BACKGROUND Infertility can be a source of anxiety and marital disharmony to a couple. The male factor traditionally contributes 40%. Varicocoeles are a significant cause of male infertility. AIM To assess the effect of varicocoelectomy on... more
BACKGROUND Infertility can be a source of anxiety and marital disharmony to a couple. The male factor traditionally contributes 40%. Varicocoeles are a significant cause of male infertility. AIM To assess the effect of varicocoelectomy on seminal fluid analysis parameters in sub-fertile males. METHODOLOGY This was a prospective study of fifty four patients who presented with infertility to the urology clinic of University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria between January 2015. and January 2016 . Those who had clinically palpable varicocoeles as the only suspected cause of their infertility were enrolled. The varicocoeles were classified into right, left or bilateral and graded into grades 1, 2 and 3 using Dubins criteria. Each patient had two semen analyses done two weeks apart and underwent a bilateral varicocoelectomy via the inguinal approach. Seminal fluid analyses were done post operatively at four and six months. RESULTS Of the 54 patients that underwe...
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A 38 year-old man presented with a long history on intermittent epigastric abdominal pain. He had been treated empirically for peptic ulcer disease. His symptoms included severe pain, abdominal distension and vomiting. There was a... more
A 38 year-old man presented with a long history on intermittent epigastric abdominal pain. He had been treated empirically for peptic ulcer disease. His symptoms included severe pain, abdominal distension and vomiting. There was a palpable epigastric mass. The symptoms worsened so rapidly to warrant emergency laparotomy without definitive diagnostic investigations. The mass contained a jejuno-jejunal intussusception within a membrane. Enterotomy was necessary to enable reduction of the intussusception. Intestinal resection was done because of an unviable intestinal segment. The literature is reviewed. Nigerian Quarterly Journal of Hospital Medicine Vol.9, No.3 (1999) pp. 184-185
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Research Interests: Medicine, Humans, Female, Male, Aged, and 3 moreIntestinal Obstruction, Small Intestine, and Acute Disease
ABSTRACT Background: The infant feeding tube is a cheap and readily available device with many uses in the urinary tract. Many types of stents are available in the market but among other factors, cost and affordability limit their use in... more
ABSTRACT Background: The infant feeding tube is a cheap and readily available device with many uses in the urinary tract. Many types of stents are available in the market but among other factors, cost and affordability limit their use in developing countries and remote areas. Aim: To document experience with infant feeding tubes as stents in the urinary tract. Methods: Data from the hospital records of patients who required stents at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria were obtained from their case notes from May 2003 to May 2006. Information extracted from these case notes included: age and sex of patient, indications for stenting, stent-related complications and outcome of surgery. The data were analysed using Microsoft Excel Software. Results: Thirty-three patients who required stents within the period were included in the study. In nineteen patients (57.6%) feeding tubes were used as urethral stents while in 14 (42.4%) as ureteric stents. Operations requiring stents include: dismembered pyeloplasty 9.1% (3), ureteric re-implantation 24.3% (8), ureterolithotomy 9.1% (3), and urethroplasty 57.6% (19). The stents were left in situ for 2-3 weeks depending on the indication. Ureteric stents were left for 3 weeks while urethral stents were usually left for 2 weeks. However, where a significant complication was noted, the stent was removed. Complications noted in 4 patients (12.1%) which were probably stent-related include: bladder spasm, infection and wound dehiscence. Conclusion: Infant feeding tubes can be used as suitable urinary tract stents where expensive stents are not available.
