Nigerian Journal of Surgery最新文献

{"title":"Use of the World Health Organization Surgical Safety Checklist by Nigerian anesthetists.","authors":"John Olutola Olatosi,&nbsp;Nneka Chinedu Anaegbu,&nbsp;Adeniyi Adesida","doi":"10.4103/njs.NJS_16_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_16_18","url":null,"abstract":"<p><strong>Background: </strong>Surgery and anesthesia are essential parts of global healthcare. Surgical intervention has been largely beneficial but remains associated with significant morbidity and mortality. The increasing complexity of surgical interventions has made providers more prone to avoidable errors. The World Health Organization Surgical Safety Checklist (WHO SSC) was disseminated worldwide with the aim of reducing perioperative morbidity and mortality.</p><p><strong>Objective: </strong>There is a paucity of data to assess awareness and use of WHO SSC in low- and middle-income countries. The aim of this study is to evaluate the knowledge and use of WHO SSC by Nigerian anesthetists.</p><p><strong>Methodology: </strong>A structured self-reporting questionnaire was distributed to Nigerian physician anesthetists. One hundred and twenty-two questionnaires were distributed with 102 completed reflecting a response rate of 83.6%.</p><p><strong>Results: </strong>Awareness of the WHO SSC was reported by 93.1% of the respondents. Routine use of the checklist was reported by 62.7% of the respondents mostly in the teaching hospitals compared with the general hospitals and comprehensive health centers (86.2%, 23.3% and 14.3%, <i>P</i> = 0.0001). The respondents who had a perception that WHO SSC does not prevent errors were the least likely to use it (odds ratio: 0.08, <i>P</i> = 0.0117).</p><p><strong>Conclusion: </strong>This study identified a high level of awareness and use of the WHO SSC by physician anesthetists in Nigeria. However, its use is mostly use of The WHO SSC list by Nigerian anesthetists in teaching hospitals.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 2","pages":"111-115"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/cb/NJS-24-111.PMC6158986.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36554044","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":"Efficiency of Ultrasonography in Swellings of Orofacial Region.","authors":"Sameer Ramesh Zope,&nbsp;Abhishek A Talathi,&nbsp;Avadhut Kamble,&nbsp;Selabh Thakur,&nbsp;Pradeep Dilip Taide,&nbsp;Vaibhav Kumar,&nbsp;Harkanwal Preet Singh","doi":"10.4103/njs.NJS_38_17","DOIUrl":"https://doi.org/10.4103/njs.NJS_38_17","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasonography (USG) is found to be important in identifying various soft-tissue pathologies in the orofacial region. Therefore, its features should be studied and documented in these lesions so that a more appropriate provisional diagnosis can be made.</p><p><strong>Aim: </strong>This study aims to study ultrasonographic features in various kinds of swellings in the orofacial region.</p><p><strong>Materials and methods: </strong>The study grouped consists of 30 patients of both sexes (20 males and 10 females) with an age range of 15-70 years complaining of swellings in the orofacial region. All the patients in the study were explained the need of tests and subjected to clinical, ultrasonographic, and histopathologic examination. Sonosite Micromaxx sonography machine was used with a linear array transducer of 13-6 MHz frequencies. Ultrasonographic diagnosis is then correlated with clinical and histopathologic diagnosis. Chi-square test and contingency coefficient tests were used.</p><p><strong>Results: </strong>A significant association was observed between clinical and ultrasonographic diagnoses (contingency = 0.872, <i>P</i> < 0.05) and between ultrasonographic and histopathologic diagnoses (contingency = 0.904, <i>P</i> < 0.05). There was 100% congruency between clinical diagnosis and ultrasonographic diagnosis in all the cases except in cases of cysts, abscess, and sialadenitis. Reliability of USG was found to be 97% in diagnosing all the cases with respect to histopathological diagnosis, while it was 90% with respect to clinical diagnosis.</p><p><strong>Conclusion: </strong>USG was found to be a reliable diagnostic modality in the diagnosis of orofacial swellings.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 2","pages":"82-89"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/df/NJS-24-82.PMC6158989.