ABSTRACT
BACKGROUND: The field of vascular surgery is evolving in sub-Saharan Africa but the practice is bedeviled by lack of expertise and infrastructure challenges. The consequences are a low volume of operations and a dearth of data. Available data are not representative of the wider picture, therefore, this study was undertaken to evaluate the practice of vascular surgery in a tertiary institution, in the light of the prevailing challenges. METHODS: Data from all patients with vascular-related pathologies managed in our surgical outpatient clinic and accident and emergency wards were obtained from the clinic and in-patient records from January 2008 to December 2012. Age, sex, diagnosis, treatment, and complications were noted. There were 73 patients comprising 45 (61.6%) males and 28 (38.4%) females. The age range was 1-90 years (mean 43.5 years). RESULTS: The pathologies managed included end-stage renal disease (n = 36, 49.3%), nontraumatic and posttraumatic aneurysms (n = 13, 17.8%), vascular trauma (n = 12, 16.4%), peripheral vascular disease (n = 5, 6.9%), congenital vascular malformations (n = 4, 5.5%), and thrombotic diseases (n = 3, 4.1%). Fifty-four (74.0%) surgeries were performed, with a complication rate of 5.5% and 2.7% mortality. CONCLUSIONS: The practice of vascular surgery in Zaria, Nigeria, is fraught with challenges. The gap created by the dearth of skilled vascular surgeons is filled by competent cardiothoracic surgeons. Infrastructure decay and lack of prostheses limit the number and variety of operable cases. These challenges result in preventable morbidity and mortality.
Subject(s)
Postoperative Complications/epidemiology , Surgeons , Vascular Diseases/surgery , Vascular Surgical Procedures/methods , Adolescent , Adult , Aged , Aged, 80 and over , Cause of Death , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Nigeria , Postoperative Complications/mortality , Postoperative Complications/prevention & control , Survival Rate , Vascular Diseases/diagnosis , Vascular Diseases/etiology , Vascular Diseases/pathology , Vascular Surgical Procedures/adverse effects , Vascular Surgical Procedures/instrumentation , Vascular Surgical Procedures/mortality , Young AdultABSTRACT
BACKGROUND: In the developing world, the diagnostic power of nephrologists is heavily limited by financial, technical and human resource constraints. Urine microscopy (UM) is a basic, inexpensive and relatively simple diagnostic tool, which supplies irreplaceable information. Recently, a theoretical and practical course on UM was organized during the 22nd annual meeting of the Nigerian Society of Nephrology. METHODS: The 2-day course was based on power point presentations and on examination of true urine samples by means of a microscope equipped with phase contrast, polarized light and a video camera for projection of the findings. RESULTS: The presentations described were the methodology, the particles of the urine sediment and their clinical interpretation, the urine sediment in different clinical conditions, and 12 clinical cases, which demonstrated the value of UM in clinical practice. Practical sessions showed the most important urine particles, and how they could be identified and combined into urine profiles. More than 97% of the participants found the course to be useful and practicable and a UM program was actually started in 1 Nigerian center a few days after the course. CONCLUSION: This course demonstrated that nephrological skills can be transferred from the developed to the developing world without large financial investments.
