Outcome of transurethral resection of the prostate (TURP) using 5% dextrose water as irrigant.

Background: TURP remains the gold standard for simple prostatectomy presently. Different fluids have been used for irrigation while performing monopolar TURP. The choice of irrigation fluid depends on a lot of factors. Aim: We sought to find out if the outcome of monopolar TURP using 5% dextrose water in our setting compares with findings in other studies using different fluids as irrigation fluid in monopolar TURP. Materials and Methods: This was a prospective study of 220 patients who had monopolar TURP using 5% dextrose water as irrigation fluid from 2015 to 2020. Results: The study was completed by 220 patients. The mean age was 66.25 yrs. The mean weight of prostate was 53.2 g, and mean resected weight was 30.10 g using a mean irrigation volume of 45.35 liters, 5% dextrose water over a mean resection time of 66.08 mins. The mean changes in International Prostate Symptom Score/quality of life score (IPSS/QOLS) were statistically significant. Early complications recorded were postoperative hematuria with clot retention (1.4%), urinary tract infection (UTI) (13.2%), and secondary hemorrhage (10%). TURP syndrome was not recorded. Late complications seen within 2 years follow-up were transient urinary incontinence (6.4%), urethral stricture (4.1%), and bladder neck contracture (2.3%). There was no repeat TURP for residual adenoma within this period. Conclusion: TURP using 5% dextrose water has comparable outcomes to other irrigation fluids for monopolar TURP. It is a good alternative to any other irrigation fluid.

Unusual case of bladder stone with an embedded scalpel blade.

ME is an 84-year old man who presented with a 3-year history of storage urinary symptoms associated with strangury. He had an open radical prostatectomy and direct visual internal urethrotomy 10 years prior to presentation for early prostate cancer and partial urethral stricture, respectively. A plain abdominal X-ray revealed a bladder stone in which there was an opaque foreign body embedded within the stone. A cystolithotomy was done, and the retrieved stone was cracked open, revealing a surgical blade.The patient had an uneventful recovery postoperatively.

Physical Activity among Healthcare Workers in a Major Tertiary Hospital, Southeast Nigeria.

BACKGROUND: Physical inactivity (PIA) is the fourth leading risk factor in an estimated global death of 3.2 million annually. To reverse this negative impact of PIA, there is a need to increase physical activity (PA). This could be achieved through creation of awareness, promotion, and good practice of PA by healthcare workers. OBJECTIVE: To evaluate physical activity among healthcare workers (HCW) in a major tertiary hospital, southeast Nigeria. METHODS: The Global Physical Activity Questionnaire (GPAQ) was researcher-administered to investigate PA level among consenting HCW who met the inclusion criteria. Participants were recruited from their workstations in the hospital. The questionnaire recorded age, anthropometrics, demographics, and physical activity. Data were summarized with descriptive statistics of frequency and percentages. The spearman rank correlation test was used to assess for the relationship between PA and socio-demographic factors. RESULTS: There were 209 participants with 93 (44.5%) males and 116 (55.5%) females. The mean age was 34.32±9.88 years. Amongst different professions, Nurses were 53(25.3%), Doctors, 31 (14.8%), and Dietitians, 21 (10%), Accountants, 19 (9.1%). The majority of the participants 100 (47.8%) had physical activity level that was high (extra sufficient), 31 (14.8%) had a moderate PA level while 78 (37.3%) had a low physical activity level. There was a significant negative relationship between PA and age, marital status, number of children, and other dependents respectively, whereas there was no significant relationship between PA and gender, income, and family type. CONCLUSION: HCWs have the minimum required PA in a week. About 63% met the minimum required PA in a week. Age, marital status, and having children or dependents reduce participation in PA. However, there is a need for conscious awareness and practice of PA among HCW in the hospital.

