Agbaje, E. O.

Babatunde, E. O.

Bioline International

Annals of African MedicineVol. 6, No .2; 2007: 84 – 86LETTERS TO THE EDITORSubcutaneous Lipomata in Sokoto,Nigeria: A 4-Year ReviewLipomas have been variously described as “universaltumors” or “ubiquitous”. 1 They could occur virtuallyin every part of the human body where cells arefound. These slow-growing benign tumors of fattytissue have been described in all age groups. Mostlyreported are those lipomas involving internal bodyorgans and cavities, which usually present withvariable clinical manifestations. 2, 3 Subcutaneouslipomas, on the other hand, are usually asymptomatic,being superficial. Their hospital presentation ismainly for cosmetic reasons. The diagnosis of thisgroup of lesions is usually clinical. Histopathologicalstudies are however important in order to identify thevariants of this growth, as well as exclude otherrelevant differential diagnosis. Various modalities oftherapy exist.4, 5 The gold standard and commonestform of treatment remains total surgical excision. Thisbrief communication was predicated on the need todraw attention once more to this group of commonbenign tumors, highlight their epidemiological andclinical peculiarities, as well as share an experience intheir surgical management in our local environment.This is a 4-year retrospective review of 52 patientswith clinically diagnosed and histologically confirmedsubcutaneous lipoma. Fifty-two patients were studiedin whom there were 59 subcutaneous lipomas.Twenty-two patients were males and 30 females, agedbetween 2 and 65 years. The mean age was 39 years.However, the peak age at diagnosis was the 5th decadeof life. In 47 (90.4%) individuals, the subcutaneouslipomas were single. It was multiple in the remainder.The highest number of these benign tumors, 32.2%,occurred in the upper limbs, while only 1 case (1.7%)was seen in the vulva (Table 1). Most (94.9%) werepainless. All had complete excision for treatment. Thecommoner form of anaesthesia was local xylocaineinfiltration (63.5%). The rest were removed underketamine sedation. Twenty eight (53.8%) patientswere treated on day-case basis. The commonest postoperative complication was wound infection in 4patients. No tumor recurrence or mortality wasrecorded in this series.Table 1: Anatomical distribution of subcutaneouslipomas in Sokoto, NigeriaAnatomical region No. (%)Upper limbs 19 (32.2)Posterior trunk 15 (25.4)Head and neck 10 (16.9)Anterior trunk 6 (10.2)Lower limbs 5 (8.5)Buttocks 3 (5.1)Vulva 1 (1.7)Total 59 (100)Subcutaneous lipomas represent a common groupof benign soft-tissue tumors in our environment. Theoutcome of treatment is very favorable. With therecent interest in, and the added advantages of day-care surgeries, a greater majority of these tumorswould be suitable for day-case treatment.N. Mbah and U. AbubakarDepartment of Surgery, Usmanu DanfodiyoUniversity Teaching Hospital, P. M. B. 2370. Sokoto,NigeriaE-mail: mbanonso@yahoo.co.ukReferences1. Russell RCG, Williams NS, Bulstrode CJK.Tumors, cysts, ulcers, sinuses. In: Russell RCG,Williams NS, Bulstrode CJK. (eds). Bailey andLove’s short practice of surgery. Arnold, London,2000; 150-1522. De Visscher JG. Lipomas and fibrolipomas of theoral cavity. J. Oral Maxillofac Surg 1982; 10:177-1813. Wakely C, Somerville P. Lipomas. Lancet 1952;2: 995 -9994. Salam AG. Lipomas excision. Am Acad FamPhysician 1998; 65: 901-9045. Wilhelm BJ, Blackwell SJ, Mancoll JS. Anotherindication for liposuction: small facial lipomas.Plast Reconstr Surg 1999; 103: 1864-1867Awareness, Beliefs and Practice ofTraditional Medicine in a NigerianCommunity in the 21st CenturyTraditional medicine (TM) is a part of the tradition orculture of each country where it is practiced. Westernor scientific medicine, actually developed from TM,for example, William Withering, a keen botanist in1785 identified digitalis as the potent agent infoxglove.In Nigeria, the practice of TM has been informaland the health care is controlled by Orthodoxmedicine. The authors through this study embarked onthe scientific evaluation of TM in the 21st century,among Nigerians by assessing their awareness, beliefsand