Journal of the West African College of Surgeons最新文献

{"title":"A Prospective Study on Tibial Shaft Fractures Treated with Suprapatellar Approach.","authors":"Shamith Chandar, Maddula Venkataramana Rao, Vijayakumar Druva, Raghavendra Dorai","doi":"10.4103/jwas.jwas_176_23","DOIUrl":"10.4103/jwas.jwas_176_23","url":null,"abstract":"<p><strong>Background: </strong>Tibial diaphysis represents the primary location for tibial fractures, accounting for 80% of such cases, often accompanied by fibular fractures. In terms of surgical management, the recommended technique for addressing both displaced and undisplaced tibial shaft fractures in adults is intramedullary nail fixation. Additionally, there is a growing consideration for suprapatellar nailing, which involves performing the procedure with the knee in a semi-extended position, as a potentially safe and efficacious alternative.</p><p><strong>Objectives: </strong>To evaluate the clinical and functional union amongst tibial shaft fracture cases, managed by nailing in the suprapatellar approach, and to study the complications associated with it.</p><p><strong>Materials and methods: </strong>Our study with prospective observational design was conducted for 18 months on 30 patients with tibial shaft fractures. Following comprehensive laboratory assessments and confirmation of surgical fitness, the patients underwent surgical intervention through a specialised suprapatellar approach employing expert tibial nailing.</p><p><strong>Results: </strong>The mean age of the subjects was 42.83 ± 11.47 years, and the majority were males (70.0%). Notably, there was a statistically significant reduction in Visual Analogue Scale scores and a concurrent increase in Lysholm Knee Scoring Scale scores during the follow-up period, indicating substantial enhancements in both clinical and functional outcomes. Delayed union was the complication observed in three individuals. We found that the younger the age of the subjects, the earlier the surgery after an injury, the better the functional outcome.</p><p><strong>Conclusion: </strong>Expert tibial nailing with a suprapatellar approach was successful in yielding clinical and functional union amongst the subjects with tibial shaft fractures. In addition, delayed union was the complication observed in the approach, which was evident in a few cases.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302717","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":"An Unusual Presentation of Intestinal Obstruction: Uterine Perforation and Bowel Herniation Following Manual Vacuum Aspiration.","authors":"Terna Aule, Moses Ahangba Adamgbe, Mary Musa Usman, Anthony Aboki Eko, Akut Daniel John, Busari Abdulmumini, Sunday Christopher Jock, Evelyn Oluwatobi Solomon, Jonah Musa, Benjamin Tagbo Ugwu","doi":"10.4103/jwas.jwas_166_23","DOIUrl":"10.4103/jwas.jwas_166_23","url":null,"abstract":"<p><strong>Introduction: </strong>Uterine perforation following manual vacuum aspiration (MVA) of early pregnancy is an uncommon occurrence. It is even more unusual to be complicated by bowel herniation and intestinal obstruction. Proper evaluation and intervention are required to ameliorate the attendant morbidity.</p><p><strong>Case report: </strong>We reported a case of a 39-year-old known retroviral disease P₁+[1] nonalive who presented 2 weeks after MVA with clinical and radiological features of complete small bowel obstruction. She was resuscitated and had a laparotomy that revealed a herniated loop of small bowel through a uterine perforation. Resection and anastomosis were done; she made a full recovery and was subsequently discharged on the 7th postoperative day.</p><p><strong>Conclusion: </strong>Public enlightenment, safe sex practices, and public access to health care covered by health insurance would reduce the incidence of this uterine perforation.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302718","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":"Lumbar Pedicle Dimensions Using CT Scan in Adults of South-Eastern Nigeria as Related to Transpedicular Fixation.","authors":"Sunday Patrick Nkwerem, Samuel C Ohaegbulam, Wilfred Mezue, Jude-Kennedy Chinedu Emejulu, Chika Anele Ndubuisi, Geraldine Ifechukwu Nkwerem","doi":"10.4103/jwas.jwas_169_23","DOIUrl":"10.4103/jwas.jwas_169_23","url":null,"abstract":"<p><strong>Background: </strong>Transpedicular fixation depends on accuracy of the entry points, angle of insertion and pedicular isthmus width for adequate screw insertion. Preoperative measurements of pedicle dimensions reduce the chances of failure during insertion. These pedicle dimensions (transverse diameter, longitudinal diameter, and maximum length of purchase [MLP]) vary with sex and race. Such data, from a large-scale study, are not available for our population.