CONTEXTE: L'inactivité physique (AIP) est le quatrième facteurde risque dans une mortalité mondiale estimée à 3,2 millions de personnes par an. Pour inverser cet impact négatif du PIA, il est nécessaire d'augmenter l'activité physique (AP). Cela pourrait être réalisé par la sensibilisation, la promotion et les bonnes pratiques de l'AP par les travailleurs de la santé. OBJECTIFS: Évaluer l'activité physique chez les travailleurs de la santé (HCW) dans un grand hôpital tertiaire, au sud-est du Nigeria. METHODES: Le questionnaire global sur l'activité physique (GPAQ) a été administré par des chercheurs pour étudier le niveau d'activité physique chez les travailleurs de la santé consentants qui répondaient aux critères d'inclusion. Ils ont été recrutés à partir de leurs postes de travail à l'hôpital. Le questionnaire enregistrait l'âge, l'anthropométrie, la démographie et l'activité physique. Les données ont été résumées avec des statistiques descriptives de fréquence et de pourcentages. Lacorrélation du rang de lanceur pour le test de la relation entre l'AP et les facteurs sociodémographiques. RESULTATS: Il y avait 209 participants avec 93 (44,5 %) hommes et 116 (55,5 %) femmes. L'âge moyen était de 34,32 ± 9,88 ans. Parmi les différentes professions, les infirmières étaient 53 (25,3%), les médecins, 31 (14,8%), et les diététiciens, 21 (10%), les comptables, 19 (9,1%) etc. La majorité des participants 100 (47,8%) avaient des problèmes physiques niveau d'activité élevé (extra suffisant), 31 (14,8%) avaient un niveau d'AP modéré tandis que 78 (37,3 %) avaient un niveau d'activité physique faible. Il y avait une relation négative significative entre l'AP et l'âge, l'état matrimonial, le nombre d'enfants et d'autres personnes à charge, respectivement, alors qu'il n'y avait pas de relation significative entre l'AP et le sexe, le revenu et le type de famille, respectivement. CONCLUSION: les travailleurs de la santé ont l'AP minimale requise en une semaine. 62,6 % ont atteint l'AP minimale requise en une semaine. L'âge, l'état matrimonial et le fait d'avoir des enfants ou des personnes à charge réduisent la participation à l'AP. Cependant, il existe un besoin de sensibilisation consciente et de pratique de l'AP parmi les travailleurs de la santé à l'hôpital. Mots-clés: Inactivité physique, Facteurs de risque, Nigéria, Questionnaire global sur l'activité physique, Équivalent métabolique.

The Impact of Co-Morbidities on the Pattern of Blood Pressure Control in Elderly Hypertensives in Nigeria.

INTRODUCTION: The elderly hypertensive patients often have increased prevalence of cardiometabolic risk factors and their attendant co-morbidities. The aim of this study was to determine the prevalence of cardiometabolic risk factors and blood pressure control among elderly hypertensive patients, and to determine the influence of modifiable cardiometabolic risk factors on the control of hypertension among elderly hypertensive patients. SUBJECTS AND METHODS: A case-control comparative and hospitalbased study involving a total of 190 consenting elderly (>65 years), hypertensive patients (subjects) (n=100) and normotensive controls (n=90) was carried out over a period of ten months. Using interviewer-administered questionnaire, biodata and information regarding their lifestyle was obtained. Standard protocols were used to measure blood pressure, weight, height, waist circumference, fasting plasma glucose and fasting lipid profile of the subjects. Body mass index was derived from weight and height. RESULTS: The mean age of the subjects was 71.5 ± 6.3 years and the controls was 72.3 ± 7.2 years. Forty-eight percent (48%) and 47.8% of the subjects and controls were females (p = 0.651). The level of control of hypertension was poor in over two-thirds (68%) of the elderly hypertensive patients. The prevalence of modifiable cardiometabolic risk factors burden was higher in the hypertensive subjects when compared with the controls. Prevalence of Dyslipidaemia was 76% in the subjects and 51% in the controls (p = 0.004). Prevalence of Diabetes Mellitus was 40% among the subjects and 17.8% in the controls (p = 0.0001); prevalence of Obesity was 24% in the subjects and 4.4% in the controls (p=<0.001); prevalence of excess alcohol intake was 49% in the subjects and 14.4% in the controls (p=<0.001). Prevalence of sedentary life style was high in both the subjects (53%) and controls (50%), p=0.679. Poor blood pressure control was predicted by dyslipidaemia and central obesity. CONCLUSION: The level of control of hypertension was poor among the elderly and modifiable cardiometabolic risk factors were relatively prevalent. Central obesity and dyslipidaemia were predictive of poor control of hypertension. Addressing these factors may therefore improve blood pressure control.

