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Oro-facial carcinoma in kaduna 卡杜纳口腔-面部癌
Pub Date : 2010-05-28 DOI: 10.4314/NJSR.V8I3-4.54877
Ds Adeola, A. Obiadazie
Background To review the epidemiology and morbidity Oro-Facial cancers seen and managed at Ahmadu Bello University Teaching Hospital (ABUTH).To estimate the incidence and prevalence of Oro-facial Cancer presenting at the clinic. To highlight the poor prognosis inspite of better facilities for management.To evaluate the various factors affecting the poor prognosis. Patient and Method A 5-years retrospective study of 211 patients with Oro-facial cancers in the maxillo-facial unit of Ahmadu Bello University Kaduna, was carried out. The demographic pattern, clinical features, Histopathological findings and treatments modalities as obtained from the patients’ folder were studied. Result From the 211 Oro-facial cancers studied, Squanmous cell carcinoma accounted for 136 (64%), Adenocystic carcinoma 30 (14%), Adeno carcinoma 11 (5%), metastatic carcinoma 8 (4%), other 26 (13%). House wives, farmers and trader accounted for 152 (71%) of all the patients. 92% (192 patients) presented at very advanced stage of the disease when little or no help can be rendered. The age of presentation ranged between 15 to 84 years with median age at 44.5. There were 135 (64%) males affected and 76 (36%) females with a male to female ratio of 1.8:1. Conclusion : Public enlightenment is necessary to encourage early presentation, since majority of people in this environment has access to radio media.
背景回顾在ahudu Bello大学教学医院(ABUTH)就诊和治疗的口腔面部肿瘤的流行病学和发病率。目的:估计临床上出现的口腔-面部癌的发病率和患病率。强调尽管有较好的管理设施,但预后较差。评价影响预后不良的各种因素。患者与方法对卡杜纳Ahmadu Bello大学211例上颌面癌患者进行了5年的回顾性研究。研究了从患者文件夹中获得的人口统计学模式、临床特征、组织病理学结果和治疗方式。结果211例口腔面部肿瘤中,鳞状细胞癌136例(64%),腺囊癌30例(14%),腺癌11例(5%),转移癌8例(4%),其他26例(13%)。家庭主妇、农民和商人占152人(71%)。92%(192例)的患者出现在疾病的非常晚期,此时很少或根本无法提供帮助。出现的年龄在15至84岁之间,中位年龄为44.5岁。男性135例(64%),女性76例(36%),男女比例为1.8:1。结论:公众启蒙是必要的,以鼓励早期呈现,因为大多数人在这个环境中有机会获得广播媒体。
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引用次数: 3
Malignant transformation in Pre-existing Naevi. A review of two cases 既存痣的恶性转化。回顾两个案例
Pub Date : 2010-05-28 DOI: 10.4314/NJSR.V8I3-4.54903
M. Samaila, A. Adesiyun
Pigmented naevi (melanocytic naevi) are common and are widely distributed all over the body. The average number of naevi seen in a Caucasian is between twenty and thirty. They are either congenital or acquired benign neoplasm of melanocytes. They may occur as giant lesions at birth, and are more prone to malignant transformation. However, the risk of malignant transformation associated with naevi irrespective of size is well established and a variety of malignancies have been reported to arise from a naevus. The incidence of malignant transformation in naevi is 4% to 9%. We present two cases of malignant tumours arising from pre-existing naevus. The first was a 60-year old woman with a malignant melanoma arising in a vulva intradermal naevus. The second was a 51-year old woman with a basal cell carcinoma arising in a facial naevus.
色素痣(黑素细胞痣)是一种常见的痣,广泛分布于全身。高加索人的平均痣数在20到30个之间。它们要么是先天性的,要么是获得性的黑色素细胞良性肿瘤。它们可能在出生时出现巨大的病变,并且更容易恶性转化。然而,与痣相关的恶性转化的风险是确定的,无论大小,各种恶性肿瘤都是由痣引起的。neevi恶性转化的发生率为4% ~ 9%。我们提出两例恶性肿瘤引起的既往痣。第一位患者是一名60岁的女性,她的恶性黑色素瘤起源于外阴皮内痣。第二例为51岁女性,面部痣基底细胞癌。
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引用次数: 2
Orbital cellulitis complicating sinusitis: a 15-year review 眼眶蜂窝织炎并发鼻窦炎:15年回顾
Pub Date : 2010-05-27 DOI: 10.4314/NJSR.V6I1-2.54769
O. Nwaorgu, F. Awobem, P. Onakoya, A. Awobem
Background : Orbital cellulitis is an infection of the orbital soft tissues behind the orbital septum. Primary sinus infection is the most common cause of orbital cellulites. It is an ocular emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain abscess. Method : A fifteen-year retrospective review (1986 – 2000) of all cases of orbital cellulitis, but with special focus on those of sinogenic origin seen at the University College Hospital, Ibadan, Nigeria. Results : Ninety patients were managed. There was a male preponderance (M: F ratio of 2:1) while 84% of the patients were below 20 years of age. Sinogenic orbital cellulitis constituted 57% of the study population (ninety cases) with the left orbit being involved most (55%), while the maxillary sinus had the highest incidence of sinusitis either singly (18%) or combined (65%). Complication of orbital cellulitis was found to be 52%, with no death but 11% became blind due to panophthalmitis. Conclusion : Though antibiotics have altered the course of sinusitis, its grave complications still persist in our environment. It is hoped that a well-structured health education/awareness programme and early referral to specialists will improve the final outcome.
