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Cervicothoracic arachnoid cyst in a patient with neurofibromatosis: Case report
No full textIntradural cervicothoracic arachnoid cysts are not common. They may be congenital, or secondary to trauma, surgery, haemorrhage, or inflammation. This is a report of a 39-year-old man who presented with cutaneous neurofibromatosis and cervicothoracic arachnoid cyst causing gradualquadriparesis. Magnetic resonance imaging showed an intradural extramedullary anterior cystic lesion at C5 – T2 level. Laminectomy and mersupialisation of the cyst was performed. Histology confirmed the diagnosis of arachnoid cyst. The patient recovered without neurological deficit
THE CASE FOR VENOUS THROMBOEMBOLISM PROPHYLAXIS IN AFRICA
No full textWhile venous thromboembolism (VTE) is a well recognised occurrence in clinicalpractice in the developed world, with event rates of at least 2-3 million per year, littleattention is paid to this entity in the developing world where the burden of infectiousdiseases and limited access to care have not recognised VTE as a significant cause ofmorbidity and mortality. The opportunity for Africa to do better as the inevitablerecognition of the consequence of VTE becomes more apparent is available usingbasic tools and therapies
PLAQUE AND GROWTH CHARACTERISTICS OF DIFFERENT POLIOVIRUSES ISOLATED FROM ACUTE FLACCID PARALYSIS IN NORTHERN NIGERIA
No full textObjective: To determine some virulent trait-related properties of poliovirus isolates from children with acute flaccid paralysis following vaccination with oral polio vaccine (OPV).Design: Six polioviruses earlier characterised into wild, vaccine-derived and OPV-like were studied using the plaque morphology and growth kinetics at supra-optimal temperature.Setting: Department of Virology, University of Ibadan, Nigeria.Subjects: Polio isolates from six children who developed acute flaccid paralysis following vaccinations with various doses of OPV were used. All the children were located in the Northern part of the country where poliovirus is still circulating.Main outcome measures: The two vaccine-derived polioviruses acquired wild type characteristics.Results: All the six poliovirus isolates developed different forms of plaques ranging from tiny, small and large. The plaque formed could however not be used to identify the different isolates. Growth of the different isolates at supra-optimal temperature showed that the three wild polioviruses grew to a higher titre when compared with the Sabin 2 control. The two vaccine derived isolates behaved like the wild poliovirus while the OPV-like virus acquired an intermediate characteristics between wild and sabin.Conclusion: The wild polioviruses represented in this study are among the last vestiges of the circulating polioviruses found in the world. It is possible that the observed biological properties of wild types 1 and 3 described in the study are typical of the West African polioviruses. These properties will provide useful previews to the final identification of some important clinical isolates especially type 1 which may grow rapidly in cell culture
PRIMARY DUODENAL CANCER: CASE REPORT
No full textSUMMARYPrimary carcinoma of the duodenum is uncommonly encountered. This is a report of a 64-year-olddiabetic/hypertensive who was admitted in our unit with six months history of upper abdominalpain, vomiting on and off and weight loss of greater than 10 kgs. Endoscopy revealed completeobstruction of the third part of the duodenum. Lesion biopsy revealed moderately differentiatedadenocarcinoma and associated duodenitis. A staging CT scan showed thickening of the duodenalwall over a span of six centimetres, luminal narrowing, mucosal irregularity and multiple paravascularlarge nodes some greater than or equal to two centimetres. Palliative bypass surgery wassuggested as the preferred mode of treatment. He underwent cholecysto-jejunostomy/jejunojejunostomyto palliate biliary and intestinal obstruction
Botswana, Africa's Haven of Ethnic Peace and Harmony: Status and
Get PDFThis paper has the dual objectives to highlight some of the factors that account for the absence of ethnic tensions and conflict in Botswana since independence and to reflect on the future of ethnic relations in the country. It identfles factors such as the nature of ethnic relations during the colonial period, the nature of British indfrect rule, the relatively even development across regions occupied by different ethnic groups, deliberate government efforts to create national as opposed to tribal consciousness and the institutions of chieftaincy as having contributed to harmonious ethnic relations. An examinatn of the current situation, however, points to emerging disintegrative ethnic consciousness. This is evident from three factors: I) The political debates centred on ethnic representation in the House of Chiefs and the fairness of sections 77, 78, and 79 of the Constitution that are sweeping across the country; 2) the appointment of a Presidential Commission to review sections 77, 78 and 79 of the Constitution, and 3) the focus the subject of ethnicity has received in the print ,?ledia. It is concluded that Botswana is no longer safe from the ethnic strjfe, tensions and conflicts that have engulfed most other Africa countries, unless deliberate corrective measures are adopted by the state, drawing from other African countries to ident5.' what works and what does not work
