Complicated appendicitis in Children in Aba, Nigeria

2019 ◽  
Vol 9 (11) ◽  
pp. 661-664
Author(s):  
Samuel Chidi Ekpemo
Keyword(s):  
Stable State ◽  
Postoperative Outcome ◽  
Pelvic Abscess ◽  
Complicated Appendicitis ◽  
University Teaching ◽  
First Episode ◽  
Female Ratio ◽  
Duration Of Hospitalization ◽  
Treatment Complication ◽  
Wrong Diagnosis

Introduction: Acute appendicitis is one of the most common abdominal emergencies globally. Etiologyremains poorly understood with few advances over the past decades. Obtaining a confident pre-operativediagnosis remains a challenge, as appendicitis must be entertained in any patient presenting with an acuteabdomen. A clinical classification is used to stratify management based on simple (non-perforated) andcomplex (gangrenous or perforated) inflammation, although many patients remain with an equivocaldiagnosis, which remains one of the most challenging dilemmas. The aim of the study is to evaluate themanagement and outcome of complicated appendicitis at the Abia State University Teaching HospitalAba Nigeria. Methodology: A prospective analysis of all children treated for appendicitis at the AbiaState University Teaching Hospital Aba between 2016 and December 2018. Proforma was opened fordemographic data, clinical presentation, diagnosis, treatment, complication and outcome. Results: A totalof 100 children aged between 2 and 15 (mean 8.7 ± 2.8) years, comprising 60males and 40 females withmale/female ratio 3:2 had appendectomy which accounted for 8% of total pediatric operations and 40% ofpediatric abdominal operations. Only 40 (40%) children presented during the first episode of symptomsand in clinically stable state while 60 (60%) were referred after wrong diagnosis and treatment by generalpractitioners which resulted in different complications ranging from appendix abscess 10 (10%), appendixmass 15 (15%), perforated appendix 30 (30%), gangrenous appendix 5 (5%) . These influenced postoperative outcome with wound infection recorded in 20 (20%), wound break down 10 (10%), septicemia15 (15%), pelvic abscess 5 (5%) and death 1 (1%). These were not recorded among those who presentedearly who also had significantly lower duration of hospitalization and cost of treatment. Conclusion: Latereferral due to paucity of knowledge, long referral chain and low index of suspicion was rampant whichsignificantly increased associated morbidities and mortality among children managed with appendicitisKeywords: Appendicitis, children, complicated

Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. (Preprint)

2019 ◽  
Author(s):  
Waheed Atilade Adegbiji ◽  
Shuaib Kayode Aremu ◽  
AbdulAkeem Adebayo Aluko
Keyword(s):  
Foreign Body ◽  
Head And Neck ◽  
Clinical Features ◽  
University Teaching ◽  
Age Group ◽  
Geriatric Population ◽  
Female Ratio ◽  
Common Diagnosis ◽  
Foreign Body Impaction ◽  
Nose And Throat

BACKGROUND Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. OBJECTIVE This study aimed at determining prevalence, sociodemographic features, aetiology, clinical features, Complications and sources ofreferral of geriatric otorhinolaryngological, head and neck emergency in our center. METHODS This was a prospective hospital based study of geriatric otorhinolaryngology emergency in the Ear, Nose and Throat Department of Ekiti State University Teaching Hospital. The study was carried out between October 2016 and September 2018. Data were obtained by using pretested interviewers questionnaire.All data were collated and analyzed using SPSS version 18.0. The data were expressed by frequency table, percentage, bar charts and pie charts. RESULTS Geriatric otorhinolaryngology, head and neck emergency accounted for 5.3%. Major prevalence age group was 43.9% in the age group (60-64). There were 38.6% males with male to female ratio of 1:1.5. The main aetiology of geriatric otorhinolaryngology emergency was 29.5% trauma/road traffic accident/foreign body impaction and 25.8% tumour. Main anatomical distribution of geriatric otorhinolaryngology emergency were 38.6% throat diseases and 31.1% ear diseases. The most frequent clinical features were pain in 27.3%, hearing loss in 21.2%, tinnitus in 15.9%, bleeding in 14.4%, difficulty breathing in 12.9% and discharge in 11.4%. Common diagnosis in this study were 15.9% sinonasal tumour, 14.4% upper aerodigestive foreign body impaction, 10.6% earwax impaction and 19.8% otitis externa. Acute presentation (<13 weeks) occurred in 1 week in 74.2% and 2-13 weeks In 19.7%. Commonest time of presentation was daytime in 65.9%. Major sources of referral were 43.2% general practitioner and 31.1% casualty officers. Presentation of geriatric otorhinolaryngology emergency were mainly ear, nose and throat clinic in 59.8% with accident and emergency in 28.8%. Commonest associated comorbid illnesses among the geriatric patients were 18.2% hypertension, 14.4% arthritis and 9.8% diabetes mellitus. CONCLUSIONS Geriatric otorhinolaryngological emergency are common pathology with associated with comorbid illnesses. Detailed clinical assessment are mandatory for effective management outcome.

