Biomedical subjects
Publications and source records attributed to A L Akinyoola.
A 23-year-old immunocompetent woman presented with a two-month history of fungating left shoulder and left elbow swellings associated with fever, weight loss and anaemia. X-rays showed lytic destruction of the lateral third of the left clavicle and distal half of the left humerus. Histology of biopsy specimen confirmed African histoplasmosis. The lesion resolved following treatment with ketoconazole.
BACKGROUND: Infections of open musculoskeletal injuries, especially open fractures, continue to pose a challenge to the Orthopaedic and Trauma surgeons. There is a dearth of information on the early bacterial contaminants of these open wounds and their antibiotic sensitivity patterns in our environment. OBJECTIVE: To determine the bacteriology of open wounds of the musculoskeletal system at initial presentation in hospital and their antibiotic susceptibility profile in Ile-Ife, Nigeria. MATERIALS AND METHODS: A prospective study of 86 consecutive patients over an eight-month period (March to October 2002). Eighty-six patients with 96 open wounds of the musculoskeletal system admitted to the Accident and Emergency unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. Bacteria were isolated from swabs taken from the depth of the wounds and their antibiotic susceptibility determined. RESULTS: A total of 126 bacterial isolates were recovered from 96 wounds in 86 patients (61 males and 25 females) with mean age of 31.4 years +/- SD. About 73.3% of the wounds were from road traffic accidents and 72.3% of the wounds were severe open fractures (Grades IIIA to C). Staphylococcus aureus constituted 22.2% while coagulase negative Staphylococci (CONS) accounted for 21.4% with Staphylococcus. epidermidis leading the group with 13.5%. Gram negative rods constituted 40.5% of the isolates with Pseudomonas aeruginosa accounting for 11.1%. Antibiotic sensitivity profile revealed that many of the isolates were multiply resistant to the antimicrobials employed but were sensitive to Ofloxacin. CONCLUSION: This study has shown that open wounds of the musculoskeletal system are usually contaminated at presentation with pathogenic organisms. The antibiotic sensitivity pattern of the isolates shows that the quinolones, represented by Ofloxacin, is the most effective antibiotic.
Conjoined twins are rare phenomena occurring in one in 1 in 50,000 live births. Successful surgical separation of conjoined twins is a major undertaking requiring careful planning by a multidisciplinary team. Reports of seperation of joined twins in developing countries like Nigeria are rare. Ten cases of conjoined twins were separated between 1936 and January 2003 (including the authors two new cases). There were five omphalopagus, two pygopagus, two heterpagus and one ishiopagus twins. Three underwent emergency separation with 83.3% mortality while seven underwent elective seperation with 64.3% survival. The overall mortality rate was 50%. Despite the absence of advanced technological resource selected group of conjoined twins can be successfully separated in a developing country like Nigeria. An improvement in facilities and availability of trained personnel in likely to be associated with improved outcome.
We report a 33-year-old trader with bilateral traumatic anterior hip dislocation following a road traffic accident. Both hip dislocations were reduced under general anesthesia followed by immobilization of the hips with skin traction. He discharged himself against medical advice one week after injury.
Many patients with Human Immunodeficiency Virus (HIV) Infection now live long due to the availability of antiretroviral drugs. This has resulted in many hitherto unknown complications being reported. We report a 56-year-old trader who presented with a seven-month history of pain in both shoulders and hips. Laboratory investigations and x-rays confirmed oesteonecrosis of both humeral heads and femoral heads in HIV/AIDS. She is presently on antiretroviral drugs and conservative management of her multiple joint disorders.
BACKGROUND: Septic arthritis is an important osteoarticular infection in children. There is insufficient data on its pattern of presentation and sequelae in our environment. OBJECTIVE: To identify the aetiologic factors, patterns of presentation and sequelae of septic arthritis in Nigerian children. METHODS: A retrospective analysis of the clinical, roentgenographic and laboratory records of children with septic arthritis admitted over a 14-year period to Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria was undertaken. RESULTS: Ninety three patients with septic arthritis involving 104 joints with a mean age of 4.5 years +/- SD (range 2 months to 15 years) were studied. The most commonly involved joint was the hip (48.4%) though the shoulder was the most commonly affected joint in infancy (36%). Trauma (a history of fall and intramuscular injection) was associated in 28% of the cases. Staphylococcus aureus was the predominant aetiologic bacterial agent (50%) even in patients with sickle cell disease. Anaemia was a common complication (64.5%). The overall result of treatment was unsatisfactory as only 37.7% had complete resolution while most had varying degrees of joint destruction resulting in limb length discrepancy and ankylosis.