The prospect of anatomy as a career choice among clinical year medical students in Nigeria

Background : Medical doctors are potential important source of anatomy teachers. The aim of this study was to determine the choice of anatomy as a career option among medical students in a Nigerian medical school Method : Descriptive survey of second- and third-year medical students using a self-administered questionnaire to asses age, sex, perception of anatomy as a subject, anatomy training experience and choice of anatomy as a career among respondents. Analysis was conducted using the SPSS and statistical significance inferred at P< 0.05. Results : Three hundred and fifty three (85.3% response rate) who completely filled questionnaire were returned and analyzed of which 195 (55.2%) were males and 158(44.8%) were females. Their ages ranged between 18 and 37 years with a mean of 22.4 \ub1 9.9 years. Although most students agreed that anatomy was an important subject in medical sciences 346 (98%), they had benefited from anatomy training in their clinical classes 320 (90.7%), and the knowledge of anatomy is useful in investigating patients with certain diseases 251 (71.1%), only 22 (6.2%) would choose anatomy as a career. Male students were more likely to choose anatomy as a career (P=0.026). Textbooks were the most common 334 (94.5%), while radiological means were the least 23 (6.5%) method employed in learning anatomy. Conclusion : Anatomy as a subject is perceived positively by clinical medical students, but the choice as a career option is low; attempt at increasing career interest is needful

Strangulated Tension Viscerothorax with Gangrene of the Stomach in Missed Traumatic Diaphragmatic Rupture

Acquired diaphragmatic hernias are usually posttraumatic in occurrence. In patients who have blunt trauma and associated diaphragmatic hernia, the diagnosis may be missed or delayed, often leading to poor treatment outcomes. We present a rare occurrence of tension viscerothorax due to missed traumatic diaphragmatic rupture in a 25-year-old woman whose condition was complicated by gangrene and perforation of the fundus as well as questionable viability of the anterior wall of the body of the stomach. The patient had a successful emergency transabdominal suture plication of the diaphragm and gastroplasty and has remained symptomless 3 months postoperatively

The prospect of anatomy as a career choice among clinical year medical students in Nigeria

Background : Medical doctors are potential important source of anatomy teachers. The aim of this study was to determine the choice of anatomy as a career option among medical students in a Nigerian medical school Method : Descriptive survey of second- and third-year medical students using a self-administered questionnaire to asses age, sex, perception of anatomy as a subject, anatomy training experience and choice of anatomy as a career among respondents. Analysis was conducted using the SPSS and statistical significance inferred at P< 0.05. Results : Three hundred and fifty three (85.3% response rate) who completely filled questionnaire were returned and analyzed of which 195 (55.2%) were males and 158(44.8%) were females. Their ages ranged between 18 and 37 years with a mean of 22.4 ± 9.9 years. Although most students agreed that anatomy was an important subject in medical sciences 346 (98%), they had benefited from anatomy training in their clinical classes 320 (90.7%), and the knowledge of anatomy is useful in investigating patients with certain diseases 251 (71.1%), only 22 (6.2%) would choose anatomy as a career. Male students were more likely to choose anatomy as a career (P=0.026). Textbooks were the most common 334 (94.5%), while radiological means were the least 23 (6.5%) method employed in learning anatomy. Conclusion : Anatomy as a subject is perceived positively by clinical medical students, but the choice as a career option is low; attempt at increasing career interest is needful

Early experience with open heart surgery in a pioneer private hospital in West Africa: The Biket medical centre experience

Introduction: More than forty years after the first open heart surgery in Nigeria, all open heart surgeries were carried out in government-owned hospitals before the introduction of such surgeries in 2013 at Biket Medical Centre, a privately owned hospital in Osogbo, South-western Nigeria. The aim of this paper is to review our initial experience with open heart surgery in this private hospital. Methods: All patients who underwent open heart surgery between August 2013 and January 2014 were included in this prospective study. The medical records of the patients were examined and data on age, sex, diagnosis, type of surgery,  cardiopulmonary bypass details, complications and length of hospital stay wereextracted and the data was analysed using SPSS version 16.Results: Eighteen patients comprising of 12 males and 6 females with ages rangingbetween 8 months and 52 years (mean= of 15.7 +/- 15 years) were studied. Pericardial patch closure of isolated ventricular septal defect was done in 7 patients (38.9%) while total correction of isolated tetralogy of Fallot was carried out in 5 patients (27.8%). Two patients had mitral valve repair for rheumatic mitral regurgitation. Sixty day mortality was 0%.Conclusion: Safe conduct of open heart surgery in the private hospital setting is feasible in Nigeria. It may be our only guarantee of hitch free and sustainable  cardiac surgery

Missed Distal Tracheal Foreign Body in Consecutive Bronchoscopies in a 6‑year‑old Boy

It is unusual but not uncommon for foreign bodies to be missed at bronchoscopy. This case report highlights the importance of the clinical history in the diagnosis of aspirated foreign bodies and the usefulness of chest imaging modalities. A 6‑year‑old boy presented with recurrent breathlessness and cough of 2 months. He was said to have aspirated the base cap of a pen at about the time symptoms started. He had two sessions of rigid bronchoscopy and a session of flexible bronchoscopy at three different  hospitals. He had an initial rigid bronchoscopy which failed to show the foreign body (FB). A chest computerized tomographic scan demonstrated the FB, which was retrieved at combined flexible/rigid bronchoscopy. Although rigid bronchoscopy is the gold  standard for managing airway foreign bodies, there remains a false negative rate for this procedure and where necessary,  appropriate imaging may compliment rigid  bronchoscopy, especially where there is some confusion.Keywords: Bronchoscopy, foreign body, trache