practice.Agege Local Government Area of Lagos State wasselected as study location. The study sample wasrandomly selected to cover males and females, youngand old of ages 12 and above. Three hundred andtwenty, well - structured, fixed-alternative, and self-administered questionnaire that investigatedawareness, beliefs and practice of TM were randomlydistributed among respondents. Comparisons between85 Lettersgroups were made using chi-squared test. Values ofp<0.01 were considered significant.Out of the 320 copies of questionnaire distributed,only 300 could be retrieved. This rendered acompliance rate of 93.8%. The mean and modal ageswere 38.6 (S.D ± 9.72) and 40.5 years respectively,while 163 (54.3%) were males. The result issummarized in table 1.Table 1: Awareness, beliefs and practice of traditional medicine among 320 Agege residentsQuestion Response No. (%)What is Traditional medicine?i. use of incantations, juju and spiritism to prevent and curediseasesyes 36 12.1)ii. use of medical procedures outside western medicine andoccultismYes 178 (59.2)iii. combination of (i) and (ii) above Yes 64 (21.4)iv. use of herbs only Yes 22 (7.3)Do respondents regulate their intake of local medicaments? Yes 204 (68.0)No 62 (20.7)No response 34 (11.3)Do respondents always find TM effective when employed? Yes 17 (5.7)No 249 (83.0)No response 34 (11.3)Are they aware of the side effects of medicaments? Yes 161 (53.7)No 105 (35.0)No response 34 (11.3)Which of the two health care systems would they always prefer? Western 292 (97.3)TM 8 (2.7)Would they advocate a total replacement of western by TM? Yes 25 (8.3)No 275 (91.7)The study showed that several indigenes are notwell informed about TM and the system is beingemployed by indigenes; mostly unaided or unguidedby practitioners, therefore most users are ignorant ofhow to adequately employ TM for its optimalbenefits, possibly because of the secrecy ofpractitioners. It was also observed that users are stillvery ignorant of the side-effects and contra-indicationof the medicaments. This might have to do with thefact that it is more difficult to recognize adverseeffects that develop over time e.g. hypokalaemia fromanthraquinone laxatives1 or those that are readilyascribed to an underlying disease e.g. hepatitis fromthe bile duct remedy celandine.2 It must also beemphasized that herbs which are apparently safeunder normal conditions may be more hazardous inspecific patients under special circumstances e.g.during perioperative period3 or when combined withconventional drugs e.g. hyperforin, a potent P450inducer found in the herbal medicine St. John’s wort.4There is a need to allay the fears of TMpractitioners who feel threatened and insecure. Thegovernment should launch an awareness programmethat will promote effective uses of local medicaments.E. O. Agbaje and E. O. BabatundeDepartment of Pharmacology, College of Medicine,University of Lagos, P. M. B. 12003, Idi- Araba,Lagos- NigeriaE-mail: agbajegoriite@yahoo.comReferences1. Blumenthal M. The complete Germancommission E Monographs-therapeutic guide toherbal medicines, 19992. Benninger J, Schneider HT, Schuppan D,Kirchner T, Hahn EG. Acute hepatitis by greatercelandine (Chelidonium majus).Gastroenterology 1999; 17: 1234-12373. Ang-Lee MK., Moss J, Yuan CS. Herbalmedicines and perioperative care. JAMA 2001;286: 208-2164. Schwartz UI, Buschel B, Kirch W. Unwantedpregnancy on self-medication with St. John’swort despite hormonal contraception. Br J ClinPharmacol 2003; 55: 112-113Improvisation in Lower UrinaryTract Endoscopy in a NigerianTertiary HospitalVarious forms of improvisation and innovations havebeen done in different aspects of surgery.1, 2 Pare’improvised egg yolk to dress wound when hot oil ranout. 1 In developing countries, improvisation has madesurgical practice possible in many hospitals includingthe teaching hospitals. 3 - 5 Awojobi1 in Oyo State,Nigeria use the gear system of a car to improvise foroperation table and he also used the rear wheel of a

Awareness, Beliefs and Practice of Traditional Medicine in a Nigerian Community in the 21st Century

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