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BACKGROUND Penile fracture is a surgical emergency which often frightens the patient and partner. Varying incident rates, precipitating mechanisms and outcomes of treatment have been reported from different parts of the world. AIM To... more
BACKGROUND Penile fracture is a surgical emergency which often frightens the patient and partner. Varying incident rates, precipitating mechanisms and outcomes of treatment have been reported from different parts of the world. AIM To determine clinical presentation, aetiological factors and outcome of treatment of penile fracture in Port Harcourt, Niger Delta region of Nigeria. METHODS This was a retrospective study of all patients who presented with penile fracture to our institution from 2007 and 2015. Data on age of patient, events leading to the injury, mode and time of presentation, mode and outcome and complications of treatment were collected and analysed with SPSS 20.0 software. RESULTS Twenty one patients with a median age of 34.0 years (21-45) were treated within the study period. Nine patients (42.9%) were married. Overenthusiastic/ vigorous sex-related events were responsible for penile fracture in 17 patients (81.0%). Seven injuries were self inflicted while in 14 patie...
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This study aims to present the management of priapism in adult men in Port Harcourt, Nigeria. All patients who presented with priapism in 2 hospitals in Port Harcourt from July 2007 to April 2014 were prospectively studied. Treatment was... more
This study aims to present the management of priapism in adult men in Port Harcourt, Nigeria. All patients who presented with priapism in 2 hospitals in Port Harcourt from July 2007 to April 2014 were prospectively studied. Treatment was assigned based on clinical presentation. Data analyzed included: age on clinical presentation, risk factor, mode, and outcome of management. There were 18 patients aged 17 to 60 years (median age: 30 years). Three patients (16.7%) presented with stuttering priapism. Most of the patients presented after 24 hours of onset. Sixteen patients (89.9%) had hematological disorders. Five patients (27.8%) took suspected aphrodisiac medications. Seven patients (38.9%) were managed conservatively. The rest achieved detumescence following glandulo-cavernous shunting. Erectile function after treatment was satisfactory in 5 patients (27.8%). The commonest cause of priapism in Port Harcourt was hematological disorder. Most of the patients presented late. Prevalence...
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The spectrum of renal tract infections is wide. When the kidney has been severely damaged, the radiological findings may suggest a malignancy. To report a case of chronic pyonephrosis, which even at exploration appeared to be a... more
The spectrum of renal tract infections is wide. When the kidney has been severely damaged, the radiological findings may suggest a malignancy. To report a case of chronic pyonephrosis, which even at exploration appeared to be a malignancy. The case record of the patient as well as the literature were reviewed and reported. A 25 year-old woman presented with a 5-year history of left lumbar pain, urinary frequency and intermittent total haematuria. The intravenous urography showed non-function in the left kidney harbouring a calculus. Treatment was delayed for poor finances. At laparotomy a huge renal mass invading the colonic mesentery and showing neovascularisation was removed. The final diagnosis was chronic pyonephrosis. She recovered from postoperative septicaemia. Neovascularisation is a feature of malignant disease mediated by angiogenesis factors. These factors are probably present in chronic inflammation. It is suggested that for nephrectomy, prophylactic antibiotics should b...
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BACKGROUND Guidelines for the surgical treatment of HIV infected patients are lacking in Nigeria. The Social stigma of the infection and fears of contracting the disease discourage healthcare providers from treating the patients.... more
BACKGROUND Guidelines for the surgical treatment of HIV infected patients are lacking in Nigeria. The Social stigma of the infection and fears of contracting the disease discourage healthcare providers from treating the patients. OBJECTIVE To present cases treated by surgeons and thereby stimulate interest on the need to offer these patients needed treatment. METHODS A written questionnaire was sent to surgeons based in the University of Port Harcourt Teaching Hospital who have operated on patients known preoperativly to have HIV. Information sought included age, gender, indication for surgery, operation done, outcome of operation, indication for HIV test and information given to the patient after the test. RESULTS a total of 26 HIV infected patients received surgical treatment in private and company clinics and there were 18 females and 8 males aged between 8 and 48 years. Most of these were in the 2nd to 4th decades. The operations were elective, emergency or urgent. Pregnancy-rel...
