Bacteriology and clinical course of camel-bite wound infections.
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Biomedical subjects
Publications and source records attributed to O A Badejo.
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We conducted a review of eight ureteric injuries associated with major gynecologic surgery in seven patients over an 11-year period. Our low incidence of 0.36% is comparable with other reports. Diagnosis was made either intra-operatively or postoperatively. Immediate ureteric repair is advocated for all injuries discovered intra-operatively. Attention to preventive measures both before and during gynecological operations will reduce the incidence of ureteric injuries.
A case of priapism complicating essential thrombocythaemia in a 45-year old Nigerian gardener is described. His platelet counts ranged from 1.2-1.6 x 10(12)/L, haematocrit from 0.25-0.33 L/L and leucocytes from 23.4-30.6 x 10(9)/L. There was a splenomegaly of 5cm. He had bilateral cavernostomy but is yet to regain penile erection 3(1)-2 months after surgery.
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The commonest cause of large-bowel obstruction in Nigeria is sigmoid volvulus. Patients usually present late, dehydrated, and in very poor condition. The mortality of emergency colonic surgery is undoubtedly high, more so in developing countries poorly equipped to cope with such a condition. To reduce the mortality rate and improve management of the patients, a four-year prospective study of detorsion followed by elective surgery after adequate resuscitation and bowel preparation was carried out between January 1979 and December 1982. Volvulus is classified into three groups: torsion, obstruction, and strangulation. Criteria for short colonoscopic detorsion of torsion and obstruction types are discussed, and the contraindication in the case of strangulation type mentioned. This article describes the management of 92 cases of sigmoid volvulus between 1979 and 1982.
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Sixteen cases of scrotal gangrene are presented. The aetiology, environmental factors and pattern of clinical presentation are described. A total reconstruction of the scrotal sac in all cases as practised in Ife is described. It is advocated that surgeons in the tropics should, in spite of various constraints, try to salvage any infected testis before considering orchidectomy. Infective gangrene of the scrotum is considered a more suitable diagnostic label than Fournier's gangrene.
Four cases of unilateral giant breasts from two unrelated families are described. Three of the patients were managed surgically. It is speculated from a review of available published reports that this condition may be genetic with an autosomal dominant mode of inheritance.
Three cases of fungating accessory breast carcinoma out of a total of 22 malignant breast formations seen and treated in Ile-Ife, Nigeria between January 1977 and November 1981 are described. The clinical presentations, features and histologic findings are presented. The methods of management and the need for close observation as well as follow up for at least two years is emphasized. A frequency of 14% as seen in this series appears so high that one cannot describe the occurrence of malignant changes in the accessory breast as rare.
A review of 86 cases of fissure-in-ano as seen in Ife is presented. The method of management is described and compared with other conservative methods of treatment. The results show a complete healing of the condition within two weeks as compared with four to six weeks recorded in other series. Healing was confirmed by a complete resolution of symptoms together with re-epithelisation of the fissure on inspection at proctoscopy. It is suggested that the described surgical management is simple, fast, cost reducing and time saving in the treatment of fissure-in-ano. It is further envisaged that this procedure may also serve as a means of relief to our already congested hospitals.
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A hundred and fifty-two patients with recurrent inguinal hernias, 10 females and 142 males seen over a ten-year period have been reported. The patients, none of whom were earlier seen or operated on by the author were managed with two parallel rows of four-layer fascioplasty held with nonabsorbable Astralen sutures. The complications which may arise from the method applied were reviewed. The recurrence rate in advanced countries ranges between 7% and 30% for all types of inguinal hernias, but in Nigeria is higher. The author does not claim that recurrence cannot occur with this method but he has not recorded any. The technique has also alleviated the fears of many and removed the social problems of having just one testis, an important factor in this environment.
Two hundred and ten cases of typhoid enteritis were seen and treated in Ife, Nigeria, between 1972 and June 1979. A comparative analysis was made between those treated conservatively and surgically. A new and hitherto undescribed method of approach, peritoneal irrigation after surgery, was used in 180 patients. The results obtained have convinced us that all cases of typhoid must be promptly and adequately resuscitated, operated, drained, and irrigated.
A case of ectopic lesion of Schistosoma haematobium of the penis with extensive tissue destruction, simulating an early carcinoma of the penis and almost resulting in an autoamputation of the crown of the penis, is presented. The penis was surgically repaired and the patient treated with ambilhar. In schistosoma endemic area, it is important to think of ectopic schistosoma lesion by such a presentation. Existing theories to explain the presence of schistosoma eggs in locations outside the portal-caval system were reviewed and another one was advanced: its being sexually transmitted.
Sixty-two patients diagnosed as early and advanced cancer of the prostate gland were studied under three categories. The survival rate of those diagnosed early was 80% in the first five years while the overall survival rate in the series was 19.23%. The prognostic determinants in all categories while under therapy was, however, similar. The study confirmed that poor prognostic features were body weight of about 40 kg, haematocrit below 20%, Urea level of 10 mmol/lit and above, raised white cell count, raised erythrocytes sedimentation rate and total confinement to bed. The paper concluded that these findings, in a local pilot study, are of significance and sufficient value to merit further study and clinical evaluation.
Twenty patients with Urethral stricture disease presenting with difficulty in micturition, azoospermia, and oligospermia were studied. Only 5% of our patients could firmly claim to be fertile at the time of presentation with a rise to 80% fertility rate at the end of management. Fifteen percent did not notice any change in their status. Surgical approach claimed better result over conservative management because of other complications following gonococcal infections. The need for a close forensic analysis in the determination of paternity in all cases of Urethral strictures was stressed while a treatment protocol of graft urethroplasty in all cases of traumatic rupture and dilatation in cases following inflammatory lesions of the urethra was established.