Torsed Intraabdominal Testis: A Rarely Considered Diagnosis

Cryptorchidism, or maldescended testis, is a common problem encountered in pediatric age groups. Despite more than 100 years of research, many aspects of cryptorchidism are not well defined and remain controversial. However, cryptorchidism clearly has deleterious effects on the testis over time.1–

Pattern and outcome of management of fractures in a Nigerian community

Background: There has been increasing incidence of road traffic accidents and gun shot injuries in Benin City in the recent past. A major complication of these events is fracture of the bones. Various patterns of fractures are reported from different communities. Aim: To determine the pattern and outcome of fractures in Ikpoba Hill, a sub-urban community in Edo State. Methods: A retrospective study of all cases of fractures that presented to “Our Medical Centre” in Ikpoba Hill, a sub-urban community in Edo State between January 1998 and December 2004 was carried out. Parameters analysed included age, sex, and occupation, cause of fracture, site of fracture, associated injuries, treatment offered and outcome of management. Results: A total of 285 cases of fractures were seen over the period of study. There was a steady increase in the number of cases of fractures over the period of study. The 20 -29 years age group was more commonly affected (25.61%). The male: female ratio was 1.9: 1. Civil servants and business people were most commonly affected (36.49% and 24.56% respectively). The humerus was the bone most commonly affected (24.32%). Road traffic accident was the commonest aetiological factor accounting for 80%. Some 69.47% of the cases discharged themselves against medical advice to seek help with a traditional bonesetter. Head injury was the commonest cause of death (44.44%). The average duration of hospital stay was 21 days. Conclusion: Road traffic accident was a common cause of fracture. The humerus was the bone most commonly fractured. Most patients with fracture prefer to patronize the traditional bone setters. Public enlightenment campaign should be mounted to discourage the attitude of most patients with fracture seeking help in traditional bonesetters\' place. Port Harcourt Medical Journal Vol. 1(1) September 2006: 17-2

Analysis Of Gunshot Injuries In A Semi-Urban Community In Nigeria

Background: Gunshot injuries are taking a worrisome dimension in all parts of Nigeria with associated significant morbidity mortality. Most cases of gun shot injuries in our community prefer to be managed by traditional healers rather than medical doctors. The purpose of this study is to evaluate the pattern and outcome of gun shot injuries in Ikpoba Hill; a sub-urban community in Edo State. The study also seeks to determine incidence of gunshot injuries as seen at the study centre and to also determine why most patients with gunshot injuries prefer to be managed by traditional healers.Patients and Methods: The case files of all the cases of gunshot injuries managed at Our Clinic/Medical Centre over a five year (January 2003 to December 2007) period were analysed.Results: Gun shot injuries were more common in individuals in their 3rd decade of life and most injuries occurred between the hours of 1.00am and 4.00am. Pellets were the commonest offending agents and superficial soft injuries were the commonest form of injuries. Over 60% of the patients discharged themselves against medical advice. Late presentation was a prominent finding in most patients. The case fatality was 5.8%; sepsis being the commonest cause of death.Conclusion: Gunshot injuries are quite common in Benin City. Most of thepatients present very late with attendant consequence of significant morbidity and mortality. Health education is essential in this regard with a view to encouraging early presentation to hospital.Keywords: Analysis of gunshot injuries

Pattern And Outcome Of Road Traffic Accidents In A Suburban Community In Nigeria

Background: There is an increase in the incidence of road traffic accidents in Nigeria, with evidence of poor data from many sub-urban communities.Objectives: To determine the pattern and outcome of road traffic accidents and their management, with a view to identifying control measures and help reduce morbidity and mortalityPatients and Methods: A retrospective study of cases of Road Traffic Accidents in Ikpoba-Hill (a sub-urban community in Benin City, Nigeria), that were managed at ‘Our Medical Centre” (a private medical facility) was carried out. The period studied was from January 2003 to December, 2007. The demographic characteristics, injuries sustained, time of accident, treatment offered and outcome were analysed. The data were obtainedfrom the case files of the patients.Results: A total of 825 patients who had road traffic accidents were studied. The incidence was lowest in year 2003 (17.6%) and higher in year 2007 (23.5%). The 20 – 29 year age group was the most vulnerable (33.0%). About 55.8% were males while 44.1% were females. Students (36.9%), motorcycle riders (19.4%) and business people (12.0%) were mostly involved. Lacerations and abrasions were the commonest injuries(64.3%) followed by fractures (12.5%). Humerus was the most commonly fractured bone (33.3%), while 24.9% had compound fracture. Road traffic accident was most common between 16.00hrs and 19.00hrs. Mortality rate was 7.0% and the commonest cause of death was head injury (48.3%). Cases of discharge against medical advice constituted 14.7%.Conclusion: The epidemiology of cases of road traffic accident in this community reveals several areas of prevention. There is the need for health education for the road users to keep to the rules that will ensure road safety. There is also the need to health educate our patients against the common practice of discharge against medical advice as most of the patients studied discharged against medical advise in order to obtain carefrom traditional healers.Keywords: Pattern, outcome of road traffic accident