Research Interests: Nigeria, Medicine, General Surgery, Pregnancy, Humans, and 7 moreChild, Female, Male, Middle Aged, Adult, Hiv seropositivity, and HIV infections
BACKGROUND The advances in human endeavours have led to changes in technology. New words, neologisms, have been creeping up and are coined with astounding speed. While these terms are fascinating etymologically, their impact needs to be... more
BACKGROUND The advances in human endeavours have led to changes in technology. New words, neologisms, have been creeping up and are coined with astounding speed. While these terms are fascinating etymologically, their impact needs to be appreciated from a realistic perspective to keep one aware of the collateral changes we are importing into common language, particularly in medical practice. The aim of this paper is to identify some of such neologisms, outline their current use and then discuss their potential to be 'useful' 'useless' or 'misleading'. METHODS Terminologies in medical practice and information technology have been selected by the authors and their meanings have been analysed. RESULTS The terminologies of our present interest include: Computer literacy; Surfing the web; Networking; Information technology; Medical informatics; Telemedicine; Capacity building; Problem-based learning; Mentoring; Learning curve; Evidence-based medicine; Impression; ...
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Some urological procedures are regarded as minor or simple. As a result, these may be delegated to trainee surgeons to do. Occasionally nonmedical persons embark on some of the procedures such as male circumcision. Published serious... more
Some urological procedures are regarded as minor or simple. As a result, these may be delegated to trainee surgeons to do. Occasionally nonmedical persons embark on some of the procedures such as male circumcision. Published serious complications from urological procedures considered minor or simple were identified from a Medline search (1966 through 1999) and reference lists of relevant publications. The operations regarded as minor were carried out by medical personnel of all grades as well as by nonmedical persons. The complications can be classified as mutilatory, infective, hemorrhagic, or obstructive. Although the mutilatory complications affect mainly procedures on the penis, infective and hemorrhagic complications affect almost all the procedures. Tumor implantation has occurred along needle biopsy tracts. Although many of the complications are not related to technique or competence, a plea is made for the awareness of their occurrence to encourage preventive strategies. Ade...
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BACKGROUND Phaeochromocytoma is a rare surgically treatable cause of hypertension. The aim of this paper is to present a case of phaeochromocytoma treated in Port Harcourt. METHOD The case record of a patent with phaeochromocytoma and a... more
BACKGROUND Phaeochromocytoma is a rare surgically treatable cause of hypertension. The aim of this paper is to present a case of phaeochromocytoma treated in Port Harcourt. METHOD The case record of a patent with phaeochromocytoma and a review of the relevant literature. RESULT A 40 year-old man presented with episodic malignant hypertension resistant to several anti-hypertensive drugs. A 24-hour urinary Vanillyl Mandelic Acid estimation was high at 68 mmol. An ultrasound scan revealed a huge right suprarenal mass. Preoperative medication was given to reduce the blood pressure and prevent perioperative arrhythmias. Under general anaesthesia with propofol, the tumour was explored. It appeared to invade the kidney and there were multiple hepatic secondaries. It was resected in block with the kidney. Intra- and postoperatively he had episodes of hypertension which were successfully controlled with a combination of intravenous chlorpromazine 50 mg, tramadol 100 mg and lorazepam 4 mg. Hi...
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BACKGROUND Renal cell carcinoma occasionally presents in an unusual manner. AIM To report the rare presentation of renal cell carcinoma as a scalp swelling. METHOD The case record of a patient with renal cell carcinoma and the literature... more
BACKGROUND Renal cell carcinoma occasionally presents in an unusual manner. AIM To report the rare presentation of renal cell carcinoma as a scalp swelling. METHOD The case record of a patient with renal cell carcinoma and the literature on the disease were reviewed. RESULT A 42-year old woman presented with a scalp swelling. Haematuria was missed at the first visit until she volunteered it on a subsequent visit. Investigations suggested renal cell carcinoma. This was confirmed following a right nephrectomy. The scalp lesion was a metastasis extending through the skull into the intracranial compartment. She was not given any systemic drugs because none was available. She survived until she was lost to follow up. CONCLUSION Haematuria remains an important symptom of renal cell cancer and should be elicited during systemic enquiry.
