Papers by victor Abhulimen
Zenodo (CERN European Organization for Nuclear Research), May 11, 2023
Background: Trauma is increasingly becoming a public health concern worldwide. Femoral fractures ... more Background: Trauma is increasingly becoming a public health concern worldwide. Femoral fractures resulting from trauma are challenging to manage. Definitive stabilization of the fractured femur shaft could be done by various methods. Locked intramedullary nailing is the gold standard for surgical stabilization and plating are two options for management. Both methods have advantages and disadvantages. Method: This is a prospective randomized study conducted in two centres, located in Port Harcourt metropolis over a period of twelve months. Ethical approval was obtained from both hospitals and informed consent was obtained. Data were analysed using Statistical Package for Social Science (SPSS) version 20. Results were presented in graphs and tables. Result: A total of 70 patients completed the study with 35 in each group. Males were more in number. The commonest cause of injury was motor vehicular accidents with n= 16 (45.7%) in the nailing group and n= 24 (68.6%) in plating group. The average time to weight bearing was 4 weeks for nailing and 9.26 weeks for plating. Also, the average time to return to normal activity was 8.31 weeks for nailing and 14.09 weeks for plating. The average time to early bony union was 14.49 weeks for nailing and 18.69 weeks for plating. Conclusion: Fixation of traumatic femoral shaft fracture using locked intramedullary nailing resulted in a shorter duration of hospital stay and early commencement of normal duties.
Journal of West African College of Surgeons
Background: Testicular cancers are rare malignancies. They are however very common in males aged ... more Background: Testicular cancers are rare malignancies. They are however very common in males aged 15–40 years. Reports of increasing incidence of testicular cancer in western countries have been noted. Despite the increasing incidence, mortality has remained low in these countries. There are few publications on the management of testicular tumors in Nigeria. Aim: The aim of this study was to determine the hospital prevalence and highlight our experience in the management of patients with testicular cancer. Materials and Methods: This was a 10-year retrospective study on patients diagnosed with histologically confirmed testicular cancer from January 2009 to December 2018. The case records were retrieved. Data obtained included biodata, clinical presentation, investigations, treatment received and outcomes. Data analysis was carried out using SPSS version 20.0. Results: Eleven patients with testicular cancer were managed during the study period, constituting 0.01% of new cases seen in the hospital. Peak age was 20–29 years (54.55%), with a mean age of 29.27 ± 9.51yrs. The most common presentation was painless scrotal swelling, observed in nine (81.8%) patients. Nine (81.8%) patients presented six months or more after onset of symptoms with advanced disease. Distant metastasis was seen in two (18.2%) patients. Right sided disease was found in seven (63.6%) and left sided disease in four (36.4%). All had radical inguinal orchidectomy. The most common histological diagnosis was seminoma in 8 (72.7%) patients. All the subjects were offered four courses of chemotherapy with bleomycin, etoposide and cisplatin. However, only four (36.4%) completed the chemotherapy. A statistically significant association was observed between the duration of symptoms and the disease stage (P = 0.003), and between number of chemotherapy sessions and survival (P = 0.02). Conclusion: Testicular cancer was an uncommon condition in the catchment area of the University of Port Harcourt Teaching Hospital, affecting relatively young men. The commonest presenting complaint was painless scrotal swelling. Most patients presented with Stage II disease, with seminoma being the commonest histopathology. All had surgical treatment; adjuvant chemotherapy improved 5-year survival. Public education is necessary to surmount sociocultural barriers to effective management of testicular tumors in our environment.
International Journal of Health, Medicine and Nursing Practice
Purpose: To compare the outcome of patients admitted to the ICU with Medical diagnoses against th... more Purpose: To compare the outcome of patients admitted to the ICU with Medical diagnoses against those with Surgical diagnoses. Methodology: This is a ten-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital’s ethical committee. The information gotten includes history, age, sex, diagnosis, length of admission, and outcome. The data collected was analyzed and presented in tables and charts. Findings: Three-quarters of the patients admitted to the ICU had surgical diagnoses. More patients with Medical diagnoses (102,19.7%) were discharged from the ICU compared to patients with surgical diagnoses (78,5%). More patients with Surgical diagnosis (919, 52.9%) were transferred out compared to patients with Medical diagnosis (140,27.1%). Patients admitted with medical diagnosis tend to be older and paid more and stayed longer in the ICU compared to patients with surgical diagnosis and thi...
