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

The Pattern and Outcome of Chest Injuries in South West Nigeria

Objective: The pattern and management outcome of chest injuriespresenting to our tertiary university hospital located in a semi-urbanpopulation in the South West of Nigeria, has not been documentedpreviously. We therefore sought to identify factors that may contributeto mortality.Method: We analyzed 114 patients presenting to the Accident andEmergency Unit with chest trauma, prospectively entered into a database over a two year period.Results: Chest trauma accounted for 6% of all trauma admissionswith a male preponderance (M:F = 3.6:1). Rib fractures were the mostcommon injury (46.3%) while limb fractures were the most commonassociated injury (35.8%). Associated head injury accounted for mostdeaths (56%) in those with severe ISS. Majority of patients (51.8%)required only analgesics, while additional closed tube thoracostomydrainage was necessary (41.8%) in the others who suffered blunttrauma. Thoracotomy was indicated for only 5 (4.5%) penetratinginjuries. There is a rising trend towards penetrating gunshot injuries,with mortality increasing with age (p=0.03) and severity of associatedinjuries (ISS) (p=0.003).Conclusion: Majority of the patients required only minimal interventionwith chest drainage or analgesics, with low mortality. Increasingage and severity of injury contributed significantly to mortality. Initiationof care for chest trauma victims is still delayed in our centre

Recurrence of Malignant Pleural Effusion Following Pleurodesis: Is There a Difference Between Use of Povidone-Iodine or Cyclophosphamide?

Background: Malignant pleural effusion is associated with poor quality of life. The success of pleurodesis varies with different agents, with talc being the most effective. It is however not available in Nigeria. This study aimed to determine the efficacy of povidone iodine and cyclophosphamide, the two commonly available agents for pleurodesisMethods: A prospective simple randomized enrollment of consecutive patients with malignant pleural effusion over a five year period (2008- 2012).Results: Thirty four patients were analyzed with a M:F ratio of 1:2.4. Breast cancer was responsible for almost half (47.1%) of the effusions. Although the povidone iodine group was slightly younger both groups were similar. There was no difference in the effusion recurrence for both groups. Age, duration of symptoms and cancer type were not predictors of recurrence of effusion following pleurodesis.Conclusions: Both agents are readily available and perform well with minimal side effects. However, povidone iodine being cheaper may be a more affordable alternative.Key Words: Malignant effusion, Pleurodesis, Povidone-iodine, Cyclophosphamid

Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020.

OBJECTIVES: Retinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria. DESIGN: Descriptive case study. SETTING: Neonatal intensive care units in Nigeria. PARTICIPANTS: Staff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria). METHODS AND ANALYSIS: A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. RESULTS: In 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems. CONCLUSION: ROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential

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

Lung hamartomas in Alexandra

Background: Lung hamartomas are rare tumours with compressive effects on lung parenchyma and bronchi. This is a report of our experience in the management of this condition.Methods: We retrospectively studied the records of patients with lung hamartomas managed at Alexandria University Hospital between 2001 and 2007. Information on presentation, treatment and outcome were obtained.Results: Five patients aged 35.6+14.4 years had lung hamartoma. Two patients were asymptomatic, 2 had cough and 1 presented with haemoptysis. Pre-operative diagnosis was lung carcinoma in 4 patients. Four patients had lobectomy while 1 had wedge resection. Histology confirmed fibrochondromatous hamartomas in all patients.Conclusion: Lung hamartomas should be a consideration in solitary coin lesions.Keywords: Lung hamartomas, benign tumours, lung carcinoma

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

Testicular and para-testicular tumors in south western Nigeria

Background: Tumors of the testis and paratesticular tissues are rare, especially in men of African descent. In recent reviews however, the incidence is rising among the Caucasians and black Americans. We set out to determine the incidence in South- Western Nigeria and to examine the histopathologic variants. Methods: A retrospective study of patients who had histopathologically confirmed testicular and para-testicular tumours between 1989 and 2005 (17 years). Their records were documented at the Ife-Ijesha cancer registry which serves 4.7 million men residing in three states of South-Western Nigeria. Results: There were 26 cases of testicular and para-testicular tumors with an average incidence of 1.5 cases per year. The incidence of testicular cancer in our study was 0.55 per 100,000 population (95% CI, 0.52- 0.57) and accounted for 1.1% of all male cancers. Rhabdomyosarcomas were the most common variety (70% of the paratesticular tumors and 26.8% of all tumors of the testis). Seminomas comprised 50% of the germ cell tumors and 15.4% of all testicular tumors in this series. Conclusion: There still remains a low incidence of testis cancer in the South Western Nigeria. The reduction in the incidence of seminomas makes rhabdomyosarcomas the most predominant tumor in South Western Nigeria

Predictors of death from chest trauma in a resource- poor community in Southwestern Nigeria

Background: Injuries to the chest are usually associated with increased mortality as compared with injuries to other regions of the body due to significant respiratory and hemodynamic disturbances. We aimed at determining the predictors of mortality in thoracic trauma patients in lle Ife, Nigeria. Method: This retrospective study included all patients with chest trauma who presented at the Accident and Emergency Unit of The Obafemi Awolowo University Teaching Hospital, lle Ife between 2005 and 2007. Data was analyzed using Stata version 9. Results: There was a male preponderance (M: F = 3.5: 1) in the 118 patients. Death occurred in 9.3% of patients. The mean age was 37.6 ΁ 16.6 years with a median age of 35 years. About a third (38 of 118) sustained penetrating chest injuries while others had blunt chest injuries. The causative agent included motor vehicle accidents 66 (55.9%), gunshot injuries 28 (23.7%) and falls 12 (10.2%). Others occurred as a result of stab wounds to the chest in 10 patients (8.5%) and domestic assault in 2 (1.7%) cases. Age above 40 years and complications of chest trauma such as pulmonary contusions and adult respiratory distress syndrome were positive predictors of mortality using multiple logistic regression analysis (p- 0.041 and 0.001 respectively). Conclusion: Patient′s age above 40 years and the presence of pulmonary contusions are independent predictors of mortality in chest trauma in south western Nigeria