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Biomedical subjects

A O Ogunseyinde

Publications and source records attributed to A O Ogunseyinde.

At least 19 recordsLinked to original sources

Factors influencing visual and clinical outcome in Nigerian patients with cranial meningioma.

We retrospectively analysed the impact of selected clinicopathological factors on visual and clinical outcome in patients with histologically verified cranial meningioma. The 60 patients analysed for tumour characteristics consisted of 32 females and 28 males (sex ratio 1.1:1) aged 9-77 years (mean 40 years) seen between 1977 and 1999 at the University College Hospital, Ibadan, Nigeria. The patients for whom sufficient clinical data was available (n=35) presented within 2-60 months (mean 18 months) of symptom onset with large tumours (mean size 52 mm), and perifocal oedema (26/35), poor vision, focal neurological deficits, seizures and clinical evidence of intracranial hypertension. The most common tumour site was the convexity. There was loss of vision in 30/35 (85.7%) patients. Loss of vision was significantly related to tumour site and tumour size as well as perifocal oedema, (P<0.05). The case-mortality rate was 11.4% at 1 month and 20% at 6 months post-operation and was significantly correlated with intracranial hypertension. Neither age nor sex affected the outcome (P>0.05).

Brain Neoplasms↗

Bilateral congenital cystic adenomatiod malformation of the lungs: a case report.

A six weeks old infant presented with scalp ulcer and fever. and on examination was found to have resonant percussion notes bilaterally. The initial chest radiograph revealed multiple lucencies which were initially thought to be due to diaphragmatic hernia, but the dilemma was resolved by Computerised tomography which revealed the lucencies to be multiple cysts characteristics of Congenital Cystic Adenomatiod Malformation (CCAM) type II.

Cystic Adenomatoid Malformation of Lung, Congenita↗

Computed tomographic pattern of stroke in children with sickle cell anaemia in Ibadan.

We present the findings in 14 paediatrics patients with SCA who had CT examination at the University College Hospital Ibadan on account of stroke between 1993 and 2000. There were 8 female and 6 male with a mean age of 11.25 years and SD of 3.66. Cerebral infarction was the most common finding occurring in 57% of the patients while intracerebral bleed was seen in 21%. Two patients had a mixed lesion and atrophy was seen in one patient. Five patients (36%) had their lesion on the right hemisphere while eight (57%) had their lesions on the left side. The frontal and parietal lobes were mainly affected. Prompt CT screening of the brain in a child with sickle cell anaemia who presents with symptoms and signs suggestive of stroke can help identify the particular type of lesion and this may influence mode of therapy given as well as prognosis

Adolescent↗

Giant fibrolipomatous polyp of the oesophagus: a case report.

Giant pedunculated oesophageal polyps are rare intraluminal tumours which are usually benign. they include fibrovascular polyp, liposarcoma, harmatomas and lipomas. They may be asymptomatic for a long time and thus attain an enormous size. We present one of such cases of giant oesophageal polyp in a 28 year-old man with a history of difficulty in breathing and vocalisation, easy fatigability and cough. Dysphagia was late in the complaint and he also had lost 7 kg in the last six months before his presentation. A chest radiograph, barium swallow and oesophagoscopy gave the clinical diagnosis. The thoracic CT examination gave a better delineation of the site of the pedicle, the nature and extent of the tumour mass. The tumour was surgically removed and the final pathological diagnosis was afibro-lipoma of the oesophagus. The patient has since been discharged to follow-up in the Surgical out-patient.

Adult↗

Presentation of primary mediastinal masses in Ibadan.

