Journal of the West African College of Surgeons最新文献

{"title":"Steroid-Induced Osteonecrosis of the Femoral Head in Northern Nigeria: Reasons for Steroid Use and Outcome of Total Hip Replacement.","authors":"Mohammed Nuhu Salihu, Soliudeen Adebayo Arojuraye, Mohammed Musa Mohammed, Ali Mohammed Ramat, Musliu Kolawole Odunola","doi":"10.4103/jwas.jwas_154_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_154_25","url":null,"abstract":"<p><strong>Background: </strong>Glucocorticoid use and alcoholism constitute over 90% of all non-traumatic causes of avascular necrosis (AVN) of the head of the femur (HOF). Total hip arthroplasty (THA) is the treatment of choice for end-stage AVN of HOF. In Nigeria, patients use oral corticosteroids for many medical and social reasons. The purpose of this study was to analyse various reasons why steroids are used and to document the early outcomes of THA in steroid-induced osteonecrosis of HOF in northern Nigeria.</p><p><strong>Materials and methods: </strong>This prospective interventional multicentre study was conducted at various government hospitals across northern Nigeria between January 2021 and June 2025. The reasons for taking steroids were documented in this study. The functional outcomes after THA were assessed using the Harris Hip Score (HHS), and patients' overall satisfaction was also reported using a 5-point Likert scale. Statistical analyses were performed using Statistical Package for the Social Sciences version 23 for Windows.</p><p><strong>Results: </strong>Most of the patients, 102 (73.9%), use steroids for social reasons. Only 36 (26.1%) of the patients used the drugs for medical reasons. There was a significant improvement in postoperative HHS (<i>P</i> = 0.000), and most of the patients were satisfied with the treatment.</p><p><strong>Conclusion: </strong>Most patients with steroid-induced AVN of HOF in northern Nigeria used steroids for social reasons. The outcome of THA for steroid-induced osteonecrosis of the HOF was excellent, and most patients were satisfied with the result.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"486-490"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165801","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":"Pericardial Diseases in Lagos: A 5-Year Institutional Experience of Surgically Managed Cases.","authors":"Ezekiel O Ogunleye, Olugbenga O Olusoji, Peter-Marie O Iwuchukwu, David B Idowu, Casmir E Amadi, Adeniyi A Adesida, Okezie O Kanu","doi":"10.4103/jwas.jwas_141_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_141_25","url":null,"abstract":"<p><p>Pericardial diseases are common in clinical practice and may occur in isolation or form part of systemic disease. The clinical presentation of patients with pericardial disease is dependent on multiple factors, including the rate and volume of pericardial fluid accumulation, chronicity of the inflammatory process, and the degree of pericardial fibrosis and calcification. Cardiac tamponade and pericardial constriction are life-threatening sequelae of pericardial diseases, occurring in the acute and chronic stages, respectively. The management of pericardial diseases is multidisciplinary and may require surgical intervention. The aim of this study was to review our institutional experience in the surgical management of pericardial diseases.</p><p><strong>Materials and methods: </strong>We conducted a single-centre retrospective review of records of patients with pericardial diseases managed over a 5-year period spanning from August 2018 to 2023.</p><p><strong>Result: </strong>A total of 141 patient records were analysed for the study period with a male-to-female ratio of 1:1.39 and a mean age of 32.7 ± 18.82 years. Tuberculous pericarditis was the most frequent cause of pericardial disease (53%), with most (74%) patients presenting with pericardial tamponade.</p><p><strong>Conclusion: </strong>Pericardial diseases are common reasons for presentation, and tuberculous pericarditis ranks highest. There are notable challenges in diagnosis and treatment. Surgical morbidity and mortality could improve with the addition of recent advanced techniques to our diagnostic and surgical armamentarium.