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Biomedical subjects

E O Odelowo

Publications and source records attributed to E O Odelowo.

At least 19 recordsLinked to original sources
PubMed2003

Surgical emergencies in a Nigerian university hospital.

An audit of surgical emergencies was carried out to monitor acute trauma care and determine areas needing clinical improvement. This is essential for the development of institutional and national health policies on trauma and non-trauma diseases. All patients attending the surgical Accident and Emergency were studied prospectively from September 1999 to August 2000 to obtain their age, sex and diagnosis and to determine causes and injury-arrival time for trauma cases and the outcome of care for all cases. Out of 2,455 patients comprising 1,696 males and 759 females (M:F = 2.2:1) age range two weeks to 95 years, trauma accounted for 1,679 (68.4%). The median age (and the mode) of presentation overall and in males was in the third decade. Females had a 'plateau' age of presentation for the first four decades before the gradual fall to zero. Superficial skin trauma (lacerations, abrasions and bruises) represents the commonest presentation (16.1%) followed by fractures (13.9%), acute abdominal conditions (7.6%), head injury, HI (5.5%), multiple injury (4.1%), urinary retention (3.3%), burns and scalds (3.3%) and others. Eight-one patients died, comprising 54 males and 27 females, out of which 64 were trauma related deaths. Most common causes of death were HI (35 patients, 43.2%) and septicaemia (13 patients, 16.0%). Late presentation and poor finances contributed to the deaths in patients with septicaemia. Trauma is an important entity in our emergency practice. Prompt access to surgical care should reduce the morbidity and mortality from acute abdominal conditions and HI. The high incidence of urinary retention requires further analysis. Statistics of this nature can aid planning of care delivery and study of preventable deaths.

Adolescent↗
PubMed1994

Pattern of trauma resulting from motorcycle accidents in Nigerians: a two-year prospective study.

A two-year prospective study of injuries sustained from motor-cycle accidents (MCA) was conducted at the University of Ilorin Teaching Hospital, Ilorin, Nigeria, in 1983 and 1984 after repeal of the national mandatory helmet law. MCA patients constituted 10.3% of 715 road traffic accident (RTA) patients and also presented a 5.7:1 male preponderance. Peak age was 18 to 30 years. Nearly 75% sustained lower extremity, chest and cranioencephalic injuries. Non-operative management sufficed in 34 patients (45.9%) while 30 (40.5%) and 10 (13.5%) require operations respectively. Eighteen (24.3%) and 17 (23.0%) patients required local/spinal and general anesthesia respectively. Mortality was 6.8% (5 patients). This analysis of MCA injuries provides objective basis for current comparison with what obtains in jurisdictions with/without mandatory helmet law and future comparison when the law is re-enacted in our state.

Accidents, Traffic↗
PubMed1994

Mantoux test tuberculin reaction in Nigerians.

Thirty-seven Nigerian tuberculosis patients and 75 control volunteers were Mantoux-tested with 1 or 5 or 10 tuberculin units of Tween-80 stabilised purified protein derivative (P.P.D.) in order to relate tuberculosis infection to skin reactivity. Serum transferrin and albumin levels determined by radial immunodiffusion technique showed some overlap but test patients tended to have lower values than controls. Skin reaction was not significantly affected by age which varied from 6 to 55 years or the extend of tuberculosis treatment at Mantoux testing. For comparable P.P.D. doses Mantoux readings greater than 9.9mm showed 86.5% sensitivity for tuberculosis but presented low (28%) specificity in contrast to readings greater than 15mm with specificity of 74.7%. Significantly higher proportion of test patients than controls showed skin reaction greater than 9.9mm (p < 0.05) whereas the difference was insignificant at 9mm. With improving nutrition there is need for a large-scale reappraisal of the value of intradermal tuberculin test in diagnosing active tuberculosis in Nigerian reactors.

Adolescent↗
PubMed1993

Factors affecting morbidity and mortality from road traffic accidents: a Nigerian peri-urban study.

