|Year : 2012 | Volume
| Issue : 2 | Page : 112-114
Abstracts from the 59 th meeting of the Nigerian Surgical Research Society, Dutse, Jigawa State, July 2011
|Date of Web Publication||2-Nov-2012|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. Abstracts from the 59 th meeting of the Nigerian Surgical Research Society, Dutse, Jigawa State, July 2011. Niger J Surg 2012;18:112-4
Surgical Site Infection Following Laparatomy in ABU Teaching Hospital
Shika-Zaria, Bature UG, OdigieVI, Kalayi GD, Olayinka AT
Department of Surgery, ABU Teaching Hospital Shika, Zaria Nigeria
Background: Abdominal operations form part of the general surgeon's procedure. Surgical infections resulting from theses interventions represents a significant burden in term of morbidity, mortality and cost to health care service worldwide. Objectives: Determine the incidence of surgical site infections. Identify possible risk factors associated with SSI. Identify common aerobic pathogenic bacteria involved and their sensitivity pattern. Materials and Methods: It is prospective study of adult patients who had laparatomy for abdominal surgical condition in the division of general surgery. All patients received parental antibiotics cifrofloxacin and metronidazole in therapeutic doses for 5 days. Patients studied were investigated as per proforma. Wound swabs were taken from clinically infected wounds for microscopy, culture and sensitivity. Data obtained was analyzed using Epi info version 3.4. Results: Two hundred and sixty three patients were studied. Male to female ratio of 1.6:1, fourty four patients (16.7%) developed SSI. Mean age of patients with infected wound is 34.1 years (SD 16.5) P = 0.26 associated risk factors to SSI are prolonged preoperative hospital stay, incision length, wound classification, ASA score >2 and higher NNIS risk index. Type of operation (Elective vs Emergency) shaving time before surgery and duration of operation were not statistically related to the development of SSI. Staphylococcus aureus and Pseudomonosaeruginosa made up 33% each of the isolated organism. Mixed infections occurred in 4.5%. 70.5% of the organism isolated were sensitive to cefriazone. Conclusion: SSI in this study was relatively high (16.7%) this could be reduced if the preoperative hospital stay is shortened and NNIS score is used to identify patients at risk of developing SSI.
Knowledge, Attitude and Utilization of Central Venous Line by Resident Doctor in ABUTH Zaria
Edaigbini SA, Delia IZ, Aminu MB, Anumenechi N, Okwunodulo O
Department of Surgery, Cardiothoracic Surgery Unit, Ahmadu Bello University Zaria, Nigeria
Aims and Objectives: To assess the knowledge of central line, its uses and complications amongst residents of major clinical departments of a tertiary institution. This serves as the first phase (pre-test) of the study. The final assessment (post-test) would be conducted after 5 years of initial assessment. Materials and Methods: A structured proforma was used to assess the above information from ten resident doctors, 5 junior and 5 senior residents each from paediatrics, obstetrics and gynaecology, medicine and surgery department of Ahmadu Bello University Teaching Hospital Shika, Zaria. The data was analysed with SPSS 15. Results: A total of 40 residents were assessed, 30 (75%) males and 10 (25%) females with a mean age of 35.08 years. 12 (30%), 24 (60%) and 4 (10%) had spent <2 years, 2-4 years and >4 years in residency respectively. Only 19 (47.5%) respondents knew that a line in the subclavian or the femoral vein 1 (2.5%) is a central line 15 (37.5%) ticked correctly examples of central line. Only 19 (47.5%) had observed the procedure in their institution and 7 (17.5%) had observed it elsewhere. 11 (27.5%) knew that any experienced doctor could insert a central line. Only 1 (2.5%) resident had inserted a central line. 10 (25%) knew that central line can be inserted either in the theater or by the bedside. 30 (75%) ticked correctly the uses of central line. Only 3 (7.5%) knew a combinations of central line complications. 25 (62.5%) knew that chest X-ray is required after central line insertion. 5 (12.5%) rightly ticked that central line is inserted to rule out complications like pnemothorax and haemothorax. 28 (70%) believed central line should be inserted frequently. 1 (2.5%) respondent believed central line is frequently (e.g. daily) inserted in the institution, fifteen (37.5%) believe it is infrequent (once or twice monthly), 6 (15%) don't believe central line is been inserted, 17 (42.5%) were not sure while 1 (2.5%) said only during surgery is central line inserted. Chi-square test of association (P value, 0.05) showed no statistical differences between level of training, duration of training, the clinical department and knowledge of central venous line and its utilization respectively. Conclusion: The result showed that the knowledge (insertion, uses and complications of central line limited even amongst clinicians in tertiary institutions and efforts must be made to improve upon this.