INTRODUCTION: Les patients hypertendus âgés présentent souvent une prévalence accrue de facteurs de risque cardiométaboliques et de leurs comorbidités. Le but de cette étude était de déterminer la prévalence des facteurs de risque cardiométabolique et le contrôle de la pression artérielle chez les patients hypertendus âgés, et de déterminer l'influence des facteurs de risque cardiométabolique modifiables sur le contrôle de l'hypertension chez les patients hypertendus âgés. SUJETS ET MÉTHODES: Une étude cas-témoins comparative et hospitalière portant sur un total de 190 patients âgés (e"65 ans) consentants, hypertendus (sujets) (n=100) et témoins normotendus (n=90) a été réalisée sur une période de dix mois. A l'aide d'un questionnaire administré par un enquêteur, des données biographiques et des informations concernant leur mode de vie ont été obtenues. Des protocoles standard ont été utilisés pour mesurer la pression artérielle, le poids, la taille, le tour de taille, la glycémie à jeun et le profil lipidique à jeun des sujets. L'indice de masse corporelle a été calculé à partir du poids et de la taille. RÉSULTATS: L'âge moyen des sujets était de 71,5±6,3 ans et celui des témoins de 72,3±7,2 ans. Quarante-huit pour cent (48 %) et 47,8 % des sujets et des témoins étaient des femmes (p=0,651). Le niveau de contrôle de l'hypertension était faible chez plus de deux tiers (68 %) des patients hypertendus âgés. La prévalence des facteurs de risque cardiométabolique modifiables était plus élevée chez les sujets hypertendus que chez les témoins. La prévalence de la dyslipidémie était de 76 % chez les sujets, 51 % chez les témoins (p=0,004). La prévalence du diabète sucré était de 40% chez les sujets et de 17,8% chez les témoins (p= 0,0001), la prévalence de l'obésité était de 24% chez les sujets et de 4,4% chez les témoins (p=<0,001), la prévalence de la consommation excessive d'alcool était de 49% chez les sujets et de 14,4% chez les témoins (p=<0,001). La prévalence du style de vie sédentaire était élevée chez les sujets (53%) et les témoins (50%), p=0,679. Un mauvais contrôle de la pression artérielle était prédit par la dyslipidémie et l'obésité centrale. CONCLUSION: Le niveau de contrôle de l'hypertension était faible chez les personnes âgées et les facteurs de risque cardiométaboliques modifiables étaient relativement prévalents. L'obésité centrale et la dyslipidémie étaient prédictives d'un mauvais contrôle de l'hypertension. La prise en compte de ces facteurs peut donc améliorer le contrôle de la pression artérielle. Mots clés: Pression artérielle, Facteurs de risque cardiométabolique, Personnes âgées.

Perioperative mortality among surgical patients in a low-resource setting: A multi-center study at District hospitals in Southeast Nigeria.