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A review of 21 consecutive cases of Fournier's gangrene seen at the University of Port Harcourt Teaching Hospital (UPTH) in the period 1994-1998 is presented. All the patients were males with an average age of 43.4 years. Most of the... more
A review of 21 consecutive cases of Fournier's gangrene seen at the University of Port Harcourt Teaching Hospital (UPTH) in the period 1994-1998 is presented. All the patients were males with an average age of 43.4 years. Most of the patients had a predisposing factor. There was a low incidence of pre-existing medical conditions. The commonest organisms isolated were of the enterobacteria group. All the patients were treated with antibiotics, surgical debridement and frequent wound dressings with hypertonic saline, hydrogen peroxide and Eusol. In 71.4% of the cases, the wounds healed by secondary intention. The mortality was 9.5%. The deaths occurred in the older age group. We recommend surgical debridement of necrotic tissues as they present and suggest that the surgical procedures be minimal as scrotal wounds heal satisfactorily.
Research Interests: Surgery, Nigeria, Humans, Male, Clinical Sciences, and 5 moreAged, Middle Aged, Adult, Debridement, and Fournier gangrene
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The case records of patients who had nephrectomy from 1989 to 1998 were retrieved. Data extracted for analysis included age, sex, clinical features, indications for nephrectomy, post-operative complications and histological findings.... more
The case records of patients who had nephrectomy from 1989 to 1998 were retrieved. Data extracted for analysis included age, sex, clinical features, indications for nephrectomy, post-operative complications and histological findings. Thirty-four unilateral nephrectomies in 21 males and 13 females were done. The patients were aged between 1.5 to 75 years. The predominant presenting features were abdominal pain (76.5%), abdominal mass (70.6%), haematuria (61.8%) and weight loss (47.1%). Diagnostic investigations were intravenous urography and renal ultrasound scan. The major indications for renal exploration included non-functioning kidney and renal mass suspected to be carcinoma. The histopathological findings included renal malignancy 23 (67.6%), hydronephrosis 6 (17.6%) and renal infections 3 (8.8%). The male/female ratio in nephrectomy for malignancy was 1:1.09. Renal trauma was the indication in only one patient. Non-functioning kidneys on intravenous urography (IVU) occurred in ...
Research Interests: Nigeria, Adolescent, Humans, Child, Female, and 8 moreMale, Infant, Aged, Middle Aged, Adult, Nephrectomy, Child preschool, and Outcome assessment (Health care)
Two cases of acute abdominal crisis due to intramural haemorrhage of the colon are presented with a review of the literature. One was a 10-year-old Nigerian boy; the haemorrhage occurred in the caecum and ascending colon. The other was a... more
Two cases of acute abdominal crisis due to intramural haemorrhage of the colon are presented with a review of the literature. One was a 10-year-old Nigerian boy; the haemorrhage occurred in the caecum and ascending colon. The other was a 69-year-old Caucasian woman with a haemorrhage in the colonic splenic flexure and descending colon. Both had a one-stage resection with anastomosis. The child survived; the woman died two days after the operation. The preoperative diagnosis of bleeding colonic lesions remains difficult especially when facilities for investigation are scarce. It is re-emphasized that in patients with acute abdomen it is not necessary to insist on accurate preoperative diagnosis before offering appropriate treatment.
