Pub Date : 2019-07-01DOI: 10.4103/archms.archms_14_19
H. Umar, N. Ameh, Umma Suleiman, F. Bakari
Background: The use of natural family planning (NFP) methods is low worldwide with few existing data. Aim: The aim of the study is to determine the factors affecting the use and discontinuation of NFP methods in our setting. Methodology: In this descriptive cross-sectional study, 302 clients who presented at the Reproductive Health Clinic of Ahmadu Bello University, Zaria, were interviewed, with the aid of pretested questionnaires. Sociodemographic variables, reasons affecting the use, and discontinuation of NFP methods were recorded and analyzed using SPSS software version 15. Results: Among the 302 clients interviewed, 88.1% (266) had used a form of family planning method: 38.4% (116) used NFP, 49.7% (150) used artificial methods, whereas 37.1% (43) discontinued the NFP methods. Major factors hindering the use of an NFP method include lack of awareness (24%), been single (17%), unknown reason (17%), irregular menstrual cycle (10%), and fear of method failure (8%). Major factors for discontinuing the NFP methods include high failure rates (21%), irregular menstrual cycle (18%), introduction to other methods (14%), want of conception (12%), and fear of pregnancy (12%). Conclusion: The most common factor affecting the uptake of NFP was lack of awareness. Failure rates and irregular menstrual cycles were the common denominators, affecting both the use and discontinuation of NFP methods.
{"title":"Factors affecting uptake of natural family planning methods among clients at the reproductive health clinic of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria","authors":"H. Umar, N. Ameh, Umma Suleiman, F. Bakari","doi":"10.4103/archms.archms_14_19","DOIUrl":"https://doi.org/10.4103/archms.archms_14_19","url":null,"abstract":"Background: The use of natural family planning (NFP) methods is low worldwide with few existing data. Aim: The aim of the study is to determine the factors affecting the use and discontinuation of NFP methods in our setting. Methodology: In this descriptive cross-sectional study, 302 clients who presented at the Reproductive Health Clinic of Ahmadu Bello University, Zaria, were interviewed, with the aid of pretested questionnaires. Sociodemographic variables, reasons affecting the use, and discontinuation of NFP methods were recorded and analyzed using SPSS software version 15. Results: Among the 302 clients interviewed, 88.1% (266) had used a form of family planning method: 38.4% (116) used NFP, 49.7% (150) used artificial methods, whereas 37.1% (43) discontinued the NFP methods. Major factors hindering the use of an NFP method include lack of awareness (24%), been single (17%), unknown reason (17%), irregular menstrual cycle (10%), and fear of method failure (8%). Major factors for discontinuing the NFP methods include high failure rates (21%), irregular menstrual cycle (18%), introduction to other methods (14%), want of conception (12%), and fear of pregnancy (12%). Conclusion: The most common factor affecting the uptake of NFP was lack of awareness. Failure rates and irregular menstrual cycles were the common denominators, affecting both the use and discontinuation of NFP methods.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"104 1","pages":"42 - 45"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82518332","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}
Pub Date : 2019-07-01DOI: 10.4103/archms.archms_15_19
P. Abur, L. Yusufu, V. Odigie
Background: Visceral metastasis from breast cancer usually results in high tumor burden with poor prognosis. Aim: This study aimed to document the pattern, treatment, and outcome of breast cancer patients with visceral metastasis in our hospital. Patients and Methods: This is a 5-year prospective study of breast cancer patients with visceral metastasis from January 2011 to December 2015. All patients had tru-cut biopsy to establish diagnosis. Chest X-ray, abdominopelvic ultrasound, and computed tomography of the thoracoabdominal region were done to establish the extent of visceral organ involvement. Information documented included patients' biodata, histology, site of visceral metastasis, treatment, and outcome. Results: Two hundred and fourteen out of 1087 patients with breast cancer had visceral metastasis (19.7%). Their age ranged 15–83 years. Eighty-four (39.4%) patients had metastasis to the lungs. Thirty-nine (18.3%) patients had metastasis to the liver. Fifty-eight (27%) patients had metastasis to two or more visceral organs. One hundred and eighty-one (84.6%) patients had chemotherapy, 158 (73.8%) had hormonal therapy, whereas 103 (49.1%) had surgery. The mortality at 3-year follow-up was 58.4%. Conclusion: The lungs were the most common organ of visceral metastasis followed by the liver in this study. A significant percentage had metastasis to two or more visceral organs. Early presentation will reduce the incidence of visceral metastasis and the high mortality associated with it.
