Nigerian Medical Journal : Journal of the Nigeria Medical Association最新文献

{"title":"Profile of Nonmotor Symptoms and the Association with the Quality of Life of Parkinson's Disease Patients in Nigeria.","authors":"Babawale Arabambi, Olajumoke Oshinaike, Shamsideen Abayomi Ogun","doi":"10.4103/nmj.NMJ_119_19","DOIUrl":"10.4103/nmj.NMJ_119_19","url":null,"abstract":"<p><strong>Context: </strong>Parkinson's disease (PD) is the second most common neurodegenerative disorder. Several nonmotor symptoms (NMS) are associated with the condition, affecting multiple body systems in addition to the nervous system.</p><p><strong>Aims: </strong>The aim of the study is to describe the profile of NMS and the factors related to their severity as well as their association with the quality of life (QoL) among patients with PD in a Nigerian neurology clinic.</p><p><strong>Methods: </strong>A total of 105 patients with PD and 105 healthy controls were assessed for various NMS using a validated NMS assessment scale. A validated PD-specific QoL assessment tool, the PD Questionnaire-39 was also administered to the study patients with PD. Analyses for correlation and difference were performed to determine the associated factors of NMS severity and their association with QoL.</p><p><strong>Results: </strong>The most common NMS in the PD patients were in the domains of sleep/fatigue and mood/cognition. The total NMS score were significantly higher in patients compared to controls (median [interquartile range] 42 [13-72] vs. 20 [14-29], <i>P</i> < 0.001). There was a significantly higher score in the advanced Hoehn and Yahr stages (<i>P</i> < 0.001). The duration of PD had a positive correlation with the NMS scores (r_s= 0.207, <i>P</i> = 0.034. The total NMS score had a strong positive correlation with the QoL (r_s= 0.851, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>PD is associated with significant NMS and worsens with the progression of the disease and the duration of illness. These NMS have a significant association with the QoL, necessitating the need for detailed and prompt evaluation and management.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 5","pages":"273-278"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/9c/NMJ-60-273.PMC6900905.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37463794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Mortality in the Niger Delta Region of Nigeria: A Case Study of the University of Port Harcourt Teaching Hospital.","authors":"Ogechukwu F Amadi,&nbsp;Ifenyinwa B Okeke,&nbsp;Ikenna K Ndu,&nbsp;Uchenna Ekwochi,&nbsp;Obinna C Nduagubam,&nbsp;Osita U Ezenwosu,&nbsp;Isaac N Asinobi,&nbsp;Chidiebere DI Osuorah","doi":"10.4103/nmj.NMJ_51_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_51_19","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study is to determine the pattern of cancer mortality (CM) seen in the University of Port Harcourt Teaching Hospital (UPTH) which is a cancer reference center in the Niger Delta Region.</p><p><strong>Methodology: </strong>This is a 6-year retrospective study of cancer-related deaths in UPTH using patients' admission registers in all the wards and emergency units. Furthermore, the death certificates of cases were reviewed.</p><p><strong>Results: </strong>Three hundred and sixteen cases of cancer-related deaths occurred, involving 174 females and 142 males, in a female-to-male sex ratio of 1.2:1. All age groups were affected, with age group 40-49 years accounting for the majority (20.6%). CM was seen in all the systems, except the central nervous system. Cancers of the gastrointestinal tract and its accessory organs (liver and gall bladder) caused most mortality (27.9%), in a female-to-male ratio of 0.8:1. The single most involved organ in CM is the female breast (20.6%), distantly followed by mortality due to prostate cancers and hematolymphoid cancers which accounted for 9.2% each. Colorectal cancers accounted for 7.3% of cancer deaths and ranked 4^th. Cancers of both cervix and stomach each accounted for 5.7% of mortality. The major histologic diagnoses were carcinomas (adenocarcinoma; 36.7%, invasive ductal carcinoma; 20.3%, squamous cell carcinomas; 8.2% and hepatocellular carcinomas; 4.4%). Leukemias and lymphomas accounted for 9.2% of cases, whereas sarcomas accounted for 5.1% of cases.