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ABSTRACT
Year : 2013  |  Volume : 19  |  Issue : 1  |  Page : 35-40  

Abstracts Presented at the 62 nd Scientific Meeting of the Nigerian Surgical Research Society Held at the Ladoke Akintola University of Technology, College of Health Sciences, Osogbo, Osun State, Nigeria on 7 th December 2012


Date of Web Publication7-May-2013

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. Abstracts Presented at the 62 nd Scientific Meeting of the Nigerian Surgical Research Society Held at the Ladoke Akintola University of Technology, College of Health Sciences, Osogbo, Osun State, Nigeria on 7 th December 2012. Niger J Surg 2013;19:35-40

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. Abstracts Presented at the 62 nd Scientific Meeting of the Nigerian Surgical Research Society Held at the Ladoke Akintola University of Technology, College of Health Sciences, Osogbo, Osun State, Nigeria on 7 th December 2012. Niger J Surg [serial online] 2013 [cited 2019 Sep 15];19:35-40. Available from: http://www.nigerianjsurg.com/text.asp?2013/19/1/35/111510

Introduction of the Technique of Circumareolar Incision-Subdermal Tunneling Dissection for the Excision of Fibroadenoma of the Breast

Agodirin O, Rahman G, Olatoke S,

Akande H 1


Departments of Surgery, and 1 Radiology, University of Ilorin Teaching Hospital, Ilorin

Background: Fibroadenomas are the most common lesions of the breast requiring excision in young unmarried women where cosmesis has weighty social implications. Using an incision that leaves a cosmetically acceptable scar is desirable. The circumareolar incision fits this requirement. Unfortunately, most literatures do not describe the technical aspects of the procedure to depth. We describe the circumareolar incision - subdermal tunneling dissection for excision of fibroadenomas of the breast. Technique: The location of the lesion is identified by likening the areola to the face of a clock. The incision is made at the junction of the rough pigmented areola skin and the unpigmented smooth breast skin. Subdermal tunneling is done in the plane above the superficial layer of the breast. The lump is localized and mobilized into the wound. It is enucleated and any obvious bleeders are ligated. Closure of the cavity or plane of dissection is unnecessary. The skin incision is closed with subcuticular continuous non-absorbable suturing and firm compression dressing is applied. Conclusion: We acknowledge a steep learning curve. In the mastery of this technique the rate limiting steps are staying in the appropriate plane of dissection and localizing the lump. We hope this description will simplify the procedure and encourage utilization of circumareolar incision for fibroadenoma excision.

Preliminary Report of Clinicoradiologic Assessment of Axillary Nodes in Patients with Cancer of the Breast for "No Axillary Dissection"

Agodirin O, AKande
1 , Rahman G,

Olatoke S, Adeniji
2 , Olafimihan 1

Departments of Surgery, 1 Radiology, and 2 Histopathology, University of Ilorin Teaching Hospital, Ilorin

Background: The trend in the axillary treatment for breast cancer is towards selective dissection. In developing centers, this trend is scarcely adopted because of many reasons. The readily available methods of selecting patient for no axillary dissection are Axillary Clinical Examination (ACE) and axillary ultrasound (AUS). As a preparatory step towards introducing selective axillary dissection, we assess the accuracy of the methods (ACE and AUS)) that we may adopt in selecting our patients for no axillary dissection. Methods: The ACE and AUS finding were collected. Operative finding was the gold standard. Calculated sample size was 38 axillary dissections. Total number of axillary dissections so far is 11. One-sample Z tests were used in analysis of the proportions. Significant level of P value was set at 1% and our prior probability of accuracy was set at 70%. Results: Accuracy of ACE and AUS to predict presence of axillary node was 70% (P = 0.64) and 80% (P = 0.38 respectively. Combined accuracy was 80% (P = 0.38). Prediction of number of nodes present in the axilla was 16% (P = 1.0) accurate for ACE and 223% (P = 1.0) for AUS. The smallest node picked by ACE and AUS was 1.0 cm while the smallest node present was 0.2 cm. Conclusion: In this early report, ACE and AUS have not achieved 70% accuracy as methods of predicting presence or number of axillary nodes. However, the sample size examined so far is a great limitation.

