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   Table of Contents - Current issue
Coverpage
April-June 2020
Volume 10 | Issue 2
Page Nos. 43-71

Online since Thursday, May 20, 2021

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ORIGINAL ARTICLES  

Transurethral resection of the prostate: An initial experience in a tertiary health institution p. 43
Ahmad Tijjani Lawal, Muhammed Ahmed, Muhammad Jami'u Isah, Awaisu Mudi, Sudi Abdullahi, Nasir Oyelowo, Musliu Adetola Tolani, Hamza Babatunde Kolapo, Ahmad Bello, Hussaini Yusuf Maitama
DOI:10.4103/ais.ais_15_20  
Background: Transurethral resection of the prostate (TURP), is the gold standard treatment for prostatic obstruction. TURP is associated with less morbidity. Despite this obvious edge, limited availability, access, and affordability are major drawbacks to the utility of this treatment modality in our setting. The purpose of this study is to examine our initial experience with TURP. Patients and Methods: Patients undergoing TURP in our institution over a period of 20 months (April 2013–November 2014) were prospectively followed. Consecutive patients who hadprostatic obstruction and indication for TURP were included in this study. Patients with contra-indications to TURP were excluded from this study. Informed consent was routinely obtained preoperatively. Patients' demographics, pre-, intra- and post-operative clinical records, and outcome details were entered into pro formas. The results were analyzed using descriptive statistics. Results: Fourteen men with a median age of 66.5 years (50–102) were included in this study. The mean prostate size was 56 g (32–91). They all had bothersome lower urinary tract symptoms (LUTS). Nine (64.3%) were in the middle socioeconomic class, whereas five (35.7%) were in the lower class. The mean duration of hospital stay was 4.3 days. Thirteen of the patients (92.9%) stayed for ≤7 days. One of the patients (7.1%) had a duration of hospital stay of nine days. Three patients (21.3%) had postoperative complications. The mean follow-up was 10 months. All had a satisfactory patient-reported subjective outcome at follow-up. Conclusion: TURP was found to be effective, and associated with few peri-operative morbidities. These findings, however, remain to be verified with long-term studies involving a larger number of patients.
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The burden of urinary incontinence in late pregnancy: Antenatal clinic experience in a tertiary hospital in Northern Nigeria p. 47
Asma Irshad, Sana Irshad, Adebiyi Gbadebo Adesiyun, Hajaratu Umar Sulayman, Khaleequr Rahman, Nana Hawwa Madugu
DOI:10.4103/ais.ais_31_20  
Background: Urinary incontinence is an under-diagnosed and underreported problem especially among women living in developing countries. Pregnancy is one of the most consistent risk factors in the development of urinary incontinence in women with prevalence increasing with gestational age; being more marked in the late second and third trimester resulting in detrimental effects on the quality of life women live. The objective of this study was to determine the prevalence of urinary incontinence in late pregnancy and help identify women at risk who would benefit from interventions during and after pregnancy. Patients and Method: This was a cross-sectional study that was conducted to determine the prevalence of urinary incontinence in late pregnancy using a structured interviewer administered questionnaire. Respondents were recruited from the antenatal clinic of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. The result was analyzed using SPSS version 20. Results: The prevalence of urinary incontinence was found to be 26.20% with the majority of the respondents having symptoms in keeping with stress urinary incontinence (57.2%) while 34.1% had urgency urinary incontinence and 8.6% had mixed urinary incontinence. Conclusion: There is a high prevalence of urinary incontinence in pregnancy in our environment with every 1 in 5 women being affected. The antenatal period is an opportunity to identify such patients so as to ensure continuity of care and effective referral in order to improve outcome in women at risk.
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CASE SERIES Top

Glomus tumour: A review of clinical presentation and treatment p. 52
Ibad Sha, Ajin Edwin, Namitha Shah, Roshna Cini
DOI:10.4103/ais.ais_25_20  
Glomus tumors are perivascular hamartomas originating from glomus apparatus which are rare in occurrence and have a higher predilection for the subungual region of the hand. We retrospectively analyzed the management and outcome of patients with subungual glomus tumor treated over a period of 5 years from January 2013 to December 2018. Clinical evaluation included Love's test, Hildreth's test, and cold sensitivity tests. X-ray and MRI were done for all patients. Transungual approach was used in the treatment of all the patients. Total of seven cases were included in the study (6 females and 1 male). Mean age was 30.4 years with a range from 21 to 42 years. Average duration of complaints was 1.6 years ranging 1-3 years. Bone involvement was detected only in one case. Average size of the lesion was 2.7 mm ranging from 1.8 to 4 mm. Post operatively there was no nail deformity except in one patient.
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CASE REPORTS Top