</p><p><strong>Conclusion: </strong>Infection-related and noninfection-related cancers cause most mortality in UPTH. The 5^th decade was the most commonly affected, while female breast was the single most involved organ. Breast, prostate and hematolymphoid malignancies are common causes of CM with death from breast occurring earliest. Majority of the deceased were educated, working-class urban dwellers. More advocacies on public acceptance of cancer screening and cancer preventive lifestyles as well as governments' improvement on workforce training and treatment infrastructure will improve the current CM profile in Port Harcourt.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 5","pages":"262-267"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/c2/NMJ-60-268.PMC6900904.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37463899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and Practice of Breast Self Examination among Women in Different African Countries: A 10-Year Review of Literature.","authors":"Ofonime Effiong Johnson","doi":"10.4103/nmj.NMJ_84_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_84_19","url":null,"abstract":"<p><p>Breast self examination (BSE) is an important screening technique in detecting breast abnormalities. This procedure enables women become familiar with their breasts, thus making it easier for them to detect any changes that may occur. Routine performance of BSE is recommended for females above 20 years. This review of literature was conducted to assess the awareness and practice of BSE among women in different countries in Africa. A total of 28 out of 80 articles were reviewed from 15 African countries based on relevance. Review identification was performed through the search of Google Scholar and PubMed/MEDLINE/PubMed Central databases. Search terms used were \"BSE,\" \"awareness,\" \"practice,\" and \"Africa.\" Reference lists of identified studies were also used to find more studies. Majority of the reviewed studies showed adequate awareness, mainly from the media, but poor practice of BSE among women in various countries in Africa. A major barrier identified was inadequate knowledge of BSE technique. Although awareness of BSE was relatively high in many of the reviewed studies, the practice was low. Educational intervention program should be carried out among women in various African countries, not only to raise awareness but also to educate on the skills required to carry out BSE effectively.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 5","pages":"219-225"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/a7/NMJ-60-219.PMC6900901.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37463456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of Adenotonsillar Specimen Histology in a Private Hospital Setting.","authors":"Waheed Atilade Adegbiji,&nbsp;Shuaib Kayode Aremu,&nbsp;Akindele Abdurrazaq Oladipo","doi":"10.4103/nmj.NMJ_71_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_71_19","url":null,"abstract":"<p><strong>Background: </strong>All adenoid and tonsils tissue specimens are routinely histologically examined in pediatric otorhinolaryngology practice worldwide. This study aimed at determining the sociodemographic features, clinical presentation, indications, postoperative management, and histological diagnosis of the adenoid and tonsils tissues.</p><p><strong>Materials and methods: </strong>This is a retrospective hospital-based study of patients who had adenotonsillectomy done between August 2008 and July 2018 at Golden Cross Infirmary Hospital, Festac Town, Lagos, Nigeria. All data were obtained from the patients' record, case note, and theater operation register. All the data obtained were collated and analyzed using SPSS version 18.0.</p><p><strong>Results: </strong>There were 59.2% of males with a male-to-female ratio of 1.5:1. Clinical presentation among the pediatric patients was 71.8% difficulty breathing, 64.8% snoring, 63.4% sleep apnea, 60.6% catarrh, and 54.9% noisy breathing. The most common indications for adenoid and tonsils surgery were obstructive sleep apnea in 64.8%. Adenoidectomy in 42.3% was the most common form of pediatric adenoid and tonsils surgery. The most common complication of adenoid and tonsils surgery was pain at surgical site/odynophagia in all the patients. Postoperative histological reports were reactive lymphoid hyperplasia in all the patients.</p><p><strong>Conclusion: </strong>Adenoid and tonsils surgeries are common pediatric otorhinolaryngology, head-and-neck surgical procedures. The most common indication found for adenoid and tonsils surgery was obstructive sleep. Adenoidectomy was the most common form of pediatric adenoid and tonsils surgery. All the adenoid and tonsils tissue specimens revealed histological benign diseases.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 5","pages":"234-237"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/2f/NMJ-60-234.PMC6900899.