Road traffic census was taken along major roads linking Ilorin, Nigeria, with the north, east, south and north-west at different times on three randomly selected days per month during 16 months of 1982 and 1983. Road physical characteristics thought to affect safe and free traffic flow were also documented along the same roads. Trauma patients at the University of Ilorin Teaching Hospital were prospectively studied between 1983 and 1984. Of 715 road traffic accident (RTA) victims 78.6% were males, 48% suffered multiple injuries while 43.7% were managed non-operatively. Seventy-nine patients (11.0%) died. Of 10 variables analysed, outcome was significantly affected by non-operative management (P < 0.01) while patients' primary admission versus referral status was of borderline significance (P = 0.05). In addition to these indices of trauma severity, high truck-trailer traffic and high frequency of narrow bridges, bends and vehicle wrecks per kilometer of road were associated with high RTA rates.

Accidents, Traffic↗
PubMed1993

Thoracic trauma in Nigerians: an eight year experience.

An eight-year combined retrospective and prospective review of thoracic trauma patients managed at the University of Ilorin Teaching Hospital, Ilorin, Nigeria between 1979 and 1986 is presented. Among 239 patients fully reviewed, were 189 (79.1%) males and 50 (20.9%) females. Mean age was 29.4 +/- 14.6 years. Road traffic accidents caused injuries in 72% of patients. The need for non-operative care, limited or extensive operations reflected severity of trauma except that eight severely injured patients were dead on arrival and another 12 were alive on arrival but died during resuscitation. Overall thoracotomy and mortality rates were 5.4% and 15.3% respectively. Unlike experience in developed countries there is a low incidence of penetrating, occupational and heart injuries and a high percentage of fractures of proximal ribs without associated aortic or bronchial ruptures. There is also a high incidence of multiple trauma.

Accidents, Traffic↗
PubMed1991

Surgical diagnosis of bronchopulmonary disease in Nigerians: the role of mediastinal biopsy.

Surgical diagnostic procedures were done on 33 Nigerians (20 males and 13 females [mean age 47.0 years +/- 20.5 SD]) who presented with atypical noneffusive bronchopulmonary diseases between 1982 and 1988. Rigid bronchoscopy was done 16 times with or without mediastinal biopsy. Mediastinal biopsy was done through scalene, supraclavicular, or suprasternal approach or by anterior mediastinotomy on 23 occasions. Diagnostic yield and clinicopathologic concurrence for the 23 mediastinal biopsies were 91.3% and 95.6%, respectively. No deaths were associated with these biopsy procedures.

Adolescent↗
PubMed1990

Clinical, operative and pathological correlations in fatal and near-fatal thoracic trauma in Nigerians.

A combined retrospective and prospective review of 248 chest trauma patients has been carried out at the University of Ilorin Teaching Hospital between 1979 and 1986. Eight and 12 of these patients respectively were so severely injured that they were certified dead on arrival in the Emergency Room or at varying periods during resuscitation but before definitive management. Ten others were subjected to major operation. The peculiar clinical features of this sub-group of 30 patients within the context of the entire series are analysed in detail and correlated with autopsy and operative findings in 20 and 10 patients respectively. Most (36.7%) of the severe injuries occurred in the 21-30 age group followed by children under 10 years of age (16.7%). When injuries are classified into life-threatening, potentially life-threatening and mild (including incidental pathology found at autopsy), the majority (95%) of autopsy cases sustained multiple trauma combining cranio-encephalic, abdominal, extremity and spinal injuries, in descending order, with chest trauma. Penetrating trauma constituted 50% of the thoracotomy group while all but one of 20 autopsy cases sustained blunt injuries. Multiple rib fractures including proximal ones were common. No major tracheobronchial or aortic disruptions were encountered while two cases of heart injury were seen. Suggestions are made towards decreasing the injury treatment interval, improving the general level of preparedness and diagnosis of visceral injury despite more obvious non-visceral trauma.

Adolescent↗
PubMed1990

Perioperative infections in Nigerians: a seven-year prospective study.

The introduction of simple, measures in addition to usual aseptic and antiseptic measures at the University of Ilorin Teaching Hospital theatre in Ilorin, Nigeria, led to a significant decrease in perioperative infection rate in a pilot study. These measures were applied to 440 operative procedures in a unit over a 7-year period in an old as well as new theatre. Sterility tests on sterilizing packs, nasal and throat swabs and bacteria-carrying particle samplings were done to document and limit the sources of wound contamination. Mortality and infection rates were significantly higher among patients undergoing thoracic than extrathoracic surgical operation (P less than 0.05; p less than 0.005) including post-tube thoracostomy empyema. Clean and clean-contaminated cases survived operations significantly more frequently and were significantly less infected than the contaminated and dirty cases (less than 0.001; p less than 0.005). Although there was significantly higher mortality (p less than 0.05) in patients older than 31 years, there was no significantly higher infection rate. Neither the mortality rate nor infection rate was significantly affected by seasonal and patients' sex. Overall infection rate was 7.5% (32 out of 428 fully evaluated patients) while wound and non-wound infection rate in this study is an improvement over those previously reported in this country.