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"501-506"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171257","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":"Predictors of Difficult Laparoscopic Cholecystectomy in Adults in a Nigerian Tertiary Hospital.","authors":"Grace I Bassey, Adebayo M Olugbami, Freedman Ita-Lincoln, Adewale O Adisa","doi":"10.4103/jwas.jwas_144_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_144_25","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is the recommended treatment for benign gall bladder diseases. Difficult LC (DLC) is a recognised cause of prolonged surgery, the need for conversion to open procedure, and postoperative complications. The identification of the predictors of DLC preoperatively may contribute to improved preoperative planning and surgical outcome.</p><p><strong>Aims and objectives: </strong>To determine the rate of DLC and predictors of DLC in adult patients at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife.</p><p><strong>Materials and methods: </strong>We retrospectively analysed data from 129 case notes of patients who had LC over a 7-year period using STATA 18. Patients were grouped into normal LC and DLC. Bivariate analyses were conducted using appropriate statistical tests. Relevant factors were entered into a multivariable logistic regression model to identify independent predictors. Significance was set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>Mean age was 45.8 ± 14.6 with a 5.8:1 female to male ratio. Nearly a quarter of the patients (<i>n</i> = 30, 23.3%) had a positive Murphy's sign. Overall mean surgery duration was 76.8 ± 21.9, with a 38.8% prevalence of DLC. Four LC were converted to open (<i>n</i> = 4, 3.1%). Positive predictors for DLC were age ≥60 years (adjusted odds ratio [AOR]: 3.34; 95% confidence interval [CI]: 1.02-11.02; <i>P</i> = 0.047) and a positive Murphy's sign (AOR: 3.63; 95% CI: 1.41-9.32; <i>P</i> = 0.07).</p><p><strong>Conclusion: </strong>The low rate of postoperative complications and conversion to open procedure despite the significant DLC rate indicates that with improved expertise/skills of the surgeon, safe LC is feasible and could become the main approach for cholecystectomy in Nigeria.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"357-364"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165720","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":"Intragastric Balloon Versus Sleeve Gastrectomy: Baseline Characteristics and Comorbidity Prevalence in a Nigerian Cohort.","authors":"Adedire Timilehin Adenuga, Oluwatosin Wuraola Akande, Shekina Iyefu Adanu, Esther Nnenna Madu, Isaiah Oluwasegun Atoyebi, Pedro Gloria Igoni","doi":"10.4103/jwas.jwas_145_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_145_25","url":null,"abstract":"<p><strong>Background: </strong>Data describing baseline demographics, clinical characteristics, and obesity-related comorbidities among patients seeking bariatric interventions in Sub-Saharan Africa are limited. We describe demographics, obesity class, procedure selection, and comorbidity prevalence among patients undergoing intragastric balloon (IGB) or sleeve gastrectomy (SG) at a private center in Nigeria.</p><p><strong>Materials and methods: </strong>Retrospective analysis of prospectively collected electronic records for adults (≥18 years) who underwent IGB (<i>n</i> = 113) or SG (<i>n</i> = 55) between January 2023 and January 2025 was performed. Data on demographics, anthropometrics, obesity class, and comorbidities were extracted. Group comparisons used <i>χ</i> ² for categorical and <i>t</i>-tests or Mann-Whitney <i>U</i> for continuous variables; with the significance set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>A total of 168 patients (92.3% female) were included; mean age 35.4 ± 9.4 years. SG patients presented with higher mean body mass index (SG: 43.1 ± 6.8; IGB: 39.3 ± 7.9 kg/m²; <i>P</i> = 0.003) and weight (SG: 122.8 ± 19.9 kg; IGB: 111.7 ± 26.0 kg; <i>P</i> = 0.006). Higher obesity classes (IV-V) were more frequent in SG (38.2% combined) than IGB (18.5% combined; <i>P</i> = 0.013). Overall, 47.0% had ≥1 comorbidity; the prevalence was higher in SG (56.4% vs 42.5%; <i>P</i> = 0.09). Hypertension was the most common comorbidity (28.6%), and male patients (<i>n</i> = 13) carried a disproportionate comorbidity burden (≥1 comorbidity 84.6% vs 43.9% in females; <i>P</i> = 0.01) and had a higher prevalence of hypertension, diabetes, dyslipidemia, and obstructive sleep apnoea.