African Journal of Medicine and Surgery

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 7 (8), pp. 001-008, August, 2020. © International Scholars Journals

Case Report

Intraoperative low molecular weight heparin and postoperative bleeding

Michael K. F. Choo

Department of Anaesthesia, Box Hill Hospital, Nelson Road, Box Hill, Victoria 3128, Australia. E-mail: [email protected]. Tel.: (03) 98953333. Fax: (03) 98953461.

Accepted 16 March, 2020

Abstract

A case of postoperative bleeding associated with low molecular weight heparin (LMWH) administration is reported. A literature search suggests that perioperative bleeding can be as high as 11% when LMWH is administered intraoperatively. When administered 6 h postoperatively, LMWH does not signi-ficantly increase the risk of bleeding whilst retaining efficacy for venous thromboembolism prophy-laxis. Although LMWH has not been shown to be superior when compared to unfractionated heparin for general surgery, advantages include no need for monitoring and once daily dosage. During an acute bleeding episode, bedside functional monitoring (e.g. thromboelastography) is appropriate rather than anti-Xa levels. To reverse LMWH, use protamine first to reverse its effects partially, followed by replenishing factor X and II with FFP/Prothrombinex. If bleeding continues, consider using activated factor VIIa.

Key words: Heparin, postoperative bleeding, venous thromboembolism

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 7 (7), pp. 001-003, July, 2020. © International Scholars Journals

Review

The significance of Candida infections of medical implants

INABO, H. I.

Department of Microbiology, Faculty of Science, Ahmadu Bello University, Samaru-Zaria, Nigeria. E-mail: [email protected].

Accepted 07 April, 2020

Abstract

Infection of medical implants is acquired at the time of instrumentation or surgery. It is an early complication of this intrusive procedure. Biofilm formation on implanted implants such as dentures, catheters or a prosthetic heart valve may lead to Candida infections. Factors affecting the biofilm formation and the risk factors associated with the implantation of the various medical devices are highlighted in this paper. The modification of biomaterial surface with anti–infective agents to enhance biocompatibility of the indwelling medical devices is discussed.

Keywords: Candida albicans, medical implants, biofilm, biomaterial manufacture.

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 7 (7), pp. 001-007, July, 2020. © International Scholars Journals

Full Length Research Papers

Breast self examination among female undergraduates in Enugu, Southeast, Nigeria

Okolie, Uchenna Virginia

Department of Nursing Sciences, Faculty of Health Sciences and Technology, College of Medicine,

University of Nigeria, Enugu Campus. Enugu, Nigeria. E-mail: [email protected]. Tel: +234 803 6741 302.

Accepted 15 May, 2020

Abstract

This study was a cross sectional descriptive survey that assessed the knowledge, attitude and practice of breast self examination (BSE) among university female nursing undergraduates. It also identified the factors that affected their practice of BSE. The total population of the female students (200) was used. The instrument used for data collection was the questionnaire and descriptive statistics were used to summarize the data. Fifty-eight percent of the respondents were between the ages of 21-25 years, 29% between 16-20 years while only 13% were between 26-30 years. Majority of them were Christians and single (88 and 85% respectively. Majority of the respondents had good knowledge of breast cancer and BSE as 84% knew that it has familial tendencies and 77% knew it can be caused by oral contraceptives. They also knew the symptoms such as discharge from the nipple (92%), change in the skin of the breast (80%), pain in the breast (80%) and swelling in the breast (68%). Majority (90%) knew about mammography and BSE (90%) as detection methods. Majority of the respondents (95%) knew how to do BSE, while 5% did not know how to do BSE. The respondents had a positive attitude towards BSE (Overall Mean ≥ 2.5). Most of the respondents (32%) affirmed that they examine their breasts after menstruation and (68%) anytime they felt like. Respondents identified forgetfulness, procrastination, laziness, lack of time, fear of discovering a lump, no trust in their practice ability as factors affecting their practice of BSE.

Key words: Breast cancer, breast self examination, knowledge, Practice, female nursing undergraduates

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 7 (6), pp. 001-004, June, 2020. © International Scholars Journals

Full Length Research paper

Histopathologic analysis of benign breast diseases in Makurdi, North Central Nigeria

Echejoh Godwins¹*, Dzuachi David² and Jenrola Akeem²

¹Department of Pathology, Jos University Teaching Hospital, Jos, Nigeria.

²Departments of Pathology/Surgery, Federal Medical Centre, Makurdi, Nigeria.

