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ORIGINAL ARTICLES
Efficacy and safety of doxazosin (Cardura TM ) in the management of Benign Prostatic Hyperplasia
EA Jeje, AS Dogunro, MA Ogunjimi, KH Tijani
July-December 2011, 17(2):55-59
Objective: To assess the efficacy and safety of the selective a!-blocker doxazosin in black men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia. Patients and Methods : An open-label study involving consecutive patients with benign prostatic hyperplasia. They were asked to complete the International Prostate Symptom Score (IPSS), with its eighth question (bother score) and perform basic uroflowmetry. The study involved the use of doxazosin for the treatment of symptomatic benign prostatic hyperplasia in three phases. Phase 1 of washout period/enrolment, a two weekly interval titration phase and a maintenance phase for four weeks. The symptom score (IPSS), bother score and uroflowmetry were used to evaluate the severity of the condition and the efficacy of the drug. Results: Twenty-four patients were enrolled into the study, only 18(75%) completed the eight-week study. The ages of the patients ranged between 46 years and 82 years with a mean of 66 years. (SD, 10.0) Fourteen patients were stabilized on 4mg doxazosin while the remaining 4 patients had 2mg. There was significant improvement of the symptoms, with a remarkable sharp decline after two weeks of medication in IPS S by 8 points from baseline. The improvement was sustained over the following six weeks period. The bother score (quality of life index) was similarly observed to decline from a mean of 4.7 at baseline to 1.3 at the end of the study. The clinical trial showed a significant increase in the urine flow rate with an improvement of 4mls/second from baseline and a 24.1 % increase in voided volume. There was no adverse event recorded in all the patients to warrant discontinuation of the study. Conclusion: Doxazosin is an effective and well tolerated drug in the treatment of symptomatic BPH inNigerians.
[ABSTRACT]   Full text not available  [PDF]  [Mobile Full text]  [EPub]
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REVIEW ARTICLE
Organ transplantation: Legal, ethical and Islamic perspective in Nigeria
Abubakar A Bakari, Umar S Abbo Jimeta, Mohammed A Abubakar, Sani U Alhassan, Emeka A Nwankwo
July-December 2012, 18(2):53-60
PMID:24027394
Organ transplantation dates back to the ancient times and since then it has become one of the important developments in modern medicine; saving the lives, as well as improving the quality of life of many patients. As the demand for organ transplantation far exceeds the organ availability, the transplant program is often saddled with complex legal and ethical issues. This review article highlights the legal and ethical issues that might arise regarding organ transplantation and appraises the existing legal frame work governing organ transplantation in Nigeria. Information on legal, cultural, religious and medical ethical issues regarding organ transplantation in Nigeria was obtained by searching the PubMed and Google Scholar, conference proceedings, seminar paper presentations, law library and other related publications were collated and analyzed. In decision making for organ transplantation, the bioethical principles like autonomy, beneficence and justice must be employed. It was believed by Catholic theologians that to mutilate one living person to benefit another violates the principle of Totality. Among Muslim scholars and researchers, there are those who throw legal support as to its permissibility while the other group sees it as illegal. Organ/tissues transplantation is considered a medical intervention that touches on the fundamental rights of the donor or the recipient. Where there is an unlawful infringement of the right of such persons in any way may be regarded as against Section 34 of the 1999 Nigerian Constitution dealing with right to dignity of the human person. Worldwide, the researchers and government bodies have agreed on informed consent for organ/tissue donation and for recipient should be obtained without coercion before embarking on such medical treatment Worldwide organ transplantation has become the best medical treatment for patients with end stage organ failure. However, there is no law/legislation backing organ/tissues transplantation in Nigeria. The government should take measures to combat transplantation tourism and the problem of national and international trafficking in human tissues and organs, ethics commission and National Transplant registry should be established in order to monitor and regulate the programme in the country.