World Journal of Advanced Research and Reviews
Background: Patients with chronic skin ulcers undergo several wound dressing protocols to achieve... more Background: Patients with chronic skin ulcers undergo several wound dressing protocols to achieve wound healing. Povidone iodine and Platelet Rich Fibrin (PRF) are agents that can be used to accelerate tissue healing and cell regeneration. This study aims to compare the effects of both agents on chronic cutaneous ulcers. Materials and method: The study was a prospective study carried out at the outpatient clinic of the University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State. Ethical approval was sought and obtained from the hospital’s ethical committee. Half of the patients with chronic cutaneous ulcers were dressed with PRF, while the other half were dressed with povidone-iodine. Each of the groups was followed up for 8 weeks. The data were recorded on a proforma, entered in Microsoft Excel 2010 and analyzed with Epi-info version 7.02. Results: The presence of infection and slough were commoner in the cutaneous ulcers treated with povidone-iodine with statistical...
British Journal of Surgery
Background The Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measur... more Background The Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation. Methods This was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling a...
Zenodo (CERN European Organization for Nuclear Research), Feb 24, 2023
Background: Renal cell carcinoma (RCC) is an insidious neoplasm, accounting for approximately 2% ... more Background: Renal cell carcinoma (RCC) is an insidious neoplasm, accounting for approximately 2% of global cancer diagnoses and deaths, and is projected to increase in burden worldwide. Studies on renal malignancies in Port Harcourt are few and where present have focused on the pathology or the paediatric population. This study is on the presentation, risk factors and management of RCC in an adult population. Materials and Methods: This is a ten-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and obtained from the hospital's ethical committee. The information gotten included symptoms, number of cases per year, the side affected, stage of disease, risk factors, treatment received, prognosis, neoadjuvant and adjuvant treatment. The data were collected and evaluated. Frequencies, percentages, the mean and standard deviation were used to summarize the data as appropriate. Results: The hospital incidence of RCC is 98/100,000 at UPTH. The disease was more common from the third to the fifth decade and commoner in females and on the left kidney. The disease has increased in incidence over the years. Haematuria was the most common symptom and radical nephrectomy was the most common form of treatment. Most patients presented with advanced disease and this affected prognosis. Conclusion: RCC is rare but its incidence is increasing in Port Harcourt. Many patients presented with an advanced disease which led to poor prognosis. Open radical prostatectomy was the most common form of treatment.
Nigerian Journal of Medicine
International Journal of Innovative Research in Medical Science
Background: Polydactyly is a common congenital abnormality of the hands and feet characterized by... more Background: Polydactyly is a common congenital abnormality of the hands and feet characterized by more than five fingers and toes. Polydactyly is amongst the commonest inherited skeletal conditions. Polydactyly can be familial or sporadic. Methods: This article presents a case of familial postaxial polydactyly in a male neonate involving all four limbs seen in our hospital. The mother has history of postaxial polydactyly in both upper limbs consisting only of soft tissue unlike the index patient who has well developed bone on the extra digit. Conclusion: Polydactyly is easily diagnosed at birth however earlier diagnosis during the early antenatal period provides an opportunity for counselling, investigation for syndromic associations or familial gene transmission and planning treatment.
International Journal of Innovative Research in Medical Science
Introduction: Renal Cell Carcinoma (RCC) accounts for 2% of global cancer diagnoses and deaths, i... more Introduction: Renal Cell Carcinoma (RCC) accounts for 2% of global cancer diagnoses and deaths, its incidence is increasing globally. In Africa, the incidence of RCC is relatively low but many patients present late with advanced-stage disease and consequently, poorer prognosis. Anaesthetic care of these patients is important. Materials and Methods: This is a ten-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital’s ethical committee. The information gotten includes the type of anaesthesia and method of postoperative pain management. The data collected was analyzed and presented in a table. Results: 84% had general anaesthesia while 16% had regional anaesthesia, all the patients had multimodal method of pain management. Conclusion: Perioperative management for renal surgery varies significantly depending on the disease and patient groups, the anaesthetic must take into consider...
