Nigerian Postgraduate Medical Journal最新文献

{"title":"Malnutrition in a Megacity: A Community-based Survey of Anthropometric Patterns among Children under Five in Lagos, Nigeria.","authors":"Kikelomo Ololade Wright, Temiloluwa Fagbemi, Modupe Akinyinka, Taiwo Johnson, Victoria Omoera, Motunrayo Adekunle, Folashade Oludara, Olusegun Ogboye, Akin Abayomi","doi":"10.4103/npmj.npmj_115_26","DOIUrl":"https://doi.org/10.4103/npmj.npmj_115_26","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is widespread among children under five in densely populated areas like Lagos State, Nigeria's economic hub.</p><p><strong>Objective: </strong>This study examines the prevalence and anthropometric patterns of malnutrition among children under the age of 5 yearsin Lagos, Nigeria.</p><p><strong>Methods: </strong>The was a cross sectional study of 8157 children under the age of 5 years old, selected from households in all 20 local government areas of Lagos, Nigeria. The main outcomes were underweight, wasting, stunting, overweight and obesity. Data analysis was performed using SPSS and the World Health Organization Anthro Survey Analyser.</p><p><strong>Results: </strong>The average age of the children was 19.6±16.81 months and male to female ratio was 1.1:1. Among the children, 23.2% (95% CI: 22.3%, 24.1%) were underweight, 15.9% (95% CI: 15.0%, 16.9%) showed varying degrees of wasting, 38.3% (95% CI: 37.2%, 39.5%) were stunted. The prevalence of wasting and stunting was higher among male children, with wasting at 16.8% in males versus 15.1% in females and severe stunting at 26.6% in males versus 22.3% in females.</p><p><strong>Conclusion: </strong>The burden of malnutrition in Lagos from this survey is generally high. It is essential to improve feeding practices, develop community based nutrition programmes and enforce state policies aligned with global targets.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"643-650"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Ceruloplasmin in Pre-eclampsia: A Case-Control Study in a Tertiary Health Centre in Southwest Nigeria.","authors":"Joy Onyinyechi Chionuma, Olusegun Cosmos Adebara, Nosimot Omolola Davies, Oladimeji Abiodun Makinde, Kabiru Afolarin Rabiu","doi":"10.4103/npmj.npmj_175_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_175_25","url":null,"abstract":"<p><strong>Background: </strong>Pre-eclampsia is a pregnancy disorder linked with increased maternal and perinatal complications. An imbalance between free radical-induced lipid peroxidation and the antioxidant system may contribute to its pathogenesis.</p><p><strong>Aims: </strong>This study aimed to compare serum ceruloplasmin levels in women with pre-eclampsia and their normotensive counterparts and to assess its predictive value for disease severity.</p><p><strong>Subjects and methods: </strong>A prospective case-control study was conducted involving 100 pregnant women diagnosed with pre-eclampsia, matched for age and parity against 100 healthy controls. Patients with pre-eclampsia were classified into mild (55) and severe (45) pre-eclampsia groups. Data on demographics, obstetric characteristics and outcomes were collected. Ceruloplasmin protein concentration was measured using a competitive enzyme-linked immunosorbent assay kit. Data analysis was performed using Stata Version 17. The reference range of serum ceruloplasmin for determining the risk of pre-eclampsia was from the 2.5 th to the 97.5 th percentile of the controls. The statistical significance level was set at P < 0.05.</p><p><strong>Results: </strong>The median interquartile range (IQR) serum ceruloplasmin levels were 21 mg/dL (IQR 17.5-23.8) in normotensive women, 35.5 mg/dl (IQR, 33.8-38.3) in mild pre-eclampsia, and 46.5 mg/dL (IQR, 42.5-49) in severe pre-eclampsia, with significant differences ( P = 0.001). The cut-off point for serum ceruloplasmin using Youden's index was 29 mg/dL. Ceruloplasmin exhibited 90.8% sensitivity, 95.6% specificity and positive and negative predictive values and accuracy of 96.1%, 89.6% and 92.3%, respectively, in pre-eclampsia.</p><p><strong>Conclusion: </strong>Serum ceruloplasmin was elevated in pre-eclampsia, and the levels correlate with the severity of pre-eclampsia. The sensitivity and specificity observed in this study suggest that ceruloplasmin may be a potential marker for discriminating between normotensive pregnant women and those with pre-eclampsia. Elevated levels may be an indicator of severe disease.