  5,863 309 -
ORIGINAL ARTICLES
Fistula-in-Ano complicated by Fournier's gangrene our experience in North-Eastern region of Nigeria
Abubakar A Bakari, Nuhu Ali, Ibrahim A Gadam, Bata M Gali, Chubado Tahir, KDT Yawe, Adamu B Dahiru, Baba S Mohammed, Dauda Wadinga
July-December 2013, 19(2):56-60
DOI:10.4103/1117-6806.119237  PMID:24497752
Background: Fistula-in-ano when complicated by Fournier's gangrene is an unusual finding and always carries high morbidity. This study details our experience in managing 10 cases. Methods of Study: Case files of all patients managed in University of Maiduguri Teaching Hospital and Federal Medical Center of Yola and Gombe from January, 2007 to December, 2011 were retrieved from Medical Record Departments and other Hospital Records. These were analyzed for demographic, clinical and pathological variables, the type of treatment and follow-up. Results: A total of 10 men with a mean age of 50.5 years (35-60) were managed in the period of study. Nearly, 50% of the patients were farmers, 30% businessmen and 20% were civil servant. 7 (70%) of these patients presented with Fournier's gangrene within 4 weeks of development of fistula-in-ano and the rest within 8 weeks. 4 (40%) of these patients had inadequate drainage of their perianal abscess and 2 (20%) had incision and drainage. Another 4 (40%) had spontaneously rupture of the perianal abscess. 6 (60%) of the fistula-in-ano was submuscular, 30% subcutaneous and 10% were complex or recurrent. Nearly, 20% of patients had fistulotomy and seton application for adequate drainage. Mucosal advancement flap was performed in 5 (50%) and fistulotomy in 3 (30%) patients. Another 30% had fistulotomy and continuing sitz bath. Conclusion: Cryptoglandular infection is an important cause of perianal abscesses and fistula-in-ano and if poorly managed results in Fournier's gangrene. Early broad spectrum parenteral antibiotic therapy and primary surgical treatment can prevent Fournier's gangrene.
  5,489 141 -
ABSTRACTS
Abstracts of Joint NSRS/ASON Meeting of July 2013

July-December 2013, 19(2):88-100
  4,954 113 -
ORIGINAL ARTICLES
New visual prostate symptom score versus international prostate symptom score in men with lower urinary tract symptoms: A prospective comparision in Indian rural population
Ashutosh Roy, Amandeep Singh, Darshan Singh Sidhu, RP Jindal, Mishi Malhotra, Haramritpal Kaur
July-December 2016, 22(2):111-117
DOI:10.4103/1117-6806.189002  PMID:27843276
Introduction: Benign prostrate hyperplasia (BPH) is a leading source of healthcare problem in aging men around the world including India. Both International Prostate Symptom Score (IPSS) and New Visual Prostate Symptom Score (VPSS) are used to assess the lower urinary tracts symptoms (LUTSs) in men. The present study was planned to compare these two scores, IPSS and VPSS in Indian rural men prospectively and their efficacy was compared with urodynamic evaluation of the patients. Materials and Methods: With Institutional Ethical Committee approval, this study was conducted on 100 patients having LUTS and BPH after obtaining written informed consent. Patients' educational status was noted. All the patients were requested to complete the IPSS and VPSS questionnaire, and they were correlated. The urodynamic study was performed on all the patients with uroflowmeter. Two parameters of uroflowmetry, Q max (maximum urine flow rate expressed in ml/s) and Q avrg (average urine flow rate expressed in ml/s) were measured and correlated. Results: Most of the patients (55%) in this study were uneducated. Out of 100 patients, 83% were able to fill the VPSS questionnaire without assistance as compared to only 40% patients in IPSS questionnaire (Z = 6.557, P < 0.001). There was a positive correlation between IPSS and VPSS total score in this study (r = 0.453 and P ≤ 0.001). It was noticed that IPSS Question 2 for frequency of urination had a positive correlation with VPSS Question 1 (day time frequency of urination) r = 0.645 (P = 0.000). Similarly, IPSS Question 7 for night frequency when compared with VPSS Question 2 (nocturia); the value for r was found to be 0.536 (P = 0.000).The IPSS Question 5 for straining when compared to the VPSS Question 3, i.e., the question for the strength of stream during micturition; the positive correlation was found to be 0.266 (P = 0.007). There was a negative correlation between IPSS total score and Q avrg with value − 0.368 (P = 0.000) and between IPSS total score and Q max of − 0.433 (P = 0.000). A negative correlation is also noted between VPSS total score and Q avrg of value 0.497 (P = 0.000) and VPSS total score and Q max of value − 0.719 (P = 0.000). Conclusion: VPSS correlates significantly with the IPSS to quantify the LUTS due to BPH. The VPSS can be used instead of the IPSS for the assessment of symptom severity in men with LUTS, who are illiterate or have limited education.
