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Biomedical subjects

J H Lawrie

Publications and source records attributed to J H Lawrie.

At least 19 recordsLinked to original sources
PubMed1993

Gastric teratoma: a case report.

Gastric teratoma is a very rare, usually benign, tumour of childhood. In industrialized countries, the diagnosis is facilitated by advanced technology when the infant is still in utero or soon after birth, and surgery is performed quite early in life, long before symptoms appear. This tumour was seen in our hospital in a 4-month-old boy. A mass had been noted at birth, but the infant remained symptomless. He was brought to hospital only on account of its rapid growth. The teratoma was successfully excised and the child was not seen again after discharge from hospital. We presume he remains well.

Developing Countries↗
PubMed1988

Burns in adults in Zaria, Nigeria.

From 1971 to 1981, 245 adults with burn injuries were admitted to the Ahmadu Bello University Hospital, Zaria. The burns were major in 197 patients, moderate in 28 and minor in 20. Socioeconomic factors contributing to the injuries included the use of wood fires for cooking, for warming the body and the dwelling during the cool harmattan season, loose indigenous garments, thatch-roofed huts, petrol hoarding and epileptic seizures. Flame burns exceeded scalds with a high seasonal frequency in both men and women during the harmattan. Scalds occurred predominantly among the women, puerperal hot baths being a major cause. The overall mortality rate of 22 per cent is excessive. General economic development, architectural improvements, proper handling of petrol and kerosene, modification or abandonment of the puerperal ritual of hot baths, the maintenance of chronic epileptics on anticonvulsants and a programme of universal active immunization against tetanus would contribute to the prevention of burns and complications in adults and decrease the mortality rate.

Adolescent↗
PubMed1987

Childhood burns in Zaria, Nigeria.

From 1971 to 1980, 429 children with burn injuries were admitted to the Ahmadu Bello University Hospital, Zaria. These were major burns in 275 patients, moderate in 82 and minor in 72. Fourteen of the patients were neonates, 102 infants, 228 were 5 years old or younger and 85 were older. Socioeconomic factors contributing to the injuries included the use of firewood for cooking at ground-level and for warming the house and body during the cold season; loose indigenous garments; thatch-roofed huts and the post-partum rituals of mud-bed heating and hot baths. Flame burns exceeded scalds with a seasonal frequency which peaked during the harmattan. In the absence of a 'burn's unit', burned children were nursed on the general ward together with other sick children by the same nursing personnel supervised by general surgeons. Complications included wound infection, respiratory distress, measles, malnutrition and tetanus. One-fifth of the patients absconded. Overall mortality was 13 per cent but 29 per cent of the neonates died. Preventive strategy should include public information, nursery school supervision, economic development and architectural improvements.

Adolescent↗
PubMed1985

Surgical management of advanced gastric carcinoma in Zaria, Nigeria.

In Zaria, Nigeria, 47 men and 37 women aged 25 to 70 years were operated upon for advanced carcinoma of the stomach between 1971 and 1982. In 1971-1976, gastric resection was performed in 33% of the 42 patients and by-pass in 31% compared to 67% and 17% respectively in the other 42 patients treated in 1977-1982. Increased resection of tumours of the corpus, cardia and fundus and of involved adjacent organs accounted for this increase. The in-hospital death rate (29%) was the same for gastric resection and by-pass operations. In this part of the world where reliable chemotherapy and radiation technology are not yet available, the role of the surgeon in securing palliation from gastric cancer remains very prominent.

Adenocarcinoma↗
PubMed1984

Bacterial liver abscesses in Nigeria.

There has been no previous report on bacterial liver abscess (BLA) from West Africa. During the period 1972-1979, 13 patients were treated for BLA in Zaria, Nigeria. S. aureus was the most frequent pathogen but an anaerobic streptococcus was identified in one instance. The case fatality rate was 54%, similar to those reported in the literature. Since diagnosis was made without the benefit of the newer liver-imaging technologies it seems probable that BLA is underdiagnosed and therefore untreated in some patients.

Adolescent↗
PubMed1983

The perineal urethrotomy approach to posterior urethral valves.

We treated 25 patients with posterior urethral valves by a perineal urethrotomy approach that required no sophisticated radiological or endoscopic equipment. The over-all results were considered good in 17 patients (68 per cent) who had restoration of normal micturition and renal function. Of the remaining patients 4 (16 per cent) had some residual stricture that responded to urethral dilation, 2 (8 per cent) had fairly normal micturition with occasional dribbling, 1 had persistent chronic renal insufficiency despite adequate relief of obstruction and 1 died of renal failure. The results of this approach are comparable to other methods described in the literature. The method is particularly appropriate in developing countries or in centers with limited urological facilities.