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"665-671"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of 10-year Cardiovascular Risk with Left Ventricular Hypertrophy in a Population of Nigerian Hypertensives.","authors":"Olugbenga Olusola Abiodun, Tina Anya","doi":"10.4103/npmj.npmj_580_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_580_25","url":null,"abstract":"<p><strong>Background: </strong>The pooled cohort equation (PCE) for predicting the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) has been utilised in Black populations to predict cardiovascular events.</p><p><strong>Objective: </strong>We explored the relationship between PCE ASCVD risk and left ventricular hypertrophy (LVH).</p><p><strong>Materials and methods: </strong>A total of 934 hypertensives from the Federal Medical Centre Abuja Hypertension Registry were analysed for this study. The participants were divided into two groups: those with low ASCVD risk (<7.5%) and those with elevated ASCVD risk (≥7.5%). Electrocardiographic (ECG) LVH was defined by the presence of any of Sokolow-Lyon, Cornell voltage or Gubner-Ungerleider criteria. Echocardiographic LVH was defined as an elevated LV mass index using the linear cube formula of the American College of Cardiology.</p><p><strong>Results: </strong>Participants with elevated ASCVD risk were older (59.2 ± 9.0 years) than those with low ASCVD risk ( P < 0.001). Among participants with elevated ASCVD risk, 299 (42.1%) and 181 (26.3%) had echocardiographic and ECG LVH compared with 75 (32.3%) and 44 (19.6%) in those with low ASCVD risk, respectively ( P < 0.05). Those with elevated ASCVD risk had higher odds of having echocardiographic (odds ratio [OR]: 2.02, 95% confidence interval CI 1.39-2.93) and ECG LVH (OR: 2.00, 95% CI 1.29-3.08) compared to those in the low-risk group ( P < 0.05).</p><p><strong>Conclusion: </strong>In this study, an elevated 10-year ASCVD risk was associated with a two-fold increase in the risk of echocardiographic and ECG LVH in a population of Nigerian hypertensives. In resource-limited settings, the use of the ASCVD risk score may facilitate timely referrals for the diagnosis and management of LVH.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 5","pages":"637-642"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomised Controlled Trial Comparing Early versus Interval Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis: A Study of Feasibility and Outcomes.","authors":"Anil Kumar, Shesh Kumar, Rafey Abdul Rahman, Asha Verma, Survesh Kumar Gupta","doi":"10.4103/npmj.npmj_67_26","DOIUrl":"10.4103/npmj.npmj_67_26","url":null,"abstract":"<p><strong>Background: </strong>Acute calculous cholecystitis (ACC) is a common surgical emergency. The optimal timing for laparoscopic cholecystectomy (LC) remains controversial.</p><p><strong>Aims: </strong>This study compared outcomes between early LC (ELC) and interval LC (ILC) for ACC.</p><p><strong>Materials and methods: </strong>A prospective randomised controlled trial was conducted with 100 patients equally allocated to ELC (within 72 h) or ILC (6-8 weeks post-conservative management). Primary outcomes included operative time, conversion rate and total hospital stay. Secondary outcomes assessed intraoperative events and post-operative complications.</p><p><strong>Results: </strong>Mean operative time was significantly longer in the ELC group (95.47 min vs. 73.69 min, P = 0.001). Total hospital stay was shorter with ELC (6.50 days vs. 10.80 days, P = 0.009). Conversion rates were higher in the ILC group (18% vs. 8%, P = 0.245). Bile duct injuries occurred exclusively in the ELC group (8% vs. 0%). Significant intraoperative bleeding (80% vs. 56%) and total postoperative complications (30% vs. 8%, P = 0.006) were more frequent with ELC.</p><p><strong>Conclusion: </strong>ELC reduces hospital stay but is associated with longer operative times and higher complication rates. ILC may offer a safer operative field but extends overall treatment duration. Timing should be individualised based on patient factors, surgical expertise and institutional resources, with stringent adherence to safety principles.