ABSTRACT
BACKGROUND: Quality surgical training is crucial to meeting manpower needs and creating a vibrant healthcare delivery. Feedback from trainees provides insight to understanding training challenges and needs to improve the programme. The objective of this study was to determine the challenges faced by surgical trainees and their perception of their training in Nigeria. MATERIALS AND METHODS: A questionnaire survey of trainees in 16 academic surgical training centres in Nigeria between September and December 2012. RESULTS: Of 235 respondents, 227 were males (96.6%) and 8 females (3.4%) with mean age of 33.9 years. A significant proportion (62.3%) of the respondents believed that the volume and diversities of surgical cases managed during their training were sufficient; however, 53.9% were less satisfied with their operative experience. Majority (71.8%) of the respondents felt "supported" by their trainers but they also believed that the training was skewed towards service provision. They were not actively involved in research due to lack of funds in 77.7%, lack of time/motivation in 15.8%, indifference in 11.8% and poor knowledge of research methods in 9.2%. Inadequate training facilities (50.7%), poor welfare (67.2%), inadequate sponsorship (65.9%) and poor remuneration (88.3%) were identified among their challenges. On the whole, majority (62.3%) believed that their training would adequately prepare them to function independently. CONCLUSION: Surgical residents in Nigeria face a variety of challenges. Based on our findings, a training that tracks and keeps trend with global changes through a higher investment in surgical training, improved facilities and residents' well-being from both the teaching authorities and government will more likely improve the quality of training.
ABSTRACT
BACKGROUND: Pseudocyst arises from pancreatic inflammation or ductal disruption and is the commonest cystic lesion of the pancreas. Although spontaneous resolution is common particularly in its early phase, progression of the cyst may culminate in grave consequences for the patient. The aim of the study is to highlight the presentation, management and outcome of pseudocyst in an environment where it is reportedly uncommon. METHODOLOGY: Case series with review of literature. RESULT: Although pancreatic pseudocyst is not very frequently seen in this environment, it is not entirely rare but is frequently misdiagnosed. Non specific symptoms in the early stage and subsequent confusion with various intra abdominal pathologies are among the reasons for late diagnosis and delayed intervention. CONCLUSION: Pseudocyst is amenable to surgical treatment. Early recognition is imperative in preventing complications and in defining the true incidence of this disease entity in our locality. Clinical suspicion in every setting of pancreatitis complemented by serum amylase estimations and early ultrasound scan will improve the diagnosis.
Subject(s)
Pancreatic Pseudocyst/diagnostic imaging , Pancreatic Pseudocyst/surgery , Adult , Biopsy , Diagnosis, Differential , Female , Humans , Male , Nigeria , Pancreatic Pseudocyst/pathology , Treatment Outcome , UltrasonographyABSTRACT
Pseudocyst arises from pancreatic inflammation or ductal disruption and is the commonest cystic lesion of the pancreas. Although spontaneous resolution is common particularly in its early phase; progression of the cyst may culminate in grave consequences for the patient. The aim of the study is to highlight the presentation; management and outcome of pseudocyst in an environment where it is reportedly uncommon. Case series with review of literature. Although pancreatic pseudocyst is not very frequently seen in this environment; it is not entirely rare but is frequently misdiagnosed. Non specific symptoms in the early stage and subsequent confusion with various intra abdominal pathologies are among the reasons for late diagnosis and delayed intervention. Pseudocyst is amenable to surgical treatment. Early recognition is imperative in preventing complications and in defining the true incidence of this disease entity in our locality. Clinical suspicion in every setting of pancreatitis complemented by serum amylase estimations and early ultrasound scan will improve the diagnosis
Subject(s)
Incidence , Pancreatic Pseudocyst/diagnosis , Pancreatic Pseudocyst/surgeryABSTRACT
BACKGROUND: Diseases of the breast are common and include problems, related to pregnancy and lactation, abscesses and other inflammatory conditions, nonneoplastic proliferative disorders and neoplasms. No known previous histopathological analysis has been done in our setting to classify breast lesions. The purpose of this study is to review all cases of breast diseases seen in the department over a six-year period and to determine the pattern of histological diagnosis of breast diseases in our setting. METHODS: This was a hospital based retrospective study where our bench record books were used to identify all the breast lesions after which the Haematoxylin and Eosin stained slides and the request cards were retrieved. The slides were reviewed based on the diagnostic criteria by Juan Rosai. RESULTS: A total of 291 breast lesions were seen in the department. One hundred and seventy three (59.5%) of these were inflammatory non-neoplastic proliferative and benign neoplastic disorders, while 118 (40.5%) were malignant neoplasms. Fibroadenoma was the commonest benign breast lesion with 69 (23.7%) cases. Of all the malignancies, invasive ductal carcinoma was the most frequent (68.6%). Breast cancer was found most frequently in the 4th decade (32.2%), followed by the 5th decade (24.6%) of life. CONCLUSION: Female breast cancer was quite common in this study and most of our patients presented with advanced disease.
