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Year : 2015  |  Volume : 21  |  Issue : 1  |  Page : 73-78  

Book of Abstracts 65 TH Scientific Meeting of the Nigerian Surgical Research Society

Date of Web Publication13-Mar-2015

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. Book of Abstracts 65 TH Scientific Meeting of the Nigerian Surgical Research Society. Niger J Surg 2015;21:73-8

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. Book of Abstracts 65 TH Scientific Meeting of the Nigerian Surgical Research Society. Niger J Surg [serial online] 2015 [cited 2021 Sep 21];21:73-8. Available from: https://www.nigerianjsurg.com/text.asp?2015/21/1/73/153198

Preliminary report on the role of culture positive urine and intra-vesical catheter in postopen prostatectomy wound infection

Okojie C Akumabor PN, Oguike TC, Obarisiagbon EO, Agbugui J, Osaigbovo E, Ezenwa EV

Urology unit, University of Benin Teaching Hospital,

Benin City

Background: Postprostatectomy wound infection is one of the postoperative complications still plaguing urologic surgeons in Nigeria where open procedures still abound. The presence of an intravesical catheter and preoperative infected urine is a common occurrence in patients undergoing this form of surgery. Aim: The aim of this study is to asses the relationship of culture positive urine and intravesical catheter with postprostatectomy wound infection. Methodology: Patients undergoing open transvesical prostatectomy for benign prostatic hyperplasia were categorized into catheter bearing and noncatheter bearing groups. The preoperative urine was evaluated for infection. The status of the postoperative wound was noted in these categories of patients. Permission for this study was obtained from the hospitals Ethical Committee. The results of this study was analysed using SPSS package. Results: 36 patients were seen over the study period. They age range was 60-83 years with a mean age of 70. The wound infection rate recorded was 33.3% (n = 12) all being superficial with Clavien-Dindo grade III. 40% of the patients on catheter (n = 12) had their wounds infected while none of the patients without catheter had wound infection. 33% (n = 10) of patients with culture positive preoperative urine had wound infection postoperatively, while the wounds of 25% (n = 2) of those with culture negative urine were infected. When preoperative culture specific antibiotics was administered to patients on catheter 33.3% of them had wound infection while 37.5% of those that received nonculture specific antibiotics had their wounds infected. Prolonged duration of intravesical catheter and placement of the catheter in the suprapubic region were catheter-related factors associated with increased rate of postprostatectomy wound infection. Conclusion: The presence of intravesical catheter and preoperative infected urine increased the risk of postprostatectomy wound infection. Urine should be sterilized before elective open prostatectomy, while suprapubic catheter should be avoided in patients with urine retention due to enlarged prostate that are likely going to need open prostatectomy.

Age at presentation of breast cancer in Uyo

Umeh KU, Udo IA

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

Background: Carcinoma of the breast is the most common malignancy and cause of death from malignancy in females. The true burden of the disease in Nigeria is unknown because of lack of population studies; but there is increased awareness of the disease in the general population with heightened anxiety which has increased consultations. Breast cancer in blacks has aggressive cellular features, behaviour and worse stage-specific survival, occurring on average 10 years earlier than in Caucasians. This implies the disease in Blacks require aggressive therapy to improve outcome, apply less aggressive surgery and prolong survival. Screening and early diagnosis are key to achieving these ideals and provision of the needed tool is important. Aim: To audit the age at first presentation of patients with carcinoma of the breast at the surgery clinic. Methods: A unit based study from December 2012 to January 2013 involving all females who were diagnosed with breast cancer in the surgical clinics. The patient bio-data were recorded in a prepared format. Results: A total of 62 patients with breast cancer were enrolled in the study with an average age of 40.2 years. The highest incidence of the disease was in the second to fourth decades of life. Conclusion: Breast cancer in Nigerians would appear to occur at an early age. Aggressive measures are required to contain the mounting morbidity and mortality associated with this disease.

Choking hazard from whistles in children's toys: A sudden trend?

