Patellofemoral joint instability is a debilitating condition that affects the biomechanical relationships between the soft tissues and the bony architecture of the knee joint. Trochlear dysplasia is an identifiable etiology in 85-96% of patients with patellar instability. Trochleoplasty is a surgical procedure that aims at restoring a sulcus or creating a near-normal trochlear deep enough to accommodate the patellar in the trochlear groove, restoring patellofemoral congruence, patella tracking, and biomechanics during flexion and extension. This case report describes a sulcus-deepening trochleoplasty through a superolateral parapatellar arthrotomy in a 15- year-old adolescent who presented with a severe form of patellar instability due to trochlear dysplasia.
{"title":"Patellofemoral Instability Secondary to Trochlear Dysplasia - A Case Report","authors":"Timothy Kagoda Byakika, P. G. Mwawingwa","doi":"10.4314/aas.v20i4.2","DOIUrl":"https://doi.org/10.4314/aas.v20i4.2","url":null,"abstract":"Patellofemoral joint instability is a debilitating condition that affects the biomechanical relationships between the soft tissues and the bony architecture of the knee joint. Trochlear dysplasia is an identifiable etiology in 85-96% of patients with patellar instability. Trochleoplasty is a surgical procedure that aims at restoring a sulcus or creating a near-normal trochlear deep enough to accommodate the patellar in the trochlear groove, restoring patellofemoral congruence, patella tracking, and biomechanics during flexion and extension. This case report describes a sulcus-deepening trochleoplasty through a superolateral parapatellar arthrotomy in a 15- year-old adolescent who presented with a severe form of patellar instability due to trochlear dysplasia. ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"40 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The research output in surgical branches such as orthopedics and sports medicine (OSM) is meager from Africa, considering the population and the high burden of health-related problems. We conducted this study to analyze the trend of publications in OSM from African countries and compared it with other surgical specialities. Methods: We used the SCOPUS data from the Scimago Journal & Country Rank website, as it allows us to draw substantial journal metrics for research. Results: During the past three decades (between 1996 and 2022), Africa’s global contribution to all surgical specialities has increased. In OSM, this was only 0.65% in 1996 and had risen to 1.79% in 2022. The total publications in OSM were 8297 from 49 countries during this period. The number of publications has risen from 61 (in 1996) to 931 (in 2022), with the maximum surge seen during the past decade. South Africa, Egypt, and Tunisia are the leading African nations in OSM publications and have contributed 77% of the total publications from Africa in 2022. There were only three orthopedic and four other surgical specialities indexed journals listed in the SCImago, arising from Africa. Conclusions: There was an increased research output from Africa in OSM during 1996–2022, especially in the past decade. However, only three nations have contributed more than three-fourth of these publications. There is a scarcity of indexed journals in the surgical disciplines arising from Africa.
导言：考虑到非洲的人口数量和健康相关问题的沉重负担，非洲在矫形外科和运动医学（OSM）等外科分支领域的研究成果很少。我们开展了这项研究，以分析非洲国家在骨科和运动医学领域发表论文的趋势，并将其与其他外科专业进行比较。研究方法：我们使用了 Scimago 期刊与国家排名网站上的 SCOPUS 数据，因为该网站允许我们得出实质性的期刊研究指标。结果过去三十年间（1996 年至 2022 年），非洲对全球所有外科专业的贡献都在增加。1996年，非洲在OSM中所占比例仅为0.65%，而到2022年，这一比例已上升至1.79%。在此期间，49 个国家共发表了 8297 篇 OSM 论文。出版物数量从 61 种（1996 年）上升到 931 种（2022 年），在过去十年中激增幅度最大。南非、埃及和突尼斯是发表 OSM 论文最多的非洲国家，占 2022 年非洲发表论文总数的 77%。在SCImago收录的期刊中，只有3种骨科和4种其他外科专业期刊来自非洲。结论： 1996-2022 年间，非洲在 OSM 方面的研究成果有所增加，尤其是在过去十年。然而，只有三个国家发表了超过四分之三的论文。非洲外科学科的索引期刊很少。
{"title":"Status of Surgical Research and Publication in Africa","authors":"Raju Vaishya, A. Vaish, James Kigera","doi":"10.4314/aas.v21i1.1","DOIUrl":"https://doi.org/10.4314/aas.v21i1.1","url":null,"abstract":"Introduction: The research output in surgical branches such as orthopedics and sports medicine (OSM) is meager from Africa, considering the population and the high burden of health-related problems. We conducted this study to analyze the trend of publications in OSM from African countries and compared it with other surgical specialities. \u0000Methods: We used the SCOPUS data from the Scimago Journal & Country Rank website, as it allows us to draw substantial journal metrics for research. \u0000Results: During the past three decades (between 1996 and 2022), Africa’s global contribution to all surgical specialities