DOKITA

Editorial

2024-11-15T01:39:20+00:00

No Abstract

Foreword

2024-11-15T01:42:30+00:00

No Abstract

DOKITA: The early years

2024-11-14T19:29:29+00:00

The choice of the name DOKITA generated and excitement which had many factors rolled into one - originality which produced an identity uniquely acceptable to a multi-ethnic/cultural society at a point in the history of our country when national political independence was as paramount as national unity. It is seems intriguing that virtually all the sectors of the nation accept and understand DOKITA to refer to the Western trained medical practitioner as distinct from his traditional counterpart.

Nuclear appendages in neutrophil polymorphs

2024-11-14T19:38:29+00:00

The description by Davidson and Smith (1954) of sex differences in the nuclear morphology of neutrophil polymorphonuclear leucocytes related to a specific appendage (the "Drumstick") of the nuclei has led to further detailed study of these cells by other workers(3), (4), and (5). Many types of appendages have consequently been observed, described and classified. There are four main types of nuclear appendages termed A,B,C and D.

Reminiscence with a view of renaissance

2024-11-14T19:51:15+00:00

Four decades ago, a group of visionary medical students decided that "enough does happen in , and emanate from this institution to need that reports be made, for our successors as a record of our findings, progress and ideas and to our contemporaries, for record and exchange."² With this in mind they conceived and presented our own medical students' journal, DOKITA , with the vision that "through it and in it we may arouse, terrify, teach , comfort and open our hearts to each other as brothers!"². Today, what began as tiny rays of light has become a glowing beacon that adds to the illumination of our medical terrain in its own modest way.

40 years in pictures

2024-11-14T22:06:39+00:00

In my opinion, there is in every institution of Higher Learning one Student organisation that best exemplifies the ideals and values of that Alma mater, that serves as the custodian of all the traditions that institution calls excellent and seeks to inculcate into those who pass through it for the Ibadan medical School, that body is DOKITA. No other organisation comes close in consistency of producing results, even in the face of the worst odds over such a long period. It has been no mean feat to sustain the ideals of the founding fathers through four decades of topsy turvy, tumultous upheavals; when all standards feel and still be standing firm at the end of it.I therefore, doof my hat to all board members past and present, custodians of a great legacy who have held the dream, carried the torch and passed the baton over these last 40 years; and I count myself fortunate to be among those who can lay claim to having once and for all time been members of this indomitable DOKITA family.

Current concepts in the drug therapy of HIV/AIDS

2024-11-14T22:21:33+00:00

Since the first reports were made in 1981 of AIDS among some American young male professionals who were all homosexuals, the infection has become a pandemic and now appears to affect poor countries most seriously. Shortly afterwards, its causative agent, the human Immunodeficiency virus (HIV) a retrovirus, was discovered and its' essential biology including molecular biology, epidemiology, pathogenesis and diagnostic elements and technology were described and developed. Although these fascinating developments have taken place in such a very short time interval and we therefore have considerable knowledge about the characteristics of the epidemic and its trend compared with past epidemics (Cartwright & Biddis 1972), we have however, not made as much progress with treatment of Aids in its many manifestations as we ought to have done.

Distribution of sickle cell disease in Africa

2024-11-14T22:29:25+00:00

The term sickle cell disease includes a variety of pathological conditions resulting from the inheritance of sickle haemoglobin either in a homozygous state or the S gene in a heterozygous state with another abnormal haemoglobin e.g SS, SC, SD, S B_thal, SOArab, SD, SG. The origin of the haemoglobin S (HbS) gene has been rather controversial. The HbS gene has often been regarded as an African ancestry because of its high frequency among blacks. Sickle cell anaemia is also prevalent in parts of Asia mainly the Arabian peninsula and the Indian subcontinent. It is seen in parts of Europe (mainly Greece and Sicily). It is also prevalent where people from the above areas have migrated. It is now prevalent in America including tropical America. It has recently been recognised in Southern Nepal. The S gene exists in all the three major "races" of human kind:- black, white and oriental.

The human genome project

2024-11-14T22:41:08+00:00

The human genome project is one of the most ambitious human endeavors of recent history and whatever its outcome, the world is not likely to be the same again after its completion. The output of the program and others like it in the biological sciences that are unraveling the genetic code of human and other organisms are likely to lead to a new way of understanding biology and modulating it either in the form of prevention ofdiseases, understanding the processes underlying the development, progress, resolution, and treatment of disease processes. The impact is no less profound in the other areas of biology including environment management, development of new chemical and lately the use of deoxyribonucleic acid (DNA) as the building blocks of the CPU of future computers.

