Determinants of outcome of final undergraduate surgery examinations in a Nigerian University.

BACKGROUND: Medical students' assessment is an important aspect of medical undergraduate training that requires periodic review to achieve objectivity and improve training. We reviewed the outcome and factors that influenced outcome of undergraduate students' final surgery examination. MATERIALS AND METHODS: Final examination records of undergraduate medical students in surgery from a single institution for 5 years (2013-2017) were retrospectively reviewed. Scores of the students in continuous assessments (CA), multiple-choice questions (MCQs), essays, long case, short cases, orals, and objective structured clinical examinations (OSCE) were extracted as appropriate. The data were analyzed using SPSS® for Windows version 21. RESULTS: A total of 960 candidates' results were analyzed over 5 successive years, 722 candidates (75.2%) were males, and 238 (24.8%) were females. The overall pass rate was 62.6%. Success rate in the clinical examinations was higher in females (84.5%) compared to males (72.7%). χ2 = 13.381, P < 0.001. MCQs section of the examinations had the highest failure rate (49.5%). Female gender (P < 0.001), passing CA (P < 0.001), and shorter duration-<9 years in medical school (P < 0.001) were strongly associated with passing the final surgery examination. Pass rate was 73.1% for females and 56.2% for males during the OSCE period. CONCLUSION: CA is the single most important determinant of success in final surgery examination, while MCQs constitutes the most difficult aspect of the examinations. Irrespective of method of assessment, females seem to do better than males.

Fluconazole in the therapy of multiple osteomyelitis in African histoplasmosis.

Amphotericin B has been the standard treatment for deep mycoses including African histoplasmosis, but its use is complicated by its toxicity. More recently, Fluconazole, a water-soluble triazole with antimycotic activity and little side effects, has become available. A case of African histoplasmosis from Nigeria, manifesting as multiple osteomyelitis and successfully treated with oral Fluconazole, is presented. Fluconazole may be preferred in the therapy of African histoplasmosis.

African histoplasmosis: osteomyelitis of the radius.

Bone lesions in African histoplasmosis caused by Histoplasma capsulatum var, duboisii, without other signs of the infection, are often misdiagnosed as cancer. A case of isolated osteomyelitis due to this fungus in a 30-year-old woman is described. Diagnostic and therapeutic problems of isolated bone lesions in African histoplasmosis are discussed. A high diagnostic index of African histoplasmosis is advocated in isolated bone lesions in the endemic region of this disease.

Madelung's Deformity

We have presented a case of bilateral Madelung's deformity in a 15-year-old Nigerian girl. The authors believe that this is the first case to be reported in Nigeria. The deformities were corrected surgically by a combination of Darrach's procedures and bi-plane osteotomy. The clinical and radiological features were highlighted with particular reference to subluxation of the lower ulna; bowing of the distal radius and ulna; increase in interosseous space; lucency in the medial end of the distal radius; triangularization of the distal radial epiphysis and wedging of the carpal bones with the lunate at the apex and bayonet deformity of the hand. It is hoped that these features will help to unravel more cases and enable the correct incidence of this deformity to be determined in Nigeria