has increased. In OSM, this was only 0.65% in 1996 and had risen to 1.79% in 2022. The total publications in OSM were 8297 from 49 countries during this period. The number of publications has risen from 61 (in 1996) to 931 (in 2022), with the maximum surge seen during the past decade. South Africa, Egypt, and Tunisia are the leading African nations in OSM publications and have contributed 77% of the total publications from Africa in 2022. There were only three orthopedic and four other surgical specialities indexed journals listed in the SCImago, arising from Africa. \u0000Conclusions: There was an increased research output from Africa in OSM during 1996–2022, especially in the past decade. However, only three nations have contributed more than three-fourth of these publications. There is a scarcity of indexed journals in the surgical disciplines arising from Africa. ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"59 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asli Mohamed Abdullahi, Mohamed Abdullahi Awale, Bashiru Garba, Mariam Adawe, Fatima Ibrahim Nor, M. Kahiye
Aggressive angiomyxoma is a mesenchymal tumor that is frequently found in women of reproductive age mostly appearing in the vulva, perineal region, head, neck, trunk, and lower limbs. A 33-year-old multiparous Somali woman presented to the outpatient department of Dr Sumait Hospital, with a complaint of swelling around her vulva. The patient reported that the mass had progressively grown for the past 8 years and that she experienced stigma from her previous spouses. Her past medical history and socioeconomic status were unremarkable. During the physical examination, a welldefined pedunculated mass measuring 14 cm × 8 cm, originating from the labia majora, was noted. The mass was pinkish, non-tender, non-reducible, and had a soft consistency. Some areas of ulceration measuring 2 cm × 2 cm, covered with necrotic granulation tissues, were also noticed. With the patient’s written informed consent, a biopsy was performed, and the histopathology results revealed aggressive angiomyxoma. Following confirmation of the diagnosis, the mass was surgically excised under sterile conditions and spinal anesthesia. Aggressive angiomyxoma is an important consideration when evaluating vulvovaginal growth in females. Given its tendency for local recurrences, it is vital to establish an accurate diagnosis.
{"title":"Diffuse Aggressive Angiomyxoma of the Vulva: A Case Report","authors":"Asli Mohamed Abdullahi, Mohamed Abdullahi Awale, Bashiru Garba, Mariam Adawe, Fatima Ibrahim Nor, M. Kahiye","doi":"10.4314/aas.v20i4.6","DOIUrl":"https://doi.org/10.4314/aas.v20i4.6","url":null,"abstract":"Aggressive angiomyxoma is a mesenchymal tumor that is frequently found in women of reproductive age mostly appearing in the vulva, perineal region, head, neck, trunk, and lower limbs. A 33-year-old multiparous Somali woman presented to the outpatient department of Dr Sumait Hospital, with a complaint of swelling around her vulva. The patient reported that the mass had progressively grown for the past 8 years and that she experienced stigma from her previous spouses. Her past medical history and socioeconomic status were unremarkable. During the physical examination, a welldefined pedunculated mass measuring 14 cm × 8 cm, originating from the labia majora, was noted. The mass was pinkish, non-tender, non-reducible, and had a soft consistency. Some areas of ulceration measuring 2 cm × 2 cm, covered with necrotic granulation tissues, were also noticed. With the patient’s written informed consent, a biopsy was performed, and the histopathology results revealed aggressive angiomyxoma. Following confirmation of the diagnosis, the mass was surgically excised under sterile conditions and spinal anesthesia. Aggressive angiomyxoma is an important consideration when evaluating vulvovaginal growth in females. Given its tendency for local recurrences, it is vital to establish an accurate diagnosis. ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"124 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Imaralu, O. Loto, Adebisi Florence Oguntade, O. Jagun, Taofeek Ogunfunmilayo, A. Akadri, Oladapo Walker