Pattern of Extremity Arterial Injury and Outcome of Repair in Southwest, Nigeria

Background: Extremity arterial injuries are an important cause of loss of life/limb after trauma. Early intervention is important for the good outcome. Objectives:&nbsp;The objective of this study is to review the pattern of presentation and study the factors that influences the outcome of extremity arterial injuries in our hospital.&nbsp;Patients and Methods:&nbsp;This is a retrospective study of all patients with injuries to the extremity arteries requiring surgical intervention from July 2007 to June 2015. Data obtained included biodata, ischemic time, arteries involved, surgical intervention, and outcomes and analyzed using SPSS version 22.&nbsp;Setting:&nbsp;Our hospital is the main referral hospital for vascular trauma serving four adjoining states in Nigeria and is linked to major cities by at least 3 Trunk-A federal roads.&nbsp;Subjects:&nbsp;The subjects are patients who were managed in our cardiovascular surgical unit for the study duration (July 2007–June 2015) who had extremity arterial injuries.&nbsp;Results: A total of 36 patients presenting with 40 arterial injuries in 37 limbs were studied. The mean age was 28.4 ± 10.3 years with male preponderance (88.9%). Gunshot injuries were the most common cause of arterial injuries (37.8%), followed by assault (27%). The mean time from injury to presentation for acute injuries was 20.4 h but 23 of the patients (63.8%) presented to the accident and emergency department within 12 h of injury. A limb salvage rate of 64.9% was achieved though ischemic times of ≥12 h were associated with poor outcomes. Conclusion:&nbsp;Prolonged ischemic time is associated with poor outcomes. Efforts should be put in place to reduce the limb ischemic times

Early experience with permanent pacemaker implantation at a tertiary hospital in Nigeria

Introduction:&nbsp;artificial pacemakers generate electrical impulses and regulate the heart´s conduction system. They are often used to treat individuals with bradycardia. Permanent pacemaker implantation is a lifesaving procedure especially in patients with symptomatic bradyarrhythmias. The objectives was to evaluate the clinical attributes and outcomes of permanent pacemaker implantation in Ile-ife, Nigeria. Methods:&nbsp;we retrospectively reviewed medical records of 22 patients who had pacemaker implantation from January 2015 to December 2019. Patient´s demographics, clinical presentation, diagnosis, comorbidities, type of device, complications and long-term follow up were studied. Results:&nbsp;sixteen males (72.7%) and 6 females (27.3%) were recruited into the study with ages ranging between 54 and 84 years and a mean of 70.3 +8.7 years. The commonest symptom was easy fatigability (45.5%) followed by syncope (31.8%). The main indication for permanent pacemaker implantation was complete heart block (86.4%). Seventeen (77.3%) patients had hypertension as the comorbidity present at diagnosis. Single chamber (VVIR) pacemaker was implanted in 13(59.1%) patients while dual chamber (DDDR) was implanted in 9(40.9%) patients. Hematoma, pneumothorax and acute lead dislodgement were the complications observed in 3 patients. There was no statistical significance between the type of device implanted and the occurrence of complications, p-value 0. 186. There was no mortality and 15 patients (68.2%) are currently attending regular 6 monthly follow-up. Conclusion:&nbsp;complete heart block is the most common indication for permanent pacemaker implantation and the procedure is safe with minimal complications and satisfactory outcomes

Pattern of extremity arterial injury and outcome of repair in Southwest, Nigeria

Background: Extremity arterial injuries are an important cause of loss of life/limb after trauma. Early intervention is important for the good outcome. Objectives: The objective of this study is to review the pattern of presentation and study the factors that influences the outcome of extremity arterial injuries in our hospital. Patients and Methods: This is a retrospective study of all patients with injuries to the extremity arteries requiring surgical intervention from July 2007 to June 2015. Data obtained included biodata, ischemic time, arteries involved, surgical intervention, and outcomes and analyzed using SPSS version 22. Setting: Our hospital is the main referral hospital for vascular trauma serving four adjoining states in Nigeria and is linked to major cities by at least 3 Trunk-A federal roads. Subjects: The subjects are patients who were managed in our cardiovascular surgical unit for the study duration (July 2007–June 2015) who had extremity arterial injuries. Results: A total of 36 patients presenting with 40 arterial injuries in 37 limbs were studied. The mean age was 28.4 ± 10.3 years with male preponderance (88.9%). Gunshot injuries were the most common cause of arterial injuries (37.8%), followed by assault (27%). The mean time from injury to presentation for acute injuries was 20.4 h but 23 of the patients (63.8%) presented to the accident and emergency department within 12 h of injury. A limb salvage rate of 64.9% was achieved though ischemic times of ≥12 h were associated with poor outcomes. Conclusion: Prolonged ischemic time is associated with poor outcomes. Efforts should be put in place to reduce the limb ischemic times