背景:眶蜂窝织炎是一种眶隔后软组织的感染。原发性鼻窦感染是眼眶脂肪团最常见的原因。这是一种眼部急症,不仅威胁视力,而且还会引起脑膜炎、海绵窦血栓形成和脑脓肿等并发症,危及生命。方法:对1986 - 2000年间在尼日利亚伊巴丹大学学院医院发生的眼眶蜂窝织炎病例进行回顾性分析。结果:成功治疗90例患者。男性居多(M: F比为2:1),年龄在20岁以下的占84%。窦性眼眶蜂窝织炎占研究人群的57%(90例),其中左眼眶最多(55%),而上颌窦单发(18%)或合并(65%)的鼻窦炎发生率最高。眼窝蜂窝织炎并发症占52%,无死亡病例,11%因全眼炎致盲。结论:虽然抗生素改变了鼻窦炎的病程,但其严重的并发症仍然存在于我们的环境中。希望结构良好的健康教育/认识方案和尽早转诊给专家将改善最终结果。
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引用次数: 23
Anastomotic leakage: experience from a colorectal unit 吻合口漏:结直肠单位的经验
Pub Date : 2010-05-27 DOI: 10.4314/NJSR.V6I1-2.54793
A. Agaba, G. Duthie
Background : Whilst the incidence of anastomotic dehiscence is decreasing, it remains a significant setback to the patients and their surgeons. In most centres, minor leaks are treated conservatively but surgery remains an options. Major leaks are best treated aggressively by surgical means, as the mortality among this group of patients remains unacceptably high. Methods : We reviewed all case-notes, radiological records and histology reports of all patients who underwent major colonic restorative resection between July 1997 and September 199 in order to determine the leak rate and their outcomes. Seven Surgeons (3 Consultant Colorectal surgeons and 4 Senior Colorectal Registrars) were involved in these resections. Results : Of the 348 restorative resections performed during the study period, 6% leaked. In 52%, the leak was classified as major and all of these patients underwent further surgery. Most leaks followed anterior resection and in most patients the anastomoses were below the peritoneal reflection. Among the minor leaks, four of the patients were defunctioned primarily. Mortality rate among patients with major leaks remain significantly high. Conclusion : Anastomotic dehiscence remains a significant problem. Although blood supply, nutritional factors, the level of anastomosis and the experience of the surgeon are perhaps the two most important factors that determine the outcome of anastomosis
背景:虽然吻合口裂开的发生率正在下降,但它仍然是患者及其外科医生的一个重大挫折。在大多数中心,轻微的渗漏保守治疗,但手术仍然是一种选择。由于这类患者的死亡率仍然高得令人无法接受,严重的渗漏最好通过手术手段进行积极治疗。方法:我们回顾了1997年7月至1999年9月间所有结肠恢复性切除术患者的病例记录、放射学记录和组织学报告,以确定漏出率及其结果。7名外科医生(3名结直肠外科顾问医生和4名高级结直肠登记员)参与了这些手术。结果:在研究期间进行的348例恢复性切除中,有6%发生泄漏。在52%的患者中,泄漏被归类为严重泄漏,所有这些患者都接受了进一步的手术。大多数瘘发生在前切除术后,大多数患者吻合口位于腹膜反射下方。在轻微渗漏中,4例患者主要功能丧失。严重渗漏患者的死亡率仍然很高。结论:吻合口开裂仍然是一个重要的问题。虽然血液供应、营养因素、吻合水平和外科医生的经验可能是决定吻合结果的两个最重要的因素
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引用次数: 1
Intussusception in pregnancy: report of a case 妊娠期肠套叠1例报告
Pub Date : 2010-05-27 DOI: 10.4314/NJSR.V6I1-2.54799
M. Abdul, L. Yusufu, D. Haggai
A 35 year old Gravida 10 Para 8+1 (7 alive) presented with three months amenorrhoea and acute onset of abdominal pain with vomiting and constipation. Clinical and sonological evaluations were supportive of an intussusception occurring in a first trimester twin pregnancy. She was resuscitated and had ileal resection with end to end anastomosis. She subsequently had home delivery at term with resultant perinatal death of the second twin and severe anaemia. As intestinal obstruction is a rare but serious event in pregnancy, the importance of high index of suspicion in the evaluation of abdominal pain in pregnancy is emphasised. The usefulness of ultrasound in the early diagnosis of intussusception in pregnancy is discussed.
