Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding.

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Introduction: The Proliferation of small arms in the West African sub-region and the activities of insurgent groups and rustlers have caused renewed interest in Gunshot injuries. We aim to document the trend and outcome of such injuries in our sub-region. Methods: It was a prospective study of cases of gunshot injuries admitted at the University Teaching hospital over a period of 18 months. Parameters analysed included patients' bio-data, region of the body affected, mechanism and source of projectile, clinical presentations and short term outcome. Statistical analysis was done with IBM SPSS 20. Level of significance was p<0.05. Results: A total of 43 patients were seen with a mean age of 33.76 ± 10.59. There were 42(97.7%) males and 1(2.3%) female. The victims were mostly farmers (25%), professional drivers (13.6%), Students (11.4%). The body region affected were the lower extremity (36.4%), upper extremity (27.3%), Most of the cases were from armed robbery attack (77.3%) and Assaults (13.6%). Low velocity weapons like Dane guns were the common sources of projectile 95.3%. High velocity weapon like AK 47 was used in 4.7% of cases. Majority of victims were shot at closed range (86.4%) and 79.5% were stable on presentation. Intervention carried out included wound debridement (65.9%), external fixation (23%), and chest tube drainage (9.1%). The outcome was such that 68.2% survived without residual deficit while 31.8% survived with residual deficit. Conclusion: Gunshot injuries were mainly from armed robbery attack using low velocity weapon with farmers being the most victims. Strict regulations in the acquisition and use of light firearms would reduce the incidence of armed robbery and gun related violence in our sub region.

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Background: Primary endometriosis is the presence of endometrial glands and tissues outside the endometrial cavity. Primary umbilical endometriosis is a very rare entity. Case:We reported a 40-year-old Para 2 plus 2Alive 2 patient who presented with 2 year history of umbilical swelling with cyclical pain. The case was managed by simple excision and histopathological examination diagnosed it as a case of umbilical endometriosis. Conclusion: Endometriosis should be considered as a differential diagnosis in cases of any umbilical pain or swelling in women of reproductive age group.