Background: The perioperative mortality rate (POMR) has been recognized as a useful indicator to measure surgical safety at an institutional or national level. The POMR can thus be used as a tool to identify procedures that carry the highest mortality rates and provide hindsight based on past surgical experiences. Aim: To document the pattern of perioperative mortality and the factors that influence it at district hospitals in southeast Nigeria. Patients and Methods: This was a retrospective study of cases of perioperative mortality at district hospitals in southeast Nigeria between January 2014 to December 2018. All perioperative mortalities from surgical admissions in both elective and emergency set-ups were included. During analysis, we computed P values for categorical variables using Chi-square and Fisher's exact test in accordance with the size of the dataset. Furthermore, we determined the association between some selected clinical variables and mortality using logistic regression analyses. Results: During the period under review, 254 perioperative deaths occurred from 2,369 surgical operations, giving a POMR of 10.7%. Of the 254 deaths, there were 180 (70.9%) males and 74 (29.1%) females. Nearly one-third (31.2%) were farmers and 64.2% of the deaths occurred in those 50 years and below. Delayed presentation was two-pronged: delay before presentation and in-hospital delay. The POMR was the highest among general surgery emergencies and least among those with plastic surgery conditions. The observed factors associated with mortality were time of presentation (early or late), type of surgery (emergency or elective), category of surgery (general surgery or others), American Society of Anesthesiologists (ASA) score (high or low), place of admission after surgery (intensive care unit or general ward), level of training of doctors who performed the surgery (specialist or general duty doctor) (P < 0.05). Conclusion: The POMR was higher in male patients and in those with general surgery emergencies compared to other conditions. Delayed presentation, high ASA scores, and operations performed under emergency set-ups were associated with elevated POMRs.

Posture-induced intraocular pressure changes among patients with primary open angle glaucoma in a Nigerian Tertiary Hospital: Any implication for management.

Background and Aim: To determine the effect of postural changes on intraocular pressure (IOP) among newly diagnosed patients with primary open-angle glaucoma (POAG). Patients and Methods: This was a cross-sectional observational study of 55 consecutive newly diagnosed patients with POAG attending Glaucoma clinics at a Federal Teaching Hospital in Abakaliki, Ebonyi state, from July to September 2017. Patients IOPs were measured in the sitting position, supine without a pillow, and supine with pillow positions using Perkin's handheld applanation tonometer. All data were analyzed with SPSS version 20.0. Results: A total of 55 subjects were recruited comprising 30 (54.5%) males and 25 (45.5%) females, with a mean age of 50.13 ± 9.97 years and an age range of 30-79 years. The mean intraocular pressure was 27.54 ± 3.98 mmHg in the sitting position, 30.15 ± 4.41 mmHg in the supine with pillow position, and 35.22 ± 4.61 mmHg in the supine without pillow position. The mean difference of mean IOP of sitting compared to supine without the pillow was 7.68 ± 2.08 mmHg (P-value < 0.001, 95% CI: 7.12-8.24); sitting compared to supine with the pillow was 2.61 ± 1.49 mmHg (P-value < 0.001, 95% CI: 3.01-2.21), whereas supine without the pillow compared to supine with the pillow was 5.07 ± 2.24 mmHg (P-value 0.001, 95% CI: 4.47-5.68). Conclusion: IOP was lowest in the sitting position and highest in the supine without pillow position. There was a statistically significant reduction in IOP on the assumption of supine with pillow position compared to supine without pillow position. The use of thick pillows in supine positions (such as during sleep or relaxations) rather than lying supine without pillows may reduce IOP spikes in POAG patients. This may have a positive effect as regards treatment and progression of glaucoma.

Evaluation of Foetal Haemoglobin Status among Nigerian Patients with Sickle Cell Anaemia Using High Performance Liquid Chromatography.

