|Year : 2019 | Volume
| Issue : 2 | Page : 226-232
Abstract of papers presented at the nigerian surgical research society meeting, Bida, Nigeria, July 2019
|Date of Web Publication||19-Sep-2019|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Abstract of papers presented at the nigerian surgical research society meeting, Bida, Nigeria, July 2019. Niger J Surg 2019;25:226-32
| Comparative Study of Endoscopic Band Ligation versus Injection Sclerotherapy with 50% Dextrose in Water in Symptomatic Internal Hemorrhoids|| |
Abiodun AA1, Alatise OI2, Adesunkanmi ARK2, Eletta EA1, Gomna A1
1Department of Surgery, Federal Medical Centre, Bida, Niger State, Nigeria,2Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
Background: Hemorrhoids are common anorectal conditions seen in surgical practice. Owing to the high prevalence of the disease, researchers have come up with a wide spectrum of treatment modalities, operative as well as nonoperative. Some of the treatments are more effective but are more painful, whereas others are less painful but their efficacies are also lower and recurrence rate is high. In these days of minimally invasive therapies, effective treatment modalities with very minimal physiological trespass are more appealing both to surgeons and patients. Management of hemorrhoids by injection sclerotherapy and rubber band ligation is an effective and safe treatment option for treating uncomplicated hemorrhoids. Objective: This study aimed to compare the short-term outcome of injection sclerotherapy with 50% dextrose in water and rubber band ligation in the management of second- and third-degree hemorrhoids in terms of symptom improvement, complications, recurrence rate, re-treatment rate, and acceptability. Methodology: It was a prospective comparative study that was carried out in the Endoscopic Unit of Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, from March 2015 to February 2016. Sixty patients with second- and third-degree hemorrhoids who gave their consent were recruited into the study and were randomized into two groups equally using ballot papers prelabeled with either rubber band ligation or injection sclerotherapy with 50% dextrose in water. Each prelabeled paper was sealed in an opaque envelope. Group A had endoscopic injection sclerotherapy and Group B had endoscopic rubber band ligation. Findings in each case were recorded over a follow-up period of 3 months. Data collected were analyzed using the Statistical Package for Social Sciences software for Windows version 17. Results: The common presenting symptoms were anal protrusion (47 [40.5%]) and anal bleeding (45 [38.8%]). Twenty-two patients (73.3%) with anal protrusion were in Group A (injection sclerotherapy) and the remaining 25 (83.3%) were in Group B (rubber band ligation), whereas 22 (73.3%) patients with anal bleeding were in Group A and the remaining 23 (76.7%) were in Group B. In Group A (injection sclerotherapy Group), nine patients (40.9%) had complete resolution of anal protrusion, five patients (22.7%) had partial resolution, and eight patients (36.4%) had no change, whereas in Group B (rubber band ligation group), 16 patients (64.4%) had complete resolution, seven patients (28.0%) had partial resolution, and two patients (8.0%) had no change (P = 0.03). In terms of resolution of anal bleeding, 17 patients (77.3%) in Group A and 22 patients (95.7%) in Group B had resolution of bleeding (P = 0.07). In terms of severity of pain, the data revealed statistically significantly high (P = 0.01) proportion of patients with severe pain who underwent band ligation than those who underwent injection sclerotherapy. After 3 months of follow-up, none of the patients with resolution of anal protrusion had recurrence in both treatment groups, whereas two (11.8%) patients in Group A and one (4.5%) patient in Group B had a recurrence of bleeding after the initial resolution of anal bleeding. Conclusion: Endoscopic rubber band ligation had a significantly higher success rate and required fewer sessions than endoscopic injection sclerotherapy to relieve symptoms.
