scholarly journals Surgical management of gynaecomastia: Experience from a tertiary health facility in Southwest Nigeria

2020 ◽  
Vol 6 (1) ◽  
pp. 67-73
Author(s):  
BA Salami ◽  
BA Ayoade ◽  
AO Adekoya ◽  
O Odusan ◽  
OM Fatungase
Keyword(s):  
Postoperative Complications ◽  
Local Anaesthesia ◽  
University Teaching ◽  
Subcutaneous Mastectomy ◽  
Duration Of Symptoms ◽  
Local Experience ◽  
Southwest Nigeria ◽  
Good Cosmetic ◽  
The Mean ◽  
Age Range

Background: Gynaecomastia is the benign enlargement of the male breast as a result of glandular proliferation, usually resulting in feminine appearance. The treatment is usually surgical for cosmetic reasons. Objective: To describe the local experience with the surgical treatment of gynaecomastia by conventional subcutaneous mastectomy. Methods: This is a retrospective study of all cases of gynaecomastia seen at the surgical out-patient department of the Olabisi Onabanjo University Teaching Hospital, Sagamu, covering the period from January 2009 to October 2019.The data obtained included age, duration of symptoms, treatment, postoperative complications and type of anaesthesia. Results: A total of twenty-three cases were seen. The mean age was 26.4±17.5 years with an age range of 15 to 84years. The mean duration of symptoms was 2.9±3.6 years. About 70% of the cases were aged less than 21years. Twenty-one patients (91.3%) had a subcutaneous mastectomy, and local anaesthesia was deployed for the procedure in 16 (76.2%) cases. Two patients (9.5%) developed postoperative haematoma while one patient developed severe keloid at the surgical site. Conclusion: Subcutaneous mastectomy for gynaecomastia can be safely done under local anaesthesia and it gives a good cosmetic effect with minimal postoperative complications.

scholarly journals An Ex-Press implant versus trabeculectomy in a fibrotic bleb with late failure after previous trabeculectomy

2021 ◽  
Vol 14 (3) ◽  
pp. 383-387
Author(s):  
Faried Wagdy ◽  
◽  
Hisham Elsorogy ◽  
Ahmed Alnagdy ◽  
Dina Abd Elfattah ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Open Angle Glaucoma ◽  
Implant Surgery ◽  
Late Failure ◽  
Group I ◽  
The Mean ◽  
The Difference ◽  
One Year ◽  
Age Range

AIM: To compare the outcome of an Ex-Press implant and subscleral trabeculectomy (SST) in the management of glaucoma after previous trabeculectomy on a fibrotic bleb. METHODS: This randomized prospective study included 28 eyes from 28 patients (age range: 42-55y) with primary open angle glaucoma (POAG) presented with elevated intraocular pressure (IOP) with fibrotic bleb despite previous SST for more than 4mo. The eyes enrolled in the study were divided into two groups: group I (subjected to Ex-Press implant surgery) and group II [subjected to SST with mitomycin C (MMC)]. The follow-up continued one year after surgery to evaluate IOP, visual acuity (VA), visual field (VF), and postoperative complications. RESULTS: A significant decrease in IOP was found in both groups with a higher reduction in Ex-Press implant surgery with the mean IOP of 14.50 mm Hg (P=0.001), while the SST group recorded the mean IOP of 16.50 mm Hg (P=0.001) after one year. However, the difference between the two groups in terms of the decrease in IOP was insignificant. Fewer postoperative complications were recorded in the Ex-Press implant surgery and more cases requiring further anti-glaucomatous medications were seen in the SST group. Both groups showed stability in terms of VA and VF. CONCLUSION: Ex-Press implant surgery and SST with MMC are two surgical alternatives for controlling IOP in late failure that occurs more than 4mo after previous SST with a fibrotic bleb. However, Ex-Press shunt is a safer surgery with fewer complications.

scholarly journals Clinicopathological Features, Management and Outcome of Paediatric Solid Renal Tumours in Southeast Nigeria: The Need for Protocol and Multidisciplinary Collaboration

2021 ◽  
Author(s):  
Okechukwu Hyginus Ekwunife ◽  
Jideofor Okechukwu Ugwu ◽  
Victor Ifeanyichukwu Modekwe ◽  
Chijioke Elias Ezeudu ◽  
Thomas Obiajulu Ulasi ◽  
...  
Keyword(s):  
Left Kidney ◽  
Treatment Protocol ◽  
University Teaching ◽  
Renal Tumour ◽  
Duration Of Symptoms ◽  
Multidisciplinary Collaboration ◽  
Retrospective Audit ◽  
Abdominal Masses ◽  
Renal Tumours ◽  
The Mean