Enterostomies for acute abdominal surgical condition in children: An experience in a developing country

2020 ◽  
pp. 1-4
Keyword(s):  
Damage Control ◽  
Intestinal Atresia ◽  
University Teaching ◽  
Salvage Procedure ◽  
State University ◽  
Female Ratio ◽  
Peritoneal Contamination ◽  
Surgical Conditions ◽  
Age Range ◽  
Surgical Condition

Background: Pediatric abdominal surgical condition that is complicated by gross peritoneal contamination may require enterostomy as a damage control or salvage procedure. Late presentations mostly seen in developing countries make creation of enterostomy a relatively common surgical procedure. The aim of this study was to evaluate the creation of enterostomy in children who presented with acute abdominal surgical conditions. Methods: This was a retrospective study of children that had enterostomy in the pediatric surgery unit of Enugu State University Teaching Hospital, Enugu, Nigeria. Medical records of pediatric patients that had enterostomy over a 10-year period were assessed. Results: There were 32 cases of enterostomies performed during the study period. There were 25 males (78.1%) and 7 females (21.9%) with a male to female ratio of 3.6:1. The age range of the patients was 3 weeks to 180 months, with a median age of 96 months. There were 1 neonate (3.1%), 10 infants (31.3%) and 21 children (65.6%) older than 1 year. The primary diagnoses were typhoid intestinal perforation in 21 patients (65.6%), intussusception 10 (31.3%) and intestinal atresia 1 (3.1%). Ileostomy was performed in 31 patients (96.9%) and jejunostomy in 1 patient (3.1%). Enterostomy was created at the time of initial laparotomy (damage control) in 21 patients (65.6%) while 11 patients (34.4%) had their enterostomy as a salvage procedure at the time of re-exploration. Peristomal skin complication was the most common complication recorded in our patients. Mortality was 12.5%. Conclusion: Enterostomy is lifesaving in the management of acute abdominal surgical condition when there is gross peritoneal contamination in severely ill children. Proper surgical technique and electrolyte derangements are important considerations when enterostomies are created.

scholarly journals Clinical study on complicated presentations of groin hernias

2017 ◽  
Vol 5 (8) ◽  
pp. 3303 ◽  
Author(s):  
Hariprasad S. ◽  
Teerthanath Srinivas
Keyword(s):  
Femoral Hernia ◽  
Groin Hernia ◽  
Cumulative Risk ◽  
Surgical Techniques ◽  
Postoperative Outcome ◽  
Subsequent Treatment ◽  
High Rate ◽  
Age Group ◽  
Female Ratio ◽  
Groin Hernias