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similar to other western countries, other than some cultural characteristics that could identify a specific group at risk. Soccer is the national Brazilian sport, practiced in all areas of the country from an early age. During the 1970s... more
similar to other western countries, other than some cultural characteristics that could identify a specific group at risk. Soccer is the national Brazilian sport, practiced in all areas of the country from an early age. During the 1970s and 1980s, there was a free, and sometimes excessive, use of intravenous vitamin complexes by many athletes in the desire to enhance physical performance. These compounds were usually injected minutes before a game by use of glass syringes; often the syringe was shared among all the athletes. We have followed three patients who belonged to the same amateur soccer club, and all were found to be contaminated by HCV genotype 1a. These patients claimed the use of these vitamin shots as the only risk factor for the disease transmission. The coincidence of all three being members of the same soccer club, reporting the same risk factor, in addition to the presence of the same viral genotype, points to the implication of this peculiar transmission route. Based on these preliminary observations, this practice should be included in epidemiologic questionnaires in Brazil to screen individuals for HCV infection as well as to avoid blood donation of individuals who practiced communal multiple vitamin injections.
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The aim of this paper is to highlight areas in which urologists collaborate with other healthcare practitioners and to identify further areas of beneficial collaboration. A review of the literature using Medline search and the authors... more
The aim of this paper is to highlight areas in which urologists collaborate with other healthcare practitioners and to identify further areas of beneficial collaboration. A review of the literature using Medline search and the authors clinical experience. There is close collaboration with the radiologists in urological investigations and embolization of tumours, aspiration of cysts and abscesses as well as obtaining biopsy specimens. Cross referral of patients occurs between urologists, gynaecologists, oncologists and radiotherapists. Technological advances enabling different specialist to master certain procedures like ultrasonography and laser surgery should make collaboration obligatory and mandatory. Collaboration also occurs with orthopaedic, paediatric and plastic surgeons, proctologists and specialist nurses involved in urological treatments. Sometimes, there have been competition and conflicts with the above specialists, especially the gynaecologist in the treatment of uroge...
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Background: Prostate cancer causes significant morbidity and mortality among African men. Anaemia is a known association of cancer patients. Aim: To determine the prevalence and risk factors for anaemia in prostate cancer (CaP) patients... more
Background: Prostate cancer causes significant morbidity and mortality among African men. Anaemia is a known association of cancer patients. Aim: To determine the prevalence and risk factors for anaemia in prostate cancer (CaP) patients in Nigeria. Method: A prospective study of prostate cancer patients and matched healthy controls, clinical data were obtained and samples were taken for Haemoglobin estimation. Data analysed using EPI Info, version 6.0 . Result: A total of 128 men were recruited for the study, 88 men with histologically proven prostate cancer and 40 otherwise healthy male controls. The mean haemoglobin for the cancer patients’ population was 10.79 ± 2.20g/dl and 13.59± 2.02g/dl in controls (p=0.001). Thirty four patients (38.64%) had anaemia. There was a statistically significant reduction in the haemoglobin levels of the patients with metastasis, compared with those with localized disease, (p=0.001). Increased number of co-morbidities in the patients significantly a...
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... Arch Sex Behav 1981; 10:325-335. Steeno O. Coital death. Andrologia 1987; 19 Spec No:229-232. Ikedife D. Fatal coital rupture of pouch of Douglas. Niger Med J 1976; 6:210-211. ... Singapore Med J 1996;37:547-548. McColgin SW, Williams... more
... Arch Sex Behav 1981; 10:325-335. Steeno O. Coital death. Andrologia 1987; 19 Spec No:229-232. Ikedife D. Fatal coital rupture of pouch of Douglas. Niger Med J 1976; 6:210-211. ... Singapore Med J 1996;37:547-548. McColgin SW, Williams LM, Sorrells TL, Morrison JC. ...
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... 2, No. 1 (January-June 2001): ; Published: January 4, 2001, (Accessed: Email Dr. Ndubuisi Eke by clicking here. ... 4. Balogun JA, Abereoje OK. Pattern of road traffic accident cases in a Nigerian university teaching hospital between... more
... 2, No. 1 (January-June 2001): ; Published: January 4, 2001, (Accessed: Email Dr. Ndubuisi Eke by clicking here. ... 4. Balogun JA, Abereoje OK. Pattern of road traffic accident cases in a Nigerian university teaching hospital between 1987 and 1990. ...
