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Prevalence and attitude of self-ear cleaning with cotton bud among doctors at aminu Kano teaching hospital, Northwestern Nigeria 尼日利亚西北部aminu Kano教学医院医生棉签自洁耳的流行程度及态度
Pub Date : 2016-07-01 DOI: 10.4103/1595-1103.194215
M. Gadanya, S. Abubakar, Abdulazeez Ahmed, A. Maje
Background: The use of cotton bud for self-ear cleaning is a common practice among many people despite its attendant ill-effects. This study examined the prevalence, attitude toward the use of cotton buds, and reasons for the use of cotton buds and problems or ill-effects associated with its use among medical doctors working at Aminu Kano Teaching Hospital. Materials and Methods: A descriptive cross-sectional study was carried out among a randomly selected sample of 130 medical doctors working in Aminu Kano Teaching Hospital spread across several departments in the hospital using a self-administered semi-structured questionnaire. Data were analyzed using MINITAB statistical software and the results summarized using measures of central tendency while Chi-square test was used to assess for associations between categorical variables. Results: The respondents' age ranged from 25 to 55 years with a mean age of 33.6 ± 5.4 years. Most of the respondents were males (68.0%) The prevalence of cotton bud use was found to be 76.3% and for many, the frequency of use of cotton buds was once daily, and both ears were frequently cleaned. A common problem encountered with cotton bud use was retention of the bud as a foreign body. There was an association between owning a cotton bud and using it (χ2 = 38.317, P= 0.001). There was also a significant association between the use of cotton buds and the department where the respondent works (χ2 = 19.28, P= 0.0001). Conclusion: The use of cotton buds for self-ear cleaning is surprisingly prevalent among medical doctors working at Aminu Kano Teaching Hospital. There is a need for health education and promotion strategies for health workers in the hospital community that ear cleaning is best done by trained personnel.
背景:使用棉签进行自耳清洁是许多人普遍的做法,尽管其伴随的不良影响。本研究调查了在Aminu Kano教学医院工作的医生中使用棉签的流行程度、对使用棉签的态度、使用棉签的原因以及与使用棉签有关的问题或不良影响。材料与方法:采用自填半结构化问卷,对随机抽取的分布在明野教学医院多个科室的130名医生进行描述性横断面研究。采用MINITAB统计软件对数据进行分析,采用集中趋势法对结果进行汇总,采用卡方检验评估分类变量之间的相关性。结果:受访者年龄25 ~ 55岁,平均年龄33.6±5.4岁。男性居多(68.0%),棉签使用率为76.3%,棉签使用率为1天1次,双耳清洁频率较高。使用棉签时遇到的一个常见问题是棉签作为异物滞留。拥有棉签与使用棉签之间存在相关性(χ2 = 38.317, P= 0.001)。棉签的使用与被调查者所在的部门之间也存在显著关联(χ2 = 19.28, P= 0.0001)。结论:棉签自耳清洁在明野教学医院的医生中非常普遍。有必要对医院社区的卫生工作者进行卫生教育和宣传战略,使他们认识到,耳部清洁最好由受过培训的人员进行。
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引用次数: 11
Caudal regression syndrome with a solitary kidney: A case report and review of the literature 尾侧退化综合征伴孤立肾:1例报告及文献复习
Pub Date : 2016-07-01 DOI: 10.4103/1595-1103.194213
A. Abubakar, B. Abubakar
Caudal regression syndrome (CRS) is a rare, congenital anomaly that is often complicated by a neurogenic bladder. Congenital anomalies of the kidney and urinary tract in aforesaid patient present an added challenge in the management. The aim and objective of this study is to report a rare case of CRS with neurogenic bladder and right solitary hydronephrotic kidney. The patient was a 3-year-old female infant with burdensome lower urinary tract symptoms and congenital back and lower limbs deformities. Her examination unveiled vertebra and lower limbs anomalies. The computed tomography scan showed lumbosacrococcygeal agenesis with a right solitary hydronephrotic kidney. She was treated for urinary tract infection at presentation, after which cystometry confirmed high-pressure neurogenic bladder. She did well to the initial continuous bladder drainage and the ensuing oxybutynin with clean intermittent catheterization. Instantaneous management of the bladder dysfunction prevents potentially permanent solitary renal dysfunction and the secondary bladder malfunction in a patient with CRS and neurogenic bladder.