Cutaneous squamous cell carcinoma of the neck: Dramatic response to cytotoxic chemotherapy or spontaneous regression? p. 57
M Daniyan, MM Dauda, AA Liman, SE Nwabuoku, M Abubakar
DOI:10.4103/ais.ais_29_20  
Skin cancers are common worldwide though incidence is higher among Caucasians. While basal cell carcinoma (BCC) is more common among Caucasians, squamous cell carcinoma (SCC) is the most common non-melanoma skin cancer in Nigeria as well as in other African countries.The Standard of care remains surgical resection with preservation of function and cosmesis, followed by adjuvant radiotherapy. Occasionally, however, systemic chemotherapy may be indicated. When it is, Cisplatin-based regimen has been the standard of care. We hereby report two cases of high risk cutaneous SCC with a dramatic response to preoperative Cisplatin/Methotrexate combination chemotherapy and highlight the possibility of spontaneous regression of SCC.
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Pyloroduodenal duplication cyst presenting like hypertrophic pyloric stenosis p. 63
Tunde T Sholadoye, Saidu U Abdulkarim, Halima O Aliyu, Oluseyi O Ogunsua
DOI:10.4103/ais.ais_11_20  
Gastrointestinal duplication cyst is a rare congenital anomaly. When it involves the pylorus or the first part of the duodenum, it may present with features of gastric outlet obstruction. We present a 4-month-old baby girl, second of a set of twins who presented with features of gastric outlet obstruction. A diagnosis of gastric outlet obstruction querying hypertrophic pyloric stenosis was made and she was resuscitated. The intraoperative finding was that of a huge non-communicating duplication cyst involving the pylorus and the first part of the duodenum. Excision and mucosal stripping of the cyst was done. Histology showed ectopic gastric mucosa. Pyloroduodenal duplication cyst is a rare congenital anomaly of the gastrointestinal tract and a close differential for patients who present too early or too late with features of Hypertrophic pyloric stenosis.
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Self-inflicted urethral and vesical foreign bodies – Case report p. 66
Jayant Nikose, Mayank Agrawal, Venkat A Gite, Prakash Sankapal
DOI:10.4103/ais.ais_37_20  
Foreign bodies in the lower urinary tract are rare with self-infliction for sexual gratification as the commonest reason. Presenting complaints are lower urinary tract symptoms, abdominal pain, and haematuria. We report two cases of self-inflicted foreign bodies in the lower urinary tract of adult male patients; one by an electrical wire and another by Bengal grams. Bengal gram as the foreign body has never been reported previously. X-ray, ultrasound, and computed tomography of the KUB region help to confirm the diagnosis. The primary goals of treatment are safe removal of foreign bodies, avoiding iatrogenic injuries to the lower urinary tract, and preservation of the sexual function. Endoscopic management is the commonest procedure performed and described in such cases. We were able to manage both cases endoscopically. Psychiatric consultation and appropriate counselling should be given to prevent further repetitions of such acts in the future.
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Primary renal squamous cell carcinoma: A case report and literature review p. 69
Abdullahi M Ahmad, Ali B Umar, Sani A Ali
DOI:10.4103/ais.ais_42_20  
Squamous cell carcinoma is an aggressive but rarely diagnosed cancer of the kidney. Most cases occur in association with renal calculi and thus require a high index of suspicion for their diagnosis. Though aggressive, it usually presents at a late stage and has an average 5-year survival rate of less than 10%. This is a case report of a 61-year-old male who presented with right flank pain and swelling of 4 years duration and fever and weight loss for 4 months. There was no hematuria and urinalysis and serum chemistry were within normal limits. A tumor in the right kidney was identified clinically and by computerized urography (CTU). At nephrectomy, multiple stones, hydronephrosis and pyonephrosis were found in addition to the tumor in the right kidney. Histological examination revealed squamous cell carcinoma of the kidney.
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