Management of Conjoined Twins : a Report of Two Sets

Background: Conjoined twinning is a rare congenital anomaly. We present here; our experience in the management of two sets of conjoined twins at a Teaching Hospital in north central Nigeria. Method: Data of conjoined twins managed at the Jos University Teaching Hospital in 1987 and 2004 were retrospectively collated and analyzed. Result: Two sets of pyopagus tetrapus conjoined twins were managed within the period; one was a set of triplets. The conjoined pairs in both sets of twins were females. None of the twins was diagnosed prenatally. Both sets of conjoined twins were delivered spontaneously by vaginal route. Emergency surgical separation was undertaken in both sets be- cause of deteriorating anencephaly in one twin in the first set and anorectal malformation and intestinal obstruction in one twin in the second set. Both sets of twins died after separation. Conclusion: Our experience showed that separation of conjoined twins may be associated with high mortality. Sepsis and electrolyte imbalance appear to be the major causes of morbidity and mortality; particularly when the resultant skin defects are large

Acute myocardial infarction in Kuwait: Current status and recommendations for prevention

This report presents the current situation of acute myocardial infarction [AMI] in Kuwait revealing the ongoing programmes, weaknesses of the present strategies and recommends measures for its prevention. Mortality due to AMI among the Kuwaiti population continues to remain high [37% out of total ischaemic heart disease mortality in 1994] and is the main cause of cardiovascular deaths [CVD] in Kuwait. Statistics for the years 1989,1992 and 1993 revealed CVD, neoplasms and traffic accidents to be the first three causes of death. The hospital discharge rate for AMI for the age group 20 years and above has increased among Kuwaitis, while a decrease was seen in non-Kuwaitis. By gender, approximately three times more male than female AMI discharges have been observed. Patients attending the Cardiology Department at the Chest Diseases Hospital also showed a significant linear trend towards an increase in the inpatients from 37.1% out of total in-patients in 1983 to 62.2% in 1994 [p<0.0001]. This report also focuses upon the extent of AMI risk factors in the population e.g. smoking, hypertension, diabetes, obesity and recommends emphasis upon studies to unreveal the role of any new existing AMI risk factors such as stress due to the Iraqi invasion. This information provides the fundamental basis to evolve strategic programmes for AMI risk-reduction, build a standardized information resource, and evolve a unified approach for disease management and prevention for the country as a whole

Curvas de sobrevida mediante técnicas multivariadas (Kaplan-Meier, Mantel-Haenszel, regresión de Cox) / Survival curve means of multivariate methods (Kaplan-Meier, Mantel-Haenszel, cox regression)

La supervivencia de pacientes con enfermedades de larga duración ha sido analizada tradicionalmente mediante el método de la curva de sobrevida "actuarial" que permite llegar hasta la comparación visual de varias curvas relacioandas con dos factores . En las últimas décadas nuevos métodos permiten profundizar el estudio de sobrevida, la comparación de curvas y la cuantificación estadística de diferencias, y además la magnitud de la influencia de factores. Se pasa revista a esos nuevos métodos y a sus posibles aplicaciones