Introduction: The effectiveness of the uterine tourniquet alone for securing hemostasis during abdominal myomectomy remains debatable; however, its combination with uterine compression though popular has very scanty documented evidence of hemostatic efficacy. Aim: To determine the effect of uterine incision compression (UIC) combined with tourniquet on operative blood loss associated with abdominal myomectomy. Materials and Methods: A multicenter randomized double blind, controlled trial involving 184 participants randomized into two groups: 92 in the UIC and 92 in the control arm. UIC was administered in the interval from release of the uterine tourniquet to palpation of contraction. Data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 21. Results: The mean intraoperative blood loss was lower in the UIC group (951.41 ± 362.32 mL) than in the control group (1051.30 ± 427.77 mL), but did not reach statistical significance (p = 0.125). The observed mean duration of myomectomy was, however, longer among the controls (152.95 ± 32.67 min, compared with 119.70 ± 23.96 min, p = 0.001). The control group also had significantly higher rates of deployment of additional hemostatic measures (OR = 4.68, 95% CI = 2.304–12.784, p = 0.001), occurrence of postoperative pyrexia (OR = 1.65, 95% CI = 1.256–2.154, p = 0.002), and greater mean postoperative blood loss (p = 0.003). Conclusion: Although no statistically significant difference occurred in intraoperative blood loss, adjunctive UIC was useful in reducing operating time and postoperative blood loss
{"title":"Adjunctive Uterine Incision Compression Versus Tourniquet Alone for Reduction of Blood Loss During Abdominal Myomectomy: A Randomized Controlled Trial","authors":"J. Imaralu, O. Loto, Adebisi Florence Oguntade, O. Jagun, Taofeek Ogunfunmilayo, A. Akadri, Oladapo Walker","doi":"10.4314/aas.v21i1.4","DOIUrl":"https://doi.org/10.4314/aas.v21i1.4","url":null,"abstract":"Introduction: The effectiveness of the uterine tourniquet alone for securing hemostasis during abdominal myomectomy remains debatable; however, its combination with uterine compression though popular has very scanty documented evidence of hemostatic efficacy. \u0000Aim: To determine the effect of uterine incision compression (UIC) combined with tourniquet on operative blood loss associated with abdominal myomectomy. \u0000Materials and Methods: A multicenter randomized double blind, controlled trial involving 184 participants randomized into two groups: 92 in the UIC and 92 in the control arm. UIC was administered in the interval from release of the uterine tourniquet to palpation of contraction. Data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 21. \u0000Results: The mean intraoperative blood loss was lower in the UIC group (951.41 ± 362.32 mL) than in the control group (1051.30 ± 427.77 mL), but did not reach statistical significance (p = 0.125). The observed mean duration of myomectomy was, however, longer among the controls (152.95 ± 32.67 min, compared with 119.70 ± 23.96 min, p = 0.001). The control group also had significantly higher rates of deployment of additional hemostatic measures (OR = 4.68, 95% CI = 2.304–12.784, p = 0.001), occurrence of postoperative pyrexia (OR = 1.65, 95% CI = 1.256–2.154, p = 0.002), and greater mean postoperative blood loss (p = 0.003). \u0000Conclusion: Although no statistically significant difference occurred in intraoperative blood loss, adjunctive UIC was useful in reducing operating time and postoperative blood loss ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Erectile dysfunction (ED) is an adverse effect of chronic kidney disease (CKD) treatment that can reduce patients’ quality of life. Consequently, the purpose of this study is to assess the incidence and severity of ED in CKD patients who have undergone continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis. Methods: We performed a systematic search on several electronic reference databases (PubMed, ScienceDirect, Web of Science, and Cochrane). Inclusion criteria are articles published in English, full-text availability, and articles published between 2001 and 2023. The reviewed studies were observational studies. The studies analyzed either CAPD or hemodialysis. Results: A total of 15 studies were included. ED in patients with CKD who had undergone CAPD and hemodialysis varied, ranging from 51.84% to 80.5%and 56% to 89%, respectively. A pooled estimate showed that CKD patients who underwent hemodialysis had higher odds of developing ED (odds ratio [OR]=12.56; 95% confidence interval [CI]=6.37–24.77; p<0.001) compared with those who underwent CAPD (OR=8.02; 95%CI=1.64–39.15; p=0.01). Regarding the laboratory outcomes, no significant differences were found in creatinine serum (MD= −1.08; 95%CI= −3.21 to 1.06; p=0.32) and hemoglobin levels (MD= −0.38; 95%CI= −1.05 to 0.30; p=0.27) between CKD patients who underwent dialysis, either with or without ED. Conclusion: ED is prevalent among patients undergoing hemodialysis. In addition, hemodialyzed patients exhibited more severe levels of ED compared with CAPD patients. Therefore, we suggest CAPD for CKD patients with ED.
