A pilot study was undertaken to determine the feasibility of establishing a heart surgery programme in northern Nigeria. During three medical missions by a visiting US team, in partnership with local physicians, 18 patients with heart diseases underwent surgery at two referral hospitals in the region. Sixteen (88.9%) patients underwent the planned operative procedure with an observed 30-day mortality of 12.5% (2/16) and 0% morbidity. Late complications were anticoagulant related in mechanical heart valve patients and included a first-trimester abortion one year postoperatively, and a death at two years from haemorrhage during pregnancy. This has prompted us to now consider bioprosthetics as the valve of choice in women of childbearing age in this patient population. This preliminary result has further stimulated the interest of all stakeholders on the urgency to establish open-heart surgery as part of the armamentarium to combat the ravages of heart diseases in northern Nigeria.
Angiosarcoma is a rare and aggressive malignant tumor that has a poor prognosis. It represents less than 1% of all malignancies occurring in the oral cavity and salivary glands. We present a 35-year-old male with angiosarcoma of the cheek following traumatic injury and a review of the current literature.
The practice of vascular surgery in Zaria, Nigeria, is fraught with challenges. The gap created by the dearth of skilled vascular surgeons is filled by competent cardiothoracic surgeons. Infrastructure decay and lack of prostheses limit the number and variety of operable cases. These challenges result in preventable morbidity and mortality.
Aims and Objectives Trauma continues to be a major cause of morbidity and mortality world over. This study is aimed at the patterns of presentation and the outcome of management. Materials and Methods A prospective study of trauma patients admitted to Ahmadu Bello University Teaching Hospital through the Accident and Emergency units was commenced in January 2008.This preliminary report is for the period of 27months.The clinical history, physical examination and outcome of management recorded in a predesigned proforma, were analysed with SPSS 15 and the patients were followed up in the surgical outpatient department. Results A total of 4784 patients (3143 men and 1641 women) were admitted during this period for trauma. There were a total of 628(13.13%) deaths. Of the 42 consecutive patients identified with chest trauma35 (83.3%) were males and 7(16.7%) were females. The age range was from 5-75years and the mean age was 35.4years, while the most affected ages were in the range of 20 to 49years. Blunt injury constituted 71.4% and penetrating injury constituted 28.6%. Road traffic accident was responsible for 61.9%, stab injury 21.4%, falls 7.1%, gunshot injury 4.8%, impalement 2.4% and animal attack also 2.4%. The average time taken between accident and admission was 31hours,40minutes and 12seconds while the average duration of hospital stay was 16.10 days. The injury pattern included rib fracture(s) (23.8%), hemopneumothorax (14.3%), hemothorax (7.1%), pneumothorax (4.8%), combinations of chest injuries (7.1%), chest laceration 7.1%, bruises 11.9%, lung contusion 4.8%, subcutaneous empyema 2.4%, flail chest 4.8% and no specific injury (11.9%). Associated injuries included head injury (63.6%), orthopaedic injury (27.3%) and combinations (abdominal, head, orthopaedic (9.1%). The fatality of road traffic accident was 36.8%. No patient was attended to by paramedics at the scene of accident while 21.9% of the patients had prehospital resuscitation in peripheral clinics before admission. The transfusion requirement was 14.3%. One patient (2.4%) required a median sternotomy and cardiopulmonary bypass, 54.8% required tube thoracostomy while 42.9% had general resuscitation /non-operative intervention. Only one (2.4%) required ICU care. The complication rate was 4.8%. The mortality rate was 2.4%. Only 7(16.7%) patients were seen beyond the first outpatient clinic appointment. Conclusion Most patients arriving at the hospital survived, requiring general resuscitation or simple tube thoracostomy with few complications. Mortalities from trauma and the cause of death at the site of accident are often not accounted for due to nonpresentation to the hospital and lack of autopsy for those that present.
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