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Northern Nigeria has a high number of cattle populations, the majority of which are in the hands of Fulani herdsmen. A crosssectional study was conducted with the aim of determining the common species of ticks and their prevalence on cattle in three selected areas within Sabon Gari-Zaria, Kaduna State, Nigeria from June 2018 to October 2018. During the period, a total of 384 cattle were sampled and 439 ticks (Ixodidae) were collected from 335 infested cattle in the selected sampling sites. Three genera of ticks comprising five species were found infesting cattle in Sabon Gari. Amblyomma variegatum (47.8%; 210/439) constituted the highest percentage of ticks collected from the sample sites, followed by Rhipicephalus (Boophilus) decoloratus (31.0%; 136/439). Hyalomma species had the least percentage infestation, with Hyalomma truncatum having (18.5%; 81/439) infestation. Hyalomma impeltatum had (1.8%; 8/439) and Hyalomma rufipes had (0.9%; 4/439) infestation. The infestation of ticks in Bomo village was highest at 176 (40.1%) compared to Zangon Shanu at 167 (38.0%) and Angwan Fulani at 96 (21.9%). Tick infestation has serious medical and economic implication because of their tendency to inflict pathological effects on the cattle. Attention should therefore be given to prevention and control of ticks, since they affect the general health of the animal thereby causing serious production and economic losses. [ABSTRACT FROM AUTHOR]

Aim: Pouch–vaginal fistula (PVF) is an uncommon but serious complication of ileo‐anal pouch reconstruction. This study aimed to review the recent management of PVF, in particular the role of anti‐tumour necrosis factor (anti‐TNF) drugs. Method: All patients presenting for management of PVF to our surgical service between 2007 and 2016 were studied. The median duration of follow‐up from diagnosis of PVF was 6 years. Details of the original pouch surgery, timing of presentation of PVF, management and final outcome were recorded. Primary outcome was gastrointestinal (GI) continuity (as defined by the presence or absence of a stoma). Results: A total of 23 patients were identified (median age 45 years) of whom nine had pelvic sepsis at the time of original pouch surgery. Management included local surgical repair, defunctioning ileostomy, pouch excision and anti‐TNF therapy. GI continuity was achieved in 12 patients (52%). Healing of the PVF was achieved in 12 patients (52%). Pelvic sepsis was significantly associated with the need for a long‐term ileostomy (P = 0.009). Biological therapy was used in 12 patients, of whom seven maintained GI continuity. Patients with late presentation PVF (60 months or longer postsurgery) and those with clinical features of Crohn's disease appeared to benefit from anti‐TNF treatment. Conclusion: PVF remains a challenging problem with overall healing rates and GI continuity rates of just over 50%. Anti‐TNF therapy may have a role in patients with late presentation PVF and those with features suggestive of Crohn's disease. [ABSTRACT FROM AUTHOR]

Aim: There is a requirement of an expansive and up to date review of surgical management of inflammatory bowel disease (IBD) that can dovetail with the medical guidelines produced by the British Society of Gastroenterology. Methods: Surgeons who are members of the ACPGBI with a recognised interest in IBD were invited to contribute various sections of the guidelines. They were directed to produce a procedure based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. An editorial board was convened to ensure consistency of style, presentation and quality. Each author was asked to provide a set of recommendations which were evidence based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after 2 votes were included in the guidelines. Results: All aspects of surgical care for IBD have been included along with 157 recommendations for management. Conclusion: These guidelines provide an up to date and evidence based summary of the current surgical knowledge in the management of IBD and will serve as a useful practical text for clinicians performing this type of surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: Peri-rectal tumors are rare and their management is challenging, especially when presenting with local recurrence. The aim of the current study was to report a multicenter series of peri-rectal tumors, focusing on the risk of recurrence. MATERIAL AND METHODS: From 1994 to 2014, patients with peri-rectal tumors from three different centers were retrospectively analyzed. Sixty-two patients were identified and divided into two groups; Group 1: patients who presented with local recurrence at follow-up (n = 9, recurrence rate: 14.5%), and Group 2: patients without recurrence (n = 53). RESULTS: In Group 1, there were initially more patients with symptoms of a perineal mass (44.4% vs. 12.2%; p = 0.04), more malignant tumors (55.6% vs. 15.1%; p = 0.02), and larger lesions (+2.6 cm; p = 0.004). Incomplete resection was also more frequent in Group 1 (44.4% vs. 3.8%; p = 0.003). Eight patients with recurrence had further surgery, whilst one patient had radiological recurrence and was treated medically. Among the eight re-resections, five patients remain disease-free; two have had further recurrences and have had palliative treatment, whilst another has had a further resection and remains disease-free. CONCLUSIONS: Peri-rectal tumors are uncommon and there is no consensus on best management. Based on this large multicenter series, several risk factors seem to be associated with local recurrence, namely patient- (discovery of a perineal mass), tumor- (malignant and large lesion), and surgery-related (incomplete resection). Clinical follow-up should be adapted according to these factors. [ABSTRACT FROM AUTHOR]

Over four years the histological features of benign breast diseases, diagnosed after biopsy of non-palpable mammographic abnormalities, were reviewed and correlated with the mammographic appearances. The histological features were compared with those from all other benign biopsy specimens taken during the same period. The incidence of sclerosing adenosis and microcalcifications was considerably higher in the group of non-palpable mammographic lesions; fibrous disease of the breast and radial scar (infiltrating epitheliosis) were also more common. There was no difference in the incidence of epithelial hyperplasia between the two groups. Correlation with the mammographic appearances showed that microcalcification was most often associated with blunt duct adenosis and that stromal distortion or masses were most often caused by fibrous disease. [ABSTRACT FROM PUBLISHER]

Two cases of male breast carcinoma presenting as cystic swellings are reported. Cysts of the male breast are rare, but unlike cysts in female breasts are more likely to represent significant pathology. We recommend consideration of excision biopsy of isolated cysts in male breasts. [ABSTRACT FROM PUBLISHER]

The surgical management of perianal Crohn's disease is complex with a wide range of operations being described. The initial emergency treatment is to drain any source of underlying sepsis. A loose seton drainage or a defunctioning stoma can then be used as a 'bridge' to definitive treatment allowing both adequate assessment of the condition and preventing further sepsis. The likelihood of success of any surgical repair must be weighed against the risk of faecal incontinence. Improved results of a local surgical repair are seen with optimal surgical and medical management of perianal Crohn's disease.