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Biomedical subjects

J H Lawrie

Publications and source records attributed to J H Lawrie.

At least 19 recordsLinked to original sources
PubMed1988

Burns in adults in Zaria, Nigeria.

From 1971 to 1981, 245 adults with burn injuries were admitted to the Ahmadu Bello University Hospital, Zaria. The burns were major in 197 patients, moderate in 28 and minor in 20. Socioeconomic factors contributing to the injuries included the use of wood fires for cooking, for warming the body and the dwelling during the cool harmattan season, loose indigenous garments, thatch-roofed huts, petrol hoarding and epileptic seizures. Flame burns exceeded scalds with a high seasonal frequency in both men and women during the harmattan. Scalds occurred predominantly among the women, puerperal hot baths being a major cause. The overall mortality rate of 22 per cent is excessive. General economic development, architectural improvements, proper handling of petrol and kerosene, modification or abandonment of the puerperal ritual of hot baths, the maintenance of chronic epileptics on anticonvulsants and a programme of universal active immunization against tetanus would contribute to the prevention of burns and complications in adults and decrease the mortality rate.

Adolescent↗
PubMed1987

Childhood burns in Zaria, Nigeria.

From 1971 to 1980, 429 children with burn injuries were admitted to the Ahmadu Bello University Hospital, Zaria. These were major burns in 275 patients, moderate in 82 and minor in 72. Fourteen of the patients were neonates, 102 infants, 228 were 5 years old or younger and 85 were older. Socioeconomic factors contributing to the injuries included the use of firewood for cooking at ground-level and for warming the house and body during the cold season; loose indigenous garments; thatch-roofed huts and the post-partum rituals of mud-bed heating and hot baths. Flame burns exceeded scalds with a seasonal frequency which peaked during the harmattan. In the absence of a 'burn's unit', burned children were nursed on the general ward together with other sick children by the same nursing personnel supervised by general surgeons. Complications included wound infection, respiratory distress, measles, malnutrition and tetanus. One-fifth of the patients absconded. Overall mortality was 13 per cent but 29 per cent of the neonates died. Preventive strategy should include public information, nursery school supervision, economic development and architectural improvements.

Adolescent↗
PubMed1985

Surgical management of advanced gastric carcinoma in Zaria, Nigeria.

In Zaria, Nigeria, 47 men and 37 women aged 25 to 70 years were operated upon for advanced carcinoma of the stomach between 1971 and 1982. In 1971-1976, gastric resection was performed in 33% of the 42 patients and by-pass in 31% compared to 67% and 17% respectively in the other 42 patients treated in 1977-1982. Increased resection of tumours of the corpus, cardia and fundus and of involved adjacent organs accounted for this increase. The in-hospital death rate (29%) was the same for gastric resection and by-pass operations. In this part of the world where reliable chemotherapy and radiation technology are not yet available, the role of the surgeon in securing palliation from gastric cancer remains very prominent.

Adenocarcinoma↗
PubMed1984

Bacterial liver abscesses in Nigeria.

There has been no previous report on bacterial liver abscess (BLA) from West Africa. During the period 1972-1979, 13 patients were treated for BLA in Zaria, Nigeria. S. aureus was the most frequent pathogen but an anaerobic streptococcus was identified in one instance. The case fatality rate was 54%, similar to those reported in the literature. Since diagnosis was made without the benefit of the newer liver-imaging technologies it seems probable that BLA is underdiagnosed and therefore untreated in some patients.

Adolescent↗
PubMed1983

The perineal urethrotomy approach to posterior urethral valves.

We treated 25 patients with posterior urethral valves by a perineal urethrotomy approach that required no sophisticated radiological or endoscopic equipment. The over-all results were considered good in 17 patients (68 per cent) who had restoration of normal micturition and renal function. Of the remaining patients 4 (16 per cent) had some residual stricture that responded to urethral dilation, 2 (8 per cent) had fairly normal micturition with occasional dribbling, 1 had persistent chronic renal insufficiency despite adequate relief of obstruction and 1 died of renal failure. The results of this approach are comparable to other methods described in the literature. The method is particularly appropriate in developing countries or in centers with limited urological facilities.

Adolescent↗
PubMed1983

Congenital posterior urethral valves: problems of management in countries with limited facilities.