Okugbo Stanley Ukadike,

Omoregbee Benjamin

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

Background: Foreign body inhalation in children is a major life threatening emergency. In children due to their inquisitiveness, they tend to put an array of things into their mouth and inadvertently inhale some. We noticed a common trend in 2013 of inhalation of whistles and therefore undertook a prospective analysis of these patients as they present and this is the preliminary report of this study. Materials and Methods: This is an ongoing prospective study on consecutive cases of inhaled whistles presenting to the Cardiothoracic Unit of the University of Benin Teaching Hospital, Benin City from January 2013 till date. Results: A total of 8 patients have been recruited so far, male female ratio is 5:3. The mean age is 4.5 years with a preponderance of them below 5 years of age. All had the whistles from toys which they were playing with at the time. The whistles was easily removed from the toys and placed in their mouth prior to inhalation. All had rigid bronchoscopy and successful retrieval of the foreign body. The main presenting complain was choking, then cough, stridor, worsening difficulty with breathing. Only one patient presented within hours of inhalation, 7 (87.5%) presented weeks and months after the initial episode and were all mismanaged by being told they would cough it out and placed on antibiotics. Conclusion: Inhalation of whistles is an ongoing threat in our pediatric patients and though choking is the main presentation many of the patients are mismanaged initially, significant morbidity exists in delayed presentation. Public enlightenment and advocacy must now become a priority to prevent further incidences.

Pattern of spinal cord injuries, a 6 months prospective study: UBTH experience

Azeez AL, Usiholo AE, Udoh DO

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

Background: This is a prospective study conducted in a teaching hospital in Nigeria to survey new patients with traumatic spinal cord injuries. Methods: In the first 6 months of 2014, new patients that presented in University of Benin Teaching Hospital were assessed for their age, sex, causes and levels of spine injuries. Results: 31 new traumatic spinal cord injured patients were identified. The male/female ratio was 9:1. The age range was 16-74 years, 71% of the patients were under the age of 50. The major causes of spinal cord injury were road traffic accidents (58.07%) and falls from heights (29.03%). Most accidents occurred on the highways (45.16%) intracity roads (25.81%) and farms (12.9%). Majority of the patients had some form of prehospital care (93.55%) but none was adequately transported from the scene of the accident to the hospital of first contact. 7 (22.58%) patients presented within a day of the trauma while 9 (29.03%) presented after 1-week. The commonest level of injury was cervical (58.84%) and eighteen patients (58.07%) had complete injuries. Conclusion: The commonest cause of traumatic spinal cord injury was road traffic accidents and more than half had cervical spine injuries in men in the productive age group.

The degree of completeness of operations notes in two tertiary institutions in south-south Nigeria

Udo IA, Umoh MS 1 , Umeh KU, Nottidge TE 2 , Ubochi D

Departments of Surgery and 2 Orthopaedics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, 1 Department of Surgery, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria

Background: The operation report is an important record of surgical procedures; it easily communicates the intra and postoperative events between clinicians. The quality of the report depends on its completeness and clarity. A well-documented report is essential for further clinical decision making, quality assurance, patient outcomes research and also has medico-legal implications. Purpose: To assess the degree of completeness of operation reports in two tertiary hospitals in south-south Nigeria. Patients and Methods: Operation notes were reviewed daily after procedures over 12 weeks for degree of completion of fields. Thirteen fields considered important were extracted and validated as essential by two general surgeons from both institutions and accepted by members in the study group. These fields were checked in each report to determine the degree of completion of the write-up. Data analysis was done with SPSS for Windows version 17 and reported as simple percentages. Result: A total of 245 operations reports were analysed over 12 weeks, involving 123 (50.2) elective procedures. Consultants undertook 50% of the procedures while residents made the write-up in 212 (86.5%). No field was 100% complete. The drain (39%) and pack (47.8%) fields recorded the worst completion rate. Type of skin closure (60%), operations details (72.2%), blood loss (62.9%), and postoperative orders (73.9%) were low. Conclusion: There is compelling need for improving the technical quality of operations records in our practice. Surgeons must teach and supervise their residents on techniques of operations report writing to prevent avoidable litigations.

Is intra-operative peritoneal lavage obsolete in secondary peritonitis in children?

Edeh AJ, Odetunde AO, Okenwa WO, Onyejizu CJ, Mba FI

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

Purpose: The classical, laparotomy for secondary peritonitis includes intra-operative peritoneal lavage. This lavage supposedly purses the infected peritoneal cavity. Evidence is lacking that peritoneal 'toileting' reduces mortality or septic complications. Our objectives is to determine whether there is increased mortality or septic complications in laparotomy for secondary peritonitis in children without intra-operative peritoneal lavage. Method: All children with secondary peritonitis due to typhoid perforation treated by the classical laparotomy in the hospital between January 2008 and December 2012 did not have intra-operative peritoneal lavage. Results: 58 laparotomies for typhoid perforation were performed within the period. There were 32 males and 26 females. The outcome include 3 mortalities, 7 with recurrent intra-abdominal abscesses which responded to conservative treatment. 2 0 had various grades of surgical site infection which responded to good wound care with or without antibiotics. Conclusion: Although popular with surgeons, intra-operative peritoneal lavage is not necessary in secondary peritonitis in children receiving adequate systemic antibiotics.

