Hematological and serum biochemistry comparison between cotton hair thread and silk suture on surgical skin wounds of rabbits

A total of 12 rabbits randomly assigned into three groups (I, II, and III) of 4 rabbits each were used. A 6-cm-long paralumber skin incision was aseptically performed in groups I and II using xylazine (0.5 mg/kg) and ketamine (22 mg/kg) as premedicant and anesthetic, respectively. The incised skins in group I rabbits were apposed with conventional silk suture, while the incised skins in the group II rabbits were approximated with cotton hair thread (CHT). Group III served as a control (no surgery). The hematological and serum biochemistry responses following the use of these sutures were evaluated. Packed cell volume (PCV), red blood cell (RBC) count, total and differential white blood cell (WBC) counts, total protein, and albumin and globulin levels were determined using standard methods at presurgery (day 0) and on postoperative days 1, 3, 7, 10, 14, and 21 in all the groups. Hematological and serum biochemistry parameters were analyzed using one-way analysis of variance (ANOVA). The means of PCV and RBCs in rabbits in groups I, II, and III showed no significant variations (p?>?0.05) throughout the study. The WBC count increased significantly (p?p?>?0.05) throughout the study. However, at day 3 postsurgery, the means of lymphocytes in rabbits in groups I and II increased significantly (p?p?>?0.5), but they vary and are significantly higher (p?p?>?0.05) throughout the study. Cotton hair Thread elicited insignificant hematological and serum biochemical changes compared to the conventional silk suture material.     

The use of camera mobile phone to assess emergency ENT radiological investigations

Objectives: To determine the accuracy of assessment of common ENT emergency radiological investigations using mobile phone digital images. Design: Prospective case controlled series. Setting: Tertiary referral otolaryngology centre. Participants: Fourteen randomly selected patients who underwent emergency ENT radiological investigations over a 1‐month period. Main Outcome Measures: The accuracy and confidence of six ENT consultants and five specialist registrars in making diagnoses based on a brief history and assessment of CT scans and X‐ray images taken from and transmitted via a mobile phone, compared with examination of the same films on a conventional X‐ray box. Results: With 14 films, a total of 154 cases were assessed by the 11 subjects. All doctors made the correct diagnosis for every case examined. Overall, the relative confidence of diagnosis was ranked highly for both image media, although the overall confidence of diagnosis using the X‐ray box was significantly greater than the mobile phone (95% CI upper bound = 1.6 lower bound = 0.9; paired t‐test P < 0.0001). The seniority of the clinician did not predict a difference in the confidence of diagnosis (P = 0.3). There is no statistical relationship between confidence of diagnosis of the original films and degradation of film quality on the mobile phone (P = 0.7). Conclusions: The accuracy and confidence of diagnosis of common ENT emergency radiological investigations using mobile phone digital images seem compatible with X‐ray box. Financially it is a much cheaper than conventional telemedicine technology. It may be used to augment information sent to non‐resident specialists in the management of emergency ENT cases.     

Isolated dextrocardia with bilateral undescended testis and bilateral polydactyl of the hands and feet: a case report

The incidence of dextrocardia with or without situs inversus is rare though the true incidence in Nigeria is not known. Plain films are the preliminary investigations of choice in diagnosis of situs anomalies. The aim of this case report is to emphasise the importance of recognition of the spectrum of situs anomalies, because the altered anatomy associated with these anomalies may result in confusing imaging findings, misdiagnosis and difficulties with treatment when seen in conjunction with acquired abnormalities of the chest and abdomen. This study also aim to emphasise the need for accurate placement of radiographic markers by the radiographers before exposure of the films as the key for identification of situs anomalies. The case of dextrocardia without situs inversus diagnosed in a 4-month old baby boy who also had bilateral undescended testis and bilateral polydactyl of hands and feet is presented. The imaging modalities for assessment of situs anomalies are discussed.     

