South African Journal of Surgery - Volume 46, Issue 4, 2008
Volume 46, Issue 4, 2008
Mucus: Slippery, sticky, but sweet and satisfying : 29th D. J. du Plessis Lecture, delivered at the Surgical Research Society Meeting, Cape Town, 3 July 2008 : D. J. du Plessis LectureAuthor Anwar Suleman MallSource: South African Journal of Surgery 46, pp 100 –105 (2008)More Less
It is indeed an honour to present the 29th D. J. du Plessis lecture in memory of the man who was Chair and Head of the Department of Surgery at the University of Witwatersrand (Wits), a teacher, an academic, and in the latter part of his career between 1978 and 1983, Vice-Chancellor of Wits (an unenviable position during turbulent times in the history of South Africa).
Delayed treatment of symptomatic breast cancer : the experience from Kaduna, Nigeria : general surgerySource: South African Journal of Surgery 46, pp 106 –110 (2008)More Less
Background. A cross-sectional study carried out at a teaching hospital in Kaduna, Nigeria, to investigate the extent and reasons for the delay between onset of symptoms and admission for treatment of symptomatic breast cancer.
Methods. The patients had histologically proven breast cancer and had been admitted for treatment. Data were obtained from interviews and patients' clinical and referral records.
Results. One hundred and eleven consecutive breast cancer patients were interviewed from July 2003 to June 2005. Only 12 (10.8%) could be admitted for treatment within a month of onset of symptoms. Delays were significantly associated with younger patients, elementary or no Western education, and domicile outside the Kaduna metropolitan area. Patients who were referred from, or received initial treatment at, peripheral hospitals had longer delays than those who came for first consultation at the teaching hospital. The proportion of early breast cancer cases (stages I and II) decreased from 45.9% at diagnosis to 25.2% at treatment, as concerns about mastectomy and hospital treatment led a significant number of the patients to temporarily abandon hospital treatment for alternatives, only to return with advanced cancers. The predominant reasons among the 99 patients who had delays of more than a month before admission were: ignorance of the seriousness of a painless breast lump (47.5%), nonacceptance of hospital treatment (46.5%), and preference for traditional treatment (38.4%). A significant number of patients referred from peripheral hospitals had inappropriate surgeries and biopsy management which contributed to the advanced stage on admission.
Conclusion. This study shows that delayed treatment of symptomatic breast cancer at this centre in Nigeria is as much related to the quality of medical care as it is to local beliefs, ignorance of the disease, and lack of acceptance of orthodox treatment.
A tension-free technique for the repair of large incisional hernias during abdominal surgery : results and long-term outcome : general surgerySource: South African Journal of Surgery 46, pp 112 –115 (2008)More Less
Incisional hernias have traditionally been treated by primary closure of the fascial defect. However, especially with large incisional hernias, this procedure exposes the suture to excessive tension and can result in two severe complications: acute respiratory insufficiency and early incisional hernia recurrence. The majority of surgeons have therefore given up performing primary repair.
Source: South African Journal of Surgery 46, pp 116 –118 (2008)More Less
Aim. To review cases of chronic osteomyelitis managed at a private health institution (Ela Memorial Medical Centre, Ilorin, Nigeria) between March 1995 and February 2005.
Patients and methods. Case notes and X-rays of the patients who presented at EMMC with chronic osteomyelitis were reviewed retrospectively. Age, sex, sites of bone involvement and outcome of treatment were recorded. Local surgical debridement (including saucerisation, sequestrectomy and curettage) was the cornerstone of treatment. All patients received antibiotics for at least 6 weeks.
Results. Of the 107 cases, 71 (66.4%) were males, with a male-to-female ratio of 2:1. The mean age was 21.9 years (range 1.5 - 80 years). Chronic osteomyelitis is most common in the first and second decades of life (55.2%) and mostly affects people <50 years of age (93.5%). Haematogenous osteomyelitis was the most common cause of chronic osteomyelitis (81.3%). The most common bone site was the tibia (32.7%). Nearly all (103) were adjudged cured; only 3 patients suffered a recurrence.
Conclusion. Chronic osteomyelitis is common in Nigeria. Most cases occur in the first and second decades of life, with haematogenous osteomyelitis being the most common cause. A high index of suspicion of osteomyelitis in children with septicaemia, and the proper treatment of patients with open fractures, will help to reduce the occurrence of the disease.
Source: South African Journal of Surgery 46, pp 120 –135 (2008)More Less
Ruptured internal carotid arteryaneurysm presenting with bloody otorrhoea and epistaxis as a result of ear syringing : letter to the editorSource: South African Journal of Surgery 46 (2008)More Less