African Journals Online
Sahel Medical Journal

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Volume 6 No.2 April-June 2003
ABSTRACTS

The ideal qualities of a good consultant:  Who does the cap fit?

*K I Airede, FWACP.

Department of Paediatrics,Usmanu Danfodio University Teaching Hospital, P.M.B. 2370, Sokoto, Sokoto State, NIGERIA.

Summary

The ideal qualities of a good Consultant  defy definition, and a full description of one is difficult to completely proffer. Such a description, would also depend on which ‘Camp’ or ‘School’ you belong to. To a junior doctor, a good Consultant is easily accessible, approachable, friendly, with the patience of a Saint, and the sense of humour of an undergraduate.

However, I consider the most important quality to be ‘availability’ or ‘presence’ - at least on the end of a phone! Tolerance, empathy and understanding are the other basic ideal qualities of a good Consultant. As regards health-care delivery, the good Consultant should have a passionate concern to maintain basic standards of  Patient Care. He or she should want his or her colleagues to adopt the same standard and approach towards their Government patients, as they would to their Private patients.

The good Consultant never writes  “I have given the patient a supply of my formula for asthma“ or denies access to simple tests like fundoscopy nor audiogram.

Yes, the Consultant can still change his or her characteristics to fit the “ideal”,  if there are more significant negative attributes when you complete reading through this viewpoint on Ethics of Medical Practice.

 

 

Pattern of primary female genital cancer in Port-Harcourt, Nigeria:  a 12-year Review

*D Seleye-Fubara, FWACP and **S A Uzoigwe, FWACS.

Departments of *Anatomical Pathology and **Obstetrics and Gynaecology,

University of Port-Harcourt Teaching Hospital, PMB 6173, Port-Harcourt, Nigeria.

Benin City, Edo State

Summary

A retrospective study of 278 gynaecological malignancies was carried out for a period of 12 years (1990-2001) by the authors in the University of Port-Harcourt Teaching Hospital, Port-Harcourt (UPTH) with respect to age, site and histological pattern of the cancers in each anatomical class. Cancers of the cervix, ovaries and the vulva were commoner in the age group 50 – 59 years while those of the uterus and the vagina were commoner in the age group 60 – 69 years. Of the given anatomical classes, cancer of the cervix formed the majority, accounting for 63% of the cases, and the least was cancer of the vulva which recorded 3.2%. Others in order of frequency were ovary 15.5%, uterus 13.3% and vagina 5%.

In all the cases, except those of the uterus and ovaries-where choriocarcinoma and serous papillary cystadenocarcinomas were more frequent, squamous cell carcinoma of “well and moderately differentiated variants formed majority. The uterine cancers were made up of both epithelial and mesenchymal cancers. Severely dysplastic lesions were considered as malignant since they showed all the characteristics of malignancy except infiltration of the surrounding tissues.

Key words: Gynaecological malignancies; Age, Sites and Histological types

 

 

Calcification of Falx Cerebri in childhood:  a normal variant or a pathological entity?

*A Ojuawo, **D A Nzeh and *A Salisu

Departments of *Paediatrics and **Radiology, University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Summary

The skull radiograph of 102 children with seizure disorders seen at the University of Ilorin Teaching Hospital over a 3-year period were reviewed and compared to those of 42 children with indications for skull radiographs other than seizures.  Intracranial calcifications were reported in 14(13.7%) of those with seizure disorders, with calcification of the falx cerebri accounting for 57.1% of all the intracranial calcifications.  In comparison to the controls, falx cerebri calcification was significantly higher in the children with seizures (c2 = 9.25, p< 0.001).  Of the 8 cases that had calcification of the falx, birth asphyxia was associated in 5 (62.5%) of the cases with a relative risk "RR" of 2.1.  Eighty seven percent of the falx calcification was seen in those with generalised seizures.

We conclude that calcification of the falx cerebri is a pathological entity with a possible role in the genesis of centroencephalic abnormal discharges in childhood.  It is associated with generalised seizures, and birth asphyxia seems to be a predisposing factor.

Key Words:  Seizures, Calcification of the falx cerebri, Pathological.

 

 

Abdominal Wall Hernias as seen in LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria

* SO Fadiora, FWACS., *AS Oguntola, FWACS., *AOA Aderounmu, FMCS., **TO Bello, FWACS., *ML Adeoti, MD, FHCS., and *OO Awe, MBBS.

Departments of *Surgery and **Radiology, Ladoke Akintola University of Technology (Lautech) Teaching Hospital, Osogbo, Osun State, Nigeria.

Summary

A prospective survey of Abdominal Wall Hernia patients was done in LAUTECH Teaching Hospital, Osogbo, from November 2000 to February 2002.  The objective is to determine the pattern, management and outcome in a 101 patients with 110 hernias.  Males accounted for 88.1% of the patients with mean age of 51.1 ± 11.7 years and 48.5% were farmers.  Benign prostatic hyperplasia coexisted with hernia in 19.8% of patients.  Inguinal/inguino-scrotal was the commonest (88.1%), while femoral hernia was rare (2.7%).

