African Journal of Medicine and Surgery

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 9 (8), pp. 001-004, August, 2022. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Impact of Surgical Magnitude on Serum Ferritin and Iron Levels: A Comparative Study of Healthy Women and Surgical Patients

M. F. Asaolu¹*, A. O. Oyeyemi¹ and J. B. Fakunle²

¹Department of Biochemistry, University of Ado-Ekiti, Nigeria.
²Department of Chemical Pathology, Obafemi Awolowo University, Ile-Ife, Nigeria.

Accepted 21 May, 2022

Abstract

This study was carried out on serum ferritin, acute phase reactants (APR), iron (Fe) and total iron binding capacity (TIBC) in healthy women in Ado Ekiti, Nigeria and in female patients undergoing suture (minor operation) and ceaserean operations at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria between February and March, 2009. The results revealed post -operative serum ferritin and APR concentrations to be significantly higher (p > 0.01) while iron and TIBC were significantly lower in patients undergoing caesarean operation compared to both patients with minor operation and healthy women. The pre-operative results of serum ferritin were however significantly lower in patient undergoing major operation than in patients with minor operation. The present study was carried out to examine the changes in serum ferritin and other acute phase reactants in response to the magnitude of tissue damage. It can be concluded that the concentrations of serum ferritin and acute phase reactant increases as the magnitude of tissue damages increases. There is an acute phase response of serum ferritin levels following major surgery.

Key words: Suture, surgery, ceaserean, acute phase reactants.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 9 (7), pp. 001-003, July, 2022. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Awareness and Health-Seeking Behavior in Patients with Stress Incontinence: Insights from a Prospective Study

Eric Kinoti Mutema

SPR-Royal Preston hospital, Lancashire. E-mail: [email protected].

Accepted 28 September, 2021

Abstract

A prospective study was done to look at the awareness of patients to the availability of treatment for stress incontinence and whether this would have altered their health seeking pattern. Stress incontinence is when urine leaks because there is a sudden extra pressure ('stress') on the bladder. Questionnaires were distributed to all the patients admitted for continence surgery (n = 26). A second cohort included all patients attending the gynaecological outpatient clinic for any reason during a period of 2 months (n1 = 65) comprising of 2 groups A and B. After 1 month, a simple poster reminding patients with continence problems to discuss this with the doctor they were about to see. Group A was before and group B was after the implementation of the poster. In the pre-operative group, 26 patients completed the questionnaire. Of these 19 (73%) had been experiencing symptoms of involuntary urine leakage for more than 3 years. Majority of them had been referred for treatment following consultation with their doctor for an unrelated complaint. Only 42% (11) of the patients had seen the GP for the incontinence per se. More than 80% (22 patients) delayed in seeking treatment due to lack of awareness of treatment availability. With the introduction of the poster, there was an increase from 10 - 60% of patients informing the doctor of their incontinence complaints in the outpatient clinic. Lack of awareness was found to be the main reason for delayed/failure to seek treatment for incontinence.

Key words: Stress incontinence, medical taboo, lack of awareness, WHO initiative.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 9 (6), pp. 001-005, June, 2022. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research paper

Evaluating Inflammatory Responses in Total Hip and Knee Arthroplasties: Insights from Blood Transfusion and Ischemic Extremity

Motoki Sonohata*, Kenji Tsunoda, Hajime Kugisaki, Shinsuke Someya, Hidefumi Honke, Mitsunori Komine, Masaru Kitajima, Masaaki Mawatari and Takao Hotokebuchi

Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Japan.

Accepted 2 November, 2021

Abstract

This study aims to clarify the difference between surgical stress of total hip arthroplasty (THA) and total knee arthroplasty (TKA) under the same conditions through blood transfusion and ischemic extremity. Body temperature, white blood cell (WBC) count, the level of C- reactive protein (CRP), and interleukin-6 (IL-6) were measured for eleven patients undergoing THA and eight patients undergoing TKA. All the patients who underwent THA and TKA received a transfusion of 2 units of autologous blood but no transfusion with homologous blood, and the TKA surgery was performed without an air tourniquet. The first day after the surgery, there was no significant difference between the THA and TKA with respect to body temperature and CRP. However, there was a significant difference between the THA and TKA in WBC count (p < 0.05) and IL- 6 (p < 0.01) on the first day after the surgery. In addition, there was a significant difference between the THA and TKA in IL-6 (p < 0.05) and CRP level (p < 0.05) on the seventh day after the surgery. The surgical stress of TKA was significantly larger than the surgical stress of THA. There may be more potential complications in the patients who underwent TKA than those who underwent THA.

Key words: Cytokine, surgical stress, total hip arthroplasty, total knee arthroplasty.

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 9 (5), pp. 001-004, May, 2022. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Cross-Match to Transfusion Ratios: Implications for Blood Management and Cost Efficiency in Hospital Settings

Enosolease Mathew Ebose¹* and Imarengiaye Charles Osalumese²

¹Department of Haematology and Blood Transfusion, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria, and University of Benin Teaching Hospital, P. M. B. 1111, Benin City, Nigeria. ²Department of Anaesthesiology, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria.