{"title":"Pattern of visceral metastasis from breast cancer patients in Ahmadu Bello University Teaching Hospital, Zaria, North Western Nigeria","authors":"P. Abur, L. Yusufu, V. Odigie","doi":"10.4103/archms.archms_15_19","DOIUrl":"https://doi.org/10.4103/archms.archms_15_19","url":null,"abstract":"Background: Visceral metastasis from breast cancer usually results in high tumor burden with poor prognosis. Aim: This study aimed to document the pattern, treatment, and outcome of breast cancer patients with visceral metastasis in our hospital. Patients and Methods: This is a 5-year prospective study of breast cancer patients with visceral metastasis from January 2011 to December 2015. All patients had tru-cut biopsy to establish diagnosis. Chest X-ray, abdominopelvic ultrasound, and computed tomography of the thoracoabdominal region were done to establish the extent of visceral organ involvement. Information documented included patients' biodata, histology, site of visceral metastasis, treatment, and outcome. Results: Two hundred and fourteen out of 1087 patients with breast cancer had visceral metastasis (19.7%). Their age ranged 15–83 years. Eighty-four (39.4%) patients had metastasis to the lungs. Thirty-nine (18.3%) patients had metastasis to the liver. Fifty-eight (27%) patients had metastasis to two or more visceral organs. One hundred and eighty-one (84.6%) patients had chemotherapy, 158 (73.8%) had hormonal therapy, whereas 103 (49.1%) had surgery. The mortality at 3-year follow-up was 58.4%. Conclusion: The lungs were the most common organ of visceral metastasis followed by the liver in this study. A significant percentage had metastasis to two or more visceral organs. Early presentation will reduce the incidence of visceral metastasis and the high mortality associated with it.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"79 1","pages":"31 - 34"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83472307","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}
Pub Date : 2019-07-01DOI: 10.4103/archms.archms_17_18
P. Yakubu, N. Khanna, Emmanuel Edafe, S. Rao, A. Abubakar
Ortner's syndrome is defined as left recurrent laryngeal nerve palsy resulting from cardiovascular disease. Though it was first reported in patients with dilated left atrium in mitral stenosis, many cases have been associated with other cardiovascular diseases such as thoracic aortic aneurysm, enlarge pulmonary artery, abberent subclavian artery etc. We report a case of 45 year old presented with hoarseness and dyspnea who was confirmed to have aortic arch aneurysm. His symptoms resolved completely after transthoracic endovascular aortic repair (TEVAR)
{"title":"Aortic arch aneurysm presenting as ortner's syndrome","authors":"P. Yakubu, N. Khanna, Emmanuel Edafe, S. Rao, A. Abubakar","doi":"10.4103/archms.archms_17_18","DOIUrl":"https://doi.org/10.4103/archms.archms_17_18","url":null,"abstract":"Ortner's syndrome is defined as left recurrent laryngeal nerve palsy resulting from cardiovascular disease. Though it was first reported in patients with dilated left atrium in mitral stenosis, many cases have been associated with other cardiovascular diseases such as thoracic aortic aneurysm, enlarge pulmonary artery, abberent subclavian artery etc. We report a case of 45 year old presented with hoarseness and dyspnea who was confirmed to have aortic arch aneurysm. His symptoms resolved completely after transthoracic endovascular aortic repair (TEVAR)","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"76 1","pages":"49 - 52"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82722625","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}
Pub Date : 2019-07-01DOI: 10.4103/archms.archms_37_18
J. Zaman, D. Isah, A. Isah
Background: Antenatal care (ANC) is one of the pillars of safe motherhood initiative aimed at preventing adverse pregnancy outcome. Early initiation of ANC may provide avenue for early identification and management of many medical illnesses in pregnancy with the resultant better feto-maternal outcome. The objective of the study was to determine the average gestational age (GA) at booking and to determine the effect of GA at booking on the feto-maternal outcome. Materials and Methods: This was a prospective cohort study of 414 women consecutively recruited at the booking clinic of the Teaching Hospital from September 2016 to July 2017. This was divided into two arms, early and late booking. However, only 186 and 189 women in the early and late booking women, respectively, completed the study and their data were available for analysis, and they were followed up to delivery. Results: The mean GA at booking in the study was 19.4 ± 8.14 weeks. The incidence rate of low-birth-weight was 8.3%. The recorded incidence rate of low-birth-weight of 7.8% among early attendees was similar to 8.8% recorded among those that booked late in pregnancy (P = 0.373). The overall stillbirth rate in this study was 29.33/1000 birth. The cumulative incidence of hypertensive disorders in pregnancy in the study was 12.8%. The overall mean packed cell volume (PCV) at booking was 33.6 ± 3.2 and similar to the respective PCV at booking in both early and the late booking women. The PCV at delivery was, however, significantly higher among those women that booked early when compared with those that booked late. Conclusion: The mean GA at booking in our unit is 19.4 ± 8.14. Early booking and access to routine hematinics may guarantee sustenance of this recorded higher PCV at delivery. Furthermore, educated and less parous women tend to book early from this study.
