Achilles Tendon Tear Following an Unusual Pattern of Open Pure Ankle Dislocation: A Case Report

We present a rare case of concurrent open Achilles tendon tear and pure subtalar dislocation in a 20-year-old male following a motorcycle accident, highlighting the complexity of managing such unique musculoskeletal injuries. The patient was initially admitted with an open and deformed left ankle, underwent prompt primary debridement, and received immediate medical intervention. Despite unsuccessful attempts to reduce the dislocation through external maneuvers, subsequent radiographic evaluation revealed a subtalar dislocation associated with a 90° rotation of the talus. A direct reduction was achieved in the operating room, uncovering a complete tear of the Achilles tendon and a section of the posterior tibial artery during more intensive debridement. The vascular surgery team repaired the posterior tibial artery, followed by Achilles tendon repair using a Kessler suture technique. Postoperative care involved immobilization and adapted rehabilitation, resulting in the patient regaining full range of motion without complications. To the best of our knowledge, this case represents the first reported open lateral subtalar dislocation associated with an open Achilles tendon tear. The detailed treatment strategies and outcomes offer valuable insights for clinicians facing similar challenges and inspire further research on rare musculoskeletal injuries.

Pure Open Ankle Dislocation Leading to Isolated Lateral Ligament Complex Tear: A Rare Case

Pure open ankle dislocation is a rare orthopedic emergency characterized by the absence of associated bony lesions, necessitating prompt and immediate management to prevent disastrous complications. This article details a distinctive case of open pure ankle dislocation in an 18-year-old female following a motorcycle accident, resulting in a 6-cm wound and a dislocated left ankle with a concurrent tear of the anterior talofibular ligament and calcaneofibular ligament. Immediate reduction under sedation was performed, followed by intensive debridement and ligament repair in the operating room. Postoperatively, the patient received antibiotic coverage for five days and underwent immobilization for six weeks. At the 18-month follow-up, the patient exhibited a complete range of motion with no reported pain or instability. This study contributes to the existing literature by presenting a successful treatment paradigm, providing valuable insights for practitioners encountering similar cases.

Prevalence and Associated Risk Factors of Urinary Schistosomiasis among Primary School Pupils in the Jidawa and Zobiya Communities of Jigawa State, Nigeria

Background

Urogenital schistosomiasis (UgS) is a parasitic disease caused by Schistosoma haematobium and can lead to chronic ill-health. Nigeria is endemic for schistosomiasis, but epidemiology of UgS has not been studied in most states. This study was conceived with the aim to contribute towards an accurate national picture of UgS in Nigeria. The prevalence of UgS and the associated risk factors were for the first time investigated among primary school pupils in Jidawa and Zobiya communities of the Dutse Local Government Area (LGAs) of Jigawa State, Nigeria.

Method

Focus group discussions with teachers and parents were conducted. After obtaining written consent from parents, questionnaires were administered to pupils to obtain socio-demographic data and information on water contact activities. Urine samples (279) were collected and processed by the urine filtration technique to evaluate haematuria and the presence of S. haematobium eggs.

Results

Prevalences of 65.7% (90/137) and 69.0% (98/142) were recorded in the Jidawa and Zobiya communities, respectively. In both communities, there was a significant association between gender and UgS: 63.3% of the infected pupils were males as compared to 36.7% females (χ2 = 5.42, p = 0.020). Grade 5 students had a significantly higher prevalence (χ2 = 17.919, p = 0.001) (80.0%) compared to those in grades 2, 3, 4, and 6 (63.8%, 66.7%, 61.5%, and 64.6%, respectively). Water contact activities showed that pupils involved in fishing, irrigation, and swimming were at greater risk of becoming infected in Jidawa and Zobiya, with odds ratios (risk factors) of 5.4 (0.994-28.862) and 4.1 (1.709-9.862), respectively (p = 0.05).

Conclusion

Both the Jidawa and Zobiya communities of the Dutse LGAs of Jigawa State are hyperendemic for UgS. In collaboration with the State Ministry of Health, mass administration of praziquantel was carried out in the Jidawa and Zobiya communities after this study.