The difficult acute abdomen: A case report of secondary peritonitis from jejunal perforation due to metastatic melanoma from the foot

Edeh AJ, Ilo CA, Onah I, Aniago NE

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

Purpose: To report a case of metastatic intra-peritoneal melanoma involving the ovary, the mesentery and the duodenum cawing secondary peritonitis. Method: Case report of metastatic malignant melanoma in adult female. Result: A 38-year-old female presented in accident and emergency with secondary peritonitis. At emergency laparatomy was found 'Pigmented' peritoneal cavity with perforation of the upper jejunum, and deposit in the left ovary. After surgery it was noted she had excision of melanoma night foot almost 1-year prior to present illness. Discussion: Metastatic deposits to the peritoneum from many tumours are common. That from malignant melanoma is considered rare and especially to the jejunum causing perforation. Conclusion: Evaluation and treatment of malignant melanoma has continued to evolve. Perhaps by reporting cases like this, better clinical understanding of this enigma can be obtained.

The occurrence of multiple cancers in members one nuclear family: Could this be  Li-Fraumeni syndrome More Details?

Edeh AJ, Okenwa WO, Ohayi SAR,

Okafor II

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

Purpose: In a nuclear family of 7 females and 3 males, 3 females and 2 males developed various tumours at various ages. Only one female was tested genetically and found to have BRCA I and BRCA II. Our purpose is to show that standard of care and outcome are usually poor when appropriate technology for diagnosis is absent or unaffordable in hereditary cancers. Methods: Retrospectively a family who had multiple cancers in the members were reviewed. 3 females and 2 males were involved. Time frame started from 1980 to 2012. Results: In other of occurrence one male developed non-Hodgkin's lymphoma at age 32 years and died at 38 years. A female developed cervical cancer at 27 years of age and died at 34 years. Another female member had cervical cancer at age of 50 years and later breast cancer at the age of 60 years and died at 63 years. Another female member had breast cancer at age of 37 years and bilateral ovarian cancer at age of 44 years and died at 48 years of age. Another male member developed thyroid cancer at age of 60 years and is still alive. Only one member had genetic testing. Discussion: Li and Fraumeni described occurrence of multiple cancers in families as a result of genetic alterations. The key to such diagnosis is genetic testing. Without diagnosis standard of cancer is poor. Only one member was tested very late and did not benefit from early diagnosis and preventive therapy. Appropriate technology can be made available when we realize that it is essential. Conclusion: It is highly probable that these cancers may be hereditary and/genetic. Standard of care in cancer had gone beyond clinical staging. Genetic testing and counseling is becoming an essential component of diagnosis and care to improve survival.

Utilization of fine needle aspiration cytology in the diagnosis of palpable masses in Enugu, Nigeria

Edeh AJ, Ohayi SAR, Okenwa WO, Nevo C, Ilo CA

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

Purpose: To find out the scope and challenges in the use of fine needle aspiration cytology (FNAC) in the diagnosis of palpable masses in a Nigerian Teaching Hospital in Enugu. Methods: The FNAC results done in the histopathology of a teaching hospital from January to December 2013 were reviewed retrospectively. Results: Forty FNAC examinations were performed during the period. Involved are 35 females and 5 males. The commonest indication was for breast lumps in 35 cases, malignant lymph involves in three cases and one each for low back mass and jaw tumour. The procedure was conclusive in 34 smears. There were challenges of no cells, haemorhagic smears, aspiration of breast milk, and aspiration of straw colored fluid in the rest. Conclusion: FNAC though not an exact science has proved to be very useful in the diagnosis of malignancy from - palpable masses. Its limited use to only breast masses amounts to under utilization.

