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Biomedical subjects

L Wosornu

Publications and source records attributed to L Wosornu.

35 records · Page 2Linked to original sources
PubMedDate not supplied

Risk factors in wound infection following urologic operations: a prospective study.

A total of 134 urologic operations were studied prospectively for postoperative wound infection, the methodology involving direct intraoperative swab taking. Patients' variables were (mean +/- SD): age 32.4 +/- 20.7 years, Quetelet index 27.4 +/- 8, duration of operation 98 +/- 34 minutes, and male:female ratio 9.3:1. Of the 131 intraoperative swabs 28 (21%) were positive, 97% of the organisms being aerobic; 16% of the patients were nasal carriers of S. aureus. The overall wound infection rate was 9%, and it prolonged hospital stay by six days average. Significant risk factors (and their magnitude) were: age over 60 years (x 2.2), prolonged preoperative hospital stay (x 15), and wound contamination (x 4.3 and x 14.3 for classes 3 and 4 wounds respectively). Neither diabetes mellitus, obesity, nor surgeon's rank was contributory. We conclude that, although the 9% rate of postoperative wound infection was acceptable, appropriate prophylactic antibiotics may reduce it further, and, from our data, we would recommend an aminoglycoside (e.g. Amikacin) and Ampicillin combined.

Abdominal Muscles↗
PubMedDate not supplied

Evaluation of an intensive care unit in a teaching hospital in Saudi Arabia.

Intensive Care Units (ICU) in general hospitals have become a standard requirement in tertiary care centres. However, the appropriateness of their use is not widely known. We have used the Therapeutic Intervention Scoring System (TISS) to evaluate a multidisciplinary ICU in a teaching hospital in Saudi Arabia. The average occupancy rate was 79%, the nurse: patient ratio was 1:1.4, duration of stay 4.1 +/- 3.5 days, and mortality was 1.4%. The distribution of severity of illness was as follows: Classes I & II, 82%, and Classes III & IV, 18%. The average TISS points were: daily per patient 15.1 +/- 2.7 (range 11.5-21.7), total per day 125.6 +/- 38.2 (range 35-211), and patient points per nurse was 21.1. We conclude that, although less than 20% of patients required unique ICU services, the use of our ICU was appropriate to the current medical and manpower training needs of the community it was designed to serve, but the basis of nurses' complaints of overwork remains to be determined.

Hospitals, Teaching↗
PubMedDate not supplied

Wound infection following biliary surgery. A prospective surgery.

Biliary surgery in general, with cholecystectomy in particular, is probably the commonest major elective abdominal operation worldwide. A prospective study has been completed on 141 biliary operations in which intra-operative bile swabs were taken, and other risk factors for wound infection sought. Patients' characteristics were: males 51, females 90 (1:1.8); mean age 42.4 +/- 16 years; mean Quetelet index for adults was 32 +/- 5. The operations were: emergencies 10, simple-cholecystectomies 112, and choledochotomies (including other concomitant procedures) 29. The observed wound infection rates were: overall 7.8%, simple cholecystectomy 3.6% and choledochotomies 24.1%, figures which agree closely with the national and international literature. The infected patients consumed, on average, 7 days more in hospital than the uninfected ones. We found three major risk factors for wound infection: patients aged 40 years or older (over 4-fold), choledochotomy (over 6-fold), and microbiologically proven wound co-ntamination (9-fold). We conclude that, given the consistently low (less than 4%), incidence of wound infection following simple cholecystectomy, routine antibiotic prophylaxis in this subset is probably unjustified.

Adolescent↗
PubMedDate not supplied

The current status of peritoneal drainage.

It is hard to get physicians to give up their professional beliefs and alter their clinical practice. With simple cholecystectomy, the message must be a compromise: drainage is not necessary in most cases; but if one must use a drain, it must be the suction type, and removed within 48 hours. Peritoneal drainage may be used selectively after laparotomy for generalised peritonitis, but can be safely omitted after appendicectomy, colonic anastomosis, and splenectomy.

Appendectomy↗
PubMedDate not supplied

The treatment of sepsis in superficial burns: effect of 1% Silver Sulphadiazine.

One hundred patients with superficial burns were treated by the exposure method under ordinary ward conditions. Topical 1% Silver Sulphidiazine ("Flamazine") was used under controlled conditions. The exposure technique, with judicious local cleaning, resulted in spontaneous healing in 42% of cases. Topical "Flamazine" was used in 58% of cases. It was found to be soothing, giving patients instant relief of pain. It arrested crack and fissure formation with bleeding, especially in burnt areas in the neck and about major joints. It expedited healing; an astringent effect was also observed. It was concluded that the exposure technique, with topical "Flamazine", was beneficial in the treatment of superficial burns, obviating the routine daily bathing of the burnt.

Administration, Topical↗
PubMedDate not supplied

A clinical study of Osteomyelitis and septic arthritis.