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37463459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge of Cervical Cancer and the Uptake of the Papanicolaou Smear Test among Public Secondary School Teachers in Akwa Ibom State, Nigeria.","authors":"Augustina Elochukwu Ijezie,&nbsp;Ofonime Effiong Johnson","doi":"10.4103/nmj.NMJ_120_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_120_19","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is a public health problem that disproportionately affects women in less-developed countries despite the availability of effective screening tools. The objective of this study was to determine the level of knowledge of cervical cancer and uptake of the Papanicolaou (Pap) smear test among teachers in public secondary schools in Akwa Ibom State, Nigeria.</p><p><strong>Methodology: </strong>This was a cross-sectional descriptive study among 370 female teachers in public secondary schools in Akwa Ibom State, Nigeria. Data were collected with a self-administered questionnaire and were analyzed using Stata software version 10.</p><p><strong>Results: </strong>The mean age of respondents was 37.9 ± 7.9 years. More than two-thirds (71.0%) of the respondents had low knowledge of cervical cancer risk factors, whereas 168 (57.9%) respondents had low knowledge of the symptoms. Among the 226 (77.9%) respondents who knew that cervical cancer was preventable, only 65 (28.8%) had high knowledge of preventive measures. About 42.2% of respondents were aware of the Pap smear test and only 8.4% had ever had a Pap smear test. There were significant associations between knowledge of symptoms, prevention of cervical cancer, and the uptake of the Pap smear test (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The levels of knowledge of risk factors, symptoms, and methods of prevention of cervical cancer were low in this study. This may have accounted for the low uptake of the Pap smear test. Regular and comprehensive health education concerning cervical cancer and its prevention is advocated in the media and clinics to encourage higher uptake of the Pap smear test.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 5","pages":"245-251"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/b4/NMJ-60-245.PMC6900900.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37463893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Age Determination with Historical Events in Birnin Kebbi, Northwest Nigeria.","authors":"Folajimi Morenikeji Otubogun,&nbsp;Nasiru Sanni,&nbsp;Amina Lawal Bello","doi":"10.4103/nmj.NMJ_58_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_58_19","url":null,"abstract":"<p><strong>Context: </strong>Birth registration is not universal and remains elusive for some people living in developing countries, such as Nigeria; hence, age determination for healthcare and health-related research is often problematic.</p><p><strong>Aims: </strong>The aim is to validate the use of a historical events' scale as a tool for estimating the age of Nigerian adults residing in Birnin Kebbi, Northwest Nigeria.</p><p><strong>Settings and design: </strong>A cross-sectional survey was conducted in Birnin Kebbi, a metropolitan capital city of Kebbi state, Northwest Nigeria, and included adults aged 18 years and older with a valid document indicating their year of birth.</p><p><strong>Subjects and methods: </strong>Seven historical events comprising major national events were cross-referenced to the individual's personal history to estimate their ages, which were then compared to their documented ages.</p><p><strong>Statistical analysis used: </strong>Relationship of the documented and estimated ages was assessed with the Spearman's rank-order correlation and intraclass correlation coefficient (ICC) analyses.</p><p><strong>Results: </strong>A total of 288 subjects (63.2% males) with a mean documented age of 34.5 ± 11.3 (range 18-75) years were surveyed. The mean estimated age was 32.5 ± 11.18 years. Spearman's rank-order correlation analysis showed a statistically strong positive correlation between the actual and estimated ages (0.953, <i>P</i> < 0.001). The ICC between documented and estimated ages was 0.968 (95% confidence interval = 0.959-0.975).</p><p><strong>Conclusions: </strong>The use of this tool in Nigerian adults provides a reasonably accurate age estimation. Its use in populations and communities with inadequate birth registration may improve the quality of age-related health data in Nigerian adults.