| Changing Pattern of Adult External Abdominal Hernias in Zaria|| |
Abur PP, Daniyan M, Nwabuoku SE, Yusufu LMD, Odigie VI
Department of Surgery, ABU Teaching Hospital, Zaria, Nigeria
Background: External abdominal hernias are common conditions encountered in surgical practice. Previous report from this center 21 years ago documented the pattern of adult external abdominal hernias. However, there is an observed changing pattern. The aim of the study was to document the changing pattern, mode of presentation, treatment, and outcome. Materials and Methods: It was a 5-year prospective study from January, 2011, to December, 2015. Adult patients with external abdominal hernia at ABUTH and ABU Medical Center, Zaria, were studied. Information documented included patients' sociodemographic information, type of hernia, mode of presentation, treatment, and outcome. Results: Six hundred and thirty-seven patients out of 4083 patients with general surgical cases had external abdominal hernias (15.6%), with a male:female ratio of 3.1:1. The types of hernia were inguinal (451 [70.8%]), umbilical (83 [13.0%]), incisional (54 [8.5%]), epigastric (31 [4.9%]), femoral (14 [2.2%]), and others (4 [0.6%]). The common modes of presentation for inguinal hernias were simple (364 [80.7%]) and strangulated (42 [9.3%]). The most common mode of treatment for inguinal hernias was modified Bassini in 265 (58.8%) patients. The common postoperative morbidity for groin hernias was wound infection (18 [3.9%]) followed by acute urinary retention (10 [2.2%]). The 3-year recurrence rate for groin hernias was 14 (3.0%). Mortality was three (0.5%) patients. Conclusion: The pattern of external abdominal hernias in Zaria has changed with the descending order of occurrence as follows: inguinal, umbilical, incisional, epigastric, and femoral. This is in contrast to previous reports where femoral was the second most common. Modified Bassini was the preferred method of repair of inguinal hernia due to its simplicity.
| Comparison of Wound Infection Rates Following Primary Wound Closure of Open Tibial Fractures with Metallic Staples or Nylon Sutures|| |
Shodipo OM1, Idowu OS2, Choji CC2
1Federal Medical Centre, Bida, Niger State, Nigeria,2Department of Orthopaedic Surgery, National Orthopaedic Hospital, Igbobi Lagos, Nigeria
Background: Orthopedic and trauma surgeons frequently encounter traumatic wounds (particularly in the setting of open fractures) that require primary wound closure following debridement. With the availability of options for wound closure, the choice of wound closure material is a frequently debated topic. Apart from the speed of wound (skin) closure, other benefits obtained from using either metallic staples or nylon sutures have not been clearly demonstrated in the closure of wounds. Therefore, the objectives of this study were to compare the rates of wound infection (as well as time duration of wound healing and cosmetic outcome) following primary wound (skin) closure of Gustilo IIIa open tibial fractures with either metallic staples or nylon sutures. Methodology: This 1–year, prospective, randomized, interventional study was carried out on patients that presented with Gustilo IIIa open tibial fractures (who met the inclusion criteria). Patients were allocated to two groups (A and B) by simple random sampling. Group A patients had primary wound (skin) closure with metallic staples, whereas Group B patients had primary wound (skin) closure with nylon sutures following surgical wound debridement. Postoperatively, the presence or absence of wound infection as well as time duration of wound healing and cosmetic outcome was documented using Modified Hollander Cosmesis Score at 6 weeks. Subsequently, rates of wound infection, mean time duration of wound healing, and mean cosmesis scores of the two patient groups were compared for statistical significance. Data were analyzed using SPSS software version 21. Results: Out of a total of 91 patients (46 in Group A and 45 in Group B) recruited, five patients (three from Group A and two from Group B) were lost to follow-up and hence, 86 patients completed the study. The age range was between 9 and 70 years, whereas the peak age group was 31–40 years accounting for 32.6% of the patients. Males accounted for 67.4% of the participants, with a male-to-female ratio of 2:1. The results showed an overall wound infection rate of 44.2%; however, only 13 (30.2%) out of the 43 wounds closed with metallic staples were infected, whereas 25 (58.1%) out of the 43 wounds closed with monofilament nylon sutures were infected. The difference was statistically significant (P = 0.009). The mean time duration of wound healing (in noninfected wounds) was significantly shorter in wounds closed with metallic staples (18 ± 4 days) compared with 20.2 (±2) days for noninfected wounds closed with nylon sutures (P = 0.009). Finally, the mean cosmetic outcome score of the resultant scar at 6 weeks (in noninfected wounds) was higher in wounds closed with metallic staples (3.9 ± 0.50) compared to wounds closed with nylon sutures (3.6 ± 0.7). This difference was statistically significant with P = 0.002. Conclusion: The study showed that primary wound (skin) closure of Gustilo IIIa open tibial fractures with metallic staples gives superior outcomes in terms of reduced wound infection rate, shorter time duration of wound healing, and better cosmetic outcome when compared with wound closure with nylon sutures.