Trauma Preparedness In Nigeria: A Questionnaire Survey

Background: The world burden of trauma is increasing more so in developing countries with increasing incidence of road traffic accidents, urban and rural violence, as well as natural and man-made disasters. A key determinant of outcome following trauma is the level of preparedness of the health care system. This study evaluated the preparedness of doctors and hospitals in Nigeria for trauma care. Methods: Questionnaire survey among all 100 participants at a National Conference of Surgeons. Results: The response rate was 68%. 55(80.9%) of respondents had never attended an ATLS course while 13(19.1%) had but only 1(1.5%) was currently ATLS certified. 38(55.9%) felt confident managing acute trauma cases, 39(57.4%) with endotracheal intubation, 33(48.5%) with laryngeal mask airway insertion, 33(48.5%) doing a crico-thyroidotomy and 43(63.2%) with tracheostomy. Respondents who reported trauma drills in their hospitals were 20(29.4%), standing trauma team 27(39.7%), disaster management team 19(27.9%) and ambulance emergency help line 14(20.6%). Conclusion: Doctors and hospitals in Nigeria are ill-prepared for trauma care. Keywords: Trauma, Preparedness, NigeriaSahel Medical Journal Vol. 10 (3) 2007: pp. 97-10

An Atypical Presentation Of Pancreatic Carcinoma With Malignant Pleural Effusion: A Case Report

Background: Pleural effusion secondary to pancreatic tumour is a relatively rare clinical presentation.Aim of study: To present a case of a patient that had pancreatic tumour who presented with features of left sided pleural effusion with a view to highlighting the clinical features of the presentation.Method of study: The case file of a patient that presented with left sided pleural effusion but later investigated and found to have carcinoma of the pancreas was studied. The clinical features and findings on examination are highlighted.Results: There was a left sided pleural effusion and computerized axial tomography scan showed a pancreatic tumour. A pancreatic and lymph node biopsies confirmed pancreatic adenocarcinoma.Conclusion: when there is pleural effusion (especially when it affects the left side) without an obvious cause, the abdomen should be thoroughly investigated for a possible occult intraabdominal malignancy.Keywords: Left sided pleural effusion, computerized axial tomography scan, pancreatic carcinoma

Haemorheological Changes in African Breast Cancer Patients

Several Studies have indicated the existence of thrombo-embolic complications in cancer patients and that this could be associated with changes in heamorheological parameters. Packed cell volume (PCV), heamoglobin (Hb), relative plasma viscosity (RPV) and plasma Fibrinogen concentration (PFC) were measured in 50 healthy control women, 50 age-matched women with breast cancer, and 10 women with histophathologically proven benign breast tumour. There were significant differences between the controls and breast cancer patients in all the parameters measured (

Femoral herniorrhaphy and its affect on fibrinogen levels

The study consists of 10 patients with features suggestive of femoral hernia who had herniorrhaphy in our Hospital. The information collected include the age, sex, and occupation. Many years ago, femoralhernia was not common in Nigerian. This must have been due to the fact that the cases were under reported and most patients, who had femoral hernia, took native drugs and hoped for the best until it becomes complicated. The fibrinogen concentration of the control was 2.21 (0.12) g/l. The fibrinogen concentration before operation was 2.12 (0.9) g/l compare with the control level of 2.21 (0.12) g/l. Fibrinogen increased significantly during operation (p < 0.001) and decreased (p < 0.001) after operation. Therefore the increase in fibrinogen level after femoral herniorrhaphy may predispose to the development of post-operative thrombo embolic complications. The measures for the prevention of thrombo embolic complications such as early mobilization should therefore be encouraged in such patients