There is scanty reference in the literature from the tropics, especially from Africa, to posterior urethral valves (PUV). The condition is not uncommon in Africans. Forty-five patients seen during a period of 10 years at the Ahmadu Bello University Hospital, Zaria, Nigeria have been analysed in order to discover any problems this abnormality may pose that are peculiar to the developing countries of the tropics. Two-thirds of the patients were under one year of age when first seen, one-third of them being under one month. About a quarter had no urological symptoms at presentation. Most of these were neonates and infants often critically ill due to sepsis and uraemia. These non-urological presentations caused delay in diagnosis and referral with detrimental effects on prognosis. However, the diagnosis could be made on clinical examination by demonstrating a palpable bladder and/or renal masses. Voiding cystourethrogram confirmed the diagnosis when carried out carefully, and required no specialized equipment. Most children were treated satisfactorily by perineal valve ablation, using simple inexpensive instruments. The death rate was high mainly due to delay in diagnosis and in starting appropriate treatment. It is suggested that amongst all who have care of children in the tropics, increased awareness of the varied clinical manifestations of PUV would improve prognosis.

Adolescent↗
PubMed1981

Tropical paediatric intussusception--is it a different disease entity?

The presentation of intussusception in children in Zaria, Nigeria has been studied with the aim of identifying any features that may differentiate it from that which obtains in temperate countries. Our data reveal no difference in age of peak incidence, sex ratio, absence of preceding upper respiratory infection or lack of significant seasonal variation. However, there is an unusually high incidence (41%) of caecocolic intussusception. It is believed that this may account for other observed features, such as the low occurrence of constipation and other evidence of intestinal obstruction, and the relatively high incidence of "painless" intussusception and sub-acute or chronic intussusception. Twenty-nine per cent of the patients had only one or two of the usual diagnostic features of the disease and this contributed to delayed diagnosis. In all but two patients the condition was idiopathic and there was no evidence to implicate bacterial enteritis or parasitic infestation in the aetiology of the disease.

Adolescent↗
PubMed1979

Gastric ulcer in Zaria, Nigeria.

In 1971 to 1977, 34 patients were operated for gastric ulcer at Zaria in the Savannah region of Northern Nigeria. The most frequent operation (35%) was for perforation. The frequency of perforation is similar to Ibadan's but smaller than Dakar's. Compared with Ibadan and Burundi, there are fewer women, more Type I ulcers and more frequent haemorrhages. There were three giant lesser curvature ulcers. Only a few combined duodenal and gastric ulcers were seen suggesting that gastric stasis is not the immediate factor in the production of gastric ulcer in this region.

Adolescent↗
PubMed1978

The two histological types of gastric carcinoma in Northern Nigeria.

Sixty-five specimens of gastric carcinoma from Northern Nigeria were classified using the criteria of Lauren (1965). Forty were intestinal, 16 diffuse, 2 mixed, and 7 unclassifiable. The intestinal type predominated in both men and women and in all age groups contrary to the expectation of a diffuse predominance because of the relatively young age groups of the population and the low risk for gastric carcinoma in this region.

Adult↗
PubMed1976

Pathophysiologic studies in human rabies.

Six patients with proved rabies were studied with a combination of clinical, physiologic and pathologic technics. Three were given a type of intensive care but died with evidence of respiratory failure. Although circulatory failure did not develop in any of the six patients, three had supraventricular arrhythmias: interstitial myocarditis was found in one of these and rabies virus was isolated from the myocardium of another. Inspiratory muscle spasm was the dominant clinical feature in all cases. This occurred as part of the hydrophobic response and followed stimulation of the upper respiratory tract and skin. Hydrophobia may represent an exaggerated respiratory tract irritant reflex with associated arousal. Later in the course of the disease, various patterns of periodic and ataxic breathing were observed. Widespread brain stem encephalitis was discovered at autopsy, with particular involvement of the neighborhood of the nucleus ambiguous in two of three patients examined. In one patient cerebral metabolism was grossly abnormal, with greatly reduced cerebral oxygen consumption suggesting irreversible brain damage. Respiratory and circulatory disturbances may well be immediate causes of death in patients with rabies, but the present studies reemphasize the severity of the encephalitis which remains the ultimate barrier to survival. In the developing countries in which rabies is still a major problem and in which the cost precludes intensive care, the clinical management of rabies can aim only to reduce suffering by heavy sedation.

Adolescent↗