Background: Over half of infants with congenital heart disease (CHD) need surgery for non-cardiac abnormalities during the first year of life. Objective: This study looked at the variables and surgical outcomes related to non-cardiac surgery in this specific patient population. Methods: We looked at and analyzed 152 case records using SPSS software version 27 (SPSS Inc., Chicago, IL, USA) in order to identify factors associated with post-operative mortality on the 7th and 30th days using a binary and multivariable logistic regression model. Results: Infants with CHD who had non-cardiac surgery for non-heart-related abnormalities had mortality rates of 28.9% on the 7th, and 45.4% on the 30th post-operative day. Preterm neonates had a 2.16- fold higher mortality rate than mature neonates. The death rate was 1.2 times higher in patients who underwent surgery after 24 hours of diagnosis than those who had before 24 hours. Death is also associated with severe CHDs, comorbidities, genetic diseases, operating room mishaps, and age <1 year. Conclusion: The study found that among CHD cases undergoing non-cardiac surgery, the mortality rate was quite high on the 7th and 30th post-operative days.

Familial adenomatous polyposis (FAP) is a rare disease syndrome characterized by mutations in the Adenomatous Polyposis Coli gene. Affected people have a markedly increased lifetime risk of colorectal cancer. The patient was a 17-year-old female with a 4- year history of intermittent abdominal pain, rectal bleeding, and anal masses. A proctocolectomy with perineal resection and a permanent ileostomy were performed. The histological findings were consistent with that of FAP. FAP can present in young patients with rectal bleeding and anal masses

Background: Eye health is an essential aspect of overall health, and visual impairment (VI) can significantly impact academic performance and quality of life. This study aimed to determine the prevalence of VI among undergraduates and the pattern of VI. We set out to give the situational analysis of the student’s eye health. Methods: A cross-sectional study was conducted among 1407 undergraduate students at the institution. Data obtained includes sociodemographic characteristics, vital signs, and visual acuity using a structured questionnaire. Visual acuity was classified using the International Statistical Classification of Diseases and Related Health Problems version 11 (ICD-11) of VI. Results: VI was found in either the right or left eyes of 797 (56.65%) participants. Of the 645 respondents with right-eye VI, 531 (82.3%) had mild VI while 104 (16.1%) had moderate VI. VI was found in the left eye of 657 (46.7%) respondents. The study also found that females had a significantly higher prevalence of VI than males (p < 0.05). Only 231 (28.98%) of the respondents had corrective lenses presently. Conclusions: The prevalence of VI among undergraduates is high, and the proportion currently using corrective spectacles among them is quite low. Eye health should be prioritized among undergraduates.

No abstract.

Background: Despite the high incidence of pertrochanteric fractures in African countries, there are insufficient data on radiographic outcomes of fixation. Previous studies focused on cut-out as an outcome measure. Varus malunion may be a significant outcome measure as it results in biomechanical alterations at the hip. Objective: This study aimed to identify varus malunion as an outcome of pertrochanteric fracture fixation in our population. Study design: This was a cross-sectional, prospective, observational study. Patients and methods: Fifty-nine patients were operated on at three facilities over a 1-year period. Post-operative neck–shaft angle (NSA) and tip–apex distance (TAD) were measured. After 12 weeks, radiographs were assessed for varus malunion and cut-out. Results: The mean post-operative NSA was 3° of varus and the mean TAD was 36 mm. After 12 weeks, there was an average varus collapse of 6°. Predictors of varus collapse were increased TAD (p = 0.002) and decreased post-operative NSA (p < 0.001). The cut-out rate was 4.9%. Conclusion: Pertrochanteric fractures show varus collapse after fixation. Reduction in valgus may allow the fracture to collapse into a near-anatomical position, avoiding malunion. The position of the implant within the femoral head plays an active role in preventing varus malunion.

Oral cancer presenting in late stages requires extensive resection and mandibulectomy. Ideal reconstructive options for such defects are composite-free flaps so as to provide outer skin covering and bridge the mandibular defect. The availability of expertise and resources for such complex reconstructive surgeries is a setback. The predominant alternative in these cases is the use of the workhorse flap, the pectoralis major myocutaneous (PMMC) flap; there are several modifications proposed since the flap was first described. The most common modification, which is used, is bipaddle PMMC which carries an increased risk of complications. Here, we present a modification of PMMC flap for reconstruction of complex defects created after resection of buccal mucosa, mandible, and cheek skin with lesser complications and without the need for free flaps.