Sixty-nine cases of Osteomyelitis, and 27 of septic arthritis have been presented. 69/96 (71%) were children below 12. The sites frequently involved were tibia, femur and humerus. Septic arthritis commonly involved the knee. The commonest organism was Penicillin - resistant Staphylococcus aureus. Though we sought but failed to establish that overt clinical malnutrition was aetiologically important, since 54% were well-fed children, the virulence of the sepsis in which an entire bone shaft may die is disturbing but unexplained. Whereas arthrotomy plus antibiotics gave uniformly good results for septic arthritis, in osteomyelitis, no single treatment regime was outstanding. We would recommend the tetracyclines, (eg. "Reverin"), in addition to appropriate surgery, as a routine.

Adolescent↗
PubMedDate not supplied

Oesophageal atresia.

Explore the source record for details and available documents.

Abnormalities, Multiple↗
PubMedDate not supplied

Prophylaxis against post-appendicectomy wound infection. A controlled clinical trial of intravenous (i.v.) metronidazole versus i.v. metronidazole-ampicillin-gentamicin.

A controlled clinical trial has been conducted on three doses of intravenous (I.V.) metronidazole alone and of I.V. metronidazole-gentamicin-ampicillin combined in wound infection following appendicectomy for non-perforated appendicitis. Of the 205 patients entered, 154 were evaluable. There were 118 males and 36 females (3.3:1), their mean age was 24 +/- 9.8 years, and mean Quetelet index was 23 +/- 5. The two groups were comparable in terms of seven potential risk factors: age, sex, Quetelet index, mean duration of operation, wound contamination, nasal carriage of S. aureus, and operating surgeon's rank. The over-all wound infection rate was 10.4%. There were two delayed infections in each treatment group. We found no difference between the two treatment groups in terms of wound infection and delayed wound infection. No adverse drug reaction was seen. We conclude that the two regimens are equally convenient, safe, effective, and reliable. But, metronidazole alone is the less expensive of the two.

Adult↗
PubMedDate not supplied

Aetiology of acute upper gastro-intestinal bleeding at the University Teaching Hospital, Lusaka, Zambia.

A prospective clinical study into acute upper gastro-intestinal bleeding has been done and the first 60 consecutive cases analysed. It was found that contrary to the prevailing clinical impression but in agreement with published work, the commonest associated aetiological factor was chronic duodenal ulcer (33 of 60 cases). Next came acute drug or alcohol induced gastric erosions, with oesophageal varices a poor third. The unreliability of clinical impressions is confirmed.

Acute Disease↗
PubMedDate not supplied

Burns: early shaving and immediate skin-grafting of dorsum of the hand.

Fourteen men with deep dermal burns of the dorsum of the hand treated by early excision and primary skin grafting are presented. Satisfactory functional and cosmetic results within two to three weeks were obtained in ten patients and in five to six weeks in the remaining four. Three patients who refused surgery developed contractures. The procedure is recommended as a routine.

Burns↗
PubMedDate not supplied

Haematological norms in Zambians with special reference to chemotherapy.

Haematological norms for Zambian men have been determined, 100 students being studied prospectively in the University Teaching Hospital, Lusaka, care was taken to identify and quantify observer error. It was found that routine laboratory results for platelet counts were consistently low, the magnitude of the error being - 30%. From 1972 - 1977 a measurable alteration has occurred in the variables. It was concluded that the norms for healthy Zambian men were, in round figures as follows: haemoglobin 15.0g% total white cell count 6,000/cmm; neutrophils 50%, lymphocytes 44%, absolute granulocyte count 3,000/cmm; platelet count 160,000/cmm. The reason for the neutropaenia and thrombocytopaenia is obscure. For accurate work such as is required in tumour chemotherapy, special counts must be made, neutropaenia and thrombocytopaenia being borne in mind.

Adult↗
PubMedDate not supplied

Diagnosis of venous thrombosis using 125 I-fibrinogen in Zambia.

Fibronogen labelled with I125 iodine has been used as an epidemiological tool to study deep vein thrombosis (DVT) in Lusaka, Zambia. Twenty highly selected patients were studied; data was complete in 18. Six were positive. None had clinical evidence of DVT and pulmonary embolism. However the results, which should be interpreted with much caution, remain to be confirmed and their clinical significance determined.

Adult↗
PubMedDate not supplied

An unexpected foreign body in the oesophogus: a case report.

An unusual case of foreign body in the oesophagus is reported. A history of dysphagia was absent although oesophageal obstruction was total; the retained foreign body was vegetable matter. An unusual radiological appearance, "the inverted wine-glass sign" is described. Pure water depletion was diagnosed there being dehydration combined with hypernatraemia (Na = 164MEq/L), normokalaemia (K+ = 4.2mEq/L), and acidosis (Serum bicarbonate = 10 mEq/L), as well as uraemia (220 mg%), and haemoconcentration (haemoglobin=18.5g%). Treatment with oesophageal lavage and intravenous fluids was successful.

Adult↗