Nigerian Journal of Surgery最新文献

{"title":"Management of Major Postcholecystectomy Biliary Injuries: An Analysis of Surgical Results in 62 Patients.","authors":"Sushruth Shetty,&nbsp;Premal R Desai,&nbsp;Hasmukh B Vora,&nbsp;Mahendra S Bhavsar,&nbsp;Lakshman S Khiria,&nbsp;Ajay Yadav,&nbsp;Nikhil Jillawar","doi":"10.4103/njs.NJS_35_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_35_18","url":null,"abstract":"<p><strong>Background: </strong>Management of injuries sustained during cholecystectomy requires expertise and involves a patient who is troubled, usually drained of personal resources. There has been an increase in incidence with laparoscopic cholecystectomy. The standard surgical management done for major biliary injuries is Roux-en-Y Hepaticojejunostomy (R-en-Y HJ).</p><p><strong>Materials and methods: </strong>Patients managed surgically for definitive management of biliary injuries in the form of R-en-Y HJ were included. Data were collected from prospectively maintained records and through outpatient follow-up. Demographic data, early and late surgical complications, long-term outcomes, and follow-up results were analyzed.</p><p><strong>Results: </strong>Among the 62 patients, 26 were males, with a mean age of 37.4 ± 13.5 years. A total of 24 patients presented with ongoing biliary fistula. The Strasberg-Bismuth type of injury included types E1 in 8 (13%), E2 in 31 (50%), E3 in 19 (30.6%), and E4 in four patients (6.4%). There were no postoperative mortality and morbidity in 27.4% of patients. Atrophy-hypertrophy complex was seen in four patients, vascular injury in six patients, and an internal fistulisation with duodenum in two patients. Presence of comorbidities (<i>P</i> = 0.05), male gender (<i>P</i> = 0.03), tobacco use (<i>P</i> = 0.04), low albumin (<i>P</i> = 0.016), and more proximal (E4-E1) type of injury (<i>P</i> = 0.008) were independent predictors of postoperative morbidity (<i>P</i> < 0.05). The mean duration of patient follow-up was 26.2 ± 21.1 months.</p><p><strong>Conclusion: </strong>Optimization of preoperative nutrition, avoidance of intraoperative blood transfusion, proper timing of repair, and tension-free R-en-Y HJ draining all the ducts which is done at an experienced hepatobiliary center provide the best outcome.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"91-96"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/5e/NJS-25-91.PMC6452753.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37334789","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>Ex situ</i> Liver Resection and Partial Liver Autotransplantation for Advanced Cholangiocarcinoma.","authors":"Mustafa Ozsoy,&nbsp;Zehra Ozsoy,&nbsp;Sezgin Yilmaz,&nbsp;Yüksel Arikan","doi":"10.4103/njs.NJS_4_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_4_18","url":null,"abstract":"<p><p>Surgery is the only known curative treatment option for cholangiocarcinoma. <i>Ex situ</i> liver surgery and autotransplantation are promising approaches in cases that cannot be treated by conventional methods and particularly in the presence of centrally localized liver tumors as well as tumors that invade the main vascular structures. A 53-year-old female patient presented with abdominal pain and nausea. Abdominal tomography showed a tumoral mass lesion that filled the left lobe of the liver and invaded the left hepatic vein and the inferior vena cava. Cholangiocarcinoma diagnosis was reached based on biopsy findings, and the patient was scheduled for surgery as positron emission tomography did not indicate any other disease focus. The patient underwent <i>ex situ</i> liver resection and autotransplantation. She was discharged on the 7^th postoperative day. A 68-year-old male presented with abdominal pain, weakness, and weight loss. Laboratory analysis indicated elevated carbohydrate antigen 19-9: 400 U/ml and alpha-fetoprotein (AFP): 2000 U/ml, and there was no other pathology. Abdominal tomography showed a mass that filled the center of the liver and invaded the left hepatic vein and the inferior vena cava. Pathological findings of the biopsy sample were reported as combined hepatocellular-cholangiocellular carcinoma. The patient's AFP levels continued to increase despite transcatheter arterial chemoembolization and radiofrequency ablation therapy. Surgery was decided as indocyanine green clearance test, and the result was 8.5%. He underwent <i>ex situ</i> liver resection and autotransplantation. Unfortunately, he died on the 4^th postoperative day due to respiratory failure. <i>Ex vivo</i> liver resection and partial liver autotransplantation should be considered for the surgical treatment of locally advanced cholangiocarcinomas that invaded the main vascular structures.