尾侧退行综合征(CRS)是一种罕见的先天性异常,常并发神经源性膀胱。上述患者的先天性肾脏和尿路异常对治疗提出了额外的挑战。本研究的目的是报告一例罕见的CRS合并神经源性膀胱和右侧孤立性肾积水。患者是一名3岁女婴,有严重的下尿路症状和先天性背部和下肢畸形。检查发现椎体和下肢异常。计算机断层扫描显示腰肩尾骨发育不全伴右侧孤立性肾积水。患者就诊时因尿路感染接受治疗,膀胱术证实为高压神经源性膀胱。她在最初的持续膀胱引流和随后的奥昔布宁清洁间歇导尿中表现良好。膀胱功能障碍的即时管理可以防止CRS和神经源性膀胱患者发生潜在的永久性孤立性肾功能障碍和继发性膀胱功能障碍。
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引用次数: 0
Airway management with submental orotracheal intubation in maxillofacial surgery: Our experience and literature review 颏下口气管插管在颌面外科中的气道管理:我们的经验和文献回顾
Pub Date : 2016-07-01 DOI: 10.4103/1595-1103.194218
Abdurrazaq Taiwo, A. Ibikunle, R. Braimah
Background and Aim: The challenge of the “shared airway” is a recurring predicament in maxillofacial surgeries. The need to have unfettered access to the nasal pyramid and oral cavity without jeopardizing the integrity of the airway during maxillofacial surgeries is vital. The use of submental intubation has been reported as an excellent adjunct in maxillofacial trauma surgery; however, few, if any, report exists on its use for massive facial tumors. This is a report of its use in varied scenarios including traumatic and neoplastic conditions. The aim of this study was to review the indications, complications, and outcomes of airway management using submental intubation in maxillofacial surgery at a tertiary hospital in Nigeria. Patients and Methods: Records were retrieved retrospectively over a period of 28 months (June 2013–October 2015). Data recorded included demographics, indications, and intraoperative and postoperative complications. Results: A total of eight patients were evaluated, all of whom had surgery under general anesthesia. All of them had conventional orotracheal intubation initially, which was then converted into the submental route. Two of them had intraoperative complications of raised airway pressure, however no postoperative complication was observed. Conclusions: Although it requires some surgical skill, submental intubation provides a reasonable substitute to other airway management techniques in certain patients. Its importance in patients with massive maxillofacial tumors was also highlighted along with other indications.
背景与目的:“共享气道”的挑战是颌面外科手术中反复出现的难题。在颌面外科手术中,不受限制地进入鼻锥体和口腔而不损害气道的完整性是至关重要的。使用颏下插管已被报道为颌面部创伤手术的一种极好的辅助手段;然而,关于其用于大面积面部肿瘤的报道很少。这是一个报告,它的使用在各种情况下,包括创伤和肿瘤条件。本研究的目的是回顾尼日利亚一家三级医院颌面外科手术中使用颏下插管气道管理的适应症、并发症和结果。患者和方法:回顾性检索28个月(2013年6月- 2015年10月)的记录。记录的数据包括人口统计学、适应症、术中和术后并发症。结果:8例患者均在全麻下行手术治疗。所有患者最初都采用常规的气管插管,然后将其转换为颏下插管。2例患者术中出现气道压力升高并发症,术后无并发症发生。结论:虽然需要一定的手术技巧,但在某些患者中,颏下插管是其他气道管理技术的合理替代。与其他适应症一起强调了其在颌面部肿瘤患者中的重要性。
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引用次数: 2
Improvisation of surgical equipment in the surgical services of a developing country 发展中国家外科服务中外科设备的改进
Pub Date : 2016-07-01 DOI: 10.4103/1595-1103.194217
A. Adejumo, O. Adeosun, P. Omoregie, B. Alayande
Background: The perennial scarcity of surgical equipment in Nigeria has given room for improvisation of such items using locally available materials. Aim: This publication aims to appraise the ingenious methods employed by surgeons to overcome their challenges in clinical practice. Methods: An in-depth research into relevant literature about the functionality of various surgical devices was carried out using selected texts and relevant articles. Results: Many surgeons have come up with various techniques to make do with local resources in overcoming the limitations imposed by scarcity of certain equipment/device. Conclusion: Surgical practitioners in resource-limited regions have been able to surmount the challenges of scarcity of required items using different methods and materials from the local environment.
