Search

Background Laparoscopic cholecystectomy is not readily available in secondary care hospitals in Nigeria, even though it is now the gold standard for the treatment of cholelithiasis and other gallbladder diseases worldwide. Thus, many hospitals in Nigeria still offer open cholecystectomies. This retrospective study investigated the trend of cholecystectomies performed in the general surgery unit of a district hospital in Abuja before and after the commencement of laparoscopic surgery services in 2016. Methodology This retrospective study was conducted in Asokoro District Hospital, Abuja, Nigeria The records of all patients who underwent a cholecystectomy from January 2000 to December 2019 were retrieved and analyzed for the number, types, and rate of cholecystectomies performed per year. All open cholecystectomies were performed via a right subcostal incision, whereas all laparoscopic cholecystectomies were performed via the standard four-port incisions approach. Results A total of 96 patients underwent cholecystectomies from January 2000 to December 2019. In total, 50 (52.08%) open cholecystectomies were performed in 20 years with a yearly average of 2.5, and 46 (47.92%) laparoscopic cholecystectomies were performed in four years with a yearly average of 11.5. The trend of open cholecystectomies in four years dropped from three (30%) in 2016 to one (5.26%) in 2019, whereas laparoscopic cholecystectomies increased from seven (70%) to 18 (94.74%) within the same period. Conclusions There is a drop in the trend of open cholecystectomies and an increase in both laparoscopic and total cholecystectomies in our hospital. We recommend adequate capacity and subsidized laparoscopic cholecystectomy for secondary healthcare facilities in Nigeria., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Aghahowa et al.)

Background: Although laparoscopic cholecystectomy has become the gold standard for removing the Gall Bladder (GB) for operable benign diseases, many open cholecystectomies are still performed in developing countries. We present our experiences with all cholecystectomies done in a secondary health care hospital, in north-central Nigeria., Patients and Methods: All patients who had open and laparoscopic cholecystectomies over a 20year period between January 2000 and December 2019 at the general surgery unit of Asokoro District Hospital, Abuja, Nigeria were reviewed with a focus on demography, indications for surgery, type of operation, complications, and outcomes. The diagnosis of benign gall bladder diseases was by findings on patients' presentation, clinical examination, trans-abdominal ultrasound scan, and histological examination of all specimens. All open cholecystectomies were via the Kocher's incision approach while the laparoscopic cholecystectomies were via the 4-port incisions approach., Results: A total of 120 cholecystectomies comprising 74 open cholecystectomies and 46 laparoscopic cholecystectomies were performed. There were 27(22.5%) males and 93(77.5%) females giving a male to female ratio of 1:3.4. The age range was 19 to 80years and the peak age was in the 41-50years range. The commonest indication for surgery was calculous cholecystitis in 107(89.2%) patients while the commonest post-operative complication was surgical site infection in 4(3.33%) patients. Majority (80%) were cholesterol stones. All the gall bladders were benign and there was no mortality recorded., Conclusion: Open and laparoscopic cholecystectomies are safe in Asokoro District Hospital, Abuja Nigeria and the outcomes are comparable to results from other centres in the region., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)

Background: The clinical and pathologic spectrums of goitres are wide. Even though Nigeria's Federal Capital Territory is within the geographic goitre bed, there is a paucity of thyroidrelated data from this region. The objective of this study was to determine the clinical presentation, management and outcomes of patients with goitre operated-on at the Department of Surgery, Asokoro District Hospital, in Abuja, Nigeria., Methodology: This is a retrospective study involving patients managed between January 2001 and December 2015. Data were extracted from patients' medical records, operation registers, and histopathology records. Variables were; age, sex, diagnosis, types of operation performed, post-operative complications and histological findings. All patients had general anaesthesia via cuffed endotracheal intubation and the surgical technique used was skin crease transverse collar stud incision., Results: One hundred and thirty four (134) patients were involved in the study: 124(92.5%) were females and 10(7.5%) males. Mean age was 38years±11.0SD. Seventy-seven (57.5%) patients had simple multi-nodular goitre, followed by simple left nodular goitre 20(14.9%) and simple right nodular goitre 17(12.7%). One hundred and twenty-one (90.5%) patients did not have any complications. On histologic examination, most of the lesions were multinodular goitres 60(44.8%), followed by simple nodular goitres, 23(17.2%). Follicular adenoma was the commonest neoplastic variant accounting for 12(9.1%) cases., Conclusion: The pattern of goitres in Abuja simulates that from other parts of Nigeria and many other African countries though with fewer malignancies in the present study. The management and outcome of goitres in Asokoro District Hospital Abuja is comparable to those obtained from other centres in Nigeria. Pre-and postoperative complications were also minimal., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)

