21g needle-assisted Pterygium excision (21-gnap): a novel safe approach

Aim: To determine surgical efficacy of 21G needle-assisted pterygium excision. Method: A pictorial review of pterygia excised at different levels of maturity and diverse clinical history using a 21G hypodermic needle and a colibri. Ten pterygia were excised of which grade 3 were six and grade 2 were four. Nine cases were primary pterygia and a case was recurrent. The author was the only surgeon. Result: Cases reviewed showed minimal or no residual pterygial tissues post-operatively. Pterygial beds had smooth corneal optical surfaces, there were no perforations or undue corneal "guttering" from irregular cuts, no exuberant tissue formation like pyogenic granuloma or recurrence at 6 weeks of follow-up. Overall, slit lamp images were comparable with conventional "grab and cut" with surgical blade or scissors. Conclusion: 21G Needle-Assisted Pterygium (21-GNAP) excision is cheap, safe, and easy-to-learn new modality of excising all forms of pterygial and ocular surface masses

Fine needle aspiration cytology fordiagnosis of benign breast disease in a resource limited setting

Background:A majority of breast lesionisbenignin nature; benignbreast disease is four times more commonin Nigerian women. The percentage of unsatisfactory smears in breast cytology appears to behigher in benign conditions compared to malignant ones.The aim of this study is to determine the effectiveness of cytopathology in the diagnosis of benign breast disease in our institution.Methodology: This is a prospective study of 96 patients with benign breast disease seen during the study period. The patients were subjected to clinical assessment, fine needle aspiration cytology (FNAC) and open biopsy histopathology (as standardreference test).Results:One hundred andseventy-fourpatients with both FNACand histopathology reports were initially evaluated, 96 (55.2%) had benign while the rest (78, 44.8%) harbored malignant lumps. On analysis of the benign lumps, FNAC achieved high sensitivity (98.8%), specificity (96.9%) and overall diagnostic accuracy (98.0%) compared to clinical assessment with values of 83.3% (sensitivity), 82.1% (specificity) and 82.2% (overall diagnostic accuracy). The false positive rate (FPR, 2.3%) and false negative rate(FNR, 1.6%) reported for FNAC were equally better than figures of 14.9% (FPR) and 20.0% (FNR) documented for clinical assessment.Cytopathology was utilized insubclassifying 76 (79.2%) out of the 96 biopsy confirmed benign lumps; 49 slides were correctly typed giving a concordant rate of 64.5%.Conclusion:Fine needle aspiration cytology in our index study showed appreciable concordance with open biopsy histologyin the diagnosis and sub-classification of benign breast disease

Soft Tissue Foreign Body Removal: Management by another Technique: Experience of Ibn Sina Hospital of Rabat about 12 Cases

Introduction: A missed or neglected foreign body (NFB) is not infrequent in surgical practice. It constitutes a common reason for consultation later; location and removal of foreign bodies can be difficult because of possible inflammation; induration; granulated tissue and fibrous scar. This paper describes a simple method for the quick localization and surgical removal of NFB using two 25 gauge needles. Materials and Methods: In this paper we report the experience of department of plastic and reconstructive surgery in Ibn Sina Teaching Hospital in Rabat; conducted on ten patients in terms of the use of two 25-gauge needles was used in 12 NFB in soft tissue in order to achieve proper localization and fixation of foreign bodies during surgery.Results: Results were satisfactory in most of our Patients; surgical removal was successful in 11 of 12 NFB.Conclusion: Needle guided technique allows the successful surgical removal of NFB using minimal soft tissue exploration and dissection via proper localization; fixation; and propulsion of the foreign body toward the surface of the skin