An overview of gene cloning

2024-11-14T22:47:56+00:00

Gene cloning has been given varying names from genetic engineering to recombinant DNA technology and it has been attacked by various groups on religious, moral or ethnic grounds. It is defined as the isolation of individual genes by generating recombinant DNA molecules, which are then propagated in a host cell which produced a clone that contains a single fragment of the target DNA. The foundation for this field was built by numerous people, from Gregor Mendel's initial work on inheritance, to elucidation of the structure of DNA by Watson and Crick. The real spark plugs came in 1967, when DNA ligase was isolated followed by isolation of the first restriction endonuclease in 1970. These enzymes act like a molecular "glue" and "scissors" respectively allowing DNA to be cut and joined. This lead to the creation of the first recombinant DNA molecule in 1972.

Current trends in antibiotic resistance in university college hospital

2024-11-14T22:56:30+00:00

This is a retrospective study carried out at the department of Medical Microbiology, University College Hospital (UCH), Ibadan. Data retrieved focused on the following organisms - Methicillin resistant Staphylococcus aureus (MRSA), Streptococcus pneumoniae, Klebsiella species, Escherichia coli, Pseudomonas aeruginosa, Proteus species and Penicillinase producing Neisseria gonnorhea {PPNG}. The frequency of MRSA strains among Staphylococcus aureus isolated from wounds was 24.4% at MIC of >8uglml while another 24.4% were also seen to be borderline resistant at MIC 4- 8ug/ml. All the MRSA strains isolated were sensitive to vancomycin. Klebsiella specie the commonest gram negative organism was found to have greater than 80% resistance to ampicillin and cotrimoxazole. Escherichia coli showed 91.2% and 100% resistance to ampicillin and cotrimoxazole respectively, with 32% being resistant to gentamicin. Pseudomonas aeruginosa showed 100% resistant to ampicillin, tetracycline and cotrimoxazole. Ofloxacin and chloramphenicol were most effective against the gram negative organisms showing resistant rate of about 7%. As at 1996 the incidence of PPNG in Ibadan stood at 92.2%, whereas in 1970 there was virtually no incidence of PPNG. 15.6% of the isolated Streptococcus pneumoniae were resistant to penicillin, however in Ghana and South Africa the rates reported were 30.6% and 7% respectively. Data like this play an important role in determinimg the course of rational therapy and all efforts must be made to determine the prevalence rates of bacterial resistance in each locality or better still each hospital.

Overview of Alzheimer's disease in Nigeria

2024-11-14T23:26:49+00:00

Data on Alzheimer s disease (AD) in Nigeria have come largely from studies carried out by the Ibadan-Indianapolis dementia cross-cultural, collaborative research group. The age-adjusted prevalence of AD in Nigeria is 1.41% with female preponderance. The pattern of impairment is similar to documentation in other environments. The two significant risk factors are old age and female gender, while living with others appeared to be protective and there is lack of association with apolipoprotein E unlike the findings in African Americans. Further studies on disease incidence, mortality patterns and the role of vascular risk factors could provide further information on appropriate preventive measures to be undertaken to avoid an epidemic of the condition, more so as the population is ageing and the enormous resources that may be required may overwhelm our capability.

Renal transplantation: An overview

2024-11-14T23:37:51+00:00

In the past two decades, organ transplantation has become established as effective therapy for end-stage renal, hepatic, cardiac and pulmonary disease. The combination of dialysis techniques and allograft transplantation has led to kidney transplant operations being vastly greater than other transplant procedures. Patients can freely move back and forth between dialysis and transplantation, so that life does not depend on only one form of treatment. Other advances include Peter Medawar's description of second set reactions and his insights into cellular immunology. The close collaboration of pharmaceutical companies such as Burroughs-wellcome and clinical researchers such as Roy Calne led to the development of azathioprine, which made possible kidney transplantation in non-related individuals.

Stroke review and new frontiers in management

2024-11-14T23:10:47+00:00

Stroke is a sudden focal or global neurological dysfunction of vascular origin with disability lasting more than 24hours or resulting in death. When disability lasts for less than 24 hours, it is termed transient ischemic attack (TIA). It is the third most common cause of death in most western population after coronary artery disease and cancer ^1. It is thus the commonest life-threatening neurological disorder in terms of both morbidity and mortality and the resulting disability is the most important single cause of severe disability among western people living in their own homes.²

Stroke, the major consequence of cerebrovascular disease afflicts all ages but certainly is more usual in the sixth to eighth decades of life. As public health, medical, and social advances continue to extend life expectancy, we can expect an increase in the size of the world community at risk of stroke, in the new millennium.