{"title":"Effect of gestational age at booking on feto-maternal outcome at a Nigerian tertiary hospital","authors":"J. Zaman, D. Isah, A. Isah","doi":"10.4103/archms.archms_37_18","DOIUrl":"https://doi.org/10.4103/archms.archms_37_18","url":null,"abstract":"Background: Antenatal care (ANC) is one of the pillars of safe motherhood initiative aimed at preventing adverse pregnancy outcome. Early initiation of ANC may provide avenue for early identification and management of many medical illnesses in pregnancy with the resultant better feto-maternal outcome. The objective of the study was to determine the average gestational age (GA) at booking and to determine the effect of GA at booking on the feto-maternal outcome. Materials and Methods: This was a prospective cohort study of 414 women consecutively recruited at the booking clinic of the Teaching Hospital from September 2016 to July 2017. This was divided into two arms, early and late booking. However, only 186 and 189 women in the early and late booking women, respectively, completed the study and their data were available for analysis, and they were followed up to delivery. Results: The mean GA at booking in the study was 19.4 ± 8.14 weeks. The incidence rate of low-birth-weight was 8.3%. The recorded incidence rate of low-birth-weight of 7.8% among early attendees was similar to 8.8% recorded among those that booked late in pregnancy (P = 0.373). The overall stillbirth rate in this study was 29.33/1000 birth. The cumulative incidence of hypertensive disorders in pregnancy in the study was 12.8%. The overall mean packed cell volume (PCV) at booking was 33.6 ± 3.2 and similar to the respective PCV at booking in both early and the late booking women. The PCV at delivery was, however, significantly higher among those women that booked early when compared with those that booked late. Conclusion: The mean GA at booking in our unit is 19.4 ± 8.14. Early booking and access to routine hematinics may guarantee sustenance of this recorded higher PCV at delivery. Furthermore, educated and less parous women tend to book early from this study.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"109 1","pages":"35 - 41"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74751069","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}
Pub Date : 2019-07-01DOI: 10.4103/archms.archms_5_19
P. Abur, L. Yusufu, V. Odigie
Background: Pregnancy-associated breast cancer (PABC) is breast cancer diagnosed during pregnancy or within 1 year of delivery. It is the most frequent malignancy diagnosed during pregnancy or lactation. There is a paucity of information on PABC in our hospital. Aim: The aim of the study is to highlight the clinicopathological features, treatment, and outcome of PABC in the center. Materials and Methods: It was a 6-year prospective study of PABC from January 2007 to December 2012 at our hospital. Information documented included patient's biodata, clinical features, pathological types, receptor status, staging, treatment, and outcome of PABC patients. Results: A total of 1344 patients had breast cancer during the study period. 31 patients (2.3%) had PABC. Age ranged 20–43 years, median 31 years. Common clinical features were: breast lump/mass – 27 (87.1%) patients, skin thickness – 10 (32.3%), nipple retraction – 9 (29.0%), and inflammation – 6 (19.4%). 19 (61.3%) patients were diagnosed in pregnancy: first trimester – 4 (12.9%), second trimester – 7 (22.6%), third trimester – 8 (25.8%), while 12 (38.7%) were within 1 year of delivery. Twenty-two patients (71.0%) had advanced disease. Twenty-four (77.4%) patients had invasive ductal carcinoma. Thirteen (59.1%) patients were ER/PR positive, 6 (27.3%) were triple negative, and 3 (13.6%) were HER2 positive. Twenty-four patients (77.4%) had vaginal delivery. Three patients (9.7%) had spontaneous abortion and 1 patient (3.2%) had still birth. 25 babies (80.6%) were alive and well. 17 patients (54.8%) had modified radical mastectomy (2 patients in second trimester and 15 patients after delivery), 25 (80.6%) had chemotherapy, 14 (45.2%) had radiotherapy, and 1 (3.2%) received trastuzumab. Mortality was 8 (25.8%). Conclusion: PABC constituted 2.3% of all breast cancer patients in our hospital. Majority (71%) presented with advanced disease. 3 out of every 4 were invasive ductal carcinoma, while 1 in 4 were triple negative. The mortality was 25.8%.