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"97-100"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/91/NJS-25-97.PMC6452762.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37334790","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":"The Duration of Intra-abdominal Hypertension and Increased Serum Lactate Level are Important Prognostic Markers in Critically Ill Surgical Patient's Outcome: A Prospective, Observational Study.","authors":"Hnuman Prasad Gupta,&nbsp;Pema Ram Khichar,&nbsp;Rekha Porwal,&nbsp;Amit Singh,&nbsp;Anil Kumar Sharma,&nbsp;Mukesh Beniwal,&nbsp;Satyaveer Singh","doi":"10.4103/njs.NJS_7_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_7_18","url":null,"abstract":"<p><strong>Aim: </strong>The present study analyzed the clinical significance of duration of intra-abdominal hypertension (IAH) associated with increased serum lactate in critically ill patients with severe sepsis.</p><p><strong>Materials and methods: </strong>Our study was an observational, prospective study carried out in the Surgical Intensive Care Unit (ICU) at J.L.N Medical College, Ajmer, Rajasthan, India. In our study, we included a total of 100 patients and intra-abdominal pressure (IAP) was measured through intravesical route at the time of admission and after 6, 12, 24, 48, and 72 h via a urinary catheter filled with 25 ml of saline. Duration of ICU and hospital stay, need for ventilator support, initiation of enteral feeding, serum lactate level at time of admission and after 48 h, and 30-day mortality were noted as outcomes.</p><p><strong>Results: </strong>In our study, an overall incidence of IAH was 60%. Patients with cardiovascular surgery and renal and pulmonary dysfunction were 93.3%, 55%, and 60%, respectively, at the time of admission and 65%, 10%, and 10%, respectively, after 72 h of admission in the surgical ICU. Nonsurvivors had statistically significant higher IAP and serum lactate levels than survivors. Patients with longer duration of IAH had longer ICU and hospital stay, longer duration of vasopressors and ventilator support, and delayed enteral feeding.</p><p><strong>Conclusion: </strong>There is a strong relationship \"risk accumulation\" between duration of IAH associated with increased serum lactate and organ dysfunction. The duration of IAH was an independent predictor of 30-day mortality. Early recognition and prompt intervention for IAH and severe sepsis are essential to improve the patient outcomes.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/25/NJS-25-1.PMC6452757.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37171288","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":"Risk-Adjusted Analysis of Patients Undergoing Emergency Laparotomy Using POSSUM and P-POSSUM Score: A Prospective Study.","authors":"Mohan Lal Echara,&nbsp;Amit Singh,&nbsp;Gunjan Sharma","doi":"10.4103/njs.NJS_11_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_11_18","url":null,"abstract":"<p><strong>Background: </strong>Comparison of operative morbidity rates after emergency laparotomy between units may be misleading because it does not take into account the physiological variables of patients' conditions. Surgical risk scores have been created, and the most commonly used is the Physiological and Operative Severity Score for the enumeration of Mortality (POSSUM) or one of its modifications, the Portsmouth-POSSUM (P-POSSUM), usually requires intraoperative information.</p><p><strong>Objective: </strong>The objective of this study is to evaluate the POSSUM and P-POSSUM scores in predicting postoperative morbidity and mortality in patients undergoing emergency laparotomy.</p><p><strong>Methodology: </strong>This is a prospective, cross-sectional, and hospital-based study that was conducted at J.L.N. Medical College and Hospital, Ajmer, Rajasthan, India, from April 2017 to December 2017. Adult patients who presented at the causality and underwent emergency laparotomy were included in the study. Observed and predicted mortality and morbidity were calculated using POSSUM and P-POSSUM equations, and statistical significance was calculated using Chi-square test.</p><p><strong>Results: </strong>A total of 100 patients were included in this study, with a mean age of 42.83 ± 18.21 years. The observed (O) mortality was 12 (12.0%), while POSSUM predicted 40 (40%) and P-POSSUM 27 (27%). The O/E ratio for POSSUM was 0.29 and for P-POSSUM was 0.44, and this means that they both overestimate mortality. When the results were tested by Chi-square test, the <i>P</i> value was found to be 0.55 and 0.85 for POSSUM and P-POSSUM, respectively, which showed no significant correlation for observed and expected mortality. The observed morbidity was 69 (69%), while POSSUM expected morbidity was 79 (79%), O/E ratio is 0.87, and this again overestimates the morbidity. POSSUM is overpredicting the rate of morbidity, and test of correlation showed no significance with <i>P</i> = 0.75.