Introduction: Mammography is a major tool for the screening and diagnosis of breast cancer globally. Poor funding and lack of good public health education for mammography in resource-limited countries limit access to mammographic services. In these settings, patients bear the cost of breast cancer screening from out-of-pocket expenses. The aim of this study was to interrogate the pattern of utilization of mammography by women of childbearing age, who attended Asokoro District Hospital (ADH) for Healthcare, with the view to increase uptake., Materials and Methods: This was a 4-year retrospective, cross-sectional study of 534 women who attended ADH from July 2015 to June 2019 for screening or diagnostic mammography. Data were extracted from completed questionnaire by women who had mammography during the period under review. The data were entered into Statistical Package for the Social Sciences version 27 by IBM for analysis., Results: The mean age of the women was 47.8 years ± 7.7 with a range of 30-82 years. Most of the women, 525 (94.9%), were referred for mammography by health workers; only nine (5.1%) had mammography on self-referral. In all, 71% of the women paid for their mammography from their pockets, whereas 28.1% made payments through the National Health Insurance Scheme (NHIS). A total of 100% of women who reported for mammography on self-referral paid for the services from their pockets. The association between the funding options and mode of referral was statistically significant, P = 0.049., Conclusion: This study showed that referral for mammography by health workers was responsible for not only most of the mammograms conducted but also all the women who utilized NHIS to pay for this service. Resources should therefore be directed towards creating awareness among health workers, especially with the present level of NHIS coverage in the population, in order to increase the uptake of screening mammography in the population., Competing Interests: The study was not sponsored by any organisation and the authors declare no conflicts of interest., (Copyright: © 2022 Journal of the West African College of Surgeons.)

Background: Sonographic breast density pattern like mammography is dependent on the relative proportion of connective and glandular tissue. Breast density is a marker for breast cancer risk and has received wide spread interest in many countries in recent times., Aims and Objectives: This paper aims at describing the sonographic breast pattern in women in Ibadan using the American College of Radiology in its breast imaging reporting and data system (ACR-BI-RADS) lexicon. It will also estimate the prevalence of the different sonographic breast patterns and attempt to find any association between the breast patterns and various demographic variables in the women studied., Materials and Methods: A prospective, descriptive study of the sonographic breast pattern in 573 women carried out at the Department of Radiology, University College Hospital, Ibadan. Nigeria. Breasts scans were performed with an Aloka SSD and Logiq P5 machine., Results: A total of 573 women were recruited into the study. Their age ranged between 14 and 74 years (mean = 38.91 ± 12.51 years and median = 38 years). The modal age group was 30-39 years (26.9%). The women attained menopause between 35 and 59 years (mean = 46.2 ± 5.1 years) while the median age for menopause was 47 years. The majority of the women studied were either obese or overweight (66.9%). Sixty-one (10.6%) women had a positive family history of breast cancer with the heterogeneous fibroglandular (60.7%) breast pattern being commonest in this high risk group; and in the entire study population (52.7%). Significant associations between the sonographic breast pattern, age, menopausal status, parity, body mass index (BMI), and waist-hip ratio (WHR) was found. BI-RADS 2 breast pattern appeared to decrease with increasing age while BI-RADS I breast pattern increased with increasing age (P < 0.001)., Conclusion: Ultrasonography like mammography, can define the parenchymal breast pattern accurately. Strong correlation exists between parenchymal breast pattern and demographic, parity variables, and breast cancer risk factors.

Background: Mammography has been used in developed countries with considerable success but very little is known about this imaging modality in low resource settings. This study examined the level of awareness of mammography and determined factors influencing the level of awareness., Methods: We conducted a hospital based cross sectional study to investigate the level of awareness of mammography among 818 randomly selected women attending the General Outpatient clinics (GOP) of the University College Hospital (UCH), Ibadan, Nigeria. Independent predictors of level of awareness of mammography were identified using multiple logistic regression analysis., Results: The proportion of women who ever heard of mammography was 5%, and they demonstrated poor knowledge of the procedure. Those with primary or secondary levels of education were about three times less likely to be aware of mammography when compared with those with tertiary level of education (OR = 0.3, 95% CI, 0.12 - 0.73). Also, participation in community breast cancer prevention activities (OR = 3.4, 95% CI, 1.39 - 8.36), and previous clinical breast examination (OR = 2.34, 95% CI, 1.10 - 4.96) independently predicted mammography awareness. Newspapers and magazines appeared to be the most important sources of information about mammography screening., Conclusion: The level of awareness of mammography is poor among women attending outpatient clinics in the studied population. Interventions promoting awareness of this screening procedure should give particular attention to the illiterate and older women while clinicians performing breast examinations should utilize the opportunity to inform women about the mammography procedure. Promotion of educational articles on breast cancer and its screening methods via media remains vital for the literate.

Introduction: Intracranial tuberculomas are a rare complication of tuberculosis occurring through hematogenous spread from an extracranial source, most often of pulmonary origin. Testicular tuberculosis with only intracranial spread is an even rarer finding and to the best of our knowledge, has not been reported in the literature. Clinical suspicion or recognition and prompt diagnosis are important because early treatment can prevent patient deterioration and lead to clinical improvement., Case Presentation: We present the case of a 51-year-old African man with testicular tuberculosis and multiple intracranial tuberculomas who was initially managed for testicular cancer with intracranial metastasis. He had undergone left radical orchidectomy, but subsequently developed hemiparesis and lost consciousness. Following histopathological confirmation of the postoperative sample as chronic granulomatous infection due to tuberculosis, he sustained significant clinical improvement with antituberculous therapy, recovered fully and was discharged at two weeks post-treatment., Conclusion: The clinical presentation of intracranial tuberculomas from an extracranial source is protean, and delayed diagnosis could have devastating consequences. The need to have a high index of suspicion is important, since neuroimaging features may not be pathognomonic.