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"443-450"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphological and Morphometric Study of the Adult Human Acetabulum in South-Western Nigeria: Clinical Relevance in Hip Arthroplasty Surgery.","authors":"Olasode Israel Akinmokun, Zoe Temiloluwa Akinrele, Ogonna T Nnanna, Laura O Oni, Damian Godsfavour Ubezuo, Olumide Patrick Shoneye","doi":"10.4103/npmj.npmj_406_25","DOIUrl":"10.4103/npmj.npmj_406_25","url":null,"abstract":"<p><strong>Background: </strong>The acetabulum is the structure that the head of femur articulates with to form the hip joint. Knowledge of its structure and dimensions is helpful in clinical and forensics settings. Data on its dimensions are sparse in Southwestern Nigeria. In hip joint arthroplasty, metal backed acetabular cup implant is inserted into this structure. The implants used are designed based on the anatomic findings of countries where these implants were made.</p><p><strong>Aims: </strong>The study aimed to provide data from Southwestern Nigeria and to correlate the distances between bony prominences in the hemipelvis that will be useful to implant manufacturers.</p><p><strong>Materials and methods: </strong>This was a prospective, descriptive and observational study that involved the measurements of parts of the acetabulum and distances between some bony points of 78 cadaveric hemipelvic bones. Parameters documented included 'Vertical diameters' (VDs), 'Transverse diameters' (TDs), 'Total diameters' (VD + TD)/2, acetabular depth and morphology of the anterior acetabular ridge. The acetabular rim thickness was also estimated. The distance between the anterior superior iliac spine (ASIS) and pubic tubercle (PT) was measured and documented. Data obtained from the study were transferred into Microsoft Excel 2010 (by Microsoft Corporation, Redmond. Washington) and analysed with Stata 13 (StataCorp, Texas, USA).</p><p><strong>Results: </strong>The mean VD, TD and total diameters measured were 57.6 mm, 56.2 mm and 56.9 mm and 51.0 mm, 49.5 mm and 50.3 mm for outer and inner diameters of the acetabulum, respectively. The mean acetabular rim thickness estimated was 3.3 mm for each acetabular rim along the vertical and transverse axes for both left and right sides. Mean acetabular depth was 27.2 mm. The curved pattern was the most common anterior acetabular ridge observed. There was no statistically significant relationship between the acetabular diameters and the distance between ASIS and PT.</p><p><strong>Conclusion: </strong>This study has contributed data that would be useful to orthopaedic surgeons, implant manufacturers and forensic pathologists. These data should be used when population specific acetabular cup implants are being considered. This study documented no significant statistical relationship between the acetabular diameter and the distances between any of the bony prominences around the hemipelvis. Therefore, no equation could be generated for pre-operative estimation of acetabular diameter. The use of plain radiograph remains the reliable method for pre-operative estimation of the acetabular diameter.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"521-528"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Litigation Prevention, Mediation and Alternative Dispute Resolution in Health Care: A Narrative Review of Perspectives from Orthopaedics and Spine Practice.","authors":"Lukman Olalekan Ajiboye, Abdullallahi Bello Galadima, Nuradeen Altine Aliyu, Maryam Muhammad Hussaini","doi":"10.4103/npmj.npmj_584_25","DOIUrl":"10.4103/npmj.npmj_584_25","url":null,"abstract":"<p><strong>Background: </strong>Healthcare litigation is increasing globally and imposes significant emotional, financial and reputation and trust-related costs. Orthopaedic and spine surgery carry particularly high medico-legal risk because of technical complexity, uncertain outcomes and heightened patient expectations. Alternative dispute resolution (ADR), especially mediation, offers confidential and collaborative means to both prevent and resolve conflict.</p><p><strong>Objectives: </strong>To (i) examine litigation-prevention strategies and ADR modalities applicable to orthopaedic and spine practice; (ii) synthesise common sources of conflict, the advantages of ADR over litigation and implementation challenges within the Nigerian health system and (iii) propose recommendations for hospital governance, professional regulation and incorporation of ADR training in medical education.</p><p><strong>Methodology: </strong>A narrative review of English-language literature was conducted across biomedical databases and grey sources using predefined keywords ADR, ADR processes with outcome and barriers in low- and middle-income countries, and patient safety. Eligible studies included empirical research and programme reports. Thematic synthesis focused on conflict drivers, mediation, on medical litigation, orthopaedics, policy and legal analyses, preventive mechanisms and spine surgery.