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Biomedical subjects

M F Omojola

Publications and source records attributed to M F Omojola.

18 recordsLinked to original sources

Computed tomographic brain scan findings in Saudi epileptic patients.

Computed tomographic (CT) brain scan was performed on 142 consecutive epileptic patients of Saudi Arab extraction without clinical features of acute illness or a progressive neurological disorder at presentation. CT brain scan was normal in 56 patients (39%). CT scan was abnormal in 57 (73%) of 78 patients over 20 years of age compared with 29 (45%) of 64 younger patients (x2 = 11.3; p < 0.001); and in 25 (75%) of 36 patients presumed to suffer from symptomatic epilepsy on clinical grounds compared with 36 (46%) of 76 others with idiopathic epilepsy (x2 = 8.2; p < 0.01). Potentially treatable lesions were detected in 11 (8%) patients and congenital lesions in 9 (6%). Multiple lesions were present in the CT scan of 20 patients. Cerebral atrophy (CA), the commonest lesion detected, was present in 52 (37%) of 142 patients and 60% of 86 patients with abnormal CT scans. Diffuse CA was present in 21% of 78 patients over 20 years of age compared with 14% of 64 younger patients. Similarly, diffuse CA occurred in 25% of 48 patients with late-onset epilepsy compared with 14% of 94 patients in whom seizures began before the age of 20 years. Our findings are in accord with those previously reported and underscore the need for selective and judicious use of CT scan facilities in epileptic patients.

Adolescent

Bone changes in sickle cell anaemia.

Analysis of available radiographs of the skeletal system in 50 patients suffering from sickle cell anaemia in the Assir Region (South Western height and valley) of the Kingdom of Saudi Arabia taken over a three year period showed a wide spectrum of bone changes. Both infarctions and medullary hyperplasia were common, producing the usual previously reported changes. Spinal changes, mostly osteoporosis and vertebral end plate depression were more prominent in the younger age group. Avascular necrosis of femoral head was common and occurred earlier than in previous reports in the literature. Humeral head and radial head necrosis were also recorded. The overall findings agree with recent reports from both the Eastern and Western regions of the Kingdom that bone changes in SCA are common and could be more severe than in other countries. Complications such as osteomyelitis and fractures were not common.

Adolescent

Hydatid disease of the liver: evaluation of ultrasound and computed tomography.

We have evaluated computed tomography (CT) and ultrasonography (US) in 41 patients with hepatic hydatid disease. CT was diagnostic in all patients, while US performed on 36 patients was diagnostic in 34. In the remaining two cases, heavy calcification in one and a large amount of intracavitary air in the other prevented accurate diagnosis. The US findings in the liver regarding cyst form (multilocular or unilocular), size and location were comparable to those of CT. CT detected associated extrahepatic cysts in the abdomen and pelvis in 11 patients while US performed on the same group of patients detected such cysts in seven patients. It is suggested that the entire abdomen and pelvis should be scanned in patients suspected of hydatid disease and when a hepatic lesion is suggestive of the disease.

Abdomen

Embryonal rhabdomyosarcoma within a choledochal cyst.

The authors describe a 6-year-old girl in whom they found an embryonal rhabdomyosarcoma in a choledochal cyst; they found no previous reports of such an association. The patient presented with recurrent jaundice and loss of weight and appetite. A large abdominal mass was palpable. Ultrasonography and computed tomography revealed a large subhepatic mass, which contained multiple septations and mural masses delineating cystic areas. The common hepatic duct opened directly into the mass, and the intrahepatic radicles were dilated. Intraoperative cholangiography revealed that the cysts in the mass were continuous with the hepatic and intrahepatic radicles. The mass was completely excised, and a Roux-en-Y hepaticojejunostomy was performed. Postoperative adjunct chemotherapy and radiotherapy were instituted.

Biliary Tract Neoplasms

Intracranial haemorrhages after Nebo hierochonticus scorpion sting.

A 3-year-old boy, who was previously well, developed acute pulmonary oedema, fundal haemorrhages, temporary blindness and deafness following a Nebo hierochonticus scorpion sting. Cranial CT scan 8 days after admission showed bilaterally symmetrical multiple hyperdense areas with intense enhancement in the cerebellar and cerebral hemispheres consistent with multiple haemorrhages. He made a complete clinical recovery with resorption of the retinal haemorrhages 4 weeks after the scorpion sting. Cranial CT scan 8 months later revealed the intracranial lesions to be hypodense with no contrast enhancement, indicating resorption of the haemorrhages.