{"title":"Clinicopathological features, treatment, and outcome of pregnancy-associated breast cancer in Ahmadu Bello University Teaching Hospital, Zaria, Northwestern Nigeria","authors":"P. Abur, L. Yusufu, V. Odigie","doi":"10.4103/archms.archms_5_19","DOIUrl":"https://doi.org/10.4103/archms.archms_5_19","url":null,"abstract":"Background: Pregnancy-associated breast cancer (PABC) is breast cancer diagnosed during pregnancy or within 1 year of delivery. It is the most frequent malignancy diagnosed during pregnancy or lactation. There is a paucity of information on PABC in our hospital. Aim: The aim of the study is to highlight the clinicopathological features, treatment, and outcome of PABC in the center. Materials and Methods: It was a 6-year prospective study of PABC from January 2007 to December 2012 at our hospital. Information documented included patient's biodata, clinical features, pathological types, receptor status, staging, treatment, and outcome of PABC patients. Results: A total of 1344 patients had breast cancer during the study period. 31 patients (2.3%) had PABC. Age ranged 20–43 years, median 31 years. Common clinical features were: breast lump/mass – 27 (87.1%) patients, skin thickness – 10 (32.3%), nipple retraction – 9 (29.0%), and inflammation – 6 (19.4%). 19 (61.3%) patients were diagnosed in pregnancy: first trimester – 4 (12.9%), second trimester – 7 (22.6%), third trimester – 8 (25.8%), while 12 (38.7%) were within 1 year of delivery. Twenty-two patients (71.0%) had advanced disease. Twenty-four (77.4%) patients had invasive ductal carcinoma. Thirteen (59.1%) patients were ER/PR positive, 6 (27.3%) were triple negative, and 3 (13.6%) were HER2 positive. Twenty-four patients (77.4%) had vaginal delivery. Three patients (9.7%) had spontaneous abortion and 1 patient (3.2%) had still birth. 25 babies (80.6%) were alive and well. 17 patients (54.8%) had modified radical mastectomy (2 patients in second trimester and 15 patients after delivery), 25 (80.6%) had chemotherapy, 14 (45.2%) had radiotherapy, and 1 (3.2%) received trastuzumab. Mortality was 8 (25.8%). Conclusion: PABC constituted 2.3% of all breast cancer patients in our hospital. Majority (71%) presented with advanced disease. 3 out of every 4 were invasive ductal carcinoma, while 1 in 4 were triple negative. The mortality was 25.8%.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"38 1","pages":"46 - 48"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88507986","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}
Pub Date : 2019-01-01DOI: 10.4103/archms.archms_36_18
M. Nyamzi, D. Isah, R. Offiong, A. Isah
Introduction: Prolonged pregnancy is a high-risk pregnancy that is associated with increased maternal morbidity and increased perinatal morbidity and mortality. Objectives: The objective was to evaluate the effectiveness of sweeping of the fetal membranes to reduce the incidence of elective induction of labor for postdate pregnancy and to compare pregnancy outcome among women who had sweeping of membranes at 40 weeks with those who did not have sweeping of membranes. Subjects and Methods: This was a randomized, controlled study conducted from September 2017 to June 2018. One hundred and ninety-four consenting participants with no contraindication to vaginal delivery were randomized into two groups, those who had membrane sweeping at 40–41 weeks' gestation and a control group who had vaginal examination to assess Bishop score only at recruitment. Participants were followed up to delivery. Results: Sweeping of membranes effectively reduced the incidence of elective induction of labor. The proportion of those that had spontaneous labor in the treatment group was 85 (87.6%) compared to the control group that had 67 (62.9%). This was statistically significant with P < 0.001. The incidence of induction of labor was significantly lower in the membrane sweeping group compared with the control group (12.4% vs. 37.1%; P < 0.001). There was a significant higher mean time interval from recruitment to admission (recruitment admission interval) among the control group (5.76 ± 2.75 days) compared with those that had membrane sweeping (3.35 ± 2.55; P < 0.001). Conclusion: Sweeping of the membranes appears an effective and safe procedure in reducing the incidence of elective induction of labor and duration of pregnancy at term in low-risk population.
