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Year : 2016  |  Volume : 22  |  Issue : 1  |  Page : 58-63  

Book of Abstracts for the 68th biannual scientific conference of Nigerian Surgical Research Society, Oghara December 2015

Date of Web Publication15-Feb-2016

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How to cite this article:
. Book of Abstracts for the 68th biannual scientific conference of Nigerian Surgical Research Society, Oghara December 2015. Niger J Surg 2016;22:58-63

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. Book of Abstracts for the 68th biannual scientific conference of Nigerian Surgical Research Society, Oghara December 2015. Niger J Surg [serial online] 2016 [cited 2019 Nov 16];22:58-63. Available from: http://www.nigerianjsurg.com/text.asp?2016/22/1/58/176399

Okugbo Stanley, Anyanhun Gandhi

Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria

  Symptomatic Surgical Pleural Effusion in the University of Benin Teaching Hospital - prospective Study Top

Background: Pleural effusion is usually classified as exudate or transudate based on its protein content. Exudative effusion is rich in protein which is produced by inflammatory process ignited by direct invasion of the pleural surfaces either by infective bacteria, i.e., tuberculosis or by malignancies. Breast cancer and lung cancers are among the most common causes of significant pleural effusion. Involvement of the pleural indicates advance cancers in patients so affected. With accumulation of pleural effusions; in time, they begin to exert forces within the thoracic cavity, impeding lung expansion, producing mediastina shift, and resulting in respiratory embarrassment. Untreated, it may lead to respiratory failure and death. Chest pain, cough, dyspnea, and heaviness are the common symptoms necessitating intervention. Many exudative effusions are recalcitrant and require pleurodesis for complete resolution. Treatment usually entails thoracocentesis or tube thoracostomy. Pleurodesis is usual for malignant and recalcitrant cases, while decortication may become necessary for chronic empyema. Aim: This is a prospective study to ascertain the main causes, types, and management outcome of symptomatic pleural effusion in our hospital practice. Patients and Methods: This is the preliminary 6-month report of an ongoing prospective study commenced in April 2014. It involved the enrollment of all patients referred to the cardiothoracic surgical unit of the University of Benin Teaching Hospital, Benin City, who had moderate to severe effusion. All patients had a questionnaire filled for them including proper documentation of their clinical features, modes of presentation, diagnosis, results of investigations, and treatments given. All data were entered to spreadsheets and analyzed. All patients with minimal to mild pleural effusion not requiring tube thoracostomy were excluded from the study. All patients with hemothorax from trauma were also excluded from the study. Results: A total of forty patients were seen in the period under review, with a male: female ratio of 2:1.9. The mean age was 40.6 years (range 3 months to 72 years). The effusion was right-sided in 21 patients, left-sided in twenty, and bilateral in two patients. Pulmonary tuberculosis accounted for 25% (10); breast cancer for 22.5% (9); and bronchogenic cancer in 15% (6). The effusion was serous in 25 patients (55.6%), while 12 patients (26.7%) had empyema thoracis, and it was hemorrhagic in eight patients (20%). Four patients had systemic hypertension and another four had diabetes mellitus, while only one patient had chronic obstructive airway disease. The 19 cancer patients were distributed thus: Lung cancer 6; breast cancer 9; thoracic neuro-endocrine tumors 2; renal cell carcinoma 1; neck tumor 1; and wound sepsis occurred in four patients, while the tube was malpositioned in five. Breast carcinoma; the cancer was on the right breast in five patients with one of them having bilateral pleural effusion; of the three left breast cancer patients, only one patient had contralateral pleural effusion. While the only patient with bilateral breast cancer had right-sided effusion, all the patients had pleural biopsy done and all the breast cancer patients had pleurodesis done. Conclusion: Moderate pleural effusion (from our study) is mainly due to tumors with breast cancer being the most common cause. The effusion is commonly ipsilateral and right-sided, from direct pleural invasion. Pulmonary tuberculosis is still a significant cause of effusion.

