Impact of COVID-19 on the cost of surgical and obstetric care: experience from a Nigerian teaching hospital and a review of the Nigerian situation.

The public health impact of the COVID-19 pandemic cannot be overstated. Its impact on the cost of surgical and obstetric care is significant. More so, in a country like Nigeria, where even before the pandemic, out-of-pocket spending (OOPS) has been the major payment method for healthcare.

Impact of the COVID-19 Pandemic on Surgical Residency Training: Perspective from a Low-Middle Income Country.

Background: The COVID-19 pandemic has drastically impacted postgraduate training programmes worldwide. This study aims to evaluate the Nigerian situation with respect to surgical training, with a view to identifying gaps and proffering solutions.

Methods: A cross-sectional survey of surgical residents in Nigeria was conducted between 27 July 2020 and 14 August 2020.

Comparative study of endoscopic band ligation versus injection sclerotherapy with 50% dextrose in water, in symptomatic internal haemorrhoids.

Background: Haemorrhoids are common anorectal conditions seen in surgical practice, with various treatment modalities. This study compared the short-term outcome of injection sclerotherapy with 50% dextrose in water and rubber band ligation in the management of second-and third-degree haemorrhoids, in terms of symptoms improvement, complications, recurrence rate, retreatment rate and acceptability.

Methodology: This was a prospective comparative study that was carried out in the endoscopic unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, in southwestern Nigeria.

Daytime Versus Night-Time Emergency Abdominal Operations: Perspective from a Low-Middle-Income Country.

Background: Emergency abdominal operations carry significant risk of mortality and morbidity. The time of the day when such operations are performed has been suggested as a predictor of outcome. A retrospective comparison of outcomes of daytime and night-time emergency abdominal operations was conducted.

Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study.

Background: Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted.

Developing a Breast Cancer Screening Program in Nigeria: Evaluating Current Practices, Perceptions, and Possible Barriers.

Purpose: In low- and middle-income countries like Nigeria, women present with advanced breast cancer at an earlier age. Given the limited resources, development of screening programs that parallel resource capabilities of low- and middle-income countries is imperative. The objective of this study was to evaluate the perceptions, practices, and barriers regarding clinical breast examination (CBE) screening in a low-income community in Nigeria.

2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias.

Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used.

Comparing Lichtenstein with darning for inguinal hernia repair in an African population.

Purpose: Being a relatively new entrant into our practice, mesh repair has not been compared with previously existing tissue-based techniques in our setting. This study is set out to compare darning with Lichtenstein technique of inguinal hernia repair in terms of frequency of post-operative complications, recovery and cost.

Method: Patients with uncomplicated, primary inguinal hernia were randomized to have their hernias repaired either by the Lichtenstein or darning technique.

Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study.

The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs). 1898 patients with a mean age of 51.

Impact of introduction of laparoscopic surgery on management of unresolved intra-abdominal malignancies in a West African hospital.

Background: Intra-abdominal malignancies often pose diagnostic problems to surgeons in resource-challenged centers such as ours due to limitations in modern imaging and other facilities. This prompted the adoption of laparoscopy in our hospital as an adjunctive tool in diagnosing these conditions.

Method: Pre- and per-operative data of consecutive cases of clinically unresolved advanced intra-abdominal tumors subjected to laparoscopy from January 2009 through June 2013 were reviewed.

WSES guidelines for emergency repair of complicated abdominal wall hernias.

Emergency repair of complicated abdominal hernias is associated with poor prognosis and a high rate of post-operative complications.A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013, during the 2nd Congress of the World Society of Emergency Surgery with the goal of defining recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel.

A huge low-grade fibromyxoid sarcoma of small bowel mesentery simulating hyper immune splenomegaly syndrome: a case report and review of literature.

Introduction: Low-grade fibromyxoid sarcoma (LGFMS) is a rare non epithelial tumour. It usually arises from the smooth muscles of the extremities. It is, however, occasionally reported to arise from other regions of the body.

Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study).

Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The World Society of Emergency Surgery (WSES) has designed the CIAOW study in order to describe the clinical, microbiological, and management-related profiles of both community- and healthcare-acquired complicated intra-abdominal infections in a worldwide context. The CIAOW study (Complicated Intra-Abdominal infection Observational Worldwide Study) is a multicenter observational study currently underway in 57 medical institutions worldwide.