  4,787 161 2
CASE REPORTS
Use of mitrofanoff and Yang-Monti techniques as ureteric substitution for severe schistosomal bilateral ureteric stricture: A case report and review of the literature
Abubakar Alhaji Bakari, Ibrahim Ahmed Gadam, Suleiman Aliyu, Ibrahim Suleiman, Ahmed A Ahidjo, Umaru Hamid Pindiga
January-June 2012, 18(1):30-33
DOI:10.4103/1117-6806.95490  PMID:24027391
Distal ureteric stricture is a common complication of urinary schistosomiasis which is a disease more prevalent in the tropics and subtropics. The surgical management of this complication is more challenging when it affects more than half of both ureters. We report the case of a 17-year-old Nigerian with a long standing recurrent painless terminal hematuria associated with bilateral colicky loin pains. Ultrasound scan showed bilateral hydro ureters and hydro nephrosis with deranged biochemical renal function. The patient had bilateral tube nephrostomy and antibiotic therapy. Definitive bilateral ureteric substitution was done using Mitrofanoff technique for the right ureter and Yang-Montie technique for the left ureter. The patient's renal function became normal and he was discharged home without complication. The related literatures were reviewed. Surgical nonurothelial ureteral substitution is necessary for long, extensive, severe bilateral ureteric strictures so as to prevent progressive renal damage and end stage renal failure.
  4,726 142 -
ORIGINAL ARTICLES
Atypical localizations of hydatid disease: Experience from a single institute
Majid Mushtaque, Mohammad F Mir, Ajaz A Malik, Sajad H Arif, Samina A Khanday, Rayees A Dar
January-June 2012, 18(1):2-7
DOI:10.4103/1117-6806.95466  PMID:24027383
Introduction: The hydatid disease most often involves the liver and the lungs. The disease can involve any part of the body except the hair, teeth and nails. Primary extrahepatico-pulmonary hydatid cysts are rare and only a few sporadic cases have been reported. Materials and Methods: Two hundred and forty-four patients with hydatid cysts managed surgically from January 2005 to December 2009 were evaluated retrospectively. Fourteen (5.7%) patients had isolated involvement of the atypical sites, while six (2.4%) also had a primary involvement of liver. Results: The cysts were present in gall bladder (0.4%), peritoneum (1.6%), spleen (1.6%), ovary (0.4%), subcutaneous (0.8%), seminal vesicle (0.4%), spinal (0.4%), pancreas (0.4%), kidney (0.4%), mediastinal (0.4%), muscle (0.4%), and brain (0.8%). Discussion and Conclusions: Involvement of sites other than liver and lungs by hydatid disease is rare. Symptoms are related to size, location or possible complication of the cyst. It should be strongly suspected in differential diagnosis of all abdominal cysts especially in an endemic area. Proper surgical and medical management to avoid any recurrences, and a regular follow-up, are of utmost importance to detect any late complications such as local recurrence of the disease and development of hydatidosis at the primary sites.
  4,447 169 -
CASE REPORTS
Pre surgical evaluation of scrotal cystocele by conventional radiography (Cystogram)
Mohinder Kumar Malhotra, Yamini Kapoor
January-June 2012, 18(1):34-36
DOI:10.4103/1117-6806.95492  PMID:24027392
Urinary bladder is a known content of sliding inguinal hernias but rarely presents as irreducible direct inguinal hernia. As inguinal hernia repair is commonly undertaken even at peripheral surgical centers. Cystogram a simple radiological investigation (picturesque view) is useful for pre-surgical evaluation as it can prevent iatrogenic bladder injury during inguinal hernia repair. This investigation can be performed where other radiological expertises like computerized tomography scan/magnetic resonance imaging or even ultrasound facilities are not readily available.