International Journal of Innovative Research in Medical Science
Introduction: Cancer of the prostate (CaP) is the most common cancer among black men. The inciden... more Introduction: Cancer of the prostate (CaP) is the most common cancer among black men. The incidence of prostate cancer is rising in Africa. Prostate biopsy is the standard procedure for the diagnosis of CaP. The prostate biopsy is an invasive procedure and is associated with pain. This can be emotionally and psychologically traumatic for the patient. Intrarectal gel administration is relatively non-invasive, easy to administer, cheap and has an acceptable time of onset of action. Methods: This is a prospective study to determine the analgesic effect of intrarectal lidocaine gel for digitally guided transrectal prostate biopsy. The study was carried out at the University of Port Harcourt Teaching Hospital. Ethical approval was sought and obtained from the hospital’s ethical committee. This is a tertiary institution in Port Harcourt the capital of Rivers State in southern Nigeria. The sample size was calculated to be 159. The patients then filled in the Visual Analogue Scale score (VA...
World Journal Of Advanced Research and Reviews, Nov 30, 2022
Wilms' tumour is the most common among renal tumours in the paediatric population. In Africa, dat... more Wilms' tumour is the most common among renal tumours in the paediatric population. In Africa, data on pediatric renal tumours are rare. This study aims to highlight the challenges and peculiarities in the management of paediatric renal tumours in a resource-poor setting. Materials and Methods This is a five-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital's ethical committee. The information gotten includes history, duration of symptoms, examination findings, age of the patient, stage of disease, intraoperative findings, number of chemotherapies, and post-operative complications. The data collected was analyzed and presented in tables and charts. Results: Twenty-eight patients met the inclusion criteria; 17 males and 11 females. The mean age was 3 years 6 months and the median age was 3 years 3 months. The age range was 9 months to 16 years. Most patients presented between 3 and 9 months after the onset of symptoms. The most common symptom was a painless abdominal mass which was present in all patients. Most patients presented late as fifty percent of patients presented with Stage 4 disease. Most patients had nephrectomy followed by adjuvant chemotherapy. Only three patients are alive five years after treatment. Conclusion: Mean age of presentation of patients with pediatric renal tumours was 3.5years. Late presentation with advanced stage is common. Painless abdominal mass was the most common presentation. The most common histological diagnosis was Wilm's tumour. We carried out a nephrectomy before adjuvant chemotherapy or radiotherapy.
World Journal of Advanced Research and Reviews
Background: Diagnosis of prostatic diseases is via a prostate biopsy and subsequent histology. So... more Background: Diagnosis of prostatic diseases is via a prostate biopsy and subsequent histology. So, a prostate biopsy should be carried out to get a histological diagnosis when indicated. Materials and Methods: This is a five-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital’s ethical committee. The information gotten included history, duration of symptoms, examination findings, age of the patient, Gleason grade and histological diagnosis. The data from the folders were collected and evaluated. Frequencies, percentages, the mean and standard deviation were used to summarize the data as appropriate. Results: The age range was from 45 to 96 years with a mean age of 68.10 ± 9.11 years. A hundred and fifty patients had prostate cancer. The commonest grade of cancer was the Gleason grade 5 (46.67%). No statistically significant relationship between Gleason grade and age. Conclusio...
International Surgery Journal
Background: The undescended testes (UDT) are at risk of torsion, trauma and pathologic changes le... more Background: The undescended testes (UDT) are at risk of torsion, trauma and pathologic changes leading to subfertility and malignant transformation. Surgery for UDT should be performed before the age of 2 years.Methods: This was a 5-year retrospective study conducted on patients who presented with features of UDT in Port Harcourt. Ethical approval for the study was sought and gotten from the hospital ethical committee. Data was obtained from ward admission registers, theatre, and discharge records. The information gotten included history, examination findings and treatment received. Patients who had ectopic testes, retractile testes and incomplete records were excluded from the study. The information was collected and analysed. Categorical data was presented in the form of frequencies and percentages using tables. Continuous variables were presented in means and standard deviation. Results were presented in tables and charts.Results: The 15-19-year age group had the highest frequenc...