BIRTH PLANS AND HEALTH FACILITY BASED DELIVERY IN RURAL UGANDA
No full textObjectives: To evaluate whether the completion of birth plans is associated with delivery in a health facility and the perceptual causes of birth plan completion and health facility based delivery were explored according to a well-tested health behaviour theory.Design: A community survey.Setting: Rakai and Luwero districts.Subjects: A total of 415 (202 in Rakai and 213 in Luwero district) respondents were randomly selected and interviewed using a mixed survey questionnaire composed of open and close-ended questions.Main outcome measures: Health facility based delivery.Results: The results demonstrate a statistically significant relationship between the completion of birth plans and delivery in a health facility (OR =1.86, 95% CI =1.1, 3.1). The fear of consequences of delivering at home was found to be an important driving force in promoting the completion of birth plans, thereby indirectly influencing the likelihood of delivery in a health facility.Conclusion: Given the empirical evidence presented here, this study suggests that birth plans are an important tool in improving the rate of health facility based deliveries and thus essential in the fightagainst maternal mortality in Uganda. It is further recommended that campaigns market the use of birth plans as a way to reduce uncertainty and manage fear and the unknown about pregnancy
MANAGEMENT PATHWAY FOR CONGENITAL HEART DISEASE AT KENYATTA NATIONAL HOSPITAL, NAIROBI
No full textABSTRACTBackground: Congenital heart disease (CHD) is a significant cause of death amongst infants. Thetiming of treatment in relation to the natural history of the disease correlates with the treatmentoutcome.Objectives: To determine the age at first suspicion of CHD, the age at confirmation of the diagnosisof CHD and the percentage follow-up at the first post diagnosis out patient clinic and to determinethe influence of patient’s sex, parental income and parental education have on the MP.Design: A five year retrospective study.Setting: Kenyatta National Hospital between January 1st 2000 and December 31st 2004.Subjects: Two hundred and fourteen patients were studied.Results: The overall mean age at referral to a paediatric cardiologist was 16.9 ± 24.4 months[n = 102]. The mean age at which CHD was confirmed by echocardiography was 18.6 ± 25.6 months[n = 202]. The mean age at which CHD was first suspected in patients from the province with thehighest parental income was 9.5±5.1 months [n = 6]. The mean age at which CHD was first suspectedin patients from a province with a significantly lower parent income was 19.1 ± 23.2 months[n = 22], (p = 0. 046). The mean age at which CHD was confirmed in referred male patients was16.0 ± 17.6 months [n=48] and the mean age at which CHD was confirmed in referred female patientswas 18.8 ± 21.7 months [n = 52] (p = 0.25).Conclusion: The mean age at referral to a paediatric cardiologist was 16.9 months. This suggests thata significant number of patients may miss the opportunity to have optimal surgical intervention.Parental income appears to influence the MP, however, the level of parental education and patientsex did not
Diet and socio-economic factors and their association with the nutritional status of pre-school children in a low income suburb of Kampala City, Uganda
No full textObjective: To establish dietary and socio-economic factors and their association with the nutritional status of pre-school children in a poor suburb of Kampala city, Uganda.Design: A cross-sectional study.Setting: Three nursery schools in a low income suburb of Kampala city, Uganda.Subjects: A sub-sample of forty one randomly selected pre-school children (three to six years of age) from a larger intervention study, participated in the present investigation.Results: The results reveal high levels of chronic malnutrition (stunting and underweight) among the children. Almost half (46.3%) and one third (29.3%) of the children had height-for-age and weight-for-age centiles, respectively, below the 20th centile. The father’s educational status wassignificantly (p = 0.017) associated with the children’s nutritional status with all the children whose fathers had tertiary education and above having better weight-for-age centiles (above the 50th).Economic status too was significantly (p = 0.026) associated with the nutritional status of the children with children from the upper and mid-upper socio-economic classes having better weight-for-age centiles than children from the lower socio-economic status. Analysis of the diet showed a significant association between the nutrition status of the children and some of the foods consumed.Children who were above the 50th weight-for-age centiles consumed significantly more bread (p = 0.008) and light-green-leafy vegetables (p = 0.020) than those who had lower weight-for-age centiles. Children who were above their 50th height-for-age centiles consumed significantly (p = 0.049) more soybeans than children who had lower height-for-age centiles.Conclusion: Socio-economic as well as dietary factors were found to be inextricably linked and have been shown to be significantly associated with the nutritional status in this group of suburbanpre-school children in Kampala city, Uganda