Preliminary Report of Prospective Study Comparing Physical Examination and Ultrasound in the Assessment of Physical Characteristics of Breast Lumps

Agodirin SO, Rahman GA, Olatoke SA, Akande Olafimihan


Departments of Surgery, University of Ilorin, Ilorin

Background: In the diagnosis of breast lumps triple assessment is extremely useful but physical examination and ultrasound are often more pivotal in the overall decision making. We compare the accuracy of physical examination and ultrasound features and estimate the extent of errors of tumor size assessment. Methods: The size, surface and margins or edge of all lumps were determined by physical examination and ultrasound scan. The operative findings and result of cytology and histology were used as gold standard. Size correlation was by spearman rho analysis. Comparison of proportions was by Chi-square test. Level of significance was set at 5%. Results: The minimum size of tumor diagnosed by physical examination and ultrasound scan were 0.5 mm and 0.4 mm respectively, while the smallest size found at operation was 3 mm. There was correlation between the tumor size estimated by clinical examination and by ultrasound (Spearman rho =0.853 (P = 0.00) n = 21). The accuracy of estimation within 90% and 110% of actual size of the tumors was 40% by ultrasound and 31% by physical examination (P = 0.74). Conclusion: Use of physical examination and ultrasound scan for estimating tumor size have low accuracy and none seems to have advantage over the other.

Comparing Intraoperative Findings During Uncomplicated Appendectomy with Histological Diagnosis of Appendicitis, when Do We Progress to Further Exploration?

Oguntola AS, Adeoti ML, Agodirin SO,

Oremakinde AA, Ojemakinde KO


Department of Surgery, LAUTECH Teaching Hospital, Osogbo, Nigeria

Background: Very few studies have tried to relate the final histology of excised appendix with the detailed intra-operative findings during appendectomy, both open and laparoscopic. This study was aimed at correlating the histological features of appendix specimen with the intra operative findings at open appendicectomy (OA) in a bid to determine when to change the planned procedure to include further exploration. Methodology: A prospective study that observes the condition of the greater omentum (GO, the vermiform appendix and peritoneal exudates at all OA done for uncomplicated appendicitis. Results : Patients' ages range from 6 years to 62 years (median =23 years). Histology showed histologic normal appendix (HNA), 56 histologic acute appendicitis (HAA), and 22 histologic non-acute appendicitis (HNAA). Negative appendicectomy rate was 8.2%. The GO was sighted more in patients with HAA than HNAA (P = 0.00015) and also significantly more inflamed in the former (P = 0.00028). It is not significantly inflamed in those with HNAA (P = 0.945). The negative predictive value (NPV) of absent GO is 35.7% while the positive predictive value (PPV) of sighted normal GO and inflamed GO are 92.8% and 100% respectively. The PPV and NPV of presence of pus for diseased appendix are 95.8% and 9.8% respectively while those of excess fluid are 94.8% and 10.8%. The PPV and NPV of macroscopic assessment of the appendix for inflammation are 97% and 45.5% respectively giving the diagnostic accuracy of 90.6%. A significant trend of increasing probability of histologically inflamed appendix with increasing severity of macroscopic feature was seen (χ2 = 004 df = 1, P < 0.005). Conclusion: High positive and low NPVs are similar for all the three parameters assessed. The macroscopic appearance of the appendix has a predictive likelihood ratio for further exploration.

