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   2011| January-June  | Volume 17 | Issue 1  
    Online since July 21, 2012

 
 
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ABSTRACTS
6th ASON Conference, Enugu, April, 2010

January-June 2011, 17(1):44-54
  4,602 85 -
ORIGINAL ARTICLES
The scope and challenges of rural surgical practice in Nigeria
JI Umunna
January-June 2011, 17(1):25-28
Background: Rural surgical practice is the practice of Surgery under conditions of limited resources which brings surgical services to the doorsteps of the rural Populace, majority of whom are poor. Aims: The aim of this paper is to highlight rural surgical practice in Nigeria. Materials and Methods: A review of personal experiences in rural surgery and interaction with other practitioners in the field as well information gathered at Rural Surgery conferences in Nigeria and abroad. Results: Scope of surgery performed is commonly usually limited by infrastructure, manpower and funding. Procedures include fields as Obstetrics and Gynaecology, Urology, Orthopaedics, Ear Nose and throat, Anaesthesia as well as General Surgery. A high proportion is contributed by emergencies especially Caesarian Sections, removal of foreign bodies from the ear, nose and throat, initial management of simple fractures, Hip-pinning, appendectomies, relief of intestinal obstruction, suprapubiccystostomies, catheterization and management of ruptured ectopic tubal pregnancies. The procedures are carried out by General Duty doctors with only a few surgeons in established self-owned practices. Challenges include poor living conditions, poor accessibility, lack of infrastructure and equipment, lack of suitably trained assistants, inadequate schools for their children, lack of suitable jobs for spouses. In spite of difficulties Rural Surgery in Nigeria has come to stay and is growing especially with formation of Rural Surgical Practitioners in Nigeria. Conclusion: Rural surgical practice is feasible in Nigeria and should be encouraged by the Government as it forms an important arm of Healthcare delivery in Nigeria.
  3,367 109 -
Profile of chest trauma in Zaria Nigeria: A prelminary report
SA Edaigbini, IZ Delia, MB Aminu, HH Shehu
January-June 2011, 17(1):1-4
Aims and Objectives Trauma continues to be a major cause of morbidity and mortality world over. This study is aimed at the patterns of presentation and the outcome of management. Materials and Methods A prospective study of trauma patients admitted to Ahmadu Bello University Teaching Hospital through the Accident and Emergency units was commenced in January 2008.This preliminary report is for the period of 27months.The clinical history, physical examination and outcome of management recorded in a predesigned proforma, were analysed with SPSS 15 and the patients were followed up in the surgical outpatient department. Results A total of 4784 patients (3143 men and 1641 women) were admitted during this period for trauma. There were a total of 628(13.13%) deaths. Of the 42 consecutive patients identified with chest trauma35 (83.3%) were males and 7(16.7%) were females. The age range was from 5-75years and the mean age was 35.4years, while the most affected ages were in the range of 20 to 49years. Blunt injury constituted 71.4% and penetrating injury constituted 28.6%. Road traffic accident was responsible for 61.9%, stab injury 21.4%, falls 7.1%, gunshot injury 4.8%, impalement 2.4% and animal attack also 2.4%. The average time taken between accident and admission was 31hours,40minutes and 12seconds while the average duration of hospital stay was 16.10 days. The injury pattern included rib fracture(s) (23.8%), hemopneumothorax (14.3%), hemothorax (7.1%), pneumothorax (4.8%), combinations of chest injuries (7.1%), chest laceration 7.1%, bruises 11.9%, lung contusion 4.8%, subcutaneous empyema 2.4%, flail chest 4.8% and no specific injury (11.9%). Associated injuries included head injury (63.6%), orthopaedic injury (27.3%) and combinations (abdominal, head, orthopaedic (9.1%). The fatality of road traffic accident was 36.8%. No patient was attended to by paramedics at the scene of accident while 21.9% of the patients had pre-hospital resuscitation in peripheral clinics before admission. The transfusion requirement was 14.3%. One patient (2.4%) required a median sternotomy and cardiopulmonary bypass, 54.8% required tube thoracostomy while 42.9% had general resuscitation /non-operative intervention. Only one (2.4%) required ICU care. The complication rate was 4.8%. The mortality rate was 2.4%. Only 7(16.7%) patients were seen beyond the first outpatient clinic appointment. Conclusion Most patients arriving at the hospital survived, requiring general resuscitation or simple tube thoracostomy with few complications. Mortalities from trauma and the cause of death at the site of accident are often not accounted for due to non-presentation to the hospital and lack of autopsy for those that present.
  3,218 144 -
Communication skills among surgical trainees: Perceptions of residents in a teaching hospital in Northern Nigeria
A Ibrahim, ZI Delia, ME Asuku, T Dahiru
January-June 2011, 17(1):5-10