</p><p><strong>Objective: </strong>The study aims to evaluate the dimensions of pedicle that are relevant for pedicle screw fixation in Southeast Nigerian population.</p><p><strong>Materials and methods: </strong>A prospective multi-slice CT based clinical anatomy study done at Memfys Hospital for Neurosurgery, Enugu. This study is on the lumbar pedicle dimensions that are related to transpedicular fixation (transverse and longitudinal diameters of the pedicle, MLP, pedicle transverse and longitudinal angles of inclination). Sample size (273) was calculated with the confidence interval formula based on the number of patients that present for images. Consent and ethical approval were obtained.</p><p><strong>Results: </strong>The mean values are as follow: LD1 8.22 mm, LD2 7.73 mm, LD3 7.40 mm, LD4 7.16 mm, LD5 6.87 mm TD1 5.05 mm, TD2 5.31 mm, TD3 6.72 mm, TD4 8.27 mm, TD5 11.31 mm, MLP1 46.60 mm, MLP2 47.97 mm, MLP3 47.14 mm, MLP4 45.54 mm, MLP5 43.47 mm TA1 17.8°, TA2 19.34°, TA3 20.80°, TA4 22.00°, TA5 25.70° LA1 19.42°, LA2 18.61°, LA3 18.00°, LA4 17.09°, LA5 16.40°. Unlike transverse diameter, transverse angle, longitudinal dimension, longitudinal angle (LA), MLP there was significant correlation between age and mean LA. The mean values also correlated significantly with the gender.</p><p><strong>Conclusion: </strong>The mean values varied with the different vertebral levels and was good correlations between some of the parameters with age and gender.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302725","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":"Prosthodontic Rehabilitation of a Completely Edentulous Patient with Sunken Cheeks Using Detachable Cheek Plumper Retained with Customised Ball Attachments and Orthodontic Separators: A Case Report.","authors":"Manu Rathee, Pardeep Singh, Amit Tamrakar, Maqbul Alam, Pritish Dixit, Sarthak Singh Tomar, Kritika Diwan","doi":"10.4103/jwas.jwas_175_23","DOIUrl":"10.4103/jwas.jwas_175_23","url":null,"abstract":"<p><p>Prosthodontic rehabilitation is incomplete without taking aesthetic considerations into mind, even in the elderly, who are assumed to be mainly concerned about the loss of masticatory ability rather than an alteration in appearance. The ageing process brings changes in facial appearance, which if more pronounced lead to unacceptable facial aesthetics. A common means of restoring the support of ageing-induced sunken cheeks is the use of cheek plumper. This case report describes an economical method of retention of cheek plumper using customised cast ball attachments and orthodontic separators. The modified prosthesis design did not negatively affect the retention of the prosthesis, resulting in a satisfactory resolution of the patient's complaints.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302731","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":"Recovery of Learning and Memory Deficits Despite Persistent Pyknosis of the Hippocampal Pyramidal Neurons of Adult Hydrocephalic Mice.","authors":"Ebenezer O Ajiboye, Funmilayo Eniola Olopade, Omowumi Moromoke Femi-Akinlosotu, Matthew Temitayo Shokunbi","doi":"10.4103/jwas.jwas_118_23","DOIUrl":"10.4103/jwas.jwas_118_23","url":null,"abstract":"<p><strong>Background: </strong>The hippocampal alterations resulting from hydrocephalus are associated with various cognitive dysfunctions. Reduced learning and memory are early functional deficits that recover with time in experimental hydrocephalus. This study investigated the recovery processes of learning and memory loss in relation to the morphology of hippocampal pyramidal neurons and the degree of expansion of the ventricles.</p><p><strong>Materials and methods: </strong>Hydrocephalus was induced in adult mice by intracisternal injection of sterile kaolin while controls received sham operation. Neurobehavioral tests for memory and learning were conducted, after which the animals were sacrificed in batches: 7 (acute) and 28 (subacute) days postinduction. After sacrifice, mice were categorized into mild and moderate hydrocephalus, and their fixed brain samples were processed for hematoxylin, eosin, and Nissl stains.