Study design: Description of 12-week programme of treatment. Objectives: In Enugu, Nigeria, not all spinal injured (SCI) can be treated in teaching and orthopaedic hospitals. The 12-week programme was developed with the aim of getting such patients back into society as useful and independent as possible, using the patients relations to complement the de®ciency in personnel. Setting: Enugu, Nigeria. Methods: Staged weekly programmes of assessment and treatment were mapped out to end at the twelfth week. Spinal injured patients of less than 2 weeks duration were entered into these programmes as they presented. Outcome was assessed at the end of the twelfth week. The study lasted for 6 years (January 1996 to December 2000). Results: Seventy-four patients were admitted into the study. Nine patients had incomplete cord injury of Frankel C while 65 had clinically complete injury of Frankel A on admission. Eight of the nine incomplete injuries improved to Frankel D and walked home within the 12-week programme. In the clinically complete group, eight died. Out of the 57 remaining, six recovered to Frankel D and walked home, while the remaining 51 who did not recover, 49 were conversant with wheelchair use within the 12-week programme. Conclusion: It is concluded that adoption of this programme would allow the spinal cord injured to get expert treatment within a reasonable time in less ideal hospital settings where man-power and skilled members of the spinal cord injury treatment team are lacking.
Chemical overexposure is a growing environmental risk factor for many medical issues. Cobalt toxicity from environmental, industrial, and medical exposure, has previously been linked to neurological impairment. Hence, the current study looked into the neuroprotective potential of curcumin, a natural polyphenol contained in spice turmeric, against cobalt-induced neurotoxicity. Adult rats were randomly divided into six groups as follows: control, 40 mg/kg cobalt chloride (CoCl2) only, 240 mg/kg curcumin only, 120 mg/kg or 240 mg/kg curcumin or 100 mg/kg Vitamin C co-administered with CoCl2. The administration was via oral route daily for four weeks. After that, neurobehavioral tests were undertaken to evaluate short-term spatial memory. Biochemical investigation was performed to determine the hippocampal levels of status via measures of SOD, CAT, GST, and LPO). Furthermore, immunohistochemical assessment of the expression of GFAP and Nrf2 in the hippocampus was carried out. In the CoCl2 group, the results showed altered behavioral responses, a decrease in antioxidant activities, increased expression of GFAP and the number of activated astrocytes, and decreased immunoexpression of Nrf2. These effects were mitigated in the Curcumin and Vitamin C treated groups.These results collectively imply that curcumin enhances cognitive functions in rats exposed to cobalt possibly by attenuating oxidative responses, mitigating astrocytosis, and modulating Nrf2 signaling.
Introduction: Total hip replacement (THR) surgery is still evolving in Nigeria with increasing awareness as more cases are being done. This has attraction for individuals who hitherto had no solutions for their hip pathologies. These are mostly complex primary hips which present challenging technical difficulties with increased risk of complications, thus requiring detailed planning to ensure successful operation. This work aims to present the pattern of complex primary hips presenting for THR, the challenges and complications.Methodology: Data collected over a seven year period, of patients who presented for THR, were analyzed for age, sex, diagnosis, type of hip, complications, duration of surgery, blood loss and transfusions, challenges and outcome.Results: Fifty-nine (43.4%) of the 136 cases of THR done were complex primary hip replacement surgeries. Avascular necrosis of femoral head amongst sickle cell disease patients (23.7%) was the commonest cause of complex primary hips in our series. Most of them had absent/tight medullary canals. This is followed by old unreduced hip dislocation and non-united hip fractures with an incidence of 10.1% each. The major peri operative complication noted was calcar split in 10 patients (16.9%)Discussion: Sickle cell disease patients presented more with complex primary hips and the commonest difficulty was recreating medullary canals. Increased operation time and blood loss alongside technical difficulties should be anticipated and measures put in place to avert complications.
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