妊娠延长是一种高危妊娠，与孕产妇发病率增加和围产期发病率和死亡率增加有关。目的:目的是评估胎膜清扫术在减少晚期妊娠择期引产发生率方面的有效性，并比较40周时进行胎膜清扫术与未进行胎膜清扫术的妊娠结局。对象和方法:这是一项随机对照研究，于2017年9月至2018年6月进行。194名同意无阴道分娩禁忌的参与者被随机分为两组，一组在妊娠40-41周进行膜清扫，另一组仅在招募时进行阴道检查以评估Bishop评分。参与者被跟踪到分娩。结果:扫膜术可有效降低择期引产的发生率。治疗组自然分娩85例(87.6%)，对照组67例(62.9%)。P < 0.001，差异有统计学意义。扫膜组引产发生率明显低于对照组(12.4% vs 37.1%;P < 0.001)。对照组从招募到入院的平均时间间隔(招募入院间隔)(5.76±2.75天)明显高于扫膜组(3.35±2.55天;P < 0.001)。结论:在低危人群中，扫膜术在减少择期引产发生率和足月妊娠持续时间方面是一种有效和安全的方法。
{"title":"Effectiveness of sweeping of membranes in reducing the incidence of elective induction of labor for postdate pregnancies","authors":"M. Nyamzi, D. Isah, R. Offiong, A. Isah","doi":"10.4103/archms.archms_36_18","DOIUrl":"https://doi.org/10.4103/archms.archms_36_18","url":null,"abstract":"Introduction: Prolonged pregnancy is a high-risk pregnancy that is associated with increased maternal morbidity and increased perinatal morbidity and mortality. Objectives: The objective was to evaluate the effectiveness of sweeping of the fetal membranes to reduce the incidence of elective induction of labor for postdate pregnancy and to compare pregnancy outcome among women who had sweeping of membranes at 40 weeks with those who did not have sweeping of membranes. Subjects and Methods: This was a randomized, controlled study conducted from September 2017 to June 2018. One hundred and ninety-four consenting participants with no contraindication to vaginal delivery were randomized into two groups, those who had membrane sweeping at 40–41 weeks' gestation and a control group who had vaginal examination to assess Bishop score only at recruitment. Participants were followed up to delivery. Results: Sweeping of membranes effectively reduced the incidence of elective induction of labor. The proportion of those that had spontaneous labor in the treatment group was 85 (87.6%) compared to the control group that had 67 (62.9%). This was statistically significant with P < 0.001. The incidence of induction of labor was significantly lower in the membrane sweeping group compared with the control group (12.4% vs. 37.1%; P < 0.001). There was a significant higher mean time interval from recruitment to admission (recruitment admission interval) among the control group (5.76 ± 2.75 days) compared with those that had membrane sweeping (3.35 ± 2.55; P < 0.001). Conclusion: Sweeping of the membranes appears an effective and safe procedure in reducing the incidence of elective induction of labor and duration of pregnancy at term in low-risk population.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"37 1","pages":"15 - 21"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84090798","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}
Pub Date : 2019-01-01DOI: 10.4103/archms.archms_4_19
P. Abur, L. Yusufu, V. Odigie
Context: Necrotizing fasciitis of the breast is rare globally. There is an observed increase in the number of cases seen in our hospital. Moreover, there is no previous documentation on the disease from this center. Aims: The aim was to highlight the clinical features, predisposing factors, complications, treatment, and outcome of necrotizing fasciitis of the breast. Settings and Design: It was a 5-year prospective study from January 2012 to December 2016. Subjects and Methods: The biodata, clinical features, predisposing factors, complications, treatment, and outcome of necrotizing fasciitis of the breast were documented. Statistical Analysis Used: The results were analyzed using SPSS software version 21 and presented as percentages and charts. Results: Thirty-nine out of 163 women with infective breast disease had necrotizing fasciitis of the breast. Majority of the patients (28 [71.8%]) were <31 years. Most of the patients had low educational status (33 [84.6%]). The most common clinical features were foul-smelling discharging ulcers/sinuses and necrosis of the skin of the breast in all patients. Majority of the patients (29 [74.4%]) were lactating mothers. Poorly treated mastitis/breast abscess was the predominant predisposing factor. Culture revealed polymicrobial organisms in 20 (51.3%) patients. Thirty-six (92.3%) patients had serial wound debridement, 25 (64.1%) had split-thickness skin grafting, and 3 (7.7%) had toileting mastectomy. Mortality rate was 10.3%. Conclusions: Necrotizing fasciitis of the breast is not uncommon in our center. Majority of the patients were illiterate with low socioeconomic status. Poorly treated mastitis/breast abscess in lactating women was the major predisposing factor.
