Biomedical subjects
Publications and source records attributed to T G Ijaduola.
Variances in religious practices and beliefs require health care providers to find alternative ways of meeting medical standards of care in cases where religious beliefs preclude the use of blood transfusions or blood products. We report a case of head and neck tumor with low hemoglobin in which we utilized temporary arterial ligation to aid in minimal blood loss.
This study reviews the current understanding of the pattern of breast cancer among whites, African Americans, and West Africans who have never immigrated to the US to find better ways of improving the prevention, early detection, and care of breast cancer world-wide. In the United States, the behavior pattern of breast cancer in African-American women differs from that of white women. Among the three populations, breast cancer appears to be least common in nonimmigrant West-African women. The peak incidence in African Americans and West Africans occurs around the premenopausal period while it occurs postmenopausal period in whites. Also, unlike white women, West-African and African-American women present late for treatment with a greater cancer burden and consequently lower survival rates. The predominant histological type is infiltrating ductal carcinoma in the three groups but the highest percentage (33%) of infiltrating poorly differentiated anaplastic carcinoma occurs in West Africans. Menstrual and obstetric history, obesity, and high body mass index status appear to be greater specific risk factors among African Americans than among West Africans. African Americans and West Africans have three "Ls" in common: late stage in seeking treatment, lower age at peak incidence with severe tumor burden, and consequently lower survival rates. There is a need for more detailed population-based research at molecular levels to elucidate the basis for some of these features.
Frontal sinus surgery for chronic disease presents a variety of problems, in particular that of drainage. No matter how successful the surgical technique is in clearing disease from the sinus, it is still important that the fronto-nasal duct is kept patent unless the procedure is an obliterative one. Usually a tube is inserted for drainage and has to be kept in place for several weeks or months. This paper presents a study of 16 patients, suffering from frontal sinus disease, in whom a short-term drainage technique using a Foley catheter was employed between 1979 and 1988 at Lagos University Teaching Hospital, Nigeria. This type of drainage allows effective anchorage and irrigation with a decongestant. It has been found to give satisfactory results after 14 days in place and has had no unusual complications. It is therefore recommended for use in such cases.
A study of 15 Nigerian children with parotid fistulae was carried out. The causes of the fistulae were found to be infection in nine children (60%), trauma in five (33.3%) and carcinoma in one (6.7%). The commonest infection was tuberculosis, with the primary site in the palatine tonsil and with associated tonsillar gland enlargement. In these cases there was no good response to tympanic neurectomy, surgical repair and anti-tuberculous therapy until palatine tonsillectomy was performed. It is therefore advised that the continued role of the tonsils as a primary site of tuberculous infection in the head and neck must always be sought, even in the management of parotid fistulae in children.
A study of 14 children with multiple neurofibromatosis (von Recklinghausen's disease) seen at the Lagos University Teaching Hospital within a six-year period (1979-1985) has been conducted. Eight patients were boys and six were girls. The youngest was aged 3 months. The cafe-au-lait spots that were observed in all these patients showed poor color contrast, thus making this condition not easily discernible in infancy and an early diagnosis difficult. These spots are perhaps better called "cafe-sans-lait" or blackish-brown spots in the African patient. Hyperpigmented patches were observed in eight (57 percent) patients and multiple, grotesque, soft tissue swellings were observed in ten (71 percent) others. Prolonged follow-up is mandatory in these patients so as to provide them with a better quality of life.
Otorhinolaryngological manifestations of 13 patients with von Recklinghausen's disease appearing at Lagos University Teaching Hospital over a five-year period have been studied. Among patients with ENT manifestations of the disease, the most common general features exhibited were cutaneous neurofibromas (100 per cent), headache (69.23 per cent) and pruritus (46.15 per cent). But the head and neck findings included external meatal canal stenosis (30.77 per cent), conductive deafness (30.77 per cent), nasal discharge (30.77 per cent), cranial nerve involvement (30.77 per cent) and disfigurement of the soft tissues of the face (30.77 per cent). Involvement of pinna (23.31 per cent), rhinolalia aperta (15.38 per cent), mental retardation (15.38 per cent) and pharyngeal swelling (7.69 per cent) also featured. Clinically detectable bilateral acoustic neurofibromas in adults or astrocytomas in children were not found in this series. Involvement of the frontoparietal bone (7.65 per cent) presented with skull bossing which had to be differentiated from that due to sickle cell disease in the African. There was also a singular case of phrenic nerve involvement. However, malignancy occurred in one (7.69 per cent) of these patients. Thus, it is important always to follow-up these patients closely so as to detect malignant transformation in time.
A Transcannular Tru-Cut needle maxillary antral biopsy technique, which has been devised as an out-patient procedure to speed up histological diagnosis in antral disease, is here described. A trial carried out with this technique shows that the histological diagnosis reached from such biopsy specimens compares favourably with that reached from specimens taken through an intranasal antrostomy.
In view of the various technical and electricity maintainance problems with endoscopes in any developing country, a new suspension device for laryngeal endoscopy with a straight-bladed anaesthetic laryngoscope has been described. The advantages of this system are its small size, cheap cost, lack of a chest piece and the use of a non-failing battery source. It also makes use of bipod stands already available in a tonsillectomy set. It can be used in the countryside, and in out-patient and mobile clinics.
A study of cases of retropharyngeal abscess in Nigerian children was carried out. It occurred most commonly in children under the age of 6 months and in more male children than female in a ratio of 5:3.Most children seen at the Lagos University Teaching Hospital were brought in late with the upper airway already obstructed. A diagnostic tool of soft-tissue x-ray examination of the neck is not foolproof. In fact, 22.58 percent of soft-tissue x-ray examinations of the neck in this study produced false-positive results. Factors contributing to these results are discussed.Bacteriology showed the main organisms to be Hemophilus influenzae (45.84 percent) and Streptococcus pyogenes (33.33 percent). All cases were found to be secondary to upper respiratory tract infection.
A study of 112 referred children with acute otalgia labeled 'acute otitis media' by the referring physicians was carried out at the E.N.T. clinic of Lagos University Teaching Hospital in 1981-1982. Only 11% of these were actually due to acute otitis media, reflecting poor technique at otoscopy. Of the acute otalgia cases 56% were due to ear pathology while 44% resulted from referred pain. Otological causes included foreign body in the ear (23%), acute otitis media (11%), otitis externa (10%), secretory otitis media (6%) and myringitis bullosa haemorrhagica (4%). Cases due to referred otalgia were from tonsillitis (21%), foreign body in the pharynx (5%), traditional uvulectomy (5%), and foreign body in the nose (2%). Thus, there is a need for more careful examination of the ear in all cases of acute otalgia.