The use of performance status score in cancer patients admitted for chemotherapy

Okugbo Stanley Ukadike,

Irowa Omorodion

Department of Surgery, University of Benin Teaching Hospital, Benin, Edo State, Nigeria

Introduction: Performance score evaluation is a tool for assessment of patients prior to cytotoxic chemotherapy administration. It allows the surgeon to prognosticate and thus adequately assess the benefit of administration of chemotherapy to cancer patients. It has also been used to modify and personalize the dosage, route and types of the various chemotherapeutic agents. While various methods abound for performance status evaluation, the commonest appears to the World Health Organization (WHO) and the Karnofsky performance status index. Identification and evaluation of patients would ensure maximum benefit and reduce incidence of morbidity and even mortality encountered in such patients. Our study was aimed at evaluating the use of performance status as assessment tool for patients on cytotoxic chemotherapy. Materials and Methods: This is a questionnaire survey involving all residents in surgery. They were asked to fill a form that detailed their knowledge attitude and practice of the use of performance status evaluation. All the data were entered into spread sheets and analysed using the SPSS 20 package. Results: A total of 29 doctors where enlisted in the study. 79% had knew about performance status in the assessment of oncology patients. However 37.9% could not name any type of performance status. 2 (7%) knew only the ECOG, whereas 55% (16) knew of the Karnofsky performance status index. Of the 23 who knew about the use of performance status only 35% actually reported its routine use in their practice. Only 41% where aware of the WHO performance status scoring system. Whereas 38% (11) respondents would adjust the medication according to the performance score; 48.3 would not reduce chemotherapy based on the performance score. Even though seven of the senior registrars knew about performance status, yet only three reported routine use. Conclusion: The awareness of performance status score is high amongst doctors in the hospital however its use was low.

Tunnel lines for haemodialysis: Feasibility of the procedure without the use of fluoroscopy

Okugbo Stanley Ukadike, Iyamu Collins

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

Introduction: Vascular access for hemodialysis is an important aspect of their care. In patients on chronic dialysis therapy, poor management may lead to them practically running out of options for vascular access. Tunneled central jugular lines are a main stay of vascular access as they are long stay, require low maintenance and are easily hidden and so find good patient acceptance in comparison with other forms of central lines. The main drawback is that usually in the procedure fluoroscopy are routinely done in most centers to ascertain the position of the catheter and its tip. In a resource poor setting like ours where fluoroscopy is either not readily available or affordable, it is an attractive proposition to carry out insertion of tunneled lines without the use of fluoroscopy. A few centers have good results and we present our attempt at rationalizing the use in our center. Materials and Methods: This is the preliminary report of a prospective study on consecutive cases of insertion of tunneled lines carried out in our center. The procedure was first carried out in April 2014 and since then, we have kept a register of all patients, including the complications, and need for ascertaining the position of the tip as well as other patient variables. Result: A total of seven cases have been carried out. There were three males and four females with a mean age of 42 years. All the cases where day cases with the patient presenting in the accident and emergency theatre and then going home following the procedure. Anaesthesia was by the use of 15-20 ml of 1% lignocaine. All the lines were passed through the right internal jugular vein. Average estimated blood loss was 100 ml. All the patients had a routine chest radiograph done following the procedure and reported with the X-ray to the clinic. There was no case of malposition of the catheter. Significant bleeding was encountered in two patients from the site of the exit of the catheter. In both cases the bleeding occurred following hemodialysis and continued for 72 h postoperation. The bleed was attributed to heparin toxicity which resolved promptly with treatment. Wound infection and sepsis was noticed in a patient who had the catheter removed. All patients are still using their tunnel lines at present. Conclusion: Our preliminary report shows good patient outcome and there was no need to review the catheter position following the chest X-ray.

Congenital anomalies of the central nervous system in the Niger Delta: A neurosurgical perspective

Udoh DO, Osabuohien KO, Azeez AL

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

Background: Congenital anomalies of the neuraxis are an important cause of morbidity and mortality in the perinatal period and during infancy. We look at its occurrence in our geographically distinct population that includes patients from the country's major oil producing areas. There is dearth of background data to compare with, however. Patients and Methods: A prospective study of 207 patients surgically managed on our service from its inception in June 2006 May 2014. We studied demographic, clinical and radiologic data as well as outcomes. Data was analysed using SPSS 16.0. Results: We surgically managed 207 patients representing 16.5% of all neurosurgical operations in our centre during the 8-year period. Most patients, 60%, present in infancy. Overall male to female ratio is 1.4:1, though there are significantly more males born with spina bifida. Age range at time of operation is 18 days to 23 years. There were twice more patients with hydrocephalus than spina bifida. The other anomalies managed surgically were encephalocoeles, craniosynostosis, porencephalic cysts and Adeloye-Odeku disease. Conclusion: Congenital anomalies of the central nervous system are common in paediatric neurosurgical practice. Most present in early infancy while an index of suspicion, meticulous clinical and radiological examination will detect about 2.5-5% presenting between the second and third decades.

