Annals of African Surgery最新文献_第9页

Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi 马拉维一家三级公立医院乙状结肠扭转患者的手术治疗和预后

Annals of African Surgery Pub Date : 2021-07-20 DOI: 10.4314/AAS.V18I3.9

Ephraim Bitilinyu-Bangoh, Fatsani Mwale, Loveness Ulunji Chawinga, G. Mulima

{"title":"Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi","authors":"Ephraim Bitilinyu-Bangoh, Fatsani Mwale, Loveness Ulunji Chawinga, G. Mulima","doi":"10.4314/AAS.V18I3.9","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.9","url":null,"abstract":"Background: Sigmoid Volvulus (SV) is a common cause of acute bowel obstruction in Malawi. We aimed to describe the surgical management of SV and its outcomes at Kamuzu Central Hospital, Lilongwe, Malawi. \u0000Methods: We retrospectively reviewed records from January 2019 to December 2019 of all SV patients, aged 18 years and above. Data extracted included age, sex, admission date, surgery date, bowel viability at time of surgery, procedure done, suspected anastomotic leakage, length of hospital stay and mortality. The data was analyzed using STATA 14.0. \u0000 Results: There were more males (n= 59, 81.9 %) than females. The median (IQR) age was 50.5 (38-60) years. A viable sigmoid colon was present in 61 (84.7%) patients. The commonest procedures done were sigmoid resection and primary anastomosis (RPA) (59.7%, n=43) and Hartmann’s procedure (HP) (36.1%, n=26). The median length of hospital stay was 5 days in HP, 7 days in RPA and longest in mesosigmoidopexy (10 days). Suspected anastomotic leakage occurred in 2(4.7%) patients. The overall mortality was 6.9% with all deaths occurring in RPA patients. \u0000Conclusion: Mortality is high in SV patients who undergo RPA. We recommend Hartmann’s procedure in cases where the bowel has significant oedema or is gangrenous.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86729008","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}

引用次数: 0

Pattern and Outcome of Splenic Injury in Children 儿童脾损伤的类型和预后

Annals of African Surgery Pub Date : 2021-07-20 DOI: 10.4314/AAS.V18I3.5

K. Chukwubuike

引用次数: 2

Lymphocytic Colitis in Nigeria: A Case Series 尼日利亚淋巴细胞性结肠炎:一个病例系列

Annals of African Surgery Pub Date : 2021-07-20 DOI: 10.4314/AAS.V18I3.10

A. Oluyemi, M. Momoh, E. Odeghe, S. Keshinro

引用次数: 0

Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana 加纳手工小切口白内障手术(msic)与超声乳化术(PHACO)的疗效比较

Annals of African Surgery Pub Date : 2021-07-20 DOI: 10.4314/AAS.V18I3.4

S. Kyei, Ebenezer Zaabaar, Frank Assiamah, M. Kwarteng, Kofi Fred Asiedu

{"title":"Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana","authors":"S. Kyei, Ebenezer Zaabaar, Frank Assiamah, M. Kwarteng, Kofi Fred Asiedu","doi":"10.4314/AAS.V18I3.4","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.4","url":null,"abstract":"Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. \u0000Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. \u0000Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. \u0000Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87381207","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}

引用次数: 0

Association Between Serum Sodium Abnormalities and Clinicoradiologic Parameters in Severe Traumatic Brain Injury 重型颅脑外伤患者血清钠异常与临床放射学参数的关系