</p><p><strong>Conclusion: </strong>POSSUM and P-POSSUM were found to overestimate mortality and morbidity in our patient's population.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"45-51"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/1d/NJS-25-45.PMC6452761.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37173240","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":"Limb Revascularization of Peripheral Artery Disease in the Developing Countries: Earliest 1-Year Experience from Northwestern Nigeria.","authors":"Anas Ismail,&nbsp;Abulkadir M Tabari,&nbsp;Kabiru Isyaku,&nbsp;Nafiu Ahmed","doi":"10.4103/njs.NJS_21_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_21_18","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study is to present the preliminary audit and challenges of earliest cases of balloon angioplasty from Northwestern Nigeria.</p><p><strong>Materials and methods: </strong>We present our first 25 cases of peripheral angioplasty in Northwestern Nigeria. The clinical diagnosis of peripheral artery disease was confirmed with Doppler ultrasound and angiography. Angioplasty was done either through femoral or brachial artery approaches. The patients were monitored for minimum of 6 months with serial clinical and Doppler ultrasound examinations.</p><p><strong>Results: </strong>Our patients consist of 19 males and 6 females. Their ages ranged from 20 to 80 years with a mean of 54 ± 17.5 years. There were 13 hypertensive and 15 diabetic patients while 5 patients have co-morbidities of diabetes and Hypertension. Although femoral antegrade route is the common access for angioplasty (14 out of 25), seven patients who were treated through the left brachial artery, six of them had either Type C or D aortoiliac disease in addition to distal lesions. At follow-up, 36% had limb amputation while one patient died a day after the procedure. Out of nine patients who had amputation, six are diabetic.</p><p><strong>Conclusion: </strong>Although more than half of them had improved blood flow with healing ischemic ulcers and reducing claudications, still substantial number of our patients often present late with severe peripheral artery disease. As a result, we had to resort to cumbersome arterial access and high amputation rate.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"80-84"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/19/NJS-25-80.PMC6452763.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37334787","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":"Determination of Visual Portfolio for Surgeons OverSeas Assessment of Surgical Needs Nigeria Study: Consensus Generation through an e-Delphi Process.","authors":"Felix Makinde Alakaloko,&nbsp;Etienne St-Louis,&nbsp;Adesoji O Ademuyiwa,&nbsp;Dan Poenaru,&nbsp;Christopher Bode","doi":"10.4103/njs.NJS_30_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_30_18","url":null,"abstract":"<p><strong>Background: </strong>Surgery as a public health priority has received little attention until recently. There is a significant unmeasured and unmet burden of surgical illness in low- and middle-income countries (LMICs). Our aim was to generate a consensus among expert pediatric surgeons practicing in LMICs regarding the spectrum of pediatric surgical conditions that we should look out for in a community-based survey for Surgeons OverSeas Assessment of Surgical Needs Nigeria study.</p><p><strong>Materials and methods: </strong>The Delphi methodology was utilized to identify sets of variables from among a panel of experts. Each variable was scored on a 5-point Likert scale. The experts were provided with an anonymous summary of the results after the first round. A consensus was achieved after two rounds, defined by an improvement in the standard deviation (SD) of scores for a particular variable over that of the previous round. We invited 76 pediatric surgeons through e-mail across Africa but predominantly from Nigeria.</p><p><strong>Results: </strong>Twenty-one pediatric surgeons gave consent to participate through return of mail. Thirteen (62%) answered the first round statements and 8 (38%) the second round. In general, the strength of agreement to all statements of the questionnaire improved between the first and second rounds. Overall consensus, as expressed by the decrease in the mean SD from 0.84 in the first round to 0.68 in the second round, also improved over time. The strength of consensus improved for 23 (74%) of the statements. The strength of consensus decreased for the remaining 8 (26%) of statements. Out of the 31 consensus-generating statements, 16 (51%) scored high agreement, 13 (42%) scored low agreement, and 2 (15%) scored perfect disagreement.