm (P = 0.32). Gametocyte clearance time (GCT)AL was 104 h and (GCT)AA was 152 h (P = 0.44). Conclusion: AL and AA demonstrated comparable gametocytocidal activity in North-Central Nigeria. There is a need for continuous monitoring of the efficacies of these artemisinin-based combination therapies to keep track with the emergence of resistant Plasmodium gametocyte isolates in Nigeria.","PeriodicalId":16477,"journal":{"name":"Journal of Medicine in the Tropics","volume":"308 1","pages":"60 - 64"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78269737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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