</p><p><strong>Results: </strong>One hundred and fifty-two sources met the inclusion criteria. Major conflict drivers were consent and communication failures, poor documentation, expectation-outcome mismatch, disputes over surgical indication, peri-operative complications, implant and device issues, financial hardship and delayed presentation. ADR consistently showed advantages in cost, timeliness, confidentiality, therapeutic relationship preservation and learning potential. Barriers included weak institutional ADR frameworks, limited mediator clinical literacy, fragmented regulation, low insurance penetration and poor quality-improvement data.</p><p><strong>Conclusions: </strong>ADR provides an effective, confidential approach to reducing litigation in orthopaedic and spine practice by addressing communication failures early and preserving therapeutic relationships. Strengthening consent, documentation, institutional ADR pathways and mediator clinical skills, supported by policy reforms and ADR education, can reduce preventable conflicts and promote safer, more accountable surgical care in Nigeria.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"460-466"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of the Clinical Outcomes, Complications and Patient Satisfaction of One-stage versus Two-stage Bilateral Total Knee Arthroplasty.","authors":"Mohammed Nuhu Salihu, Soliudeen Adebayo Arojuraye","doi":"10.4103/npmj.npmj_683_25","DOIUrl":"10.4103/npmj.npmj_683_25","url":null,"abstract":"<p><strong>Background: </strong>The safety of single-stage bilateral total knee arthroplasty (TKA) has been a subject of debate due to concerns of morbidity and mortality. The advantages of one-stage (OS) bilateral TKA include shorter recovery time, a shorter hospital stay and perhaps reduced total treatment costs.</p><p><strong>Aims: </strong>This study aimed to evaluate the clinical outcomes and complications following OS versus two-stage (TS) bilateral TKA for severe osteoarthritis of both the knees.</p><p><strong>Patients and methods: </strong>This retrospective comparative analysis was carried out between January 2021 and December 2025 at the National Orthopaedic Hospital, Dala, Kano, and the University of Abuja Teaching Hospital, Gwagwalada. Clinical outcomes using the KSS scoring system and the rate of complications were recorded. Patients' satisfaction was also documented using the Likert scale. The statistical analysis was performed using SPSS version 26.0. Using a level of significance of 0.5, the two independent groups were compared using independent Student's t -test.</p><p><strong>Results: </strong>There was no significant difference in post-operative KSS between the two groups ( P = 0.717). The mean post-operative KSS in the OS and TS groups were 97.78 ± 1.78 and 97.76 ± 1.74, respectively. Post-operative complications also did not significantly differ in the two groups ( P = 0.712).</p><p><strong>Conclusion: </strong>In properly selected cases, OS bilateral TKA is less expensive and yields clinical outcomes, complication rate and patient satisfaction comparable to those of a TS procedure.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"529-532"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Three-dimensional Multicolour Holography in Endocrine Surgery: An Innovative Approach.","authors":"Ankit K Badge, Brij Raj Singh, Nandkishor J Bankar, Vaishnavi Ade","doi":"10.4103/npmj.npmj_114_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_114_25","url":null,"abstract":"","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"550-551"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Hotspot: Evaluating the Safety of Day-case Early Cholecystectomy for Acute Cholecystitis.","authors":"Andrew Chiagozie Ekwesianya, Farjana Enayathulla, Abraham Jesudoss, Abraham Abiodun Ayantunde","doi":"10.4103/npmj.npmj_684_25","DOIUrl":"https://doi.org/10.4103/npmj.npmj_684_25","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy is increasingly being performed as a day-case procedure globally, and the previously held notion of 'interval cholecystectomy' is now being abandoned in favour of early cholecystectomy. Cholecystectomy for acute cholecystitis is associated with an increased risk of operative difficulty and intraoperative complications.</p><p><strong>Aims: </strong>This study aimed at is to assess the safety of day-case laparoscopic cholecystectomy (DCLC) for acute cholecystitis.