African journal of medicine and medical sciences
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Sensorineural hearing loss (SNHL) is one of the known complications of sickle cell disease (SCD). However, there is paucity of information on SNHL as a complication of SCD, especially in sickle cell anaemia (SCA) in our environment, hence this study. This was a prospective study of pure tone audiological assessment of 167 adult SCA patients in stable condition attending the adult Sickle Cell Clinic and 100 apparently healthy Haemoglobin AA adults as control in the University College Hospital, Ibadan. ⋯ There was no significant correlation between the severity of hearing loss and the frequency of vaso-occlusive crisis. It is hoped that this study would have increased the awareness that SNHL is a common complication of SCA in our patients. There is thus the need for periodic evaluation of the auditory function of SCA patients in our environment.
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Case Reports
Acute isovolaemic haemodilution in two Jehovah's Witnesses presenting for major intracranial surgery.
The Jehovah's Witnesses (JWS) is a religious sect with strong convictions against acceptance of blood and its products for medical care, including surgery. We present two cases of JWS, aged 24 and 19 years old, who had craniectomy for trauma and craniotomy for tumour excision, respectively. A team approach was employed in the care of both patients. ⋯ Postoperative PCV were 42% and 25%. The latter improved to 30% over the following two weeks with oral haematinics. The two cases are discussed in the light of the experience gained.
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Children and young adults who suffer from sickle cell disease (SCD) are at risk of blindness from retinopathy and other complications. The incidence of proliferative retinopathy in SCD patients varies from 5 to 10% depending on the genotype, being commoner in SC than SS and S-thal. 'Sudden' blinding sequelae such as vitreous haemmorrhage and tractional retinal detachment can eventuate from vasculo-proliferative retinal lesions, known as sea fans, in otherwise 'quiet' eyes. This risk can be minimised considerably if the lesions are detected in a timely fashion and treated, usually with laser photocoagulation and possibly with cryotherapy. ⋯ Children with SCD should, from about the age of ten, be referred for at least biennial dilated binocular indirect ophthalmoscopy preferably with fluorescein angiography if such facilities are available, so that neovascular lesions can be treated before blinding sequelae occur. From the age of 20, the frequency of eye examination should increase to yearly. Antisickling remedies, such as NIPRISAN may be beneficial in prophylaxis.
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The purpose of this retrospective study is to show the pattern of penetrating chest injury, methods of management and the outcome. Were viewed all consecutive penetrating chest injured patients admitted to the Cardiothoracic Surgical Unit of the University College Hospital, Ibadan between May 1975 and April 1999. We found that 597 patients had penetrating chest injuries. ⋯ It is commoner in men and currently involves the older age group and it is most frequently inflicted by gunshot. Majority may be managed conservatively with low incidence of complications. Prompt major surgery limits mortality among the salvageable.
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Four families of venomous snakes are found in Nigeria--Viperidae, Elapidae, Colubridae and Actraspididae but three species carpet viper (Echis ocellatus), black-necked spitting cobra (Naja nigricollis) and puff adder (Bitis arietans), belonging to the first two families, are the most important snakes associated with envenoming in Nigeria. The incidence of bites has been reported as 497 per 100,000 population per year with a 12 percent natural mortality, with Echis ocellatus accounting for at least 66 percent in certain foci. Bites occur more often while victims were farming, herding or walking although the spitting cobra may bite victims who roll upon it in their sleep. ⋯ Antivenom should be used cautiously when indicated. As only 8.5 percent of snake bite victims attend hospitals in Nigeria, health education should be the main preventive measure, mean-while, the study of immunisation of occupationally predisposed individuals in endemic areas should be intensified. A new Fab fragment antivenom specific to Nigerian Echis ocellatus was investigated clinically, just as the local herbs-Aristolochia spp, Guiera spp and Schummaniophyton spp are investigated experimentally.