OBJECTIVES: To determine clinical features, anatomic location and histological types of primary mediastinal masses diagnosed and treated in a black African population. DESIGN: A retrospective study of clinical data collected from patients case notes, the cardiothoracic unit's and pathology records between June 1975 and May 1999. SETTING: University College Hospital, Ibadan, Nigeria which hosts a major cancer center in the West African sub-region, and serves community clinics. PATIENTS: All patients with primary mediastinal masses referred for evaluation and treatment. MAIN OUTCOME MEASURES: Excluded metastatic, oesophageal and vascular-lesions. All patients had radiological evalulation and tissue biopsies. The anatomic subdivision of the mediastinum into anterosuperior, middle and posterior section was used. RESULTS: One hundred and five consecutive patients were evaluated and treated. The mean age was 34.0 +/- 20.4 years. There were 75 males and 30 females. Eighty one (77.1%) were symptomatic, 24 (22.9%) were asymptomatic. Thirty seven (45.7%) of the symptomatic patients had malignant disease while 44 (54.3%) had benign disease. Forty five patients (43%) and 60 patients (57%) had malignant and benign diseases respectively. Incidence of symptoms, was 82.2% for malignant and 73.3% for benign diseases. This difference in incidences is statistically insignificant (p=0.283). Majority of asymptomatic patients (70.8%) had benign disease while 29.2% of patients with malignancy were asymptomatic. This difference in incidence was statistically significant (p=0.0039). The frequency of mediastinal masses were anterosuperior, in 67 patients (63.8%), posterior mediastinal, 24 patients (22.9%) and middle mediastinal in 14 patients (13.3%). Lymphoma 23 (21.9%), thymus glands tumours 19 (18.1%) and endocrine tumours (goiters) 18 (17.1%) were the commonest types of primary mediastinal masses treated. CONCLUSION: Majority of our patients with mediastinal masses (whether benign or malignant) are symptomatic and the absence of symptoms is more associated with benign disease. Majority of lesions are situated in the anterosuperior mediastinum. Lymphoma is the most frequent primary mediastinal mass.

Adolescent↗

A comparison of visual function scores in hydrocephalic infants with and without lumbosacral myelomeningocoele.

PURPOSE: The cerebrum is frequently malformed in children with myelomeningocoele. This anomaly renders them potentially susceptible to cerebral visual impairment. In these patients, hydrocephalus is an important and frequent complicating lesion which compromises intellectual function and may also cause cerebral visual impairment. In this study, we determined whether hydrocephalic patients with lumbar myelomeningocoele (HLM) are at a greater risk of visual impairment than hydrocephalic patients without this lesion (H). METHODS: In this prospective study, we assessed five parameters of visual function in 20 hydrocephalic children with lumbar myelomeningocoele and compared the total visual function scores (TVFS) obtained with those from hydrocephalic children without overt spinal dysraphism, but similar in age, sex and ventricular size. The parameters, which were assessed with the aid of a quantitative grading scale, were pupillary size and reaction, optic atrophy, visual fixation and tracking. RESULTS: The age and sex distributions of the patients in the two groups were similar. The anterior and posterior dimensions of the lateral ventricles were also similar. The mean (SD) of the TVFS were 24.25 (3.63) and 24.20 (3.47) respectively for the two groups (P = 0.90). CONCLUSIONS: The results suggest that, in hydrocephalic infants with lumbar myelomeningocoele, visual function is not further diminished by the associated dysraphism and that ventricular dilatation is the major determinant of visual impairment.

Age Distribution↗

Comparison of entrance surface doses of some X ray examinations with CEC reference doses.

Entrance surface dose (ESD) measurements have been carried out in Nigeria as part of the ongoing dose reduction programme. Thermoluminescence dosemeters (TLD) were used to measure skin entrance doses for four common radiographic views in three hospitals. The mean ESD for the PA chest examination in all the participating hospitals was in the range 0.12 - 4.46 mGy. The mean ESD for the AP skull. PA skull and LAT skull were 8.55, 5.17 and 6.97 mGy respectively. The mean ESD values are greater than the CEC reference doses, except for rooms 1 and 2 in UCH where the entrance surface doses for PA chest examination are below the CEC reference dose. The QA test results show non-compliance of the accuracy of tube voltage with acceptance limit in three rooms. The timer accuracy is also not within the acceptance limit in two rooms. The reproducibility of both the kVp and timer in all the rooms is good.

