Preoperative localization of undescended testes in children: comparison of clinical examination and ultrasonography.

BACKGROUND: Preoperative localization of the testis aids effective management of undescended testes. Various diagnostic techniques have been applied in the localization of undescended testes with varying results. The aim of this study was to compare clinical assessment and ultrasound evaluation in the preoperative localization of undescended testes in children. METHODS: A prospective evaluation of all boys undergoing operation for undescended testes at the Lagos University Teaching Hospital, Idi Araba, from July 2010 to June 2011 was carried out. The findings on preoperative clinical and ultrasound examinations were compared with intraoperative findings. RESULTS: Forty boys with 52 undescended testes were studied. The median age of the boys at the time of surgery was 4 years (range 1-11 years). Forty-five testes (86.5%) were accurately localized preoperatively by ultrasound while 25 testes (48.1%) were accurately localized on clinical examination. Ultrasound evaluation had an accuracy of 86.5% in preoperative localization of undescended testes. Clinical examination had an accuracy of 48.1% in preoperative localization of undescended testes. Ultrasound was more accurate than physical examination (p < 0.001). CONCLUSIONS: Ultrasonography is more accurate than clinical examination in the preoperative localization of undescended testes in children and could play a role in preoperative evaluation of patients with undescended testes.

Decreasing need for elective peptic ulcer disease surgery.

BACKGROUND: With the advent of potent gastric acid suppressing drugs and antibiotics effective against Helicobacter pylori, the rate of surgical operations for the treatment of peptic ulcer disease (PUD) and its complications have drastically fallen. OBJECTIVE: To audit our experience with this disease and its operative treatment at the surgical services of one tertiary health institution in Nigeria. METHODS: A-5-year retrospective audit (January 2000-December 2004) of all hospital admissions of PUD managed at the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. The case folders of those who were surgically treated were subsequently isolated and further analyzed in detail. Data collected included patient's demographics, clinical details, indication for surgical treatment, operation report and outcome of care. RESULTS: Out of 624 patients admitted with a clinical diagnosis of peptic ulcer disease into the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto during the study period, 21 (3%) were surgically treated. Of this subpopulation, 18 were males and three females; giving a sex ratio of 6:1. Their ages ranged between 30 and 62 years with a mean of 40.8 years. Thirteen (62%) of the patients had emergency procedures for life threatening complications of the disease. The remainder were operated electively. All but one survived representing a mortality rate of 4.8%. CONCLUSION: Elective peptic ulcer surgery has decreased in comparison with the emergency procedures in our centre. The advent of effective antibiotics against Helicobacter pylori and the use of potent gastric acid suppressing drugs may relegated the surgical approach to the treatment of PUD to history someday in the 21st century.

A comparative study of the ileum in rat (Rattus norvegicus), Bat (Eidolon helvum) and Pangolin (Manis tricuspis) as investigated using histological method / Estudio comparativo del íleon en rata (Rattus norvegicus), murciélago (Eidolon helvum) y pangolín (Manis tricuspis) utilizando como investigación el método histológico

The histological and morphometric differences in some parts of the gastrointestinal tracts of rat, bat and pangolin have been well established. This investigation aims at comparatively elucidating any adaptational changes the ileum of the three mammals must have adopted to meet its dietary requirements and also cope with their morphological differences. The investigation was carried out using ten rats, ten bats and ten pangolins of both sexes. The animals were slightly anaesthetized under chloroform inhalation. The intestines were harvested and the ileum excised and fixed in 10 percent formol saline. The tissues were processed for light microscopic study. The following stains were employed: Haematoxylin and eosin (H & E), Van Gieson and Verhoeff's haematoxylin elastic tissue stain. Stained slides were also analysed morphometrically. The results revealed microstructural modifications which characterized the mucosa as well as the pattern of distribution of the conjuntive tissue fibers in the ileum of the three mammals. These modifications are means of successfully coping with their respective diets and morphological differences.