Background: Groin hernia is a very common type abdominal wall hernia encountered in surgical practice. Irreducibility, obstruction and strangulation are its commonest complications which usually presents as acute emergencies. Emergency repair of complicated hernias is associated with poor prognosis and a high rate of post-operative complications even with better care, improved anaesthetic management and advanced surgical techniques. The aim of this study was to determine the various modes of presentation, clinical finding, diagnostic and therapeutic strategies and to evaluate the postoperative outcome in complicated groin hernia surgeries in our set up.Methods: The study was carried out among 40 patients of groin hernia, who had complicated clinical presentation like irreducibility, strangulation and obstruction in the department of general surgery, during the period from March 2012 to June 2014. Patients were enrolled into the study after proper consent for detailed clinical examination, investigation and subsequent treatment. The Data obtained included demographic characteristics, presentation, operative findings and outcome. The patients were followed up for immediate and late complications for once a week for 1 months, once every month for the next 6 months. After data collection, analysis was done with help of by SPSS software version 21.Results: A total of 40 groin hernia patients with complicated presentation were evaluated during the study period. Among these cases 38 cases had inguinal hernias and two cases had femoral hernia. Majority of the patients were in 5th and 6th decade. Complicated presentation of groin hernia was commonly seen in males (95%) than in females (5%) with male to female ratio of 19:1. Inguinal hernia complications were seen predominantly in males and femoral hernia complications in females. Right sided hernias were more common. Incarceration was the commonest complication seen in 70% of case followed by strangulation (30%). Incarceration was high (17.5%) in the age group of 64-73 years and 44 - 53 years. Strangulation was high in the age group of 54-63 years. The duration of hernia varied for 1-2 years in 42.5% of cases and 3-6 years in 27.5% of cases. Majority of the patients (30%) presented with localized groin pain, vomiting, constipation and abdominal distension. All patients presented with swelling in the inguinoscrotal region, which was tender, and there was no impulse on coughing and 35% of patients had cardiorespiratory illness. Majority of the cases (34 numbers) were operated as emergency procedure. Viable bowel was seen in 77.5% of cases. Bowel resection and end-to-end anastomosis was done in all cases of non-viable bowel and orchidectomy in atrophied and gangrenous testis. The commonest postoperative complication encountered in the study was wound infection (22.5%) and scrotal seroma (17.50%). There was no evidence of recurrence in any of the operated cases.Conclusions: Complicated presentations of groin hernias like, incarceration and strangulation are seen in low and middle socio-economic category of people and may be associated with chronic illness. The cumulative risk of strangulation increases with time and type of hernias. Timely diagnosis and prompted surgical repair is essential to prevent the complications. 

scholarly journals Profil Évolutif Des Accidents Vasculaires Cérébraux Hémorragiques À Yaoundé (Hôpital Général& Centre Hospitalier Et Universitaire)

2016 ◽  
Vol 12 (21) ◽  
pp. 197
Author(s):  
Patrice Emmanuel Awono Ateba ◽  
Justin Ndié ◽  
Julienne Louise Ngo Likeng ◽  
Benjamin Alexandre Nkoum
Keyword(s):  
General Hospital ◽  
Teaching Hospital ◽  
Public Health Problem ◽  
Premature Mortality ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Evolutionary Trend ◽  
Cross Sectional ◽  
Duration Of Hospitalization ◽  
The University

Nowadays, strokes constitute a real public health problem in the world. In Cameroon, because of the people’s lifestyle potential risk factor, the prevalence of hemorrhagic strokes as well as its mortality is on the rise. This study was aimed at analyzing the evolutionary profile of hemorrhagic strokes at the General Hospital and the University Teaching Hospital in Yaoundé. A retrospective cross-sectional study with a qualitative component was carried out at the General Hospital and the University Teaching Hospital in Yaoundé for 2 months. Were included, all patients with a diagnosis of hemorrhagic strokes confirmed by CT Scan. With the help of a scale, patient data over a 30 month’s period (2013-2015) were collected. Over 1037 patients hospitalized in intensive care unit at the General Hospital and the University Teaching Hospital in Yaoundé, 122 cases of hemorrhagic strokes were diagnosed, that is a prevalence of 11.8%. The average age was 58±10.52 and the most vulnerable age range was between 50 and 70 years with 67.2%. Men were most affected (60.7%) with a sex ratio of 1.54(74 men/48 women). Among these cases of hemorrhagic strokes still hospitalized, 70 had died giving a lethality rate of 57.4%. Only the duration of hospitalization had an effect on the outcome of patients with hemorrhagic strokes. Actually the patients, victims of hemorrhagic strokes who had had less than 21 days of hospitalization, had 2.91 chances of dying as compared to those patients hospitalized for over 21 days (OR=2.91 IC 95% [5.1-65.7]; p=0.000). The late admission to reanimation, the difficulties encountered by victims of hemorrhagic strokes and their careers, to handle the enormous cost of their treatment and the insufficiencies of the technical platform, were factors also influencing the evolution of hemorrhagic strokes hospitalized in reanimation at the General Hospital and the University Teaching Hospital in Yaoundé. Despite certain efforts aimed at reducing premature mortality, the prevalence of hemorrhagic strokes was increasing in reanimation at the General Hospital and University Teaching Hospital in Yaoundé. Only multisectorial actions of sensitization, the restructuring and amelioration of the care of this ailment will help reverse the evolutionary trend.