Introduction: Renal malignancies are common in children and they constitute 6-7% of all childhood tumours and nephroblastoma is the most common solid renal tumour in children. Currently, standardised institutional protocols in management of renal tumours in children are the norm. Large scale collaborative studies have started emerging, yet not much has been documented on the clinical presentation, pathology and outcome of solid renal tumours particularly in Africa. Aim: To review the presentations, pathology and the management-outcome of solid renal tumour in the centre in the absence of a coordinated protocol and multi-disciplinary collaboration. Materials and Methods: This was a nine and a half year longitudinal retrospective audit study of consecutive patients with solid renal tumours managed in a single tertiary centre: Nnamdi Azikiwe University Teaching Hospital Nnewi South-east Nigeria. It took place from January 2009-June 2018. Relevant data on demography, clinical features, management and outcome were extracted from records. Results were analysed using Statistical Package for Social Sciences (SPSS) version 22. Categorical data were tested for independence using Chi-square test and significant p-value set at <0.05. Results: Twenty two paediatric cases (15 males and 7 females) were included in the study. The mean age at presentation was 50.10±4.8 months. There were 15 males and 7 females. The mean duration of symptoms was 5.5 months; 21 (95%) presented with abdominal masses while 6 (27.3%) had gross haematuria and 13 (59%) were emaciated. Tumours involved left kidney in 15 (68%). Histological reports were available in 9 cases with nephroblastoma being the most common 6 (27.3%). The Commonest stage was stage 3, 10 (45%) and commonest procedure was nephroureterectomy, 11 (50%). Neo-adjuvant and adjuvant therapies were inconsistent. Conclusion: Late presentation, discordant treatment protocol, noncompletion of treatment and poor collaboration, were found to contribute largely to poor outcome of solid renal tumours in children in our setting. It is strongly believed that adoption of standard protocol and a multidisciplinary collaboration in management will improve records keeping and outcome.

scholarly journals Diabetic Ketoacidosis in Children with Type-1 Diabetes in a Tertiary Hospital in Sokoto, North-Western Nigeria: Clinical Profile and Outcome

2021 ◽  
pp. 142-152
Author(s):  
M. O. Ugege ◽  
T. Yusuf
Keyword(s):  
Type 1 Diabetes ◽  
Abdominal Pain ◽  
Diabetic Ketoacidosis ◽  
Clinical Profile ◽  
University Teaching ◽  
Duration Of Symptoms ◽  
Male Adolescents ◽  
The Mean ◽  
North Western

Introduction: Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D). Few reports are available on DKA among children in North-west Nigeria.  Objective: To describe the clinical profile and outcome of children managed for DKA in the Paediatric Endocrinology Unit of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, North-western Nigeria over a ten-year period (January 2011- December 2020). Methods: This was a retrospective review of the case records of all children managed for T1D between 2011 and 2020.  Socio-demographic and clinical data of those with DKA were extracted and analysed using SPSS version 23. Results: Ten (62.5%) out of 16 children with T1D had DKA, comprising 8 males and 2 females; M: F ratio 4:1. Majority (90%) were adolescents aged 10-15years. The mean age ± standard deviation (SD) at diagnoses of T1D was 11.1 ± 3.14 years; DKA was the presenting manifestation of diabetes in 4 (40%) children, while 6(60%) were known diabetics with an average of 2-episodes per patient. The median duration of symptoms was 5 days (range 1-42 days). Abdominal pain (90%), polyuria (80%), fast breathing (70%), vomiting (70%), altered consciousness (70%), dehydration (100%) and Kussmaul respiration (70%) were the common presenting features. The mean blood glucose, bicarbonate and venous PH at admission were 23.28± 7.14 (range; 12.3-33.3) mmol/L, 14.1± 3.41 (10-21) mmol/L and 6.96± 0.06 (6.92-7.00) respectively. Co-morbid conditions included infections (80%), predominantly malaria (70%). There was no mortality. Conclusion: DKA is common in male adolescents, with good management outcome in our facility.  Abdominal pain, dehydration, polyuria and Kussmaul respiration were the commonest presenting features. A high index of suspicion of DKA is recommended in any child, particularly, male adolescents with the aforementioned features. Effort should be made to confirm diagnosis and prompt treatment instituted.

scholarly journals Risk Score for Prediction of Severe Postoperative Complications After Pancreaticoduodenectomy