BACKGROUND: Sickle cell anaemia (SCA, HbSS) is a genetic disorder of haemoglobin with marked variation in clinical manifestation. The aim of this study was to determine the foetal haemoglobin (HbF) status of patients with HbSS, compared with that of individuals with HbAS and HbAA control as well as to establish the relationship between HbF level and age and gender of the participants. METHODS: This was a cross-sectional study in which HbF values of known HbSS patients along with HbAS and HbAA controls were analysed using High Performance Liquid Chromatography. Socio-demographic and other information were obtained with the use of questionnaire. Data was analyzed using SPSS software, version 20.0. Ethical approval was obtained for the study. RESULTS: One hundred and two (102) participants were recruited for the study, comprising 60 patients with HbSS, 22 HbAS and 20 HbAA controls, with mean age of 11.0 years±9.6, 11.7 years ±8.8 and 12.3 years±8.1 respectively. There were 30 (61.2%) males and 30 (56.6%) females for HbSS group, 9 (18.4%) males and 13(24.5%) females for HbAS group and 10(20.4%) males and 10(18.9%) for HbAA group. Mean HbF level among HbSS participants was 8.0 ±6.1% and was significantly higher than that of HbAS (3.0 ±3.4%) and HbAA (2.2 ±4.1%) control (P<0.05). Mean HbF level was higher in children (<18 years) than adults (e"18 years) among HbSS, HbAS and HbAA participants, though not statistically significant (p >0.05). Mean HbF level was also higher among female HbSS, HbAS and HbAA groups compared to corresponding male groups, though only HbSS female group was significant (p = 0.031). CONCLUSION: Patients with HbSS have significantly higher HbF level than individuals with HbAS and HbAA. Foetal haemoglobin level tend to decrease with advancing age and higher in females. Increased HbF level may play a compensatory mechanism in sickling in HbSS, thus the use of agent that increase HbF level may improve clinical outcome.

CONTEXTE: L'anémie falciforme (SCA, HbSS) est un mal de l'hémoglobine avec une variation marquée de la manifestation. Le but de cette étude était de déterminer le fœtus le statut d'hémoglobine (HbF) des patients atteints d'HbSS, par rapport à celle des personnes ayant un contrôle de l'HbAS et de l'HbAA ainsi que établir la relation entre le taux d'HbF et l'âge et le sexe des participants. MÉTHODES: Il s'agissait d'une étude transversale dans laquelle l'HbF valeurs des patients HbSS connus ainsi que l'HbAS et l'HbAA les contrôles ont été analysés à l'aide d'un liquide haute performance Chromatographie. Informations sociodémographiques et autres ont été obtenus à l'aide d'un questionnaire. Les données ont été analysées à l'aide du logiciel SPSS, version 20.0. L'approbation éthique a été obtenue pour l'étude. RÉSULTATS: Cent deux (102) participants ont été recrutés pour l'étude, comprenant 60 patients avec HbSS, 22 HbAS et 20 contrôles HbAA, avec un âge moyen de 11,0 ans ± 9,6, 11,7 ans ± 8,8 et 12,3 ans ± 8,1 respectivement. Il y avait 30 (61,2%) hommes et 30 femmes (56,6%) pour le groupe HbSS, 9 hommes (18,4%) et 13 femmes (24,5%) pour le groupe HbAS et 10 hommes (20,4%) et 10 (18,9%) pour le groupe HbAA. Niveau moyen d'HbF parmi l'HbSS participants était de 8,0 ± 6,1% et était significativement plus élevé que celle du contrôle HbAS (3,0 ± 3,4%) et HbAA (2,2 ± 4,1%) (p <0,05). Le taux moyen d'HbF était plus élevé chez les enfants (<18 ans) que chez les adultes (e "18 ans) chez les participants HbSS, HbAS et HbAA, cependant non statistiquement significatif (p> 0,05). Le taux moyen d'HbF était également plus élevé parmi les groupes féminins HbSS, HbAS et HbAA par rapport aux groupes masculins correspondants, mais seulement au groupe féminin HbSS était significative (p = 0,031). CONCLUSION: Les patients atteints d'HbSS ont des Taux d'HbF que les individus avec HbAS et HbAA. Fœtal le taux d'hémoglobine a tendance à diminuer avec l'âge et plus élevé chez les femmes. L'augmentation du niveau d'HbF peut jouer un rôle compensatoire mécanisme de la faucille dans l'HbSS, donc l'utilisation d'un agent qui l'augmentation du taux d'HbF peut améliorer les résultats cliniques. Mots clés: hémoglobine fœtale, liquide haute performance Chromatographie, drépanocytose, traits drépanocytaires, normaux l'hémoglobine adulte.