  4,490 102 -
REVIEW ARTICLES
Imperative role of dental pulp stem cells in regenerative therapies: A systematic review
Ramchandra Kabir, Manish Gupta, Avanti Aggarwal, Deepak Sharma, Anurag Sarin, Mohammed Zaheer Kola
January-June 2014, 20(1):1-8
DOI:10.4103/1117-6806.127092  PMID:24665194
Stem cells are primitive cells that can differentiate and regenerate organs in different parts of the body such as heart, bones, muscles and nervous system. This has been a field of great clinical interest with immense possibilities of using the stem cells in regeneration of human organ those are damaged due to disease, developmental defects and accident. The knowledge of stem cell technology is increasing quickly in all medical specialties and in dental field too. Stem cells of dental origin appears to hold the key to various cell-based therapies in regenerative medicine, but most avenues are in experimental stages and many procedures are undergoing standardization and validation. Long-term preservation of SHED cells or DPSC is becoming a popular consideration, similar to the banking of umbilical cord blood. Dental pulp stem cells (DPSCs) are the adult multipotent cells that reside in the cell rich zone of the dental pulp. The multipotent nature of these DPSCs may be utilized in both dental and medical applications. A systematic review of the literature was performed using various internet based search engines (PubMed, Medline Plus, Cochrane, Medknow, Ebsco, Science Direct, Hinari, WebMD, IndMed, Embase) using keywords like "dental pulp stem cells", "regeneration", "medical applications", "tissue engineering". DPSCs appears to be a promising innovation for the re-growth of tissues however, long term clinical studies need to be carried out that could establish some authentic guidelines in this perspective.
  3,963 427 -
REVIEW ARTICLE
Gallstones
Gabriel E Njeze
July-December 2013, 19(2):49-55
DOI:10.4103/1117-6806.119236  PMID:24497751
Gallstone disease is a worldwide medical problem, but the incidence rates show substantial geographical variation, with the lowest rates reported in African populations. Publications in English language on gallstones which were obtained from reprint requests and PubMed database formed the basis for this paper. Data extracted from these sources included authors, country, year of publication, age and sex of patients, pathogenesis, risk factors for development of gallstones, racial distribution, presenting symptoms, complications and treatment. Gallstones occur worldwide, however it is commonest among North American Indians and Hispanics but low in Asian and African populations. High biliary protein and lipid concentrations are risk factors for the formation of gallstones, while gallbladder sludge is thought to be the usual precursor of gallstones. Biliary calcium concentration plays a part in bilirubin precipitation and gallstone calcification. Treatment of gallstones should be reserved for those with symptomatic disease, while prophylactic cholecystectomy is recommended for specific groups like children, those with sickle cell disease and those undergoing weight-loss surgical treatments. Treatment should be undertaken for a little percentage of patients with gallstones, as majority of those who harbor them never develop symptoms. The group that should undergo cholecystectomy include those with symptomatic gallstones, sickle cell disease patients with gall stones, and patients with morbid obesity who are undergoing laparotomy for other reasons.
  4,001 375 -
ORIGINAL ARTICLES
A survey of the awareness of prostate cancer and its screening among men attending the outpatient clinics of a tertiary health center in Lagos, Nigeria
Sunday Oladunjoye Ogundele, Stephen Odunayo Ikuerowo
July-December 2015, 21(2):115-118
DOI:10.4103/1117-6806.162589  
Background: Prostate cancer is the most common cancer among Nigerian men and the second most common cause of death from cancer in men worldwide. The aim of this study was to assess the level of awareness of prostate cancer among men attending the various outpatients' clinics of the Lagos State University Teaching Hospital, Ikeja. Materials and Methods: This study is a descriptive cross-sectional study. Self-administered structured questionnaires were used to collect information from consecutives patients attending the various outpatient clinics of the hospital. Results: One hundred and forty-six respondents with an age range of 40–80 years participated in this study. Sixty-nine (47.3%) respondents were aware of prostate cancer while 77 (52.7%) have never heard of the disease. Twenty (13.7%) participants were aware of the availability of a screening test for the disease and only 12 (8.2%) have had any form of screening for prostate cancer. Conclusion: There is a low level of awareness of prostate cancer among patients seen at our center and also level of voluntary screening for the disease is low.