</p><p><strong>Conclusion: </strong>We have successfully identified the pediatric surgical conditions to be included in any community survey of pediatric surgical need in an LMIC setting.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"30-35"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/2f/NJS-25-30.PMC6452749.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37173236","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":"A Modified Open Primary Laparoscopic Surgery Port Placement through Umbilical Tube.","authors":"Bashiru Omeiza Ismaila,&nbsp;Barnabas T Alayande","doi":"10.4103/njs.NJS_34_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_34_18","url":null,"abstract":"<p><strong>Background: </strong>A safe, reliable technique for primary trocar introduction is important for laparoscopic surgery. In resource-constrained settings where there is paucity of needed equipment and cost is prohibitive, a method utilizing fewer instruments will be useful.</p><p><strong>Aim: </strong>This study aims to describe a method of primary trocar introduction that utilizes any available port.</p><p><strong>Methods: </strong>A supra- or infra-umbilical incision is made into an everted tubular umbilicus. The linear alba is incised and the resultant opening bluntly developed, after which any available port is inserted using the trocar as a guide. The trocar is withdrawn while the sleeve is pushed in.</p><p><strong>Results: </strong>One hundred and three successful insertions were affected in 107 patients with age range of 1-75 years, with no significant gas leaks.</p><p><strong>Conclusion: </strong>This modified open approach is a simple and reliable way of primary port insertion. Access is gained easily in different age groups and umbilicus types.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"76-79"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/72/NJS-25-76.PMC6452752.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37334785","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":"Comparison of Vacuum-Assisted Closure Therapy and Conventional Dressing on Wound Healing in Patients with Diabetic Foot Ulcer: A Randomized Controlled Trial.","authors":"Sangma M D James,&nbsp;Sathasivam Sureshkumar,&nbsp;Thirthar P Elamurugan,&nbsp;Naik Debasis,&nbsp;Chellappa Vijayakumar,&nbsp;Chinnakali Palanivel","doi":"10.4103/njs.NJS_14_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_14_18","url":null,"abstract":"<p><strong>Background: </strong>Vacuum-assisted closure (VAC) therapy has been shown to be beneficial in a variety of wounds. However, evidence of its benefit in diabetic foot ulcers (DFUs), especially with respect to Indian population, is sparse.</p><p><strong>Methodology: </strong>This randomized controlled trial included DFUs of Wagner's Grades 1 and 2. Patients were further stratified with respect to DFU size <10 cm and ≥10 cm. Patients with vascular disease, osteomyelitis, and bilateral DFUs were excluded from the study. The enrolled patients were randomized to receive VAC therapy or conventional dressing. The time to wound healing, granulation tissue formation, and complications such as pain, infection, and bleeding were compared between the two groups.</p><p><strong>Results: </strong>A total of sixty patients were randomized, of which 27 in each group were analyzed. The mean time to healing in days was significantly less in VAC group (22.52 vs. 3.85; <i>P</i> < 0.0001). Mean time to achieve 75%-100% granulation tissue cover was significantly less in VAC group (23.33 vs. 32.15; <i>P</i> < 0.0001). Rate of granulation tissue formation was also found to be significantly better in VAC group (2.91 cm²/day vs. 2.16 cm²/day; <i>P</i> = 0.0306). There was no difference between the two groups with respect to wound infection and bleeding which are commonly attributed to VAC therapy. VAC therapy group had significantly lesser pain at week 3 (Visual Analog Scale score 3 vs. 4; <i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>VAC therapy significantly decreases the time to complete wound healing, hastens granulation tissue formation, and reduces the ulcer area compared to conventional dressing. The study did not find any significant increase in the bleeding and infection in the VAC therapy group.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"14-20"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/49/NJS-25-14.PMC6452767.