Penopubic testicular ectopia with bilateral cryptorchidism presenting as obstructed inguinal Amyand's hernia.

Testicular ectopia is an aberrant deviation of the migration of the testis from its usual path of descent into the scrotum. Of the forms of ectopic testis, the penopubic (also called pubopenile) type is one of the least common; in this case, presented as an obstructed hernia. We report a rare case of penopubic testicular ectopia with bilateral cryptorchidism in a 17-year-old boy who presented to the emergency room with right obstructed inguinal hernia. Intraoperative findings included bilateral cryptorchidism, hernia sac with right undescended testis and normal vermiform appendix, a left penopubic testis abutting the hernia sac. Both testes had separate epididymides and adequate length of vasa deferentia and were transposed into their respective hemiscrotum via an open inguinal approach. The patient had an uneventful recovery. Penopubic testicular ectopia can present as obstructed Amyand's hernia. Early open groin exploration with orchidopexy was satisfactory.

Popliteal fossa reconstruction with medial genicular artery flap in a low resource setting: A report of two cases.

BACKGROUND: Popliteal fossa defects are common arising from several causes. Options of reconstruction around the knee could be limited by the cause of defect or interventions. Medial genicular artery flap is known in the books but not in popular use despite its obvious advantages of superior vascularity, adequate size, suppleness, and hidden donor site. AIM: To promote the use of this flap due to its advantages and ease of use especially in resource poor settings. PATIENTS AND METHODS: We report two patients from a low resource setting aged 23 and 20 years respectively. The first case was managed for avulsion wound of the popliteal fossa while the second had post burn knee contracture release. The resultant large popliteal fossa defects on both patients were seen on clinical examination. Both patients were offered popliteal fossa reconstruction for the popliteal fossa defects using medial genicular artery flap with good outcome. CONCLUSION: The medial genicular artery flap is a veritable option of popliteal fossa reconstruction especially for defects that are located contiguous to the flap and when other regional flap options are not available. Flap survival is excellent and donor site is hidden.

Necrotizing soft tissue infection of both ear lobules occurring concomitantly in a set of twins following non-aseptic ear piercing: a case report.

BACKGROUND: Necrotizing soft tissue infection of the ear following ear piercing is a very rare condition. It is easily misdiagnosed leading to reconstructive morbidities and mortality in neonates. High clinical suspicion is important for early diagnosis. Our knowledge, this is the first case reported in the literature in this unique initial presentation. We hope to heighten the awareness of necrotizing soft tissue infection of the ear following ear piercing to ensure early aggressive intervention. CASE PRESENTATION: We report a set of 19-day-old female twin neonates who developed bilateral ear sores following ear piercing in a primary healthcentre without adherence to surgical asepsis. Examination findings showed features consistent with necrotizing soft tissue infections of the ears. They were successfully managed with antibiotics and wound care. CONCLUSION: Necrotizing soft tissue infections is a very rare complication of neonatal ear piercing. It may occur following suboptimal aseptic procedure and a high index of suspicion is necessary to make this diagnosis to ensure early intervention and to forestall the potential reconstructive morbidities and mortality associated with late recognition. Adherence to basic aseptic surgical principles is the key to prevention of necrotizing soft tissue infections.

Antibiotic use among surgical inpatients at a tertiary health facility: a case for a standardized protocol for presumptive antimicrobial therapy in the developing world.

