Demographic profile and endoscopic findings among patients with upper gastrointestinal bleeding in Ahmadu Bello University Teaching Hospital, Zaria, North-Western Nigeria

Background

Upper gastrointestinal bleeding (UGIB) is a common medical emergency that can result in significant morbidity and mortality.

Aim

The aim of this study was to determine the demographic profile and etiology of UGIB in patients seen at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, North-Western Nigeria.

Subjects and Methods

This descriptive retrospective study was carried out at the Gastroenterology Unit of ABUTH Zaria. Data of patients referred for upper gastrointestinal endoscopy with UGIB from June 2017 to December 2019 were extracted from the endoscopy register and analyzed.

Results

One hundred and forty-four patients had upper gastrointestinal (UGI) endoscopy done for UGIB during the period under review. Of these, 105 (72.9%) were males while 39 (27.1%) were females with male-to-female ratio of 2.7:1. The mean age of the patients was 43.5 ± 17.3 and their age ranges from 11 to 89 years. The modal age group was 40-49 years. The most common cause of UGIB was esophageal varices (67 [46.5%]) followed by erosive mucosal diseases: gastritis/duodenitis 43 (29.9%), esophagitis 12 (8.3%). Less common causes were peptic ulcer disease (PUD) in five (3.5%) patients, gastric tumor in two (1.4%), hiatus hernia in one (0.7%), and portal hypertensive gastropathy in one (0.7%). Thirteen patients (9.0%) had normal findings.

Conclusion

Esophageal varices are the most common cause of UGIB among our patients and middle-aged male patients were the most commonly affected group.

Porocephalosis due to encysted Armillifer nymph presenting as an acute abdominal emergency: case report and review of literature

A rare case of porocephalosis infection presenting with an acute abdominal emergency in a 60 year old Nigerian is presented. The characteristic radiologic appearance of Armillifer nymph is described, and clinical findings which may be caused by this parasite are reviewed. A brief review of the epidemiology of porocephalosis is also included.

Abdominal tuberculosis in surgical practice in northern Nigeria

BACKGROUND

Abdominal tuberculosis is a common complication of pulmonary tuberculosis. With the rising incidence of HIV, tuberculosis has become a major public health problem particularly in developing countries.

METHODS

This is a retrospective study involving patients whose surgical specimens were processed at the central histopathology laboratory of the Ahmadu Bello University Teaching Hospital (ABUTH) Zaria--Nigeria, between January 1975 to December 2006.

RESULTS

There were 68 males and 49 females, aged 12-70 years (mean 28.6 yrs 11 yrs). While paroxysmal dry cough was present in about 20 patients, abdominal pain and distension were very common. Concomitant pulmonary tuberculosis was confirmed in 15 patients (14%). The findings at Surgery in 66 patients are presented in fig. 2. Multiple deposits on the peritoneum and omentum were the commonest findings (48.7% and 26.2%) respectively

CONCLUSION

Abdominal tuberculosis is not uncommon and there is need to establish an early less invasive diagnostic protocol.

Awareness of occupational hazards and utilization of safety measures among welders in Kaduna metropolis, northern Nigeria

BACKGROUND

Welders are exposed to a variety of occupational hazards with untoward health effects. However, little is known of welders' awareness of health hazards and their adherence to safety precautions in developing countries. This study assessed the awareness of occupational hazards and adherence to safety measures among welders in Kaduna metropolis in northern Nigeria.

METHODS

A structured questionnaire was administered on a cross-section of 330 welders in Kaduna metropolis in northern Nigeria. Information was sought on their socio-demographic characteristics, their awareness of occupational hazards and adherence to safety measures.

RESULTS

All welders were males with a mean age of 35.7 +/- 8.4 years. The illiteracy rate was 7.6%. Overall, 257 (77.9%) of the welders were aware of one or more workplace hazards. This was positively influenced by educational attainment, age, nature of training and work experience. Of the 330 respondents, 282 (85.3%) had experienced one or more work-related accidents in the preceding year. The most common injuries sustained were cut/injuries to the hands and fingers (38.0%), back/waist pain (19%), arc eye injuries/foreign bodies (17.0%), burns (14.0%), hearing impairment (7.0%), fractures (4.0%) and amputation (1.0%). Only 113 (34.2%) welders used one or more types of protective device with eye goggles (60.9%), hand gloves (50.3%) and boots (34.5%) being more frequently used. Regular use of safety device, shorter working hours and increasing experience were protective of occupational accidents.

CONCLUSIONS

The level of awareness of occupational hazards was high with sub optimal utilization of protective measures against the hazards. There is therefore need for health and safety education of these workers for health and increased productivity.

Malignant melanoma: a review

The incidence of malignant melanoma the most malignant of all skin neoplasms, has doubled within the last 10 years. Exposure to high intensity sunlight, racial susceptibility, hormonal status, age, environmental factors as well as injury have all been shown to play a role individually or synergistically in the activation of the melanocytic oncogen. Controversies still exist in which factors actually determine prognosis, in patients with advanced malignant melanoma. Management has remained even more controversial, with surgical excision, with or without lymphadenectomy, radiotherapy, chemotherapy, laser therapy and more recently immunotherapy and intra-arterial neutron thermal capture therapy, having their proponents and opponents.

Fournier's gangrene in neonates and infants

BACKGROUND

Fournier's gangrene is uncommon in childhood and little is known about the disease in this age group.

METHOD

A retrospective review was carried out of neonates and infants treated for Fournier's gangrene over a period of 16 years.

RESULTS

Twelve neonates and infants aged 5 days-3 months (median 3 weeks) were treated in our hospital. The precipitating cause was omphalitis in 7 babies, strangulated inguinal hernia in 2 and in 3 babies there was no identifiable cause. Gram-negative bacteria were cultured in 3 patients, but in most the culture was sterile. Treatment consisted of debridement of devitalised tissue and administration of broad-spectrum antibiotics. Primary closure was achieved in 1 baby and secondary closure in 2 others. In 7 babies the wound contracted rapidly and healed. There was no mortality.

CONCLUSION

Fournier's gangrene in neonates and infants in our environment is largely preventable. Early debridement and appropriate antibiotics give good results.