一位35岁的孕妇,10 Para 8+1(7活着)表现为闭经3个月,急性腹痛伴呕吐和便秘。临床和超声评价支持肠套叠发生在早期妊娠双胞胎。术后复苏,行回肠切除术,端端吻合。随后,她在家中足月分娩,导致第二个双胞胎围产期死亡和严重贫血。由于肠梗阻是一种罕见但严重的妊娠事件,因此在评估妊娠腹痛时强调高怀疑指数的重要性。本文讨论了超声在妊娠期肠套叠早期诊断中的作用。
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引用次数: 5
One-stage correction of intermediate imperforate anus in males: preliminary results 男性中期肛门闭锁一期矫正术:初步结果
Pub Date : 2010-05-27 DOI: 10.4314/NJSR.V6I1-2.54766
J. Adeniran, L. Abdur-rahman, B. Bolaji
Background: This prospective study was designed to assess the safety, cost effectiveness, and advantages of performing posterior sagittal anorectoplasty without colostomy on males with intermediate imperforate anus. Method: Five consecutive males with intermediate imperforate anus were entered into the study. Chest and abdominal x-rays, skeletal surveys, renal ultrasound scans, and invertograms were done. Patients were resuscitated, and Pena’s posterior sagittal anorectoplasty (PSARP) done in prone positions. Two-ml syringe vents were inserted into the new anus for 10 days. Cephalosporin and metronidazole were given as peri-operative antibiotics. Results: All patients had intermediate anomalies. There were no other major associated congenital anomalies. Urethral catheter could not be inserted in one patient. One patient presented with septicaemia and jaundice. He was deemed too ill to withstand a major operation. These 2 patients therefore had diverting colostomies. There were no problems with posterior sagittal anorectoplasty in the other 3 patients. The father of one patient discharged him against medical advice on the 5 th postoperative day. The mother had post-partum haemorrhage and they went for traditional treatment because they could not provide blood donors. The skin wound of 2 patients healed completely at removal of stitches. Both are having monthly dilatations 9months and 1 year post-operatively. Conclusion: This preliminary study shows that it is feasible for males with intermediate imperforate anus to have safe posterior sagittal anorectoplasty without colostomy. The advantages of one, instead of 3 major operations, are many, especially in developing countries. If this result can be reproduced in high anomalies colostomy may be unnecessary in many cases of anorectal malformations with a lot of benefits to these unfortunate children and their poor families.
背景:本前瞻性研究旨在评估无结肠造口的后矢状肛门成形术对中度肛门闭锁男性的安全性、成本效益和优势。方法:连续5例男性肛门中段闭锁患者为研究对象。做了胸部和腹部x光片,骨骼检查,肾脏超声扫描和倒置图。对患者进行复苏,并在俯卧位进行Pena后矢状肛肠成形术(PSARP)。将2 ml注射器孔插入新肛门10天。围手术期给予头孢菌素、甲硝唑等抗生素。结果:所有患者均有中度异常。没有其他主要的相关先天性异常。1例患者不能插入导尿管。1例患者出现败血症和黄疸。他被认为病得太重,无法承受大手术。因此,这2例患者进行了转移结肠造口术。其余3例患者均行后矢状肛肠成形术。一名患者的父亲在术后第5天不顾医嘱让他出院。母亲产后出血,由于无法提供献血者,他们接受了传统治疗。2例皮肤创面拆线后完全愈合。术后9个月和1年均有每月扩张。结论:本初步研究表明,对于肛门中间闭锁的男性,无需结肠造口而行安全的后矢状肛门成形术是可行的。一个大手术而不是三个大手术的好处很多,特别是在发展中国家。如果这一结果可以在高度畸形的肛肠畸形中重现,那么结肠造口术可能在许多情况下是不必要的,对这些不幸的孩子和他们贫穷的家庭有很多好处。
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引用次数: 4
A comparative evaluation of outcome of cataract surgery at Ago- Iwoye, Ogun State 奥贡州Ago- Iwoye白内障手术结果的比较评价
Pub Date : 2010-05-27 DOI: 10.4314/NJSR.V6I1-2.54782
C. Bekibele