How Many Surgeons Does it Take to Write a Research Article? Authorship Proliferation and Internationalization of the Surgery Literature in Nigeria
Ibrahim A, Mai A, Garba ES, Asuku ME
Department of Surgery, Ahmadu Bello University Teaching Hospital Shika, Zaria, Nigeria
Aims and Objectives: Recent years have witnessed an increasing trend in multi-author publications and a decrease in single or dual-author article worldwide in both the physical sciences and biomedical research. The purpose of this study was thus to determine if the changing trend in authorship and international contribution of articles have been mirrored within African Journal of Paediatric Surgery, Nigerian Journal of Orthopaedics and Trauma and Nigerian Journal of Plastic Surgery over the last 5 years. Materials and Methods: An African Journal Online ( www.ajol.com ) search was conducted to identify all journal article and case report published in African journal of paediatrics surgery, Nigerian Journal of Orthopaedics and Trauma and Nigerian Journal of Plastic Surgery over 5 year period (2006-2010) the number of single-author articles, number of articles with 6 or more authors and the geographical distributions of the author were analyzed using descriptive statistics. Results: One thousand one hundred fourty seven authors published three hundred fifteen articles (African Journal of Paediatric Surgery n = 558, Nigerian Journal of Orthopaedics and Trauma n = 417 and Nigerian Journal of Plastic Surgery n = 172) the mean number of author per article did not increase significantly between 2006 and 2010 for African Journal of Paediatric Surgery and Nigerian Journal of Plastic Surgery; 3.5-3.6 and 1.2-1.6 respectively. The proportion of international articles increased significantly in 2009 and 2010 across the 3 journals. The proportion of articles with 6 or more authors increased significantly in the Nigerian Journal of Orthopaedics and Trauma between 2006 and 2010 from 29% to 71%. Conclusion: The trend of multi-authorship was not evident in the surgery literature in Nigeria, however there is a globalization of the literature similar to trends seen in other leading journals in surgery.
Rural Surgery as a Sub Specialty in West Africa, Ascope in Federal Centre, Birin Kudu
Dauda MM, Donwa OJ, Bature UG
Department of Surgery, Federal medical Centre, Birin Kudu, Nigeria
Background: More than 1/3 of the world's population live in the rural areas, where obtaining surgery for eminently curable conditions is difficult. An estimate of 11% of the global burden of disease is surgically treatable. The recent experience in sub specialties ophthalmology and anaesthesia in the West African sub region and the recent national interest in developing the sub specialty of family medicine, are good indicators that rural surgery can be developed into a sub specialty surgery, in Nigeria. It has been suggested that senior specialist surgeon is necessary in over 80% of cases. Aims: 1. To ascertain the scope of surgery carried out in atypical rural society where specialist surge 2. To compare the scope with other rural/urban federal medialcentre. Materials and Methods: Operation notes from 1 st January 2010 to 31 st August 2011 in the Federal Medical Centre, Birnin Kudu were categorized into major, intermediate and minor. The demographic, clinical and outcome of these operations were analysed and presented. The corresponding number of patients who were operated at Federal Medical Centre Nguru (rural areas) Federal Medical Centre Gusau (urban) and Federal Medical Centre Katsina (urban) over twenty four months period is currently under study for comparison. Results: This is a preliminary result of the findings of Federal Medical Centre Birnin Kudu. A total of one thousand four hundred and nine, aged 7 days-68 years were operated in the surgery and Obstetrics and Gynaecology department during the study period. Ear, Nose and Throat, dental and ophthalmological surgery were excluded. There were six hundred fourty four obstetrics' and gynaecology operations and seven hundred sixty five general surgical and orthopaedic surgeries. One hundred and twelve were children aged 8-12 years (94 boys-girls) thirty eight had circumcision, 8 had appendectomy, twenty seven hermiotomies, twenty seven orthopaedics and debridement, twelve had laporotomy for peritonitis. There were one hundred seventy six adult female and fourty hundred seventy seven adult male who had surgical or orthopaedic manipulation. Of the six hundred fourty four gynaecological surgeries fifty eight were hysterectomies, three hundred eighty two caesarian sections, thirty one ruptured ectopics, one hundred and nine evacuations, 8 marsupinalization and ten tubal ligations, while twenty eight had surgery for ruptured uterus. Overall one hundred ninety six (13.9%) surgeries were categorized as major, comprising fourty exploratory laparotomies for peritomitis, 4 thyrodectomies, 5 mastectomies, twenty prostatectomy's, 4 urethroplasties, Open Reduction and Internal Fixation 8 and salivary gland excision in 2. Caesarian section is considered intermediate. Conclusion: With only 134.9% of one thousand four hundred and nine surgical operations requiring senior specialist surgeon, we firmly believe rural surgery as a sub-specialty can bring immense benefit to the teaming population in Nigeria.