</p><p><strong>Conclusions: </strong>Bariatric interventions in Nigeria are predominantly sought by younger women. Patients opting for SG had significantly greater obesity severity and tended towards higher comorbidity rates. Men were underrepresented but had markedly higher comorbidity burden when presenting for care. These findings highlight gender disparities, procedure selection patterns, and the need for broader awareness and access to metabolic and bariatric services in Nigeria.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"480-485"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168096","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 Technique for Non-fluoroscopic Contrast Swallow in Younger Children Presenting in Resource Limited Setting.","authors":"Adeniyi S Aderibigbe","doi":"10.4103/jwas.jwas_175_24","DOIUrl":"https://doi.org/10.4103/jwas.jwas_175_24","url":null,"abstract":"<p><strong>Background: </strong>Contrast swallow (CS) under fluoroscopic guidance remains an important investigation in exploring functional and structural oesophageal disorders. However, paucity of functional fluoroscopic machines in most secondary/tertiary hospitals and diagnostic centres in Nigeria makes the investigation less popular. Commendably, many radiologists currently improvise static X-ray machines to produce \"non-fluoroscopic\" CS spot images useful in investigating structural oesophageal pathologies. Unfortunately, both fluoroscopic and static CS are often limited in younger children by sub-optimal positioning with attendant risk of aspiration in the uncooperative minor.</p><p><strong>Materials and methods: </strong>This manuscript presents a simple modified technique for diagnosing structural oesophageal lesions in younger children using the regular over-table X-ray machine angulated 30° cranially, while the child is positioned in 30° semi-recumbent position on a wedged imaging plate for additional comfort and stability. Flavoured contrast agent was then given in the same position and spot images were obtained. CS images/reports of younger children (≤6 years) conducted by a consultant radiologist over a 3-year period using the aforementioned technique were also reviewed.</p><p><strong>Results: </strong>The 22 retrieved cases of CS included children with median age of 2.0 years. The most common indications were postoperative assessment of surgical correction (45.5%) and dysphagia following corrosive substance ingestion (31.8%). Corrosive oesophageal stricture (29%) was the most prevalent oesophageal structural abnormality reported. All the studies produced clear spot images with conclusive diagnostic quality.</p><p><strong>Conclusion: </strong>Although not previously reported in published English literature, non-fluoroscopic CS in semi-recumbent position is helpful in assessing structural oesophageal abnormality when fluoroscopy is unavailable.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"386-389"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171396","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":"Scrotal Reconstruction Following Excision of Idiopathic Scrotal Calcinosis: A Rare Condition with a Psychological Impact-A Case Report.","authors":"Ayodele Olukayode Iyun, Mustapha Akanji Ajani, Ifeanyichukwu Chinedum Ugwu, Izegaegbe O Obadan","doi":"10.4103/jwas.jwas_30_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_30_25","url":null,"abstract":"<p><p>Idiopathic scrotal calcinosis (ISC) is a rare and benign disorder occurring in the absence of a systemic disorder of calcium-phosphate metabolism. It presents in childhood or early adulthood, and affected individuals present with multiple, asymptomatic calcified nodules on the scrotum. We report the case of a 38-year-old man who presented via referral from the dermatologist to the plastic surgery clinic with a 22-year history of multiple scrotal nodules. The examination revealed multiple hard nodules in his scrotal skin. Following evaluation, he underwent scrotal excision with scrotoplasty. Histology of the scrotal nodules showed varying sizes of nodular aggregates of deeply basophilic calcified materials in the dermis (dystrophic calcification) - features in keeping with calcinosis cutis. ISC is a benign condition. Though asymptomatic, it can have psychological impacts and may also lead to embarrassment for the patient. Histological evaluation reveals areas of calcification. Excision and adequate scrotoplasty are the treatment of choice.