2021 ◽  
Vol 43 (1) ◽  
pp. 11-14
Author(s):  
Surendra Shah ◽  
Ramesh S Bhandari ◽  
Pradeep Vaidya ◽  
Yogendra P Singh ◽  
Paleswan Joshi Lakhey
Keyword(s):  
Postoperative Complications ◽  
Pancreatic Duct ◽  
Risk Score ◽  
Delayed Gastric Emptying ◽  
Univariate Analysis ◽  
Postoperative Pancreatic Fistula ◽  
University Teaching ◽  
Duct Diameter ◽  
Number Of Patients ◽  
The Mean

Introduction Morbidity after pancreaticoduodenectomy (PD) still remains high. Postoperative pancreatic fistula (POPF) is the most common cause of increased morbidity after PD. Assessment of predictability of risk score for severe postoperative complications was the objective of this study. MethodsThis was a retrospective observational study. Patients undergoing pancreaticoduodenectomy at Tribhuvan University Teaching Hospital (TUTH) between January 2017 to December 2017 were included in the study. Variables were recorded from case sheets of the patients. The “Risk Score” was calculated using the pancreatic duct diameter and body mass index (BMI). Association of risk score and severe postoperative complications were analyzed. ResultsA total number of patients were 43, including 23 (53.5%) males and 20 (46.5%) females. The mean age was 57.09 ± 11.85 years ranges from 29 years to 76 years. The POPF and delayed gastric emptying (DGE) was 23.3% (10/43); and post-pancreaticoduodenectomy hemorrhage (PPH) was 11.6% (5/43). Severe postoperative complications were present in 13.9% (6/43) patients. In univariate analysis, pancreatic duct diameter (p=0.045) and Risk Score (p=0.02) were significantly associated with severe postoperative complications after PD. However none of them were significant in multivariate analysis. ConclusionRisk score failed to predict severe postoperative complication after pancreaticoduodenectomy.

scholarly journals Profile of Abdominal Surgical Complications of Enteric Fever in Children in a Developing Country

2020 ◽  
Author(s):  
Kevin Chukwubuike
Keyword(s):  
Teaching Hospital ◽  
Intestinal Perforation ◽  
Surgical Complications ◽  
Enteric Fever ◽  
Right Hemicolectomy ◽  
University Teaching ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Presenting Symptoms ◽  
Age Range

Background: Surgical complications of enteric fever has been associated with significant morbidity and mortality. The aim of this study was to determine the pattern and outcome of the treatment of abdominal surgical complications of enteric fever in children in a teaching hospital in Enugu, Nigeria. Methods: This retrospective study included children who had undergone a surgery for abdominal complications of enteric fever at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH), Enugu, Nigeria. The medical records of the pediatric patients over a five-year period were evaluated for the patients’ demographics, presenting symptoms, investigations, intraoperative findings, procedures performed, and postoperative complications and outcome. Results: During the study period, there were 44 cases of abdominal surgical complications of enteric fever with an age range of 6–14 years (mean 9.5 years) and the male to female ratio of 2.7:1. The mean duration of symptoms prior to presentation was five days. All the patients had fever and abdominal pain. While 95% of the patient had typhoid intestinal perforation, 5% had typhoid hemorrhage. Primary closure of intestinal perforation and right hemicolectomy with ileotransverse anastomosis were performed for typhoid intestinal perforation and typhoid intestinal hemorrhage, respectively. Surgical site infection was the most common postoperative complication. The mortality rate was 6.8%. Conclusion: Abdominal surgical complications of enteric fever are still obtainable in developing countries. Typhoid intestinal perforation was the most common complication recorded in the present study. Keywords: abdominal, children, enteric fever, surgical complications

scholarly journals Prevalence of HIVInfection inPatients with TBSpine Admitted to the University Teaching Hospital, Lusaka, Zambia

2021 ◽  
Vol 3 (2) ◽  
pp. 64-68
Author(s):  
Chabwela D. Shumba ◽  
Keyword(s):  
Hiv Infection ◽  
Teaching Hospital ◽  
Prevalence Rate ◽  
Laboratory Data ◽  
University Teaching ◽  
Duration Of Symptoms ◽  
Radiological Features ◽  
The Mean ◽  
Extra Pulmonary ◽  
The University

