Typhoid perforation in Maiduguri, Nigeria

Background: Typhoid fever is still a serious health burden in our environment. Though it is primarily a medical problem, its complications such as perforation require the attention of the surgeon. The disease spears no age or sex; including pregnant women. Four patients with pregnancy and pregnancy related conditions were managed during this period of review and this actually stimulated this study. Method: This is a retrospective study of all patients managed for typhoid perforation over a five-year period in University of Maiduguri Teaching Hospital. Results: Four hundred and sixty-seven patients were managed for typhoid fever in University of Maiduguri Teaching Hospital during the 5-year study period. Forty-three (9.2%) of these patients had typhoid perforations. There were six (14%) deaths among those patients with perforations. High rate of mortality was noted among those with pregnancy and pregnancy related perforations (50%) and multiple perforations requiring resection and anastomosis (100%). Conclusion: The morbidity and mortality associated with typhoid fever in our environment can only be reduced significantly when the nation and public health officials begin to pursue the principles of primary health care with all seriousness it deserves i.e. emphasis on provision of potable water supply and sanitation. Key Words: Typhoid perforation, pregnancy, public health Annals of African Medicine Vol.3(2) 2004: 69-7

Fracture patternsas seen at the accident and emergency department of the university of maiduguri teaching hospital Nigeria: - a five year prospective study

Most trauma resulting from vehicular accidents or otherwise, often involve the skeleton (made up of 206 bones), resulting into a fracture. Fractures are a cause of high morbidity and occasionally mortality. Objective: The aim of this study is to analyze the anatomical regions most involved, fracture types, their causes, outcome of treatment and the commonest complication of the fracture in our environment. Method: A five year prospective study (January 2005 to December 2009) was undertaken. All patients presented at the Accident and Emergency Unit of the University of Maiduguri Teaching Hospital, both fresh and old fractures were included. All were followed up to discharge from the hospital and some years after. Those that died were noted. A proforma was used to collect the data. Follow up was between 2 to5 years. Results: During the period of the study, there were 24, 041 emergencies that reported to UMTH, 6,535(27.2%) were due to RTA and 596 (2.5%) had fractures, presenting with 677 fractures. There were 477(80.2%) males and 189(19.8%) females, giving a ratio of 4:1. The lower limbs were affected in 247(41.5%) patients, upper limbs in 146(24.6%), more than one region 54(9.1%), maxillofacial 47(7.9%), skull 41(6.9%), spinal fractures 33(5.5%) andpelvic fractures 28(4.7%). There were 435(73.2%) motor vehicular cases, (3.4%) follows domestic accidents and11(1.9%) from assaults. There were 66 associated injuries. Conclusion: Fractures occurred in about 10% of RTAs with males more involved than Females (4:1) and motor vehicular accidents causing most of the fractures. The lower limbs were more involved and most of the fractures were closed. Association with head injury leads to more mortality

Aberrant axillarybreast carcinoma: a case report andliterature review

Ectopic breast tissue (EBT) develops along the mammary line owing to incomplete embryologic regression of the mammary ridges. This includes supernumerary breasts and aberrant breast tissue, in which malignancy is rarely reported. The commonest site of ectopic breasts is at the axilla, and the subcutaneous axillary mass may pose a diagnostic challenge to theclinician. Case Report: We report the case of a 31 year old multiparous Nigerian woman who presented with a painless left axillary mass of two months' duration. The anatomical breasts were grossly and radiologically normal. A diagnosis of aberrant breast carcinoma in her left axilla was confirmed by tissue biopsy. She had wide local excision and left axillary dissection, followed by one course of cytotoxic chemotherapybeforeshe began radiotherapy. Conclusion: Malignancy of aberrant breast tissue is a rare entity. A high index of suspicion and a low threshold for biopsy of subcutaneous lesions in the periphery of the breast allows for early intervention and a better prognosis. Triple assessment with clinical, radiological and pathological assessment of lesions in the axilla or along the embryonic milk line can not be over-emphasized

A Histological Analysis Of Malignant Tumours Of Skin In University Of Maiduguri Teaching Hospital (UMTH), Nigeria

