Does Arthroscopic Repair of Femoroacetabular Impingement Pathology Affect Clinical Outcomes after Ipsilateral Total Hip Arthroplasty? / 대한고관절학회지

PURPOSE: Arthroscopy for repair of femoroacetabular impingement (FAI) and related conditions is technically challenging, but remains the preferred approach for management of these hip pathologies. The incidence of this procedure has increased steadily for the past few years, but little is known about its potential long-term effects on future interventions. The purpose of this study was to evaluate whether prior arthroscopic correction of FAI pathology impacts postoperative complication rates in patients receiving subsequent ipsilateral total hip arthroplasty (THA) on a national scale.MATERIALS AND METHODS: A commercially available national database – PearlDiver Patients Records Database – identified primary THA patients from 2005 to 2014. Patients who had prior arthroscopic FAI repair (post arthroscopy group) were separated from those who did not (native hip group). Prior FAI repair was examined as a risk factor for complications following THA and a multivariable logistic regression analysis was applied to identify risk factors for complications following THA.RESULTS: A total of 11,061 patients met all inclusion and exclusion criteria; 10,951 in the native hip group and 110 in the post arthroscopy group. Prior FAI repair was not significantly associated with higher rates of 90-day readmission (P=0.585), aseptic dislocation/revision within 3 years (P=0.409), surgical site infection within 3 years (P=0.796), or hip stiffness within 3 years (P=0.977) after THA.CONCLUSION: Arthroscopic FAI repair is not an independent risk factor for complications following subsequent ipsilateral THA (level of evidence: III).

Colour Profile, Pasting and Sensory Properties of Processed Sweet Potato Flour

In this study, sweet potato was purchased and processed using different methods to obtain 4 different sweet potato flour samples. Sample A was unfermented sweet potato flour, sample B was fermented spontaneously, while sample C and D were produced by fermentation using indigenous starter cultures of lactic acid bacteria and yeast for 48 h and 72 h respectively. Colour profile, Pasting and Sensory evaluation was conducted. The whiteness (L* value) obtained in this study is within the range of value (87.29-89.52), Also, the redness value (a*) and yellowness value (b*) of the sweet potato flour samples also showed a significant difference (p<0.05). Sample a had a higher value when compared with samples B,C and D. Pasting properties such as peak viscosity, trough viscosity, breakdown viscosity, setback, pasting temperature were determined. It was noticed that fermentation process and increase in fermentation time significantly (p<0.05) decrease the peak viscosity in this research work and all samples had a higher cooled paste viscosity than their corresponding hot paste viscosity. Nevertheless, sensory evaluation was carried out using thet 9-point hedonic scale, samples A,B,C,D are significantly different (P < 0.05).

Proximate and phytochemical compositions of leaf and root of (cattle stick) Carpolobia lutea G. Don

ABSTRACT: Carpolobia lutea is a medicinal plant commonly utilized in Nigeria to boost libido. The ethnomedicinal importance of any plant lies in some secondary metabolites. Hence, the present study was carried out to investigate the proximate and phytochemical composition of roots and leaves of this plant using standard methods. The proximate composition of leaves and roots showed moisture, ash, fibre, protein, fat and carbohydrate contents with values that ranged between 8.84-9.55, 3.48-3.65, 1.10-1.06, 6.64-8.39, 1.80-1.80 and 76.16-77.47% respectively. The leaves contained higher amount of ash, crude protein and fat than the roots. The results of ethanolic extracts showed the presence of alkaloids, anthraquinones, steroids, saponins, tannins, phenols, terpenoids, anthocyanin, carotenoids and flavonoids in both the leaves and roots. These phytochemicals were found to be significantly higher in roots except for anthraquinones, flavonoids and steroids which were significantly higher in the leaves. Among the phytochemicals, alkaloids were found to be highest in concentration followed in decreasing order by saponins, steroids, tannins, flavonoids, anthraquinones, anthocyanin, terpenoids, phenols and carotenoids. The results indicated that, C. lutea leaf and root have high nutritive and medicinal values and this could be explored for pharmaceutical purposes

Discrete Breast Masses in Female Children and Adolescents: Is there a Place for Non-operative Management by Pediatric Surgeons.