| Incisional Hernia in Northwestern Nigeria: A Review of Epidemiology, Surgical Management, and Outcome|| |
Daniyan M, Abur PP, Nwabuoku ES, Ajagha OM, Mai A, Yusufu LMD, Adamu A, Dauda MM
Department of Surgery, ABU Teaching Hospital, Zaria, Nigeria
Background: Incisional hernia is a common complication of a weak laparotomy scar. While no abdominal incision is immune, preoperative, intraoperative, and postoperative events play a significant role in its occurrence. Aim: To review prospectively collected data on incisional hernia among adults seen at ABU Teaching Hospital, Zaria. Methods: All adult patients who presented to ABU Teaching Hospital, Zaria, with incisional hernia between January 2012 and December 2016 were prospectively studied. All patients had open repair under general anesthesia and were followed up for an average of 51 months. Results: A total of 47 patients were studied over the 5-year period. Majority of the patients were within the age range of 40–49 years (n = 19, 40.4%), with a male:female ratio of 1:3.7. The mean duration of protrusion was 9.9 months. Ten patients (21.3%) had a body mass index (BMI) >40 kg/m2. Obstetric and gynecological operations constituted 61.7% (n = 29) of prehernia surgeries (PHS). The average interval between PHS and protrusion was 30 months. Surgical-site infection complicated 45% of PHS. Cosmesis and discomfort were the reasons for seeking surgical intervention among twenty (42.6%) patients. Majority were located infraumbilical (n = 27, 57.4%) with fascial defects ranging from 6 to 480 cm2. Repair was by the use of onlay mesh in 63.8% of patients, whereas two patients had component separation. Complications occurred in 27.7% of posthernial repair. There was a statistically significant relationship between BMI and complications (P = 0.001). One patient conceived 8 months after surgery and had recurrence 20 months after repair. Conclusion: Obstetric and gynecological surgeries are still a major contributor to incisional hernia. Early pregnancy post repair may contribute to hernial recurrence.
| Sinonasal Tuberculosis Mimicking Malignancy: Case Report|| |
Muhammad SI1, Sule AA2
1Department of Otorhinolaryngology, General Hospital, Minna, Nigeria,2Department of Pathology, General Hospital, Minna, Nigeria
Background: Primary sinonasal tuberculosis is an infrequent form of tuberculosis even in developing countries where tuberculosis flourishes, as it usually results from preexisting foci elsewhere in the body. It most often possess a diagnostic dilemma. There are few reported cases of sinonasal tuberculosis in literature. This aim of this study is to report another case of primary sinonasal tuberculosis in a resource-poor setting. Case Report: A 27-year-old female presented with a 5-month history of nasal blockade and epistaxis. There was no history of cough, night sweat, malaise, anorexia, weight loss, or fever. Examination revealed a mass in the left nasal cavity up to the nasopharynx with contact bleeding. Computed tomography scan showed a mass in the maxillary, ethmoid, and sphenoid sinuses, suspected to be sinonasal tumor. Chest X-ray, retroviral screening, and other biochemical results were essentially normal. The lesion was excised via lateral rhinotomy, and histology revealed a sinonasal tuberculosis. Conclusion: Primary sinonasal tuberculosis is seldom seen; meticulous and a high index of suspicion in the context of clinical, radiological, and pathological characteristics remain paramount and critical in making an otherwise challenging diagnosis.
| Early Outcome of Locked Intramedullary Nailing of Infected Tibial Fracture Nonunions: A Report of Two Cases|| |
Shodipo OM, Adeniran JA, Asu-Eze J
Department of Surgery, Federal Medical Centre, Orthopaedic Unit, Bida, Niger State, Nigeria
Background: Eradication of infection and fracture union are the two major objectives of the treatment of infected nonunions. Recent studies indicate that locked intramedullary nailing of tibial fracture nonunions provides a mechanical environment which enhances fracture healing even in the presence of infection. It also allows early weight-bearing without the burden of an external frame, making it more acceptable to patients when compared to external fixators. The authors present two cases of infected tibial nonunions. The first case had fibulectomy, fracture debridement, deep tissue sampling, locked intramedullary nailing, and cancellous bone grafting. The second case had fibulectomy, wound and fracture debridement, deep tissue sampling, locked intramedullary nailing, cancellous bone grafting, and fasciocutaneous flap wound cover. Results: The first case had a satisfactory (early) outcome having achieved full weight-bearing at 12 weeks with no clinical evidence of infection; however, the second case was complicated with surgical-site infection. Based on these two cases, the important technical aspects and guiding principles were identified and discussed. Conclusion: With appropriate surgical technique and strict adherence to surgical principles, the outcome of locked intramedullary nailing for infected tibia nonunions is satisfactory.