Objective : To compare the outcome of cataract surgery using intracapsular/ extracapsular extraction alone to surgery with lens implantation. Methods : A retrospective review of all patients who had cataract surgery by all methods between February 1998 and October 1999 at St Mary’s Catholic eye hospital Ago-Iwoye, Ogun state, for post operative visual acuity and surgery related complications. Results : Two hundred and forty nine eyes of 211 patients were reviewed. 128 (60.7 %) were males and 83(39.3) were females. The age range was from 9years to 90years. Post op vision of 6/18 or better was present in 71% of the posterior chamber intra ocular lens (PC-IOL) group; 50% of anterior chamber lens (AC-IOL) group, 62% of intracapsular cataract extraction (ICCE) group and 31.2% of the extracapsular cataract extraction group. Preventable causes of poor visual outcome were present in 14.9% 0f the cases reviewed especially the ECCE and ICCE groups and included: posterior capsule opacity, uveitis, cystoid macular oedema and endophthalmitis. Poor outcome was associated with pre-existing ocular disease in 10.8% of the eyes operated and were due to pre-existing glaucoma, macular degeneration, optic atrophy and diabetic retinopathy. Conclusion : Best functional visual results are obtained by modern techniques of ECCE with IOL, which ensures that the patient has adequate post op vision for his needs. Adequate case selection to exclude pre-existing ocular morbidity as well as prevention or proper management of surgery related complications when they occur are also essential for satisfactory results. Older techniques of ICCE or ECCE with out IOL are associated with less satisfactory functional visual acuity and should therefore be discouraged.
目的:比较单纯囊内/囊外摘出与晶状体植入术的效果。方法:回顾性分析1998年2月至1999年10月在奥贡州Ago-Iwoye圣玛丽天主教眼科医院接受各种方法白内障手术的所有患者的术后视力和手术相关并发症。结果:对211例患者249只眼进行了回顾性分析。男性128例(60.7%),女性83例(39.3%)。年龄范围从9岁到90岁。71%的后房型人工晶状体(PC-IOL)组术后视力达到6/18或更好;前房晶状体(AC-IOL)组占50%,囊内白内障摘出(ICCE)组占62%,囊外白内障摘出组占31.2%。14.9%的病例(尤其是ECCE组和ICCE组)存在可预防的视力不良原因,包括:后囊混浊、葡萄膜炎、囊样黄斑水肿和眼内炎。10.8%的手术眼与既往眼部疾病相关,主要是由于既往青光眼、黄斑变性、视神经萎缩和糖尿病性视网膜病变。结论:现代ECCE联合人工晶状体技术可获得最佳的功能视力,确保患者术后视力满足其需要。充分的病例选择以排除先前存在的眼部疾病,以及在发生手术相关并发症时预防或适当处理,也是获得满意结果的必要条件。旧的ICCE或ECCE技术与不含IOL的功能视力较差相关,因此不建议使用。
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引用次数: 7
Report of six cases of metastatic jaw tumours in Nigerians 尼日利亚6例转移性颌骨肿瘤报告
Pub Date : 2010-05-27 DOI: 10.4314/NJSR.V6I1-2.54784
E. Adebayo, S. Ajike
Background : Metastatic tumours make up approximately one per cent of all oral malignancies. Such tumours may present in the jawbones and oral soft tissues. The commonest oral site is the mandible. Nigerian reports of metastatic tumours to the jaws are very rare. Method : This is a retrospective study of six cases of metastatic tumours to the jaws seen at the Maxillofacial Unit, Ahmadu Bello University Hospital, Kaduna from1979-1998,representing 1% of all histologically confirmed malignant jaw tumours in the hospital. Results : Unlike in other reports, most (three of our six cases) originated from the thyroid gland while the rest were from the breast, uterus and the nasopharynx. More of our lesions occurred in the mandible (4) than the maxilla (2) and almost all patients presented with oral complaints oblivious of the primary malignancy. These complaints resemble those from odontogenic infections and benign neoplasms. The most common histological type of metastatic tumours in this study was the adenocarcinoma (50%). Conclusion : In view of the similarity in presentation of metastatic lesions to the jaws and other odontogenic tumours and even infections, a high index of clinical suspicion is advocated to ensure early, multidisciplinary care of patients.