Effect of locally sourced Nigerian gypsum on the strength and microstructure of Portland cement mortar

The objective of this study was to investigate the suitability of Nigerian, sourced Gypsum for the manufacture of Portland cement. Gypsum samples were obtained from eighteen deposits across Nigeria. These were classified into five purity groups based on their calcium sulphate content.Foreign Gypsum, imported from Morocco, was used as control. Six cement samples where produced for each of the five Gypsum purity groups by grounding and blending cement clinker with 3%, 4%, 5%, 6% and 7% Gypsum content. The group 1 cement mix (having not more than 65% calcium sulphate content) has displayed flash set and could not be moulded and therefore not used for further analysis. Cement mortar prisms were produced for the groups 2, 3, 4 and 5 cement mixes, and subjected to flexural and compressive strength tests at 7, 14, 21 and 28 day curing periods. The cement mortar prisms were also subjected microstructure analysis at 7 and 28 days curing period. The spongy, gel and whitish colouration observed from the  microstructure of the specimens indicated silicates enriched regions which have proven the strength increase from 7 to 28 day curing period. The optimum gypsum content of 5.5% was recommended. The results show that all but the class one gypsum with less than 65% purity content are suitable for cement manufacture. Keywords: Gypsum, clinker, mortar, microstructure, compressive strength, flexural strength

Effect of nanosilica on the mechanical and microstructural properties of a normal strength concrete produced in Nigeria

The failure of conventional concrete to have classical mechanical properties, reduced permeability and lead to sustainability in concrete production called for the use of supplementary Cementitious Materials (SCM) in concrete to improve its performance. This study investigates the effect of adding optimal dosage of an SCM called nanosilica (nS) on the tensile and compressive strengths, microstructural properties and cement hydration reaction for grade 30 concrete. The optimal dosage of the nS was determined to be 1.5% by weight of cement using compressive strength test. The influence of optimal nS dosage on the concrete properties was investigated using compressive strength test, splitting tensile strength test, Scanning Electron Microscopy (SEM) and Energy Dispersion Spectroscopy (EDS). Results revealed that optimal nS addition led to 30% and 23.3% respective increase in compressive and tensile strengths of conventional concrete at 7days of curing. SEM micrographs show better packing density in the nano-concrete at 90days of curing. EDS shows that addition of optimal nS dosage in concrete led to formation of more C-S-H gels at 90days curing period, and a corresponding reduction in Ca/Si ratio of the nano-concrete to 0.89; a ratio that is very close to that of 14Ǻ tobermorite reported in literature. The optimal nano-concrete can be used where strength improvement, especially at early age and reduction in concrete permeability are requirements. Keywords: Compressive strength, Tensile strength, Normal strength nano-concrete, SEM, EDS.

Cardiovascular responses and perceived exertion of young adults to head and shoulder load carriage

Objective: To determine the cardiovascular responses and perceived exertion of young adults walking and carrying a load of 10 kg on shoulder and the head.Method: Healthy participants (n=50) between the ages of 21 and 27 were subjected to three testing sessions at self-selected normal pace without load, and carrying a 10 kg load on the shoulder and on the head for 10 minutes. Cardiovascular parameters and their ratings of perceived exertion (RPE) were measured before and after testing at each session.Results: Higher pulse pressure (correlates of stroke volume) and rate pressure product (index of myocardial oxygen uptake) values were observed following load on shoulder testing compared to no load testing values and a higher RPE value was observed for load on shoulder testing when compared to load on head testing.Conclusion: It is conceivable that carrying load on the head can potentially be more economical than carrying load on the shoulder for this cohort of young adults. Keywords: Cardiovascular responses, perceived exertion, load carrying, rural communities

Effects of ground granulated blast furnace slag and pulverized fuel ash on rheology of concrete

The rheology of concrete containing Pulverized Fuel Ash (PFA) and Ground Granulated Blast Furnace Slag (GGBS) has been scarcely studied and reported, despite their increase application as Supplementary Cementitious Materials (SCM) that drives improvement of sustainability of the construction industry. This work studied the effect of these SCMs and Superplasticizer proportions on rheological properties of concrete using rate controlled concrete rheometer. Two groups of mixes containing replacement or addition on mass basis using either PFA or GGBS or their combinations were derived from the control mix. The dynamic yield stress, plastic viscosity and 28 day compressive strength of the control mix are 1258 Pa, 6 PaS, and 40.5 MPa respectively. The results of the rheology tests of the various binary mixes (PFA and Portland cement) and ternary mixes (Portland cement, PFA and GGBS) structural concrete shows wide disparity in the measured rheological parameters. The results show that the decrease in dynamic yield stress of the ternary mix containing 20% GGBS is 4.1%, whereas the decrease in dynamic stress of the ternary mix containing 20% PFA is 35.9% compared to the control ternary mix. The high volume Portland cement replaced ternary concrete can therefore be effectively characterized as a workable and pumpable concrete. Keywords: Rheology, PFA, GGBS, superplasticizer, concrete.