背景:尼日利亚外科设备的长期短缺为使用当地可用材料即兴制作此类物品提供了空间。目的:本出版物旨在评估外科医生在临床实践中克服挑战的巧妙方法。方法:选取相关文献和相关文章,对各种手术器械的功能进行深入研究。结果:许多外科医生在克服某些设备/装置的稀缺所带来的限制时,已经提出了各种技术来应付当地资源。结论:在资源有限的地区,外科医生已经能够通过使用不同的方法和材料来克服当地环境中所需物品稀缺的挑战。
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引用次数: 5
Simultaneous bilateral femoral neck fractures following electroconvulsive therapy 电休克治疗后双侧股骨颈同时骨折
Pub Date : 2016-07-01 DOI: 10.4103/1595-1103.194211
I. Dahiru, K. Amaefule, Y. Lawal, Maitama Inuwa, Yunus Adeniyi Abdulgafar
Fracture neck of femur occurs commonly among elderly people with osteoporosis being the risk factor favoring its occurrence. Its occurrence among young adults, though uncommon, follows high-energy trauma with multisystem affectation. Fracture neck of femur poses a management challenge to the surgeon in deciding on the best option of treatment, in achieving accurate reduction and fixation, and in dealing with complications which may be inevitable. Fracture neck of femur following electroconvulsive therapy is rare. Simultaneous bilateral femoral neck fractures following electroconvulsive therapy are even rarer. Simultaneous bilateral femoral neck fractures management is technically demanding, requiring considerable experience, appropriate instrumentation, and equipment. It is also associated with high morbidity which includes nonunion and avascular necrosis. These fractures can be prevented by the use of modified electroconvulsive therapy. This case seeks to reemphasize the rarity of simultaneous bilateral femoral neck fractures following electroconvulsive therapy, highlight the challenges of managing this condition and proffer ways of avoiding its occurrence.
股骨颈骨折常见于老年人,骨质疏松症是其发生的危险因素。它发生在年轻人中,虽然不常见,但发生在高能量创伤和多系统影响之后。股骨颈骨折对外科医生在确定最佳治疗方案、实现准确复位和固定以及处理可能不可避免的并发症方面提出了管理挑战。电休克治疗后股骨颈骨折是罕见的。电休克治疗后同时发生双侧股骨颈骨折更是罕见。同时处理双侧股骨颈骨折在技术上要求很高,需要丰富的经验、合适的器械和设备。它也与高发病率相关,包括骨不连和无血管坏死。这些骨折可通过改良电休克疗法加以预防。本病例旨在再次强调电休克治疗后同时发生双侧股骨颈骨折的罕见性,强调处理这种情况的挑战,并提供避免其发生的方法。
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引用次数: 0
Utero-cutaneous fistula following cesarean section 剖宫产术后子宫皮瘘
Pub Date : 2016-07-01 DOI: 10.4103/1595-1103.194212
M. Taingson, J. Adze, S. Bature, A. Durosinlorun, Mohammed Caleb, A. Amina
Utero-cutaneous fistula is an extremely rare entity, and only a few case reports have been published. Most Utero-cutaneous fistulas are secondary to postpartum or postoperative complications. A 23-year-old woman, para 1+0, not alive, noticed bleeding through her abdominal incision scar, following a cesarean section for retained second twin 5 years before presentation. A fistulous tract was demonstrated at examination under anesthesia with a probe, between the uterus and wound. The patient had laparotomy with excision of the fistulous tract and uterine repair; she did well postoperatively. Although our patient had a successful surgical treatment, prevention of utero-cutaneous fistula by meticulous technique during the primary surgical procedure and measures to prevent postoperative sepsis would have spared this patient the distress, cost, and risk of a second operation.