Background: Extra pulmonary TB is an AIDS defining opportunistic infection in patients with HIV infection. TB spine is the commonest form of bone TB and whose clinical picture depends on the site and the presence of HIV infectionMethod: This was a retrospective review of patient records (n=101) over a two-year period (2008-2010) at the University Teaching Hospital, Lusaka, Zambia. Clinical and radiological features, laboratory data were analyzed Results: One hundred and one patients (57 male: 44 female) had TB spine in this period. The mean age was 37.22 ± 14.29 years. The main presenting complaint was backache in 71(70.3%) patients and the mean duration of symptoms was 2.68 ± 1.23 months. The Gibbus was present in 77 (76.24%) of the patients while neurological deficit was identified in 32 (31.6%) patients. The lumbar spine the most affected in 64(63.4%) patients. The mean ESR was determined to be 59.43 ± 32.23 mm/hour. The prevalence rate of HIV infection in the patients with TB spine was 24.8 %. The average CD4 count was found to be 262± 121.3 cells/μl.Conclusion: The prevalence rate of HIV infection (24.8%) is higher than that obtaining in the Zambian general population (13.7%) but lower than the general prevalence of HIV infection in patients with TB (68%).

scholarly journals Incomplete Kawasaki disease - a diagnostic and therapeutic challenge

2014 ◽  
Vol 9 (4) ◽  
pp. 30-35
Author(s):  
S Datta ◽  
S Maiti ◽  
G Das ◽  
A Chatterjee ◽  
P Ghosh
Keyword(s):  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Incomplete Kawasaki Disease ◽  
Duration Of Symptoms ◽  
Clinical Criteria ◽  
Echocardiographic Finding ◽  
2D Echocardiography ◽  
Acquired Heart Disease ◽  
The Mean ◽  
One Year

Background The diagnosis of classical Kawasaki Disease was based on clinical criteria. The conventional criteria is particularly useful in preventing over diagnosis, but at the same time it may result in failure to recognize the incomplete form of Kawasaki Disease. Objective To suspect incomplete Kawasaki Disease, because early diagnosis and proper treatment may reduce substantial risk of developing coronary artery abnormality which is one of the leading causes of acquired heart disease in children. Method Nine cases of incomplete Kawasaki Disease were diagnosed over a period of one year. The diagnosis of incomplete Kawasaki Disease was based on fever for five days with less than four classical clinical features and cardiac abnormality detected by 2D- echocardiography. A repeat echocardiography was done after 6 weeks of onset of illness. The patients were treated with Intravenous Immunoglobulin and/or aspirin. Result The mean age of the patients was 3.83 years and the mean duration of symptoms before diagnosis was 12.1 days. Apart from other criteria all of our patients had edema and extreme irritability. All the patients had abnormal echocardiographic finding. Five patients received only aspirin due to nonaffordability of Intravenous Immunoglobulin and four patients received both aspirin and Intravenous Immunoglobulin, but the outcome was excellent in all the cases. Conclusion Incomplete Kawasaki Disease can be diagnosed with more awareness and aspirin alone may be used as a second line therapy in case of non affordability of Intravenous Immunoglobulin. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 30-35 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10234

scholarly journals Cognitive Performance and Its Associations with Dental Caries: Results from the Dental, Oral, Medical Epidemiological (DOME) Records-Based Nationwide Study

Biology ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 178
Author(s):  
Itzhak Abramovitz ◽  
Avraham Zini ◽  
Matan Atzmoni ◽  
Ron Kedem ◽  
Dorit Zur ◽  
...  
Keyword(s):  
Dental Caries ◽  
Cognitive Performance ◽  
Odds Ratio ◽  
Allocation Of Resources ◽  
Cross Sectional ◽  
Intelligence Score ◽  
Health Related ◽  
The Mean ◽  
Nationally Representative ◽  
Age Range

Relatively few studies have analyzed the association between cognitive performance and dental status. This study aimed to analyze the association between cognitive performance and dental caries. Included were data from the dental, oral, medical epidemiological (DOME) study; cross-sectional records-based research, which integrated large socio-demographic, medical, and dental databases of a nationally representative sample of young to middle-aged military personnel (N = 131,927, mean age: 21.8 ± 5.9 years, age range: 18–50). The cognitive function of draftees is routinely measured at age 17 years using a battery of psychometric tests termed general intelligence score (GIS). The mean number of decayed teeth exhibited a gradient trend from the lowest (3.14 ± 3.58) to the highest GIS category (1.45 ± 2.19) (odds ratio (OR) lowest versus highest = 5.36 (5.06–5.68), p < 0.001). A similar trend was noted for the other dental parameters. The associations between GIS and decayed teeth persisted even after adjusting for socio-demographic parameters and health-related habits. The adjustments attenuated the OR but did not eliminate it (OR lowest versus highest = 3.75 (3.38–4.16)). The study demonstrates an association between cognitive performance and caries, independent of the socio-demographic and health-related habits that were analyzed. Better allocation of resources is recommended, focusing on populations with impaired cognitive performance in need of dental care.