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36597360","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":"Evaluation of Immunohistochemical Profile of Breast Cancer for Prognostics and Therapeutic Use.","authors":"Prem Chand,&nbsp;Anubha Garg,&nbsp;Vandana Singla,&nbsp;Nisha Rani","doi":"10.4103/njs.NJS_2_18","DOIUrl":"https://doi.org/10.4103/njs.NJS_2_18","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is leading cancer in women, and the incidence of breast cancer in India is on the rise. The most common histologic type of breast cancer is infiltrating ductal carcinoma. Prognostic and predictive factors are used in the management of breast cancer. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2/neu) are immunohistochemical markers of prognosis as well as predictors of response to therapy.</p><p><strong>Aims and objectives: </strong>The study was conducted to evaluate ER, PR, and HER2/neu expressions in invasive ductal carcinomas of the breast by immunohistochemistry, to explore the correlation of these markers to each other and to various clinicopathological parameters: age of the patient, histological grade, tumor size, and lymph node metastasis.</p><p><strong>Materials and methods: </strong>This prospective study was conducted on 100 cases of infiltrating ductal carcinoma. Slides were prepared from blocks containing cancer tissue, and immunohistochemical staining was done for ER, PR, and HER2/neu expressions. Interpretation of expressions was done using Allred scoring system for ER/PR and the American Society of Clinical Oncology/College of American Pathologists guidelines for HER2/neu. Statistical analysis was performed to determine the statistical significance by applying Chi-square test.</p><p><strong>Results: </strong>Majority of tumors were ER and PR positive and HER2/neu negative. ER and PR correlated significantly with age, tumor size, and tumor grade; whereas, HER2/neu correlated significantly with tumor size only. No association was seen with axillary lymph node metastasis. ER and PR expression correlated with each other, but none correlated with HER2/neu.</p><p><strong>Conclusions: </strong>As the majority of the tumors are ER, PR positive and since ER and PR correlate with each other as well as with age, tumor size, and grade. Therefore, routine assessment of hormone receptors is recommended for prognostic and therapeutic information in breast cancer cases.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 2","pages":"100-106"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/e6/NJS-24-100.PMC6158994.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36554042","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":"Emergency Ileo-cecal Anastomosis with Inclusion of Appendicular Stump in Terminal Ileal Pathology: A Newer Approach.","authors":"Shyam Bhutra,&nbsp;Amit Singh,&nbsp;T P Devpura","doi":"10.4103/njs.NJS_35_17","DOIUrl":"https://doi.org/10.4103/njs.NJS_35_17","url":null,"abstract":"<p><strong>Background: </strong>In emergency settings, several surgical procedures are described while dealing with pathology of terminal ileal lying within 15 cm of the ileocecal valve, but there is still confusion and controversy over the optimal surgical treatment.</p><p><strong>Methods: </strong>A nonrandomized study of 210 patients with near terminal ileal pathology (within 15 cm) was carried out over a period of 10 years. The study included 112 cases in which an ileocecal anastomosis with inclusion of appendicular stump was used in terminal ileal pathologies, and in rest 98 cases, other surgical procedures were used. The outcomes were measured in relation to postoperative complications and mortality.</p><p><strong>Results: </strong>Postoperative complications encountered in emergency ileocecal anastomosis with the inclusion of appendicular stump were wound infection in 31 patients (34.72%), respiratory complications in 10 patients (11.2%), septicemia in 6 patients (6.72.%), and anastomotic leak in one patient (1.12%).</p><p><strong>Conclusion: </strong>The technique of ileocecal single-layer anastomosis with the inclusion of appendicular stump was found to be very effective in dealing this common problem and had less morbidity and mortality.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 2","pages":"116-120"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/bd/NJS-24-116.PMC6158983.