An audit of the Day-of-Surgery Cancellation of Scheduled Surgical Procedures in Sagamu, Nigeria

Background: Timely performance of scheduled surgical procedures may be an indirect method of assessing the quality of surgical services in a hospital. Objective: This study aimed to determine the rate and the reasons for day-of-surgery cancellation of elective surgical procedures. Methods: A prospective study was conducted at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria to audit the type of surgery and the reasons for the cancellation of procedure among patients scheduled for elective surgical procedures. Results: A total of 1,324 patients were scheduled for elective surgeries during the period of audit and 268 (20.2%) were cancelled on the day of surgery. One hundred and seventy-four of the 268 (65.0%) cancellations were avoidable while 94 (35.0%) cancellations were unavoidable. The reasons for the cancellation of surgeries included patient-related factors (35.0%), unfavourable pre-operative clinical evaluation (31.0%), facility-based factors (28.0%) and surgeon-related factors (6.7%). Conclusion: The day-of-surgery cancellation rate was 20.2%, and the three leading causes of cancellation of elective surgeries in Sagamu included patient-related factors, unfavourable pre-operative clinical evaluation and inadequacies of hospital resources

Urethral obstruction from dislodged bladder Diverticulum stones: a case report

BACKGROUND: Secondary urethral stone although rare, commonly arises from the kidneys, bladder or are seen in patients with urethral stricture. These stones are either found in the posterior or anterior urethra and do result in acute urinary retention. We report urethral obstruction from dislodged bladder diverticulum stones. This to our knowledge is the first report from Nigeria and in English literature. CASE PRESENTATION: A 69 year old, male, Nigerian with clinical and radiological features of acute urinary retention, benign prostate enlargement and bladder diverticulum. He had a transurethral resection of the prostate (TURP) and was lost to follow up. He re-presented with retained urethral catheter of 4months duration. The catheter was removed but attempt at re-passing the catheter failed and a suprapubic cystostomy was performed. Clinical examination and plain radiograph of the penis confirmed anterior and posterior urethral stones. He had meatotomy and antegrade manual stone extraction with no urethra injury. CONCLUSIONS: Urethral obstruction can result from inadequate treatment of patient with benign prostate enlargement and bladder diverticulum stones. Surgeons in resource limited environment should be conversant with transurethral resection of the prostate and cystolithotripsy or open prostatectomy and diverticulectomy

Quality of Sleep and Psychological Distress in Glaucoma

Background: People living with glaucoma are psychologically burdened because of the threat of visual loss. Therefore, understanding the psychosocial issues and quality of sleep holds important implications for the recognition, prevention, and treatment of emotional problems among people with glaucoma. This study investigated the quality of sleep and psychological distress among people with glaucoma. Methods: This was a cross-sectional study of adults recruited over a period of 12 weeks from a glaucoma clinic of a Teaching Hospital in south-west Nigeria. The quality of sleep and psychological distress were evaluated using the Pittsburgh Sleep Quality Index and General Health Questionnaire respectively. Results: Ninety-three adults with glaucoma participated in the study. The mean age was 62.33 ± 15.25 years. Fifty-seven (61.3%) of the subjects were poor sleepers while 27 (29.0%) were psychologically distressed. Psychological distress correlated with global sleep score (r = 0.399, p = 0.000), subjective sleep quality (r = 0.341, p = 0.001), sleep latency (r = 0.245, p = 0.018) and sleep disturbance (r = 0.279, p = 0.007). Conclusion: Psychological distress and sleep disturbances were common among patients with glaucoma. Concerns about these issues should be incorporated into routine clinical evaluations of patients with glaucoma

Abdominal Masses in Children: A 10-Year Review

Background: Some childhood diseases present with abdominal masses alone or with other constitutional symptoms. The knowledge of the common causes of abdominal masses in children can assist in developing a protocol of management by clinicians. Objective: To describe the aetiology and presentation of abdominal masses in children. Methods: The hospital records of all cases of intra-abdominal masses in children managed between May 1998 and April 2008 were retrieved for analysis. Socio-demographic and clinical data were obtained and analysed using simple descriptive statistics. Results: A total of 93 children were included while those without clinical, radiological and intra-operative evidence of intra-abdominal masses were excluded from the study. There were 49 males (52.7%) and 44 (47.3%) females with male-to-female ratio of 1.1:1. The children were aged 1 day to 14 years; 15 (16.1%) were aged 6-9 years, >9-12 years and >12-14 years. The most common cause of abdominal masses was appendiceal mass/abscess in 29%, followed by hydronephrosis in 22.6% and nephroblastoma in 16.11%. The most common symptoms included abdominal pain (86.0%), fever (46.2%), vomiting (40.9%) and abdominal distension (32.2%). The mortality rate was 13%. Conclusion: Non-malignant conditions were mostly responsible for abdominal masses in children while abdominal pain, fever and vomiting were the leading presentations of abdominal masses in children

Quality of Sleep among Adults in Sagamu, Southwest Nigeria

Sleep plays an essential restorative function and is essential for good health, good quality of life and well-being. This study aimed to assess quality of sleep in a southwestern community within Nigeria.Participants were recruited using a multi-stage random sampling technique from Sagamu community. Four hundred and sixteen participants were interviewed using a socio-demographic questionnaire, Pittsburgh Sleep Quality Index and the 12-item General Health Questionnaire. Poor sleep quality was reported by 25.7% (n=107) of the respondents. There was a significant difference in the average hours of sleep across gender (male = 7.166 ± 1.385; female = 7.640 ± 1.201, t = 3.710, p = 0.000). Respondents that were 65 years and above were likely to be poorer sleepers compared to other age groups (X2 = 5.416, p = 0.067). Respondents who were separated or divorced (52.4%), widowed (46.7%) and married (31.2%) were significantly poorer sleepers compared with those that were single or never married (14.6%) (X2 = 25.926, p = 0.000) The overall sleep quality correlated positively with age (r = 0.220, p = 0.000) and psychological morbidity (r = 0.211, p = 0.000).A good proportion of the community dwellers were poor sleepers. Sleep disturbance might represent a significant and unrecognized public health issue within the community. Keywords: Quality of Sleep, Sleep Duration, Psychiatric Morbidity and Pittsburgh Sleep Quality inde