Animals

Cerebrovascular accidents (strokes) in children with sickle cell disease residing at high and low altitudes of Saudi Arabia.

In a 3-year period, eight cases of cerebrovascular accident were seen out of 400 patients with sickle cell disease residing at high and low altitudes of Asir Province of Saudi Arabia. They were all Saudi nationals and comprised five boys and three girls of ages ranging from 3.5 to 9 years. They had varied clinical presentations of their cerebrovascular accident. Cranial computed tomography in seven of them showed abnormality in the region of the middle cerebral circulation. Management and some suggested factors contributing to the occurrence of the cerebrovascular accident are discussed.

Altitude

Diverticula of the colon in three Nigerian siblings.

This is a report of diverticular disease of the colon in three Nigerian adult siblings. Diverticular disease of the colon is known to be rare in Nigerians. Presence of this disease in a large number of a particular family raises the possibility of a familial tendency or some other undefined underlying abnormality. The three siblings have spent some years in the industrialized world. Our anecdotal experience however shows that the prevalence of diverticular disease of the colon may be on the increase in Nigeria.

Diverticulum, Colon

Thoracic myelopathy secondary to ossified ligamentum flavum.

The authors report a case of ossification of the ligamentum flavum at T-10 and T-11 associated with compressive myelopathy. Metrizamide myelography with computerized tomography allowed precise preoperative diagnosis and anatomic localization of the lesion. The patient had satisfactory and prompt improvement after surgical intervention.

Humans

Hemorrhagic encephalitis produced by selective non-occlusive intracarotid BCNU injection in dogs.

A selective non-occlusive technique was developed for administration of BCNU (1,3-bis(2-chloroethyl)-1-nitrosourea) into the internal carotid artery of the dog, and the neuropathological effects in the brain were studied. One out of three dogs showed ipsilateral hemorrhagic necrotizing encephalitis at doses of 102 mg/sq m, and all of three dogs showed similar but more severe pathology at doses of 215 to 232 mg/sq m. This study and previous studies in the dog and monkey suggest definite thresholds above which cerebral toxicity occurs when BCNU is administered via the intracarotid route. Greater dilution of drug in the larger territory of supply of the human internal carotid artery allows somewhat higher doses in man. The pathology of the lesion induced by BCNU suggests a primary vascular injury as a pathogenic mechanism, consonant with similar findings following high-dose systemic BCNU administration in man. Investigators conducting ongoing and future trials of intracarotid BCNU in the human for the treatment of intracranial neoplasms should be especially vigilant for a similar toxic effect.

Animals

Osteoid osteoma: an evaluation of diagnostic modalities.

Significant delays still occur in the diagnosis of osteoid osteoma yet in two-thirds of cases the plain films show the characteristic features; unfortunately, early changes may be overlooked. A diagnostic approach is proposed for the investigation of focal bone pain in young individuals. Plain radiography is followed by isotope bone scanning with, if possible, a bone blood flow study. Tomography is sometimes helpful in atypical cases. CT scanning is valuable in foci in the axial skeleton including the pelvis. Lesions in the appendages of the vertebrae should be sought in patients with painful scoliosis or lordosis of relatively recent onset.

Adolescent

Case report. Calcified gastric duplication.

A case of gastric duplication with dystrophic calcification that was radiographically visible in a 53-year-old female is reported. We could not find any previous similar report in the literature.

Calcinosis

Stenosis of afferent vessels of intracranial arteriovenous malformations.

Four women are described with stenoses of the feeding arteries to cerebral arteriovenous malformations. These stenoses were hemodynamically significant in that the nidus malformations filled late in the arterial phase of angiography and the draining veins did not fill much earlier than the usual venous phase. In two of these patients, who were referred for possible embolization, the stenosis served as an impediment to balloon navigation in the feeding vessel in one and served as a partial contraindication to embolization in the other. It is possible that if these stenoses progress, they may lead to thrombosis of the arteriovenous malformations.

Adult