  3,911 285 1
CASE REPORTS
Cold abscess of the anterior abdominal wall: An unusual primary presentation
Mohinder Kumar Malhotra
January-June 2012, 18(1):22-23
DOI:10.4103/1117-6806.95481  PMID:24027388
Tuberculosis is considered as ubiquitous disease as it involves any organ, but primary involvement of abdominal muscles is very rare. In most cases, the muscle involvement is secondary and is caused by either hematogenous route or direct inoculation from a tuberculous abdominal lymph node or extension from underlying tubercular synovitis and osteomyelitis. Autopsy studies have shown abdominal wall involvement in less than 1% of patients who died of tuberculosis. Antitubercular therapy is main form of management. Surgical intervention is always secondary in the form of either sonography or computerized tomography-guided aspiration or open drainage which is usually reserved for patients in whom medical treatment has failed. A case is hereby reported about primary tubercular anterior abdominal wall abscess without any evidence of pulmonary, skeletal or gastrointestinal tuberculosis in an apparently healthy individual with any past history of contact or previous antituberculosis therapy.
  3,752 127 -
ORIGINAL ARTICLES
Surgically correctable morbidity from male circumcision: Indications for specialist surgical care in Lagos
Adesoji O Ademuyiwa, Rufus W Ojewola, Olumide A Elebute, Emmanuel A Jeje, Chris O Bode
July-December 2012, 18(2):71-74
DOI:10.4103/1117-6806.103106  PMID:24027397
Aim/Objective: To determine the pattern of morbidity and outcome among patients referred to the Pediatric Surgery Unit of the Lagos University Teaching Hospital (LUTH) following circumcision. Materials and Methods: Retrospective descriptive study of all patients with complications of circumcision who were managed in LUTH between 2008 and 2010. Results: There were 36 patients. The age range was between 2 days and 9 years (median-3 months). Fifteen cases (42.9%) were due to urethro-cutaneous fistula while there were six cases (16.7%) of postcircumcision bleeding. There were four cases (11.1%) each of partial penile amputation and buried penis. There were also cases of meatal stenosis, penile implantation cyst and glanulo-preputial skin bridge. With respect to the treatment offered, eleven (30.6%) patients had urethroplasty for the urethro-cutaneous fistulae while seven (19.4%) patients had penile refashioning for the buried penis and penile amputation. Appropriate surgical treatments were performed for the other complications. Conclusion: Urethrocutaneous fistula and penile amputation are the commonest complications of circumcision for which referral is made to LUTH. Treatment outcome was satisfactory. Health education and legislation to ensure procedure is performed by qualified medical and paramedical staff may reduce the morbidity.
  3,716 147 -
ABSTRACTS
6th ASON Conference, Enugu, April, 2010

January-June 2011, 17(1):44-54
  3,734 74 -
REVIEW ARTICLE
Surgical templates for dental implant positioning; current knowledge and clinical perspectives
Mohammed Zaheer Kola, Altaf H Shah, Hesham S Khalil, Ahmed Mahmoud Rabah, Nehad Mohammed H Harby, Seham Ali Sabra, Deepti Raghav
January-June 2015, 21(1):1-5
DOI:10.4103/1117-6806.152720  PMID:25838757
Dental implants have been used in a variety of different forms for many years. Since the mid-20 th century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.
  3,159 274 9
ORIGINAL ARTICLES
Missing intrauterine contraceptive device amongst clients in Enugu, Nigeria
HU Ezegwui, LC Ikeako, C Egbuji
July-December 2011, 17(2):60-67
Background Missing intrauterine contraceptive device (IUCD) is a known complication of IUCD use. Objective To examine the methods of diagnosis and Management modalities of missing IUCD at the University of Nigeria Teaching Hospital, Enugu. Materials and Method This was a retrospective review of the records of all clients who presented with complaints of missing IUCD over an 11 year period, from 1 st January 1990 to 31 st December 2000. Relevant information on biodata, methods of diagnosis and removal were extracted and analysed using tabulations and simple percentages. Results A total of 44,975 clients were seen at the family planning clinic within the period under review. Twenty two thousand, one hundred and sixty eight clients used IUCD, giving a 55.96% of total contraceptive use. Of these, 20 IUCD missed, giving the incidence of missing IUCD as 0.08%. The mean age of clients with missing IUCD was 38±2.18 years and the mean parity was 6.00 ± 0.54. Majority (30%) were asymptomatic. Twenty five percent presented with lower abdominal pain. One client had a co-existing pregnancy of about 10 weeks. The commonest mode of diagnosing missing IUCD was the use of plain abdominal x-ray with a marker in-utero (50%) and retrieval hook was used for removal in 45% of the cases. Three patients had exploratory laparotomy for removal of the missing IUCD. Conclusion IUCD is a method of contraception most commonly used in UNTH, Enugu. Plain abdominal x-ray with a marker in-utero is a simple and reliable diagnostic technique for missing IUCD.
