Inguinal mesh hernioplasties: a rural private clinic experience in South Eastern Nigeria.

OBJECTIVE: The objective of this paper is to review hernioplasties done for inguinal hernias in a rural private hospital, bringing out the socio-demographic and clinical pattern and to sensitize surgeons and family physicians in our environment about the possibility of making hernioplasty a standard of care for inguinal hernias. METHOD: The records of seventy seven patients operated in a rural private hospital were reviewed. Socio-demographic data, operative techniques and post-operative outcomes were documented. The results were compared with relevant findings in the literature. RESULTS: Eighty one Lichtenstein procedures were done, of which four were bilateral. Polypropylene mesh was used in all cases. A total of three patients (3.9%) had early post-operative complications. The complications were scrotal haematoma, haematoma complicated by wound sepsis and wound sepsis only. All the complications were successfully managed. There was no case of mesh removal or mortality. CONCLUSION: Early post-operative results suggest that mesh hernioplasty is in rural communities of West Africa, given the availability of mesh, basic medical infrastructure and relevant skilled manpower.

Family biosocial variables influencing the use of insecticide treated nets for children in Eastern Nigeria.

BACKGROUND: Effective reduction of malaria morbidity and mortality in Nigerian children under the age of five depends to a large extent on family biosocial factors. Although, the awareness of insecticide treated bed nets (ITNs) is reportedly high and increasing in Nigeria there remain large gaps between awareness, possession and use by families with children under the age of five in Nigeria. AIM: To determine the family biosocial variables that influence the use of insecticide treated nets for children in Eastern Nigeria. MATERIALS AND METHODS: A descriptive hospital-based study was carried out from June 2008-June 2011 on a cross-section of 415 mothers with children under the age of five, who were treated for confirmed malaria, and met the selection criteria were interviewed using a pretested, structured researcher-administered questionnaire. The questionnaire tool elicited information on family socio-demographic variables, inter-spousal discussion, communication, concurrence and participation in the use of insecticide treated bed nets; and reasons for non-utilization. The period of usage in the previous 6 months was assessed and graded using a scoring system of 0-4. Scores of 1-4 indicated usage while score of 0 meant non use. RESULTS: The rate of ITNs use was 53.0%. The family variables that significantly influenced utilization were secondary education and above of parents (mother: P = 0.009; father: P = 0.001), monogamy (P value = 0.024), family size of 1-4 (P value = 0.016) and parents living together (P = 0.001); others included parents' occupation (mother: P = 0.003; father: P = 0.04) and inter-spousal discussion (P value = 0.001), communication (P value = 0.001), concurrence (P = 0.000) and participation (P = 0.000). The commonest reason for non- use was inconvenience during sleep (P = 0.04). CONCLUSION: This study shows that the rate of ITN use was marginally good. Specifically, this rate was significantly influenced by some family variables. The families of children under the age of five should, therefore, be the focus of intensive health promotion campaign to influence the use of ITNs to produce ITN family friendly communities.

The Magnitude of Under-five Emergencies in a Resource-poor Environment of a Rural Hospital in Eastern Nigeria: Implication for Strengthening the House-hold and Community-integrated Management of Childhood Illnesses.

BACKGROUND: Under-five in Nigeria are the most vulnerable group that are often challenged by emergency health conditions. AIM: The study was to describe the magnitude of under-five emergencies in a resource-poor environment of a rural hospital in eastern Nigeria. MATERIALS AND METHODS: A descriptive cross-sectional hospital-based study of 282 under-five patients with emergency health conditions at a rural Hospital in Imo state, eastern Nigeria. Data extracted included bio-data and diagnosis. RESULTS: A total of 282 under-five emergencies were studied. The ages of the patients ranged from 12 days to 58 months with mean age of 34 ± 9.4 months. There were 153 (54.3%) males and 129 (45.7%) females with male to female ratio of 1.2: 1. The three most common causes of under-five emergencies were acute uncomplicated malaria (29.1%), severe malaria anemia (24.5%), and acute respiratory infections (22.7%). The predominant outcome of emergency admission was discharged home (83.0%). The preeminent cause of death was severe malaria anemia (81.8%). All deaths occurred within 24 hours of hospitalization. CONCLUSION: The three most common under-five emergencies were infectious medical emergencies and the preeminent cause of death was malaria-related. Strengthening the quality of the Roll Back Malaria Initiative, household and community-integrated management of childhood illnesses will help to reduce these preventable medical emergencies and deaths.

A middle-aged man with newly diagnosed HIV infection and rash.

TEN is a rare cutaneous drug reaction associated with high morbidity and mortality. The underlying pathogenic mechanisms are poorly understood. Development of an effective treatment algorithm has been hampered by the low incidence of this disorder, incomplete knowledge of the mechanisms of epidermal death, and lack of large controlled trials to evaluate therapeutic interventions.