| Correlation of Catheter-Related Infection with Wound Outcome in Postprostatectomy Patients at Federal Medical Center, Bida: A 5-Year Study|| |
Adekanye AO, Akinola OO, Uzoigwe LA, Muhammad MS
Department of Surgery, Federal Medical Centre, Urology Unit, Bida, Niger State, Nigeria
Background: Benign prostatic hyperplasia is a common disease among men. Most of the affected patients have indwelling urethral or suprapubic catheters (SPCs) before operative intervention. Positive or negative urine culture preoperatively has been a consideration by many to determine whether to proceed with the operative intervention. Objective: To determine the association between catheter-related infections (CRIs) and wound outcome in postprostatectomy patients. Methods: This prospective study of patients with benign prostatic hyperplasia who had open simple prostatectomy was done between January, 2012, and December, 2016. The data on demographic characteristics and preoperative investigations – urine microscopy, culture and sensitivity, postoperative urine microscopy, culture and sensitivity, and wound outcome – were collated using a structured pro forma and analyzed on SPSS software version 20. Results: Eighty-six patients were studied, with a mean age of 65.8 years, in the age range of 47–92 years. Fifty-six (65.1%) patients were on catheter immediate preoperatively, 16 were on SPC, whereas 30 (34.9%) were not. Preoperative urine culture was positive in 55 (64%) and negative in 31 (36%) patients. The two most common isolates were Escherichia More Details coli in 44 (51.2%) and Pseudomonas in 7 (8.1%) patients, with high sensitivity to levofloxacin and nitrofurantoin. Positive urine culture was observed in 67 (77.9%) patients postoperatively with the same pattern of organisms, of which 45 (67.2%) patients were on catheter immediate preoperatively. Postoperative bacteriuria was detected in ten (11.6%) patients who had negative urine cultures preoperatively. However, the difference in positive urine culture between those with catheter and without catheter was statistically significant neither preoperatively (P = 0.13) nor postoperatively (P = 0.45). Twenty-nine (33.7%) patients developed surgical-site infection (SSI), of which 23 (79.3%) were on catheter, which was statistically significant with P = 0.04. However, there was no statistically significant association between positive urine culture preoperatively (P = 0.09) or postoperatively (P = 0.82) with the incidence of SSI, hence no adverse effect on wound outcome. Conclusion: Although SSI postprostatectomy was higher in patients on catheter immediate preoperatively in this study, it is not associated with positive urine culture either preoperatively or postoperatively. CRI, therefore, does not seem to adversely affect the wound outcome. E. coli was found to be the most common isolate with sensitivity to levofloxacin and nitrofurantoin.
| Sex Distribution of Acute Appendicitis among Adult Patients in University of Benin Teaching Hospital|| |
Osemwegie O, Osime OC, Odigie VI
Department of Surgery, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
Background: Acute appendicitis is a transmural inflammation of the vermiform appendix. Acute appendicitis has been reported to be more common in males than females, with a lifetime risk of 8.6% in males and 6.7% in females. This study was conducted to determine the sex distribution of adult patients with acute appendicitis at the University of Benin Teaching Hospital. Methodology: This was a prospective study of patients who presented with right iliac fossa pain at the University of Benin Teaching Hospital between September 1, 2014, and August 31, 2015 (12 months). History taking and examination were done, and a diagnosis of acute appendicitis was made for each patient. Appendicectomy was done, and specimens were subjected to histologic examination. Sex distribution was assessed for the patients who presented for this study. The male-to-female ratio also correlated with the histologic diagnosis. Data were extracted from a pro forma into a data collection sheet and analyzed using SPSS software. Results: A total of 124 patients were studied. The age range of the patients was between 21 and 30 years. Eighty-six (69.4%) females and 38 (30.6%) males were enrolled for the study, giving a female-to-male ratio of 2.3:1. Eighty-two out of the 124 patients had histologically confirmed acute appendicitis. Of these, 54 (65.9%) were female and 28 (34.1%) were male, giving a male:Female ratio of 1:1.9, with P = 0.237. Conclusion: The study reports that female patients presented more commonly with the symptoms and signs of acute appendicitis. More females also had histologically confirmed acute appendicitis at the University of Benin Teaching Hospital.