scholarly journals Carbapenem-Resistant Enterobacteriaceae Posing a Dilemma in Effective Healthcare Delivery

Antibiotics ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 156 ◽  
Author(s):  
Oli ◽  
Itumo ◽  
Okam ◽  
Ezebialu ◽  
Okeke ◽  
...  
Keyword(s):  
Urban Areas ◽  
Klebsiella Oxytoca ◽  
Healthcare Delivery ◽  
Educational Status ◽  
University Teaching ◽  
Diffusion Method ◽  
Female Ratio ◽  
Carbapenem Resistant ◽  
Klebsiella Spp ◽  
Carbapenem Resistant Enterobacteriaceae

The emergence and spread of Carbapenem-resistant Enterobacteriaceae (CRE) is seriously posing threats in effective healthcare delivery. The aim of this study was to ascertain the emergence of CRE at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Awka. Biological samples were collected from 153 consenting patient from 5 clinics in the hospital. The isolates were identified using standard microbiological protocols. Susceptibility to meropenem was done using Kirby-Bauer disc diffusion method on Mueller Hinton Agar. A total of 153 patients were recruited in this study. About one half of those from rural, 63.64% from Sub-urban and 42.27% from urban areas had significant E. coli and Klebsiella spp infections. The male: female ratio of the Enterobacteriaceae infection was 1:1. Almost as much inpatient as outpatient study participants had the infections. The infections were observed mostly on participants with lower educational status. The unmarried individuals were most infected compared to their married counterparts. Enterobacteriaceae infection rate was 50.98%. Of this, 28.21% had CRE infection while the overall prevalence of the CRE in the studied population was 14.38% (22/153). This study shows that CRE is quickly emerging in both community and hospital environments. Klebsiella spp was the most common CRE in this hospital especially Klebsiella oxytoca. Hospitalization was a strong risk factor in the CRE infections. Rapid and accurate detection is critical for their effective management and control.

The Histopathologic Patterns of Intracranial Neoplasms in the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria: A 10-Year Retrospective Study, January 2008 to December 2017

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S120-S121
Author(s):  
Kasiemobi Uchime ◽  
Luqman Adebayo ◽  
Charles Anunobi
Keyword(s):  
Teaching Hospital ◽  
Pituitary Adenomas ◽  
Age Groups ◽  
University Teaching ◽  
Geographical Differences ◽  
Intracranial Neoplasms ◽  
Female Ratio ◽  
Intracranial Neoplasm ◽  
Male To Female ◽  
Age And Sex

