Appendicitis: Trends in incidence, age, sex, and seasonal variations in South-Western Nigeria

Background: Appendicitis is a common clinical condition worldwide. Differences in incidences, sex, age, and seasonal variations have been reported widely, with paucity of information from Nigeria.Aim: To assess the trends in incidence and pattern of variation with age, sex, and seasons of the year.Materials and Methods: A review of the records of all patients with confirmed appendicitis treated in both the LAUTECH Teaching Hospital (LTH) and the Abake Medical Center (AMC), both situated in Osogbo, Nigeria, between January 2003 and December 2008, was done. LTH was a 320-bed University Hospital (with 100 surgical beds), while AMC was a 20-bed surgical center. The age, sex, and month of admission of all the histologically proven cases of appendicitis were retrieved and treated. Analysis was done using simple percentages, Student t or Chi-square tests, where applicable.Results: A total of 299 out of 321 cases of appendicitis recorded during the observed period were confirmed histologically from both hospitals (69.56% from LTH). Fifty-two percent were males. It made up 0.94, 1.43, and 1.86% of the total hospital admissions in 2004, 2006, and 2008, respectively. There has been an increasing incidence in both sexes almost in a similar pattern. The overall mean age was 25.79 years (M 25.94 and F 25.43 years) with 6% below the age of ten and 1.3% above 60 years. The highest incidence in males and females occurred in the second and third decades, respectively. Incidences were higher during the rainy season (April to September) 68%, P < 0.05), with peaks from June to August, when 39.5% of all cases presented.Conclusion: The increasing incidence of appendicitis in both sexes in this region may be due to the change to a Western lifestyle. The age distribution has a similar pattern in both sexes and 87% are 40 years or less, although the incidence is marginally higher in males. Higher prevalence of infections and allergens from pollens in the rainy season could contribute to a higher incidence of appendicitis

Electrocardiographic changes during oesophagogastroscopy

Background: Oesophagogastroduodenoscopy (EGD) should be very safe, but there are many potential hazards, although the rate of serious complications is small. There are so many complications that can arise during this procedure. Most of these complications involve the respiratory or cardiovascular systems, especially in sick or sedated patients. The aim of this study was to determine the various electrocardiographic changes that can occur at different stages of diagnostic EGD and to determine their severity.Materials and Methods: The study is a descriptive one which was carried out at the endoscopy unit of Ladoke Akintola University of Technology Teaching Hospital, (LAUTECH), Osogbo, Osun State. Consecutive patients who were referred for oesophagogastroduodenoscopy (EGD) over a 3-month period and who consented to take part in the study were recruited. The electrodes of a portable electrocardiographic (ECG) machine (model Cardiovit AT_1ECG Machine) were attached to the patients accordingly and remained fixed till the end of the procedure. ECG recordings were done at baseline, postpremedication, during intubation and 5 minutes postprocedure. The results of the study were analyzedusing simple descriptive statistical methods such as range, mean and standard deviation for continuous variables, and numbers and percentages for discreet variables.Results: Twenty-six (26) patients were studied, comprising 14 (53.8%) males and 12 (46.2%) females. The mean age of the patients was 47.19 ± 14.42 years. Three (11.5%) patients had tachycardia at the beginning of the procedure, while 13 (50%) patients developed tachycardia  postpremedication and during the procedure, whereas 17 (65.4%) patientshad tachycardia at the end of the procedure. Only one patient had bradycardia. Various ST-T wave abnormalities were observed at each stage of the procedure. Conduction abnormality was observed in 8 (30.8%), 9 (34.6%), 7 (26.9%) and 5 (19.2%) patients at rest, post-premedication, during the procedure and postprocedure respectively. Premature ventricular complexes (PVC) were observed in 4 (15.4%), 5 (19.2%), 4 (15.4%), and 4 (15.4%) patients at rest, postpremedication, during the procedure and post procedure respectively.Conclusion: This study has shown that, although ECG abnormalities do occur during EGD, these abnormalities are not severe enough to warrant specific interventions or discontinuation of the procedure.Key words: Changes, electrocardiography, oesophagogastroduodenoscop

Bilateral Breast Cancer: Experience in a Poor Resource Black African Setting

Background: Breast cancer is the most common malignancy in women in Nigeria. Women previously treated for ipsilateral breast cancer have increased risk of developing contalateral breast cancer (CBC), the chance of which increases with longer period of survival and is associated with worse prognosis. Reports from Nigeria are few on this.The aim of this study was to assess the prevalence, predisposition, presentation, and outcome of management of bilateral breast cancer (BBC) in a population, South-western Nigeria.Methods: A review of bio-data of all patients with BBC seen in LTH, Osogbo, Nigeria between 2001 and 2008 was done. Age, parity, age at menarche and first child birth, family history, duration of symptoms, tumour characteristics and exposure to cigarette, oral contraceptive pills (O.C Pills) and outcome of treatment were also assessed.Results: BBC constituted 4.6% of the 256 breast cancer patients. Eight (73%) were metachronous and 91% were infiltrating ductal carcinoma. Patients’ mean age, mean age at menarche and first child birth were 39, 14.5+3 and 22.5yrs respectively. Mean parity was 3.5 child birth, 91% were premenopausal and all have menstruated for 12-31yrs. None had positive family history while only 1 and 3 had insignificant exposure to cigarette and O.C pills respectively. The mean interval between the 2 onsets was 18mths (0-68mths). 91% of all tumours were advance, while 81% of the first tumours were on the right. Mean duration before presentation for the first and second tumours were 261 and 111days respectively. One patient has survived for 2 years thus far.Conclusion: The incidence of BBC was 4.26%. Most patients were young and premenopausal with mostly infiltrating ductal carcinoma (NOS) and presenting with late stage disease, hence poor prognosis. Aggressive follow-up of patients with ipsilateral cancer will aid early detection of CBC

