Niger J Clin Pract
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To determine mortality predictors among patients admitted for community-acquired pneumonia to the medical wards of Ladoke Akintola University of Teaching Hospital between Jan. 2003 and Dec. 2005. ⋯ The Pneumonia Severity Index score remains an important mortality predictor in patients with community-acquired pneumonia, but there is need to widen its scope to include functional class, duration of admission, and locally important co-morbid illnesses.
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We report an unusual case of lower limb gangrene in a pubertal boy following a typical clinical presentation of septicaemia due to Salmonella typhi. After an initial response to presumed appropriate antibiotic and supportive therapy, the patient developed tissue ischaemia in both feet. ⋯ This necessitated surgical disarticulation of the metatarsophalangeal joints two months after admission. This report is to alert clinicians about this rare complication of a common curable disease with a view to anticipating the possibility of it occurring as well as considering appropriate preventive measures.
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Case Reports
Severe idiosyncratic drug reaction (Lyells syndrome) after ingesting dihydroartemisinin.
Lyells syndrome also called Toxic epidermal necrolysis is the extreme form of idiosyncratic drug reaction that is called Steven Johnsons Syndrome: The condition results in an extensive loss of the skin with mucous membrane involvement. Lyells syndrome has been induced by many agents. The commonest agent in the literature being sulphonamides. ⋯ In these patients the earliest symptoms were not recognized and there was considerable delay before referral. In view of the recent WHO recommendation ofArthemisinin Combination Treatment (ACT) for malaria, we expect more cases of Steven Johnson Syndrome and Lyells syndrome from ACT treatment. The aim of this report is to raise the awareness of clinicians to this potentially fatal complication.
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Death rates in the accident and emergency department may be a reflection of the quality of care in the hospital. Trauma related mortality is a significant cause of preventable death. ⋯ Trauma is a preventable cause of death. The poor outcome of the trauma patients underscores the need to equip the attending doctors in the emergency room with basic skills in trauma care.
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Randomized Controlled Trial
Glycated haemoglobin and glycaemic control of diabetics in Ilorin.
With increasing adoption of Western Lifestyle in Nigeria, the incidence of Diabetes Mellitus is on the increase in the country with its attendant complications. The objective of this study was to determine the prevalence of patients at risk of developing diabetic complications in Ilorin, Nigeria, among our patients with diabetes mellitus. ⋯ The mean HbA1c values between the patients and the control subjects were significantly different. Diabetics in our environment with mean HbA1c value of 8.0% are prone to developing complications because of poor glycaemic control. We therefore advise that, periodic estimation ofglycated haemoglobin be carried out along side fasting blood glucose, in our diabetics.