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At least 883 records · Page 49Linked to original sources

Pattern and outcome of medical admissions at the Ogun State University Teaching Hospital, Sagamu--a three year review.

This is a three-year retrospective study of the pattern and outcome of acute medical admissions at the Ogun State University Teaching Hospital, Sagamu. Our findings showed that there were 1,938 admissions over the study period of which 1,044 (54%) were females and 894 (46%) were males. The ages of the patients ranged between 12 to 86 years with a mean of 49 +/- 1.7 years. The age range was 14 to 80 years for males with a mean of 47 +/- 6.1 years and 12 to 86 years for females with a mean of 49 +/- 4.5 years. The length of stay was between 5 to 25 days with a mean of 15 +/- 0.5 days. There were 16 patients per bed per year with a turn around of 8 days and bed occupancy of 65% 194 (10%) patients discharged themselves against medical advice and there were 488 (25%) deaths. The interval between admission and death ranged between 4 to 7 days with a mean of 5.5 +/- 0.07 days. Indications for admissions were infectious diseases (38%), neurological disorders (19.6%) gastro-intestinal disorders (11%), genito-urinary tract disorders (10.2%) endocrine disorder (10%), cardiovascular disorders (9.9%), respiratory disorders (6.4%) and haematological disorders (4.9%). Tuberculosis accounted for 10% of total medical admissions and was the commonest disease entity responsible for medical admissions. Acquired immuno deficiency syndrome (AIDS) constituted 1.8% of medical admissions. Mortality was highest for infections accounting for 32% of deaths while malaria accounted for the lowest. The reasons for the relative frequency and mortality are adduced. The study recommends improvement of preventive strategies towards communicable diseases in the community and encourages better admission policy, provision of appropriate facilities and manpower to improve the hospital services.

Acute Disease↗

[A case of spontaneous regression of malignant lymphoma, complicated with miliary tuberculosis, liver dysfunction and pancytopenia].

An 82-year-old woman was admitted to Iwamizawa Rosai Hospital, Cardiovascular Medicine, for detailed examination of an aneurysm of abdominal aorta. CT scan revealed marked swelling of para-aortic lymph nodes which regressed spontaneously in three months. She was re-admitted to our hospital because of general malaise and gait disturbance. Her chest X-ray on the second admission revealed miliary disseminated shadows, which were confirmed to be tuberculous granuloma by lung biopsy. She was initially well controlled with anti-tuberculosis drugs, followed by severe liver dysfunction and pancytopenia, and died of respiratory and cardiac failure. At autopsy, wide-spread malignant lymphoma and miliary tuberculosis of the lung were found. The cause of liver dysfunction was strongly suspected to be due to infiltration of the lymphoma cells to portal triads of the liver. Hemophagocytosis found in the bone marrow, spleen and liver might be consistent with clinically so-called "hemophagocytic syndrome", causing pancytopenia, associated with infection.

Aged↗

Complications of HIV disease and antiretroviral therapy.

Metabolic, opportunistic, and other infectious complications of HIV infection and antiretroviral therapy continue to be major areas of active investigation. This year's Conference on Retroviruses and Opportunistic Infections included many important presentations on the clinical aspects of HIV complications. In each successive year, the studies reported in the area of complications have matured and now include more randomized trials evaluating interventions for the management of HIV complications and more well-designed observational studies with long-term follow-up. This article will review new data presented on metabolic complications, including cardiovascular risk, lipid disorders and lipoatrophy, renal complications, hepatic complications (hepatitis B and C virus infections), tuberculosis, and other bacterial infections.

Anti-HIV Agents↗