  Clinicopathological Features, Treatment, and Outcome of Pregnancy-Associated Breast Cancer in Ahmadu Bello University Teaching Hospital, Zaria, Northwestern Nigeria Top

Abur PP1, Odigie VI1, Yusufu LMD1, Dawotola DA1,2

Departments of 1Surgery and 2Radio-oncology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Background: Pregnancy-associated breast cancer (PABC) is breast cancer diagnosed during pregnancy or within 1 year of delivery. It is the most frequent malignancy diagnosed during pregnancy or lactation. There is paucity of literature of PABC in Northwestern Nigeria. Aim: To highlight the clinicopathological features, treatment, and outcome of PABC in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Northwestern Nigeria. Methods: It was a 6-year prospective study of PABC from January 2007 to December 2012 at ABUTH Zaria. Information documented included patients' biodata, clinical features, pathological types, receptor status, staging, treatment, and outcome of PABC patients seen in ABUTH. Results: About 1344 had breast cancer during the study period. Thirty one patients (2.3%) had PABC. Age ranged 20–43 years, median of 31 years. Common clinical features were breast lump/mass −27 (87.1%) patients, skin thickness 10 (32.3%), nipple retraction 9 (29.0%), and inflammation 6 (19.4%). Nineteen (61.3%) patients were diagnosed in pregnancy: 1st trimester, 4 (12.9%); 2nd trimester, 7 (22.6%); 3rd trimester, 8 (25.8%); while 12 (38.7%) were within 1 year of delivery. Twenty-two patients (71.0%) had advanced disease. Twenty-four (77.4%) patients had invasive ductal carcinoma. Eight (36.4%) patients were ER/PR positive. Six (27.3%) were triple negative and 2 (13.6%) were HER 2 positive. Twenty-four patients (77.4%) had vaginal delivery. Three patients (9.7%) had spontaneous abortion and 1 patient (3.2%) had still birth. Twenty-five babies (80.6%) were alive and well. Seventeen patients (56.9%) had modified radical mastectomy (2 patients in 2nd trimester and 15 patients after delivery), 25 (80.6%) had chemotherapy, 14 (45.2%) had radiotherapy, and 1 (3.2%) received trastuzumab. Mortality was 8 (25.8%). Conclusion: PABC constituted 2.3% of all breast cancer patients in our hospital. Majority (71%) presented with advanced disease. Three out of every four were invasive ductal carcinoma, while one in four were triple negative. The mortality was 25.8%.

  Quality Of Life Of Breast Cancer Patients Receiving Chemotherapy in Delta State University Teaching Hospital, Oghara Top

Afeyodion Akhator, Martins Odes Akpomiemie

Department of Surgery, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria

Introduction: The World Health Organization defines the quality of life (QOL) as the individual's perception of life, its values, objectives, standards, and interest in the framework of culture. This is increasingly been used by investigators to assess treatment outcomes in terminal diseases and malignancy. The complications of chemotherapy negatively impact on the QOL of breast cancer patients receiving chemotherapy alongside the negative impact of the primary pathology. Aim: The objective of this study is to describe the QOL in breast cancer patients receiving chemotherapy in Delta State University Teaching Hospital, Oghara. Materials and Methods: This is a questionnaire-based study; the European Organization for Research and Treatment of Cancer QOL Questionnaire, breast cancer module was used to measure QOL in the study population. The module assesses both the patient's functional and symptom scales. Results: There were 39 patients in this study; all were females with advanced breast cancer at various cycles of chemotherapy. The mean age was 49.02 years, with range of 31–63 years. Thirty-two patients (82.05%) had favorable body image, 17 (43.59%) had no or minimal side effects from systemic therapy, 22 (56.41%) had no or minimal breast symptoms, and 21 (53.85%). While 27 had hair loss, only 3 (11.11%) were very upset with the hair loss. Twenty-four patients (61.53%) were significantly worried about their future health and only 12 (30.77%) had any interest in sex in the preceding 4 weeks of the interview. Conclusion: This study shows that breast cancer patients receiving chemotherapy had a favorable QOL in spite of the late stage of presentation.