子宫皮瘘是一种极为罕见的疾病,仅有少数病例报道。大多数子宫皮肤瘘管是继发于产后或术后并发症。一名23岁女性,第1+0段,死亡,发现腹部切口疤痕出血,在分娩前5年对保留的第二胎进行剖宫产手术。在麻醉下用探针检查发现子宫和伤口之间有瘘道。患者行剖腹手术,切除瘘道,修复子宫;术后情况良好。虽然我们的患者手术治疗成功,但在初次手术过程中通过细致的技术预防子宫皮瘘和预防术后脓毒症的措施将使该患者免于第二次手术的痛苦、费用和风险。
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引用次数: 5
Emerging rare causes of lower gastrointestinal bleeding 下消化道出血的罕见原因
Pub Date : 2016-07-01 DOI: 10.4103/1595-1103.194216
J. Makama
Lower gastrointestinal bleeding (LGIB) is defined as bleeding from a source located at any point in the lumen of the small bowel from ligament of Treitz and the large bowel down to the anal opening. The ligament of Treitz has been considered to be the fibrous band of tissues that plastered the duodenojejunal junction to the posterior peritoneum. It is often referred as the reference point of LGIB. As it is a well-known fact, LGIB has been a significant cause of morbidity and mortality worldwide.[1] There are numerous causes which are often classified as common causes because they occur quite common in virtually every community and rare causes which rarely occur or cause a threat to life. However, in the recent times, these so-called rare causes are becoming significant causes, particularly in the presence of certain conditions[2] couple with new causes that were not known before. These, together constitute an emerging rare cause of LGIB which this editorial intends to highlight.
下消化道出血(LGIB)是指从Treitz韧带和大肠到肛门开口的小肠管腔内任何位置的出血。Treitz韧带被认为是粘接十二指肠空肠连接处至后腹膜的纤维带组织。它通常被称为LGIB的参考点。众所周知,LGIB一直是世界范围内发病率和死亡率的重要原因。[1]有许多原因通常被归类为常见原因,因为它们在几乎每个社区都很常见,而罕见原因很少发生或对生命造成威胁。然而,近年来,这些所谓的罕见原因正在成为重要原因,特别是在某些情况下[2],加上以前不知道的新原因。这些共同构成了本社论打算强调的LGIB的一个新兴的罕见原因。
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引用次数: 0
Thromboelastography parameters versus classical coagulation profile in trauma patients: Retrospective study 创伤患者的血栓弹性成像参数与经典凝血特征:回顾性研究
Pub Date : 2016-07-01 DOI: 10.4103/1595-1103.194214
Abdulraouf Y. Lamoshi, Alison M Wilson
Background: Thrombelastography (TEG) assesses the viscoelastic properties of the whole blood and it is more comprehensive and capable to detect any coagulation abnormalities in comparison to classical coagulation tests (CCTs). On this ground, TEG can be more efficient in acute settings. Therefore, the primary aim was to compare TEG parameters of traumatic brain injury (TBI) versus non-TBI (NTBI) patients. The secondary aim was to identify TEG versus CCT parameters associated with outcome. Methods: A cross-sectional retrospective observational study of 142 patients admitted to a university-based, Level 1 trauma center. TEG and CCT were collected on admission. Institutional Review Board approval was obtained for this study. SAS was used for categorical data were analyzed using Chi-square or Fisher's exact test. A comparison of continuous variables between TBI and NTBI patients was performed using the independent-sample t-test. Results: In a total of 142 patients, 48 patients had TBI and 94 patients did not. Overall, mortality was 20.4% (45.8% TBI vs. 7.4% NTBI). There were no significant associations between TEG or CCT parameters and studied variables some of which are injury severity score, abbreviated injury scale, craniotomy/ectomy, type of brain injury, discharge status, and blood pressure. There was no difference between the TBI and NTBI groups regarding TEG or CCT parameters. Maximum amplitude (MA) was the only parameter (TEG or CCT) associated with need for transfusion of packed red blood cell (PRBC) (P = 0.0377). PRBC transfusion was given in 94% of patients with an MA <57.4. Platelet transfusion was given in 89% of patients who have MA < 58.1. Fresh-frozen plasma (FFP) transfusion was given in 80% of patients who have R ≥5.8. PRBC transfusion was given in 77% of 18 patients with α <62.9. Conclusions: TEG parameters are potentially useful as means to rapidly diagnose coagulopathy and predict transfusion in trauma patients. Independently, the presence of TBI does not cause a detectable coagulopathy. TEG analysis is more efficient than the classical parameters in detecting patients who will need PRBC and FFP transfusion.