The literature on spinal cord involvement in prostate cancer is reviewed by searching the Medline from 1965 to 1997 and references in publications on the subject. The objective was to identify the clinical characteristics and treatment... more
The literature on spinal cord involvement in prostate cancer is reviewed by searching the Medline from 1965 to 1997 and references in publications on the subject. The objective was to identify the clinical characteristics and treatment modalities of the disease. Prostate cancer is the leading cause of metastatic spinal cord disease in men. The tumour reaches the spinal column mainly by the venous route. The frequency of involvement in decreasing order is thoracic spine, lumbar spine and cervical spine. The tumour usually exerts compression of the cord from the extradural space. However, intradural and intramedullary metastases have devastating effects. The patients have other neurological and urological symptoms prior to the onset of paraplegia. But in some, spinal cord compression may be the first symptom of prostate cancer. Plain X-rays may suffice in diagnosis but MRI is the single most valuable investigation for anatomic definition or localization of spinal cord secondaries. All forms of treatment are palliative. Treatment options, singly or in combination, include hormonal manipulation, radiotherapy and laminectomy each often with high dose corticosteroids. Recurrence of symptoms after an initial relief with hormonal manipulation signifies escape of the tumour from endocrine control and portends a poor prognosis.
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To ascertain the urological complications of coitus, as the proximity of the lower urinary tract to the organs of coitus exposes the tract to coital trauma. Medline was searched from 1966 to 2000 to identify reports on coital injuries.... more
To ascertain the urological complications of coitus, as the proximity of the lower urinary tract to the organs of coitus exposes the tract to coital trauma. Medline was searched from 1966 to 2000 to identify reports on coital injuries. Publications and relevant references were retrieved. Those reporting urological complications were selected for analysis. In all, 1454 cases of reported coital injuries were reviewed; 790 occurred in men while 664 occurred in women, mainly in the genital area. Physical urological complications were more common in men than in women. The injuries were often sustained during voluntary coitus, but one penile fracture was sustained during an attempted rape. The presentations included penile swellings and deviations, haemorrhage, erectile dysfunction and urinary incontinence. Complications included vesicovaginal fistulae, bladder and cavernosal ruptures, and urinary tract infections. Rare complications included isolated rupture of the penile vasculature. Major risk factors included penovaginal disproportion, excessive force at coitus, urethral coitus, fellatio and anal intercourse. Urethral injuries were the commonest complications; in men these were associated with 10-38% of penile fractures. The treatments included cold compress and anti-inflammatory agents in contusions, repairs of lacerations, closure of fistulae and urethral and vaginal reconstruction. The results of treatment were essentially good. Recurrent penile fractures were reported. Coitus, although pleasurable, may be risky. The complications have been termed 'faux pas' implying that they are preventable. While the ultimate prevention is abstinence, this is an unrealistic prescription. Therefore, efforts are necessary to identify risk factors to enable preventive strategies.
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Sporadic reports of penile fracture give the impression of a rare trauma. The value of diagnostic investigations is doubtful and treatment options are controversial. A Medline search from January 1966 to July 2001 using the terms... more
Sporadic reports of penile fracture give the impression of a rare trauma. The value of diagnostic investigations is doubtful and treatment options are controversial. A Medline search from January 1966 to July 2001 using the terms 'fracture of penis', 'penile trauma' and 'coital injuries' was used to identify full texts of publications on fracture of the penis. Full texts of relevant references from these publications were also identified. Data extracted for review included authors, country and year of publication, number of cases in each report, aetiology, clinical features, investigations, treatment and outcome. In 183 publications 1331 cases were reported between January 1935 and July 2001. Most reports were from the Mediterranean region. The commonest causes were coitus and penile manipulations, especially masturbation. Most patients were in their fourth decade. Clinical features included sudden penile pain, detumescence, voiding difficulties, and penile s...