| The Outcome of Hypertensive Disorders in Pregnancy at a Tertiary Hospital in North-Central Nigeria|| |
Idris H1, Nwachukwu CND1, Adamu UG2, Abdullateef RM1, Isah AY3
1Department of Obstetrics and Gynaecology, Federal Medical Centre, Bida, Niger State, Nigeria,2Department of Internal Medicine, Federal Medical Centre, Bida, Niger State, Nigeria,3Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Abuja, Nigeria
Background: Cases of hypertensive disorders in pregnancy (HDP) are on the rise in developing economies. Identifying the pattern of HDP in a particular community and documenting their management outcome may allow for proper planning by all stakeholders. Aim: To determine the pattern and management outcome of hypertensive disorders among pregnant women at Federal Medical Centre, Bida, North-Central Nigeria. Methods: This was a prospective cohort study involving 183 consecutive cases of pregnant women with hypertensive disorders at Federal Medical Centre, Bida, Niger state, Nigeria, over a 12-month period between September 1, 2015, and August 31, 2016. All the recruited women were managed according to departmental protocol and were followed up till 6 weeks after delivery; the treatment outcomes including adverse fetal and maternal outcomes were documented. Statistical analysis was done using SPSS software version 23. The level of significance was set at P < 0.05. Results: A total of 1956 deliveries occurred during the study period with 183 cases of HDP, giving an incidence of 9.4%. The mean age of the women was 27.6 ± 6.4 years. Pregnancy-induced hypertension alongside preeclampsia constitutes the majority of HDP during the study period and had accounted for over 64%. Cesarean section rate (46%) among these patients was statistically significantly higher among unbooked pregnancies (P = 0.008). Women who did not receive antenatal care at our center were at significantly greater risk of eclampsia (P = 0.000), abruption placentae (P = 0.003), and maternal death (P = 0.002). They had increased risk of very low-birth weight babies (P = 0.002), extremely low-birth weight babies (P = 0.03), and perinatal death (P = 0.000). Conclusion: Pregnancy-induced hypertension and preeclampsia were the predominant HDP during the study period, which were associated with significant adverse maternal and perinatal outcomes. Hence, there is a need for prenatal screening that enables early identification and prompt management of all expectant mothers with HDP.
| Serum Magnesium Levels in Preeclampsia and Normal Pregnancy|| |
Onabanjo KO, Nwachukwu CND, Adewale BF, Nwosu IC, Idris H, Abdullateef R
Department of Obstetrics and Gynaecology, Federal Medical Centre, Bida, Niger State, Nigeria
Aim: This study aimed to compare the serum magnesium levels in preeclamptic patients with that of healthy normotensive pregnant women. Methods: This cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, Federal Medical Centre, Bida, from October 2016 to April 2017 after ethical clearance was obtained from the Ethics and Research Committee of the hospital. One-hundred and twenty participants who satisfied the inclusion criteria and consented were recruited consecutively using the convenient sampling method and were divided into two groups (sixty preeclamptic and sixty healthy pregnant patients). The preeclamptic patients and controls were matched based on the maternal age, gestational age, and parity. Relevant information was obtained using a purpose-designed pro forma. Blood pressure measurement and dip stick urine analysis were carried out before blood was drawn. The serum magnesium levels in both groups were measured using atomic absorption spectrophotometric method. The data were analyzed using the computer software Statistical Package for Social Sciences version 20.0. Continuous variables were expressed as mean ± standard deviation. Comparison of results between the two groups was done using the independent t-test for continuous variables and Chi-square test for categorical variables. Karl Pearson's correlation coefficient (r) was calculated to assess the correlation between serum magnesium concentration and the blood pressure of the preeclamptic patients. A 95% confidence interval was used, and P < 0.05 was considered statistically significant. Results: The mean serum magnesium level in the preeclamptic patients was 0.64 ± 0.26 mmol/L, whereas that of healthy pregnant patients was 0.76 ± 0.22 mmol/L (t = 2.647, P = 0.009). The mean serum magnesium concentration in the mild preeclamptic cases was 0.72 ± 0.17 mmol/L, whereas that of severe preeclamptic patients was 0.61 ± 0.29 mmol/L (t = 1.492; P = 0.042). There was also a statistically significant inverse correlation when serum magnesium level was correlated independently with the systolic and diastolic blood pressure of the preeclamptic patients (r = −0.242, P = 0.008, and r = −0.226, P = 0.013, respectively). Conclusions: It may be concluded that hypomagnesemia can be considered as having an association in the etiopathogenesis of preeclampsia and as a severity indicator in preeclamptic women in this environment.