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 4","pages":"190-192"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d2/7e/NMJ-60-190.PMC6892333.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37453055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Helicobacter pylori</i> Infection in Malnourished Children in Lagos.","authors":"Oluwafunmilayo Funke Adeniyi,&nbsp;Iretiola Bamikeolu Fajolu,&nbsp;Edamisan Temiye,&nbsp;Christopher Imokhuede Esezobor,&nbsp;Cecilia Abimbola Mabogunje","doi":"10.4103/nmj.NMJ_127_18","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_127_18","url":null,"abstract":"<p><strong>Background/aim: </strong><i>Helicobacter pylori</i> infection is acquired in childhood, but there are conflicting reports on malnutrition and the infection. This study aimed to determine the prevalence of <i>H. pylori</i> infection among malnourished children and highlight the socioeconomic (SE) and clinical factors associated with the infection.</p><p><strong>Methodology: </strong>This was a descriptive cross-sectional study of 122 malnourished children and 120 healthy controls. Anthropometry was done for all the study participants, and the <i>H. pylori</i> status was determined with the use of monoclonal stool antigen test in all the participants. Logistic regression analysis was used to determine the factors that could predict the occurrence of the infection in the children.</p><p><strong>Results: </strong>Seventy percent (70.8%) of the malnourished children had moderate malnutrition, whereas 29.2% were severely malnourished. The prevalence of <i>H. pylori</i> in the malnourished children was 22.8% compared to 32.5% in the controls (<i>P</i> = 0.09). The infection was most prevalent in toddlers (60.7%). The SE class was significantly related to the infection (<i>P</i> = 0.01) and about a fifth (21.3%) of the malnourished children who belonged to the low SE class were <i>H. pylori</i> positive compared to 9.2% of the controls. About 64.3% of the malnourished children with <i>H. pylori</i> infection had fever and 25.8% had diarrhea. Multivariate analysis showed that stunting was significantly related to the infection (<i>P</i> = 0.02).</p><p><strong>Conclusion: </strong><i>H. pylori</i> infection was prevalent among the toddlers and was significantly associated with stunting in this cohort of malnourished children. Screening of children for the infection is still advocated, and infected children should be referred for appropriate treatment and follow-up. The relationship between SE class and the infection still requires further research.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 4","pages":"205-210"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/4b/NMJ-60-205.PMC6892334.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37453063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Immunodeficiency Virus Self-Testing in Adolescents Living in Sub-Saharan Africa: An Advocacy.","authors":"Serge Tonen-Wolyec,&nbsp;François-Xavier Mbopi-Kéou,&nbsp;Donato Koyalta,&nbsp;Mounir Filali,&nbsp;Salomon Batina-Agasa,&nbsp;Laurent Bélec","doi":"10.4103/nmj.NMJ_75_19","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_75_19","url":null,"abstract":"<p><p>Acquired immune deficiency syndrome (AIDS) has become the leading cause of death among adolescents (aged 10-19) in sub-Saharan Africa. Less than 20% of African adolescents know their human immunodeficiency virus (HIV) status, whereas HIV testing remains the gateway to care. To end the AIDS epidemic by 2030 according to the Joint United Nations Programme on HIV/AIDS target, it is necessary to introduce scalable HIV testing strategies specific to different settings such as age groups, populations, and geographical areas. Demonstrated evidence on HIV self-testing (HIVST) in sub-Saharan Africa settings is reported, including data among adolescents. The All In initiative, which is the current international platform for the fight against HIV in adolescents is a good opportunity to address the challenge of HIV testing, including HIVST. Adapted strategies of HIVST such as (i) implementation of several listening and recreation centers for adolescents, (ii) door-to-door HIVST approach, and (iii) reducing the age of consent is urgently needed to promote HIV testing among adolescents living in Africa.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 4","pages":"165-168"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/88/NMJ-60-165.PMC6892330.