Haemorheological changes in African breast cancer patients.

Several studies have indicated the existence of thrombo-embolic complications in cancer patients and that this could be associated with changes in heamorheological parameters. Packed cell volume (PCV), heamoglobin (Hb), relative plasma viscosity (RPV) and plasma Fibrinogen concentration (PFC) were measured in 50 healthy control women, 50 age-matched women with breast cancer, and 10 women with histophathologically proven benign breast tumour. There were significant differences between the controls and breast cancer patients in all the parameters measured (p < 0.05). However, patients with cancer have significantly higher RPV and PFC (P < 0.001) respectively than controls. There was significant mean difference between pre and post mastectomy in fibrinogen concentration (p < 0.05) and this was observed over the 5-week study period. Since increased fibrinogen may give rise to increase fibrin formation which has been asserted as an independent cardiovascular risk factor for thromb-oembolic complications, African patients with breast cancer may well be predisposed to thrombotic complications during illness. The theological assessment may offer valuable benefit for the management and early diagnosis of breast cancer in African women.

Haemorheological changes in African breast cancer patients

Several Studies have indicated the existence of thrombo-embolic complications in cancer patients and that this could be associated with changes in heamorheological para- meters. Packed cell volume (PCV); heamoglobin (Hb); relative plasma viscosity (RPV) and plasma Fibrinogen concentration (PFC) were measured in 50 healthy control women; 50 age-matched women with breast cancer; and 10 women with histophathologically proven benign breast tumour. There were significant differences between the controls and breast cancer patients in all the parameters measured (p0.05). However; patients with cancer have significantly higher RPV and PFC (P0.001) respectively than controls. There was significant mean difference between pre and post mastectomy in fibrinogen concentration (p0.05) and this was observed over the 5-week study period. Since increased fibrinogen may give rise to increase fibrin formation which has been asserted as an independent cardiovascular risk factor for thromb-oembolic complications; African patients with breast cancer may well be predisposed to thrombotic complications during illness. The rheological assessment may offer valuable benefit for the management and early diagnosis of breast cancer in African women

Pneumomediastinum and subcutaneous emphysema associated with asthma exacerbation.

The case of a nineteen year old male student who presented with marked dyspnoea, dysphagia and horseness of voice is presented. Chest examination revealed bilateral polyphonic rhonchi and the chest radiograph showed the presence of subcutaneous emphysema and pneumomediastinum. A diagnosis of acute severe asthma complicated with subcutaneous emphysema and pneumomediastinum was made and the patient was managed conservatively on nebulized salbutamol, steroids, oxygen and chest physiotheraphy. He made a remarkable improvement and has remained in a stable clinical condition.

Effects of breast cancer and mastectomy on fibrinolytic activity in African women.

Reduced blood fibrinolytic activity (FA) has been postulated in cancer. It is good to know if this is also the case in Africans with breast cancer. Africans are known to possess enhanced fibrinolysis. This study was designed to assess the effect o breast cancer on fibrinolytic activity and the effect of mastectomy on fibrinolysis in African women. Sixty histo-patholically proven breast cancer patients aged 25 - 45 years were compared with 50 healthy age-matched controls. Plasma fibrinogen levels and euglobulin lysis time (ELT) were estimated in breast cancer patients and th controls. Patients with breast cancer had significantly increased fibrinogen levels euglobulin lysis time (P < 0.001) compare with controls. There was significant mean difference between pre and post-mastectomy fibrinogen and euglobulin lysis time values (p < 0.05). Progressive significant decrease in fibrinogen levels and euglobulin lysis time values (P < 0.05) were observed over the weeks studied respectively. African women with breast cancer have defective fibrin clearing which could predispose them to thrombotic diathesis and early mastectomy may be beneficial. We suggest that fibrinolytic components may be a prognostic marker for breast cancer.

Pattern and outcome of management of fractures in a Nigerian community

"Background: There has been increasing incidence of road traffic accidents and gun shot injuries in Benin City in the recent past. A major complication of these events is fracture of the bones. Various patterns of fractures are reported from different communities.Aim: To determine the pattern and outcome of fractures in Ikpoba Hill; a sub-urban community in Edo State.Methods: A retrospective study of all cases of fractures that presented to ""Our Medical Centre"" in Ikpoba Hill; a sub-urban community in Edo State between January 1998 and December 2004 was carried out. Parameters analysed included age; sex; and occupation; cause of fracture; site of fracture; associated injuries; treatment offered and outcome of management.Results: A total of 285 cases of fractures were seen over the period of study. There was a steady increase in the number of cases of fractures over the period of study. The 20 -29 years age group was more commonly affected (25.61). The male: female ratio was 1.9: 1. Civil servants and business people were most commonly affected (36.49and 24.56respectively). The humerus was the bone most commonly affected (24.32). Road traffic accident was the commonest aetiological factor accounting for 80. Some 69.47of the cases discharged themselves against medical advice to seek help with a traditional bonesetter. Head injury was the commonest cause of death (44.44). The average duration of hospital stay was 21 days.Conclusion: Road traffic accident was a common cause of fracture. The humerus was the bone most commonly fractured. Most patients with fracture prefer to patronize the traditional bone setters. Public enlightenment campaign should be mounted to discourage the attitude of most patients with fracture seeking help in traditional bonesetters' place."

Gastric volvulus and gastroduodeno-jejunal intussusception (an unusual cause of acute abdomen).

An elderly man who presented with colicky abdominal pain had gastric volvulus which was reduced after barium meaL More than a year later the symptoms recurred and at laparotomy a gastroduodenojejunal intussusception was found and its apex was formed by a polypoidal gastric tumour (leiomyoma). The patient did very well without any recurrence after the resection of the tumour.

Comparative study of single dose and five days dose of gentamicin as prophylaxis in appendicectomy.

One hundred patients who had appendicectomy for uncomplicated acute appendicitis over 1 year were randomly allocated to two groups of 50 patients each. Patients in group 1 had a single prophylactic injection of gentamicin while those in group 2 had a five days course with the first dose given just before the operation. There was no wound infection in any of the patients in either groups. There was also no statistically significant difference in the incidence of other postoperative complications. These findings suggest that a single prophylactic dose of gentamicin was as effective as a five days course in preventing postoperatively complications, like wound infection.