Preliminary Report of a Survey of the Knowledge of Brainstem Death and Attitude Toward Organ Donation among Relations of Neurosurgical Patients in Nigeria

Rabiu TB, Oshola HA, Adebayo BO
1

Departments of Surgery, Division of Neurological Surgery, LAUTECH Teaching Hospital, Osogbo, 1 Federal Medical Centre, Ido-Ekiti, Nigeria

Background: Organ transplantation is a newly developing field in Nigeria and availability of organs for donation would be a determining factor of the success of the transplant programs. Patients with brain stem death (BSD) are a major source of organ for transplantation. The level of knowledge of BSD as well as attitudes toward organ donation are very important determinants of people's willingness or otherwise to donate organs. We conducted a survey of relations of our in-service neurosurgical patients to assess their knowledge of BSD and attitude to organ donation. To our knowledge, this is the first study of its kind among the growing Nigerian neurosurgery patient population. Methods: A prospective study among randomly-selected relations of neurosurgical patients on admission using interviewer-administered questionnaires was done. Demographic information and information about BSD, attitude towards BSD, knowledge of organ donation and attitude towards organ donation were obtained. Results: There were seventy four respondents and their mean age was 35 years (range: 19-70). Majority of the respondents (51, 68.9%) were Christians, 71 (95.9%) were Yorubas and 39 (52.7%) were males. Fifty six (75.7%) of the respondents had at least secondary level of education while 46 (62.1%) were of low socio-economic status. Sixteen (21.6%) of the respondents had heard of BSD and 8 (50%) of them heard through electronic media/internet. Fifteen (93.8%) of those that had heard of BSD believed the brain could die long before life finally ceases. Seventy two (97.3%) of the respondents believed death only occurs when both breathing and heartbeat stops and 61 (82.4%) would agree with the physician on a diagnosis of BSD in the relation. Thirty six (48.6%) would want such patients put on a ventilator and of these, 34 (94.4%) want such patients on the ventilator because they hope he/she may recover and 18 (50%) would keep their relations on the ventilator for as long as they can afford. Sixty (81%) of the relations were aware of organ donation and knew that the kidney can be transplanted while 14 (18.9%) and 7 (9.4%) were aware of heart and cornea transplant respectively. Sixty four (86.4%) of them supported organ transplantation, 54 (73%) of them could donate an organ while 53 (71.6%) could accept a transplanted organ. Majority of the respondents (55, 74.3%) would generally not allow an organ to be taken from their relation although 26 (35.1%) would allow organ(s) to be harvested from their relation if the person had consented to it before death. Conclusion: The knowledge of brainstem death is low among respondents, although, most of them would agree with the physician if such diagnosis was made for their relation. Most of the respondents are aware of organ donation and support it but majority won't allow an organ to be harvested from their relations. Hence, education of the Nigerian people about brainstem death and organ donation is essential to increase the pool of available organs for transplantation in our community.

Awareness of and Attitude to Glaucoma among Rural Adult Population in Osun State, Nigeria

Isawumi MA, Hassan MB, Akinwusi PO 2 , Wasiu O 2 , Esther Asekun-Olarinmoye EO 1 , Alebiosu CO 2 , Adewole TA 3


Department of Surgery, Ophthalmology Unit, 1 Departments of Community Medicine, 2 Medicine, and 3 Biochemistry, College of Health Sciences, Osun State University, PMB 4494, Oke-Baale, Osogbo, Nigeria

Purpose: To obtain baseline data and assess the level of awareness, and attitudes of respondents to glaucoma in Alajue and Ibokun communities of Osun state. Methods: Descriptive cross-sectional study. Serial recruitment of all participants as they present on the day of screening. Socio-demographic data, and information about glaucoma were obtained through face to face administered semi-structured questionnaires. SPSS version 15 was used for data entry and descriptive analysis. Confidence intervals, means, SD and P values were derived. Results : A total of 259 respondents comprising 100 males (38.6%) and 159 females (61.4%) were screened. Age ranged from 18 years to 90 years (mean 49.73, SD 16.6 years). Skilled workers were commonest130/259 (50.3%), family history of blindness (5.8%), only 41 (15.8% CI 11.4-20.2) had ever heard of glaucoma. Sources of information were from visits to eye-clinic 21/41 (51.2% CI 35.9-66.5) and relations-of-glaucoma-patients 15/41 (36.6% CI 21.8-51.3). Causes were 'I don't know' 20/41 (48.8% 33.5-64.1) and 'curse-from-God' 10/41 (24.4%). Forty eight 20/41 (48.8%) responded 'I don't know how it can be treated' and 10/41 (36.6% CI 11.2-37.5) said medically. Thirty 30/41 (73.2% CI 59.6-86.7) refused surgery, because 'it cannot cure or reverse disease' in15/30 (50.0% CI 32.1-67.9) and 'fear' (26.7% CI 10.8-32.4). Only 8/41 (19.5% CI 7.4-31.6) would accept surgery for maintenance. Older age group P =0.028, males P = 0.018, and skilled workers P = 0.001 were predictors of awareness of glaucoma. Conclusion: There was a low-level of awareness of glaucoma and its management in these communities. Health education at all levels of health and eye care is required to prevent ocular morbidity and irreversible blindness from glaucoma.

