Ekundayo S. Garba

The mobile phone as a tool in improving cancer care in Nigeria.

Objective: The use of mobile phone as a tool for improving cancer care in a low resource setting.

Progress in management of typhoid perforation

Case fatality rate (CFR) for typhoid perforation (TP) has been on gradual but variable decline world wide. This review highlights the progress in management of TP from 1960 including the controversies, current principles of management and the advances associated with the best results of treatment. This is a review of publications on TP from 1960 to 2010 principally from Medline and Ovid databases. Main search terms used are typhoid and perforation. The median CFR by decade was estimated from studies that reported CFR. With advances in surgery and supportive care, median CFR for TP declined from over 50% in 1960 to single digits in the last decade in some countries but with West Africa lagging behind at 16%. Variations in CFR are attributed to differences in perforation-operation interval and quality of care. Opportunities now exist for patients with TP to recover from the disease but priority remains with prevention of enteric fever in endemic areas.

Infected Hydrocoele of the Canal of Nuck in a Neonate

Hydrocoele of the canal of Nuck is an uncommon presentation in the neonate and complications are rare. A 6-day-old girl presented with a right groin swelling from birth. The swelling remained static until age 3 days when it increased rapidly in size. There was no fever or gastrointestinal symptoms. Physical examination showed a large nontender mass extending from the right groin into the ipsilateral labium majus with distortion of the external genitalia. Needle aspiration yielded cloudy fluid, which gave a growth of Klebsiella on culture. A hydrocoele of the canal of Nuck was confirmed at surgery and was excised. Postoperative course was uneventful and there has been no recurrence at 2 years of follow-up.

Bilateral gestational gigantomastia complicated by severe sepsis; case report of a preventable mortality

Gestational gigantomastia is characterized by a rapid and disproportionate growth of the breasts with a homogeneous increase in breast volume. Enlargement of the breasts with infection, ulceration and sepsis are potentially fatal for the patient and her fetus. The management is challenging, however the need for appropriate surgical intervention is rarely in question. A multidisciplinary approach regarding the decision for surgery and the timing of surgery is crucial to outcome. We report a case of gestational gigantomastia complicated by severe sepsis in a low resource setting to highlight the peculiar challenges of management.

Cancer pain and management: Providers' perspective in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Background: Pain is a frequent disturbing symptom of cancer, the prevalence and severity of which depend on the primary tumor, its metastatic sites, and the disease stage. The place of pain management in cancer patients cannot be over emphasized. Proper management results in improved quality of life. Aims: To assess providers′ attitude and practice toward cancer pain management in Ahmadu Bello University (ABU) Teaching Hospital, Zaria, Nigeria. Materials and Methods: This was a cross-sectional descriptive pilot study on provider perspectives on pain management in cancer patients. A structured self-administered questionnaire was completed by 79 medical practitioners of various specialties and ranks. Results: Seventy-nine clinicians were recruited for the study. The majority of the respondents, 36 (46%), believe that pain was the commonest symptom in cancer patients. Most, 61 (78%), of the doctors assessed pain using subjective methods and only 30 (29%) of the respondents were conversant with other treatment options for pain. Fifty (64.3%) use analgesia, and their choices were guided mainly by the response of the patients. Forty-eight (61.5%) of those who admit to the use of analgesia, were actually limited by the side effects of the drugs. More than half (57.6%) believed that pain management in our settings is suboptimal, and the commonest limitation to optimal pain management in our settings was availability and affordability of drugs. Conclusion: Professional education needs to focus on the proper assessment of pain, the management of side effects of analgesics, and the use of adjuvant therapies for pain. A better understanding of the pharmacology of opioid analgesics is also needed.

Gastroduodenal Intussusceptions in An Adult: Report of A Case. -

Gastroduodenal intussusceptions are an uncommon condition usually caused by the prolapse of a gastric tumor into the duodenum with subsequent invagination of a portion of the stomach wall. The diagnosis of adult intussusceptions can be delayed because it occurs infrequently and is nonspecific. The differential diagnosis of intermittent symptoms of pyloric stenosis in adults should include gastroduodenal intussusceptions.A rare case of this condition associated with a pedunculated gastric tumor is presented and relevant literature is discussed.