A prospective study of the stool samples of 129 rural patients with symptoms of upper abdominal pain, tenderness and indigestion was carried out from 2 February 1998 to 31 December 1998 and followed up to June 1999. The age range was 11-85 years, female:male ratio 2.4:1: 102 specimens were positive for helminths--Ancylostoma duodenale (hookworm) 80 (62%); Trichuris trichuria (threadworm) 12 (9.3%); Ascaris lumbricoides (large roundworm) 10 (7.76%); Strongyloides stercoralis three (2.3%); Taenia saginata (tapeworm) three (2.3%). The female:male ratio for hookworm was 3:1. Treatment with appropriate anthelminthic agents were given serially at each visit according to the result of faecal examination. At 6 months follow up 88 patients were free of symptoms, 60 of which were caused by helminths the hookworm group. Stool 'test and treat' strategy appears to be a cost-effective approach in the management of these patients.

This is a report of a rerecurrence of extensive lymphangioma involving the neck, chest and both breasts of a female. The patient has had recurrence of the lesion twice following surgical excision. Surgery alone seemed to be insufficient in this case. Could adjunct of sclerotherapy have made a difference at the first surgery? Faced with a third recurrence, what other options are left? We report this case to highlight the difficulties and dilemma in managing extensive lymphangiomas.

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Background: Visually estimated blood loss has long been known to be imprecise, inaccurate, and often underestimated, which may lead to delayed diagnosis and treatment. Aim: To determine the accuracy of blood estimates by health workers in surgical and obstetric specialties. Methodology: This was a cross sectional single blinded observational study done in January 2016 to determine discrepancy between actual blood loss (ABL) and estimated blood loss (EBL) by consenting healthcare practitioners working in various surgical and obstetric departments of the Federal Medical centre, Owerri. Reconstituted whole blood was obtained from the blood bank, and simulated scenarios with known measured blood loss were created using common surgical materials. Visually estimated blood loss was performed by medical personnel. Percent errors of estimated blood loss were calculated and comparisons were made among the health professionals. The statistical analysis was done using SPSS version 21. Results: A total of 113 health professionals comprising 64 doctors and 49 nurses assessed 7 clinical scenarios. On the average, there was a general tendency for the health workers to under estimate the volume. Majority of the participants underestimated the blood volume by more than 20% of actual volume. Though the nurses were more likely to underestimate blood volume than the doctors however, there was no statistical difference between the estimations by the nurses and the doctors except in station 3 with a p value of 0.045. Conclusion: This finding calls for action in training and retraining of every health worker in blood loss estimation, so that intervention can be initiated early.

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