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   Table of Contents - Current issue
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July-December 2016
Volume 26 | Issue 2
Page Nos. 25-45

Online since Monday, June 12, 2017

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ORIGINAL ARTICLES  

Evaluation of nonpalpable breast mass excision and sentinel node biopsy using radio-guided occult lesion localization: A Single-stage Procedure p. 25
Timor Hamza Alshee, Sheikh Muzamil Shafi, Khalid Alsalman, Misbah Afsheen Malah
DOI:10.4103/1116-5898.207751  
Introduction: With the increased awareness and use of breast cancer screening programs, detection of nonpalpable lesion of breast is also increasing in incidence. Previously, wire guidance under ultrasonography was used for localization of these occult lesions, and in the second stage, sentinel node biopsy (SNB) was taken under radioactive guidance or blue dye injection. Materials and Methods: We conducted a study to combine radioactive-guided occult lesion localization (ROLL) with SNB. Results and Conclusion: We concluded that ROLL is an efficient method for the detection of these occult lesions, enabling more effective planning of skin incision, precise excision of the lesion with minimal normal tissue edge excision, and ultimately better postoperative cosmetics. When combined with SNB, it effectively decreases the intraoperative time.
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Etiology of upper gastrointestinal bleeding in the University of Benin Teaching Hospital, South-Southern Nigeria p. 29
Rose Ashinedu Ugiagbe, Casmir E Omuemu
DOI:10.4103/njss.njss_7_15  
Background: Upper gastrointestinal (GI) bleeding is a medical emergency that remains a common cause of morbidity and mortality worldwide. The aim of this study was to determine the common causes of upper GI bleeding in the University of Benin Teaching Hospital, South-Southern Nigeria. Methods: Records of all patients referred with upper GI bleeding to the endoscopy unit of the University of Benin Teaching Hospital from February 2006 to January 2013 were reviewed. Relevant data and findings at diagnostic upper GI endoscopy were retrieved from the endoscopy register. Data obtained were analyzed using Statistical Package for Social Sciences version 15.0. Results: A total of 1084 patients had upper GI endoscopy during the study, of those 311 (28.7%) had upper GI bleeding. The mean age of patients with upper GI bleeding was 51.48 ± 17.5. Range was 14–90 years and the male: female ratio was 2.04:1. The most common cause of upper GI bleeding was peptic ulcer disease (PUD), found in 102 (32.8%) cases, followed by gastritis in 88 (28.3%) cases. Esophageal varices accounted for 47 (15.1%) cases whereas duodenitis was found in 16 (5.1%) cases. Carcinoma of the stomach occurred in 13 (4.2%) cases while 12 (3.9%) patients had esophagitis. Gastroesophageal reflux disease accounted for 11 (3.5%) cases whereas esophageal ulcers occurred in 3 (1.0%) cases. Carcinoma of the esophagus and esophageal candidiasis each constituted 2 (0.6%) cases. The cause of bleeding was not found in 15 (4.8%) patients. Conclusion: PUD is the most common cause of upper GI bleeding in patients undergoing endoscopy in the University of Benin Teaching Hospital, South-Southern Nigeria.
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Recurrent inguinal hernia in Ile-Ife Nigeria: Characteristics and outcome of management p. 33
Elugbaraonu Augustine Agbakwuru, Amarachukwu Chiduziem Etonyeaku, Olalekan Olasehinde, Adedapo O Kolawole, Ademola Olusegun Talabi, Akinbolaji Andrew Akinkuolie, Funmilola O Wuraola
DOI:10.4103/njss.njss_7_16  
Background: There are very few reports addressing patients' characteristics, patterns, and outcome of treatment of recurrent inguinal hernia irrespective of the method of hernia repair. Purpose: The purpose of this study is to evaluate the patients and disease characteristics, treatment and early outcome of surgery for recurrent inguinal hernia. Patients and Methods: The medical records of patients who had repair of recurrent inguinal hernia at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife from January 1, 2004, to December 31, 2013 were reviewed for demographics, number and place of previous repair, technique of repair, intraoperative findings at repair of recurrence, and outcome of this intervention. Data generated were analyzed for frequencies, percentages and Fisher exact test for statistical significance. Results: Forty-one recurrent hernia repairs were done during the period, constituting 3.2% of all hernia repaired. The male:female ratio was 40:1. Mean age was 56.1 ± 17.7 years. Most cases were first-time recurrences 36 (87.8%), reducible 35 (85.4%) and were electively repaired. Six (14.6%) were complicated requiring emergency repair. Recurrence within 1 year of earlier repair was common (36.6%). Relatively, more patients 22 (53.7%) had their primary repair in nonspecialist centers (P < 0.05) while only eight patients had their primary repairs in specialist centers. Lichtenstein and Nylon Darn techniques were common repair methods for recurrent hernia. Overall complication rate was 36.6% (n = 15) with wound hematoma being the most predominant 11 (25.6%). There was no record of re-recurrence over 3–60-month period (mean = 6 months). Conclusion: Place of the previous repair was associated with increased risk for hernia recurrence. Tension-free repair remains pivotal in recurrent hernia repair.
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CASE REPORT Top

Postmastectomy breast reconstruction at University of Benin Teaching Hospital, Benin City p. 39
Ferdinand Onwuemene Ijekeye, Nnamdi Jude Nwashilli
DOI:10.4103/njss.njss_2_16  
Post-mastectomy breast reconstruction, though a desirable rehabilitation procedure has remained an uncommon procedure in most resource-limited environments. Most breast cancer patients in our environment undergo total mastectomy, however only a few of them seek or have access to breast reconstruction. Breast reconstruction has potential for improving the psychosocial wellbeing of a patient post-mastectomy. The availability of expertise for breast reconstruction and increased societal awareness will help maximize patients's benefit.We present a case series of five patients with breast cancer who had immediate postmastectomy breast reconstruction with autologous tissue with good outcome.
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