Correlation of clinical and computerised tomographic findings in posttraumatic in basal skull fractures

Udoh DO, Emokpaire E

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

Background: The diagnosis of a base of skull fracture remains clinical and may not be shown on skull radiographs and computerised tomography scans. Basal skull fracture is the commonest cause of cerebrospinal fluid (CSF) leak or fistulae which is found in 2% of closed head injuries. Many patients with serious head injury usually sustain other life threatening injuries and it is important not to overlook basal skull fractures which, though nonlife threatening may result in adverse complications such as meningitis, beside cranial nerve palsies, if untreated. Aims / Study Objectives: To determine the incidence of basal skull fracture (and CSF leakage). Methods: A prospective analysis of basal skull fracture cases managed in our neurosurgical unit between over a 2 years. We studied the demographic, radiological and clinical data as well as treatment outcomes. Results: Basal skull fractures were found in 141 of 483 cases (29%) of head injuries with CSF fistulae in 17% that is, 59% of basal skull fractures. Basal skull fracture occurred most frequently (30%) in the third decade of life, the commonest cause being motor vehicle accidents in 78%. Though majority (55%) of basal skull fracture were admitted with severe head injuries 95.8% of survivors had Glasgow coma score 13-15. Calvarial fracture found on computed tomography in 38% but only in 13% was basal skull fracture demonstrable, despite CSF leak. In 85% of those who died admission GCS was 3-8 with a mean of GCS of 5. Mortality was 9%, proportionately higher in the elderly (40%), in severe head injuries (85%), and in the presence of cerebral parenchymal injury 92%. Conclusion: Basal skull fractures, though may be missed by conventional radiological evaluation in the head-injured patient, may result in significant complications. Meticulous clinical evaluation and prompt treatment of associated intracranial injuries reduces morbidity and mortality.

Quality neurosurgery in low resource environments: Building a neurosurgery program in a resource limited environment

Udoh DO, Ademola RO, Azeez AL, Elehinde T, Oke KI

Department of Surgery, Division of Neurological Surgery, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria

Background: The diversity of medical and surgical specialties unequivocally places the demand for continuing subspecialisation within nursing services for safe and efficient patient care especially in tertiary institutions. Though orthopaedic, psychiatric, obstetric, intensive care and ophthalmic nursing are established, neurosurgical nursing is almost unknown in West Africa. Thus, nurses, whatever their training are deployed and regularly redeployed between specialty units without prior training or previous exposure. Training and subsequently dedicating nurses, to neurosurgical patient care makes a significant difference to patient care outcomes. Objectives: The purpose of this paper is to document the process of the establishment of the first functioning Neurosurgical facility with indigenously trained dedicated subspecialty nursing staff in West Africa using a simple, reproducible design. Study Design / Setting: A special report on the establishment of a new neurosurgical facility highlighting indigenous subspecialty training for nurses. It also includes an observational documentation of the effect on the volume, effectiveness and outcomes of patient care in a tertiary hospital setting institution which commenced neurosurgical care after 31 years of establishment in mid-Western Nigeria. Methods: Twenty-six nurses (from nursing officer II to chief nursing officer cadres) were selected from already established hospital units for training in neurosurgical nursing. None had previous exposure to/in neurosurgery though they had between them 6 months and 30 years of nursing experience in tertiary health institutions. They received a structured training in neurosurgical patient care which had five stages/phases. Other efforts at establishing our neurosurgical facility included acquisition of a building and basic neurosurgical equipment, and the commencement of neurosurgical procedures. The challenges faced and strategies for overcoming them are also documented. Results: Over 8 years, we established a fully dedicated neurosurgical facility with thirty specialty nurses and other in-house staff; analysis of the result of pre and posttraining examinations showed significant gain in the knowledge of basic neurosciences and neurosurgical patient care. Yearly training and examination showed improved expertise and experience. The numbers of in-patient admissions (and discharges), numbers of operations and reduction in morbidity and mortality underscored improved patients care. Conclusion: Subspecialty training of dedicated nurses in neurosurgical care facilitates rapid expansion/growth of new neurosurgical units, improves experience and expertise of nursing staff as well as outcomes of patient care as compared with the results than obtained from managing neurosurgical patients by nonneurosurgical nurses. A functioning neurosurgical unit may be established in almost any part of West Africa despite scarce resources.