Clinical responses in cows vaccinated with a developed prototype killed Staphylococcus aureus mastitis vaccine

Mastitis is an inflammatory condition of the udder that occurs as a result of the release of leucocytes into the udder in a response to bacterial invasion. The major causes of mastitis are an array of gram positive and negative bacteria, however, algae, virus, fungi, mechanical or thermal injury to the gland have also been identified as possible causes. Mastitis vaccines are yet to be developed using Malaysian local isolate of bacteria. The objective of the present experimental trial was to develop a monovalent vaccine against mastitis using S. aureus of Malaysian isolate and to evaluate the clinical responses such as temperature, respiratory rates and heart rates in vaccinated cows. S. aureus is a major causative bacteria in clinical and subclinical types of mastitis in cows. Four concentrations of the bacterin (10⁶, 10⁷, 10⁸ and 10⁹ cfu/ml of the local isolate of S. aureus) were prepared using Aluminium potassium sulfate adjuvant. Thirty cows were grouped into four treatment groups (B, C, D and E) with a fifth group as control (A). These groups were vaccinated intramuscularly(IM) with the prepared monovalent vaccine and its influence on the vital signs were intermittently measured. The mean of rectal temperature was significantly different (p˂ 0.05) at 0hr Post Vaccination [1]" in groups D and E (39.5 ± 0.15 °C and 39.4 ± 0.15 °C respectively) and at 3 h PV in groups C, D and E (39.8 ± 0.14 °C, 39.9 ± 0.14 °C and 40.3 ± 0.14 °C respectively) compared to the control group. This indicated a sharp increased rectal temperatures between 0hr and 3 h PV in groups C, D and E which later declined at 24 h PV. The mean of rectal temperature of group E was significantly different (p˂ 0.05) at weeks 1 and 2 PV (39.87 ± 0.19 °C and 39.80 ± 0.18 °C respectively) compared to the control group. The mean of heart rate was significantly different (p˂ 0.05) at week 1 PV in groups D and E (83.0 ± 3.8 beats/minute and 80.0 ± 3.8 °C respectively) compared to control. A trending decrease was however observed in heart rates of group E from weeks through 4 PV and in group D from weeks 1 through 3 PV. The mean of respiratory rates was significantly different (p˂ 0.05) at week 3 PV in group B and D (31.0 ± 1.2 breaths/minute and 28.0 ± 1.2 breaths/minute) compared to control. In conclusion, this study highlights responses of these vital signs due to vaccination against S. aureus causing mastitis in cows. To the best of our knowledge the findings of this study adds value to the shallow literature on vital signs alterations in cows vaccinated against mastitis as elevated levels of temperature and heart rates of group D and E indicated obvious response.

Mucosal and systemic responses of immunogenic vaccines candidates against enteric Escherichia coli infections in ruminants: A review

Innumerable Escherichia coli of animal origin are identified, which are of economic significance, likewise, cattle, sheep and goats are the carrier of enterohaemorrhagic E. coli, which are less pathogenic, and can spread to people by way of direct contact and through the contamination of foodstuff or portable drinking water, causing serious illness. The immunization of ruminants has been carried out for ages and is largely acknowledged as the most economical and maintainable process of monitoring E. coli infection in ruminants. Yet, only a limited number of E. coli vaccines are obtainable. Mucosal surfaces are the most important ingress for E. coli and thus mucosal immune responses function as the primary means of fortification. Largely contemporary vaccination processes are done by parenteral administration and merely limited number of E. coli vaccines are inoculated via mucosal itinerary, due to its decreased efficacy. Nevertheless, aiming at maximal mucosal partitions to stimulate defensive immunity at both mucosal compartments and systemic site epitomises a prodigious task. Enormous determinations are involved in order to improve on novel mucosal E. coli vaccines candidate by choosing apposite antigens with potent immunogenicity, manipulating novel mucosal itineraries of inoculation and choosing immune-inducing adjuvants. The target of E. coli mucosal vaccines is to stimulate a comprehensive, effective and defensive immunity by specifically counteracting the antibodies at mucosal linings and by the stimulation of cellular immunity. Furthermore, effective E. coli mucosal vaccine would make vaccination measures stress-free and appropriate for large number of inoculation. On account of contemporary advancement in proteomics, metagenomics, metabolomics and transcriptomics research, a comprehensive appraisal of the immeasurable genes and proteins that were divulged by a bacterium is now in easy reach. Moreover, there exist marvellous prospects in this bourgeoning technologies in comprehending the host bacteria affiliation. Accordingly, the flourishing knowledge could massively guarantee to the progression of immunogenic vaccines against E. coli infections in both humans and animals. This review highlight and expounds on the current prominence of mucosal and systemic immunogenic vaccines for the prevention of E. coli infections in ruminants.