</p><p><strong>Results: </strong>In moderate acute hydrocephalus, the indices of learning and memory were reduced escape latency (67.20 ± 12.83 s), number of platform crossing (4.000 ± 1.658), duration in platform quadrant (4.000 ± 1.658), and percent of total investigation (44.857% ± 3.981%) but not in the subacute stage. Pyknotic indices (PI) were significantly higher in the cornu ammonis (CA)1 and 3 regions in all hydrocephalic groups than in controls. However, within groups, PI was significantly higher only in the CA1 of moderate acute (28.149% ± 1.875%) compared to moderate subacute hydrocephalic group (12.903% ± 3.23%).</p><p><strong>Conclusion: </strong>Hydrocephalus caused cellular injury to the hippocampus associated with spatial learning and memory deficits. However, these functional deficits were partially reversed in moderate subacute hydrocephalus despite the persistence of the structural alterations in the CA1 and CA3 subregions.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302732","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":"Solitary Masseter Metastasis from Renal Cell Carcinoma: A Rare Case Report.","authors":"Rustam Karanjia, Pallab Sarkar, Muhammad Eraibey, Sashi Kommu","doi":"10.4103/jwas.jwas_149_23","DOIUrl":"10.4103/jwas.jwas_149_23","url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma (RCC) frequently presents with metastatic spread, sometimes many years after treatment. However, masseter muscle metastasis is extremely rare, with just six reported cases in literature, and none in the United Kingdom (UK). Given its rarity, we hope our case will add to the body of knowledge on the subject and encourage clinicians to maintain a high index of suspicion when reviewing patients with previous RCC and an unexplained mass.</p><p><strong>Case summary: </strong>Here presented is a 62-year-old man who previously underwent left radical nephrectomy in 2014 for an 11 cm clear cell renal carcinoma (ccRCC). He had subsequent right adrenalectomy in 2020 for a 19 mm recurrence, which was excised with clear margins. He then presented in 2022 with a three-month history of enlarging painless mass in the left side of his face. Imaging was inconclusive, but biopsy showed a singular ccRCC metastatic deposit in the masseter. Surgical resection was not possible due to extension into the infratemporal fossa, and he was referred for radiotherapy.</p><p><strong>Conclusions: </strong>Masseter muscle, whilst rare, can be a site of distant metastases for renal cell carcinoma. Diagnosis relies on a high index of clinical suspicion in patients with prior RCC, combined with cross-sectional imaging and biopsy. Early detection gives the best chance for cure with metastasectomy.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302733","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 Study of Correlation between Symptoms of Gastritis and Endoscopic Biopsy.","authors":"Shravan R Dave, Jayeshkumar B Bagada, Jitesh H Desai, Shivangi Jha","doi":"10.4103/jwas.jwas_96_23","DOIUrl":"10.4103/jwas.jwas_96_23","url":null,"abstract":"<p><strong>Background: </strong>Gastritis is a very common disorder that is widely distributed worldwide, representing one of the most prevalent pathological entities in gastroenterology and digestive endoscopy. This study aims to analyse the correlation between the endoscopic findings and the symptoms of gastritis. Upper gastro-intestinal (UGI) endoscopy is a widely used investigation for a variety of UGI symptoms namely dysphagia, dyspepsia, abdominal pain, etc., and when combined with biopsy, its diagnostic accuracy get increased manifold.</p><p><strong>Materials and methods: </strong>This is a study with 70 patients with symptoms of gastritis underwent UGI endoscopy and biopsy included in study. Biopsy was taken from gastric/duodenal mucosa and was sent for histopathology examination. Data of patient's age, gender, food habits, oral hygiene, etc., were then taken into consideration and findings of UGI endoscopy were correlated with these data and also correlated with histopathological report.</p><p><strong>Results: </strong>Gastritis significantly affects the lifestyle of the majority of our participants as out of 70, 65 (95%) had gastritis in our study. <i>Helicobacter pylori</i> was present among 41.5 % of study participants. Other less common findings were esophagitis in 20 % and duodenitis in 7% of study participants. The mean age of participants were 46.76 ± 16.25 years.