Annals of African Surgery Pub Date : 2021-07-20 DOI: 10.4314/AAS.V18I3.6

P. Mwachaka, A. Amayo, N. Mwang'ombe, P. Kitunguu

{"title":"Association Between Serum Sodium Abnormalities and Clinicoradiologic Parameters in Severe Traumatic Brain Injury","authors":"P. Mwachaka, A. Amayo, N. Mwang'ombe, P. Kitunguu","doi":"10.4314/AAS.V18I3.6","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.6","url":null,"abstract":"Background: Secondary brain insults after traumatic brain injury such as electrolyte dysfunctions are associated with poor outcomes. This study aimed at determining the incidence of serum sodium ion abnormalities and their association with clinicoradiological parameters. \u0000Methods: A prospective crosssectional study of one hundred and seventeen patients with severe head injury. Data collected included patient demographics, prehospital interventions, clinical examination findings, computed tomography (CT) scan head findings, serum sodium ion levels (at admission and 48 h later), and outcome (30 days). \u0000Results: At admission, 93(79.5%) patients had normal serum sodium ion levels. However, 48 h post-admission, hypernatremia was prevalent in 56(63.6%) patients (p < 0.001). Hypernatremia was significantly associated with the use of mannitol (p = 0.036), lower Glasgow Coma Score (p = 0.047), higher Injury Severity Score (p = 0.015), presence of subdural hematoma (p = 0.044), midline shift >5 mm (p = 0.048), compressed/absent basal cistern (p = 0.010), and higher Rotterdam CT Score (p = 0.003). Hypernatremia reported 48 h postadmission was associated with a high 30-day mortality rate [odds ratio (OR) 3.55, p = 0.0095]. Risk of mortality associated with hyponatremia and hypernatremia at admission was not statistically significant. \u0000 Conclusion: While both hyponatremia and hypernatremia can occur in serious TBI patients, hypernatremia predominates 48 hours post- admission and is associated with statistically significant increased risk of death.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"243 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72517827","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}

引用次数: 1

Indications and Outcomes of Corneal Transplant Surgery in Ghana 加纳角膜移植手术的适应症和结果

Annals of African Surgery Pub Date : 2021-07-20 DOI: 10.4314/AAS.V18I3.3

S. Lartey, E. K. Antwi-Adjei, A. Mohammed, Emmanuel Owusu Poku

{"title":"Indications and Outcomes of Corneal Transplant Surgery in Ghana","authors":"S. Lartey, E. K. Antwi-Adjei, A. Mohammed, Emmanuel Owusu Poku","doi":"10.4314/AAS.V18I3.3","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.3","url":null,"abstract":"Background: Corneal blindness contributes to 25% of all blindness. We review corneal transplant, a common surgical remedy, in Ghana to determine indications and visual outcomes in resource-poor environments. \u0000Methods: A retrospective cross-sectional study of keratoplasty evaluating indications, pre- and postoperative outcomes complications and their associations, between January 2014 and December 2018 at a teaching hospital in Ghana. Descriptive statistics and McNemar’s test were used for the analyses. \u0000Results: Seventy-five eyes were studied. The mean ± standard deviation (SD) age of patients was 45.08 ± 17.85 years, the majority being 20–39 years (58.7% were male). Pseudophakia bullous keratopathy (PBK) was the commonest indication for keratoplasty (26.7%) followed by keratoconus (21.3%). Preoperatively 96% of eyes were blind with vision <3/60 with 64% out of the total eyes with vision <1/60. Postoperatively, 60% of all grafts had uncorrected vision of 3/60 or better after the last follow-up. McNemar’s test revealed a statistically significant difference between postsurgical and pre-surgical visual acuity (VA) (p < 0. 001). The median follow-up period was 12 months. The commonest postsurgical complication was raised intraocular pressure (IOP) (22.7%) with a total of 14.7% of grafts failures. \u0000Conclusion: In this setting, PBK is the leading indication for corneal transplant. Visual outcomes for corneal transplant in this resource poor area are not worse than in other settings. We need to pay attention to corneal transplant services to cater for the expected increase in PBK from the increasing cataract surgical rate.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86564510","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}

引用次数: 1

The Medical Education Environment at the University of Nairobi, Kenya: An Assessment with the DREEM Tool 肯尼亚内罗毕大学医学教育环境：DREM工具评估