A retrospective study of urogenital tract injuries treated in the Urology Unit of Port Harcourt University Teaching Hospital from January 1985 to December 1994 was done. There were 67 injuries in 62 patients. Fifty-five (82%) of these... more
A retrospective study of urogenital tract injuries treated in the Urology Unit of Port Harcourt University Teaching Hospital from January 1985 to December 1994 was done. There were 67 injuries in 62 patients. Fifty-five (82%) of these were blunt injuries. Males were more frequently injured (85%) than females. Patients younger than 60 years sustained 61 of the 67 injuries (91%) with peak incidence in the age groups 0-10 years (22%) and 21-30 years (28%). The urethra was the most frequently injured structure (49%) followed by the bladder (24%). The anatomically secured kidney and ureter as well as the fairly mobile penis and scrotum were much less frequently injured. The commonest aetiological factor was road traffic accident (57%). There were ten injuries (15%) resulting from industrial activities. Eight injuries (12%) were iatrogenic. Treatment was successful in 52 injuries (78%). It was satisfactory in the few urethral injuries that required repeated dilations. Four injuries (6%) r...
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A retrospective study was done to define the clinical characteristics and outcome of treatment of iatrogenic urological injuries in Port Harcourt, Nigeria. Consecutive cases of iatrogenic urological injuries treated by consultant surgeons... more
A retrospective study was done to define the clinical characteristics and outcome of treatment of iatrogenic urological injuries in Port Harcourt, Nigeria. Consecutive cases of iatrogenic urological injuries treated by consultant surgeons based in the University of Port Harcourt Teaching Hospital over a period of 10 years were reviewed. A total of 37 injuries occurred in 34 patients. The ages ranged from two weeks to 74 years with a mean of 30 years. The distribution of these injuries by sex was 23 males and 14 females. The operations in which the injuries occurred were: hysterectomy 12 cases (32%), hernia repairs 8 cases (22%) and male circumcision 6 cases (16%). The organs injured were ureter 13 times (35%), the bladder 12 times (32%) and the glans penis and distal urethra 12 times (32%). The surgeons responsible were mainly as follows: Gynecologist/Obstetrician 14 (38%), General Practitioner 9 (24%), Nurses 4 (11%), Non-medical persons 4 (11%), Not disclosed 3 (8%). The outcome o...
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Some urological procedures are regarded as minor or simple. As a result, these may be delegated to trainee surgeons to do. Occasionally nonmedical persons embark on some of the procedures such as male circumcision. Published serious... more
Some urological procedures are regarded as minor or simple. As a result, these may be delegated to trainee surgeons to do. Occasionally nonmedical persons embark on some of the procedures such as male circumcision. Published serious complications from urological procedures considered minor or simple were identified from a Medline search (1966 through 1999) and reference lists of relevant publications. The operations regarded as minor were carried out by medical personnel of all grades as well as by nonmedical persons. The complications can be classified as mutilatory, infective, hemorrhagic, or obstructive. Although the mutilatory complications affect mainly procedures on the penis, infective and hemorrhagic complications affect almost all the procedures. Tumor implantation has occurred along needle biopsy tracts. Although many of the complications are not related to technique or competence, a plea is made for the awareness of their occurrence to encourage preventive strategies. Ade...
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Two cases of acute abdominal crisis due to intramural haemorrhage of the colon are presented with a review of the literature. One was a 10-year-old Nigerian boy; the haemorrhage occurred in the caecum and ascending colon. The other was a... more
Two cases of acute abdominal crisis due to intramural haemorrhage of the colon are presented with a review of the literature. One was a 10-year-old Nigerian boy; the haemorrhage occurred in the caecum and ascending colon. The other was a 69-year-old Caucasian woman with a haemorrhage in the colonic splenic flexure and descending colon. Both had a one-stage resection with anastomosis. The child survived; the woman died two days after the operation. The preoperative diagnosis of bleeding colonic lesions remains difficult especially when facilities for investigation are scarce. It is re-emphasized that in patients with acute abdomen it is not necessary to insist on accurate preoperative diagnosis before offering appropriate treatment.
