Pattern Of Intestinal Obstruction In A Semiurban Nigerian Hospital

Intestinal obstruction remains one of the commonest causes of acute abdomen worldwide. The pattern of intestinal obstruction varies from one place to another. We report the pattern of intestinal obstruction observed in a semi urbanNigerian hospital over a 5 year period. Records of patient admitted and managed for intestinal obstruction between April 2001 and April 2006 at the federal medical centre, Owo, Southwestern Nigeria, were reviewed. Demographic data as well as parameters relating to the symptoms, duration, onset, type, diagnosis, intraoperative findings, aswell as postoperative outcomes were retrieved. All datawas entered into a personal computer and analyzed using SPSS forwindows version 11. Atotal of 95 patientsweremanaged during the period. Themean agewas 39 years.The male female ratio was 1.8:1. Adhesive intestinal obstruction was the commonest cause of symptoms in 44%, followed by volvulus in14% and external hernias in 11%of the patients. Acorrect preoperative diagnosis was made in over 70% of the patients. Out of thosewith adhesive obstruction, 75% had a previous abdominal or groin operation while 57% had surgical exploration for failed conservative management. The mean duration of hospital stay was 6 days and the overall mortality rate was 20%. Adhesive intestinal obstruction is the commonest cause in this semi-urban population which was studied. Obstructed hernia is becoming increasingly less common as a cause of intestinal obstruction. Keywords: Pattern, Intestinal Obstruction, Semiurban Hospital. Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 347-35

THE USE OF NOODLE WASTE AS A PARTIAL REPLACEMENT FOR MAIZE IN THE DIET OF TILAPIA (Oreochromis niloticus) FINGERLINGS

An 84 days study was conducted to investigate the effect of noodle waste as maize replacement on the growth performance, nutrient utilization and cost effectiveness in the diet of Oreochromis niloticus fingerlings.  One hundred and fifty fingerlings of Tilapia with average weight of 12.02 ± 0.19 (Mean ± S.D ) were distributed as 10 fish per plastic bowl (0.4m × 0.3m × 0.3m) in the wet laboratory. Five isonitrogenous experimental diets were formulated with noodle waste containing replacement of 0% (control) (D1), 25% (D2), 50% (D3), 75% (D4) and 100% (D5) as an energy source. The fingerlings were fed 5% body weight for 42days and 3% body weight for 42 days, the water was changed at every two day intervals. It was observed at the end of the experiment that noodle waste was most suitable when incorporated at 25% replacement. Weight gain (WG), Specific Growth Rate (SGR), Feed Conversion Ratio (FCR), Protein Efficiency (PE) and carcass analysis were evaluated during this study. The total weight gain, specific growth rate, feed conversion ratio, protein efficiency values of 52.14 ±1.78, 0.20 ± 0.03, 1.95 ± 0.08 and 1.49±0.05 respectively were highest in fish fed diet D2. The final weights of the fish showed significant difference P<0.05 between fish fed various diets. There was significant difference (P<0.05) in FCR among the dietary treatment. D1 is not significantly different from D2. There was also significant difference in the SGR among the dietary treatment, though D1 and D2 has no significant difference (P<0.05), there was also significant difference (P<0.05) in the incidence of cost. The carcass protein also shows significant difference (P<0.05) with the control having the highest (40.5533 ± 0.01) and D1 having close value among the treatment diet (21.033 ±0.02) and same pattern followed for the fat, NFE, moisture content. Noodle waste can effectively replace maize at 50% level inclusion rate without any negative effect on growth and fish health, but, it is produce best result as 25% inclusion level as maize replacement as an energy source. Keywords: Noodle-waste; Maize; Oreochromis niloticus; growth performance

Open hemorrhoidectomy under local anesthesia for symptomatic hemorrhoids; our experience in Ile –Ife, Nigeria

Background: Ligation-excision hemorrhoidectomy is considered the gold-standard treatment for prolapsed hemorrhoids. The procedure is commonly done under general or regional anesthesia. This study is aimed to assess the feasibility and tolerability of open – hemorrhoidectomy under local anaesthesia in our setting.Methods: This is a prospective study carried out in Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Nigeria, over a 5-year period. All consenting adult patients with prolapsing hemorrhoids were offered Milligan – Morgan hemorrhoidectomy under local anesthesia. They were assessed for tolerance and complications.Results: More than 95% of patients tolerated the procedure with manageable complications.Conclusions: Open excisional hemorrhoidectomy under local anesthesia is feasible, safe and well tolerated in our environment and may encourage early presentation of patients with piles to hospital.Keyword: Open hemorrhoidectomy, local anesthesia, Nigeria