The Lancet
Background Surgical site infection (SSI) remains the most common complication of surgery around t... more Background Surgical site infection (SSI) remains the most common complication of surgery around the world. WHO does not make recommendations for changing gloves and instruments before wound closure owing to a lack of evidence. This study aimed to test whether a routine change of gloves and instruments before wound closure reduced abdominal SSI. Methods ChEETAh was a multicentre, cluster randomised trial in seven low-income and middle-income countries (
American Journal of Health, Medicine and Nursing Practice
Purpose: Gunshot wounds to the extremities are a major cause of death and disability. The Red Cro... more Purpose: Gunshot wounds to the extremities are a major cause of death and disability. The Red Cross Wound Score (RCWS) is a simple classification system that is thought to fairly assess severity of injury, influence surgical management and a good predictor of outcome in gunshot wounds. This study aims to evaluate the correlation between the Red Cross Wound Score RCWS and initial response to management. Methodology: This was a prospective study recruiting all consenting patients who suffered gunshot wounds to any extremity and presented at the University of Port Harcourt Teaching Hospital (UPTH). The study was conducted over a 12-month period between October 2018 and September 2019. Data on demographics, anatomical region of the body involved, type of gun time between injury and hospital presentation were obtained using a proforma. Analysis of extracted data was done by the aid of SPSS for Windows version 20. Findings: A total of 106 wounds from 82 patients were analyzed; seventy mal...
European Journal of Health Sciences
Purpose: Fournier’s gangrene is a rapidly progressing necrotizing fasciitis. It is a true urologi... more Purpose: Fournier’s gangrene is a rapidly progressing necrotizing fasciitis. It is a true urological emergency. It is a relatively rare condition. The aim was to highlight the presentation and management of Fournier’s gangrene following circumcision. Methodology: This was a retrospective study. Eight patients who presented with features of Fournier’s gangrene post circumcision between January 2012 and December 2021 to University of Port Harcourt Teaching Hospital UPTH were included in the study. A questionnaire was used to obtain data from all patients listed in the medical records department as having been treated for Fournier’s gangrene during the study period. Data collected include age at presentation, level of education of mother, duration of symptoms before presentation, who carried out the circumcision, where the circumcision was carried out, number of debridement carried out and complications. The data was entered using Microsoft Excel 2016 version and transferred into the s...
International Surgery Journal
Background: There is an increasing incidence of gunshot injuries in most countries around the wor... more Background: There is an increasing incidence of gunshot injuries in most countries around the world. Causes of gunshot injuries include herdsmen assault on communities, religious and ethnic riots, student cultism, inter-tribal wars, accidental injuries at funeral ceremonies and politically motivated murder. This study aims to highlight the presentations of gunshot injuries to the extremities in Port Harcourt.Methods: This was a prospective carried out on all patients who presented with gunshot injuries to the extremities at the University of Port Harcourt Teaching Hospital during the period of the study. Data on age, gender, anatomical region of the body involved in the injury, nature of the gun used, time between injury and presentation at the hospital were obtained. The information gotten was analyzed and presented in form of tables and figures.Results: Eighty-two subjects with 106 injuries were evaluated. Mean age±SD=28.28±8.04 years. Seventy were males and 12 females (M:F=5.83)....
International Journal of Health Sciences
Tumours of the seminal vesicle are rare. Because of the location of the organ, the clinical manif... more Tumours of the seminal vesicle are rare. Because of the location of the organ, the clinical manifestation is indistinct and diagnosis is difficult. The purpose of the study is to discuss the management of adenocarcinoma of the seminal vesicle using two consecutive patients with seminal vesicle tumours who presented late with features suggestive of typical prostate neoplasm and were misdiagnosed even after contrast enhanced Computerized Tomography scan as case studies. To highlight the challenges encountered in diagnosis of seminal vesicle tumour and to review the literature on the management of the disease.
American Journal of Health, Medicine and Nursing Practice
Purpose: Testicular cancer is rare with increasing incidence worldwide. Testicular cancer can mi... more Purpose: Testicular cancer is rare with increasing incidence worldwide. Testicular cancer can mimic many other diseases leading to delay in diagnosis. Delays in diagnosis and management of testicular cancer are associated with advanced stage, increased morbidity and poor prognosis. This case report aims to highlight a case of testicular cancer who presented with metastasis due to delays in testicular cancer diagnosis and ways to improve diagnosis. Methodology: The study focused on a 17-year-old boy presented with severe intermittent abdominal pain for a month. He was reviewed by the general physicians, internists, haematologists, radiologists, general surgeons and urologists. He was given several diagnoses before he was correctly diagnosed as advanced right testicular cancer. It took a total of 31 days in a tertiary institution to reach this diagnosis. Findings: The boy had a radical right inguinal orchidectomy. He had 4 courses of bleomycin, etoposide and cisplatin chemotherapy. H...
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Papers by victor Abhulimen