Couching for Cataracts and its Outcomes in Osogbo, Nigeria

Isawumi MA, Hassan MB, Kolawole OU 1


Departments of Ophthalmology, College of Health Sciences, and Lautech0 Teaching Hospital, 1 State Specialist Hospital, Osogbo, Nigeria

Background: The need to raise awareness on the dangers of couching by documentation of the findings of associated complications in this state could help to reduce the patronage of couchers. Objective: To highlight the dangers of couching to the eye and its visual status, in order to discourage its patronage. Methods: A bi-center clinic-based prospective study of consecutive new cases of couched eyes over 2 years. Oral interviews, eye examination, refraction and perimetry were used to obtain information. SPSS version 16 used for descriptive analysis to find frequencies, mean, Standard Deviations, and test of significance using Chi-square and P value. Results: Twenty five patients and 30 eyes of 15 (60%) males and 10 (40%) females were studied. Age range 34-90 years and mean 67.87 years (SD 11.27. Presenting versus corrected visual acuity (VA) was 6.7% versus 23.3% normal vision, 16.7% versus 26.3% visual impairment, and 76.7% versus 50% blind. A significant number still remained blind after corrections, P = 0.014. Commonest presenting complaints were "poor/blurred vision" 24 (80.4%), most frequent period of couching before presentation 7-12 months (46.7%). All subjects with cup: d0 isc ratio >0.6 had intraocular pressures of >21 mmHg and 50% of them >40 mmHg significantly, P = 0.001. Glaucoma (13.3%) was the commonest complications, followed by cornea opacity/retinal detachment/couching maculopathy/optic atrophy (10%). Conclusions: Couching causes visually disabling complications therefore, the practice is strongly condemned. Eye care planners and providers need to increase public awareness and also put in place affordable and accessible cataract services in order to gradually phase out its patronage.

Effects of Fasting on Intra-Ocular Pressure in a Black Population

Hassan MB, Isawumi MA


Department of Surgery, Ophthalmology Unit, College of Health Sciences, Osun State University, Osogbo, Nigeria

Background: Few studies done among the Orientals and Middle Eastern populations, with scanty studies available in Blacks and Caucasians. Objectives: To determine the effects of fasting on intra ocular pressure (IOP) in a black population. Methodology: A population-based survey utilizing multistage random sampling techniques where healthy adult Muslims were examined before and during Ramadhan fast in Osogbo, Osun State, Nigeria. Demographics were obtained, visual acuities, and eye examined, and IOPs, weights and waist circumference measured. Data was analyzed using SPSS Version 16. Analysis generated frequencies and cross tabulations while statistical significant values were derived using paired sample t-test, and P values < 0.05. Results: A total of 60 patients were seen with mean age of 42.3 SD 16.7 years. There were 36 (60%) males and 24 (40%) females. Majority were professionals (33.3%). Only 18.3% had less than secondary education. Over 90% had normal vision (6/5-6/18). Before and during fasting, the mean weights were 65.92 kg SD 12.98 and 65.29 kg SD 12.41 with a reduction of 0.63 kg SD 3.82 kg (P = 0.214, 95% CI - 0.372-1.626); and the mean waist circumference 87.20 SD 12.39 cm and 81.78 SD 11.65 cm (P = 0.000, 95% CI 4.128-6.720) respectively. Mean IOPs were 15.98 SD 3.11 mmHg and 14.08 SD 2.71 mmHg. (P = 0.000, 95% CI 0.98558-2.82798). Conclusion: The study shows that fasting has a significant effect on the reduction of IOP in an ocularly.

