Glomus Tumours of the Hand in Lagos; Nigeria

"Background: Glomus tumours of the hand are uncommon intriguing tumours which cause significant morbidity. Few reports have documented the epidemiology and presentation in the West African subregion. The aim of this review is to identify the common baseline demographics; the presentation; evaluation; diagnosis and treatment outcome of glomus tumours of the hand in Lagos; Nigeria Methods: A 10 year retrospective review of the records of all patients seen with histopathologically diagnosed glomus tumor of the hand at the Lagos University teaching hospital was carried out noting the biodata; demographics; method of presentation and treatment of this condition.Results: 11 patients were seen over the study period .There were nine females and 2 males seen.The mean age of the patients was 41 years. The symptoms had been on for between 3 and 40 months .All patients seen had a positive Love test.Only one patient had associated bony erosion.All had complete excision with no recurrence at 6 months.Conclusion: Glomus tumor of the hand is an uncommon tumour often occurring in adult women. Clinical test (Love ""test"") will correctly identify the diagnosis.Surgical treatment was curative in all our cases. High index of suspicion is needed to make earlier diagnosis"

Detecting Nosocomial Intrinsic Infections through Relating Bacterial Pathogens of Incision

Surgical procedures often lead to both intrinsic and extrinsic infections. In order to improve on recovery of patients; investigations were carried out on samples collected from patients during and after surgery. Laboratory analysis was performed on wound swabs from incision; colon segments; scrapes; tissues; pus and catheter specimen urine. The samples were cultured on MacConkey and Blood agar and incubated aerobically at 370C for 16-24 hours. Thereafter; isolates were identified using standard microbiological methods. Results showed that isolates from wound were also found on endogenous indicators of surgery. Klebsiella species from incision was 15 (18.75) while those from colon segment was 30(37.6); scrapes 8(16) and pus 3(7.5). Acinetobacter species found on incision was 15(7.5) and pus 7(2.3). Pseudomonas species was distributed on incision 5(2.5); colon segment 4(5); tissue 3(1.6); scrapes 5(10) and pus was 5(12.5). Staphylococcus aureus which was isolated from incision was 2(1); while scrapes and pus were 5(10) and 7(17.5) respectively. Catheter associated urinary tract infections yielded significant bacteriuria (64.7); almost twice the rate of non-significant bacteriuria (35.3); indicating the need to remove all catheters as soon as possible. Antibiogram of isolates of Klebsiella pneumoniae with resistance pattern: ApGnNaNt; Escherichia coli (ApCtNaTtCm) and S. aureus (ApChCxErPn) with plasmid sizes in the range (30.2-52.51Kb) were common to both indicators and wound; showing that the pathogens were the same clusters. This study demonstrated surgical procedures as precursory to intrinsic infections and that bacterial pathogens found on wounds and endogenous indicators of surgery are links to intrinsic infection. The study therefore emphasizes the need to culture wounds promptly to effect speedy recovery of patients who have undergone surgery

Genito-urinary system injuries in Lagos: pattern and general treatment outcome

BACKGROUND: Genitourinary injuries (GUI) are relatively uncommon. Even though mortality from isolated injuries is rare; they are commonly associated with significant and life long morbidity. OBJECTIVE: This study is to assess the pattern of the injuries and the overall short term treatment outcome in our environment. METHODS: Fifty consecutive patients diagnosed with genitourinary injuries seen by the Urology Unit through the Accident and Emergency; emergency referrals (or consultations) from the ward or theatre between June 2004 to February 2006 were included in the study. Information collected included demographic data; pattern of presentation; aetiology of injury; type of injury the type of treatment and the immediate outcome. RESULTS: There was a total of 61 injuries in 50 patients. Road traffic accidents was the commonest cause of GUI (58) followed by straddle injuries (18) and iatrogenic causes (12) and miscellaneous (12). The male- female ratio was 6:1. The urethral was also the most commonly injured organ (60.6); followed by the kidney (11.5). The testes were the least injured organs (1.6). The blunt renal injuries and extraperitoneal bladder injuries were managed by non operative means while most other injuries were managed by surgical intervention. Immediate treatment outcome was satisfactory in most patients. There was one mortality. CONCLUSION: Most cases of GUI are preventable. Improved safety on the roads;'proper training of surgeons and attention to clinical and surgical details will go a long way in preventing GUI. Early intervention significantly reduces the morbidity and mortality

Pattern of Breast Masses in Lagos: A Private Health Facility Review of 189 Consecutive Patients

BACKGROUND:The increasing awareness concerning breast cancer has led to significant interest in breast masses in general. As a result there is considerable interest in the clinicopathologic studies of breast masses in various populations. OBJECTIVE: To study the clinicopathologic pattern of breast masses at a private health facility in Lagos; Nigeria. METHOD: The records of all patients who presented between January 1993 and December 2002 with breast lumps at the Lagoon Hospital Apapa were reviewed. Their biodata; clinical presentation and histopathological diagnosis were retrieved. RESULTS: 189 consecutive patients were studied comprising of 180 females and nine males. The peak age incidence for benign disease was 21-30 years while it was 31-40 years for those with malignant masses. Majority (66.1) presented with painless solitary lumps. 46 (77.2) patients had benign lumps while 43 (22.8) had malignant lesions. The commonest benign lesion was fibrocystic disease (47.9) while infiltrating ductal carcinoma was the commonest pathological diagnosis in the malignant group (83.1). CONCLUSION: From this study benign breast masses outnumber malignant ones by more than 3:1 in this population. The commonest pathological diagnosis was fibrocystic disease in benign lesions and infiltrating ductal carcinoma for malignant masses

Paediatric Hand Injuries at the Lagos University Teaching Hospital

Background: Paediatric hand trauma represents a subset of hand injury that can be quite challenging to manage. Local studies on this injuries are few therefore a 4 year retrospective study at the Trauma and hand rehabilitation unit of the Lagos University teaching hospital was carried out. Objectives: To determine the percentage of hand trauma occurring in the paediatric age group; the predominant age group involved; place of injury; the major injury types occurring as well as the most common surgical procedure required. Methods: The case records of all cases that presented at the hand rehabilitation clinic or the emergency center of the Lagos University teaching hospital over a 4 year period were reviewed. Those below the age of 12 years were studied. Their biodata; type of injury; place of injury and other details were obtained. Results: 634 patients were seen over the study period; 61 cases of hand injuries were in the paediatric age group. Hand trauma constituted less than a third of all paediatric hand cases. The commonest age group affected was 2-6 years. Most of the injuries occurred around the home. Burns injury; blunt trauma; glass and knife cuts were the commonest causes of hand trauma. Soft tissue reconstruction was commonest procedure done. Conclusion: Infants and toddlers were the most vunerable groups while burns injury was the commonest cause of hand trauma seen at the Lagos university teaching hospital