| Survival after Treatment for American Joint Committee on Cancer Stage III Breast Cancer in ABU Teaching Hospital, Zaria|| |
Nwabuoku SE, Abur PP, Daniyan M, Yusufu LMD, Odigie VI
Department of Surgery, ABU Teaching Hospital, Zaria, Nigeria
Background: Breast cancer is the most common malignancy in women worldwide. Patients with American Joint Committee on Cancer Stage III breast cancer have been noted to have good response to neoadjuvant chemotherapy. This study aims to evaluate the survival of such patients after treatment at ABU Teaching Hospital, Zaria. Methods: This 5-year prospective study was conducted between January, 2009, and December, 2013. Patients had four courses of neoadjuvant chemotherapy (cyclophosphamide, adriamycin, and paclitaxel), Auchincloss modified radical mastectomy, and two courses of adjuvant chemotherapy and adjuvant tamoxifen (premenopausal) or letrozole (postmenopausal) for estrogen receptor-positive tumors. Follow-up was on an outpatient basis and through phone calls. Statistical analysis was done using SPSS software version 21.0, survival analyses were carried out with Kaplan–Meier method, and multivariate analyses were done with P ≤ 0.05 regarded as statistically significant. Results: Data from 303 patients (291 females and 12 males) were analyzed. One-year, 2-year, 3-year, 4-year, and 5-year disease-free survival (DFS) were 79.80%, 56.57%, 51.51%, 47.47%, and 47.47%, respectively. One-year, 2-year, 3-year, 4-year, and 5-year overall survival (OS) were 80.80%, 61.61%, 55.56%, 51.51%, and 51.50%, respectively. Initial tumor size, response to neoadjuvant chemotherapy, number of involved nodes, tumor grade, and receptor status had statistically significant relationship with DFS and OS. The relationship between the patients' age, gender, and both DFS and OS was not statistically significant. Conclusion: Five-year DFS and OS were 47.47% and 51.50%, respectively. Initial lesion size, response to therapy, involved nodes, tumor grade, and receptor status had statistically significant relationship with DFS and OS.
| Breast Cancer Prevention: Knowledge, Awareness, and Practices of Breast Self-examination among Caregivers of Patients at a Teaching Hospital in the South-South Region of Nigeria|| |
Akpo EE, Oriakhi N, Safia E, Obanovwe E
Department of Surgery, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
Background: Breast cancer is the most common cancer among women. In hospital settings, focus on prevention may not be directed toward caregivers. Thus, the impact of preventive measures may be less than expected. Aims: This study assessed the knowledge, awareness, and practice of breast self-examination (BSE) among female caregivers. Methods: This was a cross-sectional survey of caregivers at the Delta State University Teaching Hospital, Oghara. Nigeria. A convenient sample of fifty female caregivers were randomly selected and asked to fill a structured questionnaire administered by trained personnel. The data generated were analyzed using SPSS software 21. Results: There were a total of fifty respondents aged between 16 and 65 years (mean = 30 ± 11 years). Of all the respondents, 70% (35) were single, 26% (13) were married, and 2% (1) were either divorced or cohabiting. Forty-six percent (23) of the respondents completed senior secondary school level education and 40% (20) had tertiary educational level training. Almost 94% (47) of the responders have heard of breast cancer majorly from friends (14.90% ) as a single source of information. Eight respondents (16%) have had close relatives with breast cancer. Mother was the most affected relative (4, 50%). Sixty-four percent (32) of the respondents have heard of BSE and 66% (33) were aware that BSE is useful in the early detection of breast cancer, but only 50% (25) practice BSE. Only 36% (9) of the 25 respondents who practice BSE do so monthly. Fifty-six percent (28) of the respondents have no idea of when to start BSE. The reasons given for not practicing BSE include “I do not know how to do it” (21, 42%), “it is not necessary” (1, 2%), “I believe I cannot have a breast lump” (1, 2%), and “no reason” (2, 4%). Conclusion: This study highlights the overall good knowledge of breast cancer and shows poor awareness of the usefulness of BSE culminating in poor practice of BSE among the caregivers.