{"title":"Necrotizing fasciitis of the breast in Ahmadu Bello University Teaching Hospital, Zaria, Northwestern Nigeria","authors":"P. Abur, L. Yusufu, V. Odigie","doi":"10.4103/archms.archms_4_19","DOIUrl":"https://doi.org/10.4103/archms.archms_4_19","url":null,"abstract":"Context: Necrotizing fasciitis of the breast is rare globally. There is an observed increase in the number of cases seen in our hospital. Moreover, there is no previous documentation on the disease from this center. Aims: The aim was to highlight the clinical features, predisposing factors, complications, treatment, and outcome of necrotizing fasciitis of the breast. Settings and Design: It was a 5-year prospective study from January 2012 to December 2016. Subjects and Methods: The biodata, clinical features, predisposing factors, complications, treatment, and outcome of necrotizing fasciitis of the breast were documented. Statistical Analysis Used: The results were analyzed using SPSS software version 21 and presented as percentages and charts. Results: Thirty-nine out of 163 women with infective breast disease had necrotizing fasciitis of the breast. Majority of the patients (28 [71.8%]) were <31 years. Most of the patients had low educational status (33 [84.6%]). The most common clinical features were foul-smelling discharging ulcers/sinuses and necrosis of the skin of the breast in all patients. Majority of the patients (29 [74.4%]) were lactating mothers. Poorly treated mastitis/breast abscess was the predominant predisposing factor. Culture revealed polymicrobial organisms in 20 (51.3%) patients. Thirty-six (92.3%) patients had serial wound debridement, 25 (64.1%) had split-thickness skin grafting, and 3 (7.7%) had toileting mastectomy. Mortality rate was 10.3%. Conclusions: Necrotizing fasciitis of the breast is not uncommon in our center. Majority of the patients were illiterate with low socioeconomic status. Poorly treated mastitis/breast abscess in lactating women was the major predisposing factor.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"3 1","pages":"7 - 9"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81401531","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}
Pub Date : 2019-01-01DOI: 10.4103/archms.archms_22_19
P. Agbonrofo, O. Irowa, V. Odigie
Background: Gastric outlet obstruction (GOO) is a contemporary surgical challenge. It is due to mechanical pyloroduodenal obstruction of gastric emptying. In Africa, cicatrizing duodenal ulcer or antral tumors are common causes; resultant inanition, fluid, electrolyte, and nutritional derangements could be life-threatening. Definitive therapy aims at relieving the obstruction. Aim: To highlight causes, clinical features, and outcome of management of GOO in the University of Benin Teaching Hospital. Patients and Methods: This was a 60-month prospective study from July 1, 2013, to June 30, 2018. Consecutive adult patients with GOO were studied. Diagnosis was confirmed using barium meal, esophago-gastro-duodenoscopy, biopsy, and operative findings. Preoperative optimization required nasogastric tube suctioning/warm saline lavage, intravenous fluids, antibiotics, and blood transfusion. Results: There were 52 GOO patients, constituting 7.9% of 659 gastrointestinal conditions requiring surgery during the study period. Operative intervention occurred in 50 (96.2%) patients. The male:female ratio was 1.7:1. The age ranges from 32 to 89 years, with a mean age of 63.5 ± 15.3 years. Most patients were in the 7th-8th decades of life (33 patients, 63.5%). Nonbilous vomiting and epigastric pain occurred in 50 (96.2%) patients, while 49 (94.2%) patients had weight loss. Mean duration of symptoms 10.5 ± 12.1 weeks. Malignant obstructions were 63.5% (33 patients). Palliative by-pass was effected in 58.0% (29 patients). Hospital stay was 16–23 days. Mortality rate was 3.8% (2 patients). Conclusions: GOO is a disease of the elderly in our region. Presentation is late. Most require surgical intervention. The most common cause is malignant obstruction. Most patients require prolonged, adequate preoperative resuscitation/optimization. We advocate early referral, routine endoscopy, and biopsy for patients with epigastric pain in the subregion.
{"title":"Gastric outlet obstruction in adults in the University of Benin Teaching Hospital: A 5-year prospective study","authors":"P. Agbonrofo, O. Irowa, V. Odigie","doi":"10.4103/archms.archms_22_19","DOIUrl":"https://doi.org/10.4103/archms.archms_22_19","url":null,"abstract":"Background: Gastric outlet obstruction (GOO) is a contemporary surgical challenge. It is due to mechanical pyloroduodenal obstruction of gastric emptying. In Africa, cicatrizing duodenal ulcer or antral tumors are common causes; resultant inanition, fluid, electrolyte, and nutritional derangements could be life-threatening. Definitive therapy aims at relieving the obstruction. Aim: To highlight causes, clinical features, and outcome of management of GOO in the University of Benin Teaching Hospital. Patients and Methods: This was a 60-month prospective study from July 1, 2013, to June 30, 2018. Consecutive adult patients with GOO were studied. Diagnosis was confirmed using barium