{"title":"Incidence and Severity of Erectile Dysfunction in Chronic Kidney Disease Patients Undergoing CAPD and Hemodialysis: A Systematic Review and Meta-analysis","authors":"D. Dahril, Indrayudha Pramono","doi":"10.4314/aas.v20i4.4","DOIUrl":"https://doi.org/10.4314/aas.v20i4.4","url":null,"abstract":"Background: Erectile dysfunction (ED) is an adverse effect of chronic kidney disease (CKD) treatment that can reduce patients’ quality of life. Consequently, the purpose of this study is to assess the incidence and severity of ED in CKD patients who have undergone continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis. \u0000Methods: We performed a systematic search on several electronic reference databases (PubMed, ScienceDirect, Web of Science, and Cochrane). Inclusion criteria are articles published in English, full-text availability, and articles published between 2001 and 2023. The reviewed studies were observational studies. The studies analyzed either CAPD or hemodialysis. \u0000Results: A total of 15 studies were included. ED in patients with CKD who had undergone CAPD and hemodialysis varied, ranging from 51.84% to 80.5%and 56% to 89%, respectively. A pooled estimate showed that CKD patients who underwent hemodialysis had higher odds of developing ED (odds ratio [OR]=12.56; 95% confidence interval [CI]=6.37–24.77; p<0.001) compared with those who underwent CAPD (OR=8.02; 95%CI=1.64–39.15; p=0.01). Regarding the laboratory outcomes, no significant differences were found in creatinine serum (MD= −1.08; 95%CI= −3.21 to 1.06; p=0.32) and hemoglobin levels (MD= −0.38; 95%CI= −1.05 to 0.30; p=0.27) between CKD patients who underwent dialysis, either with or without ED. \u0000Conclusion: ED is prevalent among patients undergoing hemodialysis. In addition, hemodialyzed patients exhibited more severe levels of ED compared with CAPD patients. Therefore, we suggest CAPD for CKD patients with ED. ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"102 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Gastroesophageal reflux disease (GERD) is a common benign condition with a population prevalence of 18–28%. Laparoscopic antireflux surgery is increasingly being offered to patients with GERD in our setting; however, the outcomes remain unknown. Methodology: A retrospective clinical audit of patients who underwent laparoscopic Nissen’s fundoplication in a single center. Data were summarized as mean (±SD) and median (interquartile range [IQR]); associations were analyzed with Chi square or Fischer’s exact test. A Modified Visick scoring system was used to assess the severity of symptoms after surgery. Regression models were used to analyze the factors associated with recurrence. Kaplan–Meier plots were plotted, and cox regression models, hazard ratio, and their confidence intervals were calculated. Results: A total of 127 patients were identified, with 6 having had previous laparoscopic Nissen’s fundoplication. Post-operative modified Visick scores at 2 weeks and 3 months were 1.04 (±0.05) and 1.03 (±0.04), respectively, for both typical and atypical symptoms. The recurrence rate was 12.6%, with 87.4% 5-year recurrence-free survival. Conclusion: Laparoscopic Nissen’s fundoplication provides good control of both typical and atypical GERD symptoms with a low recurrence rate and a 5- year recurrence-free survival that is comparable to universal rates.
