Constantine Ezeme

Introduction: Post-surgical hypoparathyroidism (PoSH) is a complication of thyroidectomy, that is associated with poor quality of life, increased cost of care, and morbidity and mortality. The clinical and biochemical predictors of PoSH have been evaluated in previous studies. This study explores putative factors like the surgeon’s experience, timing of surgery, and season’s impact on PoSH. Materials and Methods: A retrospective cohort study conducted in a high-volume centre. Patients who underwent total or completion thyroidectomy (TT/CT) performed by a single surgeon from January 2010 to December 2022 were included. Key outcomes were postoperative hypocalcaemia (adjusted serum calcium P = 0.02 and 1.7% in CT vs. 8.2% in CT + CND; P = 0.02). Increasing surgical experience, surrogate variables for surgeon fatigue, and seasons did not change the rate of PoSH significantly. Conclusion: The study confirmed CND as a risk factor for long-term PoSH but did not find surgeon experience, fatigue, and seasons to have an impact on the PoSH rate.

With advances in modern medicine, there is a constant need for accurate and up-to-date readily available information online to ensure patients are well-equipped for informed decision making. This study sets out to analyze websites that provide patient-centered information on robotic colorectal surgery. Three search engines (Google, Yahoo and Firefox) were used with search terms ‘robotic colorectal surgery’ and the first 20 results on each platform assessed. After screening sites using predetermined criteria, further analysis was performed with the DISCERN questionnaire and Cohen Kappa analysis. Out of the 60 websites identified from the initial search, only 14 websites contained patient information on robotic colorectal surgery. Of these, only three (21%) sites had been updated in the past year and one site was last updated 10 years ago. Ten (71%) websites were affiliated with hospitals and the majority (12, 86%) were based in the United States of America (USA). Approximately half of the websites explored alternative surgical techniques, only three (21%) discussed the risks, a similar number had details on post-operative experience, and none mentioned cost implications, ongoing research or the waiting list involved. Overall, no website had a perfect score of 5 to be classified as good or excellent. There was at least a fair level of agreement (reliability score of > 0.2) in 12 DISCERN criteria (80%), 4 of which were statistically significant. Despite the huge volume of generic information on colorectal surgery, there is still a paucity of comprehensive patient-centered information on robotics as a modality of treatment.

Background: Thoracic inlet view radiograph is an investigation for assessing patients with goitre in many centres in the sub-Saharan-region. However, there is paucity of information on its usefulness in the diagnosis of retrosternal goitre (RSG) and in planning for thyroidectomy.Method: A review of patients with goitre managed in the Division of Endocrine Surgery, University College Hospital, Ibadan, Nigeria, between 2002 and 2014 was done. Data were obtained from Operating Theatre Log and electronic data archive of the Division. Clinical RSG (CRSG) was taken as a gland that the examining fingers could not get below its lower margin and Radiological RSG (RRSG) on thoracic inlet view was any extension of the thyroid gland beyond the thoracic inlet. Intra-operatively, if any part of the gland extends beyond the thoracic inlet it was considered as an RSG.Results: 221 (96.5%) of the 229 patients who had thoracic inlet plain radiograph were included in this study. The Male to Female ratio was 1:5.5. WHO grade III goitre was seen in 56.1% of the patients and 43.9% had grade II goitre. The CRSG, RRSG and Intra-operative RSG were seen in 7.7%, 16.7% and 17.6% respectively. The specificity and sensitivity of clinical examination in determining RSG was 88.7% and 94.1% and that of Thoracic inlet radiograph was 97.8% and 94.6% respectively. Conclusion: It is a useful study for screening patients with goitre for retrosternal extension, however it could not be used to determine the need for extra-cervical surgical access during thyroidectomy.

The utilization of art for therapeutic purposes in the formal healthcare setting is gradually gaining prominence in Nigeria. However, there is a paucity of evidence on the effectiveness of these interventions. Therefore, we explored the pooled effect of the various arts-based interventions in managing clinical disorders in hospitalized and out-patients in Nigeria. An electronic search of PubMed, African Journal Online, Web of Science, Google Scholar, Cochrane Library, and Scopus databases was carried out from the inception of the databases to October 31, 2021. Three researchers using Rayyan QCRI software independently screened and de-duplicated the identified studies. Eight eligible studies were selected for this review, with a total of 541 participants. The earliest study was published in 2012. Seven of the eight studies were conducted in the Southern part of Nigeria. There were four quasi-experimental studies, two randomized controlled trials, and two comparative cross-sectional studies. The predominant art forms were music (three) and dance/movement (three), followed by visual art (two). The groups of patients in the identified studies were managed for mental health problems (two), hypertension (two), Parkinson’s disease (one), spinal cord injury (one), autistic spectrum disorder (one), and chronic back pain (one). In all the studies, the art-based intervention significantly improved the overall outcome of the patients. The findings of the available studies have proven to yield a significant positive outcome in managing different health conditions. However, there is a need to conduct more high-quality research in this field in Nigeria.