[ABSTRACT]   Full text not available  [PDF]  [Mobile Full text]  [EPub]
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CASE REPORTS
Primary hydatid cyst in gastrocnemius muscle
Saswata Bharati, Mrityunjay Pal
January-June 2012, 18(1):19-21
DOI:10.4103/1117-6806.95479  PMID:24027387
Cystic echinococcosis, which is caused by the larval stages of Echinococcus granulosus, results from the presence of one or more massive cysts or hydatids, and can involve any organ, including the liver, lungs, heart, brain, kidneys, and long bones. Muscle hydatidosis is usually secondary in nature, resulting from spread of larval tissue from a primary site after spontaneous or trauma-induced cyst rupture or after release of viable parasite material during invasive treatment procedures. Primary muscle hydatidosis is extremely uncommon, because implantation at this site would require passage through the filters of the liver and lung. Intramuscular hydatid cyst can cause a variety of diagnostic problems, especially in the absence of typical radiologic findings. We present an unusual case of a primary hydatid cyst found in the popliteal fossa of the right knee of a 52-year-old woman, presenting as an enlarging soft-tissue tumor for 6 months associated with pain. The mass initially was diagnosed to be Backer's cyst by ultrasonography, but later it was confirmed postoperatively through histopathological studies to be due to hydatid disease. In regions where hydatidosis is endemic, hydatid cyst should be included in the differential diagnosis of any unusual muscular mass.
  3,195 125 -
ORIGINAL ARTICLES
Investigation of infant brain with or without hydrocephalous in our environment using anterior transfontanelle ultrasound scan
Tobechukwu T Marchie, Charles O Ayara
January-June 2013, 19(1):7-12
DOI:10.4103/1117-6806.111497  PMID:24027410
Aim: A prospective study aimed to suggest easy and simple reproducible ventricular site that will be basic measurement plane and normal dimension determined, correlated to sizes of infants for comparative evaluation of hydrocephalous infants and should be reproducible in follow-up. Materials and Methods: A prospective study done in University of Benin Teaching Hospital Benin, Nigeria. This study used 50 consecutive infants with Ultrasound scan (US) diagnosis of hydrocephalus and a control group of 50 US normal from 1 st January 2007 to 30 th June 2008. The infants were scan through the mid-patent anterior fontanelle in sagittal, and transverse planes with minor angulations to properly outline the ventricles and the position of measurement determined at the foramen of Monro of lateral ventricles and the diameter measured. The infants' weight, crown-heel length, and head circumference were measured and body mass index (BMI) calculated and correlated to lateral ventricular measurement. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS Inc, USA), Version 11.0. Results: There was no statistically sex and age-related difference. There is statistically comparative high mean weight and height and lower BMI in hydrocephalic infants as against the control group (P < 0.001). The mean head circumference for hydrocephalus was 45.6 (± 10.5 standard deviation [SD]), whereas the control group was 35.9 (± 2.7 SD) with P < 0.001. The mean diameter of the anterior horn of left and right lateral ventricles at the level of foramen of Monro in hydrocephalic subjects is 18.4 mm ± 14.3 mm and 20.1 mm ± 16.8 mm with median diameter of 14.1 mm and 15.2 mm, respectively, whereas control group is 2.5 mm ± 0.6 mm and 2.5 mm ± 0.7 mm with median diameter of 2.5 mm and 2.4 mm, respectively. Conclusion: Transfontanelle US was found highly useful in investigation of hydrocephalous in infant.