The Clinical Relevance of Diarrhoea in Patients with Suspected Uncomplicated Appendicitis

Background: Diarrhea is uncommon in uncomplicated appendicitis and when present, it tends to bring about delay in diagnosis, thus predisposing to complications.Methods: This was a retrospective study of all cases of uncomplicated appendicitis seen at LAUTECH Teaching Hospital, Osogbo, Nigeria over a 3 year period.Results: During the period under review, 153 with uncomplicated appendicitis were seen. Their ages ranged from 4 to 62 years with a median of 23.01 years. The M: F ratio was 1.15: 1. Diarrhea was more common in patients aged under 15 years (p = 0.003). Fifteen (9.8%) of the patients had diarrhea and was more common in females (12.67%) than in males (7.31%) ( p =0.201). Diarrhea was present in 4.34% and in 18.03% patients presenting before and after 72 hours respectively (p= 0.006). Fever (T &gt;38oC) was found in 91 patients, 11 of them had diarrhoea, compared to 4 of the 62 without fever ( p= 0.283 Fisher’s exact test ). There was no significant difference in rectal findings in patients with or without diarrhea (p= 1.000). The unsuspected perforation rate was 66.6% for those with diarrhoea and 0.7% for those without diarrhea ( p&lt;0.000, odds ratio of 274). About 22% and 5.3% of patients with and without pus collection respectively had diarrhea (p= 0.0049, O R 5.18). Diarrhea was significantly more associated with appendiceal perforation compared with simple appendicitis (p= 0.00001 odds ratio 77.5) and also compared with those with normal appendix (p =0.006). The median length of hospital stay was significantly higher in patients with diarrhea (p = 0.001)Conclusion: Diarrhea as a symptom of appendicitis is commoner in  children. It is associated with late presentation, more perforation, intra-bdominal pus and prolonged length of stay Key words: clinical relevance, diarrhea, appendiciti

Physical losses could partially explain modest carotenoid retention in dried food products from biofortified cassava

Gari, a fermented and dried semolina made from cassava, is one of the most common foods in West Africa. Recently introduced biofortified yellow cassava containing provitamin A carotenoids could help tackle vitamin A deficiency prevalent in those areas. However there are concerns because of the low retention of carotenoids during gari processing compared to other processes (e.g. boiling). The aim of the study was to assess the levels of true retention in trans–β-carotene during gari processing and investigate the causes of low retention. Influence of processing step, processor (3 commercial processors) and variety (TMS 01/ 1371; 01/1368 and 01/1412) were assessed. It was shown that low true retention (46% on average) during gari processing may be explained by not only chemical losses (i.e. due to roasting temperature) but also by physical losses (i.e. due to leaching of carotenoids in discarded liquids): true retention in the liquid lost from grating negatively correlated with true retention retained in the mash (R = -0.914). Moreover, true retention followed the same pattern as lost water at the different processing steps (i.e. for the commercial processors). Variety had a significant influence on true retention, carotenoid content, and trans-cis isomerisation but the processor type had little effect. It is the first time that the importance of physical carotenoid losses was demonstrated during processing of biofortified crops

Any Association Between ABO /Rh Blood Groups and Breast Cancer ?

No Abstract

Iatrogenic Digital Gangrene: Report of a Case

OBJECTIVE: The rationale of this report is to highlight warning signals and to suggest methods of minimizing the severity of the gangrene. METHOD: A 20 year old male developed gangrene of the right thumb, index and middle fingers following what was suspected to be an accidental intra-arterial injection of ketamine as an anaesthetic agent. RESULTS: Dry gangrene of the right thumb, index and middle fingers and of the right thenar eminence CONCLUSION: During administration of any intravenous drug (including and especially anaesthetic agent), aspiration of bright red blood should alert the doctor that an artery has been cannulated. Pulsation (if elicited) along the vessel concerned should be confirmatory, and such injection discontinued. Nig Jnl Orthopaedics & Trauma Vol.2(2) 2003: 134-13

Evaluation of preoperative blood ordering practice for mastectomy and thyroidectomy in a teaching hospital

No Abstract

Clinical Spectrum of Benign Breast Diseases In Osogbo, Nigeria.

No Abstract Availabl

Cancelation of elective surgical case in a teaching hospital, South-western Nigeria

No Abstrac