  Postmastectomy Breast Reconstruction At The University Of Benin Teaching Hospital, Benin City Top

Ijekeye FO, Nwashilli NJ, Kadiri AI

Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria

Background: Postmastectomy breast reconstruction, though a desirable rehabilitation procedure, has remained an uncommon procedure in most resource-limited environments. Aim: To review the number of cases of breast reconstruction carried out. Methods: This was a retrospective study carried out over a 3-year period from January 2010 to December 2012. All the case files of patients who had mastectomy and breast reconstruction were retrieved from the Medical Records Department and analyzed for the following parameters: Age, marital status, educational level, TNM staging at presentation, body frame, breast cup size, breast reconstruction technique, postoperative complications, and patients' satisfaction. Results: A total of 86 mastectomies were carried out over the period. All were females. The indication for the mastectomies was breast cancer. Out of the 86 patients, only five had breast reconstruction. Their mean age was 37.0 ± 6.0 years. All the patients had immediate breast reconstructions. Reconstruction techniques utilized were latissimus dorsi and transverse rectus abdominis myocutaneous flap. Four out of the five patients (80%) were very satisfied with their surgical outcome. Conclusion: Breast reconstruction remains a relatively uncommon procedure in our environment, but retains the potential for improving the psychosocial wellbeing of the patient. Availability of the expertise and improved social awareness will help maximize patient's benefits.

  Utilization Of Autopsy Service In A Nigerian Teaching Hospital Top

Ohayi SAR, Edeh AJ

Department of Surgery, Enugu State University Teaching Hospital, Enugu, Nigeria

Background: Autopsy is known to be an important part of clinical practice. It serves as an audit and quality control for safety and quality of diagnosis and treatment. It provides families with “informed grieving” by giving clearer understanding of the nature and cause of illness and also may reveal diseases in the family that may be inheritable or communicable. It helps in advancement of medical research and education. It helps in providing information on the cause of death in a society and provides useful information for policy makers. Despite these benefits, the rate of autopsy is low and declining. The aim of this study is to ascertain the frequency of clinical autopsy in our hospital. Methods: A retrospective study of hospital autopsies performed from January 2011 to December 2014. The mortuary and autopsy records of the Enugu State University Teaching Hospital over the period were reviewed. We assessed the factors that affected the uptake of autopsy services. Exclusion criteria: Deaths reported to the police including sudden deaths, deaths from interpersonal violence, and other forms of trauma including various forms of accidents and deaths before arriving at the hospital (brought-in-dead). Results: A total of two thousand, two hundred and twenty five bodies were received in the mortuary in the period under review with 149 being excluded for various reasons. Of the 1976 studied, there were 1078 males and 898 females (M: F = 1:1.2). Ninety-six (4.9%) were aged 18 years and below while 1880 (95.1%) were aged above 18. Clinicians claim that they generally often suggest autopsy to patient's relations. Actual requests for autopsy made in 22 (1.1%) cases: 13 (0.66%) from pediatrics, 3 (0.15%) from internal medicine, and 2 (0.1%) from accident and emergency. Consent for autopsy was granted in five cases (22.7% of actual request and 0.3% of number of deaths) and autopsy performed in all giving an average of 1.25 autopsies/year. Four autopsies were performed on pediatric patients, namely: One neonate, two infants, and one child. Average hospital stay for those consenting for autopsy is 12.6 days and 36.3 days for those who declined autopsy. Persons who consented to autopsy belong to diverse economic and educational level. Conclusion: Autopsy rate is very low in our center. It appears that both clinicians and patients' relatives contribute to this trend. Vigorous education for all stakeholders is recommended if the autopsy art is to continue.