meal, esophago-gastro-duodenoscopy, biopsy, and operative findings. Preoperative optimization required nasogastric tube suctioning/warm saline lavage, intravenous fluids, antibiotics, and blood transfusion. Results: There were 52 GOO patients, constituting 7.9% of 659 gastrointestinal conditions requiring surgery during the study period. Operative intervention occurred in 50 (96.2%) patients. The male:female ratio was 1.7:1. The age ranges from 32 to 89 years, with a mean age of 63.5 ± 15.3 years. Most patients were in the 7th-8th decades of life (33 patients, 63.5%). Nonbilous vomiting and epigastric pain occurred in 50 (96.2%) patients, while 49 (94.2%) patients had weight loss. Mean duration of symptoms 10.5 ± 12.1 weeks. Malignant obstructions were 63.5% (33 patients). Palliative by-pass was effected in 58.0% (29 patients). Hospital stay was 16–23 days. Mortality rate was 3.8% (2 patients). Conclusions: GOO is a disease of the elderly in our region. Presentation is late. Most require surgical intervention. The most common cause is malignant obstruction. Most patients require prolonged, adequate preoperative resuscitation/optimization. We advocate early referral, routine endoscopy, and biopsy for patients with epigastric pain in the subregion.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"309 1","pages":"10 - 14"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76092189","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}
Pub Date : 2019-01-01DOI: 10.4103/archms.archms_2_19
B. Ayoade, H. Ebili, Olubunmi Fatungase, Collins Nwokoro, B. Salami, A. Adekoya, A. Oyelekan, B. Adefuye, A. Olatunji
Background: In low-Human Development Index countries, population-based screening programs for breast cancer are virtually nonexistent, but there are occasional screening programs organized by nongovernmental organizations in these countries. This study aims to describe the clinical and histopathological characteristics and the prevalence of breast diseases detected by clinical breast examination (CBE) in a cohort of women who participated in a community-based breast screening program. Methodology: This is a retrospective cross-sectional study of women who were referred for assessment in our Breast Clinic following CBE during a breast cancer screening program. Palpable lesions were subjected to biopsy and histopathological examinations. Results: Of the 2450 women screened, 102 had breast biopsy. Twenty-one were malignant (20.6%) and 79 were benign (77.5%). The mean age for benign breast disease was 32 ± 14 years, whereas that for women with malignant breast lesions was 57 ± 11 years (P < 0.001). Sixty-three women (61.8%) were married, 59 (57.8%) had tertiary education, and 27 (26.5%) were petty traders. The mean lump size was 3.8 ± 3.9 cm for benign lumps and 6.2 ± 4.2 cm for malignant lumps (P = 0.014). Histopathological examination revealed that 20.6% of the lumps were malignant, 50% were benign neoplasm (fibroadenoma,) 17.6% were fibrocystic change and related conditions (fibroadenosis), 5.9% were sclerosing lesions, 2% were inflammatory lesions, 2% were benign proliferative breast disease, and 2% were inadequate sample. Two of the 12 breast lumps (16.6%) were detected for the first time at screening, of which two were malignant. This constitutes 1.9% (2/102) of all the lumps biopsied and 0.081% of all the women who had CBE. Conclusion: This study has demonstrated that CBE as a tool for early detection of breast cancer should be encouraged and applied. It confirms that fibroadenoma is the most common cause of clinically obvious breast lumps.
背景:在人类发展指数较低的国家，几乎不存在以人群为基础的乳腺癌筛查项目，但这些国家偶尔会有非政府组织组织的筛查项目。本研究的目的是描述临床乳房检查(CBE)发现的乳房疾病的临床和组织病理学特征和流行率在一组参加社区乳房筛查计划的妇女中。方法:这是一项回顾性横断面研究，研究对象是在乳腺癌筛查项目中，在CBE后转介到我们乳腺诊所接受评估的妇女。可触及的病变进行活检和组织病理学检查。结果:在2450名接受筛查的女性中，102名进行了乳腺活检。恶性21例(20.6%)，良性79例(77.5%)。乳腺良性病变的平均年龄为32±14岁，乳腺恶性病变的平均年龄为57±11岁(P < 0.001)。63名妇女(61.8%)已婚，59名(57.8%)受过高等教育，27名(26.5%)是小商贩。良性肿块的平均大小为3.8±3.9 cm，恶性肿块的平均大小为6.2±4.2 cm (P = 0.014)。组织病理学检查显示，20.6%的肿块为恶性，50%为良性肿瘤(纤维腺瘤)，17.6%为纤维囊性改变及相关疾病(纤维腺病)，5.9%为硬化性病变，2%为炎症性病变，2%为乳腺良性增生性疾病，2%为样本不足。12个乳房肿块中有2个(16.6%)在筛查时首次发现，其中2个为恶性。这占所有活检肿块的1.9%(2/102)，占所有CBE女性的0.081%。结论:CBE作为一种早期发现乳腺癌的工具，值得推广和应用。证实纤维腺瘤是临床上最常见的乳房肿块。
{"title":"An audit of breast lumps detected during cancer screening: A report from Southwest Nigeria","authors":"B. Ayoade, H. Ebili, Olubunmi Fatungase, Collins Nwokoro, B. Salami, A. Adekoya, A. Oyelekan, B. Adefuye, A. Olatunji","doi":"10.4103/archms.archms_2_19","DOIUrl":"https://doi.org/10.4103/archms.archms_2_19","url":null,"abstract":"Background: In low-Human Development Index countries, population-based screening programs for breast cancer are virtually nonexistent, but there are occasional screening programs organized by nongovernmental organizations in these countries. This study aims to describe the clinical and histopathological characteristics and the prevalence of breast diseases detected by clinical breast examination (CBE) in a cohort of women who participated in a community-based breast screening program. Methodology: This is a retrospective cross-sectional study of women who were referred for assessment in our Breast Clinic following CBE during a breast cancer screening program. Palpable