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Biomedical subjects

A Adeloye

Publications and source records attributed to A Adeloye.

At least 19 recordsLinked to original sources
PubMed2002

Quantitative analysis of gait pattern in hemiparetic patients.

OBJECTIVE: To characterise gait pattern in hemiparetic patients quantitatively using clinical footprint method. DESIGN: A case control study. SUBJECTS: Sixteen hemiparetic patients (12 males and 4 females) aged 16 to 64 years who attended neurological clinic at Queen Elizabeth Central Hospital, Blantyre, Malawi. MAIN OUTCOME MEASURES: Stride length, step width, foot rotation angle measured using footprint method. RESULTS: The difference in mean values of the three variables of gait between affected and unaffected sides in hemiparetic patients was not significant. However, strides were significantly longer in controls than in patients (P<0.001) while patients had significantly broader steps (P<0.02). In the controls, foot was rotated externally in 87.7% of steps and internally in 14.3% of steps. In the hemiparetic patients, intoeing pattern was observed in 41.3% of steps. The difference in variability of stride length and foot angle between affected and non-affected sides of patients was not significant. Stride-to-stride variability in stride length in patients was 1.6 times higher than in controls. Variability of step width and foot progression angle was 1.4 and 1.6 times higher in patients than in controls. CONCLUSION: Footprint method provides fast and inexpensive tool for clinical gait analysis and is suitable for evaluation of hemiparetic patients. Our findings suggest that areas of emphasis for physical therapy of hemiparetic patients should include increasing stride length and decreasing step width and internal rotation of foot, particularly on the affected side.

Adolescent↗
PubMed2001

Management of infantile hydrocephalus in Central Africa.

Hydrocephalus in children in the first year of life in the Central African countries of Malawi, Zambia and Zimbabwe is due mainly to congenital and infective causes. The children first present in hospital around the age of 3 months. The clinical diagnosis is confirmed by cranial ultrasonography. Ventriculo-peritoneal CSF diversion is performed using locally made shunts (Harare, Malawi) which have given satisfactory results comparable to those from conventional shunts. The use of ETV should be explored for the future treatment of hydrocephalus as an alternative to shunting procedures.

Africa, Southern↗
PubMed2001

Left-handedness as a risk factor for head injuries.

OBJECTIVE: To study prevalence of left-handedness among traumatic patients with head injuries. DESIGN: A case-control study. SETTING: Queen Elizabeth Central Hospital, Blantyre, Malawi. SUBJECTS: One hundred and sixty three traumatic patients newly admitted to a surgical ward at Queen Elizabeth Central Hospital, Blantyre during one month period with exception of patients with arm injury, severe injury and confused patients. MAIN OUTCOME MEASURES: Maximal grip strength of both hands, questionnaire on hand preferred for eight habitual activities. RESULTS: The overall prevalence of left-handers determined on the basis of bilateral asymmetry in maximal grip strength was non-significantly higher in traumatic than in the control group. Relative to the control group, lefties were over-represented among victims of head injury, while prevalence of left-handers among patients with leg and trunk injuries and among controls was similar. Left-handed patients were more likely to sustain head traumas during fighting, road transport accidents and sport activities. Possible reasons for increased level of traumatisation among sinistrals are discussed. CONCLUSION: Left-handedness is a risk factor for head injuries obtained during confrontational activities. Therefore, left handers should avoid such type of behaviour in order to reduce traumatisation rate.

Accident Proneness↗
PubMed2000

Hydranencephaly in Malawian children.

OBJECTIVE: To show that not all big heads in children are due to hydrocephalus. SETTING: The Queen Elizabeth Central Hospital (QECH), Blantyre, the teaching hospital of Malawi College of Medicine. It is the biggest and leading hospital in Malawi and the major referral centre for the whole country. DESIGN: A prospective study was made of all children who presented at QECH, Blantyre with the diagnosis of hydrocephalus during the study period. SUBJECTS: Fifteen cases of hydranencephaly were encountered. INTERVENTION: All cases of abnormally large heads were investigated with cranial ultrasonography, a few children had air ventriculography and CT scan of the brain. All patients had ventricular aspiration of cerebral spinal fluid (CSF) to verify the colour and condition of the fluid before performing ventriculo-peritoneal shunting for which our locally made Malawi unishunt was used. RESULTS: In hydranencephaly, the brain was found replaced by large fluid-filled cavity in contrast to hydrocephalus where brain was present and ventricular dilatation was encountered. Ventriculo-peritoneal shunting benefited children with hydrocephalus but not those with hydranencephaly. CONCLUSION: Hydranencephaly is one of the causes of abnormal head enlargement in children often confused with hydrocephalus. It is important to recognise hydranencephaly to avoid unnecessary operation which does not help the patient.