  Audit Of Surgical Operation Notes In A Teaching Hospital, South -Western Nigeria: Based On Royal College Of Surgeons Of England As Standard Top

Akanbi Olusola Olateju, Adeoti Moses Layi, Oguntola Adetunji Saliu, Onilede David Adekunle, Aderounmu AOA, Olawale Lateef Idris

Department of Surgery LAUTECH Teaching Hospital, Osogbo, Nigeria

Background: Operation notes are important medical records that document operative procedures, intraoperative findings, subsequent care, and plan for the patients. The value of quality operation notes for academic, research, clinical auditing, and when medical litigation arises cannot be disputed. These notes when properly documented will help to promote prompt response to care and need of patients in postoperative period. Methodology: This study assessed the quality of operation notes in our center by retrospectively reviewing all the available operation notes over a 2-year period, against a set standard by Royal College of Surgeons of England. Results: A total of 168 general surgical operation notes were reviewed. One hundred and eleven (66.07%) cases were performed by consultants; however, only 24 (14.28%) notes were written by them (P < 0.001). One hundred and thirteen (67.2%) cases were electives whereas 55 (32.74%) cases were emergencies; however, none of the writers documented this component. Compliance of >90%, 70–90%, and <70% were achieved in 7 (43.75%), 4 (25%), and 5 (31.25%), components, respectively. None of the notes achieved up to 90% overall compliance, with highest compliance of 87.5% achieved in 11 (6.54%) operation notes. Most of the operation notes were not written by the lead surgeons. This finding is more prevalent among consultant cadres. Conclusion: Our study revealed deficit in some areas of information with good compliance in other areas. We therefore recommend the use of standard operation note-based proforma as aide-memoires will help improve the quality of our operation notes.

  Death On Arrival In A Tertiary Hospital In Enugu, Nigeria Top

Edeh AJ, Ilo C, Nevo AC, Ohayi SAR, Osodu C

Department of Surgery, Enugu State University Teaching Hospital, Enugu, Nigeria

Aim: A new accident and emergency block was opened in July 2011 at Enugu State University Teaching Hospital. It was soon observed that the number of brought-in-dead (BID) appeared high. We decided to investigate the magnitude of this problem. Methods: Retrospective recording of all BID from January 2012 to June 2014 (30 months). Attempts were made to obtain information on circumstances that made it impossible to arrive the health facility alive. Basic patients' characteristics such as age, sex, distance of home from hospital, and duration of illness were obtained where possible. Results: Two hundred and ninety-four medical, surgical, and gynecological emergencies were seen over the period. Obstetric and children emergencies were seen in other units. There were 88 cases recorded as dead on arrival (29.91% of cases attended over the period). Sixty three (71%) were referred from other health facilities. Nineteen (21.6%) were accident victims. Eleven (12.5%) were sudden deaths – at home and playground. Resuscitation effort was attempted in only one case. No record of autopsy in any was obtained. Discussion: Though this figure is high, this compares with figures from Lagos and Ghana. Majority were referrals from other health facilities. Accident victims and sudden deaths were also high. Resuscitation efforts and autopsy were not considered seriously. Conclusion: Death on arrival (BID) appears unacceptably high in Enugu. In the absence of civil strife or war; efforts, including research must be made to reduce it.

  Antibiotics Use In Inguinal Hernia Repair In West Africa: A survey Of Surgeons' Belief And Preferences And Practices Top

Amarachukwu Chiduziem Etonyeaku, Elugbaraonu Augustine Agbakwuru, Olalekan Olasehinde, Ademola Olusegun Talabi, Oladapo Adedayo Kolawole, Akinbolaji Andrew Akinkuolie

Department of Surgery, Obafemi Awolowo University Teaching Hospital, Ile Ife, Nigeria