| Characteristics and Clinicopathological Pattern of Breast Cancer Patients at the University of Benin Teaching Hospital|| |
Ezeokenwa M, Osime C, Odigie V, Agbugui J
Department of Surgery, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
Background: Breast cancer is the most common malignancy at the University of Benin Teaching Hospital (UBTH). It constituted 21% of all new cancer cases and 35.4% of all female cancers as documented in the UBTH Cancer Registry (2009–2014). In Nigeria, breast cancer is characterized by younger age at onset (40–49 years) and premenopausal status, with the most common histopathological diagnosis being invasive ductal carcinoma. The study was to determine the age at presentation, sex, menopausal status, and the most common histopathological pattern at the UBTH. Methods: This was a prospective study of patients who presented at the UBTH between January 2017 and August 2017 with breast lump and were subsequently diagnosed clinically, radiologically, and histologically as having breast cancer. Age at diagnosis, sex distribution, menopausal status, and histopathological pattern were assessed. Data were extracted from a pro forma into a data collection sheet and analyzed using SPSS software. Results: Thirty-five (21.9%) patients with breast lump had a histological diagnosis of breast cancer. All the patients were female. The average age of breast cancer was 51.6 years, with a range of 25–83 years and a peak age of 40–59 years. Thirty-three (94.3%) patients were married. Majority (22 [62.9%]) of the women were postmenopausal. The most common histological type was invasive ductal carcinoma (94.3%), and 27 (77.1%) women presented at advanced Stages (III and IV). Seventeen percent of the patients were positive for either both estrogen receptor and progesterone receptors or for one of the receptors. Conclusion: This study shows that breast cancer in women presenting at the UBTH tends to occur more in postmenopausal women, at an advanced stage, with invasive ductal carcinoma being the most common histological type and negative hormonal status being most common.
| Prolapse of Colostomy in Children: Characteristics, Predisposing Factors, and Preventive Measures in a Surgeon's Service in Southern Nigeria|| |
Okoro PE1,2, Onyeso C2
1Department of Surgery, Paediatric Surgery Unit, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria,2Department of Surgery, St Catherine's Specialist Hospital Ltd, Abuja, Nigeria
Background: Protrusion of the bowel through the stoma in a colostomy is one of the common complications of colostomy. Although it rarely gets secondarily complicated, it causes significant morbidity by virtue of the increasing bowel mass outside. The predisposing factors and progression in children are not well reported in our region. Aim: To evaluate the characteristics and occurrence of colostomy prolapse in children and to identify any factors predisposing to this complication in our practice. Methods: This is a 5-year prospective study of pediatric colostomy in the authors' service between March 2013 and April 2018. Patients were categorized into those that developed prolapse (Pro group) and those that did not (Non Pro group). Other variables investigated were gender, age at creation of colostomy; indication, type, and duration of colostomy; and presence of increased intra-abdominal pressure. Statistical analysis was performed with SPSS software 21. Results: Twenty-seven (28.4%) of the 95 children who had colostomy during the study period developed prolapse. Prolapse occurred more commonly in patients who had their colostomy at a relatively older age. There was a positive association of prolapse and Hirschsprung's disease, but no association with the gender or duration of stoma. Conclusion: Colostomy prolapse is a common complication seen in our practice. Cases of neglected Hirschsprung's disease in children have an increased risk of this complication. Extra caution is, therefore, needed in forming colostomy in this group of patients.