Abstract Background: Emergency medical services for injured patients are grossly deficient in many parts of the low- and middle-income countries, including Nigeria. This allows the initial stabilisation and transportation of the injured to be done by untrained laypersons. This study sought to evaluate the effects of first responder training among university undergraduates in Nigeria. Materials and Methods: A 1-day first responder course was conducted for university undergraduates in Ilorin, Nigeria. Pretest and post-test were performed to measure first aid knowledge improvement and improved confidence in providing first aid care. Results: A total of 127 university undergraduates (56.7% female), whose median age was 21 years, completed the training. About 61% of the trainees had no previous exposure to first aid training. The mean knowledge score improved from 40.2% before the training to 66.5% after the training ( P < 0.0001). The results demonstrated significant improvement in most areas of first aid knowledge assessed. The greatest increase in knowledge was observed for bleeding control. There was also an increase in the mean skill confidence score from 2.77 to 4.69 ( P = 0.01). Conclusion: This study has shown that basic first responder training improves students’ knowledge and perceived skill confidence in the provision of first aid care. Further research is underway to assess knowledge retention and skill utilisation during follow-up.
Abstract Background: Contrast swallow (CS) under fluoroscopic guidance remains an important investigation in exploring functional and structural oesophageal disorders. However, paucity of functional fluoroscopic machines in most secondary/tertiary hospitals and diagnostic centres in Nigeria makes the investigation less popular. Commendably, many radiologists currently improvise static X-ray machines to produce “non-fluoroscopic” CS spot images useful in investigating structural oesophageal pathologies. Unfortunately, both fluoroscopic and static CS are often limited in younger children by sub-optimal positioning with attendant risk of aspiration in the uncooperative minor. Materials and Methods: This manuscript presents a simple modified technique for diagnosing structural oesophageal lesions in younger children using the regular over-table X-ray machine angulated 30° cranially, while the child is positioned in 30° semi-recumbent position on a wedged imaging plate for additional comfort and stability. Flavoured contrast agent was then given in the same position and spot images were obtained. CS images/reports of younger children (≤6 years) conducted by a consultant radiologist over a 3-year period using the aforementioned technique were also reviewed. Results: The 22 retrieved cases of CS included children with median age of 2.0 years. The most common indications were postoperative assessment of surgical correction (45.5%) and dysphagia following corrosive substance ingestion (31.8%). Corrosive oesophageal stricture (29%) was the most prevalent oesophageal structural abnormality reported. All the studies produced clear spot images with conclusive diagnostic quality. Conclusion: Although not previously reported in published English literature, non-fluoroscopic CS in semi-recumbent position is helpful in assessing structural oesophageal abnormality when fluoroscopy is unavailable.
Abstract Pericardial diseases are common in clinical practice and may occur in isolation or form part of systemic disease. The clinical presentation of patients with pericardial disease is dependent on multiple factors, including the rate and volume of pericardial fluid accumulation, chronicity of the inflammatory process, and the degree of pericardial fibrosis and calcification. Cardiac tamponade and pericardial constriction are life-threatening sequelae of pericardial diseases, occurring in the acute and chronic stages, respectively. The management of pericardial diseases is multidisciplinary and may require surgical intervention. The aim of this study was to review our institutional experience in the surgical management of pericardial diseases. Materials and Methods: We conducted a single-centre retrospective review of records of patients with pericardial diseases managed over a 5-year period spanning from August 2018 to 2023. Result: A total of 141 patient records were analysed for the study period with a male-to-female ratio of 1:1.39 and a mean age of 32.7 ± 18.82 years. Tuberculous pericarditis was the most frequent cause of pericardial disease (53%), with most (74%) patients presenting with pericardial tamponade. Conclusion: Pericardial diseases are common reasons for presentation, and tuberculous pericarditis ranks highest. There are notable challenges in diagnosis and treatment. Surgical morbidity and mortality could improve with the addition of recent advanced techniques to our diagnostic and surgical armamentarium.
Abstract Background: Data describing baseline demographics, clinical characteristics, and obesity-related comorbidities among patients seeking bariatric interventions in Sub-Saharan Africa are limited. We describe demographics, obesity class, procedure selection, and comorbidity prevalence among patients undergoing intragastric balloon (IGB) or sleeve gastrectomy (SG) at a private center in Nigeria. Materials and Methods: Retrospective analysis of prospectively collected electronic records for adults (≥18 years) who underwent IGB ( n = 113) or SG ( n = 55) between January 2023 and January 2025 was performed. Data on demographics, anthropometrics, obesity class, and comorbidities were extracted. Group comparisons used χ 2 for categorical and t -tests or Mann–Whitney U for continuous variables; with the significance set at P < 0.05. Results: A total of 168 patients (92.3% female) were included; mean age 35.4 ± 9.4 years. SG patients presented with higher mean body mass index (SG: 43.1 ± 6.8; IGB: 39.3 ± 7.9 kg/m 2 ; P = 0.003) and weight (SG: 122.8 ± 19.9 kg; IGB: 111.7 ± 26.0 kg; P = 0.006). Higher obesity classes (IV–V) were more frequent in SG (38.2% combined) than IGB (18.5% combined; P = 0.013). Overall, 47.0% had ≥1 comorbidity; the prevalence was higher in SG (56.4% vs 42.5%; P = 0.09). Hypertension was the most common comorbidity (28.6%), and male patients ( n = 13) carried a disproportionate comorbidity burden (≥1 comorbidity 84.6% vs 43.9% in females; P = 0.01) and had a higher prevalence of hypertension, diabetes, dyslipidemia, and obstructive sleep apnoea. Conclusions: Bariatric interventions in Nigeria are predominantly sought by younger women. Patients opting for SG had significantly greater obesity severity and tended towards higher comorbidity rates. Men were underrepresented but had markedly higher comorbidity burden when presenting for care. These findings highlight gender disparities, procedure selection patterns, and the need for broader awareness and access to metabolic and bariatric services in Nigeria.
Abstract Background: Laparoscopic cholecystectomy (LC) is the recommended treatment for benign gall bladder diseases. Difficult LC (DLC) is a recognised cause of prolonged surgery, the need for conversion to open procedure, and postoperative complications. The identification of the predictors of DLC preoperatively may contribute to improved preoperative planning and surgical outcome. Aims and Objectives: To determine the rate of DLC and predictors of DLC in adult patients at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife. Materials and Methods: We retrospectively analysed data from 129 case notes of patients who had LC over a 7-year period using STATA 18. Patients were grouped into normal LC and DLC. Bivariate analyses were conducted using appropriate statistical tests. Relevant factors were entered into a multivariable logistic regression model to identify independent predictors. Significance was set at P < 0.05. Results: Mean age was 45.8 ± 14.6 with a 5.8:1 female to male ratio. Nearly a quarter of the patients ( n = 30, 23.3%) had a positive Murphy’s sign. Overall mean surgery duration was 76.8 ± 21.9, with a 38.8% prevalence of DLC. Four LC were converted to open ( n = 4, 3.1%). Positive predictors for DLC were age ≥60 years (adjusted odds ratio [AOR]: 3.34; 95% confidence interval [CI]: 1.02–11.02; P = 0.047) and a positive Murphy’s sign (AOR: 3.63; 95% CI: 1.41–9.32; P = 0.007). Conclusion: The low rate of postoperative complications and conversion to open procedure despite the significant DLC rate indicates that with improved expertise/skills of the surgeon, safe LC is feasible and could become the main approach for cholecystectomy in Nigeria.
