African journal of medicine and medical sciences
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The objective of this manuscript is to review the clinical manifestations, diagnosis and management of diabetic ketoacidosis, one of the most common acute complications of diabetes mellitus. We performed a medline search of the English-language literature using a combination of words (diabetic ketoacidosis, hyperglycemic crises) to identify original studies, consensus statements and reviews on diabetic ketoacidosis published in the past 15 years. Emphasis was placed on clinical manifestations of diabetic ketoacidosis, its diagnosis and treatment. ⋯ Many cases of DKA can be prevented by better access to medical care, proper education, and effective communication with a health care provider during intercurrent illness. Provision of guidelines will also reduce mortality. Resources need to be redirected towards prevention by funding better access to care and educational programs.
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Comparative Study
Childhood bacterial meningitis in Ibadan, Nigeria--antibiotic sensitivity pattern of pathogens, prognostic indices and outcome.
Bacterial meningitis remains a major cause of morbidity, mortality and neurodisability in childhood, particularly in the developing world where effective vaccines against the usual pathogens responsible for the disease are not in routine use. To describe the patterns and outcome of bacterial meningitis among children admitted into the University College Hospital (UCH), Ibadan, Nigeria. All children who satisfied the case definition for meningitis, admitted into the paediatric wards of the University College Hospital, UCH, Ibadan over a period of 30 months were prospectively enrolled and blood and CSF samples were taken for bacteriological analyses. ⋯ Bacterial meningitis remains a major cause of childhood mortality and neurodisability. Hib and pneumococcus remain the major pathogens responsible for this dreadful disease in Ibadan, Nigeria. The increasing emergence of antibiotic resistance calls for institution of adequate control measures, particularly routine childhood immunisation against the disease.
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Case Reports
Could Parkinsonism complicate craniotomy and excision of convexity meningioma? A case report.
Parkinsonism is a neurodegenerative clinical disorder characterized by varying combinations and degrees of rest tremor, rigidity, slowing of voluntary movements and postural instability. Amongst the aetiologic factors, massive post-craniotormy haematoma has not been previously considered. This report is to arouse the suspicion that vascular displacement in the midbrain resulting from a massive unilateral intracranial haematoma could lead to the unusual complication of Parkinsonism. ⋯ The patient was placed on medical treatment resulting in a slow but progressive neurological improvement. Reports of Parkinsonism following post-tumour excision are probably, very rare. We, hereby, report a case of Parkinsonism complicating a gross total excision of a convexity meningioma.
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Fine needle aspiration cytology (FNAC) of the breast has been used as an initial investigative procedure of palpable breast lesions. The purpose of this study is to evaluate our experience with Fine Needle Aspiration Cytology (FNAC) and to correlate between histopathologic and FNAC diagnoses of palpable breast lesions. A 5-year retrospective study was performed using records of all patients who had had both FNAC and histopathologic results of breast lumps. ⋯ The false negative and false positive rates were 2.9% and 1.9% respectively. FNAC of breast lesions is sensitive, specific, and highly accurate as the initial investigation of palpable breast lesions in our tertiary hospital. We therefore implore clinicians to embrace this procedure in the management of patients.
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Breast cancer, the commonest malignancy in women, is now the most common cancer in Nigeria, but little is known about the quality of life (QOL) of Nigerian women breast cancer survivors and the predictive factors that may influence their QOL. Health-related QOL (HRQOL) was evaluated in 35 Nigerian women receiving radiotherapy for breast cancer at the University College Hospital, Ibadan by using the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ - C30 version 3). Linear regression procedures were used to evaluate the association of HRQOL outcomes with medical and socio-demographic factors. ⋯ The overall QOL was significantly related to PF, CF and SF. It was also significantly and inversely related to the scores of fatigue, nausea and vomitng, pain, insomnia and financial difficulty. The findings of this study provide important information on QOL and their correlates among Nigerian women undergoing radiotherapy for breast cancer and are helpful in developing treatment strategies accordingly.