West African journal of medicine
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Laparoscopic cholecystectomy (LC) the preferred treatment for gallstones was not available in Ghana until 2005. ⋯ Elective laparoscopic cholecystectomy can be performed with good results in patients with symptomatic gallstones in Accra.
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Effective medical management of peptic ulcer disease (PUD) has reduced the incidence of gastric outlet obstruction (GOO) as a complication, but perforation especially in the elderly remains unchanged and is in fact on the increase. There is a changing trend in emergency surgery for perforated duodenal ulcer (PDU) from definitive anti ulcer surgery to simple closure followed by Helicobacter pylori eradication. ⋯ Simple closure with omental patch followed by Helicobacter pylori eradication is effective in managing PDU with low morbidity and mortality despite patients late presentation in our center. This technique is recommended in place of a definitive ulcer surgery.
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Myasthenia gravis (MG) is generally a rare disorder and may thus be easily misdiagnosed. Misdiagnosis is even more likely when the presentation is atypical. ⋯ Typically myasthenia gravis presents with ptosis but clinicians should be aware that that is not invariable and that it may start with limb weakness.
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Foreign body inhalation, a surgical emergency requiring prompt management to avoid morbidity and mortality , poses a diagnostic and management challenge to otolaryngologists. ⋯ The peak age of occurrence of forein body inhalation is in the zero to four year age group. The commonest inhaled foreign bodies are groundnuts, fish bones, plastic materials, metal materials and seeds. Majority of inhaled foreign bodies tend to localise in the right main bronchus.
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Most caesarean sections were previously performed under general anaesthesia but there has been an increasing trend worldwide in the use of regional anaesthesia as the preferred method of anaesthesia for caesarean delivery. ⋯ There is an overall low practice or usage of regional anaesthetic for caesarean section. A trend towards increasing administration of regional technique for caesarean section is demonstrated. A dedicated period for hand on the job workshop in regional blocks may enhance early and prompt acquisition of relevant skills in regional anaesthesia for caesarean delivery.