Perceived role of the journal clubs in teaching critical appraisal skills: a survey of surgical trainees in Nigeria.

BACKGROUND: Critical appraisal skills allow surgeons to evaluate the literature in an objective and structured manner, with emphasis on the validity of the evidence. The development of skills in critical acquisition and appraisal of the literature is crucial to delivering quality surgical care. It is also widely accepted that journal clubs are a time-honored educational paradigm for teaching and development of critical appraisal skills. The aim of this study is to determine the perceived role of journal clubs in teaching critical appraisal skills amongst the surgical trainees in Nigeria. MATERIALS AND METHODS: The West African College of Surgeons and the National Postgraduate College of Nigeria have mandated that all residency programs teach and assess the ability to develop critical appraisal skills when reviewing the scientific literature. Residents at the revision course of the West African College of Surgeons in September 2012 evaluated the role of journal clubs in teaching critical appraisal skills using a 17-item questionnaire. The questionnaire addressed four areas: Format, teaching and development of critical appraisal s kills, and evaluation. RESULTS: Most of the journal clubs meet weekly [39 (59%)] or monthly [25 (38%)]. Thirty-nine residents (59%) perceived the teaching model employed in the development of critical appraisal skills in their institutions was best characterized by "iscussion/summary by consultants" and "emphasis on formal suggestion for improvement in research." Rating the importance of development of critical appraisal skills to the objectives of the residency program and practice of evidence-based medicine, majority of the residents [65 (98%)] felt it was "very important." The commonest form of feedback was verbal from the consultants and residents [50 (76%)]. CONCLUSION: The perceived importance of journal clubs to the development of critical appraisal skills was rated as very important by the residents. However, residents indicated a need for a formal evaluation of the journal clubs. It is our hope that the results of this survey will encourage postgraduate coordinators to evaluate the quality of their journal clubs in the development of skills in critical appraisal of the literature.

Survey of urologists on clients' demand for screening for prostate cancer in Nigeria.

OBJECTIVE: The aim of this article is to document the experience of urologists on clients' demand for prostate cancer screening among Nigerians. MATERIALS AND METHODS: The study is a cross-sectional evaluation of the urologists that attended the Fourteenth Annual Meeting and the Scientific Conference of the Nigerian Association of Urological Surgeons. A structured questionnaire was used to assess the estimated workload of the respondents, with reference to prostate cancer management, the stage proportion at the time of diagnosis, and the proportion of patients requesting for CaP screening. The data was analyzed using the SPSS version 15 statistical software. RESULTS: Twenty-two respondents completed and returned the questionnaire and formed the basis of further analysis. About 76.9% of the consultant urologists were also lecturers in their respective universities. They were all actively practicing and a majority of them, 76.9%, had up to 10 years experience as practicing urologists. The majority of the respondents managed between one and fifteen new patients with CaP every month, with 36.4% of them managing more than 15 new patients on an average every month. About 95.4% of all the patients seen by the respondents were diagnosed with advanced stages of the disease, while the remaining ones were incidental findings. About one half of the respondents attended to clients seeking for advice on CaP 'often' or 'very often,' while 40.9% attended to them 'occasionally,' with a mean of 4.67 clients seeking advice per month. The majority of respondents, 20 (22); 90.9%, were 'not aware' of any national guideline on CaP screening. CONCLUSIONS: A majority of practitioners affirmed that patients with prostate cancer present late. The mean number of patients requesting for screening for prostate cancer per month, per respondent, for CaP, is still low. It is the authors' belief that the trend may not change until there is an appropriate effort at health education, to enlighten the populace.

Human mycetoma.

BACKGROUND: Mycetoma is a tropical superficial fungal infection endemic in parts of Africa. It affects the foot and leg commonly, but any part of the body may be involved. Mycetoma presents with characteristic discharging sinuses containing fungal granules, a picture that is pathognomonic. However, the disease may present without these characteristic features, thus causing diagnostic difficulty with other chronic granulomatous infections such as tuberculosis or benign skin lesions. METHODS: A review of four male and three female patients aged 28-70 years with mycetoma seen during a six-year period. RESULTS: The duration of the lesion before presentation was between two and six years (median five years). Clinical presentation included pigmented cutaneous nodules, depigmented spots, multiple discharging sinuses, or a fungating mass with bone erosion, involving almost any part of the body (face, trunk, and leg). The range of clinical misdiagnoses included skin tuberculosis, fibroma, amelanotic melanoma, basal-cell carcinoma, and brain tumor. Histologic examination of tissue biopsies showed amorphous aggregates of eosinophilic granules in a background of chronic suppurative inflammation. CONCLUSION: Mycetoma is a disease with sporadic occurrence in our environment. The presentation and clinical course may be confused with those of many skin diseases. Knowledge of mycetoma pathology is important for prompt diagnosis and treatment of this indolent clinical entity.