Tube Caecostomy: A Veritable Alternative in the Surgical Treatment of Advanced Appendicitis | Chapter 03 | Current Trends in Medicine and Medical Research Vol. 2

Background: Advanced appendicitis poses a serious challenge to surgeons in poor resource settings and it is associated with a higher morbidity and mortality.

Objective: To report the outcome of tube-caecostomy in the prevention of fistula formation after appendicectomy for appendicular mass, abscess or gangrenous appendix.

Methods: A retrospective study involving all patients diagnosed with appendix mass, abscess and gangrenous appendix admitted into Central Hospital Benin City from October 2005 to October 2010. Data was collated from patient’s case notes, theatre records and the ward registers. The Stamm procedure using a size 24 three-way catheter as caecostomy tube was used.

Results: A total of 14 patients underwent tube caecostomy during appendicectomy. There were 10(71.4%) males and 6(28.6%) females. The male to female ratio was 2.5:1. The ages of the patients ranged from 14-42 years with mean age of 28.5 years. Seven (50%) of the cases had wound infection, three (21%) had wound dehiscence. Hospital stay ranged from 14 to 33 days with a mean stay of 19.1 days. No serious catheter related complications nor residual abscess were recorded and there were no mortalities in this study.

Conclusion: Tube caecostomy as a procedure performed for advanced appendicitis is a favourable alternative to interval appendicectomy, right hemicolectomy and ileostomy. The latter two procedures require an experienced surgeon and are fraught with a high morbidity and mortality.

Biography of author(s)

O. Eboreime
Department of Surgery, Central Hospital, Benin City, Edo State, Nigeria.

Z. I. Asogun
Department of Surgery, Central Hospital, Benin City, Edo State, Nigeria.

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Prevalence of Human Papillomavirus Deoxyribonucleic Acid in Cervical Cancer Specimens in Calabar, Nigeria | Chapter 02 | Current Trends in Medicine and Medical Research Vol. 2

Aim: To determine the prevalence of Human Papillomavirus (HPV) deoxyribonucleic acid in cervical cancer specimens in Calabar, Nigeria.

Study Design: This is a retrospective prevalence, a cross-sectional study on archival cervical cancer specimens.

Place and Duration of Study: This study was done at the department of pathology, University of Calabar Teaching Hospital, Calabar, on cervical cancer specimens between 1st January 2009 and 31st December 2014.

Methodology: Paraffin-embedded tissue block of all the invasive cervical cancer specimen received during the study period were collected. Basic socio-demographic data were obtained from the medical records. Sections of the tissue were obtained from the blocks, digested using proteinase K solution and the DNA was extracted. A polymerase chain reaction and DNA enzyme immunoassay (DEIA) was done. The results of the DNA enzyme immunoassay were read, and the samples were categorized as HPV DNA positive or negative.

Results: One hundred and twenty-three cervical cancer specimens were analysed. There were one hundred and ninety-six gynaecological malignancy specimens received during the study period, giving an invasive cervical cancer prevalence of 62.7% among the gynaecological malignancies in the centre. The samples were from female subjects aged from 32 to 75 years. Their mean age was 48.6 ± 10.6 (years). A majority (86) which made up 69.9% of the subjects was below 51 years. The peak age group of the disease among the subjects is 42 – 51 years. One hundred and thirteen (91.90%) of these samples were HPV DNA positive while ten (8.10%) of the samples were HPV DNA negative. The prevalence of HPV DNA in the samples by age group distribution shows the highest prevalence of 38.6% from the 42-51 years age group followed by those in a 31 – 40 years age group (33.3%), 61 – 70 years (16.7%),  51 – 60 years (10.5%) and the age group with the lowest prevalence is >70 years (1.6%).

Conclusion: There is a need for the precise pattern of HPV DNA prevalence in cervical cancer in every part of the world to be established. The fill of this knowledge gap would help in enhancing the development of strategies targeted at the elimination of cervical cancer globally.

Biography of author(s)

Godstime I. Irabor
Department of Pathology, Saba University School of Medicine, Saba, Netherlands.

Dominic Akpan
Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada.

Kenneth A. Omoruyi
Department of Pathology, University of Calabar Teaching Hospital, Calabar, Nigeria.

Martin A. Nnoli
Department of Pathology, University of Calabar Teaching Hospital, Calabar, Nigeria.

Edoise M. Isiwele
Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria.

Uchenna M.Amaechi
Department of Internal Medicine, Lagos University Teaching Hospital, Lagos, Nigeria.

Olukayode Oshatuyi
Department of Biochemistry, Ebonyi State University, Abakaliki, Nigeria.

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Therapeutic Uses of Eltrombopag and Romiplastin in Hepatitis C and Thrombocytopenia: A Review | Chapter 01 | Current Trends in Medicine and Medical Research Vol. 2

Eltrombopag, is a thrombopoietin receptor agonist is used to increase the number of platelets sufficient to decrease the risk of bleeding in thrombocytopenia patient and also allow treatment with interferon and ribavirin in people suffering with Hepatitis C. It is not used to increase platelets to a normal level. Eltrombopag should not be used to treat people having low numbers of platelets in patients other than immune thrombocytopenia or hepatitis C patients. Eltrombopag is thrombopoietin receptor agonists and works by creating the cells in the bone marrow to produce more platelets. It is an orally bioavailable molecule with the potential to benefit patients with a wide range of thrombocytopenias including thrombocytopenia secondary to chronic liver disease. Chronic hepatitis C is a public health problem all over the world. Eltrombopag can be a solution for many patients as it will allow for antiviral therapy and getting a sustained virological response, but requires proper monitoring to prevent possible bone marrow complications or liver failure occurrence. Eltrombopag, and thrombopoietin can be used effectively in treatment of thrombocytopenia and hepatitis C.

Biography of author(s)

Sachin Kumar Jain
Associate Professor in the Department of Pharmacognosy, IPS Academy College of Pharmacy, Indore MP India affiliated to RGPV technical University Bhopal MP India.

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