Abstract Objectives Intracranial neoplasms have distinct diagnostic histologic features and some are common in certain gender and age groups. The most common intracranial neoplasm worldwide is meningioma, followed by gliomas, most especially astrocytic tumors, and then pituitary adenomas. There are geographical differences in the pattern of occurrence of intracranial neoplasms. Few studies have been done in Nigeria to demonstrate the pattern of occurrence, age, and sex distributions of these neoplasms. The aim for this study is to establish the pattern of occurrence with age and sex distribution of different histologic types of intracranial neoplasm in our environment. This study may help portray the health burden of these tumors and aid in epidemiological studies. Methods A total of 296 patients (165 females, 131 males) diagnosed with intracranial neoplasms between January 2008 and December 2017 at Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria, were retrospectively analyzed. Patients’ data were retrieved from the archives of the Department of Anatomic and Molecular Pathology, LUTH, Idi-Araba, Lagos. Histologic patterns with age and gender distribution were noted. The data obtained were analyzed with SPSS version 23. Results Majority of the patients diagnosed with intracranial neoplasm were between 41 and 50 years of age. The most frequently diagnosed intracranial neoplasm at LUTH within the study period was meningioma (105 cases, median age of 42 years, male to female ratio of 3:7), followed by pituitary adenoma (78 cases, median age of 47 years, male to female ratio of 3:2), and then gliomas (66 case), most especially the astrocytic and oligodendroglial tumors (median age of 37 years, male to female ratio of 2:3). Conclusion The result of the study shows that the pattern of occurrence of primary intracranial neoplasms in our environment is different from that in Caucasians, with meningiomas being the most common, followed by pituitary adenomas and then gliomas.

Clinico-epidemiologic review of 91 cases of non-odontogenic sarcomas of the orofacial region in a Nigerian population

2019 ◽  
Vol 8 (2) ◽  
pp. 25-31 ◽  
Author(s):  
ROWLAND AGBARA ◽  
BENJAMIN FOMETE ◽  
KELVIN OMEJE ◽  
POLYCARP ONYEBUCHI
Keyword(s):  
Malignant Tumors ◽  
Maxillofacial Surgery ◽  
Osteogenic Sarcoma ◽  
University Teaching ◽  
Oral And Maxillofacial Surgery ◽  
Female Ratio ◽  
Oncological Treatment ◽  
Orofacial Region ◽  
Surgery Department

Introduction: Sarcomas are a rare group of malignant tumors. This study highlights important findings in 91 cases of non-odontogenic sarcomas of the orofacial region. Materials and Methods: Patients who presented with orofacial sarcoma at the Oral and Maxillofacial Surgery Department of a regional University Teaching Hospital between January 1997 and June 2017 were retrospectively studied. Excluded were cases of Kaposi and odontogenic sarcomas. Data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc., Chicago, IL, USA). Results from descriptive statistics were represented in the form of charts. Results: A total of 91 cases were reviewed and consisted of 51 (56.0%) males and 40 (44.0%) females, with a male to female ratio of 1.3:1. The mandible (n=47; 51.6%) and the maxilla (n=26; 28.6%) were the major sites involved. Osteogenic sarcoma (n=44; 48.4%) and rhabdomyosarcoma (n=16; 17.6%) occurred more frequently. A total of 41 (45.1%) patients had surgery and the common hard tissue procedures were mandibulectomy (n=26; 28.6%) and maxillectomy (n=10; 11.0%). Non-surgical oncological treatment was administered to 32 (35.2%) patients, and this was the only modality of treatment in 8 (8.8%) cases. The period of follow-up Arranged from 1-43 months and within this period; there were 7 (17.1%) recurrences with 1 case of pulmonary metastasis. Discussion: Most recurrences were noted less than one-year post-treatment. There is a tendency for patients to present late and compliance with follow up review is poor in this environment.

scholarly journals The non traumatic acute abdomen and its clinical spectrum

2019 ◽  
Vol 6 (5) ◽  
pp. 1710
Author(s):  
M. Srujan Kumar ◽  
Bharath B. ◽  
K. S. Balasubramanya ◽  
K. Thinagaran
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Clinical Examination ◽  
Open Appendectomy ◽  
Postoperative Outcome ◽  
Exploratory Laparotomy ◽  
Medical Sciences ◽  
Female Ratio ◽  
Perforative Peritonitis ◽  
General Surgeons