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A 9-week-old boy developed massive postoperative abdominal distension following a Fredet-Ramstedt pyloromyotomy for hypertrophic pyloric stenosis. A plain abdominal X-ray film was suggestive of a tension pneumoperitoneum. Passage of a... more
A 9-week-old boy developed massive postoperative abdominal distension following a Fredet-Ramstedt pyloromyotomy for hypertrophic pyloric stenosis. A plain abdominal X-ray film was suggestive of a tension pneumoperitoneum. Passage of a cannula into the peritoneal space resulted in forceful expulsion of air, resulting in relief of the distension, which recurred after a few hours. At laparotomy, the tension pneumoperitoneum was due to a pyloric fistula at the proximal end of the pyloromyotomy, although a mucosal breach at the first operation had been at the distal end. Closure of the fistula resulted in complete resolution. A limited review of the literature is undertaken.
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The advances in human endeavours have led to changes in technology. New words, neologisms, have been creeping up and are coined with astounding speed. While these terms are fascinating etymologically, their impact needs to be appreciated... more
The advances in human endeavours have led to changes in technology. New words, neologisms, have been creeping up and are coined with astounding speed. While these terms are fascinating etymologically, their impact needs to be appreciated from a realistic perspective to keep one aware of the collateral changes we are importing into common language, particularly in medical practice. The aim of this paper is to identify some of such neologisms, outline their current use and then discuss their potential to be 'useful' 'useless' or 'misleading'. Terminologies in medical practice and information technology have been selected by the authors and their meanings have been analysed. The terminologies of our present interest include: Computer literacy; Surfing the web; Networking; Information technology; Medical informatics; Telemedicine; Capacity building; Problem-based learning; Mentoring; Learning curve; Evidence-based medicine; Impression; Comorbid conditions; Family...
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Postoperative intussusception (POI) is a recognised but uncommon condition. Primary intussusception has been reported several times from Africa, but there are only two reports of postoperative intussusception. A literature review on POI... more
Postoperative intussusception (POI) is a recognised but uncommon condition. Primary intussusception has been reported several times from Africa, but there are only two reports of postoperative intussusception. A literature review on POI was performed by searching the Medline between 1966 and 1998 together with relevant references in publications on the subject. Postoperative intussusception occurs within a month of an operation. It differs from primary intussusception. No specific aetiology has been found. Predisposing factors based on disorder of peristalsis have been proposed. At risk are patients with prolonged postoperative ileus after prolonged surgery with extensive dissection or after a postoperative regimen of radiation and/or chemotherapy. The diagnosis requires a high index of suspicion. Contrast radiology is not reliable in the diagnosis. The preferred treatment is operative reduction, but resection may be indicated. There are no reports of recurrence after surgical treat...
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We compared the efficacy and tolerability of oral piroxicam 1 mg/kg/day with soluble aspirin given at 100 mg/kg/day taken four-hourly in 58 patients with sickle cell anaemia and severe ostcoarticular painful attacks requiring... more
We compared the efficacy and tolerability of oral piroxicam 1 mg/kg/day with soluble aspirin given at 100 mg/kg/day taken four-hourly in 58 patients with sickle cell anaemia and severe ostcoarticular painful attacks requiring hospitalization in a randomized, paralleled study. Main investigational criteria were pain relief, limitation of movement, fever, and insomnia or agitation. Both groups were well-matched at the commencement of therapy but most patients on piroxicam showed remarkable and significant pain relief and improvement in other parameters within 24 h. Unwanted effects were absent in the piroxicam-treated group whereas those treated with aspirin experienced nausea and vomiting. There were no significant changes in liver function tests with both forms of treatment. Oral piroxicam is an effective and safe treatment in the management of the osteoarticular painful crisis in sickle cell anaemia. It might prevent the use of parenteral analgesics and hospitalization and reduce the loss of school hours in patients who are being treated for bone pain crises that characterize sickle cell anaemia.