Knowledge, Attitude and Practice of Prevention of Pressure Ulcers Among Nurses at Lautech Teaching Hospital, Osogbo

Ojewuyi OO, Oseni OG, Olaitan PB


Department of Surgery, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria

Background: Pressure ulcer is a common condition which has been in existence since ancient Egyptian times, it can be painful and costly. Although, nurses do not have sole responsibility for its prevention, they have a unique opportunity to have a significant impact on the problem. Nurses are primarily involved with the prevention of this pathology especially among in-patients. We therefore conducted this survey to assess the knowledge and prevention of this pathology among nurses in a teaching Hospital. Aims and Objectives: (1) To assess the knowledge of nurses on pressure ulcer prevention. (2) To know their attitude towards pressure ulcer prevention. (3) To evaluate their practice of pressure ulcer prevention. (4) To identify the barrier(s) against pressure ulcer prevention and proffer possible solution. Methods: A cross sectional study was done with a total of 200 questionnaires administered to obtain information from selected nurses. Information sought includes their age, qualification, years of practice post-qualification, status and ward of practice. Closed ended non-ambiguous questions were asked to obtain information on their knowledge, attitude and practice of prevention of pressure ulcer including barriers against carrying out these preventive measures. Data analyses were done using Statistical package for social sciences (SPSS) version 17. Results: Most of the respondents were young nurses with 87% (174) less than 40 years. 40% (80) were Registered Nurse (RN), 16.5% (33) were Bachelor of Nursing Science (B.NSc) holders while 27.5% had both. 24.5% (49) were nursing officers, 23.5% were student nurses, 16.5% were principal nursing officers, 15% staff nurses, 10% were senior nursing officers while 6% were chief nursing officers. Knowledge about prevention of pressure ulcer is good with 78% (156) aware of the current practices, 62.5% (125) know the cause, 67.5% are confident at identification and grading of pressure ulcer. 90.5% (181) see pressure ulcer prevention as largely the responsibility of nurses, 81% (163) agree that it is of high priority compared to other areas of nursing care. Most of the respondents have a good attitude towards pressure ulcer prevention however the practice of pressure ulcer prevention is alarmingly poor, 67% (134) practice regular turning as the only preventive measure out of all the numerous current practices. Short staffing is considered by majority (68.5%) as the barrier to carrying out preventive measures against pressure ulcer. Conclusion: There is an acceptable level of knowledge among nurses on pressure ulcer prevention, most of the respondents also have good attitude towards pressure ulcers. This however has not translated to practice of current measures aimed at preventing pressure ulcer. Inadequate staff is considered as the barrier against effective practice of pressure ulcer prevention. We advocate more awareness, regular and periodic training of nurses and adequate staffing so as to reduce to the barest minimum this pathology.

Haematological Toxicity and Safety Profile of Calotropis Procera Latex in Sprague-Dawley Rabbits

Aderounmu AO, Orafidiya LO
1 ,

Omonisi AA
2 , Akingbasote JA 3 ,

Bolarinwa RA
4 , Adegoke A 5 , Atiba A 5 ,

Bejide O
6 , Adedigba A 1

Department of Surgery, LAUTECH, Osogbo, Nigeria, 1 Department of Pharmaceutics, Faculty of Pharmacy, OAU, 2 Department of Morbid Anatomy and Forensic Medicine, OAUTHC, 3 Department of Pharmacy, OAU, 4 Department of Haematology, OAUTHC, 5 Department of Chemical Pathology, OAUTHC, 6 Department of Morbid Anatomy and Forensic Medicine OAU, Ile-Ife,