Background: There are divergent opinions on the use of antibiotics in inguinal hernia surgery (IHS). This study evaluates practices in the West African sub-region. Methods: A self-administered questionnaire-based survey on the use of antibiotics in IHS in West African sub-region. Respondents were drawn from participants at the 2014 West African College of Surgeons' conference in Kumasi, Ghana. Only those who perform IHS were studied. Results: Sixty-seven respondents were studied. The mean duration of surgical practice was 16.61 (±9.96) years. Respondents were from Nigeria (51), Ghana (10), Benin (2), and one each from the Gambia, Sierra-Leone, Liberia, and Cote D'Ivoire. Majority practice at tertiary hospitals (54; 80.6%) and perform <5 IHS monthly (58.2%). Bassini (n = 34) and nylon darn (n = 32) repair methods were most popular. Majority of the respondents (48; 71.6%) administer antibiotics: Intraoperatively (36; 75%), limiting its use to within 24 h of surgery (20; 41.7%). Concerned breach in asepsis (20, 41.7%) and desire to prevent surgical site infection (SSI) (18; 37.5%) were the major reasons for antibiotics use. The use and duration of use of antibiotics were independent of the length of surgeon's experience, location, or nature of his/her practice and the frequency of IHS or repair method deployed. However, the duration of use of antibiotics seems to be influenced by the location of practice. Conclusion: Many surgeons in West Africa still administer antibiotics in uncomplicated IHS irrespective of repair technique, work experience, location, and nature of practice. Prevention of SSI is the major reason for use.

  Congenital Anomalies Of The Gastrointestinal Tract: A Review Of 130 cases Top

Eighemhenrio Aiwanlehi, Ebuka Egwuata F, Okomayin Andrew

Department of Surgery, DELSUTH, Oghara, Nigeria

Introduction: Congenital anomalies of the gastrointestinal tract (GIT) are a common cause of serious morbidity and mortality in many pediatric surgical centers. Most patients with these conditions would present early because of the associated challenges in feeding and defecation. Aim: To evaluate the common cases of congenital anomalies of the GIT seen in our hospital and appraise their pattern of presentation and other correlates. Materials and methods: The study was a retrospective study of pediatric patients with congenital anomalies of the GIT over a 3-year duration at the University of Benin Teaching Hospital from 2011 to 2013. Information was retrieved from the case notes of patients obtained from the medical records unit. Results: A total of 130 cases were seen over the 3-year period. A wide range of anomalies were seen. Anorectal malformation was the most common anomaly seen. It accounted for 31.1% of cases. This was followed by Hirschsprung's disease with 20.1%. Most patients with congenital anomalies of the GIT are seen in the neonatal period, 6.9% presented after 5 years. Discussion: Congenital anomalies of the GIT are a common cause of pediatric surgical consultation. The outcome is usually good following the early presentation in most cases.

  Pattern Of Head Injury In The Emergency Department Of The Delta State University Teaching Hospital, Oghara, Nigeria Top

Andrew A Bock-Oruma

Department of Accident and Emergency, Delta State University Teaching Hospital, P.M.B. 07, Oghara, Delta State, Nigeria

Background: Head injury (HI) accounts for a significant proportion of morbidity and mortality of the productive age of the world's population. The objective of this study is to highlight HI patients' epidemiological properties and trauma patterns. Methodology: This is a prospective study using a proforma for assessing HI adult patients in the Emergency Department (ED) of Delta State University Teaching Hospital from January to December, 2014. The variables assessed include age, gender, mechanism of injury (MOI), severity of injury, and mortality. Glasgow Coma Scale was used to assess the severity of injury.{2}Results: Three hundred and fifty-three trauma cases presented to the ED, 88 (24.9%) were HI patients. The mean age was 32.80 ± 12.50 years. Age range was 68.00 years (17–85). Young persons (15–24 years) were most affected, with 22.6%. The male: female ratio was 9:1. On MOI, 4.4% of the patients had a fall, 13.6% were assaults, and 81.9% had road traffic accident (RTA). On the severity of injury, 55.7% of the patients had mild HI, 20.4% had moderate HI, and 23.8% had severe HI. RTA was more common in those 45-year-old and above (22.7%) and assault in young persons (5.6%). The majority of young persons had mild HI (15.9%), moderate HI, more within the age group of 25–29 years (3.9%) and severe HI more in the elderly (5.7%). Mortality was 6.8%. Conclusion: HI is a major contributor to trauma admissions in the ED. The productive age group and the male sex are mostly affected. RTA is still a major cause of head injury in our society.