  3,115 173 -
Reasons for patronage of traditional bone setters
Innocent Egbeji Abang, Joseph Asuquo, NE Ngim, Ikpeme Asanye Ikpeme, P Agweye, SE Urom, C Anisi, E Mpama
July-December 2016, 22(2):102-106
DOI:10.4103/1117-6806.188993  PMID:27843274
Aims and Objectives: The objectives of this study were to analyze the different reasons why patients with fractures patronize traditional bone setters (TBS) and their impression of the outcome of the treatment by the TBS. Materials and Methods: A 24 month prospective observational study was conducted from February 2012 to January 2014. All the patients were recruited from the orthopedics outpatient clinic. The demographic data of each patient, the type of injury, presentation to hospital or not, reasons for leaving the hospital, reasons for patronage of the TBS and their impression of the outcome of TBS' treatment, effect of educational background on patronage of TBS and reason for presenting to hospital for orthodox treatment. Data Analysis: Analysis was done with SPSS software Version 20. Results: A total 79 patients were recruited for the study and they had different reasons for patronizing TBS. These reasons include an external locus of decision making in 19 (24.1%) patients, and greater faith in TBS compared to orthodox medicine in 16 (20.3%). Twelve (15.2%) believed that TBS are more competent than orthodox medical practitioners while another group 11 (13.9%) considered the fees of TBS cheaper than those in the hospital. The delay in treatment in the hospital, forceful removal of patients from hospital against their will and nonsatisfaction with hospital treatment accounted for 5 (6.3%). Poor attitude of hospital staff, fear of amputation, and patients being unconscious during the injury accounted for 2 (2.5%). Their ages ranged from 17 to 83 years, with mean age of 36.8 ± 11.8 years. The male: female ratio was 1.5:1. Conclusions and Recommendations: With recent advancements in the practice of orthopedics and trauma, there is still a very high patronage of the TBS by most of our patients. This is largely due to the dependence of the patients on their sponsors for treatment, while the influence of cultural and religious beliefs continues to play a major role in these decisions.
  3,081 166 2
Management of fistula-in-ano with special reference to ligation of intersphincteric fistula tract
Mohanlal Khadia, Iswar Chandra Muduli, Sushanta Kumar Das, Sworupa Nanda Mallick, Laxman Bag, Manas Ranjan Pati
January-June 2016, 22(1):1-4
DOI:10.4103/1117-6806.169818  PMID:27013849
Context: The surgical management of fistula-in-ano is still debatable and no clear recommendations have been made available until now. The present study analyses the results of ligation of intersphincteric fistula tract (LIFT) technique in treating fistula-in-ano in particular with recurrence, healing time, and continence status. Aims: LIFT in the management of patients of fistula-in-ano of cryptoglandular origin. Settings and Design: Prospective study. Materials and Methods: This is a prospective study of 52 patients admitted from September 2012 to August 2014. Patients were managed with LIFT technique and results of LIFT technique were compared with other studies in terms of recurrence rate, incontinence rate, and other postoperative complications. Results: A total of 52 patients were studied. Median follow-up was 24 weeks. Primary healing was achieved in 32 (71.11%) patients. Thirteen patients (28.88%) had a recurrence. No patient reported any subjective decrease incontinence after the procedure. Conclusions: LIFT technique is simple and easy to learn. With this method fistula-in-ano could be easily treated even at primary health care level. LIFT technique is a simple and novel modified approach for the treatment of fistula-in-ano with rapid healing rate and without any resultant incontinence.
  2,983 201 3
Chest injuries associated with head injury
Wilfred Chukwuemeka Mezue, Chika A Ndubuisi, Uwadiegwu A Erechukwu, Samuel C Ohaegbulam
January-June 2012, 18(1):8-12
DOI:10.4103/1117-6806.95473  PMID:24027384
Background: Although there have been significant advances in the management of traumatic brain injury (TBI), associated severe injuries, in particular chest injuries, remain a major challenge. This paper analyses the contribution of chest injuries to the outcome of head injuries in the University of Nigeria Teaching Hospital (UNTH) and the Memfys Hospital for Neurosurgery (MHN) in Enugu, Nigeria. Materials and Methods: This is a retrospective review of the medical records, operative notes, and radiological findings of all patients admitted for head injury who had associated significant chest injuries in the MHN from 2002 to 2009 and the UNTH between 2007 and 2010. Patients with only head injury and other extracranial injury not affecting the chest were excluded. Patients who were inadequately investigated were also excluded. Results: Nineteen patients from the MHN and 11 patients from the UNTH were analyzed. Ages ranged from 9 to 65 years and the male:female ratio was 3:1. Injuries were most common between 30 and 50 years and road traffic accident accounted for 60%. Barotrauma from ventilation was documented in 2 patients. The commonest types of intrathoracic injuries are pneumothorax and hemothorax. Chest wall injuries are more common but carry less morbidity and mortality. Only 20% of patients presented within 48 hours of injury. Management of the associated chest trauma commenced in the referring hospitals only in 26.4% of the patients. All patients with hemo-pneumothorax had tube thoracostomy as did 96% of patients with pneumothorax. 10% of patients with haemothorax needed thoracotomy. Mortality is 43%, which is higher than for patients with only TBI with comparable Glasgow coma scale. Outcome is influenced by the time to admission and the GCS on admission. Conclusion: Associated chest injuries result in higher mortality from head injuries. This association is more likely in the young and more productive. All patients presenting with head and spinal cord injury should be specifically and carefully evaluated for associated chest injuries. Computerized tomographic has not replaced the need for good quality chest radiograph in the emergency management of Head Injury associated chest trauma.
