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Biomedical subjects

S M Mlay

Publications and source records attributed to S M Mlay.

11 recordsLinked to original sources
PubMed1995

Tuberculosis of the spine in children at Muhimbili Medical Centre, Dar es Salaam.

A retrospective study of 22 children with tuberculosis of the spine who were managed at Paediatric Surgical Unit (PSU) of Muhimbili Medical Centre (MMC), Dar es Salaam between 1988 and 1993 was done. There were 12 boys and 10 girls of ages ranging from 3-13 years. Majority of the patients presented with back pain and/or deformity and weakness in the legs associated with difficulty in walking. The diagnosis was based on radiological as well as haematological findings. Two patients had associated lung lesions and these gave AFB positive sputum. Majority (63.5%) were thoracolumbar T11-L2. All patients received chemotherapy and in addition two had simple drainage of paravertebral abscesses and two debridement and bone grafting. There was no formal immobilization except that they had to sleep on hard beds. All gave a history of BCG vaccination scars. Mantoux or Heaf test was done on 16/22, patients of whom 11/16 (68.8%) were positive. One patient ended up with paraplegia, one with marked paraparesis and in 17/22 the kyphosis/gibbus increased. Laxity in the tuberculosis control programmes and the widespread of HIV could play part in what seems to be a flare up of tuberculosis infection in the recent past.

Adolescent↗
PubMed1994

Undescended testis in paediatric patients at Muhimbili Medical Centre, Dar es Salaam.

A retrospective study of 40 patients with 47 undescended testis (UDT) who were managed at the Paediatric Surgical Unit (PSU) of Muhimbili Medical Centre (MMC), Dar es Salaam between April 1986 to April 1993 was done. Their ages varied from 4 months to 13 years. 12.5% of patients presented in infancy while 50% presented by the 5th year of life. The presenting symptom in 75% was either an empty scrotum or impalpable testis while in 17.5% of patients it was due to an inguinal hernia; in 5% it was due to inguinal mass while in 2.5% it was due to testicular torsion. The right side was involved in 52.5%; left side in 30% while 17.5% were bilateral. Associated hernia was observed in 75% of cases. 42.5% were operated at an age below 5 years while 85% were operated on by the age of 9 years. 76% of the testes were located in the inguinal canal; 14.8% intra-abdominal; 4.% at the superficial inguinal pouch while 4.3% could not be located. 29.8% of the testes were either subjectively smaller than would be expected or were atrophic. Of these testes, more than 50% were in children above 8 years of age. Orchidopexy was attempted in 46 testes while orchiectomy was performed in one case.

Adolescent↗
PubMed1994

Some observations on acquired oesophageal obstruction in paediatric patients in Tanzania: a 5-year review.

Thirteen consecutive paediatric patients with acquired oesophageal obstruction were managed at the Paediatric Surgical Unit (PSU) of Muhimbili Medical Centre (MMC), Dar es Salaam, Tanzania, between January 1988 and December, 1992 inclusive. There were seven males and six females. The ages of onset ranged from the neonatal period to 6 years, with seven (54%) of them being within 2 years of age. Ten (77%) of the patients had corrosive strictures, caused by the ingestion of caustic soda 4, hair-plaiting chemicals 5, and kerosene one. Two of the remaining patients had non-corrosive strictures following measles in one and candidiasis in the other, while in the last case (a newborn), the obstruction was due to post-traumatic retropharyngeal haematoma from attempted infanticide. All but one of the patients were managed with oesophageal dilation, with or without a preliminary feeding gastrostomy. Six (50%) of the stricture cases died, all of them having had corrosive strictures. The main cause of mortality was complications of oesophageal dilatation.

Barium Sulfate↗
PubMed1993

Anterior fontanelle scalp cysts in infancy.

Seven infant patients with anterior fontanelle scalp cysts who were managed at the Paediatric Surgical Department of Muhimbili Medical Centre, Dar-es-Salaam between January 1986 and December, 1992 were studied. They were all Africans. There were 2 boys and 5 girls. Their ages ranged from 4 months to 24 months. The onset was at birth in 6 infants while in one case it was at 3 months of age. Their mental as well as motor development was normal. They were all easily and completely excised and in none was there intracranial communication. The histology was that of dermoid cyst in 6 patients and sebaceous cyst in one. There were no preoperative or postoperative complications noted.