Guideline Adherence↗

Trans-hiatal oesophagectomy as palliative treatment for carcinoma of the oesophagus.

OBJECTIVE: To determine the role of palliation with trans-hiatal oesophagectomy in Nigerian patients with carcinoma of the oesophagus. DESIGN: Prospective case series. The first series was from February 1986 to September 1987 (Series A) while the second series was from March 1989 to November 1996 (Series B). SETTING: Cardiothoracic Surgery Unit (CTSU) of the University College Hospital, Ibadan, Nigeria. SUBJECTS: First series consisted of 10 consecutive operable patients with carcinoma of oesophagus seen over the period of study. The second series consisted of 21 consecutive patients with same disease. INTERVENTION: All patients had transhiatal oeosphagectomy by a two team approach and immediate placement of the freed stomach in the posterior mediastinum and cervical oesophagogastrostomy. RESULTS: Patients in both series had a comparable age range of 43 - 80 years for series A and 40 - 82 years for Series B. The duration of symptoms were 2 - 6 months and 2 - 12 months respectively, for series A and B. In series A, nine patients had carcinoma of the middle-third (M1/3) of the thoracic oesophagus and one patient had carcinoma of lower-third (L1/3) of the thoracic oesophagus. In series B, 18 patients had M1/3 and three patients had L1/3 lesions. Average blood loss in series A was 1,067 mls, corresponding value for series B was 852 mls. Postoperatively, all cases were classified as stage III or stage IV disease. There were 18 complications in eight patients in series A and 22 complications in 10 patients in series B. The commonest complications in series A were pleural enteries in six patients, haemorrhage four patients (three intraoperative, one post-operative) and respiratory failure (two patients). The commonest in series B were pleural enteries in nine patients, anastomotic leaks and stenosis in four patients and respiratory failure in three patients. Hospital mortality was 50% in Series A and 14.3% in series B. The causes of death were haemorrhage and respiratory failure in series A, respiratory failure in series B. Survival period in series A of the five patients discharged was for a median of 84 months, for series B, four patients were alive at 18 months post-operative, one patient attended follow-up clinic 24 months after surgery. No other adjunctive therapy was offered to the patients. CONCLUSION: Trans-hiatal oesophagectomy is a procedure suitable for patients with carcinoma of the oesophagus and affords palliation at an "acceptable price" among carefully selected patients with advanced carcinoma of the oesophagus.

Adult↗

Neonatal teratoma of the neck causing respiratory distress: a case report.

This is a case of a neonate with a large cervical mass and respiratory distress at birth. Radiological investigations revealed a predominantly solid mass with calcifications and multiple cysts, suggesting a teratoma. Patient died while being prepared for surgery and autopsy confirmed an immature teratoma. The clinical and pathological characteristics of paediatric cervical teratomas are discussed.

Adult↗

Abdominal computed tomographic scan-merits and demerits over ultrasonography: evaluation of 70 cases.

Computed tomography (CT) and Ultrasonography (USS) are commonly used to ascertain the cause of abdominal symptoms. In a retrospective study of 70 Nigerian patients who had abdominal ultrasonography prior to abdominal CT scans, the most frequent clinical feature was abdominal pain, which was reported in 20.8% of the patients. The prevalent ultrasonographic finding was hepatomegaly (12.2%) while bowel displacement was the most frequently reported CT finding (18.3%). There was no correlation between USS and CT findings in 11 patients (15.7%). There was some agreement in the findings of both tests in 75.7% of cases. Additional findings were noted in 38 (54.3%) of the latter group of patients on CT scans. Hundred percent agreement was reported in both imaging techniques in 5 radiological findings namely: dilated gall bladder, renal cysts, ascites, adrenal mass and utero-cervical mass. These findings suggest a high yield of diagnostic accuracy from abdominal sonography and increased diagnostic details provided by CT imaging. Our overall impression is that the diagnostic information provided by the two techniques are complimentary.

Abdominal Pain↗

Comparison of Siriraj Stroke Score and the WHO criteria in the clinical classification of stroke subtypes.