SCHISTOSOMIASIS PRESENTING AS COLONIC POLYPOID MASSES IN A NIGERIAN PATIENT

Intestinal Schistosomiasis is a serious disease and is commonly produced by S. mansoni and japonicum. The presence of viable ova of the organism in the colon elicits inflammation, formation of granuloma, ulcers, haemorrhage and colonic fibrosis with subsequent longterm sequelae. Schistosoma mansoni is endemic in the Middle East, Africa, Central and South America. This is a case of a Nigerian with colonic polypoid masses which turned out to be Schistosomal mansoni infection.

DEVELOPED PROBABILISTIC REDUCTION FACTORS FOR LOPHIRA ALATA (EKKI) TIMBER JOISTS SUBJECTED TO CREEP-RUPTURE

Wood experiences a significant loss of strength and stiffness when loaded over period of time. This phenomenon is known as creep-rupture. Several models were developed for the estimation of the reduction of load carrying capacity of timber with time. In this paper, the results of time dependent structural reliability analysis of timber joist produced with Lophiraalata (Ekki) timber specie was presented. Three load duration models were considered in the study, namely: The Model proposed by Wood, Gerhards model, and Nielsen. The timber joist was designed in accordance with the Eurocode 5. The uncertainties in all the basic design variables were fully accommodated in the time dependent reliability analysis. The entire process was implemented using a developed MATLAB program employing First Order Reliability Method (FORM). Time dependent mathematical models for modification of safety index to account for the effect of load duration were proposed. The use of both Gerhards and Nielsen model, for the design of Lophiraalata timber members was recommended.  http://dx.doi.org/10.4314/njt.v36i1.6

Correlation of intraoperative cytological and final histological diagnoses: a retrospective 10-year study of neurosurgical cases from Ibadan, Nigeria

OBJECTIVE

Intraoperative cytology is a cost-effective, rapid, and easy technique, and studies have shown good correlation between intraoperative cytology and histology. We undertook this study to compare the intraoperative cytology diagnoses of brain lesions made in our unit over a 10-year period with the definitive histological diagnoses. The aim was to determine the degree of accuracy of this procedure.

STUDY DESIGN

This is a retrospective study of intraoperative neuropathology consultation cytology smears or imprints and histology of 69 cases obtained over a 10-year period. Cytology smears were stained using both Papanicolaou and Giemsa. Histology sections were prepared from routine formalin-fixed paraffin-embedded tissue and stained using H and E method. Each of the smears and histology samples were assessed by at least two pathologists. Cytological diagnosis was correlated with final histological diagnosis. The sensitivity and specificity of cytological diagnosis was evaluated using final histological diagnosis as gold standard.

RESULTS

Correlation was strongest with inflammatory lesions followed by low-grade neoplasms. High-grade neoplasms also showed good concordance, but the degree of correlation was lower than in the other categories. Misdiagnosis was commonest with benign tumors.

CONCLUSION

Intraoperative cytology is a relatively simple, reliable, and accurate diagnostic technique and should be more commonly used, particularly in low-resource settings.

Arrow injuries to the eye

Two male siblings aged 10 and 17 years, respectively, presented to our hospital with two days history of being shot in the right eyes with arrows. The patients presented with severe pains, bleeding, swelling, discharge and loss of vision. There was positive history of application of traditional eye medicine and an unsuccessful attempt was made to remove the arrows. Both patients presented with panophthalmitis. X-rays of the orbits and para nasal sinuses indicated the tip of the arrow was lodged to the apex of the orbit in the younger patient, and the arrow vertically traverses the eye/ orbit and lodged in the roof of the maxillary sinus in the other patient with fluid level in the lower third of the sinus. The patients were placed on broad-spectrum systemic antibiotics, had base line investigations and prepared for exploration. The patients had evisceration with removal of the arrows.

Causes of red eye in Aminu Kano Teaching Hospital, Kano-Nigeria

INTRODUCTION

The red eye is one of the commonest reasons for presenting to the eye clinic. Red eye due to serious conditions that may threaten patient's vision require early detection and referral to ophthalmologists for prompt care. The aim of the study is to determine the prevalence and causes of red eye amongst patients' attending the eye clinic over a two year period from 2004 to 2005.

METHODS

The eye clinic register was used to determine the total number of new patients attending the eye clinic and those found to have red eye. The information retrieved included patients age, sex, laterality of the condition and cause of red eye.

