ABSTRACT
Introduction: Lipomas are benign soft-tissue swelling commonly found on the neck, upper back, trunk, and shoulder but are rare in the foot and particularly in the sole. Case Report: This is a case of lipoma in a 49-year-old female teacher with 2 months history of painless swelling at the sole of the left foot which later became painful when it was traumatized. The patient was referred from a peripheral hospital to a teaching hospital in Ghana. Ultrasonography assessment revealed a hematoma, so our surgical team decided to do an excision biopsy under a popliteal block. Intraoperative findings revealed a lipoma and the mass was sent for histopathological assessment. The excised mass microscopically showed lobules of mature fat cells with areas of fibrous septae which have blood vessels and some nerves. The histopathological report revealed a diagnosis of fibro lipoma with no signs of malignancy. The surgery was uneventful and a 6-month follow-up period showed a healed wound and the patient can fully step on her left foot. Conclusion: The rare nature of a lipoma found at the plantar surface of the foot makes this case interesting and the creation of awareness can help heighten the index of skepticism among clinicians especially when patients present with a swelling on the sole which has been traumatized. The Doppler ultrasound findings were different from our surgical findings; therefore, lipoma should be a differential diagnosis of swelling on the sole of the feet associated with trauma.
ABSTRACT
INTRODUCTION: Poorly controlled postoperative pain has been known to be characterized by longer post-operative care, longer hospital stays with increased readmission rates, and decreased patient satisfaction. Post-operative pain has been continuously addressed in the past three (3) to four (4) decades and has been shown that 20 to 80% of post-operative patients suffer ineffective pain management. OBJECTIVE: The study was aimed at assessing the factors that may predict the satisfaction of patients with early postoperative pain management following abdominal surgeries at the Komfo Anokye Teaching Hospital, Kumasi. METHODOLOGY: A descriptive cross-sectional study was conducted among patients who had undergone abdominal surgeries between October 2019 and December 2019 at the Komfo Anokye Teaching Hospital. Structured questionnaires based on the IPO-Q were used to obtain responses from the patients. Descriptive and Inferential statistical analysis were employed in analyzing the data obtained from the respondents of the study. RESULTS: 138 patients were involved in this study. The mean age of patients in the study was 45.81 (±16.81) years. A higher percentage, 58.7% of the patients were males. 39.1% had completed their tertiary level of education. The majority (50.7%) of the patients had had persistent pain for more than three (3) months. The satisfaction of the patients with the post-operative pain management received was generally high among a significant majority of the patients. Meanwhile, among the factors that influence the satisfaction of the patients with the post-operative pain management received, type of analgesia and pain relief methods (Pearson Coefficient = 0.523, p-value <0.05), patient's ability to request more pain relief, (Pearson Coefficient = 0.29, p-value <0.05), patient's access to information about their pain treatment options from the Nurses (Pearson coefficient = -0.22, p<0.05), were the only predictors of satisfaction in patients. CONCLUSION: This study found out that patients were generally satisfied with the post-operative pain management offered by their healthcare providers although the degree of satisfaction depended largely on the type of analgesia and pain relief methods, the ability to request for more pain relief, and access to information on pain treatment.