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36553951","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":"Mixed Adenoneuroendocrine Carcinoma of the Esophagus: A Case Report and Review of the Literature.","authors":"Fernando Mendoza-Moreno,&nbsp;M R Díez-Gago,&nbsp;J Mínguez-García,&nbsp;B Tallón-Iglesias,&nbsp;G Zarzosa-Hernández,&nbsp;S Fernández,&nbsp;M Solana-Maoño,&nbsp;J M Argüello-De-Andrés","doi":"10.4103/njs.NJS_43_17","DOIUrl":"https://doi.org/10.4103/njs.NJS_43_17","url":null,"abstract":"<p><p>The most frequent presentation of esophageal cancer is adenocarcinoma and squamous cell carcinoma. In recent years, the latter has decreased its incidence increasing the adenocarcinoma. Currently, another type of tumor with a much lower incidence has been described, which has a neuroendocrine component along with another exocrine glandular component and has been classified since 2010 as mixed adenoneuroendocrine carcinoma (MANEC). We present the case of a 68-year-old male with a history of dyspepsia and epigastric pain who after performing a gastroscopy, was diagnosed with a malignant neoplasm of the esophagus. The patient underwent a total esophagectomy with reconstruction by tubular gastroplasty with cervical anastomosis. The final result of the piece after immunohistochemistry revealed that the tumor was composed of one component of adenocarcinoma in 60% together with another component compatible with neuroendocrine in 40%. With these findings and according to the World Health Organization classification of 2010 was diagnosed as esophageal MANEC. MANECs are rare tumors, described in other locations of the digestive tract, the esophagus being an infrequent location. Its preoperative diagnosis is difficult, and it is not until the final analysis of the complete piece by means of specific immunohistochemical techniques when its diagnosis can be established. Its treatment is fundamentally surgical, whereas the adjuvant therapeutic schemes with chemotherapy are not well defined at present because of their low incidence.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 2","pages":"131-134"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/40/NJS-24-131.PMC6158990.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36554047","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":"Unsuspected Skin Metastasis of Adenocarcinoma of the Prostate in a Patient on Goserelin (Zoladex).","authors":"Timothy Uzoma Mbaeri,&nbsp;Jideofor Chukwuma Orakwe,&nbsp;Ogochukwu I Ezejiofor","doi":"10.4103/njs.NJS_15_17","DOIUrl":"https://doi.org/10.4103/njs.NJS_15_17","url":null,"abstract":"<p><p>Prostate cancer remains the most common noncutaneous cancer in men, especially in this era of prostate-specific antigen assay. Prostate cancer metastases have been known to commonly affect the lymphatics, bones, and lungs. Prostate cancer metastasis to the skin is very rare (<1%) and often signifies a terminal disease. Involvement of the skin has been thought to be through lymphatic spread by embolization or permeation, hematogenous spread, and implantation during surgery (port site in radical prostatectomy). We report a 74-year-old man on management for advanced prostate cancer with subcutaneous goserelin (Zoladex) but developed skin metastasis in the course of treatment. The skin metastasis in our patient, however, was initially localized to the site of the regions of subcutaneous goserelin injection that we imagined if there is a link between the two. We reviewed the literature and currently found no connection. Is there truly a link?</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 2","pages":"138-141"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/32/b4/NJS-24-138.PMC6158991.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36553952","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":"Combined Laparoscopic and Cystoscopic Retrieval of Forgotten Translocated Intrauterine Contraceptive Device.","authors":"Taiwo O Alabi,&nbsp;Mohan Keshavamurthy,&nbsp;Shabeer Ahmed,&nbsp;Rufus W Ojewola,&nbsp;Mahendra Jain,&nbsp;Kehinde H Tijani","doi":"10.4103/njs.NJS_18_17","DOIUrl":"https://doi.org/10.4103/njs.NJS_18_17","url":null,"abstract":"<p><p>The most commonly used long-term reversible female contraception is intrauterine contraceptive device (IUCD). Its use is however associated with documented complications. Uterine perforation, though rare, is arguably the most surgically important of all