Choice of Surgical Sub-specialties among Surgical Residents in Nigeria

BACKGROUND

There are several reasons for the choice of surgical specialty among resident doctors in Nigeria AIM: To determine the choice of surgical subspecialty among Surgical residents and the reasons for such decision.

METHODS

A cross-sectional study of Surgical residents who attended the West African College of Surgeons Update Course from 1st -13th September 2014 was conducted using a semi structured questionnaire. Information obtained included age, gender, marital status, designation (Registrar/Senior Registrar), training centers and choice of sub-specialty with reason(s). Collated information was analyzed with SPSS version 21.

RESULTS

A total of 226 Surgical Residents registered for the update course were given the questionnaires to fill. One hundred and sixty-three Residents filled the questionnaire, giving a response rate of 72%. There were 153 males and 10 females with male to female ratio of 15:1. One hundred and forty eight were Registrars while 15 were Senior Registrars. General surgery, Urology and Orthopaedic sub-specialties topped the list of choice among Surgical Residents. Interest, financial considerations and job satisfaction were the major reasons for the choice of sub-specialty.

CONCLUSION

The choice of surgical sub-specialty among Residents is guided mainly by interest, financial considerations and job satisfaction derivable from such specialty. General surgery, Urology, and Orthopaedic topped the list of choice of sub-specialty.

Presentation and management outcome of childhood corrosive oesophageal injury in Benin City

BACKGROUND

Corrosive ingestion in children occurs usually at home and frequently results in debilitating strictures. Prevention and early intervention programs are very important for good outcomes.

AIMS AND OBJECTIVES

This study aims at examining the immediate causative factors and problems of this subset of patients with a special focus on treatment and outcome. This study was to audit the management of patients in the paediatric age group who presented for treatment with history and sequelae of corrosive ingestion seen by the cardiothoracic unit of the University of Benin Teaching Hospital from January 2005 till December 2018.

MATERIALS AND METHODS

This is a 14year retrospective study of patients that presented with oesophageal burn injuries from ingestion of corrosive agents to the Cardiothoracic Unit at the University of Benin Teaching Hospital between January 2005 and December 2018. Essentially the first 5years were retrospectively included but the subsequent years were prospective. All available medical data on these patients were retrieved and studied for epidemiological, clinical and operative procedures and outcome.

RESULTS

A total of 49 patients were seen and admitted during the period under review. Male (29) : Female (20) ratio was 1:1.4 Mean age was 4.7±4.8 years with a range of 1-16years, The males presented earlier and had worse strictures as well as more surgical procedures. Caustic soda preparations ingested more (93.9%), all ingestions were within the household setting, and all had first aid given by way of oral palm oil. Only two (4.1%) ingested acids with only one flat battery ingestion. 45.5% of the patients had dilatation only and of these 50% recovered after 3 sessions and required no more sessions. A further 50% were lost to follow up. 38.8% had oesophageal replacement with colon following oesophagectomy.

CONCLUSION

In conclusion, corrosive oesophageal stricture is a debilitating disease in children and affects males more, but it is treatable by multiple dilatations and oesophageal replacement with colon. Prevention should be actively pursued as well as early intervention.

Outcome of bronchoscopic biopsies in the University of Benin Teaching Hospital

Aim:

Our study was done to evaluate our bronchoscopic techniques, sizes and diagnostic yield.

Materials and Methods:

This was a retrospective study comprising all cases of bronchial biopsies done in the University of Benin Teaching Hospital from 2007 to 2011. All patients who had flexible bronchoscopy under general anaesthesia during the period under review where enrolled in the study.

Results:

There were a total of 16 patients: Nine males and seven females, with a mean age of 46.9 years. The main indications were cough (87.5%), weight loss (62.5%), X-ray findings of a chest lesion (87.5%), chest pain (62.5%), difficulty with breathing (31.3%) and massive haemoptysis (25%). Histology results showed inadequate samples in six and Bronchogenic carcinoma in four patients. The histology was pivotal in eight patients.

Conclusion:

Bronchoscopic biopsies are fraught with problems and other clinical investigative tools would certainly be important in improving the results.

Congenital intrapericardial diaphragmatic hernia presenting radiologically as massive cardiomegaly

Intrapericardial diaphragmatic hernia is uncommon condition in which abdominal content herniate into the pericardium. It is mostly of traumatic origin, sometimes it is congenital. Radiologically, the condition may be suspected when the bowel loops are seen. However, diaphragmatic hernia may simulate acute gastrothorax, pneumotocelles and pneumothorax. The case of a 3-month-old infant with congenital diaphragmatic hernia in whom the bowel loops were not seen on chest radiograph and thus presented as massive cardiomegaly, is presented. The child had a successful surgery and was discharged home.