BACKGROUND: Indiscriminate antimicrobial use is one of the greatest contributors to antimicrobial resistance. A low level of asepsis in hospitals and inadequate laboratory support have been adduced as reasons for indiscriminate use of antimicrobials among surgical patients. At present, there are no guidelines for presumptive antibiotic use in Nigeria and sub-Saharan Africa. AIM: Surgical inpatients at the study hospital were surveyed to determine the level of antimicrobial use and degree of compliance with prescription quality indicators. METHODS: A cross-sectional survey was conducted among all surgical inpatients in May 2019 using a standardized tool developed by the University of Antwerp to assess the point prevalence of antimicrobials. Inpatients who were admitted from 08:00 h on the day of the survey were included. Data on patients' demographics, indication for antimicrobial use, reason for antimicrobial use, stop/review date, adherence to guidelines and laboratory use were collected. The prevalence of antimicrobial use in the surgical department was estimated. RESULTS: Eighty-two inpatients were included in the survey. Of these, 97.6% were receiving at least one antimicrobial agent. Only 5.4% of the prescriptions were targeted, and 37.6% of prescriptions were for empirical treatment of infections. Approximately half (50.7%) of the patients were receiving presumptive antibiotics, and 6% were receiving prophylactic antibiotics. In total, 58.7% of prescriptions were administered parenterally, and 98.2% of patients had documentation of a stop/review date. Metronidazole (P=32.3%, T=29.2%), ceftriaxone (P=28.4%, T=19.8%) and ciprofloxacin (P=14.2%, T=14.6%) were the most common antimicrobials used. CONCLUSIONS: There is a high rate of antimicrobial use among surgical inpatients, and the rate of indiscriminate antimicrobial prescribing among these patients needs to be reduced. This can be achieved by developing antimicrobial guidelines for presumptive antimicrobial therapy.

CLEFT LIP, ALVEOLUS AND PALATE IN AFRICAN NATIVES: AN UPDATE ON DEMOGRAPHICS AND MANAGEMENT OUTCOME.

BACKGROUND: Development of craniofacial structures is a complex process and disruption of any of the numerous steps can lead to development of oro-facial clefts. This is a surgically amenable anomaly as from early life that has had conflicting pattern of demographics reported by various researchers globally. There are several factors that are critical to the surgical outcome. OBJECTIVE: Study the demographics and the management outcome of cleft lip, alveolus and palate and highlight factors responsible for improved care in recent time. DESIGN: Descriptive cohort study. SETTING: Tertiary health institution. METHOD: All consecutive patients managed for cleft lip, alveolus and palate (CLAP) over 7years and 10months were studied. OUTCOME: Cleft lip, alveolus and palate repair was performed on 149 patients, January 1, 2001- December 31, 2008 with an incidence of 2.1/1000 live births. From this, 27 patients, averaging 4.5 patients per year were operated for the first 6 1/3 years while the remaining 122(81.9%) the next 1 1/2 years, averaging 81.6 patients yearly. Their ages ranged from 3 months - 60 years with 77 (51.7%) males and 72 (48.3.0%) females. Cleft lip was the main presentation in 108(72.5%) of which 72(66.7%) were left sided. Bilateral cleft lip were14 (9.4%). Five (3.4%) patients had associated anomalies out of which 3(60.0%) had CLAP while 2(40.0%) isolated cleft lip or palate. The technique for cleft lip repair was Millard's and Noordhoof's while palatal cleft was the two-flap palatoplasty with intravelar veloplasty. Success was recorded in 142(95.3%) with complication observed in 7(4.7%) patients. CONCLUSION: The rarity of cleft lip, alveolus and/or palate in the African native documented previously may no longer be tenable as observe in this study. Management outcome has improved owing to the collaboration with SmileTrain, USA, along with multidisciplinary approach.

Experience with rubber band ligation of hemorrhoids in northern Nigeria.