Objective: To describe the demographic characteristics and anatomical distribution of skin malignancy as seen at the University of Maiduguri Teaching Hospital. Methods: This study retrospectively reviewed cases of skin cancer diagnosed between January 1991 and December 2000 in the Histopathology Department of University of Maiduguri Teaching Hospital. Results: A total of 313 cases of skin malignancy were histopathogically diagnosed. The male, female ratio was 1:5.1 and the peak age incidence was in 6th decades of life. The non-melanoma, skin cancer (squamous cells carcinoma) was the commonest epidermal malignancy and accounted for 148 (47.3%). Kaposi's sarcoma was the commonest cutaneous sarcoma with 49 (15.7%) and all the cases were of melanomas were diagnosed above the age of 40 years and all occurred on the leg and foot. The lower limb (leg and foot) was the mutual site of skin malignancy, which accounted for 160 (51.1%). Childhood skin cancers are rare. Conclusion: Skin cancer is not uncommon among the black population. Nigerians suffer from late presentation of the disease. The incidence of skin cancer can be prevented or reduced through public health education or early diagnosis of skin lesion and prompt medical treatment. Key words: Skin Malignancy, Epidermal, Cutaneous. Highland Medical Research Journal Vol.1(2) 2002: 38-4

Testicular Biopsy In The Evaluation Of Male Infertility In Maiduguri North-Eastern Nigeria

Objective: To evaluate testicular biopsy in the management of male infertility in the university of Maiduguri Teaching Hospital. Method: This study reviewed retrospectively testicular biopsy in the infertile males managed at University of Maiduguri Teaching Hospital between january 1991 and December 2000. Result: Forty-six patients had testicular biopsy for infertility as part of their investigations. Mean age at presentation was 33.8 years and mean duration of marriage before presentation was 5.9 years. Forty-one (80%) had primary infertility and 5 (11%) secondary infertility. Twenty-eight (60.9%) had history suggestive of urethritis. Bacteriospermia was detected in 14 (30.4%). Thirty-three (71.4%) of the patients had azoospermia while 16 (34.8%) had severe tubular atrophy. Six (13.04%) of the patients with normal spermatogenesis but had bacteriospermia were able to achieve fertility after adequate antibiotic therapy. Conclusion: Though infertility can be caused by many factors, infection appears to be among the major contributors to infertility in this environment. Key words: Testicular biopsy, male infertility, north-eastern Nigeria. Highland Medical Research Journal Vol.2(1) 2004: 37-4

Arrow injuries in North Eastern Nigeria

Background: Arrow injuries are common presentation at the Federal Medical Centre (FMC), Nguru, North East Nigeria. The injuries are mostly unreported and there is neither a policy nor an action plan to curb their incidenceAim: To establish an accurate data base for this clinical entity in this part of Nigeria and suggest ways to curb it. Methods: A prospective study of all patients presenting with arrow shot injuries at FMC, Nguru, from January 2007 to June 2009. The age, gender, tribe, occupation, motive of assault, perpetrator information, part of body injured, treatment given and outcome were collected in a proforma.  The data was analyzed using Microsoft Excel.Results: All 57 patients seen were males. Their ages ranged from 13 to 60 years, with the mean age of 32.9±12.2years. The peak age incidence was 21-30years, accounting for 21cases (36.8%). Fighting between herdsmen and farmers over grazing land was the most common cause of arrow shot injuries, accounting for 25 cases (43.9%), followed by armed banditry with 17 cases (29.8%). Fighting over women was the cause in 10 cases (17.5%). Most of the patients had high Revised Trauma Score. Resuscitative and surgical procedures carried out resulted in recovery of 55 patients. Two patients with the highest number of arrow shots (11 and 4 each) and low Revised Trauma Score of  2 and 4 respectively, died pre-operatively.  Conclusion: The rate of arrow shot assault injuries in the North East of Nigeria remains  high with its attendant morbidity and mortality. It stems mainly from interpersonal conflicts between herdsmen and farmers over grazing land. Mapping out of grazing lands away from farm lands, enlightenment campaigns, improvement of socio-economic conditions as well as enforced legislative control on the use of bow and arrow will go a long way to reduce the incidence of arrow shot injuries in the region.&#160

An audit of non-fatal assault injuries treated in Federal Medical Center(FMC), Nguru, North East Nigeria

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