Advice given to patients with epistaxis by A&E doctors

This study was devised to determine the proportion of patients with epistaxis seen in accident and emergency (A&E) departments and discharged with verbal/written advice, and to examine if this information affects re-attendance rates. A questionnaire was given to all A&E doctors probing their current practice regarding advice given to patients with epistaxis on discharge. The information was complemented with a case note audit of patients with epistaxis seen and discharged by A&E doctors over a 2 month period, which assessed the content and format of advice given and the number of re-attendances. The standard used stated that all patients discharged from A&E should be given both verbal and written advice regarding the prevention and management of further bleeds. The A&E doctors were then invited to a presentation on the management of epistaxis and the appropriate advice to give patients on discharge. Written advice leaflets on the prevention and management of further bleeds were placed in the A&E department and were accessible to doctors and patients. Case notes were re-audited over the following 2 month period. Verbal and written advice increased from 19% to 61% and 2% to 54% respectively. The number of re-attenders who had previously only seen A&E doctors was reduced from 11 (17%) in the first half to 5 (8%) in the second half of the cycle, representing a 9% reduction. We conclude that the provision of adequate verbal and written advice to patients with epistaxis may have an important role in the prevention of further bleeds and subsequent re-attendance to A&E departments.     

Is renal medullary carcinoma the seventh nephropathy in sickle cell disease? A multi-center Nigerian survey

IntroductionPrevious studies had enlisted renal medullary carcinoma (RMC) as the seventh nephropathy in sickle cell disease (SCD). Clinical experience has contradicted this claim and this study is targeted at refuting or supporting this assumption.ObjectiveTo estimate the prevalence of RMC and describe other renal complications in SCD.ResultsOf the 3,596 registered sickle patients, 2 (0.056%) had been diagnosed with RMC over a ten year period, thereby giving an estimated prevalence rate of 5.6 per 100,000. The most common renal complication reported by the attending physicians was chronic kidney disease (CKD). The frequency of routine renal screening for SCD patients varied widely between centres — most were done at diagnosis, annually or bi-annually.ConclusionThe ten year prevalence of RMC in Nigerian SCD patients was determined to be 5.6 (estimated incidence of 0.56). RMC is not more common in SCD patients and therefore cannot be regarded as a “Seventh Sickle nephropathy”. Most of the managing physicians reported that the commonest nephropathy observed in their SCD patients was chronic kidney disease.     

Evaluation of anti-inflammatory property of the leaves of Sansevieria liberica ger. and labr. (fam: Dracaenaceae)

ObjectiveTo evaluate the anti-inflammatory property of leaves of Sansevieria liberica Ger. and Labr. and to ascertain the toxicity and phytochemical profiles of the extract of the leaves.MethodsThe juice from the fresh leaves was expressed manually and lyophilized. The crude extract (CE) was then fractionated into n-hexane fraction (HF), chloroform fraction (CF), ethylacetate fraction (EF) and methanol fraction (MF). The crude extract (CF) and the fractions were screened for anti-inflammatory activity using egg albumen-induced paw (systemic) edema in rats as a measure of acute inflammation. The toxicity test and phytochemical screening were done using standard procedures.ResultsThe CE and the fractions significantly (P<0.05) inhibited the development of paw edema induced by egg albumen in rats. The potency/activity of the CE and the fractions increased in the order HF>CE>MF>CF>EF, with the CE and HF at 400 mg/kg exhibiting inhibition comparable to that obtained with 5 mg/kg diclofenac sodium. Acute toxicity test on CE established an oral and intraperitoneal LD₅₀ of > 5 000 mg/kg in mice. Phytochemical screening of the CE and the fractions showed the presence of various bioactive substances such as alkaloids, saponins, flavonoids, terpenoids, steroids, glycosides, reducing sugars, tannins, resins, carbohydrates, proteins, acidic compounds, fats and oils.ConclusionsThe results of the study showed that the leaves of Sansevieria liberica Ger and Labr. possess anti-inflammatory effects which may be due to its bioactive constituents. Further purification on these bioactive constituents may result in the development of potent anti-inflammatory agent with low toxicity and better therapeutic index.     

Armillifer armillatus infection

We report a case of human pentastomiasis in a 70-year-old retired long-distance driver/farmer whose diagnosis was made incidentally while being investigated for a 1-month history of cough and abdominal pain. The chest X-ray revealed multiple comma-shaped and rounded opacities in keeping with Armillifer infection, most likely Armillifer armillatus. The patient made an uneventful recovery after a 10-day course of mebendazole (an antihelminthic) tablet and ciprofloxacin (antibiotic) capsules and was discharged home. He is presently being followed up. This is the first case we have seen in our medical unit thus we are reporting it.