Department of Surgery

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A CASE AGAINST THE MEMBERSHIP PROGRAMME PROPOSAL OF THE WEST AFRICAN COLLEGE OF SURGEONS
(78 JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS, 2012) AJAO OG,; UGWU BT
Following the meeting held in Accra, Ghana in September 2012, a draft proposal on Harmonization of Surgical Training was submitted for final consideration by the four Colleges in the West African Sub- region. The Council of the West African College of Surgeons (WACS) was mandated to produce a Membership Curriculum separate from the Part 1 programme of the Fellowship Examination. This, in essence, means that there is a proposal to have a Membership Examination and certification in addition to the well established Fellowship Examination and certification. This means that there will be a lower standard of examination for Membership certification than the Fellowship Examination. The President of WACS in the presidential address in Liberia at the 52™ annual meeting made an allusion to “the reluctance of Faculty of Surgery to go along with the Membership” plan. We fully support the reluctance of the Faculty of Surgery in this regard, and the following will explain our position. It was George F. Will writing for Newsweek Magazine some years back that stated that what people learn from History is that people do not learn from History. This statement could not be truer when we consider this proposal.
Experience with rubber band ligation of hemorrhoids in northern Nigeria
(Nigerian Medical Journal, 2013) Misauno, M. A.; Usman B. D.; Nnadozie U. U.; Obiano S. K.
Background: Treatment of hemorrhoids in Nigeria is usually done by the traditional open method that requires hospital admission; anesthesia and is associated with high morbidity. Rubber band ligation is a suitable alternative to open hemorrhoidectomy and has the potential to reduce the need for hospital admission. Patients and Methods: This was a prospective analysis of consecutive patients presenting with hemorrhoids that were suitable for surgical treatment to the Jos University Teaching Hospital and the Federal Medical Centre Gombe from January 2008 to December 2010 (24 months). Results: A total of 232 rubber band ligations were performed on 40 patients whose ages ranged from 20 to 54 years with a mean age of 37.1 ± 12.2 years. There were 24 males and 16 females (M:F::2:3). Thirty‑nine patients (97.5%) were cured of their symptoms following the procedure, and 1 patient (2.5%) had severe pain as complication of the treatment. Another patient had recurrence that was treated by repeat rubber band ligation. Conclusion: We conclude that rubber band ligation is a safe and reliable way for outpatient treatment of hemorrhoids in Nigeria.
CLEFT LIP, ALVEOLUS AND PALATE IN AFRICAN NATIVES: AN UPDATE ON DEMOGRAPHICS AND MANAGEMENT OUTCOME
(HHS Public Access, 2015-12) Drs O.B. Akintububo1, E.O. Ojo2, DD Kokong3, S.A. Adamu4, U.U Nnadozie5, Z Yunusa Kaltungo5, I Jalo6, and A.M Dauda7
Background—Development of craniofacial structures is a complex process and disruption of any of the numerous steps can lead to development of oro-facial clefts. This is a surgically amenable anomaly as from early life that has had conflicting pattern of demographics reported by various researchers globally. There are several factors that are critical to the surgical outcome. Objective—Study the demographics and the management outcome of cleft lip, alveolus and palate and highlight factors responsible for improved care in recent time. Design—Descriptive cohort study. Setting—Tertiary health institution Method—All consecutive patients managed for cleft lip, alveolus and palate (CLAP) over 7years and 10months were studied. Outcome—Cleft lip, alveolus and palate repair was performed on 149 patients, January 1, 2001– December 31, 2008 with an incidence of 2.1/1000 live births. From this, 27 patients, averaging 4.5 patients per year were operated for the first 6 1/3 years while the remaining 122(81.9%) the next 1 1/2 years, averaging 81.6 patients yearly. Their ages ranged from 3 months – 60 years with 77 (51.7%) males and 72 (48.3.0%) females. Cleft lip was the main presentation in 108(72.5%) of which 72(66.7%) were left sided. Bilateral cleft lip were14 (9.4%). Five (3.4%) patients had associated anomalies out of which 3(60.0%) had CLAP while 2(40.0%) isolated cleft lip or palate. The technique for cleft lip repair was Millard’s and Noordhoof’s while palatal cleft was the twoflap palatoplasty with intravelar veloplasty. Success was recorded in 142(95.3%) with complication observed in 7(4.7%) patients. Conclusion—The rarity of cleft lip, alveolus and/or palate in the African native documented previously may no longer be tenable as observe in this study. Management outcome has improved owing to the collaboration with SmileTrain, USA, along with multidisciplinary approach.
Pilot Experience with Infrared Photocoagulation As an Office Based Procedure for the Treatment of Hemorrhoids.
(IOSR Journal of Dental and Medical Sciences, 2016-05) Ale A. F; Achinge G. I; Peter S. D; Shitta A. H; Isichei M. W; Misauno M. A
There are many minimally invasive modalities in use for the treatment of hemorrhoids, most of which are unavailable in our setting. This study sought to describe our recent experience with infrared photocoagulation with a view to stressing it's suitability as an office based procedure for treating hemorrhoids. A prospective study of consecutive patients presenting with symptomatic hemorrhoids was conducted over a 3 year period. 21 (22.3%) patients had grade 1 hemorrhoid, 53 (56.4%) had grade 2 and 20 (21.3%) had grade 3 hemorrhoids. All 20 patients with grade 3 hemorrhoids at re-assessment after 2 weeks, the grade had changed to 2. 53 (56.4%) patients had 2 sessions of treatment at 2 weekly interval, while 41 (43.6%) patients had a single session of treatment to cure symptoms. 60 (63.8%) patients had minor post procedure hemorrhage, 14 (14.9%) had mild post procedure pain, 4 (4.3%) had recurrence of symptoms and were treated via open hemorrhoidectomy, while 16 (17.0%) had no procedure related complication. Infrared photocoagulation is an effective, safe and well tolerated procedure for the outpatient treatment of hemorrhoids and may be used to downstage grade 3 hemorrhoids.
Profile of Benign Breast Diseases in an African Population
(Journal of Surgery, 2016-05) Ale Alexander Femi, Ozoilo Kenneth Nnaetio, Misauno Michael Ayedima
Benign Breast Diseases (BBD) refer to all non-malignant conditions of the breast and it received little attention in the past because most of the focus was on breast cancer, despite the fact that it constitutes majority of the presentation in breast clinics. The objective of this study was to evaluate comprehensively the profile of BBD in our environment, highlight the age group distribution of these BBDs and its different modes of presentation. This was a prospective cross-sectional study conducted between May 2009 and April 2010 at the Taimako Breast and Cervical Screening Centre on women who presented for breast screening. There were two thousand and sixty five study subjects, out of which one hundred and fifty women were diagnosed with BBD (7.3%), while one thousand nine hundred and fifteen (92.7%) had normal screening results. The mean age of those with BBD was 27.9 ± 9.6 with an age range of 15 to 60 years. Breast lumps constituted 44.7% of the presentation of BBD and was the most common mode of presentation, while 17.3% of those diagnosed with BBD had no symptoms and were discovered following triple assessment. More than half (56.8%) of the women who complained of breast lumps did not actually have lumps following triple assessment. BBD comprised a spectrum of disorders, with Fibroadenoma being the commonest and occurred most frequently in the younger 2nd and 3rd decades as opposed to older decades.