Accepted 16 May, 2020

Abstract

Most breast pathologies are benign. Benign breast diseases (BBD) constitute a spectrum of lesions ranging from developmental abnormalities, inflammatory lesions, epithelial and stromal proliferations to various neoplasms. Some of the women with BBD, especially those with proliferative lesions have been reported to be at increased risk for development of subsequent breast cancer. This is a retrospective analysis of all histopathologically diagnosed benign breast diseases in archival records of the department of Histopathology, Federal Medical Centre, Makurdi. The study period is January, 1997 to December, 2006. Two hundred and eleven cases of BBD (67%) were histologically diagnosed out of 315 breast biopsies within the study period, and fibroadenoma 95(45%), was the most frequent diagnosis followed by fibrocystic changes which constituted 67(31.8%). The age of the patients ranged from 14 to 63 years with the mean age of 32.2 ± 9.4 years. The most recurring presenting complaint was painless breast lump.

Key words: Benign breast diseases, histopathology, neoplasm, proliferative, inflammatory.

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 7 (6), pp. 001-005, June, 2020. © International Scholars Journals

Full Length Research paper

Radiological findings of breast cancer screening in a newly equipped centre

Halimat J. Akande*, Olalekan I. Oyinloye, and Bola B. Olafimihan

Department of Radiology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.

Accepted 21 April, 2020

Abstract

This study is to appraise the imaging findings of all patients that came into the breast imaging unit for screening and perhaps buttress the importance of a government policy guideline on screening and treatment for breast cancer in Nigeria. This prospective study was carried out among all consecutive patients that came for screening in the breast imaging unit of the University of Ilorin Teaching Hospital (U.I.T.H), Ilorin, Kwara State, Nigeria, between April, 2009 and January, 2011. Aloka prosound SSD-350+ ultrasound machine equipped with linear and curvilinear 7.5- 10 MHz transducers was used for breast scan in longitudinal, transverse, radial and anti-radial planes. Mammograms were acquired with a GE Senographe DMR machine using two standard views (cranio-caudal and mediolateral oblique) and additional views where necessary. The biodata were retrieved from the request forms or directly from the patients and the imaging findings and prospective breast imaging reporting and data system (BIRADS) category assigned to each case were documented. These were analysed for this study. One hundred and two women presented for screening mammogram and eight for screening breast ultrasound scan. The age range was 31 to 75 years (49.7years +/- 7.65) and the modal age was 50 years (8.2%). With the modalities combined, majority of the patients (46.36%) had BIRADS 2, with 36.36, 15.45 and 0.9% having BIRADS 1, 3 and 0 respectively. A patient (0.9%) had BIRADS 5 assessment category. This study was able to detect positive and other negative lesions. The positive case was seen in a woman that presented voluntarily for screening. Mammography is becoming available in this part of the world and increased public awareness is necessary to optimise its use. However, the high cost of screening and treatment of cancer might be a limiting factor, thus a well planned government policy on screening and treatment of breast cancer will go a long way in reducing the morbidity and mortality from this dreaded disease.

Key words: Breast cancer screening.

African Journal of Medicine and Surgery ISSN 2756-3324 Vol. 7 (5), pp. 001-006, May, 2020. © International Scholars Journals

Full Length Research paper

Neuroimaging findings in breast cancer: A systematic qualitative review

Francine Nunes Ferreira¹, Arthur Guerra de Andrade^1,2 and Tânia Correa de Toledo Ferraz Alves^1,2,3*

¹ABC Region Medical School, Department Psychiatry, Santo Andre, Brazil.

²Departament of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.

³2000, Lauro Gomes Avenue, 09060-870 Santo Andre-SP, Brazil.

Accepted 18 March, 2020

Abstract

Patients with breast cancer treated with chemotherapy may develop neuropsychiatric symptoms, including fatigue and depression. The authors discuss the potential use of structural neuroimaging in the identification of these patients. Findings from neuroimaging studies improve our understanding of the wide-ranging neurobiological changes in breast cancer patients. We set out to determine whether neuroimaging studies had identified brain abnormalities in association to the presence of breast cancer. A qualitative systematic review of all structural neuroimaging studies in subjects with breast cancer was carried out. Studies were identified using general medical and specific databases as well as search engine such as PUBMED, EMBASE and COCHRANE based on current contents and other secondary sources. Systematic review of results from ten studies led to the observation that different brain areas might be vulnerable to the presence of breast cancer. The most striking observation was the extreme variability of the results observed in different studies. Some variability in the results was associated to different imaging analysis, presence of neuropsychiatric symptomatology (depression and post traumatic stress) and use of co adjuvant chemotherapy. Evidence from neuroimaging studies has suggested areas of the brain that may be damaged by the presence of breast cancer or direct effect of chemotherapy. The clinical implications of these neuroimaging findings need to be investigated further, as they challenge traditional therapeutic approaches.

Key words: Breast cancer, neuroimage, depressive symptoms, chemotherapy, cognitive function.