Background. The COVID 19 pandemic affected healthcare delivery systems worldwide. There was a redistribution of health care resources in order to deal with the effects of the pandemic, with a corresponding consequence on other clinical services rendered. The extent of this effect on other non COVID 19 related services has been reported in other centres worldwide. In our own setting, health care resources are limited with suboptimal access even in normal situations. Objective. We sought to evaluate the effects of the COVID 19 pandemic on elective surgical services in our hospital. Methods. This was a cross sectional comparative study carried out at the Jos University Teaching hospital, (North central, Nigeria) of the elective surgical services rendered during the first wave of the COVID 19 pandemic lockdown covering the period April to June 2020 with a corresponding period of the preceding year 2019. Data was obtained from the hospital records department, theatres and service areas for clinic attendance, elective surgeries and ward occupancy. The paired sample t-test was used to compare the assessed variables across the three months of both years with a level of significance of P < 0.05. Results. There was mean clinic attendance of 2859.33 ± 223.36 covering the three months in 2019 as against a mean attendance of 648.67 ± 578.24 covering a similar period in 2020, P = 0.037. The elective surgical procedures carried out across the surgical specialties over the period in 2019 gave a mean of 352.33 ± 44.60 as opposed to 64.001 ± 7.32 over the corresponding period in 2020, P = 0.018. Ward occupancy over April to June 2019 was a mean 297.33 ± 18.58 across the various surgical wards and 158.33 ± 25.70 in the same period in 2020, P = 0.007. Conclusion. There was a significant reduction in the elective surgical services rendered in the hospital during the first wave of the COVID 19
Background: Undescended testis is the commonest disorder affecting the male urogenital tract. Late presentation has significant socio-medical impact on the individual's quality of life. Aim: To evaluate the presentation of undescended testis and age at surgery in our centre. Methods: A 9-year retrospective analysis of the clinical records of patients < 18 years managed for undescended testis in our centre. Results: A total of 73 records were analysed, 58 (79.5%) presented > 1 year. Median age at presentation was 4 years, range 1 day-16 years. Males 73 (100%), only 17 (23.3%) were referred by health personnel, while 56 (76.7%) self-referred. Commonest site involved was the left 33 (45.2%), 29 (39.7%) right and 11 (15.1%) bilateral. There were 13 (17.4%) who had associated congenital malformations. Hypospadias 7 (53.8%), isolated micropenis 4 (30.8%) and 1 each (7.7%) had myelomeningocele and hernia. Median age at presentation for bilateral involvement was 30 days, with associated hypospadias was 12 days, while those with isolated micropenis was 7.5 years. Median age at surgery for bilateral involvement was 2 years, overall median age at surgery was 4 years. Surgery Findings: Supra-scrotal testis 47, canalicular 25 (34.2%), and bilateral abdominal 1 (1.4%). Outcome: Wound infections 4 (5.5%), scrotal wound breakdown 1, Recurrence 3 and testicular atrophy 1. Conclusion: Our patients presented very late beyond the recommended age for surgery, evaluating for DSD also contributed to delay in intervention even when these patients presented early. We advocate for early screening at birth, during routine child immunization and school enrollment, with prompt referral.
Background: To present this experience using the fundus-first technique during laparoscopic cholecystectomy for the management of symptomatic gall stone disease with an intra-operative finding of Fitz-Hugh-Curtis syndrome.Methods: This is a prospective review of patients who had the fundus-first dissection during laparoscopic cholecystectomy. The study was carried out at the Jos University Teaching Hospital (JUTH), and FOMAS hospital, both of which are tertiary hospitals located in Jos. Patients were recruited from January 2017 - January 2019. All patients undergoing laparoscopic cholecystectomy who had an intraoperative diagnosis of Fitz-Hugh-Curtis syndrome, and who had the fundus-first dissection, were included in the study. Patients who had fundus-first dissection for indications other than Fitz-Hugh-Curtis syndrome, were excluded from the study. Demographic and clinical information of patients included age, sex, duration of surgery, complications, and duration of hospital stay. Descriptive statistics were applied.Results: A total of 76 patients had elective laparoscopic cholecystectomies over the study period. Of that number, 17 (22.4%) patients had an intra- operative diagnosis of Fitz-Hugh-Curtis syndrome, and had the fundus-first dissection. The mean patient age was 46.3 years (SD = 11.7 years). All patients were female. The mean operating time was 70 minutes (SD = 23 minutes). The duration of hospital stay was 24 hours. There was one conversion due to uncontrollable intraoperative bleeding.Conclusions: This study revealed that the fundus-first dissection is suitable for removing the gall bladder during laparoscopic cholecystectomy in patients with gall stone disease, and an intraoperative finding of Fitz-Hugh-Curtis syndrome.
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