Bladder stones in catheterized spinal cord-injured patients in Nigeria.

OBJECTIVE: The objective was to determine the incidence of bladder stones in patients with spinal cord injury (SCI) and to assess if catheter encrustation or positive urinary culture of Proteus mirabilis is predictive of bladder stones. BACKGROUND: Bladder stones are common urological complication in those with SCI managed with indwelling urinary catheter. Detection and removal of bladder stones are important to prevent possible further complications. DESIGN: This was a prospective cohort study. MATERIALS AND METHODS: Ultrasound scan was performed in persons with SCI seen from 1st January to 31st December 2009 who had indwelling urethral catheter for at least 3-month post-injury. Indwelling urethral catheters were examined for encrustation at the time of removal, urine culture taken specifically for P. mirabilis and ultrasound scan done to detect bladder stones. RESULTS: There were 89 patients with spinal cord injury and 68 (76.4%) patients were evaluated during the review period. Twenty-nine (42.6%) patients had bladder stones and 22 (32.3%) patients had catheter encrustation. Of the 22 patients with catheter encrustation, 19 (86.3%) also had bladder stones. Forty-six (67.6%) patients had no catheter encrustation. Of these, 7 (14.7%) were found to have bladder stones. Thirty-seven (38.2%) urine cultures were positive for P. mirabilis. Of these 37 (54.4%) patients, 27 also had bladder stones. Catheter encrustation (P = 0.004) and a positive urine culture of P. mirabilis (P = 0.007) in patients with indwelling urinary catheter is highly predictive of the presence of bladder stone. CONCLUSIONS: This study shows that a large number of SCI patients have an indwelling urethral catheter and suggests that ultrasound scan for the presence of stone should be schedule in a catheterized SCI patient if catheter encrustation or a positive urine culture of P. mirabilis is noted.

Towards an assessment of bone fracture healing using pulsed mode ultrasound.

Healing rate of fractured bone differs from one patient to another which may lead to incorrect consequent medical procedures. Thus, quantitative assessment of bone healing after fracture becomes important. In this paper, we present a mathematical model which describes the interaction of a pulsed mode ultrasound waves with a multilayered biological structure. The model is applied to estimate the bone callus thickness and degree of hardness. Different frequencies are utilized to obtain highest measurement sensitivity and accuracy of callus thickness and degree of hardness. It is found that a transducer operating at 1 MHz has the highest sensitivity to the different phases of callus hardening. On the other hand, a 3 MHz transducer yields the highest sensitivity to the thickness of the callus layer. Thus, using both frequencies might prove to be useful for full quantitative assessment of the bone healing process.

Complications and causes of death in spinal cord injury patients in Nigeria.

BACKGROUND: There have been many reports on the problems of spinal cord injury (SCI) in Nigeria but few have reported on the complications and causes of death in spinal cord injured patients. OBJECTIVE: The objective of this study was to determine the complications, causes of death and associated risk factors in patients with SCI within six months post injury. METHODS: Patients were retrospectively identified from the hospital trauma database from January 1997 to December 2007. Complications and cause of death within the first six months of SCI were determined along with associated risk factors. RESULTS: Five hundred and eighty-two patients were eligible for analyses and data were obtained for 422 (72.5%) patients with a mean age of 37.2 (±14.2) years at six months follow-up. Muscle spasms 417 (98.8%) and neurogenic pain 382 (94.5%) were the main complications noted. The mortality during the review period was 144 (34.1%). Respiratory failure (44.4%) was the commonest cause of death. The independent predictors of mortality were mainly age, GCS<9, Frankel Type A at presentation and cervical spine injury (CSI) and while CSI and Frankel Type A injury were the main predictors of complications. CONCLUSION: Most common complication and cause of death following SCI are muscle spasm and respiratory failure respectively. The risk factors associated with mortality are age, GCS<9, cervical spinal injury, and complete neurologic injury and those for complications were cervical spinal injury and Frankel Type A injury.

Uveitis survey in children.

BACKGROUND/AIMS: This is a retrospective cohort uveitis survey to determine the clinical features of uveitis in children and assess the rate of complications at two referral centres in Saudi Arabia. METHODS: All children under the age of 16 years presenting with uveitis for the first time between 1997 and 2007 to The Eye Center and King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia were included. Clinical features of uveitis entities were described. Last follow-up visual acuity and ocular complications were analysed. RESULTS: A total of 163 cases of uveitis in children were included. The age range was 1-16 years with a mean age of 10 years. The most frequent clinical type of uveitis in children included acute anterior non-granulomatous uveitis 26%, intermediate uveitis 20%, Vogt-Koyanagi-Harada (VKH) disease 16% and juvenile idiopathic arthritis (JIA) 15%. Anterior uveitis accounted for 42%, intermediate for 20%, posterior for 7%, and panuveitis for 31%. Immune-mediated uveitis was present in 144 (88%) patients, while infectious causes manifested in 19 (12%) patients. CONCLUSIONS: The most common cause of uveitis in children was anterior non-granulomatous uveitis of undetermined aetiology. There was a high prevalence of intermediate uveitis, VKH and JIA. Infectious causes of uveitis were uncommon.

Biliary excretion of Tc-99m EC in renal studies.

The role of biliary excretion in Tc-99m ethylenedicysteine (EC) renal imaging was studied. Of 2,215 dynamic renal studies performed with Tc-99m EC, only nine cases of gallbladder visualizations and/or biliary excretion were identified. In no case did biliary excretion affect the interpretation of the renal study.

Changing obstetric practices and amelioration of perinatal outcome in a university hospital.

A 40 year review of obstetric statistics revealed that the perinatal outcome has improved significantly following the introduction of biophysical and biochemical fetal surveillance systems. A simultaneous increase in the cesarean section rate is noted; however, this increase in the cesarean section rate is not related to an increase in the diagnosis of fetal distress. Other factors which may influence an improved perinatal outcome have been examined. It is concluded that biochemical and biophysical fetal surveillance has played a decisive role in the improvement of perinatal results.