Biomedical subjects
Publications and source records attributed to M Ibrahim.
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Ninety patients with biliary atresia surviving more than 5 years were analysed with respect to late complications occurring after the age of 4 years. Thirty-five had complications including cholangitis, portal hypertension, hypersplenism, gastrointestinal bleeding, and esophageal varices. These complications occurred at various times. The background factors of late complications were past history of cholangitis soon after the operation, advanced age at operation, re-operation, high portal pressure at initial operation, and a long interval before disappearance of jaundice after surgery. These factors are mostly related to the first operation and its postoperative course. Therefore, we stress that late complications can be prevented by intensive treatment of the patient at the time of the first operation.
A study was conducted of African medical students in two schools to determine their level of understanding of some culinary metaphors in medicine, particularly those used in the description of certain paediatric conditions. The results showed that the vast majority of medical students and young resident doctors are not familiar with many of the European foods, fruits and beverages that are commonly used in medical textbooks to describe disease conditions. In describing disease, it is suggested that medical educators and authors in Europe should endeavour to use terms that are simple and universal. They should not assume universal knowledge of fruits and dishes available in their environment. Medical educators in Africa should also simplify the description by using appropriate terms.
Between 1984 and 1989, 773 patients less than or equal to 45 years of age, presenting with a total of 809 ovarian cysts, underwent pelviscopy at the Department of Obstetrics and Gynecology of Kiel University. In 36 cases, cysts were bilateral. 678 cysts (84%) were treated by pelviscopy alone. Organ-preserving treatment was performed in 83%, oophorectomy or adnexectomy in only 17% of cases. Two stage Ia ovarian carcinomas (0.26% of all cysts) were operated on by pelviscopy before laparotomy. Sonography is particularly important in determining whether a pelviscopic approach is appropriate. Pelviscopic procedures are unacceptable in multilocular cysts measuring greater than or equal to 7 cm in diameter with echo-dense components. Special caution is required for any cyst measuring greater than 9 cm in diameter. The risk of opening a malignant cyst must be weighed against the advantages of pelviscopic surgery: minimal physical strain, better postoperative quality of life, and organ conservation. In doubtful cases, laparotomy is recommended.
Although biliary atresia is characterized by luminal obstruction of the extrahepatic bile ducts, the etiology and the pathophysiology of the liver are still controversial. The prognosis of biliary atresia has been improved after the introduction of Kasai's hepatic portoenterostomy, but there are still many problems to be solved in the treatment of this disease. Successful results of hepatic portoenterostomy depend on early diagnosis and operation, adequate operative technique, prevention of postoperative cholangitis, and precise postoperative management. However, we are on the verge of a new era in the therapy of biliary atresia combining portoenterostomy with liver transplantation.
The cell mediated immune response in the prodromal and exanthem clinical stages of measles infection was measured by the degree of T-lymphocyte activity (E-rosette) and compared with controls. Data obtained showed T-cell activity which was markedly different in the stages of measles infection under investigation.
A 10-year-old schoolboy was referred to the Ophthalmic Unit of Ahmadu Bello University Teaching Hospital because of sudden loss of sight following 5 days of severe frontal headache. The child had bilateral ptosis with internal and external ophthalmoplegia and fixed and dilated pupils. There was no papilloedema. Eight days later, a jaw tumour and a rapidly enlarging abdominal tumour appeared. A fine needle aspiration biopsy of the jaw tumour confirmed Burkitt's lymphoma. Combination chemotherapy with cyclophosphamide, vincristine and methotrexate (COM) led to a rapid resolution of the jaw and abdominal tumour but the child never regained his sight. Cerebrospinal fluid examination was not helpful in reaching a diagnosis.
Finger clubbing was observed in 21% of 70 adult Nigerian patients presenting with pulmonary tuberculosis. These patients had a significantly higher incidence of haemoptysis and they also showed a significantly lower body weight and serum albumin than those without clubbing. Their chest x-rays revealed larger cavities and at 2 months the mortality of the patients with finger clubbing (40%) was very much higher than of those without (5.5%). It is suggested that finger clubbing is of value in assessing patients with pulmonary tuberculosis because it helps to identify those with severe destructive disease.
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