scholarly journals POS1281 HOW DOES OBESITY INFLUENCE THE FEATURES OF KNEE OSTEOARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 923.4-924
Author(s):  
H. Hachfi ◽  
D. Khalifa ◽  
M. Brahem ◽  
N. Ben Chekaya ◽  
M. Younes
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Impairment ◽  
Statistical Significance ◽  
Obese Group ◽  
University Hospital ◽  
Obese Patients ◽  
Cross Sectional ◽  
Duration Of Symptoms ◽  
Lequesne Index ◽  
The Mean

Background:Knee osteoarthritis and obesity are both major health problems. It is now admitted that the prevalence of knee osteoarthritis gets higher with obesity and that weight loss helps knee function and allows patients to avoid surgery.Objectives:The aim of this study was to study the influence of obesity on knee osteoarthritis features.Methods:A cross-sectional study was conducted in the university hospital Taher Sfar of Tunisia over a period of 6 months. Patients who had knee osteoarthritis confirmed by radiographs were included. Sociodemographic, clinical, radiological and therapeutic data were collected from medical records and visits. Obesity was defined by a body mass index (BMI) ≥30. Functional impairment was assessed by the Womac index and Lequesne index.Results:The study included 186 patients. There were 31 males and 155 femmes. The mean age was 60±10 years. The percentage of obese patients was 53,8%. The mean age was similar in both groups obese and non obese. There were more women in the obese group compared to the non obese group (p=0.0001), more patients who had diabetes mellitus and dyslipidemia (p=0.002). Non-obese patients had a shorter duration of symptoms with no statistical significance (p=0.151). Obese patients had more involvement of both knees (p<0.0001). Obesity did not have an impact on pain severity. Severity of radiological images (p=0,0001) were more frequent in obese patients. Functional impairment was similar in both groups. However, the percentage of patients having a very important functional impairment with Lequesne index was higher in obese patients (p<0.029). Obese patients also needed more physical therapy sessions (p=0.035).Conclusion:Knee osteoarthritis in obese patients is characterized with the femlae gender predominance, bilateral knee involvement, and a more severe images on radiographs. Thus the need for better control of weight and the importance of physical activity.References:[1]Coggon D, Reading I, Croft P, et al. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord J Int Assoc Study Obes 2001; 25: 622–627.Disclosure of Interests:None declared

scholarly journals Adolescents’ Bipolar Experiences and Suicide Risk: Well-Being and Mental Health Difficulties as Mediators

2021 ◽  
Vol 18 (6) ◽  
pp. 3024
Author(s):  
Ascensión Fumero ◽  
Rosario J. Marrero ◽  
Alicia Pérez-Albéniz ◽  
Eduardo Fonseca-Pedrero
Keyword(s):  
Behavioral Problems ◽  
Suicide Risk ◽  
Well Being ◽  
Self Report ◽  
Emotional Difficulties ◽  
Subjective Well Being ◽  
Mediation Analyses ◽  
Mental Health Difficulties ◽  
The Mean ◽  
Age Range

Bipolar disorder is usually accompanied by a high suicide risk. The main aim was to identify the risk and protective factors involved in suicide risk in adolescents with bipolar experiences. Of a total of 1506 adolescents, 467 (31%) were included in the group reporting bipolar experiences or symptoms, 214 males (45.8%) and 253 (54.2%) females. The mean age was 16.22 (SD = 1.36), with the age range between 14 and 19. Suicide risk, behavioral and emotional difficulties, prosocial capacities, well-being, and bipolar experiences were assessed through self-report. Mediation analyses, taking gender as a moderator and controlling age as a covariate, were applied to estimate suicide risk. The results indicated that the effect of bipolar experiences on suicide risk is mediated by behavioral and emotional difficulties rather than by prosocial behavior and subjective well-being. Specifically, emotional problems, problems with peers, behavior problems, and difficulties associated with hyperactivity were the most important variables. This relationship was not modulated by gender. However, the indirect effects of some mediators varied according to gender. These results support the development of suicide risk prevention strategies focused on reducing emotional difficulties, behavioral problems, and difficulties in relationships with others.

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