BACKGROUND: Treatment of hemorrhoids in Nigeria is usually done by the traditional open method that requires hospital admission; anesthesia and is associated with high morbidity. Rubber band ligation is a suitable alternative to open hemorrhoidectomy and has the potential to reduce the need for hospital admission. PATIENTS AND METHODS: This was a prospective analysis of consecutive patients presenting with hemorrhoids that were suitable for surgical treatment to the Jos University Teaching Hospital and the Federal Medical Centre Gombe from January 2008 to December 2010 (24 months). RESULTS: A total of 232 rubber band ligations were performed on 40 patients whose ages ranged from 20 to 54 years with a mean age of 37.1 ± 12.2 years. There were 24 males and 16 females (M:F::2:3). Thirty-nine patients (97.5%) were cured of their symptoms following the procedure, and 1 patient (2.5%) had severe pain as complication of the treatment. Another patient had recurrence that was treated by repeat rubber band ligation. CONCLUSION: We conclude that rubber band ligation is a safe and reliable way for outpatient treatment of hemorrhoids in Nigeria.

Pattern of urological malignancies seen at Federal Medical Centre Gombe North Eastern Nigeria.

BACKGROUND: The incidence of urological malignancies is on the increase globally like most other malignant tumours. There is generally poor documentation of urological malignancies in Nigeria attested to by the paucity of literature on this subject matter. This study was carried out to document the pattern and distribution of urological malignancies seen at Federal Medical Centre, Gombe, North Eastern Nigeria. MATERIALS AND METHODS: This was a retrospective analysis of all pathologically proven urological malignancies seen at this centre from January 2000 to December 2007. All records of patients with the diagnosis of urological malignancies were retrieved from the histopathology registers, operation registers and patients' case notes. The patients' biodata including their ages, sex and tumour site were extracted and analysed. RESULTS: A total of 118 cases of urological malignancies were recorded during the 8 years under review. Ninety-nine (83.9%) ocurred in males while the remaining 19 (16.1%) were in females giving a male: female ratio of 5:1. Children comprised of nine 9 (7.6%) and adults 109 (92.4%) of the population. The organ specific frequency of occurrence of the tumour in descending order comprised of prostate 63 (53.4%) bladder 33 (28.0%), kidney 17 (14.4%), testes 3 (2.5.%) penis 2 (1.7%) ureter and urethra (0%). CONCLUSION: We concluded that prostate, urinary bladder and renal carcinomas are the three most common urological malignancies in North Eastern Nigeria.

Congenital amputation involving the hands and feet: a case report.

BACKGROUND: Congenital amputation of the limbs is not uncommon. However, it is very rare when this involves both the upper and lower limbs. METHOD: This is a case report of a child who presented with congenital amputation involving both the upper and lower limbs. RESULTS: The patient was a 10-day-old baby girl that was delivered by a 21-year-old woman. She is the first and only child of the woman, whose pregnancy was uneventful and was carried to term. There is no family history of congenital anomalies. The findings on examination were: amputation of the index, middle and ring fingers at the level of metacarpophalangeal joints on both hands and a partial amputation (at the level of the middle phalanx) of the left little finger. There were forefoot amputations on both lower limbs. Scars were noticed over the amputation stumps with no associated congenital anomaly. CONCLUSION: Congenital amputation involving all limbs as an isolated entity is a rare condition; the cause of which is probably as a result of congenital amniotic bands.

Isolated bilateral macrostomia : case series and review of literature

Macrostomia is a rare congenital anomaly of the face; especially the isolated type. This report aims to document our experience inmanaging this rare pathology. All consecutive cases of children managed for isolated bilateral macrostomia at the Jos University Teaching Hospital were retrospectively reviewed. Five patients; aged between 10 weeks and 30 months were managed. They were all females and presented with bilateral symmetrical transverse lateral facial cleft (macrostomia). There were no associated anomalies; and no family history of facial clefts or any other congenital anomaly. All the patients had repair of the defect under a general anaesthesia with satisfactory outcome. Macrostomia can present as an isolated entity. The final outcome of the repair depends on the technique of repair; function of the orbicularis oris muscle and the quality of scar