Age Factors↗
PubMed1993

The management of depressed skull fractures in children at Muhimbili Medical Centre, Dar es Salaam, Tanzania.

Thirty eight consecutive children with depressed fracture of the skull admitted to the Paediatric Surgical Unit (PSU) of Muhimbili Medical Centre (MMC), Dar es Salaam between January 1986 to May 1992 were studied. There were 22 boys and 16 girls. Age range was from birth to 10 years. A fall of one form or another accounted for 25 (65.00%) patients. Falling from a sister's or mother's back occurred in 4 (10.5%) patients, while falling from trees was a cause in 8 (21%) patients. Objects hitting on the head accounted for 6 (15.8%) patients. The objects included stones in 3 and falling coconut fruits in three. Traffic motor accidents accounted for 5 (13.2%) patients. In 35 (92.1%) patients, the fractures were closed while in 3 (7.9%) they were open. The fractures were located in the frontal or parietal bone in 27 (76.3%) patients. The 3 coconut fractures were located at the sagittal area. Only 4 (10.5%) patients had focal neurological signs. Convulsions were recorded in 3 patients while loss of consciousness was observed in 4 patients. Surgery was performed on 22 (57.9%) patients while conservative approach was practised in 16 (42.1%). The indications for surgery were cosmetics in 15 patients, compound fracture in 3 patients, focal neurological deficit in 2 patients, and torn dura presenting with Pseudo-meningocele in 2 patients.

Academic Medical Centers↗
PubMed1993

Abdominal injuries in children at Muhimbili Medical Centre Dar es Salaam.

Fifty two consecutive children with abdominal trauma who were admitted and managed at the Paediatric Surgical Unit (PSU) of Muhimbili Medical Centre (MMC) between January 1987 and December 1990 were studied. There were 35 boys and 17 girls with ages ranging from 1 year to 11 years. Most of the children came from the mostly populated areas of Dar es Salaam. The commonest causes of injury were traffic accidents (57.7%), followed by falls (32.7%). All patients due to traffic motor accidents were pedestrians except two. Forty (77%) patients had blunt abdominal injuries while 12 (23%) patients had penetrating abdominal injuries. Of these patients with peritoneal penetration only two had significant vascular injury. All patients presented with specific signs of abdominal trauma. The commonest specific organ injured was the spleen followed by the liver. The mortality was 7.6%. Associated injuries were noted in 32.6% of the cases.

Abdominal Injuries↗
PubMed1990

Delayed intracranial haematomas.

Seven patients with delayed traumatic epidural and subdural haematomas who were treated at the Neurosurgical Centre, Nijmegen between 1975 and 1985 were reviewed. There were 3 males and 4 females with ages ranging from 16 to 70 years. Clinical signs which necessitated re-investigation in these patients included deteriorating level of consciousness in 3 patients, progressive hemiparesis in 1; extensor motor response and pupillary dilatation in 1; bradycardia in 1; and vomiting, severe headache and fits in 1 patient. Analysis of the initial CT-scan or angiography films demonstrated cerebral contusion in 4 patients and skull fractures in 5 cases. Of the 5 skull fractures there was a minor depression in 2 cases.

Adolescent↗
PubMed1989

Epidural haematoma: a study of 71 cases.

A study of 71 patients with epidural haematoma (EDH) who were managed surgically at the Neurosurgical Centre Nijmegen, Netherlands is presented. The male/female ratio was 5:2. 73.2% of all patients were under the age of 40 years. Traffic motor accidents and falls accounted for 84.5% as causes of head injury. 74.6% were either unconscious throughout or were initially conscious and subsequently unconscious. Only 53.7% were initially suspected to have EDH and investigated; while 46.3% developed signs suggestive of haematoma sometime after the initial assessment. The major clinical signs which influenced the initial management policy included lack of verbal response; pupillary dilatation and hemiparesis. Skull fractures were observed in 73.2% of which 9.8% had depressed fractures. The presence of a linear fracture did not influence the initial management policy.

Adolescent↗