Broomstick injuries to the eye; an emerging cause of blindness among children in Nigeria

Ukponmwan CU, Momoh RO, Obasuyi E

Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria

: Ocular trauma among children is considered a very serious public health concern as it is responsible for a high incidence of uni-ocular blindness. There seem to be a recent increase in the number of cases of broomstick injury of the eye, in children, presenting at the Ophthalmology clinics of University of Benin Teaching Hospital (UBTH) in Benin City. Objective: To evaluate the pattern of presentation and complications from broomstick eye injury with a view to proffering solutions on ways to reduce this trend. Methods: A case series study. We conducted a review of case records of all 20 patients who suffered ocular trauma from broomstick injury and presented at the Ophthalmology Department of the UBTH between 2003 and 2014. The dataset was formed by information retrieved from the case records on social demographic characteristics, interval between occurrence of injury and presentation to the eye facility, mechanism of injury, activity at time of injury, examination findings, treatments offered and complications observed. The children were treated promptly as emergencies using departmental protocols comprising of systemic and topical antibiotics and antifungals, topical cycloplegic agents and intra-vitreal antibiotic injections when indicated. Surgical repair of corneal wounds and removal of retained intraocular foreign body (IOFB) of broomstick were also carried out when indicated. Data was analysed using Epi-info version 6. Results: A total of 20 eyes in 20 patients were seen. Patients who presented with broomstick injuries were all children <14 years old. The mean (SD) age was 7.10 (+4.03) years. Male to female ratio was 3:1. Twelve children (60%) sustained trauma from broomstick shot as a missile with a rubber band and/or catapult sling, often by older male children and siblings in 60% (n = 12) of cases while at play. 10 children (50%) presented at the eye facility within 24 h of occurrence of the injury. 19 (95%,n = 19) of the children were blind at presentation in the affected eye with visual acuity ranging from count fingers, hand movement or light perception to no light perception. Using the Birmingham Eye Trauma Terminology System classification showed that 90% (n = 18) of the cases were open globe injuries from penetrating (40%, n = 8), perforating (30%, n = 6) and retained IOFB of broomstick (20%, n = 4). Only 10% (n = 2) were closed (lamellar) injuries. Most had multiple complications affecting the anterior segment such as corneal laceration (80%) and traumatic cataract (40%), posterior segment, such as endophtalmitis/panophthalmitis (55%), and orbital cellulitis (15%) among others. Conclusion: Ocular trauma from broomstick results in devastating, penetrating eye injury with loss of vision. Young, male children are vulnerable as targets of dangerous game-play by often older, male children. Primary prevention is most desirable by sensitization of caregivers and children themselves of the risks. There is a need for effective supervision of children especially when at play.

Occupational eye injuries in farm workers in an Agricultural Institute in Nigeria

Momoh RO, Abadom EG 1 , Akpata E

Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Edo State 1 Department of Ophthalmology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria

Background: Agricultural work is one of the riskiest occupations for the eyes. Farm related trauma is a major risk factor in the development of blinding corneal ulcerations. Penetrating injuries of the eye are also among the most serious and unpleasant hazards experienced by workers in agricultural industries. Objective: This study seeks to determine the types of ocular trauma and highlight the factors associated with ocular trauma in farmers in Nigerian Institute for Oil Palm Research (NIFOR), Ovia North East Local Government Area, Edo State. Methods: This was a descriptive, cross-sectional study of ocular trauma in outdoor farm workers at NIFOR conducted over a 3-month period. Social-demographic characteristics, presenting visual acuity and ocular status of farmers with selfreported ocular trauma was assessed. The impact of use of protective eye ware and type of farm activity was also assessed. Results: Of the 303 farmers examined, 78 reported that they had work related ocular trauma in the past, giving a prevalence of 25.7%. 10 (12.82%) of these haduni-ocular visual impairment/blindness attributable to trauma. Superficial foreign body was the most common type of injury reported (66.7%) followed by blunt trauma (19.6%). Ocular trauma was most common in farmers involved in weeding/clearing. Few (13.5%) used any form of protective wear but a lot more (77.9%) were willing to use one if provided for them. Ocular trauma was significantly associated with nonuse of eye protection (P > 0.03). Conclusion: Ocular trauma is a common morbidity and cause of vision loss in these farmers and was associated with nonuse of protective eyewear.


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