背景:血栓造影(TEG)评估全血的粘弹性特性,与传统的凝血试验(CCTs)相比,它更全面,能够检测任何凝血异常。基于这一点,TEG可以在急性环境中更有效。因此,主要目的是比较外伤性脑损伤(TBI)与非TBI (NTBI)患者的TEG参数。次要目的是确定与结果相关的TEG和CCT参数。方法:对一所大学一级创伤中心收治的142例患者进行横断面回顾性观察研究。入院时采集TEG和CCT。本研究获得了机构审查委员会的批准。分类资料采用SAS分析,采用卡方检验或Fisher精确检验。使用独立样本t检验比较TBI和NTBI患者之间的连续变量。结果:142例患者中,48例发生TBI, 94例未发生TBI。总体死亡率为20.4% (TBI为45.8%,NTBI为7.4%)。TEG或CCT参数与损伤严重程度评分、简略损伤量表、开颅/切除术、脑损伤类型、出院状态和血压等研究变量之间无显著相关性。TBI组和NTBI组在TEG或CCT参数方面没有差异。最大振幅(MA)是唯一与需要输血填充红细胞(PRBC)相关的参数(TEG或CCT) (P = 0.0377)。94%的MA <57.4的患者接受了PRBC输血。在MA < 58.1的患者中,89%给予血小板输注。80% R≥5.8的患者接受新鲜冷冻血浆(FFP)输注。α <62.9的18例患者中77%给予PRBC输注。结论:TEG参数可作为创伤患者凝血病快速诊断和输血预测的有效手段。单独来看,TBI不会引起可检测到的凝血功能障碍。在检测需要PRBC和FFP输血的患者时,TEG分析比经典参数更有效。
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引用次数: 1
Pattern of traumatic spinal cord injury in Makurdi, Nigeria 尼日利亚马库尔迪创伤性脊髓损伤的模式
Pub Date : 2016-07-01 DOI: 10.4103/1595-1103.194219
W. Yongu, C. Elachi, Daniel Mue, J. Kortor
Objectives: To study the pattern of presentation and outcome of conservative treatment of traumatic spinal cord injury (TSCI) in our institution. Setting: Benue State University Teaching Hospital, Makurdi, Benue State. Materials and Methods: A 3-year retrospective review (June 2012 to May 2015) of TSCI was done. Demographic data, cause, associated injuries, time interval to presentation, level of injury, American Spinal Injury Association (ASIA) classification at presentation and at 6 weeks were obtained from case notes. The patients were all managed conservatively and had bed rest on air or water mattress. Results: There were 45 patients mean age 33.26 ± 1.55 (range 8–77 years) with TSCI comprising 37 males and 8 females giving a male: female ratio of 4.6:1. Students were mostly affected (n = 11, 24%) while motor vehicular accident was the cause of injury (n = 18, 40%). Cervical spine was the most injured (n = 24 53.3%). Majority had the ASIA Class A (n = 22 48.9%) at presentation. Thirteen (48.1%) of them improved, two were referred, six remained the same, eight deteriorated, and 16 were discharged against medical advice. Period of hospitalization was 1–65 days. Conclusion: TSCI affects mainly young males involved in motor vehicular accident. Conservative treatment can be used in resource-constrained centers.
目的:探讨我院外伤性脊髓损伤(TSCI)的临床表现及保守治疗的效果。地点:贝努埃州立大学教学医院,马库尔迪,贝努埃州。材料与方法:对2012年6月至2015年5月TSCI文献进行为期3年的回顾性分析。从病例记录中获得人口统计学数据、病因、相关损伤、发病时间间隔、损伤程度、发病时和6周时美国脊髓损伤协会(ASIA)的分类。所有患者均采用保守治疗,采用气垫或水垫卧床休息。结果:45例TSCI患者平均年龄(33.26±1.55)岁,年龄范围8 ~ 77岁,其中男37例,女8例,男女比例为4.6:1。以学生为主(n = 11, 24%),以机动车事故为主(n = 18, 40%)。颈椎损伤最多(n = 24 53.3%)。大多数患者在就诊时为ASIA A级(n = 22 48.9%)。其中13人(48.1%)好转,2人转诊,6人保持原状,8人恶化,16人不遵医嘱出院。住院时间1 ~ 65天。结论:机动车事故多发于青年男性。保守治疗可用于资源有限的中心。
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引用次数: 2
List of authors in scholarly publications: Does it matter? reply 学术出版物的作者名单:重要吗?回复
Pub Date : 2016-01-01 DOI: 10.4103/1595-1103.182482
J. Makama
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引用次数: 0
期刊
Nigerian Journal of Surgical Research
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