Objective Communication between the surgeon and the patient is a core clinical skill. The ability to communicate with patients and their family members is very important in the optimum care of the surgical patient. Few studies have assessed communication between surgical trainees and their patients in sub-Saharan Africa. In response to this, the communication skills of residents in the department of surgery were evaluated to determine their perception of competency and perceived need for training in communication skills as a basis for developing an effective education programme. Method A survey of patient care - related communication skills among surgery residents and assessment of competence, rating the importance and perceived need for training in communication skills. Results Most residents rated their skills as either fairly or extremely competent in all areas except in providing bereavement counseling. They found all skills important and indicated a need for training in them. Senior registrars rated their competence and the importance higher in skills relating to breaking bad news, educating and preparing patients and families for surgery and encouraging them to express their anxieties. (p < 0.05). There was no statistical difference in communication skills between male and female residents (p >0.05). Conclusion Residents face difficult communication challenges with patients and their families. There is a dire need for improved education in communication skills. Understanding the surgical trainees perceptions of patient care related communication skills is the first step in designing an effective education programme.
  2,987 120 -
Comparative studies of the incidence of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs in males in Basel (Switzerland), Jamaica (West Indies) and Imo and Ebonyi States (South East Nigeria)
MON Ibe
January-June 2011, 17(1):19-24
Objective and Background: There are various postulated possible causes of surgically symptomatic prolapsed intervertebral discs in the lumbar and sacral regions. They may be acting singularly or collectively. Yet, these factors have not been satisfactorily confirmed. Therefore, the continued search for pre­determinants of this lesion, in males, is hereby being encouraged, and, our views are being presented. Method : From 1971 to 2009, eighty eight (88) locations of symptomatic prolapsed intervertebral discs in the lumbar and sacral regions in 68 males were treated by us in Basel (Switzerland): 67, in Imo and Ebonyi States (Nigeria): 1 and none in Jamaica (West Indies). The clinical features were those of lower back pains, with or without radiation into the lower extremities, sensory loss and paresis of the limbs. There was a case of loss of urinary bladder and ano-rectal control. All lesions were confirmed through cauda-equinograms and treated under general anaesthsia in knee-chest position (MECCA position). The patients were followed for3to 6 months postoperatively. Results: In Basel (Caucasian population only), there were 84 locations in 67 patients, 4 locations in 1 patient in Imo and Ebonyi States (African population only) and none in Jamaica (mixed population). Their ages ranged from 23 to 70 years in Basel and the only patient in Nigeria was 67 years old. The patients all tolerated the procedures very well and there were no complications postoperatively. Conclusion: We found surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs in males to have occurred more in Basel, Switzerland than in Imo and Ebonyi States of Nigeria and/or Jamaica, West Indies.
  2,880 95 -
Transurethral resection of the prostate a 3 year experience
NO Chukwujama, T Oguike, J Azike
January-June 2011, 17(1):15-18
Background: Transurethral resection of the prostate (TURP) is considered the 'gold standard' in the surgical management of bladder outlet obstruction secondary to benign prostatic hyperplasia and advanced carcinoma of the prostate. The procedure is however still not routinely available in most public health institutions in Nigeria. We present our experience with this treatment modality over a three year period Methods: The records of patients who underwent TURP over a period of three years (April 2006 May 2009) were examined. The biodata, Laboratory investigations, detail of the surgical procedure and outcome were extracted and analysed. Results: The records of forty three patients were examined. The age range was 49 76yrs (mean 65yrs +/- 5.8 SD). The prostate specific antigen ranged from 1.3 50.3ng/ml (mean 13.3 +/- 12.8). The mean prostate size was 59g +/- 20 SD (range 27 98grams). The indications for the surgery included refractory acute urinary retention 48.8%, failed medical treatment 21%, recurrent UTI 16%, recurrent haematuria 9%, chronic urinary retention 2%. The mean duration of surgery was 80.5mins +/- 14 SD (range 60 120mins). The period of hospital stay ranged from 3 32 days (mean 8.7 days +/- 7.7 SD). Complications included capsular perforation in 2 patients, TURP syndrome in 2 patients, total incontinence in 1 patient and failure to void in 2 patients. Most patients (93%) had satisfactory voiding and insignificant post void residual urine volume during subsequent follow up visits Conclusion: Transurethral resection of prostate is a safe and effective treatment modality in the surgical management of men with bladder outlet obstruction secondary to BPH and advanced CAP in our environment.
  2,808 121 -
External beam radiotherapy in metastatic bone pain from solid tumours in Zaria, Nigeria
DA Dawotola, VI Odigie, LMD Yusufu, A Adamu, P Abur, AO Jimoh, MR Mahmud, AT Ajekigbe, OB Campbell
January-June 2011, 17(1):11-14
Aim : To evaluate the effectiveness of external beam irradiation in bone pain secondary to metastases; with emphasis on the onset of symptoms relief, the duration of response and relate onset of pain relief to age in=40years and =40years patients. Setting : Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Result : Breast cancer is the commonest cause of metastatic bone pain from solid tumours in Zaria, Nigeria. Females were more commonly affected. Two out of every 5 patients were less than 40 years old. Eighty-six percent of the patients obtained significant pain relief in the first week of treatment. At 12 weeks, the mean pain score and analgesic scores were 0.67 and 0.16 respectively. Conclusion :External beam irradiation is an effective treatment modality in an African population with metastatic bone pain.
  2,728 78 -
ABSTRACTS
58th NSRS Conference Port Harcourt December, 2010

January-June 2011, 17(1):29-38
  2,300 90 -
5th ASON Conference, Nnewi August, 2009

January-June 2011, 17(1):39-43
  2,015 86 -
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