Accepted 05 January, 2022

Abstract

The objective of this work is to audit blood utilization by different specialties in the hospital using the Cross-match ratio as a guide to achieving effective transfusion practices. This was a prospective study. The blood bank of University Teaching Hospital in Benin City, Nigeria was used for the study. We analysed all blood orders from January to December, 2008. Data collection included number of units of red blood cells ordered and the origin of the orders, the actual numbers of units transfused and points of use. A total of 8988 units of red blood cells were available but 19147 cross-matches (units) were ordered for 3067 patients, representing approximately 6 cross-match per patients and the mean cross-match/transfusion ratio of 2.2 (19147/8988). Cross-match/transfusion ratio for various departments/units were: Medicine 1.8; Paediatrics 2.6; Obstetrics and Gynaecology 1.6; Surgery /Orthopaedics 3.3; Accident and Emergency 3.3 and Theatres 1 and the probability that cross-matched blood might not be used were 43, 61, 39, 70, 0 and 58%, respectively. Cost implication of unnecessary cross-match was 7, 879,500:00 Nigeria Naira (69,118.42 United States Dollar) per annum with surgical units accounting for nearly 3,000,000:00 Nigeria Naira (26,315.9 United States Dollar) for the period of the study. Cross-match orders and C/T ratio vary from one department or unit to another. The unnecessary cross-match has financial and personnel implications on transfusion service in the hospital. It may be clinically prudent to streamline transfusion and cross-match orders so as to ensure the best transfusion practices.

Key words: C/T ratio, blood transfusion, cost of cross-match.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 9 (4), pp. 001-004, April, 2022. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Uncommon Presentation of Factor XIII Deficiency: Two Cases of Spontaneous Splenic Rupture in Young Patients

Kakil Ibrahim Rasul*, Mohamed Sadiq Ahmed and Abdul-Rahman Zar Gul

Hamad Medical Corporation, Al-Amal Hospital, P.O. Box 3050, Doha, Qatar.

Accepted 23 September, 2021

Abstract

Factor XIII deficiency is a rare bleeding disorder, and spontaneous spleen rapture is not reported in cases of this disorder. We report 2 cases of spontaneous ruptured spleen in 2 young Pakistani boys who were known factor XIII deficiency who were presented at the same time within 24 h. Both cases were recovered and one was successfully treated conservatively while the other treated surgically by spleenectomy. It should also remind physicians that bleeding disorders may have unusual presentations and should keep in mind ruptured spleen in the differential diagnosis of patient with factor XIII deficiency presenting with acute abdomen. The treatment is either surgery or conservatively depending on the progress of the bleeding.

Key words: Factor XIII deficiency, ruptured spleen, bleeding diathesis.
 

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 9 (3), pp. 001-007, March, 2022. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Review

Exploring the Genetic and Therapeutic Landscape of Gastrointestinal Stromal Tumors: A Case of Successful Intervention in Metastatic Disease

Ali Mahmood^1*, Martin Luchtefeld^2, Anthony Senagore³ and Allen Silbergleit⁴

¹Department of Colon and Rectal Surgery, Colorectal Surgical Associates, 7900 Fannin, Suite 3700, Houston, TX
77054, USA.
²Department of Colon and Rectal Surgery, The Ferguson Clinic, Grand Rapids Medical and Educational Center,
Michigan State University, 1000 Monroe NW, Grand Rapids, MI 49503, USA.

³Department of Colon and Rectal Surgery, Vice President, Research and Medical Education Spectrum Health, Grand Rapids Medical and Educational Center Michigan State University, Grand Rapids, MI 49503.
⁴Wayne State University School of Medicine St. Joseph Mercy Oakland Hospital 44405 Woodward Avenue Pontiac, MI

48341.

Accepted 15 September, 2021

Abstract

Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors arising from the interstitial cells of Cajal. Originally thought to be leiomyosarcomas, these tumors are traditionally resistant to chemotherapy and radiation therapy. Molecular studies have identified the gene mutations that cause these masses to proliferate. The KIT proto-oncogene and PDGFRA mutations have been successfully implicated as the insults leading to disease. We present a 54 year old male, whose tumor was very aggressive yet multi-modality therapy did show an excellent response. Discovered incidentally while he was undergoing a sigmoid colostomy for benign disease, the patient had evidence of metastatic GIST disease. We utilized radiology, pathology and immunohistochemistry to provide a definitive diagnosis. Radiology was extremely useful in identifying disease and possible metastases. Furthermore the use of PET scans, particularly PET/CT allows clinicians to monitor and tailor therapy. Successful management of GISTs involves medical and surgical therapy. Imatinib mesylate is a drug used to inhibit the production of the KIT proto-oncogene. Coupled with surgery, this combination holds promise in successful management and possible eradication of the disease.

Key words: Gastrointestinal stromal tumor, PET scan, Imatinib, gene therapy, small bowel obstruction.