RESULTS

During the review period 4723 new patients were seen in the eye clinic and 693 patients (14.8%) had red eye. There were 356 males and 337 females (M:F= 1.1:1). Sixty three percent of the patients were below the age of 20 years. The common causes of red eye were allergic conjunctivitis in 40%, microbial conjunctivitis in 17%, corneal ulcer 11% and inflamed pterygium in 11%.

CONCLUSION

Red eye is a common cause of presentation to the eye clinic. Most of the common causes of red eye in our environment are treatable.

Congenital eye and adnexial anomalies in Kano, a five year review

BACKGROUND

Knowledge of prevalence and types of congenital eye and adnexial anomalies is important as some of these anomalies can lead to childhood blindness. The aim of the study is to determine the types of congenital eye and adnexial anomalies seen in the eye clinic of Aminu Kano Teaching Hospital Kano, Nigeria between the years 2001 to 2005. To determine the proportion of children below the age of 10 years who presented with congenital eye and adnexial anomalies, the proportion of eye surgeries due to such anomalies, and proportion of these anomalies amenable to (surgical) intervention.

METHODS

The clinic and theater registers were used to obtain the total number of children less than 10 years of age seen and those that had surgery during the review period. A list of those with congenital eye and adnexial anomalies was compiled. The case folders of patients with such anomalies were retrieved and information on age, sex, type of anomaly, laterality of the condition, and types of surgical intervention offered, was obtained. The data was manually analyzed.

RESULTS

There were 4163 children seen in the eye clinic and 268 had surgery during the review period. There were 109 eyes of 69 patients with congenital eye and adnexial anomalies. The prevalence of such anomalies amongst children (<10 years of age) is 1.7% and surgery for congenital eye and adnexial anomalies accounted for 25.7% of eye surgeries in the study population. The male to female ratio is 2.3:1. In 40 patients, the anomaly was bilateral and it was unilateral in 29 patients. The commonest congenital anomalies are buphthalmos in 38%, cataracts in 35%, and naso lachrymal duct obstruction in 14%. Other less frequent anomalies are anophthalmia/micophthalmia, limbal dermoid cysts and aniridia. Eighty six percent of the patients had surgery to correct the anomaly.

CONCLUSION

Most of the congenital anomalies seen in our hospital can lead to childhood blindness and vigilance by eye care providers is advised to ensure prompt identification and intervention.

QT dispersion in dynamic and static group of athletes

Measurement of QT dispersion as calculated from the 12-lead ECG has emerged as a non-invasive assessment for degree of myocardial inhomogeneity. Increased QT dispersion predicts sudden cardiac death in variety of disease states such as acute myocardial infarction and hypertrophic cardiomyopathy. To improve identification of athletes at high risk of sudden death, resting electrocardiograms were performed on 100 dynamic athletes (sprinters, middle and long distance runners), 50 static athletes (Hammer throwers, Weight lifters) and 100-matched control group. QT dispersion was defined as maximum QT interval minus minimum QT interval in a lead. The correlation between QT dispersion and the athletes demographic characteristics revealed that significant correlations existed between QT dispersion and age, SBP, DBP, MBP, body temperature and duration of athletic activity (DAA) [P < 0.05]. Similarly, no significant correlation existed between QT dispersion and Heart rate, height, weight and body mass index (BMI). This showed that increased QT dispersion is found in Dynamic and Static group of athletes and is significantly related to duration of athletic activity. This finding could be used for the identification of athletes at high risk of sudden death.

[Behavioral disorders after treatment with isoniazid]

Isoniazid, efficient antituberculosis drug, can provoke neuropsychiatric manifestations at certain patients. Two mechanisms of action for isoniazid-related psychosis are kept by the majority of authors: pyridoxin deficiency isoniazid toxicity, molecule near chemically to iproniazid, powerful IMAO (monoamine oxydase inhibitor). The predisposing factors are: slow acetylator, diabetes, hepatic insufficiency, old age, alcoholism. Family and personal history of mental illness are also predisposing factors. We report here the observation of a 53-year-old man presented with psychotic symptoms suspected to be relation with isoniazid. The favorable evolution after the definitive stop of isoniazid therapy is in favor of this hypothesis. Although rare, the neuropsychiatric symptoms during tuberculosis treatment by isoniazid, the possibility of iatrogenic etiology must be evoked. Isoniazid, antituberculosis very used in Africa, is mentioned by several authors like the cause of psychiatric disorders. Pyridoxin deficiency seems to play a role of trigger. Supplementation with vitamin B6 during the treatment by isoniazid must be therefore systematic to warm these unrests.