Pitfalls in the Diagnosis and Management of Nasopharyngeal Cancer in Nigeria
Bakari A, Aminu U
Department of Surgery, ORL Division, Ahmadu Bello University Teaching Hospital, Shika Zaria, Nigeria
Background: Nasopharyngeal cancer is one of the most difficult cancers to diagnose at an early stage. Patients often present at a late stage with obvious sign and symptoms. However, they are in many cases mismanaged by other physicians resulting in worsening prognosis for the patients. Aims: To present the clinical presentations of the disease to aid early recognition and discuss the pitfalls in the diagnosis of nasopharyngeal cancer in our environment by presenting four patients misdiagnosed/mismanaged by physicians before presenting to otorhinolaryngologist. Materials and Methods: Four patients with obvious signs of nasopharyngeal cancer that were mismanaged by physicians before presenting at the ear, nose and throat clinic of ABUTH Zaria were presented. Results: In all four cases presented, the delay in diagnosis, late referral and other interventions by the primary physicians worsened the patient's prognosis. Conclusion: A meticulous ear, nose and throat examination and thorough evaluation of nasal symptoms with associated cervical lymphadenopathy may an early diagnosis of nasopharyngeal cancer.
Pattern of Fractures Seen at FMC Birnin Kudu and The Acceptability of Orthodox Treatment for Them Preliminary Result
Donwa OJ, Dauda AA, Ajibade AO, Dahiru IL
Department of Surgery, Federal Medical Centre, Birnin Kudu, JiawaStae, Nigeria
Aims and Objectives: To look at the pattern of fractures presented at the centre. To use the data in planning upgrade of facilities in the trauma department. To also study possible factors affecting acceptance of orthodox treatment for the fractures in this environment. Materials and Methods: A prospective study of patients seen in the surgical outpatient department and the accident and emergency department of the hospital with fractures occurring from January 1 st this year 2011. A proforma was designed and filled for all patients of both sexes and all age groups with fractures. Patients unable to X-ray before declining treatment were excluded from the study. Results: In the first 8 months January to August 2011, eighty nine patients were included in the study with 75% male, twenty five female. The young were the commonest age group with fractures in 44%, followed by children. The femur is the commonest long bone affected, while tibia and femur were still also the commonest fracture in children, the ratio of upper limb to lower limb fracture in adults was 1:2, while in children was 1:1, the commonest cause of fracture in this environment was by Road Traffic Accident occurring in 65% of adult cases and 50% of children. In children, falls from height is more frequent than cases of the eighty nine patients in the study, eighteen who presented within 48 hours opted for traditional bone setters (TBS) treatment and twenty four had prior TBS treatment before presenting to the hospital. A total of fourty five new cases were enrolled. Conclusion: RTA remains the commonest causes of fracture n this environment while falls is a common cause of fracture in children. Lower limb fractures are commoner in children than in adults. TBS is still the preferred first port of call following fractures in this environment.