The commonest cause of large-bowel obstruction in Nigeria is sigmoid volvulus. Patients usually present late, dehydrated, and in very poor condition. The mortality of emergency colonic surgery is undoubtedly high, more so in developing countries poorly equipped to cope with such a condition. To reduce the mortality rate and improve management of the patients, a four-year prospective study of detorsion followed by elective surgery after adequate resuscitation and bowel preparation was carried out between January 1979 and December 1982. Volvulus is classified into three groups: torsion, obstruction, and strangulation. Criteria for short colonoscopic detorsion of torsion and obstruction types are discussed, and the contraindication in the case of strangulation type mentioned. This article describes the management of 92 cases of sigmoid volvulus between 1979 and 1982.

Injection sclerotherapy has a prominent role in the treatment of bleeding hemorrhoids. The commonly used sclerosants are not available or very expensive in Nigeria. We prospectively evaluated 50% dextrose water, used as a nonallergenic sclerosant, in the treatment of bleeding internal hemorrhoids. Forty consenting adult patients (median age 50 years [range 35-67]; 22 women) with bleeding hemorrhoids, seen over a 2-year period, were offered injection sclerotherapy with 50% dextrose water. They were assessed for response, tolerance and complications. The duration of symptoms before presentation was 3 months to 15 years. The bleeding stopped after the injection in all patients. No patient needed a repeat procedure. No complication was recorded during follow up which ranged from 2 months to 12 months. We conclude that endoscopic hemorrhoidal sclerotherapy using 50% dextrose water offers a simple, safe and effective modality of treatment if properly utilized.

Fifty patients with gastro-oesophageal reflux disease refractory to multiple courses of medical therapy were entered into a prospective randomized trial comparing Nissen fundoplication with the Angelchick prosthesis as a primary surgical procedure. The two groups were matched for age, sex, duration of symptoms before surgery, type of medical therapy, pattern of symptom presentation, endoscopic grade of oesophageal inflammation, manometric lower oesophageal pressure and 24-h pH profile. Twenty-five patients were randomized to each of the Nissen fundoplication and Angelchik prosthesis groups. Operation time and hospital stay were similar in both groups. Persistent dysphagia was reported in five of the patients with an Angelchik prosthesis compared with none in the Nissen fundoplication group. Three prostheses were removed because of severe dysphagia while no Nissen fundoplication required revision. No patient with preoperative dysphagia because of stricture reported swallowing difficulties after operation. At clinical assessment at 3, 6, 12 and 24 months after operation, 85-88 per cent of the patients having a Nissen fundoplication were graded Visick 1 or 2 compared with 60-72 per cent of patients in the Angelchik group.

Background:Different complications may occur at laparoscopic port sites. The incidence of these varies with the size of the ports and the types of procedure performed through them.Objectives:The aim was to observe the rate and types of complications attending laparoscopic port wounds and to identify risk factors for their occurrence.Patients and Methods:This is a prospective descriptive study of all patients who had laparoscopic operations in one general surgery unit of a University Teaching Hospital in Nigeria between January 2009 and December 2012.Results:A total of 236 (155 female and 81 male) patients were included. The laparoscopic procedures include 63 cholecystectomies, 49 appendectomies, 62 diagnostic, biopsy and staging procedures, 22 adhesiolyses, six colonic surgeries, eight hernia repairs and 22 others. Port site complications occurred in 18 (2.8%) ports on 16 (6.8%) patients including port site infections in 12 (5.1%) and hypertrophic scars in 4 (1.7%) patients, while one patient each had port site bleeding and port site metastasis. Nine of 11 infections were superficial, while eight involved the umbilical port wound.Conclusion:Port site complications are few following laparoscopic surgeries in our setting. We advocate increased adoption of laparoscopic surgeries in Nigeria to reduce wound complications that commonly follow conventional open surgeries.

Urban expansion along with other changes in land use and land cover is a global phenomenon and most parts of Western Nigeria have experienced tremendous changes in recent past. Osun state, located in Western Nigeria, was originally made up of mostly traditional farming communities. These communities have witnessed rapid urbanisation in the last few decades and most of the communities previously known to be farming communities have transformed to modern well-known cities. This project examines the use of Remote Sensing in mapping of Land Use Land Cover in Osun state over a period of 30 years (1986 to 2016) using Landsat (MSS, TM, and ETM+) images. The aim of this study is to produce a land use/land cover map of Osun state at three epochs in order to detect the changes that have taken place particularly in the built up and Vegetation areas. Landsat Images of Osun state in 1986, 2006 and 2016 were processed into five land use classes namely: Water body, Vegetation, Wetland, Built-up and Bare land. Total area of land use in each class were determined along with percentage change area, Land Consumption Rate and Land Absorption Coefficients. The result of the work shows that built-up area changed from 20.52% in 1986 to 30.71% in 2006 and then 34.45% in 2016. Land Consumption rate was 0.068 in 2016 which is indication of highly compacted living environment. The minimum Land Absorption Coefficient observed was 0.027 in between 2006 and 2016, which indicates that land is acquired for built-up development at very high rate. The resultant effect of these observed changes was a reduction of the vegetation class from 35.82% in 1986 to 31.14% in 2006 and then 23.83% in 2016. The results in this study may influence new land policy that will enhance sustainable use of land in Osun state.