The authors affirm that typhoid ileal perforation must be treated surgically. Early presentation and diagnosis, adequate resuscitation, prompt surgery and vigorous post-operative management improved mortality rates. Clearly delays in presentation necessitating prolonged resuscitation and therefore delayed surgery affected mortality.

Patient groups who presented early had low mortality rates, but patient groups who presented late had higher mortality rates. Overall mortality was 21%.

Context:Surgical instruments and materials continue to be retained in the peritoneal cavity despite precautionary measures. Even though uncommon it is also under-reported and carries serious medico-legal consequences. Gauzes and sponges (gossypiboma) are the most commonly retained materials and intra-abdominal retained artery forceps are much rarer but when they do occur lead to chronic abdominal pain and can be a rare cause of intestinal obstruction or strangulation with significant morbidity and mortality.Case Report:We present a case of intraabdominal retained artery forceps in a 70-years-old lady who underwent laparotomy with splenectomy for a large spleen in a peripheral hospital. Upon discharge she continued to complain of intermittent abdominal pain of increasing severity. 12 months later she presented to us with an acute (surgical) abdomen requiring another laparotomy. At laparotomy she had strangulated/gangrenous lower jejunual and upper ileal bowel loops, the small bowel mesentery of this area being tightly trapped between the jaws of the retained artery forceps. She had gut resection and enteroanastomosis. Unfortunately she died from continuing sepsis on the second post-operative day.Conclusion:Retained instruments in intra-abdominal surgery can cause serious complication and should be treated surgically. High index of suspicion and appropriate investigations like plain abdominal X-ray, abdominal ultrasound and CT and MRI scans should be instituted in patients who develop chronic abdominal symptoms following laparotomy. Preventive measures against retained instruments must follow strict laid down protocols for surgical instruments handling in theatre.

Objectives: Controversial in the development of anatomical science education is the role of dissection in the teaching of anatomy. Several doubts have been expressed over the usefulness of the use of cadavers in gross anatomy studies. This work was designed to compare the outcomes from a cadaver dissection-based study with a non-cadaver-based study.Methods: A total of 128 medical students divided into two groups were used for this study. Both groups were required to study the gross anatomy of a given region. While Group A used cadaver dissection and other methods of studying anatomy available in the department, Group B studied with all the materials made available for Group A, but without a cadaver. Both groups undertook the same essay and multiple-choice exams on the region studied. Results:The mean score for the various parts of the exam noted for Group A was 65%, while that for B was 55%. The percentage number of students with distinction grades in A was 39 while B was 17. In all, 91% of the students in Group A attained the pass mark while only 63% from B did. Conclusion:The students that had a cadaver dissection-based study did better in all aspects of the exams with a significant difference between the mean scores of both groups. Standard deviations were smaller for the group that studied with cadaver in all aspects of the exam.

There is need for more public health campaigns to educate communities about the harms of circumcision with the goal of eradicating the practice.