Surgical management of pericarditis in Zaria, Nigeria.

Abstract

Over eight years, 58 rural Nigerians with pericarditis were treated surgically in Zaria using basic surgical facilities. Eighteen patients had purulent pericarditis, associated with staphylococcal pneumonia in children, or pneumococcal pneumonia in adults. Treatment with antibiotics and prompt pericardiectomy appeared to be superior to drainage, since a quarter of those initially treated with surgical drainage developed early constriction and required pericardiectomy soon after. Thirteen patients had chronic pericardial effusions, of whom one had epicardial constriction and two had cardiomyopathy. Twenty-seven patients had chronic constrictive pericarditis but tuberculosis was confirmed histologically in three only. Echocardiographic findings remained unchanged in five patients evaluated before and after pericardiectomy. Eight of the 13 patients who died had already developed myocardial or hepatic insufficiency before operation, because of late presentation or diagnosis. Greater awareness of the significance of precordial pain in this rural population where ischaemic heart disease is rare would help in making an earlier diagnosis.

Gastric Carcinoma—A Big Challenge in a Poor Economy

“…However, dietary and social lifestyle in general may be a consideration in this direction, and this requires further studies.Worldwide, gastric malignancies are said to be more common in males. In the present study, the male/female ratio is 2.3:1 and is similar to reports from other studies[8,[13][14][15]. Alatise et al reported a male/female ratio of 3:2, Balint reported a male/female ratio of 2.6:1, Mabogunje reported a ratio of 1.3:1, and Siriwardana et al reported a ratio of 3.5:1…”

“…Gastric malignancies are said to be more common in the northern part of Nigeria compared to the southern part [5]. Exact reasons for these regional variations in Nigeria have not S/N Sex Age (years) 1 Male 47 2 Male 38 3 Male 60 4 Male 53 5 Male 63 6 Female 63 7 Male 60 8 Male 53 9 Male 38 10 Male 57 11 Male 76 12 Female 49 13 Female 45 14 Male 56 15 Female 65 16 Male 47 17 Male 47 18 Female 58 19 Male 70 20 Female 39 21 Female 48 22 Male 52 23 Male 50 [8,[13][14][15]. However, even though all the studies indicate a male preponderance, the regional variations in the male/female distribution of gastric malignancies are obvious in these studies.…”

Clinicopathological features and management of gastric cancer in Port Harcourt

“…Post-operative mortality from this study was 11.5%, which is lower than the 23-36% previously reported from Nigeria. 9,14,28,29 The fewer patients in this study may have been responsible for this finding.…”

Staphylococcal purulent pericarditis in a malnourished Gambian child: A case report

“…Purulent pericarditis is not uncommon in developing countries [7] where the increased incidence has been associated with delay in diagnosis and treatment of serious bacterial infections, malnutrition and overcrowding [3]. Our patient was marasmic with pneumonia, conjunctivitis and skin ulcers.…”