Background: Delay in presentation and treatment of abdominal wall hernias is phenomenal in Africa. The three-pronged problem of delayed presentation, multiple comorbidities, and advancing age makes management of complicated abdominal wall hernias more tasking and hazardous. The purpose of this study was to determine the causes of delayed presentation and treatment outcomes of complicated abdominal wall hernias in our environment. Patients and Methods: This was a 3-year multicenter prospective study of the causes of delayed presentation and treatment outcomes of complicated abdominal wall hernias in rural Southeast Nigeria. Results: A total of 138 patients with complicated abdominal wall hernias were enrolled and comprised of 117 males and 21 females. Of the entire patients, those with inguinal hernia represented 76.1% followed by umbilical hernia (8.0%). Only 18.1% presented within 24 h after the onset of complications, 24.6% between 24 and 48 h, 29.0% between 49 and 72 h, and 28.3% after 72 h. In the preoperative period, theater waiting time was 0–12 h in 10.9%, 13–24 h in 23.2%, 25–48 h in 39.1%, and >48 h in 18.1%. The major barriers against early presentation were financial constraint (23.9%) and treatment at alternative homes (15.9%). The overall morbidity rate was 58.0%, whereas the mortality rate was 13.8%. The bowel resection rate was 26.1%, and majority of the resection (77.8%) and deaths (73.7%) occurred in those who had overall delay beyond 72 h before surgical repair. Conclusion: The rates of morbidity and mortality were proportionally related to the length of delay in the presentation and duration of waiting time before operative repair.

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Background: Acute appendicitis is the most common surgical abdominal emergency worldwide. The diagnosis is mainly clinical and the treatment of choice is appendicectomy. Aim: The aim of the study was to examine the clinical features, diagnoses, treatments, and outcomes in patients with acute appendicitis. Patients and Methods: This was a prospective descriptive study carried out over a year period from September 2009 to August 2010 at the University of Benin Teaching Hospital, Benin City. All consenting and consecutive adult patients from the age of 18 years and above with a diagnosis of acute appendicitis were recruited. Demographic, clinical features, treatments, and outcomes were noted and entered into a pro forma and later analyzed using SPSS 16 version. Results: Acute appendicitis was preoperatively diagnosed in 86 patients but confirmed in 71 patients on histology. Twenty-nine were male, while 57 were female with a mean age of 28.36 ± 10.40 years. The most common age range affected was 21–30 years. All the patients had appendicectomy. Fifteen patients had a negative histology, of which two were male, while 13 were female, with an overall negative appendicectomy rate of 17%. All the patients were well and discharged. Conclusion: Acute appendicitis occurred most commonly in the age range of 21–30 years. Females accounted for a higher number of acute appendicitis, although negative appendicectomy rate was higher in them. The overall outcome was good.

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Background: Distal femoral intra-articular fractures present a serious surgical challenge to an orthopedic surgeon. These fractures are usually complex and are difficult to treat, and the operative treatment is usually recommended. Problems encountered in the fixation of these fractures include poor exposure of the articular surface, loss of fixation, and joint incongruence. Materials and Methods: This was a prospective review of all patients treated with distal femoral locking plates (including patients presenting with nonunion) between January 2017 and January 2018 using the Swashbuckler's approach. Fractures were categorized using the AO/OTA classification. Patients with AO type A fractures were excluded from this study. Results: Six patients (5 females and 1 male) were recruited into this study. The mean age of the patients was 43.2 years (age range of 31–63 years). Mechanism of injury was road traffic accident in 83.3% of cases. The mean time for radiological union was 12 weeks, and all (100%) patients achieved union without any further intervention. Conclusion: The use of the Swashbuckler's approach for distal intra-articular fractures improves exposure of the articular surface and aids reduction and proper application of the locking distal femoral plate. High union rates can usually be achieved with these implants.

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This article provides surgeons with a simplistic method to convert an injection needle into a suture needle in the operating theater itself. In the following procedure, we take an injection needle and a suture material (polypropylene number 1) and create a curved suturing needle ready to be used with minimal fuss and with the help of simple instruments. This method will definitely save time and the cost of an extra suture.

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