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37453115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Epilepsies at the Community Cottage Hospital Level in a Developing Environment.","authors":"Emmanuel E Ekanem,&nbsp;Akinwunmi O Fajola,&nbsp;Rakiya Usman,&nbsp;Rebecca N Ogbimi,&nbsp;Gloria O Ikeagwu,&nbsp;Tamunoibim E Anidima,&nbsp;Michael N Etieh,&nbsp;Chidozie N Umejiego","doi":"10.4103/nmj.NMJ_6_18","DOIUrl":"https://doi.org/10.4103/nmj.NMJ_6_18","url":null,"abstract":"<p><strong>Background: </strong>The epilepsy problem in much of Africa is characterized by stigmatization and neglect. This article describes the efforts at a cottage hospital level to ameliorate the epilepsy problem in a resource-limited environment.</p><p><strong>Methods: </strong>A seizure clinic was started in a cottage hospital after targeted health talks. The International League against Epilepsy (ILEA)/World Health Organization (WHO)/International Bureau for Epilepsy (IBE) manual was adopted for the training of staff and to guide management. Patients were followed up in the clinic and with the use of simple information communication technology.</p><p><strong>Results: </strong>Forty-five patients with ages ranging from 3 months to 42 years (who had lived with epilepsy for periods ranging from 3 weeks to 32 years) were registered over 12 months period. The most common seizure type was generalized tonic clonic (21 or 46.67%) followed by generalized clonic (8 or 17.78%). Ten (22.22%) had comorbidities mainly cerebral palsy (4 or 8.89%) and attention-deficit hyperactivity disorder (3 or 6.67%). Most (98.15%) were placed on carbamazepine. Twenty-three (51.11%) had complete control of seizures, 21 (46.67%) had reduced frequencies of attacks, and all 8 children who had dropped out of school resumed schooling.</p><p><strong>Conclusion: </strong>The epilepsy challenge in the developing world can be demystified and effectively managed at the cottage hospital level. Targeted health education, affordable management regimes, and committed follow-up are keys. A training manual based on the ILEA/WHO/IBE document should be developed for Africa.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 4","pages":"186-189"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/78/NMJ-60-186.PMC6892329.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37453054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Bloodless Surgery: A Case for Bloodless Suprapubic Prostatectomy.","authors":"Chukwudi Ogonnaya Okorie,&nbsp;Louis L Pisters","doi":"10.4103/nmj.NMJ_121_18","DOIUrl":"10.4103/nmj.NMJ_121_18","url":null,"abstract":"<p><p>Allogeneic blood transfusion is commonly prescribed to patients undergoing suprapubic prostatectomy for benign prostatic hyperplasia as a treatment option to replace blood loss. Historically, suprapubic prostatectomy has been perceived as an extremely high hemorrhagic surgery, and this has led to the association of suprapubic prostatectomy with a high rate of allogeneic blood transfusion. However, the outcome of suprapubic prostatectomy has significantly improved over the years and has become less hemorrhagic in many hands - creating the opportunity to consistently avoid allogeneic blood transfusion. On the other hand, the efficacy of blood transfusion has come under more stringent scrutiny as many clinical studies have reported inconsistent effects of blood transfusion on patient outcome. In contemporary practice, a more conservative/bloodless approach in the perioperative management of anemia in surgical patients is strongly being advocated with convincing evidence that many surgical patients can be routinely and safely managed without allogeneic blood transfusion. There is no large-scale discussion on bloodless surgery in urology in the contemporary literature, especially in the area of suprapubic prostatectomy that has been historically associated with a high rate of blood transfusion. This review article will discuss the evolution of bloodless surgery including the ongoing controversies surrounding blood transfusion in general, and then the relatively small but ongoing penetration of bloodless surgical approach in the field of suprapubic prostatectomy. Furthermore, the authors' approach to bloodless suprapubic prostatectomy will be highlighted, and in doing so, it can be emphasized that suprapubic prostatectomy is no more as hemorrhagic as was historically perceived, but rather a routine bloodless suprapubic prostatectomy is now possible in many hands.</p>","PeriodicalId":19223,"journal":{"name":"Nigerian Medical Journal : Journal of the Nigeria Medical Association","volume":"60 4","pages":"169-174"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/b9/NMJ-60-169.PMC6892331.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37453114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}