Adolescent↗
PubMed1983

Congenital posterior urethral valves: problems of management in countries with limited facilities.

There is scanty reference in the literature from the tropics, especially from Africa, to posterior urethral valves (PUV). The condition is not uncommon in Africans. Forty-five patients seen during a period of 10 years at the Ahmadu Bello University Hospital, Zaria, Nigeria have been analysed in order to discover any problems this abnormality may pose that are peculiar to the developing countries of the tropics. Two-thirds of the patients were under one year of age when first seen, one-third of them being under one month. About a quarter had no urological symptoms at presentation. Most of these were neonates and infants often critically ill due to sepsis and uraemia. These non-urological presentations caused delay in diagnosis and referral with detrimental effects on prognosis. However, the diagnosis could be made on clinical examination by demonstrating a palpable bladder and/or renal masses. Voiding cystourethrogram confirmed the diagnosis when carried out carefully, and required no specialized equipment. Most children were treated satisfactorily by perineal valve ablation, using simple inexpensive instruments. The death rate was high mainly due to delay in diagnosis and in starting appropriate treatment. It is suggested that amongst all who have care of children in the tropics, increased awareness of the varied clinical manifestations of PUV would improve prognosis.

Adolescent↗
PubMed1981

Closed digital commissurotomy for mitral stenosis in Northern Nigeria.

Despite the absence of sophisticated thoracic surgical facilities, valuable relief was provided to young patients with progressive symptoms of rheumatic mitral stenosis in Zaria (Nigeria) whose response to the medical regime had been unsatisfactory. Using digital trans-atrial commissurotomy, which is technically straightforward and involves little blood loss and no elaborate surgical equipment 18 patients with a lone mitral stenosis were symptomatically improved but three with mixed mitral stenosis and regurgitation died. There is urgent need to reduce the prevalence of rheumatic fever in this and other parts of the tropics.

Adolescent↗
PubMed1981

Tropical paediatric intussusception--is it a different disease entity?

The presentation of intussusception in children in Zaria, Nigeria has been studied with the aim of identifying any features that may differentiate it from that which obtains in temperate countries. Our data reveal no difference in age of peak incidence, sex ratio, absence of preceding upper respiratory infection or lack of significant seasonal variation. However, there is an unusually high incidence (41%) of caecocolic intussusception. It is believed that this may account for other observed features, such as the low occurrence of constipation and other evidence of intestinal obstruction, and the relatively high incidence of "painless" intussusception and sub-acute or chronic intussusception. Twenty-nine per cent of the patients had only one or two of the usual diagnostic features of the disease and this contributed to delayed diagnosis. In all but two patients the condition was idiopathic and there was no evidence to implicate bacterial enteritis or parasitic infestation in the aetiology of the disease.

Adolescent↗
PubMed1981

Surgical management of pericarditis in Zaria, Nigeria.

Over eight years, 58 rural Nigerians with pericarditis were treated surgically in Zaria using basic surgical facilities. Eighteen patients had purulent pericarditis, associated with staphylococcal pneumonia in children, or pneumococcal pneumonia in adults. Treatment with antibiotics and prompt pericardiectomy appeared to be superior to drainage, since a quarter of those initially treated with surgical drainage developed early constriction and required pericardiectomy soon after. Thirteen patients had chronic pericardial effusions, of whom one had epicardial constriction and two had cardiomyopathy. Twenty-seven patients had chronic constrictive pericarditis but tuberculosis was confirmed histologically in three only. Echocardiographic findings remained unchanged in five patients evaluated before and after pericardiectomy. Eight of the 13 patients who died had already developed myocardial or hepatic insufficiency before operation, because of late presentation or diagnosis. Greater awareness of the significance of precordial pain in this rural population where ischaemic heart disease is rare would help in making an earlier diagnosis.

Adolescent↗
PubMed1980

Orchidectomy in a rural African population.

From 1971 to 1977 in Zaria, Nigeria, orchidectomy was performed on 341 men, mostly in the third to sixth decades of life. The testis itself was diseased only in 21% of cases. Torsion of the spermatic cord with testicular infarction occurred in 11% and cancer was present in less than 2%. Orchidectomy was performed therapeutically in 5% of the patients. The major causes for testicular resection were complicated and large inguinal herniae and hydroceles. These two conditions are a source of socio-economic hardship and considerable morbidity in a farming population. It would thus be worth while to include facilities for surgery of small herniae and hydroceles in plans for rural health care.

Adult↗