Common paediatrics emergencies at the university college hospital

2024-11-14T23:47:29+00:00

In the developing world, emergency situations are common in paediatric wards due to the fact that:The guardians and parents bring minor illness of children to the hospital very late, Children often cannot complain financial constraints and ignorance on the part of the parents make them seek alternative help first, diseases progress very rapidly in children, children are very curious and active and are therefore prone to accidents and poisoning. In our environment, top on the list of common emergencies are infectious and preventable diseases. This paper highlights the commonest diagnoses made at the Otunba Tunwase Children's Emergency Ward (OTCHEW) in U.C.H., Ibadan; their presentation, commonest causes and management undertaken in these cases. In U.C.H., Bamgboye and Familusi reported on the commonest diagnoses at the Children Emergency Room (CHER) in 1978, 1981-1986. In order to detect any change in the trends of prevalent diseases in OTCHEW, we carried out a review of admissions into the ward over a I year period (April 1999-March 2000).

Jaundice in the newborn

2024-11-15T00:08:02+00:00

This is the yellowish discolouration of the skin and mucous membranes and sclera in a neonate. It is the commonest symptom in the newborn period and 'is a manifestation of hyperbilirubinaemia. It becomes apparent when serum bilirubin is 5-7mgldl. It is a common pediatric problem worldwide. It is the commonest clinical sign in the neonatal period and the commonest cause of neonatal admission in Nigeria. It accounts for 57% and 60% of neonatal admissions in UCH and LUTH respectively while the figures are 16.3% of neonatal and16.8% of paediatric admission in ABUTH and UNTH respectively. At least 25% of term neonates develop clinical jaundice while the figure can be up to 80% in preterm babies.

A review of gynaelogical laparotomy

2024-11-15T00:15:37+00:00

Laparoscopy is the ability to see inside the abdominal cavity via stainless steel tube containing a series of optic lenses. Historically the first laparoscopy was performed by H.C Jacobaeus in 1910 in Stockholm he used a direct technique not creating a Pneumoperitoneum ^1. Pneumoperitoneum prior to laparoscopy was introduced by Orndoff in Chicago about a decade later (1920). In an attempt to reduce the injuries to adjacent structures while creating a pneumoperitoneum, Verress from Budapest introduced the retractable needle which retracts the sharp edge on entering the peritoneal cavity ². In its early history, laparoscopy was entirely diagnostic until 1959 when Raoul Palmer in Paris and Hans Frangenheimin Konstanz pioneered the operative techniques. Hans Frangenheim wrote the first textbook on operative laparoscopy, the book was tittled "De Laparoskopie und die culdoskopie in der Gynaecologie” ³. The followership of these pioneers was such that centres of excellence emerged in this new operative technique. Two of these centres were Clemont - Ferrand located in France and Kiel in Germany, headed by Prof. Maurice Bruhat and Prof. Kurt Semm respectively. Prof. Kurt Semm a trained engineer was involved in the development of much of the original instrumentation. One of the 1^st major achievements of laparoscopy was in 1967 when Patrick Steptoe wrote the first English monologue on this technique and this was closely followed with the help of Prof. Robert Edward of Cambridge resulted in the birth of Louise Brown in 1979. This was the first recorded successful IVF birth. Now over 80% of gynaecological surgeries can be performed by laparoscopy. It is worthy of note to acknowledge Harry Reich of Kingston as the first person to perform a laparoscopic hysterectomy ⁴.

Chronic suppurative otitis media and complications in patients presenting at the ENT clinic, UCH

2024-11-15T00:36:16+00:00

Otitis media is the inflammation of the mucoperiosteal lining of the middle ear cleft. Chronic otitis media may follow/ result from inadequately treated acute otitis media. Other predisposing factors include: socio-economic status, poverty, overcrowding, malnutrition, anaemia, recurrent upper respiratory tract infections, mechanical obstruction in the nasal cavities and allergy. Otitis media continues to be one of the most common conditions seen in ORL practice. Complications arise when infection spreads from the middle ear cleft to structures which it is normally separated from by bone. In the developed world, it is generally believed that the incidence of complications of C.S.O.M has decreased significantly with antibiotic treatment but the mortality from intracranial complications is still high. In our country, the incidence of the complications is not known; it is likely to be very high. This is particularly true because,of poverty, ignorance, preference for traditional remedies and religious beliefs.