Background: The treatment of breast masses in female children and adolescents is controversial. While some advocate for early surgical removal others prefer the conservative non operative approach. The aim of this study is ascertain the evidence for the current protocol of early surgical removal in our centre. Materials and Methods: Retrospective observational study to highlight the epidemiology of discrete breast masses in female children and adolescents <18years seen at the Lagos University Teaching Hospital, Nigeria. Main outcome measure was to find out if there is a malignancy in excised tissue specimens. Results: Fifty three girls with 76 breast masses were evaluated. Median age at presentation was 16years (4 –17 years). Mean size of lumps was 3.6 cm (±2.1). All the breast masses had benign clinical characteristics and were confirmed histologically to be benign. There was no case of primary or secondary malignancy in any of the histological specimens. Family history, nipple discharge or ingestion of oral contraceptives did not affect presentation, diagnosis and outcome (p>0.05). Conclusion: This series show that breast masses in children and adolescents are almost always benign. It is advocated that conservative non-operative management (with close follow up with imaging such as breast ultrasound and/or MRI) should be adopted by paediatric surgeons in cases of breast masses in children except when surgery is specifically indicated. These indications which should be individualized include: cosmesis, bloody nipple discharge, persistent history of pain in the mass, rapid growth of the mass and malignancies with predilection for the breasts.

Survey of Medical Specialists on their Attitudes to and Resources for Health Research in Nigeria

Aim: To study the views of medical specialists on their attitude to and the resources for health research in Nigeria and draw appropriate policy implications. Materials and Methods: Structured questionnaires were distributed to consenting 90 randomly selected medical specialists practising in six Nigerian tertiary health institutions. Participants' background information; importance attached to research; motivations for conducting research; funding; ethical oversight; literature search; and statistical support were probed. The coded responses were stored and analyzed using the statistical SPSS software. Results: Fifty-one out of the 90 questionnaires distributed were returned; giving a response rate of 63.3. Research function was rated third by 64.7of the respondents after hospital service (72.5) and teaching (66.0). Advancement of knowledge was the strongest motivating factor for conducting research (78.4). Securing funding (94) and finding time (80) were their major constraints. Only a minority of the respondents; 20and 14; respectfully; positively rated the quality and promptness of the decisions of their institutions' ethical organs in the highest category. Most of their literature search was conducted on the internet (96.1) and they stored and analyzed their research data with commonly available statistical software. Conclusion: Our study respondents regarded research highly but were severely constrained in conducting research by lack of access to sources of funding from within and outside Nigeria and finding time from core hospital functions. We recommend periodic (re)training in research particularly on how to apply for research grants and giving some protected research time for Nigerian medical specialists in order to boost their research function

Gross and histologic evaluation of abdominal adhesions associated with chromic catgut and polypropylene sutured enteropexies in dog / Evaluación macroscópica e histológica de las adherencias abdominales asociadas a enteropexias suturadas con catgut crómico y polipropileno en perros

The gross and histologic patterns of abdominal adhesions formed by the use of chromic catgut and polypropylene suture materials were evaluated in dogs. Gross and histologic examinations did not reveal significant difference (p>0.05) in the degree of adhesions observed at enteropexy sites in both suture materials. The use of polypropylene with superior suture qualities should be considered instead of chromic catgut for procedures in which adhesion is desired in the dog.

Fueron evaluados los patrones macroscópicos e histológicos de las adherencias abdominales formadas por el uso de catgut crómico y materiales de sutura de polipropileno. Los exámenes macroscópicos e histológicos no revelaron diferencias significativas (p> 0,05) en el grado de adherencias observadas en los sitios de la enteropexia en ambos materiales de sutura. El uso de suturas de polipropileno con mejores cualidades debe ser considerado en lugar del catgut cromado para procedimientos en los que la adherencia en el perro es deseada.