Hernia occurred on the right side in 49% and bilateral in 10.9%.  Consultants operated on 66(65.3%) patients, while residents under supervision operated on 35(34.7%) patients 65.2% of the patients were above 50 years.  Day case surgery in our series was 75.3%; Elective surgery was in 76(75.2%) patients; while emergency cases was in 25(24.8%) patients.  Local, spinal and general anaesthesia were used in 54(53.5%), 27(26.7%), 20(19.8%) patients, respectively.  19.8% had benign prostatic hyperplasia with hernia, while 5% had simultaneous prostatectomy and herniorrhaphy, 11.5% had gangrenous intestine that needed resection and reanastamosis.

Commonest post operative complication was wound infection 14.9%, others were scrotal oedema, wound sinus, hypertrophic scars occurred in 3(3%), 2(2%), 3(3%) patients, respectively; with mortality in 1 patient (1%) in an elderly man who had strangulated intestinal obstruction.

Key Words:  Abdominal wall hernias, Coexisting prostatic hypertrophy.

 

 

A Ten - Year Review of Gynaecological Malignancies in Jos University Teaching Hospital, Jos, Nigeria (1990-1999)

* BM Mandong, FMCPPath., **IAO Ujah, FMCOG, mni.

Departments of *Pathology and **Obstetrics/Gynaecology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.

Summary

A restrospective study of gynaecological malignant tumours was undertaken between January 1990 - December 1999 inclusive. It consisted of all gynecological specimens sent to histopathology laboratory in 10% formalin-saline solution. Those diagnosed as malignant tumours  were retrieved from our records.

A total of 2,673 malignant tumours were recorded out of which 386 were of gynaecological malignant tumours.Cancer of the cervix accounted for77.0%  which were seen in advanced stages, followed by ovarian 11.0%, endometrial 6.5% and vulval cancers 4.1%. Cervical cancer was the predominant gynaecological cancer in this hospital. This high incidence may be attributed to a lack of  awareness of the nature of the disease which may be responsible for the late presentation in the hospital. The number of cases of other gynaecological malignancies like ovarian and endometrial cancers have continued to rise in our hospital, and like cancer of the cervix, patients presented late.

 

 

Serum levels of antioxidant vitamins in sicklers and non-sicklers in Sokoto Metropolis' children

IK Matazu, M.Sc, LS Bilbis, Ph.D, *NM Jiya, FWACP, HU Suleiman, BSc, BS Abdulkareem, BSc and UA Abubakar, BSC.

Department  of Biochemistry, Faculty of Science, Usmanu Danfodiyo University, P.M.B.2346 Sokoto, Nigeria.

*Department  of Paediatrics, Usmanu Danfodiyo University Teaching Hospital P.M.B.2370 Sokoto, Nigeria.

Summary

The serum concentrations of vitamins A (retinol), C (ascorbic acid) and E (alpha-tocopherol) of paediatric- age group were determined in sicklers and non-sicklers within the Sokoto metropolis. The levels of the antioxidant vitamins were found to be significantly lower (p < 0.001) in the sickler group when compared to that in non-sicklers. In all cases the concentrations of the antioxidant vitamins were significantly depressed in children with sickle-cell anaemia. The depletion in the levels of the three-antioxidant vitamins may probably account for some of the observed clinical manifestations of sickle-cell anaemia. This shall be the subject of our future investigation(s).

Key Words: Sicklers, Non- sicklers, Serum Vitamin A, Serum Vitamin C, Serum Vitamin E.

 

 

Spectrum of emergencies in an accident centre in Benin-City, Nigeria

*M N Okobia, FMCS, FWACS, U Osime, FWACS, FRCS.

Department of Surgery, University of Benin/University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.

Summary

A total of 1,398 patients who presented with various types of injuries at the Accident Centre of the University of Benin Teaching Hospital over a one-year period were prospectively studied to evaluate the categories of patients affected, aetiological factors, types and severity of organ injuries. There were 956 males and 442 females with a male to female ratio of 2.2 to 1. The peak age of the patients was in the third decade. Road traffic accident was the cause of injury in 52 percent of cases, followed by physical assault and falls. The lower extremities, head, face and upper extremities were the most commonly injured body regions. Most of the injuries were minor with Injury Severity Score (ISS) ranging from 1-3, and moderate severity (ISS ranging from 4-16). Majority resulted from road traffic accidents. We conclude that road traffic accidents are the major cause of traumatic injuries in Benin City and efforts should be made to quantify the burden of injury in our environment through purposeful research and establishment of a trauma data bank.   

(Key words: Trauma, injuries, road traffic accidents, accident centre.)

 

 

Unusual presentation of oesophageal foreign body in a Nigerian child

K R Iseh, FWACS, FMCORL.

ENT Department, Usmanu Danfodiyo University Teaching Hospital, Sokoto

Summary

Children commonly swallow various objects unknown to parents and guardians.  Fear of being disciplined also add to their unwillingness to confess what they had done.  In this paper a case is presented from the Ear, Nose and Throat Department of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto of a ten year old child who was treated at various hospitals, for cough for seven years with stunted growth.  Radiological investigations confirmed an oesophageal foreign body (coin) with consolidation and bronchiectatic changes in the right lung.  Patient's symptoms resolved after removal of the foreign body.  Simple chest x-ray should be done in all children with persistent cough especially when this is associated with growth retardation.

Key Words: Oesophageal foreign body, Lung complications, Growth retardation