  Epidemiology Of Road Traffic Accident Injuries As Seen At The Emergency Room Of Delta State University Teaching Hospital, Oghara, Delta State: A Preliminary Report Top

Odatuwa-Omagbemi DO, Bock-Oruma AA, Enemudo RET, Otene CI, Iwegbu GC, Okeke MO, Akpojevwe E

Department of Surgery, DELSUTH, Oghara, Nigeria

Introduction: Road traffic crash is a major cause of trauma, morbidity, and mortality worldwide. It is particularly more rampant in developing countries. An estimated 1.2 million people die annually from road traffic crashes globally. The young and productive age groups are more affected. Aim: The aim of this study is to highlight significant epidemiological features associated with road traffic accident victims presenting at the emergency room of Delta State University Teaching Hospital. Patients and Methods: Patients who presented at our emergency room during the period of study - April 1st to October 31st, 2015, with a history of road traffic crash and gave consent to participate were included in the study. Data on age, sex, vehicles involved, nature of injury, etc., were collected on already prepared proforma by attending doctors. Data analysis was done using SPSS version 17. Results: Data were collected from 53 victims of road traffic crash during the period. There were 35 males and 18 females (M:F = 2:1). The average age of victims was 36 ± 15 years. The most frequently affected age group was that of 20–29 years followed by 30–39 years, both which accounted for close to 60% of victims. More than half of the cases (51%) involved motorcycles. Three victims were known to have died at the accident scene (5.6%). About 40% of victims opined that cause of accident was probably driver-related (excessive speed, sleep driving, etc.). Drivers were the victims in 43% of cases, passengers in 43%, and the rest being pedestrians. Head and neck region was most frequently injured followed by lower limbs. About half of the victims (49%) had associated fractures; the tibia/fibula being the most frequently fractured. Most of the victims (60%) were conscious and stable at presentation, 34% were unconscious, and 6% were in shock. Over 90% of victims were rescued from crash scene by other road users. Those presenting direct from accident scene took an average of 90 min to get the hospital. Conclusion: Road traffic crashes commonly involve males and the most productive age groups in our society. Human-related factors such as excessive speed are thought to contribute substantially to its occurrence. Organized rescue and prehospital care are almost nonexistent. The need for drivers' education, road maintenance, and well organized rescue and prehospital care team is emphasized.

  The Use Of Complementary And Alternative Medicine By Breast Cancer Patients in Delta State University Teaching Hospital, Oghara Top

Afeyodion Akhator, Martins Odes Akpomiemie

Department of Surgery, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria

Introduction: The use of complementary and alternative medicine (CAM) by patients with cancer is very common worldwide. This is particularly worrisome because some of the agents of CAM are biologically active and interact with conventional orthodox cancer care by either reducing their efficacy or increasing the toxicity. Aim: This study examines the prevalence, pattern of use, and factors influencing the use of CAM among breast cancer patients in Delta State University Teaching Hospital, Oghara, and their perception of the effectiveness of CAM. Methods: This was a cross-sectional questionnaire-based study. The questionnaire used was developed by Ezeome et al. for the study of CAM use in Nigeria. Results: A total of 50 patients were interviewed. Twenty-eight patients (56%) admitted to the use of CAM during their present illness. The mean age of the CAM users was 48.57 years and that of the non-CAM users was 49.50 years. The use of CAM was not affected by age, but patients with higher educational background and higher level of income used CAM more. The most frequently used CAM were faith healing (78.57%), herbal preparation (42.86%), and massage (17.86%). Thirteen patients (46.27%) used more than one CAM. The three reasons for the usage of CAM were to achieve cure (78.57%), relieve pain (42.86%), and get good sleep (32.14%). Only one patient (3.57%) had side effect from the CAM (dizziness), the others were satisfied with the use of CAM. Conclusion: There was a high rate of usage of CAM in this study with majority of the patients satisfied with its use.