Safety of the surgeon: ‘Double-gloving’ during surgical procedures

Background. In the face of increasing HIV/AIDS prevalence in subSaharan Africa, we evaluate the effectiveness of ‘doublegloving’ during surgery as a means of protecting the surgeon operating on patients with a known or unknown HIV status.Methods. A prospective study was conducted to determine the rate of glove puncture and intraoperative injury in categories of patients with known positive, known negative or unknown HIV status.Results. The surgeon and the first assistant double-gloved in all the 1 050 procedures performed between 2009 and 2013, and a total of 8 400 surgical gloves were used. Sixty-nine patients (6.6%) were HIV-positive, 29 patients (2.8%) were HIV-negative, and the HIV status was unknown for the remaining 952 patients (90.7%). The overall glove puncture rate in the study was 14.5%. The glove puncture rate was 0%, 31% and 15% for HIV-positive, HIV-negative and HIV status unknown, respectively, and thisdifference was statistically significant. The mean operating time in the  group with glove punctures was 148 min (95% confidence interval (CI) 135 - 161), while mean operating time in the group without glove puncture was 88 min (95% CI 84 - 92).Conclusion. Double-gloving offers protection against intraoperative injury. Knowing the HIV status of the patient offers additional protection to the operating surgeon. While we recommend routine double-gloving for surgeons working in HIVprevalent patient populations, we also advocate for the routine screening for HIV in all surgical patients

A middle aged woman presenting with massive empyema of the gallbladder: a case report

Empyema of gallbladder is generally a rare disease and it is even rarer in the traditional African population where incidence of cholelithiasis is much lower compared with the Caucasian population. This is a presentation to highlight massive empyema of the gallbladder in a 58 year old woman who had no prior history of gallstone disease and who was treated with open cholecystectomy. The outcome was successful and she was followed up for a year

Composition of native and alien invasive species in soil seed banks of five different physiognomies in Akure Forest Reserve, Ondo State, Nigeria

The study investigated the composition of native and alien invasive species in soil seed banks of five different vegetation physiognomies in Akure Forest Reserve Ondo State, Nigeria. This was done with a view to determining and providing an insight into the population dynamics of alien, invasive species for subsequent prediction of potential plant population of the extant population. Five distinct sites (Natural forest, Teak plantation, Taungya system, Taungya + Teak + Gmelina and Teak + Gmelina + Pinus Plantation) designated as A, B, C, D and E were selected in the Forest Reserve. Two plots 25 m x 25 m each were selected for sampling in each of the five distinct physiognomies. Five replicates soil samples were randomly collected at 0-15 cm soil depth in dry and rainy seasons in each site and they were subjected to seedlings emergence for six months to determine the density and species composition (natives or aliens and percentage contribution) of the seed bank. The results of the seedling emergence revealed that the seed bank was dominated by herbaceous stems and also the proportion of aliens to natives was low. Analysis of variance revealed that there was no significant difference (P>0.05) in the density of both the aliens and native species in sites A, B and C indicating similarities in the seed bank density of the aliens and natives in the three sites while in sites D and E, there was a significant difference (P<0.05) indicating dissimilarity in the seed bank density of the aliens and natives in the two sites.Keywords: Plant Ecology, Forest, Seedling Emergence, Seed Bank, Alien Species, Conservation

Ambulatory Epigastric Hernia Repair Using Local Anaesthesia: A Pragmatic Approach In A Resource Poor Society

No Abstract

Crepe bandage in the management of soft tissue limb abscesses

Objective: To determine the necessity of continuous gauze packing of abscess cavities following incision and drainage of limb abscesses.Methods: Limb abscesses managed between January, 2001 and December, 2005 were prospectively studied. The wounds were packed for the first 24hrs for heamostasis after which the limbs were randomized into two groups. The first group had daily wound dressing with packing of the abscess cavity while the second group had daily dressing of the stoma only with external crape bandaging of the abscess cavity. The wounds were inspected weekly for healing and complications. Analysis was done using SPSS 13.0. The level of significance was put at p < 0.05Results: Eighty-seven limbs were studied in 33 patients, 19 were in the right upper limb, 16 in the left upper limb, 23 in the left lower limb and 29 in the right lower limb. The mean duration for the gauze packed wounds to heal was 7.0 ±1.08 weeks while the bandaged wound took 5.2 ± 1.71 weeks to heal. This was statistically significant (p < 0.000).Conclusion: Continuous wound packing in limb abscesses after the first 24hrs should be avoided. External crepe bandaging of the abscess cavity achieve faster healing