{"title":"A Clinical Audit of Post-Operative Outcomes of Laparoscopic Nissen’s Fundoplication in a Single Center in Sub-Saharan Africa","authors":"C. Munguti, Bernard Ndung'u","doi":"10.4314/aas.v21i1.3","DOIUrl":"https://doi.org/10.4314/aas.v21i1.3","url":null,"abstract":"Introduction: Gastroesophageal reflux disease (GERD) is a common benign condition with a population prevalence of 18–28%. Laparoscopic antireflux surgery is increasingly being offered to patients with GERD in our setting; however, the outcomes remain unknown. \u0000Methodology: A retrospective clinical audit of patients who underwent laparoscopic Nissen’s fundoplication in a single center. Data were summarized as mean (±SD) and median (interquartile range [IQR]); associations were analyzed with Chi square or Fischer’s exact test. A Modified Visick scoring system was used to assess the severity of symptoms after surgery. Regression models were used to analyze the factors associated with recurrence. Kaplan–Meier plots were plotted, and cox regression models, hazard ratio, and their confidence intervals were calculated. \u0000Results: A total of 127 patients were identified, with 6 having had previous laparoscopic Nissen’s fundoplication. Post-operative modified Visick scores at 2 weeks and 3 months were 1.04 (±0.05) and 1.03 (±0.04), respectively, for both typical and atypical symptoms. The recurrence rate was 12.6%, with 87.4% 5-year recurrence-free survival. \u0000Conclusion: Laparoscopic Nissen’s fundoplication provides good control of both typical and atypical GERD symptoms with a low recurrence rate and a 5- year recurrence-free survival that is comparable to universal rates.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"78 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. S. Diaouga, M. C. Yacouba, Rahamatou Madeleine Garba, Maina Oumara, Nafiou Id, Madi Nayama
Myomectomy during pregnancy is a rare situation, reserved for exceptional cases. We report two cases of myomectomy during pregnancy. Case 1 was a 31-yearold primigravida with a large transmural myoma complicated by intense pelvic pain not responding to medical treatment due to red degeneration in a 6-week pregnancy. Case 2 was a 30-year-old primigravida with multiple myomas complicated by necrosis and hydronephrosis. We performed multiple myomectomy at 17 weeks’ pregnancy after failure of medical treatment. Concerning the operative technique, we performed myomectomy during pregnancy followed by prophylactic cerclage of the cervix. The operation is carried out as quickly as possible by the most experienced surgeon of the team, in order to shorten the operating time and limit blood loss. Myomas that are in contact with the uterine cavity are not removed. In all, 500mg of hydroxyprogesterone was administered intramusculary 24h before the procedure, intraoperatively, and after operation to limit the risk of abortion. In Case 1, myomectomy was performed successfully without maternal or fetal complications. However, the patient developed placental abruption at 33 weeks of pregnancy. The newborn died 3h after birth. In Case 2, myomectomy was complicated by a spontaneous abortion at the end of the operation. The patient developed necrosis of the remaining myomas and endometritis leading to hysterectomy. Thus myomectomy during pregnancy should be performed as a last resort in only well-selected patients.
{"title":"Myomectomy During the First and Second Trimesters of Pregnancy. A Therapeutic Dilemma: Report of Two Cases","authors":"H. S. Diaouga, M. C. Yacouba, Rahamatou Madeleine Garba, Maina Oumara, Nafiou Id, Madi Nayama","doi":"10.4314/aas.v21i1.2","DOIUrl":"https://doi.org/10.4314/aas.v21i1.2","url":null,"abstract":"Myomectomy during pregnancy is a rare situation, reserved for exceptional cases. We report two cases of myomectomy during pregnancy. Case 1 was a 31-yearold primigravida with a large transmural myoma complicated by intense pelvic pain not responding to medical treatment due to red degeneration in a 6-week pregnancy. Case 2 was a 30-year-old primigravida with multiple myomas complicated by necrosis and hydronephrosis. We performed multiple myomectomy at 17 weeks’ pregnancy after failure of medical treatment. Concerning the operative technique, we performed myomectomy during pregnancy followed by prophylactic cerclage of the cervix. The operation is carried out as quickly as possible by the most experienced surgeon of the team, in order to shorten the operating time and limit blood loss. Myomas that are in contact with the uterine cavity are not removed. In all, 500mg of hydroxyprogesterone was administered intramusculary 24h before the procedure, intraoperatively, and after operation to limit the risk of abortion. In Case 1, myomectomy was performed successfully without maternal or fetal complications. However, the patient developed placental abruption at 33 weeks of pregnancy. The newborn died 3h after birth. In Case 2, myomectomy was complicated by a spontaneous abortion at the end of the operation. The patient developed necrosis of the remaining myomas and endometritis leading to hysterectomy. Thus myomectomy during pregnancy should be performed as a last resort in only well-selected patients. ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"81 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Idowu, Abdul-Karim Olayinka Shitu, P. O. Odeyemi, M. W. Rasheed, Chidi Ugwuoke