  Comparative Review Of Outcome Of Prolapsed And Unprolapsed Intussusception In Children Top

Eighemhenrio Aiwanlehi, Odion.Obomwense H, Oside CP

Department of Surgery, DELSUTH, Oghara, Nigeria

Introduction: Intussusception is the most common childhood cause of intestinal obstruction. It is commonly seen between the ages of 3 months and 3 years with a peak age of 6 months. The presentation is usually classical with one-third of the patients presenting with red-currant jelly stools. The outcome depends on the timing of presentation and presence or absence of complications. Patients and Methods: This was a prospective study of patients with prolapsed and unprolapsed intussusception over a 2-year period. Results: Twenty-two cases of intussusceptions were seen over the period. M: F ratio was approximately 1:1. About 72.7% were unprolapsed cases and 28.3% were prolapsed. There was no statistical difference in the ages of presentation in the two groups. Bowel resection and anastomosis was done in 37.5% of unprolapsed cases and 33.3% of prolapsed cases. Sixty-six percentage of prolapse occurred within 24 h after the symptoms of abdominal pain and vomiting was noticed by parents. Postoperative pyrexia and wound infection were more common in prolapsed cases. There was no statistical difference in the length of hospital stay in both cases. Discussion: Prolapsed intussusceptions from the anus can be an accompanying problem in children with intussusceptions and should be differentiated from rectal prolapse. There is no particular indicator of the risk of prolapse in patients with intussusceptions. The study shows that there are no significant difference in the ages, duration of surgery, or length of hospital stay in the two groups.

  Awareness Of The Lichtenstein Technique Among Secondary Care Surgical Care Providers In Akwa-Ibom State Top

Udo IA, Umeh KU, Etuk EB

Department of Surgery, University of Uyo Teaching Hospital, Uyo, Nigeria

Background: The Lichtenstein technique for inguinal hernia repair is widely practiced because it is simple, tension-free, easy to learn, and is done as an ambulatory procedure using local nerve block. The technique is advocated as the minimum standard of care for uncomplicated inguinal hernias, and workshops have been mounted in the state to train secondary care providers on its practice in an effort to change practice. Aim: To assess the awareness of workshop attendees of the Lichtenstein technique. Methods: A questionnaire was administered to participants at a workshop on Lichtenstein inguinal hernia repair prior to the lectures and hands-on sessions. All participants were actively engaged in hernia repairs at their hospitals and had attended at least one workshop or lecture on inguinal hernia repair in the past year, while a quarter had been exposed to practical aspects of the repair in more than five sessions. The questionnaire tested eight aspects of the repair. Results: Sixteen participants, 14 male and 1 female, took part in the workshop and all completed the questionnaire. One questionnaire was rejected. The highest awareness was in the anesthetic technique (93.3%) and absence of tension (60%), otherwise awareness was generally poor. Conclusion: There is a low awareness of the Lichtenstein repair among secondary care providers of surgical care in the state. Regular hands-on training and re-training is mandatory to change practice.

  A Prospective Study Of Colonoscopy In The University Of Benin Teaching Hospital: 2009 – till Date Top

Irowa Omorodion O, Okoro Eseosa P, Nwashilli Nnamdi

Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria

Background: The practice of colonoscopy in the Benin University of Benin Teaching Hospital (UBTH) dates back to the early 80's, but waned in the 90's. Lately, there has being renewal of the practice from 2009 till date with the acquisition of colonoscopy equipment and accompanying manpower development. The colonoscopy suite now has trained personnel at consultant level and residents in training. Aims/Objectives: The aim of this study is to review and evaluate the practice of colonoscopy in Benin and then share our experience. Methods: Data were collected from a prospectively kept record of all clients/patients who had colonoscopy from 2009 till date in the special investigation unit of UBTH. The demographic data, indication, colonoscopy findings, procedure, and complication were reviewed. Results: A total of 302 colonoscopies were done over the period of study. The most common indication for referral was bleeding per rectum (27.8%) and majority of the patients were in their sixth and seventh decades of life (50%). Our cecal intubation rate was 86%. There were positive findings in 61.8% with tumor constituting 28% of these. The site of this new growth was mainly the rectosigmoid (68.5%). The procedures done were biopsy and polypectomy (50.6%); polypectomy - 5.2%. The complications noted were bleeding in a patient and perforation in 2 (1.3%) of the total procedure. Conclusion: Bleeding per rectum is the most common indication for colonoscopy in our center. In our series, the presence of a new growth is the most common finding, mainly in the rectosigmoid. Cecal intubation rate was quite high and the risk of perforation was very low.