</p><p><strong>Conclusion: </strong>Histopathology plays a major role in diagnosing <i>H. pylori</i> infection. So, histological examination as an adjunct to UGI endoscopy should be considered as best diagnostic tool rather than UGI endoscopy alone or clinical examination or radiological examination alone. It helps to treat the gastritis patients by diagnosing the underlying cause and management accordingly.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302735","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":"Huge Choledochal Cyst in a 26-Year-Old Female: A Case Report.","authors":"Glory Adebajo, Aduragbemi Adebunmi, Adebayo Olugbami, Oluwasegun Ijarotimi, Adeniyi Aderibigbe, Titilayo Ojumu, Adewale Adisa","doi":"10.4103/jwas.jwas_163_23","DOIUrl":"10.4103/jwas.jwas_163_23","url":null,"abstract":"<p><p>We present the case of a 26-year old woman who developed obstructive jaundice and massive abdominal swelling. Investigations revealed a huge choledochal cyst with obstructive pattern of hyperbilirubinaemia. She had exploratory laparotomy, drainage and excision of the choledochal cyst and Roux-en-Y hepaticojejunostomy. She has been followed up for 6 months in good clinical condition.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302722","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":"Glass Ionomer Cement Induced Angioedema: Seldom Encounter in Prosthodontic Practice-A Case Report.","authors":"Sreetama Taraphdar, Anumita Manna, Arindam Karmakar, Aniket Sarkar","doi":"10.4103/jwas.jwas_157_23","DOIUrl":"10.4103/jwas.jwas_157_23","url":null,"abstract":"<p><p>Contact allergies are frequently encountered in dental practice, and their underlying causes are not readily apparent. These allergies can arise from allergic or anaphylactic responses triggered by commonly utilised dental materials in routine dental procedures or potentially result from the use of specific medications. This case presents a unique scenario involving a patient who sought prosthetic crowns following maxillary anterior teeth endodontic treatment. During the cementation of the prosthesis with glass ionomer cement, the patient unexpectedly experienced an acute allergic reaction in her upper lip. The patient received reassurance and was prescribed a 3-day course of oral corticosteroids and antihistamines, resulting in symptom relief within 24 h. This paper seeks to raise awareness among clinicians about the potential for contact allergic reactions and aims to emphasise the presentation and management of the uncommon incidence of angioedema during prosthodontic procedures.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302721","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":"Laparoscopic Cholecystectomy for Entirely Calcified Porcelain Gallbladder: Challenges, Management, and Literature Review.","authors":"Dharmendra Kumar Pipal, Vikram Vardhan, Prakash Biswas, Vibha Rani Pipal, Himanshu Jatoliya","doi":"10.4103/jwas.jwas_168_23","DOIUrl":"10.4103/jwas.jwas_168_23","url":null,"abstract":"<p><p>Commonly referred to as a \"porcelain gallbladder (PGB),\" gallbladder calcification is usually asymptomatic. It is observed that chronic inflammation of the gallbladder can occur as a result of another underlying condition, specifically gallstone disease. In the past, there was a belief that PGB had a correlation with gallbladder cancer, with an incidence rate of 30%. However, recent studies have indicated that the rate is only 5%-22%. Patients diagnosed with PGB, who are deemed to be at an elevated risk of developing cancer may undergo prophylactic cholecystectomies. However, recent research indicates that a subset of these patients may potentially avoid this surgical intervention. As a result of the increased risk of gallbladder cancer, and the difficulty of holding and retracting the gallbladder, laparoscopic cholecystectomy was not often recommended for patients with PGBs in the past. However, with the advancement of technology laparoscopy is now a choice for such difficult cases. Here we report a case of PGB in a 55-year-old female patient who complained of intermittent pain in the right upper abdomen with vaginal discharge. She was successfully managed laparoscopically.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302724","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}