Clinical distinction between cerebral haemorrhage (CH) and cerebral infarction (CI) is important in the management of stroke patients in areas where CT scan facility is lacking or access limited by cost and distance. This distinction is necessary in our environment where an increasing proportion of patients are suspected to have haemorrhagic stroke. This study compares Siriraj stroke score (SSS) and the WHO criteria for the acute stroke syndrome as simple tools for this purpose. The computerised tomography (CT) brain scans of all patients referred with clinical diagnosis of stroke at the University College Hospital (UCH), Ibadan, and RADMED diagnostic centre. Lagos were retrieved and reviewed as well as the case notes of these patients at the referral hospitals. Relevant clinical data were extracted from the case records. The patients were classified into either CI or CH using the WHO criteria for acute stroke syndrome and the SSS. This classification was compared with the CT scan diagnosis using the latter as the gold standard. Data analysis was performed with Epi-info software, and Kappa statistics (k value) for comparability test with 95% confidence interval was used to compare the two clinical criteria with the gold standard. Ninety-six patients had complete clinical records and CT scan features consistent with the diagnosis of stroke, of which 52 were diagnosed as CI and 44 as CH. SSS had sensitivity of 50% for haemorrhage and 58% for infarction with an overall accuracy of 54.2%. The WHO criteria for the acute stroke syndrome had sensitivity of 73% for haemorrhage and 69% for infarction with an overall accuracy of 71%. The kappa coefficient was 0.18 for the SSS and 0.41 for the WHO criteria. The diagnostic accuracy of the WHO criteria for the acute stroke syndrome is higher than that of the Siriraj stroke score. The WHO criteria showed moderate agreement (k=0.41) with the CT scan, while the SSS showed no agreement (k=0.18). When CT scan is not affordable or its use is limited by distance, the WHO criteria for acute stroke syndrome could be more useful. A prospective study with a larger sample size is suggested for definitive conclusion.

Acute Disease↗

HIV-assocated lymphoma: a case report.

We report the case of a 3(1/2) year old boy who presented with sudden onset of headache. Fever and swelling of the left eye. He had complete opthalmoplegia of the left eye and 6th cranial nerve paralysis in the right eye. He was thought to have cavenous sinus thrombosis but CT findings suggestive of lymphoma led to the correct diagnosis of HIV associated Lymphoma It view of the rising incidence of HIV infection and the protein clinical manifestations, it is advised that all patients with disseminated tumour masses should be screened for the HIV virus, and CT examination should be made available to patients.

Abdominal Neoplasms↗

Incidence of dementia and Alzheimer disease in 2 communities: Yoruba residing in Ibadan, Nigeria, and African Americans residing in Indianapolis, Indiana.

CONTEXT: Alzheimer disease (AD) represents a major and increasing public health problem. If populations were identified with significantly lower or higher incidence rates of AD, the search for risk factors in the genesis of AD could be greatly enhanced. OBJECTIVE: To compare incidence rates of dementia and AD in 2 diverse, elderly community-dwelling populations. DESIGN: The Indianapolis-Ibadan Dementia Project, a longitudinal, prospective population-based study consisting of a baseline survey (1992-1993) and 2 subsequent follow-up waves after 2 years (1994-1995) and 5 years (1997-1998). Each wave followed a 2-stage design, with an in-home screening interview followed by a full diagnostic workup of a subsample of participants based on screening performance. SETTING AND PARTICIPANTS: A total of 2459 community-dwelling Yoruba residents of Ibadan, Nigeria, without dementia, and 2147 community-dwelling African American residents of Indianapolis, Ind, without dementia (all aged 65 years or older). The cohorts were followed up for a mean of 5.1 years and 4.7 years, respectively. MAIN OUTCOME MEASURES: Incident cases of dementia and AD in each of the 2 populations. RESULTS: The age-standardized annual incidence rates were significantly lower among Yoruba than among African Americans for dementia (Yoruba, 1.35% [95% confidence interval [CI], 1.13%-1.56%]; African Americans, 3.24% [95% CI, 2.11%-4.38%]) and for AD (Yoruba, 1.15% [95% CI, 0.96%-1.35%]; African Americans, 2.52% [95% CI, 1.40%-3.64%]). CONCLUSION: This is the first report of incidence rate differences for dementia and AD in studies of 2 populations from nonindustrialized and industrialized countries using identical methods and the same group of investigators in both sites. Further explorations of these population differences may identify potentially modifiable environmental or genetic factors to account for site differences in dementia and AD.