Audit of management of gallbladder cancer in a Nigerian tertiary health facility.

Background: Gallbladder cancer is a rare malignancy with a variable incidence worldwide. It ranks number eight among all gastrointestinal cancer seen in Nigeria. It is associated with high mortality and morbidity because it is usually diagnosed very late.

Management of mass casualty: a review.

Aims And Objectives: The aim of this article is to discuss the management of mass casualty and sensitise authorities at various levels and trauma surgeons the need for awareness and training in the management of mass casualty.

Materials And Methods: Thorough Medline and bibliography search and available local literatures relevant to the management of mass casualty was reviewed. The available articles were reviewed in order to decipher the management pattern in various forms and degree of disasters resulting in mass casualty.

Short hospital stay after appendicectomy.

Aims And Objectives: To determine the applicability of short hospital stay after appendicectomy in rural and semi-urban Nigerian community.

Patients And Methods: A 30-month prospective study on patients with uncomplicated acute appendicitis was carried out The age ranged from 5-70 years, mean of 28.7 years, there was almost even sex distribution between male and female.

Metastatic breast cancer in a Nigerian tertiary hospital.

Background: Late presentation of breast carcinoma is common in resource-limited countries with attendant poor outcome.

Objective: To describe the pattern of clinical presentation and challenges of treating patients presenting with metastatic breast carcinoma in a Nigerian hospital.

Method: Clinical records of all patients who presented with metastatic breast carcinoma between January 1991 and December 2005 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria were reviewed.

Determinants of splenectomy in splenic injuries following blunt abdominal trauma.

Introduction: The management of splenic injuries has shifted from splenectomy to splenic preservation owing to the risk of overwhelming post-splenectomy infection (OPSI). This study aimed to identify the factors that determine splenectomy in patients with isolated splenic injuries, with a view to increasing the rate of splenic preservation.

Patients And Methods: Files of 55 patients managed for isolated splenic injuries from blunt abdominal trauma between 1998 and 2007 were retrospectively analysed using a pro forma.

Burden of prostate cancer in southwestern Nigeria.

Objectives: To determine the pattern of presentation, prevalent age, hospital incidence, and outcome of management of prostate cancer in our environment.

Method: Patients with histopathology evidence of prostate cancer managed between January 1991 and December 2007 were studied. Information entered into a pro-forma sheet and analyzed included the age of patients, clinical features, investigations, histopathology diagnosis, outcome of management, and duration of follow-up.

Relations of the neck of groin hernias to pubic tubercle.

Objective: The traditional anatomical and surgical teaching is that any hernia with the neck above and medial to the pubic tubercle are inguinal. Present day surgical authors and teachers mostly adhere to this teaching but observe a difference in this relationship in clinical demonstrations. This confuses most medical students and surgical residents.

Particle-induced X-ray emission (PIXE) analysis of minor and trace elements in gallstones of Nigerian patients.

Gallstone disease is a major health problem in many parts of the world. In Nigeria, however, only a few cases of gallstone disease are reported. Minor/trace elements are reported to play a significant role in the formation of gallstones.

Abdominal tuberculosis in a Nigerian teaching hospital.

Abdominal tuberculosis (TB) alone or with disseminated TB is known to mimic other conditions with non-specific investigation findings. This study aims to evaluate the clinical presentations and investigation findings of patients in our setting. The clinical records of 47 patients diagnosed as abdominal TB between January 1986 and December 2005 at the Wesley Guild Hospital Unit of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria, were reviewed.

Paradox of wellness and nonadherence among Nigerian women on breast cancer chemotherapy.

Context: Intentional nonadherence among cancer patients is rare and may occur only when the benefits of treatment are not obvious to the patient.

Aims: To highlight a group of women on chemotherapy for breast cancer who defaulted from their medications because they were improving.

Settings And Design: A study was carried out of the reasons for nonadherence to medications among women receiving chemotherapy for breast cancer at a Nigerian teaching hospital between January 1993 and December 2002.

Malignant renal tumors in adults: a ten-year review in a Nigerian hospital.

This study was undertaken to determine the age, sex, pattern of presentation, histopathology and outcome of management of adult patients with malignant renal tumors (MRT) in Nigeria. Using hospital records, a retrospective study was performed covering the period between January 1997 and December 2006. A total of 18 adult patients had been diagnosed to have MRT during this period.