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"507-510"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165738","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 University Undergraduate Students' Knowledge and Competency Following a First Responder's Training in Nigeria.","authors":"Abdulrasheed A Nasir, Mohammed J Saka, Jibril O Bello, Gbadebo H Ibraheem, Lukman O Abdur-Rahman, Benjamin O Bolaji, Olusola A Afolabi, Olasunkanmi M Babalola, Taofeeq O Mohammed, Hamid B Olanipekun, Kamil O Badmus","doi":"10.4103/jwas.jwas_197_24","DOIUrl":"https://doi.org/10.4103/jwas.jwas_197_24","url":null,"abstract":"<p><strong>Background: </strong>Emergency medical services for injured patients are grossly deficient in many parts of the low- and middle-income countries, including Nigeria. This allows the initial stabilisation and transportation of the injured to be done by untrained laypersons. This study sought to evaluate the effects of first responder training among university undergraduates in Nigeria.</p><p><strong>Materials and methods: </strong>A 1-day first responder course was conducted for university undergraduates in Ilorin, Nigeria. Pretest and post-test were performed to measure first aid knowledge improvement and improved confidence in providing first aid care.</p><p><strong>Results: </strong>A total of 127 university undergraduates (56.7% female), whose median age was 21 years, completed the training. About 61% of the trainees had no previous exposure to first aid training. The mean knowledge score improved from 40.2% before the training to 66.5% after the training (<i>P</i> < 0.0001). The results demonstrated significant improvement in most areas of first aid knowledge assessed. The greatest increase in knowledge was observed for bleeding control. There was also an increase in the mean skill confidence score from 2.77 to 4.69 (<i>P</i> = 0.01).</p><p><strong>Conclusion: </strong>This study has shown that basic first responder training improves students' knowledge and perceived skill confidence in the provision of first aid care. Further research is underway to assess knowledge retention and skill utilisation during follow-up.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"390-396"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172354","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 Practice of Parents Towards Childhood Eye Diseases in Obuoffia, a Rural Community in Enugu Southeastern Nigeria.","authors":"Lilian Obianuju Okwesili, Nkiru Zuada Nwachukwu, Stella Ngozi Onwubiko, Chimdi Memnofu Chuka-Okosa","doi":"10.4103/jwas.jwas_187_24","DOIUrl":"https://doi.org/10.4103/jwas.jwas_187_24","url":null,"abstract":"<p><strong>Introduction: </strong>Parents are the key decision makers in the eye care of their children. This study aimed to assess the knowledge, attitude, and practices (KAPs) towards childhood eye diseases among parents in a rural community in southeastern Nigeria and to determine the factors affecting the KAP.</p><p><strong>Materials and methods: </strong>A descriptive cross-sectional population-based survey was conducted among parents in Obuoffia Community, Nkanu West local government area of Enugu state, Nigeria. Data were collected using a pretested interviewer-administered questionnaire. Data were analysed with IBM Statistical Package for the Social Sciences. Descriptive, chi-square, and logistic regression statistics were done, and a <i>P</i> value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>There were 597 participants. The proportion of participants with good knowledge was 76.2%, those with positive attitudes was 75.2%, and those with good practice was 22.4%. Good knowledge was significantly associated with being married, on salaried employment, having at least secondary education, and having a positive attitude. Positive attitude was associated with being employed and good knowledge (<i>P</i> < 0.05). Good eye care practice was significantly associated with older age ≥45 years, being employed, and having a positive attitude. The significant predictors of good practice were age ≥45 years and a positive attitude. Belief in the use of traditional eye medications for red or discharging eyes was common.</p><p><strong>Conclusions: </strong>There was overall good knowledge and positive attitude towards childhood eye diseases among parents in Obuoffia, but these did not translate to good practice. Intervention eye care programmes integrated with primary healthcare and targeted at parents less than 45 years of age are recommended.