Aged↗

Experience with computed tomography (CT) pelvimetry in Ibadan, Nigeria: a preliminary report.

Computed tomography (CT) pelvimetry has largely replaced conventional radiography in the antenatal assessment of pelvic dimensions, but its usefulness in the Nigerian setting is yet to be assessed. This study was undertaken to ascertain if there is a relationship between antenatal CT pelvimetric measurements and the mode of delivery at the end of the pregnancy. A group of thirty-one patients who had antenatal pelvimetry were categorised into two groups depending on whether they achieved vaginal delivery or not and the pelvimetric and other obstetrrc characteristics of the two groups were compared. The only parameters that showed statistically significant differences between the groups were the higher maternal height and the lower head circumference in the neonates of women achieving vaginal delivery. The findings suggest that fetal parameters may be more predictive of mode of delivery than absolute pelvic measurements.

Birth Weight↗

Prevalence of cholelithiasis in Nigerians with sickle cell disease.

Gall bladder ultrasonography was performed on 157 fasting patients (mainly adults) with sickle cell disease (133 SS and 24 SC) with a view to establishing the prevalence of cholelithiasis in Nigerian 'sicklers'. There were 82 females and 75 males whose ages ranged from 9 to 60 years (mean 34.5). Gallstones were demonstrated in 38 patients, giving an overall prevalence of 24.2% (22.6% in SS and 33.3% in SC). Their ages ranged from 18 to 56 years (mean 37.0) in HbS + C patients and 10-34 (mean 22.0) in SS patients. All the patients except one were asymptomatic. Autopsy confirmed gallstones in two SS patients who died of unrelated problems. The higher prevalence obtained in this study (24.2%) compared with the prevalence (less than 10%) in earlier studies from Africa could be due to the predominantly adult age group screened and the greater sensitivity of cholecystosonography.

Adolescent↗

Routine pre-operative chest radiographs in non-cardiopulmonary surgery.

The routine pre-operative chest radiographs of 203 consecutive patients scheduled for elective non-cardiopulmonary surgery were reviewed. There were 122 abnormal findings, 27 (22%) of which were significant, 95 (77.8%) insignificant. Of the former, 74% were due to cardiomegaly, while the latter included such findings as aortic unfolding (87%), pleural thickening (5.26%) and cervical ribs (2.11%). No abnormalities were found in subjects below 30 years of age, and there were no significant abnormal findings in subjects aged less than 40 years. This study shows that routine pre-operative chest radiographs in patients undergoing elective noncardiopulmonary surgery should be limited to patients with clinical symptoms, and high-risk patients, especially individuals aged greater than or equal to 50 years. Such radiographs are unnecessary in asymptomatic patients less than or equal to 30 years of age.

Adolescent↗

Osteopetrosis in a Nigerian woman--a case report.

A case of osteopetrosis complicated by chronic osteomyelitis of the mandible, pathological fractures, pancytopenia and splenomegaly is presented. Family studies revealed a dominantly inherited pattern.

Adult↗

Percutaneous transhepatic cholangiography: Ibadan experience.

Our experience using the teflon method in carrying out transhepatic cholangiography is described. A teflon needle (20 gauge) was used instead of the conventional Chiba needle. The number of successful examinations and their complication rate are comparable with examination carried out with Chiba needle. The ease of the procedure with the teflon needle and its relative cheapness make this technique preferable, although not without risks, especially in the developing countries where inadequate funds are available for health care.

Cholangiography↗