Background: Calotropis procera is known to have medicinal and toxic effects in both man and animals. Materials and Methods: This study is interventional in design. It is a sub-acute toxicity study to assess the effect of Calotropis 19 procera latex prepared at various concentrations [0 (distilled water); 0.35 mg/kg; 0.65 mg/kg and 0.85 mg/kg] on the haematologic parameters (packed cell volume [PCV]; haemoglobin (Hb) concentration; platelet count; total white blood cell (WBC) count and the red cell indices (mean cell volume, MCV; mean Hb concentration, MCH; mean corpuscular Hb concentration, MCHC) following standard methods (Schalm et al., 1975). Results: There was a progressive decrease in the PCV with increasing concentration of C. procera latex, it was significant (P < 0.05) for groups treated with dose of 0.85 mg of the latex per kg body weight (intra-peritoneal [IP]) compared to the control treated with distilled water (0 mg latex). Statistical significance (P < 0.05) was also observed in terms of decrease in level of the red blood cell count at IP doses of 0.35 mg and 0.65 mg of the latex per kg body weight of the rat. There was significant (P < 0.05) increase in the total WBC count in the groups treated with 0.35 mg of the latex per kg body weight and a significant (P < 0.05) decrease in the WBC count of groups treated with IP doses of 0.65 mg, 0.85 mg of the latex per kg body weight and those treated orally at 2 mg of the latex per kg body weight. There was a significant reduction in the platelet count in all the treatment groups compared with the control (using one way Student t-test). Furthermore, there was a significant decrease in absolute lymphocyte count in all the groups except for the group treated with doses at 0.35 mg of the latex per kg body weight. There was an initial increase in the mean corpuscular volume and mean corpuscular Hb level of rats in the groups treated with 0.35 mg and 0.65 mg of the latex per kg bogy weight. C. procera latex did not have significant effect on the neutrophil count at doses administered via IP route. However, with oral dose of 2 mg of the latex per kg body weight there was significant neutropaenia (reduced neutrophil count) when compared to the control group. Conclusion: C. procera caused anemia, significant reduction in red cell count, lymphocyte count and platelet count following high dose of IP administration. This effect may be due to direct cytolytic effect of C. procera on the blood and other cells in the rat at high concentration.

Acute Toxicity of Latex of Calotropis Procera on Rabbits

Aderounmu AO, Orafidiya LO 1 ,

Omonisi AA 2 , Akingbasote JA 3 ,

Bolarinwa RA 4 , Adegoke A 5 , Atiba A 5 , Bejide O 6 , Adedigba A 1


Department of Surgery, LAUTECH, Osogbo, Nigeria, 1 Department of Pharmaceutics, Faculty of Pharmacy, OAU, 2 Department of Morbid Anatomy and Forensic Medicine, OAUTHC, 3 Department of Pharmacy, OAU, 4 Department of Haematology, OAUTHC, 5 Department of Chemical Pathology, OAUTHC, 6 Department of Morbid Anatomy and Forensic Medicine OAU, Ile-Ife,

Background Objective: The latex of Calotropis procera was used earlier by our research team to find its wound healing effect and potential anti-keloidal properties on rabbits. This study aims at finding its toxicity potential on animals with a view to relating the finding to its safe use in humans. Methodology: Sprague-Dawley rabbits (weighing 100-250 g) were obtained and cared for under standard laboratory conditions. Acute Toxicity test was carried out using the Method of Lorke (1983). Different doses (0.365-0.865 mg/kgbw) were given to the animals intraperitoneally and orally (2 mg/kgbw) after finding the LD50. Toxicity was measured by observing the clinical behaviors of the animals for 28 days and by its effect on some blood parameters and Histological changes on some organs, using blood removed from the heart, after necropsying the animals on day 29 or 30. Results: Observed acute/Subacute toxicity was grooming, rearing and restlessness on intraperitoneal route of 0.01-1 mg/kgbw. No mortality seen in 24 h. At higher doses of 1.5-4 mg/kgbw the rats showed symptoms as above as well as licking of paws, rearing, restlessness and rubbing of nose against cage. Mortality was observed in this group within 24 h. By the oral administration of Latex at doses of 1.5-4 mg/kgbw, paw licking and reduced activity but no death. Water intakes and body weight changes were significant, so sere hematological parameters. Histological studies showed toxicities on lungs and testis. Conclusion: Calotropis procera is relatively safe by oral route except on lungs and testis

