African Journals Online
Nigerian Journal of Surgical Research

Volume 3 Number 1 March 2001
Abstracts

Ocular Tumours in Childhood 

V. Pam

Department of Ophthalmology, A. B. U. Teaching Hospital, Kaduna, Nigeria.
(Nig J Surg Res 2001; 3:1-5)

Neonatal Resuscitation: Practical Considerations

E. O. Ogboli and S. A. Eguma

Department of Anaesthesia, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Reprint requests to: Dr. E. O. Ogboli, Department of Anaesthesia, A. B. U. Teaching Hospital, Zaria, Nigeria.
(Nig J Surg Res 2001;3:6-10)


Caesarean Delivery: The Trend Over a Ten-Year Period at Ilorin, Nigeria

M. A. Ijaiya and P. A. Aboyeji

Department of Obstetrics and Gynaecology University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Reprint requests to: Dr. M. A. Ijaiya, Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Maternity Wing, Ilorin, Nigeria.

ABSTRACT

Background: There has been tremendous increase in caesarean deliveries in modern obstetric practise as a result of extension of the indications for caesarean section, which is now an international public health issue.
Method: Records of all caesarean deliveries that occurred at University of Ilorin Teaching Hospital (U.I.T.H.) between 1st January 1990 and 31st December 1999 were reviewed retrospectively.
Results: Two thousand, seven hundred and sixty-four caesarean births occurred out of 30,267 deliveries giving an overall caesarean section rate of 9.1%. Caesarean birth rose from 1 in 26 deliveries in 1990 to 1 in 5 deliveries by 1999. Cephalopelvic disproportion, 851 (30.8%) remained the commonest indication for caesarean section throughout the study period. The other indications were antepartum haemorrhage 363 (13.1%) and pre-eclampsia/eclampsia, 258 (9.3%). The common causes of caesarean section related maternal mortality were sepsis, 9 (31.0%), haemorrhage 8 (27.6%), anaesthesia 4 (13.8%) and embolism 4 (13.8%). There were 29 and 12 maternal deaths following caesarean section and vaginal delivery respectively. All caesarean mortality cases recorded were under emergency situations. Maternal mortality ratio relating to caesarean section (1,050 per 100,000) was higher than that for vaginal delivery (40 per 1000). The difference was statistically significant (p < 0.0).
Conclusion: Caesarean section rate has dramatically increased during the study period. This high caesarean birth and caesarean mortality can be reduced by improving socio-economic condition of the populace, strict policy on active management of labour, improve blood transfusion services and anaesthetic technique in this centre. (Nig J Surg Res 2001;3:11-18)

KEY WORDS: Caesarean delivery; trend; Ilorin

Intraoperative Deaths at Ahmadu Bello University Teaching Hospital, Kaduna: A 2-Year Experience

E. A. Garba, S. A. Eguma*, A. O. Oguntayo**, N. O. Udezue

Departments of Surgery, *Anaesthesia and **Obstetrics and Gynaecology, Ahmadu. Bello University Teaching Hospital, Kaduna, Nigeria. 
Reprint requests To: Dr. E. S. Garba, Department of Surgery, A. B. U. Teaching Hospital, P. M. B. 2016, Kaduna.

ABSTRACT

Background: The car of patients undergoing surgery should accomplish a good reduction in mortality and morbidity from surgery and anaesthesia.
Methods: A retrospective study of cases of intra-operative deaths at Ahmadu Bello University Teaching Hospital (ABUTH) Kaduna, Nigeria in a 2-year period.
Result: Two thousand, four hundred and sixty - five (2,465) operations were performed in the main operating theatre of the hospital, shared by departments of departments of surgery, obstetric and gynaecology (OG) and maxillo-facial surgery (MFU). Nine cases of intraoperative deaths were recorded. Most of the deaths occurred among the gravely ill, inadequately prepared patients and patients whose operations were done in the late hours of the night.
Conclusion: This tragedy is preventable by paying meticulous attention to details and careful patient selection and care. (Nig J Surg Res 2001;3:19-23)

KEY WORDS: Intraoperative death, prevention


Management of Acute Abscesses in Jos, Nigeria

S. T. Edino and C. H. Ihezue

Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.
Reprints requests to: Dr. S. T. Edino, Department of Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria. E-mail: [email protected] 

ABSTRACT

Background: Acute abscesses are common in the tropical environment. Whereas certain types of abscesses are decreasing in prevalence in the Western world, the situation is quite different in the most developing countries.
Method: A prospective study of two hundred (200) acute abscesses managed in 2 years. 
Results: Majority of the patients, 196 (98%) were low-income earners. Identifiable associated medical conditions were diabetes mellitus, sickle cell anaemia, liver cirrhosis, and acquired Immunodeficiency Syndrome (AIDS). The age range of the patients was 0-80 years (mean 21.6 +/- 15.4 years). There were two peaks of age incidence at less than 10 years, and between 20-40 years. The M: F ratio was 1:1.4. One hundred and sixty patients (80%) had used one type or another of antibiotic before presentation. Breast abscess was the commonest type of abscess seen occurring in 65 patients (32.5%). Lactational breast abscess accounted for 59 (90%) of the breast abscess. The average size of abscesses was 6.02 +/- 1.74cm. Staphylococcus aureus was the most commonly isolated organism, in 170 aspirates (85%); it was sensitive to erythromycin in 140 isolates (82.86%). The prognosis after simple incision and drainage was generally good, with a mortality of 3 (1.5%); 2 of the patients had AIDS and one resulted from a neglected ischiorectal abscess.
Conclusion: Improvement in living standards, early presentation and treatment should reduce the incidence, morbidity and mortality from acute abscesses in our environment. (Nig J Surg Res 2001;3:24-28)