Diagnosis, Differential↗
PubMed1999

Syndrome of cervical spondylosis in Blantyre, Malawi.

OBJECTIVE: To define the spectrum of clinical and radiological presentations of cervical spondylosis in Malawians. DESIGN: A prospective study. SETTING: The Queen Elizabeth Central Hospital, Blantyre which is the main referral hospital in Malawi and the teaching hospital of Malawi College of Medicine. SUBJECTS: Thirty seven patients (nineteen females and eighteen males) who presented with cervical spondylosis between February 1997 and September 1998. INTERVENTIONS: Treatment was conservative except one patient with cervical myelopathy who had laminectomy. RESULTS: Four of the patients were aged below 40 years; six were in the seventh decade, 13 in the fifth and fourteen in the sixth decades of life. All the 37 patients had discogenic disorder which manifested as brachial neuropathy. In addition, five (13.5%) had cervical myelopathy and two (5.4%) each had vertebro-basilar artery insufficiency, pseudoangina and dysphagia. Anterior osteophytes were three times as common as posterior osteophytes. CONCLUSION: In view of the various manifestations of cervical spondylosis the term cervical syndrome can be aptly applied to this disease.

Adult↗
PubMed1997

Use of the Malawi shunt in the treatment of obstructive hydrocephalus in children.

In 1992, as a result of shortage of conventional shunts we devised our local Malawi shunt made from siliconised rubber tubing and right angled metal connector between its ventricular and peritoneal parts, like the Harare shunt from which it differs in a few ways. Between 1992 and 1995, eighty four Malawian hydrocephalic children underwent ventriculoperitoneal shunting with the Malawi shunt. The operation was routinely performed by the consultant assisted by residents. Parietal burr hole was made to introduce the ventricular catheter and the peritoneal catheter inserted by open surgery through an incision between the subcostal margin and the umbilicus. The average hospital stay after operation was eleven days. The shunt functioned satisfactorily immediately after insertion in 80% of cases; in the rest there was hyper-drainage which led to cranial collapse. The other complications noted included blockage ten at the proximal end and six at the distal; abdominal wound rupture two cases; shunt disconnection two cases and infection, one case. The blocked shunts were all revised successfully. The cases of cranial collapse recovered without neurological deficits but retained varying degrees of mild to moderate acquired craniostenosis.

Equipment Design↗
PubMed1997

Ultrasonographic study of children suspected of hydrocephalus at the Queen Elizabeth Central Hospital in Blantyre, Malawi.

Eighty Malawian children aged below 15 months who presented with rapidly enlarging head and were suspected of having hydrocephalus were investigated with anterior fontanelle ultrasonography at the Queen Elizabeth Central Hospital (QECH), Blantyre. Of the 68 (85%) who were found to have hydrocephalus, 35 (51.5%) were post infective, 14 (20.6%) were associated with lumbosacral myelomeningocele, 13(19.1%) were post haemorrhagic and the rest probably congenital or idiopathic. The remaining 12 patients with macrocephaly but without hydrocephalus comprised six children with hydranencephaly, five with subdural effusion and one with achondroplasia. Ultrasonography of the head is thus a simple, quick, non-invasive, economical diagnostic tool in the management of macrocephaly and to a limited sense as effective as CT scan. Its increased use in the investigation of infantile hydrocephalus is therefore recommended in developing countries with limited resources and without sophisticated imaging techniques.

Diagnosis, Differential↗
PubMed1997

Protrusion of ventriculo peritoneal shunt through the anus: report of two cases.

Two cases of spontaneous protrusion of the abdominal end of ventriculo peritoneal shunts through the anus are reported in two African children with hydrocephalus. In each case the protruding catheter was easily removed with successful outcome and without recourse to major abdominal surgery. Possible factors suggested that may predispose to this complication of ventriculoperitoneal shunting include a weak bowel musculature in myelomeningocele and the use of stiff peritoneal catheters.

Anal Canal↗
PubMed1997

Aetiological and epidemiological aspects of acute head injury in Malawi.

One hundred and four patients (88 males and 16 females) with acute head injuries admitted to the Queen Elizabeth Central Hospital, Blantyre from July 1st to December 31st 1995 were prospectively studied using a questionnaire. Forty seven (45.2%) of the injuries were caused by road traffic accidents, 42(40.4%) by assaults, nine (8.7%) resulted from falls from heights, two (1.9%) from occupational injuries and the remaining four (3.8%) were of miscellaneous origins. RTA associated head injuries involved 17 (36.2%) pedestrians; 14 (29.8%) vehicular passengers, 10 (21.3%) pedal cyclists; five (10.6%) drivers and one motor cyclist. Malawi males aged between 20 and 29 were mostly involved. Assault related head injuries occurred also in young adult males commonly at the weekend with more than 50% occurring on Saturday and Sunday. Fifty per cent were sustained at home, a quarter on the streets and surprisingly few at drinking houses making them the safest place to be in Malawi to avoid assaults! Alcohol usage was not statistically significant among those assaulted; it was not possible to define its aetiological role among assailants. The head injuries associated with falls from heights (FFH) involved eight males and one female; five were children. Strategies for the prevention of assaults, the various types of road traffic accidents and falls from heights are discussed.