Cosmetic Surgery in Osogbo, Nigeria: Awareness and Attitude of Health Care Professionals

Adedeji OA, Oseni OG, Olaitan PB


Department of Surgery, LAUTECH Teaching Hospital, Osogbo, Nigeria

Background: The Practice of cosmetic surgery has been rather low in Nigeria. Health care workers constitute the first group of people to educate the populace and increase the practice of cosmetic surgery. Materials and Methods: A survey was done at LAUTECH Teaching Hospital, Osogbo in 2012. Questionnaires were administered to 200 students and workers in the hospital. These were then analyzed using SPSS Version 16.0. Results: Respondents were 79 medical students, 60 nursing students, 20 doctors, 32 nurses 4 administrative workers, 1 pharmacist and 4 ward maids. There is fair awareness about cosmetic surgery generally (94.5%) and its availability in Nigeria (67.0%), even though negligible percentage is aware of facility for cosmetic surgery in their locality (44.5%). A large percentage (86.5%) favorably considers facilities outside Nigeria when making choice of facility to have cosmetic surgery done. 85.5% considers the information about cosmetic surgery reliable, 19.0% objected going for cosmetic surgery of their choice even if done free. Only 34.0% considers cosmetic surgery socially acceptable. Conclusion: The disposition of health workers to cosmetic surgery is poor. Cosmetic surgery is still socially unacceptable in Nigeria. There is a need for increase awareness. As standard of living increases, patronage is likely to be on the increase; thus, the need to make rooms available in terms of awareness and increase technical skills in preparation of the future of cosmetic surgery in Nigeria.

A Novel Surgical Technique for Reconstructing Total Upper Lip Loss

Oseni OG, Olaitan PB


Department of Surgery, LAUTECH Teaching Hospital, Osogbo, Nigeria

Background: Upper lip reconstruction following defects from varying causes is a challenge because the upper lip is not as forgiving as the lower lip. Where the loss is total, the challenge becomes greater. We present a case of total upper lip reconstruction using a combination of tissues around the face with an acceptable cosmetic result and minimal secondary morbidity. Materials and Methods: We reviewed a case of a 62-year-old farmer who presented with an advanced squamous cell carcinoma of the entire upper lip. He had excision of the tumor leaving an entire loss of the upper lip. Three different tissues were used in the reconstruction. First were bilateral inferiorly based naso labial flaps with a bi-pedicled mental flap which had bucal mucosa graft laid to recreate the sulcus. Results: The result was a functionally and cosmetically acceptable upper lip with minimal or no deformity. Conclusion: Bilateral nasolabial flaps, bipedicled mental flaps and bucal mucosagraft give good results and should be considered among the options of upper lip reconstruction.

Awareness of Mothers in Akindeko Market, Osogbo, on Prevention of Domestic Burns Among Children

Olamoyegun KD, Olaitan PB


Department of Surgery, Burns and Plastic Surgery Unit, LAUTECH Teaching Hospital, Osogbo, Nigeria