these complications. We report a case of a 48-year-old para 4⁺⁰ (4 alive) woman who had IUCD insertion 17 years earlier and had forgotten she had the device having had two children thereafter. The IUCD was subsequently translocated through the dome of the bladder into the peritoneal cavity with calculus formation around the tail and thread of the IUCD in the urinary bladder causing recurrent urinary tract infection. This \"Collar Stud\" effect made either cystoscopic or laparoscopic retrieval alone unsuccessful necessitating a combined approach. This case report highlights the need for a combined laparoscopic and cystoscopic approach in the retrieval of the unusual presentation of translocated IUCD.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 1","pages":"48-51"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4103/njs.NJS_18_17","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35999905","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":"Unusual Intravesical Foreign Body Following Perineo-vesical Injury.","authors":"Ekene Victor Ezenwa,&nbsp;Emmanuel O Osaigbovon,&nbsp;I J Ofuani","doi":"10.4103/njs.NJS_2_17","DOIUrl":"https://doi.org/10.4103/njs.NJS_2_17","url":null,"abstract":"<p><p>Reports of foreign body in the bladder are rare. Various objects have been retrieved. Diagnosis is mainly by history of lower urinary tract symptoms and low abdominal pain combined with relevant radiological investigations. Treatment depends on the size, nature, and configuration of the object. The approach may be endoscopic or through open surgery depending on the above highlighted factors.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 1","pages":"44-47"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/31/NJS-24-44.PMC5883850.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35999904","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":"Ectopic Pancreas Causing Partial Gastric Outlet Obstruction: A Case Report and Review of Literature.","authors":"Abdurrahaman Abba Sheshe,&nbsp;Ibrahim Yusuf","doi":"10.4103/njs.NJS_27_17","DOIUrl":"https://doi.org/10.4103/njs.NJS_27_17","url":null,"abstract":"<p><p>Ectopic pancreas is a rare cause of gastric outlet obstruction, perhaps rarer still among Africans. Although the entity is known, the diagnostic challenges are enormous, especially in the poor-resource environment. Gastric outlet obstruction resulting from ectopic pancreas in an adult is the first of its kind in our center; we, therefore, present this case to describe the challenges faced with diagnosis, treatment, and the lesson learned. Ectopic pancreas should be considered in the differential diagnosis of gastric outlet obstruction.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 1","pages":"56-59"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/54/NJS-24-56.PMC5883853.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35999909","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":"Camphor Burns on the Palm: An Unusual New Presentation.","authors":"B A Ramesh","doi":"10.4103/njs.NJS_19_17","DOIUrl":"https://doi.org/10.4103/njs.NJS_19_17","url":null,"abstract":"<p><strong>Introduction: </strong>Camphor burns on the palm are uncommon and rarely encountered by a plastic surgeon.</p><p><strong>Aim: </strong>This study aims to analyze different patterns of camphor burns on the palm.</p><p><strong>Methods: </strong>Five women and one man presented with camphor burns on their palm. All patients had burns on their right palm. The shape of camphor, the duration of contact with the ignited camphor on the palm, and post-burn treatments were evaluated.</p><p><strong>Results: </strong>Three types of camphor burns were noted: Type 1 (a ring-shaped or a dome-shaped blister with unburned skin in the center), Type 2 (an oval-shaped partially thick burn with unburned skin in the center), and Type 3 (a full-thickness burn exposing the palmar fascia).</p><p><strong>Conclusion: </strong>Different types of camphor burns on the palm are described in this study. This is the first study to report ring-shaped blisters and ring-shaped partially thick camphor burns caused on the palm.</p>","PeriodicalId":30399,"journal":{"name":"Nigerian Journal of Surgery","volume":"24 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/2f/NJS-24-39.PMC5883849.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35999903","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}