</p><p><strong>Methods: </strong>Author to summarize the data collected over 3 years (February 2022 to January 2025) on patients scheduled for either 'urgent' or 'very urgent' laparoscopic cholecystectomy for acute cholecystitis. Data analysis was done with IBM SPSS Statistics 29.0.1.0.</p><p><strong>Results: </strong>A total of 190 patients (age range 22-96 years, median 54) underwent urgent or very urgent laparoscopic cholecystectomy for 'hot gallbladder'; 145 (76.3%) were discharged on the same day, while 45 (23.7%) required overnight admission due to surgical difficulty or significant co-morbidities requiring monitoring. Out of the 145 day-case patients, the mean intraoperative difficulty score was 2.34 (on a scale of 1-4), with surgery durations ranging from 25 to 205 min (median of 75 min). Only four patients (2.8%) were readmitted within 30 days due to subhepatic abscess, post-operative pain, wound collection and hernia, but none required reoperation, and there was no mortality.</p><p><strong>Conclusion: </strong>DCLC for acute cholecystitis is safe and feasible for the majority of patients, even in complex cases. These results support the increasing role of early and day-case surgery in the management of acute cholecystitis. Enhanced pre-operative patient selection and optimisation, judicious use of surgical drains, streamlined theatre logistics and improved perioperative pain management could further improve the success of day case surgeries and enhance patient quality of life after laparoscopic cholecystectomy.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"439-442"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative Management of Anal Fistula in Lagos: Outcomes and Complications.","authors":"Olanrewaju Samuel Balogun, Abdulrazzak Oluwagbemiga Lawal, Adedapo Olumide Osinowo, Ayomide O Makanjuola, Oluwaseun O Oluseye, Adedoyin Adekunle Adesanya","doi":"10.4103/npmj.npmj_456_25","DOIUrl":"10.4103/npmj.npmj_456_25","url":null,"abstract":"<p><strong>Background: </strong>Fistula-in-ano (FIA) describes an anal condition in which there is a connecting tract between the perianal skin and the lining of the anal canal. Surgery is the mainstay of treatment. Disease recurrence and anal incontinence are major concerns in surgery for FIA. The conventional fistulotomy and fistulectomy have demonstrated superiority over the endoscopic and other sphincter-sparing treatments for FIA.</p><p><strong>Aims: </strong>The study aimed at reporting our experiences of surgery for fistula-in-ano. There is a scarcity of local studies on FIA in Nigeria, hence the need to report our experience with surgery for FIA.</p><p><strong>Methodology: </strong>This is a retrospective review of available records of FIA cases in patients aged 16 years or more managed between February 2016 and February 2025. Information on demographical characteristics, clinical/radiological features and the type and number of surgical treatments for complete healing were retrieved from the records for analysis. Excluded from this study were patients with incomplete records and patients with secondary fistulae. Data analysis was performed using SPSS.</p><p><strong>Results: </strong>We analysed records of 30 cases of FIA. There were 24 males (80%) and 6 females (20%) giving a ratio of 4:1. The mean age of all patients was 40.8 ± 10.8 years (range: 24-60 years). The modal age group was between 30 and 39 years. Twenty-seven cases (90%) were primary FIA; all patients presented with recurrent anal discharge of pus. Twenty-three patients (76.6%) presented with perianal pain. The number of external openings recorded was single in 22 patients (76.6%). Three patients presented with horseshoe-type FIA. Low-type fistula accounted for 90% of cases. Surgical treatments offered were anal fistulectomy in 11 patients (36.7%), partial fistulectomy and insertion of cutting seton in 11 (36.7%) patients, anal fistulotomy in seven patients (23.3%). Procedure-related complications occurred in six patients (20%). Occasional faecal incontinence was documented by two patients (6.7%). Recurrence after healing of the fistula tract was seen in two patients (6.7%).</p><p><strong>Conclusion: </strong>FIA occurs mostly in males; the majority are of low posterior type. Surgical deroofing or excision of the tract with surgical or seton fistulotomy has a good success rate. It is recommended as the first line of treatment in low-resource settings.</p>","PeriodicalId":19720,"journal":{"name":"Nigerian Postgraduate Medical Journal","volume":"33 4","pages":"467-473"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}