背景:转移性肿瘤约占所有口腔恶性肿瘤的1%。这种肿瘤可能出现在颌骨和口腔软组织。最常见的口腔部位是下颌骨。尼日利亚报道的转移到颌骨的肿瘤是非常罕见的。方法:这是对1979-1998年在卡杜纳Ahmadu Bello大学医院颌面科所见的6例颌骨转移性肿瘤的回顾性研究,占该医院所有组织学证实的恶性颌骨肿瘤的1%。结果:与其他报道不同,本组6例病例中有3例来自甲状腺,其余为乳腺、子宫和鼻咽部。更多的病变发生在下颌骨(4)而不是上颌骨(2),几乎所有的患者都有口腔症状,没有注意到原发恶性肿瘤。这些抱怨类似于牙源性感染和良性肿瘤。本研究中最常见的转移性肿瘤组织学类型是腺癌(50%)。结论:鉴于转移性病变与颌骨及其他牙源性肿瘤甚至感染的表现相似,提倡临床高度怀疑,以确保患者的早期、多学科护理。
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引用次数: 13
Spontaneous scrotal faecal fistula in a neonate: report of a case 新生儿自发性阴囊粪瘘1例报告
Pub Date : 2010-05-27 DOI: 10.4314/NJSR.V6I1-2.54797
L. Chirdan, Uba Af, D. Iya, N. Dakum
A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right inguinal hernia is reported. He had necrotizing fasciitis of the right scrotum with sparing of the testis. He successfully had debridement, herniotomy and bowel resection with end-to-end  anastomosis. This is a rare occurrence in infants and seems to result from late presentation. Health education coupled with early referral and prompt repair of inguinal hernia in neonates and infants would reduce this complication.
一个21天的男孩自发性阴囊粪便瘘后忽视绞窄性右腹股沟疝报告。他有坏死性筋膜炎右阴囊和保留睾丸。他成功地进行了清创术、疝切开术和端端吻合的肠切除术。这在婴儿中是罕见的,似乎是由于较晚的表现。健康教育结合早期转诊和及时修补新生儿和婴儿腹股沟疝可减少这种并发症。
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引用次数: 9
A comparison of two operations for pilonidal sinus disease 两种手术治疗毛窦疾病的比较
Pub Date : 2010-05-27 DOI: 10.4314/NJSR.V6I1-2.54789
Pravin J. Gupta
Background : Postoperative wound complications have always been the main cause of concern followed by the risk of recurrence, in the surgical treatment of the pilonidal sinus disease. Various techniques evolved so far mainly aimed at solving these problems. This clinical study compares the results obtained through random allocation of patients between those subjected to, a) using the excision and marsupialisation technique and b) the technique of excision of the sinus tracts using a radiofrequency device. Methods : A total of 28 patients of chronic pilonidal sinus disease were randomised to undergo radiofrequency sinus excision technique (n=14) or excision and marsupialisation (n=14). The demographic data. Postoperative results complications and recurrence were documented for comparison of the results. Patients from both the groups were recalled after 12 months to assess recurrence. Results : Radiofrequency technique resulted to reducing the execution time (13 versus 34 minutes) as well as the hospital stay (9 versus 30 hrs). The postoperative pain (p=0.0044) and period off work (p=0.0019) was more with the marsupialisation technique. Two patients from marsupialisation developed wound infection. At subsequent follow-up, there was one case of recurrence in each group. Conclusion : in dealing with a limited, chronic pilonidal disease, the radiofrequency sinus excision technique has definite advantages over sinus excision and marsupialisation technique. It needed a shorter hospital stay with reduction on postoperative pain and early resumption to work.
背景:术后伤口并发症一直是手术治疗中引起关注的主要原因,其次是复发风险。迄今为止发展的各种技术主要是为了解决这些问题。本临床研究比较了随机分配患者的结果,a)使用切除和有袋化技术和b)使用射频设备切除鼻窦束技术。方法:28例慢性毛毛窦疾病患者随机分为两组,一组采用射频鼻窦切除技术(n=14),另一组采用切除加有袋化术(n=14)。人口统计数据。术后并发症及复发率进行比较。12个月后,两组患者均被召回评估复发情况。结果:射频技术减少了执行时间(13分钟比34分钟)和住院时间(9小时比30小时)。术后疼痛(p=0.0044)和休假(p=0.0019)明显高于有袋化技术。2例有袋化患者出现伤口感染。随访时,两组各有1例复发。结论:在治疗有限的慢性毛鞘疾病时,射频窦切除技术比窦切除和有袋化技术有明显的优势。它需要更短的住院时间,减少术后疼痛和早日恢复工作。
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引用次数: 5
期刊
Nigerian Journal of Surgical Research
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