Urinary stone remains a common urological disorder. Urinary bladder stone accounts for 5% of the urinary tract calculi. They are usually small and rarely present with complications; they may progressively increase in size, occupying the urinary bladder and resulting in the development of symptoms and complications. Our aim was to report the first case of a giant urinary bladder stone in association with severe kidney dysfunction in our Community. We report the case of a 65-year-old man with a 1-week history of decrease in urinary output and uremia following a referral from the general hospital. Remarkable findings on clinical examination were an elderly man that was confused, pale, and dehydrated. He had a suprapubic bladder Foley catheter which was inserted at the source of referral. Laboratory and imaging investigation revealed raised creatinine levels, bilateral hydronephrosis, and giant urinary bladder stone. These were suggestive of obstructive uropathy likely from the stone in association with severe kidney dysfunction. He had emergency open cystolithtomy and a 400g stone was removed. There was an immediate improvement in the urinary output and renal function. We have reported our experience on the successful management of giant urinary bladder stone in association with acute kidney injury. The patient recovered satisfactorily from acute kidney injury following emergency open cystolithotomy.
{"title":"Giant Urinary Bladder Stone in Association with Acute Kidney Injury: A Rare Urological Emergency","authors":"N. Idowu, Abdul-Karim Olayinka Shitu, P. O. Odeyemi, M. W. Rasheed, Chidi Ugwuoke","doi":"10.4314/aas.v20i4.3","DOIUrl":"https://doi.org/10.4314/aas.v20i4.3","url":null,"abstract":"Urinary stone remains a common urological disorder. Urinary bladder stone accounts for 5% of the urinary tract calculi. They are usually small and rarely present with complications; they may progressively increase in size, occupying the urinary bladder and resulting in the development of symptoms and complications. Our aim was to report the first case of a giant urinary bladder stone in association with severe kidney dysfunction in our Community. We report the case of a 65-year-old man with a 1-week history of decrease in urinary output and uremia following a referral from the general hospital. Remarkable findings on clinical examination were an elderly man that was confused, pale, and dehydrated. He had a suprapubic bladder Foley catheter which was inserted at the source of referral. Laboratory and imaging investigation revealed raised creatinine levels, bilateral hydronephrosis, and giant urinary bladder stone. These were suggestive of obstructive uropathy likely from the stone in association with severe kidney dysfunction. He had emergency open cystolithtomy and a 400g stone was removed. There was an immediate improvement in the urinary output and renal function. We have reported our experience on the successful management of giant urinary bladder stone in association with acute kidney injury. The patient recovered satisfactorily from acute kidney injury following emergency open cystolithotomy. ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"89 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Munguti, Miriam Mutebi, Mukuhi Ng'ang'a, R. Wasike
Introduction: There is limited data on the recurrence rates and factors that contribute to recurrence in women managed for early breast cancer in sub-Saharan Africa. This study conducted at a tertiary level facility aims to determine the recurrence rates in patients treated for early invasive breast cancer. Methods: This is a single institution retrospective cohort study of women (18–75 years) treated for early breast cancer from 2009 to 2017. Demographic data, tumor, and treatment-related factors were summarized using descriptive statistics. Survival analysis and Cox proportional hazard regression were performed, with computation of hazard ratios and their 95% confidence intervals. Results: A total of 239 patients with an initial diagnosis of early breast cancer were identified. The mean age at diagnosis was 51 years (SD 13). The most prevalent molecular subtype was estrogen receptor/progesterone receptor (ER/PR)+ at 76% with only 2.9% having human epidermal growth factor receptor 2 (HER2) overexpressing breast cancer. The overall recurrence was 7.1% with a 1.6% case mortality. The overall 5-year and 10-year survival rate was 94% and 91%, respectively. Conclusion: Early breast cancer in our setting has a good overall survival and low recurrence rates that are comparable to that found in Western countries.