Background: Acute abdomen poses a big challenge to the general surgeons in terms of both diagnosis and management. The aim of this study was to know in detail the clinical and postoperative outcome in non traumatic acute abdomen.Methods: Prospectively collected data of 326 patients with non traumatic acute abdomen admitted in PES institute of medical sciences and research, Kuppam from November 2016 to June 2018. All patients were subjected to clinical examination, relevant blood and imaging investigations, Intra and postoperative findings events were recorded.Results: Non traumatic acute abdominal pain was more common in 2nd to 5th decade of life. Males are more affected than females with a male to female ratio of 3.4:1. Acute appendicitis forms the commonest cause of acute abdomen (n=160=49%) followed by perforative peritonitis (n=85=26%). Most common surgical procedures done were laparoscopic/open appendectomy for acute appendicitis, exploratory laparotomy with Graham’s omentoplasty for perforative peritonitis.Conclusions: Systematic approach in history taking and a proper clinical examination with supportive imaging findings are most important in making an accurate diagnosis and need of appropriate surgical intervention in patients with non traumatic acute abdomen.

scholarly journals The pattern of urine cytology in a tertiary health care facility Northwest Nigeria

2019 ◽  
Vol 6 (5) ◽  
pp. 1458
Author(s):  
Abdullahi Abdulwahab-Ahmed ◽  
Kabiru Abdullahi ◽  
Mohammed A. Umar ◽  
Ngwobia P. Agwu ◽  
Abubakar S. Muhammad ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Bladder Tumour ◽  
Care Facility ◽  
Health Care Facility ◽  
Urine Cytology ◽  
University Teaching ◽  
Female Ratio ◽  
Non Invasive ◽  
Variable Sensitivity ◽  
Age Range

Background: Urine cytology is an important investigation in the management of urothelial cancer. It is particularly an important test in the management of urinary tract cancers because of its non-invasive nature. Objective of study to review our practice of urine cytology as a diagnostic tool in the management of urinary tract pathology.Methods: A seventeen years retrospective study from 1st January, 2001 to 31st December, 2017 where records of patients who had urine cytology in Usmanu Danfodio University Teaching Hospital (UDUTH), Sokoto, Nigeria were reviewed and data was extracted and analyzed using the SPSS 20.Results: Of the 766 specimens, representing 10.1% of all cytology done in UDUTH (7,554) during the period under review, the highest number of urine cytology was done in 2013 (12%). The age range of the patients was between 2 to 90 years with modal age of 60 years. Majority of the patients were between the ages of 51 to 60 years (24.7%) and male to female ratio was 6.3:1. The commonest indication for urine cytology was bladder tumour (66.8%). However, the commonest cytological diagnosis was negative (44.6%) while 19.3% showed Non Specific Chronic Inflammation and only 77 specimens were malignant representing 10.1% of the specimen.Conclusions: Despite its variable sensitivity, urine cytology remains a useful tool in evaluating suspected bladder malignancies and can serve as an adjunct to cystoscopy in these cases.

scholarly journals The Traditionally Amputated Uvula amongst Nigerians: Still an Ongoing Practice

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Adeyi A. Adoga ◽  
Tonga L. Nimkur
Keyword(s):  
Hospital Admission ◽  
Health Outcomes ◽  
Prospective Study ◽  
Teaching Hospital ◽  
Traditional Healers ◽  
University Teaching ◽  
Female Ratio ◽  
Throat Pain ◽  
Outpatient Unit ◽  
Male To Female

Traditional healers in Nigeria continue to perform uvulectomy for all throat problems despite the severe complications they present to physicians. It is a hospital-based prospective study done at the outpatient unit of the Department of Otolaryngology, Jos University Teaching Hospital, Jos, Nigeria to determine the prevalence of traditional uvulectomy, highlighting the dangers it portends with suggested ways of providing improved health outcomes for our people. We saw 517 new cases of which 165 (32%) patients aged 2 years to 53 years had their uvulae amputated consisting of 108 (65.5%) males and 57 (34.5%) females giving a male to female ratio of 2 : 1. One hundred and forty two (86.1%) patients had uvulectomy at childhood and 23 (13.9%) in adulthood. The commonest indication was throat pain (, 21.8%). The commonest complication was hemorrhage (, 17.6%). Forty six (27.9%) patients required hospital admission.

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