Female↗
PubMed1989

Congenital chest wall malformations in Nigerians.

The pattern of congenital chest wall malformations has been studied prospectively at the University of Ilorin Teaching Hospital between 1983 and 1987. A clinical series of 20 patients was found among 2195 patients selected randomly from 10,031 patients obtaining radiographs, and also from 1070 patients seen in the Cardiothoracic Surgery Clinic. An autopsy series of 15 foetuses and newborns was found among 205 studied for malformations. The 35 cases were found to have supernumerary ribs (10 clinical, eight autopsy), absent or defective ribs (three clinical, four autopsy), sternocostal deformities (three clinical, three autopsy) and four clinical cases with thoracic/thoraco-lumbar scoliosis and neonatal dwarfism with short ribs. Apart from two autopsy specimens (Cantrell's pentalogy with acrania and extensive abdominoperineal omphalocele) whose associated malformations appeared to be incompatible with life, all foetuses and newborns apparently had usual perinatal causes of death. One patient presented with costoclavicular syndrome while another had chest wall excision for a suspected tumour in a bifid rib. A patient with Poland's Syndrome and absent digits, and another infant with Cantrell's Syndrome are awaiting surgical reconstruction. The incidence of the malformations is approximately 1.01%. Other clinicopathological features are presented and the literature is reviewed.

Adolescent↗
PubMed1984

Management of pulmonary aspergilloma in the presence of active tuberculosis.

Eleven cases of pulmonary aspergilloma complicating active cavitating pulmonary tuberculosis are reviewed. Nine of the 10 patients who had combined medical (antituberculosis drugs) and surgical treatment were cured of their disease; one patient, who had bilateral multiple aspergillomas, died from massive haemoptysis after resection of one of the affected lobes. The only medically treated patient who refused surgery had fatal haemoptysis at home. Pulmonary resection is recommended for patients who are fit for operation whenever the diagnosis of aspergilloma is made because most published reports indicate that only a few patients benefit from drug treatment alone.

Adult↗
PubMed1977

The CVP catheter: an invasive therapeutic adjunct.

Invasive techniques continue to be used in monitoring and treating the critically ill patient in spite of preference for, and increasing use of, non-invasive or minimally invasive techniques. With or without simultaneous determination of left ventricular filling pressure, the central venous pressure (CVP) catheter is widely used for gaining access to the right heart, determining right ventricular filling pressure, and for rapid infusion of fluids or medications. Even in expert hands the insertion of the CVP line is occasionally followed by complications that may require therapeutic interventions of varying degrees of severity. The possible hazards from this simple and often necessary therapeutic adjunct call for a systematic informed-consent approach which is often neglected despite its relevance in today's clinical practice. The data presented are typical of a standard teaching hospital experience. Securing informed consent for CVP catheter insertion is encouraged.

Cardiac Catheterization↗
PubMed1977

Another look at pseudotumor cerebri.

Thirteen black patients with diagnoses of pseudotumor cerebri (benign intracranial hypertension) were treated in Howard University (Freedmen's Hospital) between 1962 and 1974. These patients presented features similar to others reported with this syndrome as regards age, sex, habitus, menstrual irregularities, treatment, and prognosis. There was no suggestion of higher incidence of the syndrome in blacks. This paper emphasizes the unknown etiology. Only a complete patient work-up, including hemoglobin genotype, endocrine study, pulmonary function tests, blood and cerebrospinal fluid gases and, where applicable, brain Po(2), Pco(2) and pH can serve as a reasonable prelude to an experimental model for studying the pathophysiology of this poorly understood syndrome and a more rational basis for therapy. A review of the literature dealing with suspected etiology, diagnosis, and therapy is also presented.

Adolescent↗
PubMed1975

Granular cell myoblastoma: another unusual esophageal lesion.

The case is presented of a 48-year-old woman with esophageal granular cell myoblastoma who was treated by local excision. A review of the literature is also included. So far as we can determine, this is the thirteenth such case reported.

Esophageal Neoplasms↗