Las diferencias histológicas y morfométricas en algunas partes del tubo digestivo de ratas, murciélagos y pangolines han sido bien establecidos. Esta investigación tiene por objeto aclarar comparativamente cualquier cambio de adaptación del íleon de los tres mamíferos que hayan adoptado para satisfacer sus necesidades dietéticas y también hacer frente a sus diferencias morfológicas. La investigación se llevó a cabo usando 10 ratas, 10 murciélagos y 10 pangolines, de ambos sexos. Los animales fueron ligeramente anestesiados bajo inhalación de cloroformo. Los intestinos fueron expuestos, el íleon extirpado y fijado en formol salino al 10 por ciento. Los tejidos fueron procesados para su estudio por microscopía de luz. Los siguientes tinciones fueron empleadas: Hematoxilina y eosina (H & E), Van Gieson y tinción de hematoxilina para tejidos elásticos de Verhoeff. Los cortes teñidos también se analizaron morfométricamente. Los resultados revelaron modificaciones microestructurales características de la mucosa, así como el patrón de distribución de las fibras de tejido conjuntivo en el íleon de los tres mamíferos. Estas modificaciones son el medio para entender sus diferencias en la dieta y morfología respectivamente.

The Differential Impact of Various Assessment Parameters on the Medical Students Performance in the Professional Anatomy Examination in a New Medical School / El Impacto Diferencial de Varios Parámetros de Evaluación del Desempeño de Estudiantes de Medicina en el Examen Profesional de Anatomía en una Nueva Escuela de Medicina

There is a dearth of knowledge on the level of agreement between all the various assessment tasks on the same content area, in order to test this hypothesis we adopted the concept of convergent validity and also to isolate area of academic weakness among the students and to readjust the curriculum content to balance the weakness. A blinded cohort retrospective study was carried out on a total of sixty-six third year medical students who had sat for their first professional examination in anatomy in the new medical college of Lagos State University. Using records of their grades in the various assessments parameters- the average end-in course assessment, short essays question (SEQ), multiple-choice questions (MCQ), and practical (Steeple-chase). The mean + S.D. Pearson's correlation with students t-test (p< 0.05 being significant) were analyzed using the computerized SPSS 11 (SPSS inc. Chicago, Illinois) software package. The practical was significantly correlated with overall performance (r = 0.89, p< 0.01); with the student t-value of 6.15 (p< 0.01). Although, the SEQ showed significant correlation to overall performance (r =0.72; p<0.01), the t-value of 0.4 was non-significant, but, within an acceptable range. The practical, MCQ, SEQ and end-incourse showed an overall rank order of relative performance in assessment tasks, therefore indicates that, in general, students performance in the Professional examination was better than in the end-incourse examination and hence, the need to reappraise this pattern and emphasize the role of incourse assessment in the curriculum.

Existe escasez de conocimiento sobre el nivel de concordancia entre todas las varias tareas de evalución sobre los contenidos de una misma área. En orden a evaluar esta hipótesis, adoptamos el concepto de validez convergente y también de área aislada, de falta de solidez académica entre los estudiantes y readecuar el contenido curricular para balancear esa falta de solidez. Se llevó a cabo un estudio retrospectivo al azar sobre un total de 66 alumnos de Medicina de Tercer Año, quienes tuvieron su primer examen profesional de Anatomía en la nueva Escuela de Medicina de la Universidad del Estado de Lagos, Nigeria. Usando registros de sus grados en varios parámetros de evaluación: promedio final de la evaluación del Curso, preguntas cortas de redacción, ítemes de selección múltiple y prácticas. La media + desviación estándar, correlación de Person con el t-test de Sudents (p< 0.05) fueron analizados con el programa SPSS 11 (SPSS inc. Chicago, Illinois). La parte práctica fue significativamente correlacionada con todo el rendimiento (r = 0.89, p< 0.01); con un valor del t-Students de 6.15 (p< 0.01). Aunque las preguntas cortas mostraron correlación significativa para la totalidad de lo hecho (r =0.72; p<0.01), el valor de t de 0,4 no fue significativo, pero estuvo dentro de un rango aceptable. La parte práctica, selección múltiple y preguntas cortas de redacción y final del curso, mostraron un orden de clasificación de relativo desempeño en las tareas de evaluación, lo que indica que, en general, la actividad de los estudiantes en el examen profesional fue mejor que en el examen del curso y de ahí, la necesidad de readecuar este patrón y enfatizar el rol de evaluación dentro del curso en el curriculum.