Visual Outcome of Cataract Outreach Services in Zamfara State; Northwestern Nigeria

Background: The Ministry of Health in Zamfara State organised a cataract outreach program with the aim of operating 700 patients in 14 local government areas of the state. The programme is described and evaluated in this study. Methods: An outreach team comprising of 8 personnels of diverse background screened and operated on patients in Zamfara State. Patients with mature age related cataracts; briskly reacting pupils; accurate four quadrant light projection and normal intraocular pressures were selected for surgery. All patients were planned for extra capsular cataract extraction with posterior chamber intra-ocular lens implantation (ECCE + PC IOL) unless contra indicated. Post operative visual acuity was measured with Snellen's or Illiterate acuity chart at 2 weeks follow up. Results: A total of 784 patients between the age of 40 and 80 years consisting of 479 males and 307 females were operated. Six hundred and ninety four patients (88) had PCIOL inserted. Post operative visual acuity of 6/18 or; better was obtained in 322(41) patients. Conclusion: Cataract outreach is an effective tool of eye care services in the underserved rural areas

Causes of bone injuries and patronage of traditional bone setters in maiduguri; Nigeria

The study as an opinion survey identified Road Traffic Accidents (RTA); falling from height and gunshots/matchets as the causes of bone injuries in Maiduguri; Nigeria. Injuries sustained include fracture and dislocation. Structured Interview Schedule (SIS) and Focused Group Discussion (FGD) were the instruments used to obtain data. Population of study comprised of those involved in bone injuries between January and December; 2008. The sample size of 700 respondents was selected using stratified random sampling technique. Frequency distribution and percentages were employed to analyze data. Findings of the study revealed parents/families; relatives and friends as some of the sources of decision to patronize Traditional Bone Setting (TBS) while culture; phobia for hospitalization; no amputation and less expensive were some of the reasons adduced for patronage. Based on the findings; enactment of stringent laws/bye-laws or re-enforcement of existing ones (if any); counselling and enlightenment were suggested/recommended

Testicular Torsion : a Fifteen Year Review in a Nigerian Teaching Hospital

Aim and Objectives: To determine the prevalent age; presentation; duration of symptoms before intervention; and outcome of management of testicular torsion (TT) in our community. Design: A fifteen-year retrospective study. Setting: University Teaching Hospital. Materials and Method: Records of patients managed for TT; January 1992- Decem- ber 2006; were reviewed. Records of 91 out of 106 patients managed during the period were available for review. The age of patient; presentation; duration of symptoms; predisposing factors; interval between presentation and operation; and outcome of management were extracted and analyzed. Results: Ninety-one patients; mean age 20.1yrs (range 8-34) were reviewed. The average duration of symptoms at presentation was 26.7hrs (range 1.5- 168). The patients were mostly 74(81.3) students. All of them presented with scrotal pain; and 66(72.5) had scrotal swelling (Left: Right=1.8:1). Torsion was partial (180-270o) in 14(15.4); and complete (360o-1440o) in 77(84.6). Intra-scrotal anatomic abnormalities were observed in 77(84.6) patients. Testes were viable in 59(64.8) patients offered bilateral orchidopexy and gangrenous in 32(35.2) that had orchi- dectomy with contralateral orchidopexy. The average duration of hospital stay was 2.8days. Most of the patients 76(83.5) were lost to follow up within 3 weeks postoperative. Conclusion: TT occurs in patients aged 8-34yrs in our immediate community. Presentation is late and most patients 77(84.6) have predisposing congenital abnormalities. There is a need for increase awareness by the general public and the health personnel's of the danger posed by delay in treating TT. Where doubts exist; early scrotal exploration should be the investigation and intervention of choice to prevent irreversible damage to the germ cells