Subject(s)
Breast Diseases/pathology , Adult , Breast Diseases/epidemiology , Breast Neoplasms/epidemiology , Carcinoma, Ductal, Breast/epidemiology , Carcinoma, Ductal, Breast/pathology , Female , Humans , Middle Aged , Nigeria/epidemiology , Retrospective StudiesABSTRACT
Background:Diseases of the breast are common and include problems; related to pregnancy and lactation; abscesses and other inflammatory conditions; nonneoplastic proliferative disorders and neoplasms. No known previous histopathological analysis has been done in our setting to classify breast lesions.The purpose of this study is to review all cases of breast diseases seen in the department over a six-year period and to determine the pattern of histological diagnosis of breast diseases in our setting.Methods: This was a hospital based retrospective study where our bench record books were used to identify all the breast lesions after which the Haematoxylin and Eosin stained slides and the request cards were retrieved. The slides were reviewed based on the diagnostic criteria by Juan Rosai. Results: A total of 291 breast lesions were seen in the department. One hundred and seventy three (59.5) of these were inflammatory; non-neoplastic proliferative and benign neoplastic disorders; while 118 (40.5) were malignant neoplasms. Fibroadenoma was the commonest benign breast lesion with 69 (23.7) cases. Of all the malignancies; invasive ductal carcinoma was the most frequent (68.6). Breast cancer was found most frequently in the 4th decade (32.2); followed by the 5th decade (24.6) of life. Conclusion: Female breast cancer was quite common in this study and most of our patients presented with advanced disease
Subject(s)
Breast , Breast Diseases , Carcinoma , FibroadenomaABSTRACT
Background:Diseases of the breast are common and include problems; related to pregnancy and lactation; abscesses and other inflammatory conditions; nonneoplastic proliferative disorders and neoplasms. No known previous histopathological analysis has been done in our setting to classify breast lesions.The purpose of this study is to review all cases of breast diseases seen in the department over a six-year period and to determine the pattern of histological diagnosis of breast diseases in our setting.Methods: This was a hospital based retrospective study where our bench record books were used to identify all the breast lesions after which the Haematoxylin and Eosin stained slides and the request cards were retrieved. The slides were reviewed based on the diagnostic criteria by Juan Rosai. Results: A total of 291 breast lesions were seen in the department. One hundred and seventy three (59.5) of these were inflammatory; non-neoplastic proliferative and benign neoplastic disorders; while 118 (40.5) were malignant neoplasms. Fibroadenoma was the commonest benign breast lesion with 69 (23.7) cases. Of all the malignancies; invasive ductal carcinoma was the most frequent (68.6). Breast cancer was found most frequently in the 4th decade (32.2); followed by the 5th decade (24.6) of life. Conclusion: Female breast cancer was quite common in this study and most of our patients presented with advanced disease