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"491-500"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167714","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":"Effect of Fentanyl Added to Bupivacaine for Intrathecal Injection on the Outcome of Neonates Delivered by Caesarean Section under Spinal Anaesthesia.","authors":"Idris Mohammad El-Amin, Lawal Ibrahim Ibrahim, Mohammed Rabiu Isa, Yakubu Saidu Yusuf, Yakubu Hamisu, Toro Shehu Mohammed, Abdullahi Sheidu Owuda, Abubakar Yakubu, Aghadi Ifeanyi Kene, Junaidu Habiba","doi":"10.4103/jwas.jwas_13_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_13_25","url":null,"abstract":"<p><strong>Background: </strong>Addition of fentanyl to 0.5% hyperbaric bupivacaine for subarachnoid block (SAB) enhances the efficacy of bupivacaine and enables the use of reduced doses of the two drugs, thereby minimising their adverse effects. However, fentanyl may cross the placenta and cause chest wall rigidity, cardiovascular and respiratory depression in the foetus, resulting in poor neonatal outcome.</p><p><strong>Objectives: </strong>This study aimed to determine and compare the effects of 20 and 25 µg fentanyl added to 10 mg 0.5% hyperbaric bupivacaine on the outcome of neonates delivered by caesarean section under SAB.</p><p><strong>Materials and methods: </strong>Ninety-nine pregnant women, aged 18-45 years and American Society of Anaesthesiologists I and II, were randomly divided into three equal groups: group A, group B, and group C. Each group received 2 mL (10 mg) 0.5% hyperbaric bupivacaine, and in addition, group A received 0.5 mL normal saline, group B received 0.4 mL (20 µg) fentanyl + 0.1 mL normal saline, whereas group C received 0.5 mL (25 µg) fentanyl. Following delivery, the newborn babies' Apgar scores, Neurological and Adaptive Capacity Scores (NACS), umbilical cord arterial blood gas, peripheral oxygen saturation (SpO₂), and pulse rate were assessed.</p><p><strong>Results: </strong>The mean Apgar scores at 1 and 5 min and the mean NACS at 15 min and 2 h were significantly lower in the fentanyl/bupivacaine groups compared with the bupivacaine only group (<i>P</i> < 0.001). The mean pH and SpO₂/PR of the neonates were within normal neonatal range but decreased from group A to group C (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>Neonates whose mothers received bupivacaine only had better outcomes than those who received bupivacaine/fentanyl combination, whereas those who received 20 µg fentanyl had better outcomes than those who received 25 µg.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"425-432"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170959","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":"Surgical Management of Paediatric Naso-Orbito-Ethmoid Fracture using a Stainless Steel Plate: A Case Report.","authors":"R Mahesh Kumar, Chinta Chetana Hota, Yash Vipulkumar Vyas, Shivani Anasane, Snehasree Das, Ritika Prasad","doi":"10.4103/jwas.jwas_129_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_129_25","url":null,"abstract":"<p><p>Naso-orbito-ethmoid (NOE) fractures in paediatric patients are uncommon but can result in significant functional and aesthetic impairments if not managed promptly. This case report describes a paediatric patient, who sustained an NOE fracture following self-fall. The patient exhibited pain, periorbital swelling, ecchymosis, and depressed nasal bridge. The patient was evaluated clinically and radiologically, revealing displacement of the NOE complex. Given the potential for long-term complications, open reduction and internal fixation with a stainless steel plate and screws under general anaesthesia was performed to restore the structural integrity and aesthetics of the midface. The patient's postoperative recovery was uneventful, with no functional or cosmetic deficits noted during the follow-up. This case emphasises the efficacy of stainless steel fixation in paediatric NOE fractures. The gullwing incision offered excellent access, and a single 1.5-mm stainless steel plate with two screws was sufficient for stabilisation. Plate removal at 8 weeks helped minimise growth interference. The 6-month follow-up confirmed functional and aesthetic success.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"511-514"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169095","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}