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Limb trauma in a university teaching hospital setting
IC Nwagbara, KO Opara
July-December 2011, 17(2):64-67
Background Imo State University Teaching Hospital is located in Orlu, a sub-urban town in Imo State, South-Eastern Nigeria. With a high prevalence of road traffic crashes commonly involving motor bikes used for commercial purposes, trauma appears to be assuming epidemic proportions. Aim The aim of the study was to examine the causes of trauma involving the upper and lower limbs seen at the Imo State University Teaching Hospital, Orlu, determine the causative factors, and the treatment given. Patients and Methods The study was a 12 month retrospective study of the cases of limb trauma in adults that presented at the accident and emergency (A&E) department of the hospital. Results Two hundred cases of trauma involving the upper and lower limbs were seen in the A&E department within the period of the study. Road traffic crashes accounted for most of the cases seen (78%), while soft tissue injuries were the commonest injury type seen (54%). Treatment given included wound care (46%), closed reduction and casting (9.4%), as well as open reduction and plating (3.5%). Twenty percent (20%) of the patients left the hospital against medical advice. Of the patients that left against medical advice, 87% had fractures as their primary diagnosis. Conclusion Majority of the limb trauma cases were as a result of road traffic crashes; thus efforts should be directed at improving safety on our roads to reduce the burden of trauma on the health care system. There is also a need to create awareness in the community on the role of orthodox medicine in the management of fractures.
[ABSTRACT]   Full text not available  [PDF]  [Mobile Full text]  [EPub]
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ABSTRACTS
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

January-June 2013, 19(1):35-40
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ORIGINAL ARTICLES
Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians
Kizito Chioma Ndukwe, Stephen Babatunde Aregbesola, Innocent Chinedu Ikem, Vincent I Ugboko, Kehinde Emmanuel Adebiyi, Olawunmi Adedoyin Fatusi, Foluso John Owotade, Ramat Oyebunmi Braimah
July-December 2014, 20(2):87-91
DOI:10.4103/1117-6806.137309  PMID:25191100
Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients' records. This information include patients' demographics (age and sex) as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD) 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%). Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients) and postoperative wound infection (eight patients) were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care contributed to the good outcome.
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CASE REPORTS
Migratory surgical Gossypiboma-Cause of iatrogenic perforation: Case report with review of literature
Mohinder Kumar Malhotra
January-June 2012, 18(1):27-29
DOI:10.4103/1117-6806.95486  PMID:24027390
Forgotten foreign bodies, such as cotton sponges, gauze, or instruments, after any surgical procedure is considered a misadventure but avoidable complication. "Gossypiboma" denotes a mass of cotton that is accidentally retained in the body postoperatively. This study's goal was to systematically review the literature on retained sponges to identify incidence, site of occurrence, time of discovery, methods for detection, pathogenesis for intraluminal migration and risk factors. Author is reporting this case in which a 45-year old woman presented with features of chronic pain abdomen following abdominal hysterectomy (first surgery) which lead to open cholecystectomy (second surgery) after two and half year of first surgery. As patients continued to have persistent abdominal pain in spite of second surgery patient went to medical gastroenterologist who advised her series of tests including colonoscopy examination. The whole colon was normal on examination but on examination of terminal portion of small bowel some intraluminal mass was visualized. Attempt to retrieve this mass lead to iatrogenic ileal perforation.
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