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37171711","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":"Endoscopic Management of Ureteric Stones: Our Initial Experience.","authors":"Taiwo Opeyemi Alabi,&nbsp;Emmanuel Ajibola Jeje,&nbsp;Moses Adebisi Ogunjimi,&nbsp;Rufus Wale Ojewola","doi":"10.4103/njs.NJS_20_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_20_18","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study is to present our initial experience with intracorporeal pneumatic ureterolithotripsy highlighting the pattern of patients' clinical presentation, techniques, and limitation of the procedure.</p><p><strong>Materials and methods: </strong>This is a retrospective study of cases of ureteric stones managed over a period of 18 months in a private hospital. Data obtained include patients' sociodemography, clinical presentation, stone burden, procedural technique, complication, and need for a secondary procedure. Data were analyzed using the Statistical Package for the Social Sciences version 21.</p><p><strong>Results: </strong>The total number of patients managed was 20 with an age range of 28-75 years and a mean of 48.2 ± 12.4 years. Majority of them, i.e., 11 (55%) were middle aged. Female gender was more predominant, 11 (55%). Flank pain was the most common mode of presentation. Right-sided stone occurred in 9 (45%), left sided in 7 (35%), and bilateral in 4 (20%). Stone location was in the upper ureter in 4 (16.7%), mid-ureter in 7 (29.2%), and lower ureter in 13 (54.2%). The stone size ranged from 6 to 18 mm with a mean of 9.7 ± 2.5 mm. Four patients (20%) required initial bilateral ureteric stenting before definitive procedure to allow for recovery from sepsis and/or nephropathy. All patients had double-J stenting and were discharged 2 days after the procedure. The procedure was successful in 19 (95%) with 100% stone clearance rate and complete resolution of symptom without any complication. One patient (5%) had a very hard upper ureteric stone which retropulsed into the renal pelvis requiring open nephrolithotomy.</p><p><strong>Conclusion: </strong>Endoscopic treatment of ureteric stone with intracorporeal pneumatic lithotripsy is a safe and effective treatment modality. It is, however, limited in the management of hard upper ureteric stone, especially those that are close to the pelviureteric junction due to the risk of retropulsion of the stone into the kidney.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"26-29"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/d0/NJS-25-26.PMC6452758.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37173237","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 and Use of Biostatistics among Resident and Junior Doctors at the University of Port Harcourt Teaching Hospital, Port Harcourt.","authors":"Philemon Ekemenye Okoro,&nbsp;Ebisori Ngosai Karibi","doi":"10.4103/njs.NJS_37_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_37_18","url":null,"abstract":"<p><strong>Background: </strong>The place of research in the generation of facts and evidence on which contemporary medicine can be based cannot be overemphasized. Medical and surgical research is now more crucial than ever before for advancement of clinical practice and career progression for medical professionals. This requires good understanding and application of biostatistics among clinicians.</p><p><strong>Aim: </strong>To assess the knowledge and use of biostatistics among resident doctors at the University of Port Harcourt Teaching Hospital, Port Harcourt.</p><p><strong>Subjects and methods: </strong>This was a questionnaire-based study carried out in the University of Port Harcourt Teaching Hospital. Completed questionnaires were retrieved immediately after completion. The data were entered into an Excel spreadsheet, cleaned, and subjected to statistical analysis.</p><p><strong>Results: </strong>There were a total of 109 respondents. Sixty-nine (63.3%) respondents were included in the study. Fifty-five (79.7%) respondents indicated that they understood the basic concepts of biostatistics, and only 16 (23.2%) respondents can apply their knowledge practically in research.</p><p><strong>Conclusion: </strong>The level of appreciation and use of biostatistics among resident doctors in the University of Port Harcourt Teaching Hospital is inadequate. This may be a reflection of the situation with resident doctors in other institutions in the country. There is a need for a curriculum review both at the undergraduate and postgraduate levels to prepare medical professionals for the task of high-quality research and advancement of knowledge.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"25 1","pages":"60-63"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/cb/NJS-25-60.PMC6452770.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37173241","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}