  Acute Abdomen: Etiology And Outcome Of Patients Seen At The Delta State University Teaching Hospital Top

Akpo EE, Nwaokweanwa C, Onerhime T

Department of Surgery, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria

Background: Acute abdomen is a common cause of morbidity and/or mortality in emergency units. The incidences of the etiology of acute abdomen among health institutions vary. Aim: To describe the etiology and outcome of acute abdomen at the Delta State University Teaching Hospital (DELSUTH), Oghara. Methods: A prospective study of all patients with acute abdomen seen at the emergency section of DELSUTH between November 1, 2014 and October 31st, 2015 were reviewed. Gynecological and medical causes of acute abdomen were excluded. Results: A total of 125 patients were reviewed. Age range = 1 month –90 years. Mean age = 30.7 ± 21.4. Male: Female ratio = 1.7:1. The etiology of acute abdomen include abdominal trauma, 38 (30.4%); acute appendicitis/ruptured appendix, 25 (20%); perforated peptic ulcer disease, 19 (15.2%); bands and adhesions, 17 (13.6%); intussusceptions, 10 (8%); obstructed hernia, 6 (4.8%); volvulus, 5 (4%); typhoid perforation, 3 (2.4%); and colonic tumor, 2 (1.6%). Emergency surgery was carried out on 109 (87.2%) patients. There were 13 deaths (10.4%) (6 occurred in the emergency room), 2 (1.6%) signed against medical advice, and 1 (0.8%) was referred. Conclusion: Trauma is the main cause of acute abdomen in DELSUTH. Improvement in emergency care services is advised for patients seen in the teaching hospital, particularly postoperatively.

  Epidemiology Of Trauma In The Delta State University Teaching Hospital Top

Bock.Oruma AA, Esieke KL

Department of Accident and Emergency, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria

Background: Trauma is a leading cause of disability and preventable death. One of the effects of civilization and the quick adaptation to industrialization of developing countries such as Nigeria can be seen in the patterns on trauma presentation to the Emergency Department (ED). This study aims to describe the epidemiological factors, mechanism of injury, and disposition of trauma patients seen at the ED of Delta State University Teaching Hospital (DELSUTH). Methods: Data were collected from the departmental records of the trauma cases who attended the ED of DELSUTH between January and December 2014. Variables assessed include age, sex, mechanism of injury, trauma patterns, and their dispositions. These data were collated and analyzed using SPSS 16 and Microsoft Excel. Results: The total number of adult patients analyzed with different patterns of trauma in the period of study was 353. The mean age was 32.72 years, age range of 17–91 years. About 72.3% of the patients were within ages of 20–44 years, 66.7% of the Gun Shot Wound (GSW) were within the ages of 20–34 years, 80% of the assault cases were ages of 20–34 years, and 69.9% of the burns patients were between 20- and 39-years-old. The sex prevalence was males 267 (75.6%) and females 86 (24.4%). Road traffic accidents accounted for most cases of trauma seen with 218 (61.8%). Assault and GSW accounted for 62 (17.6%), burns, 9 (2.5%), and other trauma 60 (17.0%). Description of trauma patterns showed 88 (24.9%) with traumatic brain injury, fractures, 68 (19.3%), bruises and lacerations, 62 (17.6%), and multiple injuries 18 (5.1%) among others. Their dispositions showed 165 (46.8%) admissions into the ward, 87 (24.6%) discharged home, 19 (5.4%) discharged against medical advice, 34 (9.6%) to theater, 6 (1.7%) to Intensive Care Unit, 17 (4.8%) died, 24 (6.8%) were referred, and 1 (0.3%) absconded. Conclusion: Trauma affects mostly the young and productive workforce of the society leaving a trail of morbidities and mortalities. It also impacts negatively on the burden of noncommunicable diseases both to the society and the health sector. Stakeholders should do more to reduce this burden.


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