lesions were subjected to biopsy and histopathological examinations. Results: Of the 2450 women screened, 102 had breast biopsy. Twenty-one were malignant (20.6%) and 79 were benign (77.5%). The mean age for benign breast disease was 32 ± 14 years, whereas that for women with malignant breast lesions was 57 ± 11 years (P < 0.001). Sixty-three women (61.8%) were married, 59 (57.8%) had tertiary education, and 27 (26.5%) were petty traders. The mean lump size was 3.8 ± 3.9 cm for benign lumps and 6.2 ± 4.2 cm for malignant lumps (P = 0.014). Histopathological examination revealed that 20.6% of the lumps were malignant, 50% were benign neoplasm (fibroadenoma,) 17.6% were fibrocystic change and related conditions (fibroadenosis), 5.9% were sclerosing lesions, 2% were inflammatory lesions, 2% were benign proliferative breast disease, and 2% were inadequate sample. Two of the 12 breast lumps (16.6%) were detected for the first time at screening, of which two were malignant. This constitutes 1.9% (2/102) of all the lumps biopsied and 0.081% of all the women who had CBE. Conclusion: This study has demonstrated that CBE as a tool for early detection of breast cancer should be encouraged and applied. It confirms that fibroadenoma is the most common cause of clinically obvious breast lumps.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"2010 1","pages":"1 - 6"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73345280","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}
Pub Date : 2019-01-01DOI: 10.4103/archms.archms_9_19
S. Asuke, K. Sabitu, M. Ibrahim
Introduction: The revised Nigerian National Health Policy and the WHO Expert Committee on the Role of Hospitals as the First Referral Level both recognize primary health care (PHC) as the entry point in the referral system. This study was carried out to assess the effect of training of PHC workers on referral and instituting referral focal person among PHCs on key referral indicators in Zaria and Giwa local government areas, North-Western Nigeria. Methodology: The study was a quasi-experimental study with pre- and postinterventional components carried out among seventy participants in the intervention and 62 participants in the control groups who were selected through a multistaged sampling technique. Data were collected using a structured self-administered questionnaire containing close-ended questions. Data were analyzed with SPSS software version 20.0. Results: Preintervention, majority of the respondents (74.3%) in the intervention and (67.7%) control groups had not received training on referral process. Postintervention, increase was noted in mean referral rate from 0.18 ± 0.28 to 0.52 ± 0.34, which was statistically significant, and mean counter referral rate from 0 ± 0 to 40.34 ± 45.53 in the study group, but there was no statistically significant change in the control group. Conclusion: Postintervention, significant increases were noticed in two of the practice indicators; referral rate and counter-referral rate in the study group only. The other practice indicators did not record a significant increase.
{"title":"Pattern of referral before and after referral intervention among primary health centers in North-Western Nigeria","authors":"S. Asuke, K. Sabitu, M. Ibrahim","doi":"10.4103/archms.archms_9_19","DOIUrl":"https://doi.org/10.4103/archms.archms_9_19","url":null,"abstract":"Introduction: The revised Nigerian National Health Policy and the WHO Expert Committee on the Role of Hospitals as the First Referral Level both recognize primary health care (PHC) as the entry point in the referral system. This study was carried out to assess the effect of training of PHC workers on referral and instituting referral focal person among PHCs on key referral indicators in Zaria and Giwa local government areas, North-Western Nigeria. Methodology: The study was a quasi-experimental study with pre- and postinterventional components carried out among seventy participants in the intervention and 62 participants in the control groups who were selected through a multistaged sampling technique. Data were collected using a structured self-administered questionnaire containing close-ended questions. Data were analyzed with SPSS software version 20.0. Results: Preintervention, majority of the respondents (74.3%) in the intervention and (67.7%) control groups had not received training on referral process. Postintervention, increase was noted in mean referral rate from 0.18 ± 0.28 to 0.52 ± 0.34, which was statistically significant, and mean counter referral rate from 0 ± 0 to 40.34 ± 45.53 in the study group, but there was no statistically significant change in the control group. Conclusion: Postintervention, significant increases were noticed in two of the practice indicators; referral rate and counter-referral rate in the study group only. The other practice indicators did not record a significant increase.","PeriodicalId":93819,"journal":{"name":"The Archives of comparative medicine and surgery","volume":"54 1","pages":"22 - 27"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87876891","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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