Accidents↗
PubMed1996

Pattern of acute head injuries in Kuwait.

Of two hundred and six consecutive head injuries, 28% had fallen from heights, and 58% had been involved in road traffic accidents, mainly pedestrians (50%). Head injury preventive measures in Kuwait should be directed to road traffic accidents and falls from heights.

Accidental Falls↗
PubMed1995

Evaluation of the use of plain cervical spine radiography in patients with head injury.

The records of 457 head trauma patients who underwent plain cervical spine radiography following head injury between January 1991 and December 1991 inclusive were reviewed. Seventy-six patients (17%) all above ten years of age had abnormalities; forty five were clinically suspected to have cervical spine injury because of cervical tenderness and/or neurological deficits and in the remaining thirty-one patients the cervical spine injuries were detected first on plain radiograph. The 31 vertebral injuries consisted off fracture-dislocations 12 fractures, 4 dislocations and one odontoid fracture. None of the 235 patients below the age of 10 years had cervical vertebral or cord injury. It is recommended that plain cervical spine radiography be performed on all patients with head injury associated with altered level of consciousness and who are above ten years of age.

Adolescent↗
PubMed1994

Acute subdural haematoma in a neonate.

A male child of Jordanian parentage who was born in an ambulance was immediately admitted to Al-Adan Hospital, Kuwait, with left parietal cephalhaematoma. Two days later he started to convulse on the right side of the body and was found to have a dilated left pupil and spastic right leg. A computed tomographic brain scan showed a large subdural haematoma which extended from the posterior interhemispheric fissure to cover the left convexity of the brain (type II of Hayashi et al. [6]). The subdural haematoma was removed through a left temporoparietal craniectomy. The child had a smooth postoperative recovery and was in a neurologically satisfactory condition during a 16-month follow-up period.

Follow-Up Studies↗
PubMed1993

Immediate bone replacement in compound depressed skull fractures.

Twelve patients with compound depressed skull fractures whose post-debridement cranial defects were treated with immediate bone replacement (IBR) are described. All were fully conscious on admission and except one who had debridement two days after injury, all had surgery within 24 hours of wounding. None had post-operative wound infection or osteomyelitis of the replaced bone fragment. Four patients with severe or moderately severe head wounds had the comminuted free fragments removed without replacement. Primary repair of skull defects with bone fragments is recommended as the treatment of choice during debridement of compound depressed skull fractures of mild to moderate severity which present in hospital within 24 hours of injury.

Adolescent↗
PubMed1993

Surgical services and training in the context of national health care policy: the Malawi experience.

Malawi has a pyramidal health care structure, featuring at its broad base health centres and outreach stations in villages and rural areas; at the middle the district hospitals which receive cases from the villages and outreach health stations, and at its narrow apex the few central hospitals one of which is located in each of the three regions as a referral centre. Primary health care is practised at the health centres mostly by paramedical workers. The district hospitals are manned by general duty doctors and the central hospitals by specialists. Medical auxiliaries (clinical officers and medical assistants) play a vital role in the surgical and anaesthetic services of Malawi. Surgical education is community based and aims at providing staff for the various tiers of the health care pyramid, the surgical training being now jointly supervised by both government and non-government organizations and the new College of Medicine of Malawi. The internship programme is designed to prepare doctors for service in the districts where the bulk of their clinical hospital duties is of a surgical nature.

Allied Health Personnel↗
PubMed1990

Occipital encephalocoeles in 57 Nigerian children: a retrospective analysis.

Fifty-eight patients with occipital encephalocoeles were retrospectively examined. These comprised about one-half of the cases seen and evaluated for treatment at the University College Hospital, Ibadan, Nigeria, between January 1973 and December 1987. There was a female-to-male preponderance of 2:1. Of the patients 91% were treated during infancy. Only one patient was precluded from surgery because his large ulcerated lesion was associated with severe microcephaly and neonatal sepsis, to which he succumbed. About four-fifths of the lesions exceeded 5 cm in diameter. The operative mortality was 6%, all deaths occurring in patients who were neonates at the time of surgery and whose hernia sacs contained brain substance. Clinically apparent hydrocephalus was more frequently encountered postoperatively, than preoperatively. Developmental delay was apparent in 5 of the 13 patients in whom developmental milestones were assessed during follow-up. For most patients, the follow-up period was short, possibly a reflection of the poor prognosis of the disease.

Encephalocele↗