Background: There is overwhelming evidence that childhood burns are largely environmentally conditioned and therefore preventable. The current study therefore aimed at determining the level of awareness of mothers on burn prevention. Materials and Methods: A structured questionnaire was administered to consented adults who were traders at a popular market in Osogbo, Nigeria. The awareness of mothers on burn injury and prevention methods were assessed. Data were collected and then analyzed using spss with frequencies, tables, means. Results: One hundred questionnaires were distributed to the traders among which 98 (98%) were returned. The age range with the highest frequency was age 20-30 years with 42% followed by 30-40 years with 37.8%. 66.3% of the women were married and had children. 36.7% of the respondents had had relations who had sustained burn injuries in the past. 73.5% of the respondents agreed that lack of supervision is a major risk factor for burns. 74.5% agreed poor knowledge of burn is responsible for the injury while 52% agreed that poor knowledge of evacuation of burn patient as the time of injury increases the risk of burn injury. Storage of flammable substance at home was seen by 72.4% as a risk factor while 77.5% believe accessibility of children to lighter contribute to burn injury. 75% of the respondents agree unsafe stove and lamp, lack of access water (56%), use of candles (70%), congested houses (66) among other things contribute to domestic burns among children. Knowledge of first aid measures was also assessed and found to be low for example over 70% of them does not use how to use fire extinguishers. Conclusion: The study concludes that the awareness of burn among these women is high but knowledge of the preventive measures is rather low. Education at antenatal clinic, market and religion homes will help to increase the level of knowledge of the people in this part of the city.

Knowledge, Attitude and Practice of Perioperative Antibiotic Prophylaxis Among Nurse-Anesthetists in Nigeria

Ajibade A, Olaitan PB


Department of Surgery, College of Medicine, Ladoke Akintola University of Technology, Osogbo, Osun State, Nigeria

Background: Anesthetists administer perioperative antibiotics. In Nigeria, a large number of them are nurses. A study of perioperative antibiotic prophylaxis and nurse-anesthetists in Nigeria is therefore desirable. Objective: To evaluate the knowledge, attitude and practice of perioperative antibiotic prophylaxis among nurse-anesthetists in Nigeria and factors that influence the three domains. Methods: A cross-sectional study. A pretested, structured questionnaire was administered to nurse-anesthetists at the Annual General Meeting of Nigeria Association of Nurse-Anesthetists. Data was analyzed with SPSS version 15. Percentages were computed and Mc-Whitney test was performed to assess factors that were predictive of score on three domains studied. Results: Knowledge and practice of appropriate and safe timing of perioperative antibiotic administration as well as indications for intraoperative re-dosing were poor. There was a high level of agreement that surgeons should indicate when antibiotics should be administered. Availability of a hospital antibiotic prophylaxis protocol and practice for 10 or more years were predictive of a high knowledge score. Conclusion: Lectures during training and continuing medical education can improve the knowledge of nurse-anesthetists about perioperative antibiotic prophylaxis. Availability of hospital protocols and indication by surgeons of the time perioperative antibiotics should be administered can improve practice.

The Spectrum of Aggressive Driving Among Nigerian Drivers: An Observational Study

Kehinde O, Olaide A, Olusola A


Ekiti State University, Ado-Ekiti, Ekiti State, University of Ilorin, Ilorin, Ladoke Akintola University of Technology, Ogbomoso

Background: Aggressive driving is the unsafe operation of a motor vehicle in a hostile manner, without regard for the safety of other users of the road. It is perceived by many road users as one of the more significant problems of driving. Methods: Observations were made at three different sites in Osogbo by three different groups of observers at three different periods of the day. The observation consisted of drivers with aggressive behaviors and controls. Six types of aggressive driving, horning, wrong overtaking, off-side overtaking, hostile gesturing, driving against traffic and phoning were recorded among drivers. Results: 4550 (1856 aggressive drivers and 2694 controls) drivers were observed. Only 29.7% of female drivers were found to be aggressive versus 41.5% among males (P < 0.001). Repeated horning (53.7%) was the most commonly observed aggressive behavior followed by aggressive gestures (24.6%). Drivers of government, private and business vehicles exhibited more aggressive gestures driving than commercial and truck drivers (P < 0.001). In a similar fashion, younger drivers exhibited less aggressive driving behaviors than older drivers, and drivers adjudged to be in middle - high socioeconomic groups (P < 0.001). Finally more aggressive behaviors were observed when traffic was heavy. Conclusion: The study showed some unexpected results. We may have to re-evaluate our assumptions concerning driver aggression in the environment.




 

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