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.7

D. Ojuka, F. Aseta, Beth Githambo, Brian Wambua

{"title":"The Medical Education Environment at the University of Nairobi, Kenya: An Assessment with the DREEM Tool","authors":"D. Ojuka, F. Aseta, Beth Githambo, Brian Wambua","doi":"10.4314/AAS.V18I2.7","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.7","url":null,"abstract":"Background: The supportive learning environment can enhance impartating of knowledge and skills. Objective: To assess the learning environment at the School of Medicine of the University of Nairobi using the Dundee Ready Educational Environment Measure (DREEM) tool. Methods: A cross-sectional survey carried in 2019 out among medical students during their clinical years to obtain their perceptions about the learning environment at the School of Medicine of the University of Nairobi. The DREEM tool was used for the survey. Data were entered and analyzed in SPSS version19. Comparisons were performed using analysis of variance (ANOVA). p≤0.05 was considered statistically significant. Results: We obtained 619 responses (77.4%) from 800 tools distributed. The total mean score of DREEM was 93.3/200. This is a 46.7% score overall indicating a poor perception of the learning environment. Year IV was the class with the poorest perception with a p<0.05. Conclusion: The DREEM score shows numerous problems, with perception of learning and social support being the areas requiring the most improvement. Although teachers are knowledgeable, students are wary of their ability to transfer knowledge and skills.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"96-102"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49144428","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}

引用次数: 4

Medical Students’ Perceptions of the Medical Education Learning Environment at the University of Nairobi: II. A Qualitative Study 奈洛比大学医学生对医学教育学习环境的观感:II。定性研究

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.8

D. Ojuka, F. Aseta, Beth Githambo, Brian Wambua

{"title":"Medical Students’ Perceptions of the Medical Education Learning Environment at the University of Nairobi: II. A Qualitative Study","authors":"D. Ojuka, F. Aseta, Beth Githambo, Brian Wambua","doi":"10.4314/AAS.V18I2.8","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.8","url":null,"abstract":"Background: The educational environment (EE) has a significant influence on effective student learning. The Dundee Ready Education Environment Measure (DREEM) is a validated tool to assess the EE. A DREEM survey done in early 2019 among medical students at the University of Nairobi highlighted many problems. It was therefore important to explore why such perceptions existed among the medical students. Objectives: To explore medical students’ perceptions of the medical education learning environment at the University of Nairobi. Methods: Qualitative focus group discussions (FGD) were held among medical students in years III to VI in groups of between 8and 12 students. The discussions were recorded using a Samsung J6 phone voice recorder, transcribed, coded, and analysed for themes until saturation was reached. Results: We held six FGD with medical students in years III to VI and identified four thematic areas: 1) poor educational infrastructure, 2) poor educational structure, 3) teacher-centred teaching, and 4) lack of social support for students in difficulties. Conclusion: Exploring the perceptions of the EE confirmed students have a poor view of the educational environment. The issues raised are good feedback on teaching, governance and the social culture of the institution.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"103-108"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48457929","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}

引用次数: 1

Prepuce Transillumination: A Safety Tool in Forceps-guided Circumcision 包皮透照术：一种安全的包皮环切术工具

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.3

Maged Rihan

{"title":"Prepuce Transillumination: A Safety Tool in Forceps-guided Circumcision","authors":"Maged Rihan","doi":"10.4314/AAS.V18I2.3","DOIUrl":"https://doi.org/10.4314/AAS.V18I2.3","url":null,"abstract":"Background: Injury or even amputation of the glans or the penile shaft occurs rarely but can be a tragic circumcision-related complication. The forceps-guided technique can cause this complication due to an inability to visualize the glans before incising. This study was designed to solve this problem by transilluminating the prepuce before the incision, thus exploring whether it contains any tissue between its layers and visualizing what is being done rather than performing the procedure blindly. Methods: Forceps-guided circumcision was done on 432 males, from August 2018 to July 2019.The mean age of patients was 15.57 (1–348) days. The pulled prepuce was transilluminated, showing the prepuce and verifying that no glanular or penile tissue was involved in the forceps lock before incising. Results: The mean follow-up period was 12.45 (2–35) days. Twenty-one patients had postoperative bleeding, and six patients had a hematoma. Fourteen of the 21 patients were managed using a tight bandage; the remaining 7 patients needed surgical exploration. None of the patients had glanular or penile injury. Conclusion: Transilluminating the prepuce as a modification of forceps-guided circumcision is a protective safety step before cutting the prepuce, to eliminate the incidence of glanular or penile injuries.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"18 1","pages":"75-78"},"PeriodicalIF":0.0,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44851824","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}

引用次数: 0

Interest in Continuing Surgical Activity—A Necessity During the Pandemic 对持续手术活动的兴趣-大流行期间的必要

Annals of African Surgery Pub Date : 2021-04-23 DOI: 10.4314/AAS.V18I2.1

S. Mutambirwa

引用次数: 0