Adult Squamous Cell Carcinoma of The Scrotum in HIV Positive Patients in Nigeria

Squamous cell carcinoma of the scrotum (SCCS) is rare, particularly in West Africa. It usually affects males older than 60 years. Although it was the first cancer to be linked to environmental factors, the mechanism of action of these risk factors is still not completely understood. We reporton 4 men who presented with SCCS at our centre during a 20-month period. Three patients were relatively younger (mean age 43 years) and tested positive for human immunodeficiency virus (HIV) infection. They had no history of exposure to any known risk factor for SCCS. Thus, it seems that SCCS may occur in younger men who have HIV infection.Key Words:   Squamous cell carcinoma, scrotum, HI

Pattern of breast masses ing Lagos: A private health facility review of 189 consecutive patients.

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Glomus tumours of the Hand in Lagos, Nigeria

Background: Glomus tumours of the hand are uncommon intriguing tumours which cause significant morbidity. Few reports have documented the epidemiology and presentation in the West African subregion. The aim of this review is to identify the common baseline demographics, the presentation, evaluation, diagnosis and treatment outcome of glomus tumours of the hand in Lagos, Nigeria Methods: A 10 year retrospective review of the records of all patients seen with histopathologically diagnosed glomus tumor of the hand at the Lagos University teaching hospital was carried out noting the biodata, demographics, method of presentation and treatment of this condition. Results: 11 patients were seen over the study period .There were nine females and 2 males seen. The mean age of the patients was 41 years. The symptoms had been on for between 3 and 40 months .All patients seen had a positive Love test. Only one patient had associated bony erosion. All had complete excision with no recurrence at 6 months Conclusion: Glomus tumor of the hand is an uncommon tumour often occurring in adult women. Clinical test (Love “test”) will correctly identify the diagnosis. Surgical treatment was curative in all our cases. High index of suspicion is needed to make earlier diagnosis

Paediatric Hand Injuries At The Lagos University Teaching Hospital

Background: Paediatric hand trauma represents a subset of hand injury that can be quite challenging to manage. Local studies on this injuries are few therefore a 4 year retrospective study at the Trauma and hand rehabilitation unit of the Lagos University teaching hospital was carriedout. Objectives: To determine the percentage of hand trauma occurring in the paediatric age group, the predominant age group involved, place of injury, the major injury types occurring as well as the most common surgical procedure required. Methods: The case records of all cases that presented at the hand rehabilitation clinic or the emergency center of the Lagos University teaching hospital over a 4 year period were reviewed. Those below the age of 12 years were studied. Their biodata, type of injury, place of injury and other details were obtained. Results: 634 patients were seen over the study period, 61 cases of hand injuries were in the paediatric age group. Hand trauma constituted less than a third of all paediatric hand cases. The commonest age group affected was 2-6 years. Most of the injuries occurred around the home. Burns injury, blunt trauma, glass and knife cuts were the commonest causes of hand trauma. Soft tissue reconstruction was commonest procedure done. Conclusion: Infants and toddlers were the most vunerable groups while burns injury was the commonest cause of hand trauma seen at the Lagos university teaching hospital.Key words: Paediatric, hand, injury, LUT

Epidemiological profile of open fractures at Lagos University Teaching Hospital Lagos Nigeria

Background: Open fractures remain a challenge for orthopedists' as far as stabilization, alignment and skin coverage are concerned all these aside from possible infection. They represent severe injuries with high socioeconomic impact.Objective: To define the epidemiological profile of patients with open fracture.Methods: A prospective study of open fracture at the Lagos University Teaching Hospital between July 2008 and June 2011 was carried out using a designed proforma. Data collected included biodata, aetiology of fractures, fracturesite, injury-duration interval, type of treatment, associated lesions, outcome as well as complications.Results: A total of 261 patients presented with open fractures over a 3year period between July 2008 and June 2011. The studied patients were aged 1 to 85 years with a mean of 32.59 ± 1.23 years. One hundred and ninety (72.8%) were aged below 40years. There were 200 males and 61 females showing male to female ratio 3:1. Road traffic accident was the most common aetiology (80.12%). The most frequently seen fractures were tibia 56.7%, fibula 12.6%. Associated injury was other closed fractures 38.7%. Others were vascular 16.12%, head injury 12.90% and infection rate was 7.3%. An overwhelming majority (64%) were treated with plaster of Paris (Non- operatively)Conclusion: This study has shown that open fractures of the lower limb were commoner than upper limb fractures. Majority of the injuries were caused by road traffic accident of which motorbike and automobile-pedestrian accident accounted for over 38%. It is our belief that appropriate education of road users and diligent enforcement of the laws will reduce these injuries. It is obviously important forthe orthopaedic surgeon to be familiar with the epidemiological characteristics of open fractures and aim for optimal outcome, prevent complications and decrease hospital stay and cost.Keywords: Open fracture, Plaster of Paris, Flap

Genito-urinary system injuries in Lagos: pattern and general treatment outcome

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The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran