Mohammed Abdullahi

Pattern of maxillectomies: an analysis of 44 cases in a tertiary referral hospital, Sokoto, Northwest Nigeria

Background The maxilla occupies a prominent and crucial position in the facial structure. Maxillectomy is an ablative surgical resection of the maxilla with attendant serious cosmetic deficit. There is paucity of data on the indications and pattern of maxillectomy in our centre. This study would help in better management of patients requiring this treatment. Aim The aim of this study was to determine the pattern of presentation of patients for maxillectomy at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Patients and methods This study was a retrospective review of theatre records of the hospital between January 2007 and March 2017. Patients data were collected for sociodemographics (age and sex), indication(s), clinical presentations, diagnosis/histologic subtypes, and type of maxillectomy performed. Result During the 11-year study period, a total of 44 patients underwent maxillectomy, aged 4–77 years (mean±SD=37.6±19.6 years) with a modal age of 31–40 years [11 (25.0%)]. There were 26 (59.1%) male and 18 (40.9%) female patients (male : female=1.8 : 1). Overall, benign lesions accounted for 12 (27.3%) cases and malignant lesions for 32 (72.7%) cases. There was statistical difference between the ages of benign (mean±SD=24.9±16.2 years) and malignant lesions (mean±SD=42.3±18.8 years) (t=−2.83, d.f.=42, P=0.0071). Benign lesions [11 (25.0%)] were commonly detected in those aged 40 years and younger, whereas malignancies [16 (36.4%)] were equally distributed across both divide. Total maxillectomy [34 (77.3%)] was the major surgical resection carried out, followed by subtotal maxillectomy [6 (13.6%)]. Conclusion There is urgent need to focus on the prevention of orofacial malignancy to avoid surgery and complex rehabilitative expenses.

Instrumental vaginal delivery - an assessment of use in a tertiary care centre

Background : Sickle cell anaemia is a multi-systemic disease with variable clinical manifestations including those involving the digestive system. There is paucity of data on the digestive system complications of sickle cell anaemia in children in our setting. Objective : To determine the pattern of digestive system complications among hospitalized children with sickle cell anaemia in University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria. Methodology : A 7-year retrospective observational study of cases of digestive system complications among hospitalized children with sickle cell anaemia was carried out. Relevant clinical data including socio-demographic characteristics, digestive system complications diagnosed, definitive investigations applied, treatment given and possible outcomes were extracted from the case record files of selected cases using a semi-structured questionnaire. Data were analyzed using SPSS version 21.0 (IBM Corp, Armonk, NY 2012) while the level of statistical significance was set at p<0.05. Results : There were 350 children with sickle cell anaemia attending the sickle cell clinic out of which 33 had serious digestive system complications requiring hospitalizations during the period under review. Their mean age was 9.1±4.8years (9months to 18years).Nearly half, 16(48.5%) of the affected children were of low socio-economic background. Acute abdominal crisis, which was found in 12(36.4%) of cases was the most common complication, while cholelithiasis was the least common complication, occurring in one (3.3%) of the cases studied. Conclusion : Acute abdominal crisis is the most common digestive system complication in children with sickle cell anaemia in our setting. Efforts should be made to exclude other potential causes of acute abdomen which may require surgical intervention in children with sickle cell anaemia. History taking, diligent physical examination and relevant laboratory and imaging studies, would readily facilitate the diagnosis, and save lives. Keywords : Acute abdominal crisis, children, haemoglobin, hospitalization, multi-systemic