Idiopathic Scrotal Calcinosis (ISC) is a rare, benign dermatological condition that primarily affects the scrotal skin. It is characterized by the spontaneous deposition of calcium within the dermis, leading to the formation of multiple asymptomatic calcified nodules. ISC is diagnosed through clinical evaluation, with confirmation via histological examination. Surgical intervention is the most effective treatment for this condition. We present the case of a 37-year-old male who developed idiopathic scrotal calcinosis, a rare disorder marked by calcium deposition in the scrotal skin. The patient first noticed multiple mildly itchy nodular masses on his scrotum 6 months ago. These masses appeared suddenly, but progressively increased in size, causing discomfort and affecting his sexual function psychologically. On physical examination, multiple well-demarcated, high-density nodules, ranging from 70 to 10 mm, were observed diffusely across the scrotal skin. The patient underwent surgical resection of the lesions, with a single-step excision and primary closure. The post-operative recovery was uneventful. Histopathological examination confirmed the diagnosis of calcinosis cutis, consistent with skin calcium deposition in the scrotum. Scrotal calcinosis is a rare yet distinct dermatological condition that requires surgical excision for both diagnosis and treatment leading to favorable outcomes and patient satisfaction.

Background: Access to surgical equipment is critical to providing safe and equitable operative care. This is the first nationwide study to provide data on the availability of surgical equipment in Kenya. Methods: This cross-sectional study collected data from May to July 2018 on the availability of non-pharmaceutical equipment, patient care, intra-operative, and anesthesia supplies in level 4 hospitals. Information regarding infrastructure such as the number of functional operating rooms, sterilization capacity, and sources of water and electricity was also collected. Results: The availability of intra-operative and anesthesia equipment was 44.5% and 47%, respectively. Nearly 60% of facilities had general patient care supplies. Over 80% of the facilities had running water in maternity wards (83.1%). Sterilization equipment was present in about half of the facilities (range: 42.6–68.3%). Additionally, 79.1% had a generator as a backup source of electricity. Only 35% of facilities always had an X-ray on-site, and 52.6% of the facilities obtained blood from the national or a regional center. Conclusion: This study provides data on the availability of surgical equipment and infrastructure in level 4 hospitals in Kenya. Availability of radiology services and blood supply was lower than that in other sub-Saharan African countries, highlighting the need for improved surgical care resources in these community-based facilities.

Hereditary angioedema (HAE) is a rare genetic disorder resulting from deficiency or dysfunction of the C1-esterase inhibitor (C1-INH, C1-inhibitor) protein. It manifests with recurrent cutaneous and submucosal edema involving the extremities, abdomen, and/or larynx. Abdominal edema mimics other acute abdominal conditions including intestinal obstruction, potentially prompting unnecessary surgery if misdiagnosed. Prompt treatment with C1-INH typically alleviates abdominal angioedema symptoms within 24 hours, while untreated cases resolve within 2–5 days. Persistence of abdominal symptoms warrants further evaluation for other etiologies of acute abdomen. Surgical procedures with tracheal intubation can induce life-threatening upper airway edema in HAE patients. We describe the successful management of a 41-year-old female with HAE presenting with features of intestinal obstruction, which only partially resolved with the administration of C1-INH and conservative bowel decompressive management. Imaging revealed a small bowel tumor necessitating surgical intervention. Pre-operative prophylactic C1-INH was administered, followed by open laparotomy under general anesthesia with endotracheal intubation. Although C1-INH concentrates are the principal treatment for abdominal HAE attacks, other causes of acute abdomen should be considered, particularly in cases of persistent symptoms, to guide appropriate management. This case highlights the importance of multidisciplinary collaboration and careful perioperative planning to optimize outcomes for HAE patients requiring surgery.

Recalcitrant humeral non-unions after multiple fixation attempts pose a challenge to the surgeon when it comes to selecting effective and reliable management strategies. Confounding factors such as infection and bone segment loss may hamper achieving osteosynthesis even with suitable fixation. This is a case report of a 35-year-old man with a 4-year complex history of recalcitrant humerus non-union. It highlights a combination of various accessible strategies that encompass biological stimulation and mechanical stabilization toward timely bone union with minimal morbidity and return to optimal function. The use of a free fibular intramedullary strut autograft with a locking compression plate (LCP) has been infrequently described in the literature and this report adds to the data bank of this treatment strategy.