Chronic osteomyelitis in Ibadan

2024-11-15T00:45:18+00:00

Chronic osteomyelitis¹ refers to infection of the bone that extends beyond six to eight weeks. The term 'osteo' means bone and 'myelo' means the marrow cavity, both of which are involved in this disease. CO can arise primarily denovo or following acute osteomyelitis in which treatment has been delayed or is inadequate, and this is common among patients with sickle cell anaemia. Secondary chronic osteomyelitis can arise as a complication of open fractures, arthroplasties or following bone injuries². CO can persist for years. The hallmark feature of CO is the presence of infected dead bone, called sequestrum that has separated from living bone. The involucrum is a sheath of new bone which forms around the dead bone. There may be a cloaca which is a sinus through which pus discharges, burrowing through the soft tissues to the skin⁶. There is no medical management of C0³ and treatment is primarily surgical and involves the complete debridement of all devitalised bone and soft tissues regardless of the size of the wound⁴.

Immune response and the management of malaria

2024-11-15T00:53:15+00:00

Host immune response plays an important role in the manifestation, progression and resolution of several diseases including parasitic diseases, infections, arthritis, diabetes and allergies. Immune responses have been shown to play an important role in determining susceptibility to malaria attacks and response to treatment with antimalaria drugs. The contribution of host immunity to chemotherapy of malaria is underscored by the detection of sentinel cases of drug resistant infection in children below the age of 4 years and non-immune visitors to malaria endemic areas. Humoral and cellular immune response augment the schizonticidal activity of antimalarial drugs in the indigenous population, consequently, they are able to clear infections associated with parasites of low grades of resistance. New information available in the last 20 years on immune responses to malaria and identification of several P falciparum antigens has produced a better understanding of the disease, increased the prospects of developing a successful malaria vaccine and enhanced the introduction of new tools for malaria control.

Surgical practice in the U.K.: A personal view

2024-11-15T01:05:12+00:00

One of the most interesting experiences a surgeon can obtain is to practise in the UK. Apart from the professional bits, many other features contribute to the overall experience helping to put many things in the right (or wrong!) perspectives. This essay is an attempt to relate my own personal experiences, views and opinions. No doubt some of the views would be controversial but I feel that the young medical student and surgical trainee would obtain some benefits from this write up before proceeding on this now familiar journey. This essay would lean heavily on General Surgical Practice but opinons are expressed about other branches of surgery and indeed other aspects of medical practice as a whole. A surgeon spends all his (or her) professional life in the Operating theatres, Out-patients' clinics Wards as well as other ancillary places like the Accidents & Emergency room, the Radiology department, Surgical pathology & Post mortem departments, the Radiotherapy department and perhaps other medical departments like physics, paediatric, obstetrics etc. This review would try to focus on the surgeon and his practice in some of those places.

Literary physicians: Nigerian medical students and the art of creative writing

2024-11-15T01:12:39+00:00

There is no gainsaying the fact that in the developed countries of the world, which include the United States of America, England and Australia, the field of 'Literature and Medicine' has become a very important area of intellectual discourse. In the USA for instance, two-thirds of the medical schools now teach literature to medical students who are thereby exposed to different aspects of human activity. There are also courses designed to introduce the medical students to the art of creative writing. In Nigeria, the first medical school was established in 1948 as a component part of the University College, Ibadan. However, while it is true that literature is not currently being taught in Nigerian medical schools, Nigerian medical students have been writing poems and short stories about different aspects of human experience. In this study, we shall be examining some of these poems and a short story which have appeared in recent volumes of DOKITA, an internationally acclaimed journal published by the University of Ibadan Medical Students Association, to establish the creative potentials of Nigerian medical students.The poems and the short story that were examined in this study were published between 1990 and 1997 in volumes 19,21,23 and 24 of DOKITA.

Occurrence of acute respiratory infections (ARI) in children under five years in Igbo-Ora during the period January 1-28, 1999

2024-11-15T01:23:33+00:00

A descriptive study to determine the occurence of ARl in children under five years and the management given by mothers in Igbo-Ora, a town in Western Nigeria was undertaken. A total of 186 mothers were interviewed to determine prevalence, predisposing factors, identification of symptoms and subsequent management of the condition. Occurrence of ARl was 23.7% of sample population out of which 68.2% were below two years of age. Significant predisposing factors associated were site of cooking, type of cooking fuel and ventilation of the home. 29% of mothers were able to correctly identify symptoms of ARl and there was a statistically significant association between the age of mother and correct identification of symptoms. Concerning management, 36% of mothers claimed they would present at a health center, 32.8% would buy drugs from the chemist and 15.1% would use herbal concotions.