{"title":"Pattern of Recurrence in Early Breast Cancer at a Tertiary Center in Sub-Saharan Africa: A Retrospective Cohort Study","authors":"C. Munguti, Miriam Mutebi, Mukuhi Ng'ang'a, R. Wasike","doi":"10.4314/aas.v20i4.5","DOIUrl":"https://doi.org/10.4314/aas.v20i4.5","url":null,"abstract":"Introduction: There is limited data on the recurrence rates and factors that contribute to recurrence in women managed for early breast cancer in sub-Saharan Africa. This study conducted at a tertiary level facility aims to determine the recurrence rates in patients treated for early invasive breast cancer. \u0000Methods: This is a single institution retrospective cohort study of women (18–75 years) treated for early breast cancer from 2009 to 2017. Demographic data, tumor, and treatment-related factors were summarized using descriptive statistics. Survival analysis and Cox proportional hazard regression were performed, with computation of hazard ratios and their 95% confidence intervals. \u0000Results: A total of 239 patients with an initial diagnosis of early breast cancer were identified. The mean age at diagnosis was 51 years (SD 13). The most prevalent molecular subtype was estrogen receptor/progesterone receptor (ER/PR)+ at 76% with only 2.9% having human epidermal growth factor receptor 2 (HER2) overexpressing breast cancer. The overall recurrence was 7.1% with a 1.6% case mortality. The overall 5-year and 10-year survival rate was 94% and 91%, respectively. \u0000Conclusion: Early breast cancer in our setting has a good overall survival and low recurrence rates that are comparable to that found in Western countries. ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"17 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Idowu, A. A. Adekunle, M. A. Adeniran, Suliat Adebisi Adeleye-Idowu
Background: Bladder outlet obstruction (BOO) is a clinical condition that is characterized by impediment to the flow of urine. It affects all age groups with varying etiologies. The pattern of this clinical condition in our setting is unknown. This study aimed at determines the clinico-epidemiological pattern of BOO in southwestern Nigeria. Method: We retrospectively reviewed the case files of patients that were managed for BOO over a period of 10years in our center. Results: A total of 784 patients were managed for BOO during the period under review. Their median age was 65.9years and in all, 486 patients of in the study group had benign prostatic hyperplasia (BPH) was the most common diagnosis followed by prostate cancer, urethral strictures and neurogenic bladder. While prostate cancer, urethral stricture, neurogenic bladder, bladder cancer, and bladder stone were diagnosed in 181, 90, 20, 5, and 2 patients, respectively. Conclusion: We have done an overview of a clinico-epidemiological pattern of BOO in southwest Nigeria is documented. The most common cause of BOO in men was while in women. It was neurogenic bladder syndrome.
{"title":"Bladder Outlet Obstruction: Etiological Pattern in Southwestern Nigeria","authors":"N. Idowu, A. A. Adekunle, M. A. Adeniran, Suliat Adebisi Adeleye-Idowu","doi":"10.4314/aas.v20i3.3","DOIUrl":"https://doi.org/10.4314/aas.v20i3.3","url":null,"abstract":"Background: Bladder outlet obstruction (BOO) is a clinical condition that is characterized by impediment to the flow of urine. It affects all age groups with varying etiologies. The pattern of this clinical condition in our setting is unknown. This study aimed at determines the clinico-epidemiological pattern of BOO in southwestern Nigeria. Method: We retrospectively reviewed the case files of patients that were managed for BOO over a period of 10years in our center. Results: A total of 784 patients were managed for BOO during the period under review. Their median age was 65.9years and in all, 486 patients of in the study group had benign prostatic hyperplasia (BPH) was the most common diagnosis followed by prostate cancer, urethral strictures and neurogenic bladder. While prostate cancer, urethral stricture, neurogenic bladder, bladder cancer, and bladder stone were diagnosed in 181, 90, 20, 5, and 2 patients, respectively. Conclusion: We have done an overview of a clinico-epidemiological pattern of BOO in southwest Nigeria is documented. The most common cause of BOO in men was while in women. It was neurogenic bladder syndrome.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84194395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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