KEY WORDS: Abscess, AIDS, incision and drainage, low socio-economic status


Malignant Skin Tumours in Jos University Teaching Hospital, Jos, Nigeria (Hospital Based Study)

*B. M. Mandong, K. S. Orkar, A. Z. Sule and N. L. Dakum

Departments of *Pathology and Surgery, Jos University Teaching Hospital, Jos, Nigeria.
Reprint requests to: Dr B. M. Mandong, Department of Pathology, Jos University Teaching Hospital, P. M. B. 2076, Jos, Nigeria.

ABSTRACT

Background: The incidence of melanoma has been on the increase in Australia and Asia but in Africa, many skin cancers arise from chronic ulcers and burns.
Methods: A retrospective histopathologic study of malignant skin tumours seen at the University of Jos Teaching Hospital, Jos, Nigeria in 5 years.
Results: A total of 128 malignant skin tumours were recorded during the period. Squamous cell carcinoma accounted for 51.2%, malignant melanoma, 24.2% and Kaposi's sarcoma 10.9%. Other tumours included fibrosarcoma, malignant fibrous histiocytoma and skin adnexal tumours. Skin cancer occurred in a younger age group compared to developed countries. The tumours presented either as nodular growth or non-healing, long-standing ulcers with an average duration of 5 - 10 years. This is in contrast to Europe where the duration of ulcer is 30 - 40 years. 
Conclusion: Skin cancers are not uncommon in our environment. Early treatment of ulcers, including grafting may improve the quality of life in these patients. (Nig J Surg Res 2001;3:29-33)

KEY WORDS: Skin cancer, squamous cell carcinoma, malignant melanoma, Kaposi's sarcoma, Jos


Fatal Spontaneous Haemothorax in a Child With Acute Leukaemia: A Case Report 

L. B. Chirdan and E. A. Ameh

Paediatric Surgery Unit, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Reprint requests to: Dr L. B. Chirdan, Paediatric Surgery Unit, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.

ABSTRACT

A 6-year old boy with acute leukaemia developed spontaneous bleeding and presented with spontaneous massive haemothorax. One litre of blood was drained at tube thoracostomy and another 300mls over the next 3 hours. The patient continued to deteriorate and died despite replacement of lost blood. The rarity of spontaneous haemothorax is highlighted and the importance of early diagnosis and treatment emphasised. (Nig J Surg Res 2001;3:34-36)

KEY WORDS: Acute leukaemia, spontaneous haemothorax.


Ring Entrapment of the Finger in a Psychiatric Patient

V. M. Ramyil, N. K. Dakum, *L. N. Ayuba and D. Iya

Departments of Surgery and *Psychiatry, Jos University Teaching Hospital, Jos, Nigeria.
Reprint requests to: Dr. N. K. Dakum, Department of Surgery, Jos University Teaching Hospital, P.M.B. 2076, Jos, Nigeria, E-mail: [email protected] 

ABSTRACT

Ring entrapment of the finger is an uncommon occurrence in our environment and is usually amenable to conservative treatment by removal of the entrapped ring. Gangrene of the affected digit is rare. This is a report of a 57-year-old schizophrenic who developed ulceration, severe oedema and gangrene of the right middle finger following entrapment by a ring like motor spare part. Disarticulation at the metacarpophalangeal joint was necessary. The gangrene was possibly due to a combination of severe oedema, infection or a Raynaud's like phenomenon. (Nig J Surg Res 2001;3:37-40)

KEY WORDS: Ring, finger entrapment, gangrene, psychiatric illness


Delayed Diagnosis of Acute Extradural Haematoma

B. B. Shehu, K. A. Mannan and N. J. Ismail

Neurosurgery Unit, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Reprint requests to: Dr. B. B. Shehu, Federal Medical Centre, Birnin-Kebbi, Nigeria. E-mail: [email protected] 


ABSTRACT

An 18-year old man presented with persistent left frontal headache, ptosis, blurring of vision and early morning vomiting 3 weeks after involvement in a road traffic accident. A computed tomography scan of the brain showed left frontal extradural haematoma. The patient recovered following craniotomy and evacuation of the haematoma. (Nig J Surg Res 2001;3:41-43)

KEY WORDS: Extradural haematoma, delayed diagnosis


Diabetic Foot: Need for a Multicentre Study
(Nig J Surg Res 2001; 3:44)
B. A. Solagberu, Senior Lecturer and Consultant Orthopaedic and Trauma Surgeon, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria. E-mail: [email protected] 


Reply to Letter
(Nig J Surg Res 2001; 3:44-45)
M. O. Ogirima, Consultant Orthopaedic and Trauma Surgeon, A. B. U. Teaching Hospital, Kaduna, Nigeria.