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Introduction. Cadaveric dissection is an established effective teaching method in anatomical science education. Cadaver acquisition for dissection is, however, based on voluntary body bequeathment. As a result of the increasing numbers of medical schools and student intake, the challenges of inadequate bodies for education became obvious in most parts of the world as the main cadaver source remains anonymous corpses in the custody of the state. Cultural and religious beliefs or commercial purposes are among the several factors that influence the decision about body bequeathal. This study investigates the knowledge, attitude, and perceptions of body bequeathing among health science students who benefitted or are potential beneficiaries of cadaveric studies and identified factors influencing the bequest of bodies in Ghana for educational purposes among students in the University of Health and Allied Sciences. Method. This was a cross-sectional descriptive study. The study recruited 513 students in the bachelor programs in medicine, physician assistantship, nursing, midwifery, pharmacy, and allied health sciences at various levels. Both closed- and open-ended questions contained in the designed questionnaire were administered. Result. About 74.1% of the respondents had heard of body bequeathal. Majority (98.3%) agreed body bequeathal was important. However, only 39.6% knew the requirements and processes of body bequeathal. Most (>90%) had a negative attitude toward body bequeathal. Conclusion. The study concluded that there was a high awareness of the importance of body bequeathal for medical education and research but very low procedural knowledge on bequeathing, amongst health science students. Moreover, most were unwillingness to donate their bodies or even encourage others to donate their bodies. It is, therefore, recommended that medical schools should setup accessible body bequeathal programs that provide opportunities for interested individuals to be readily assisted through the process of body bequeathal.

Purpose: Failure of reconstructive surgery and wound breakdown occur when scrotoplasty is combined with other multiple surgeries. Unfortunately, hydroceles are common whether isolated or associated with other conditions in penoscrotal malformations that may require surgical intervention during the reconstruction procedure. Method: We retrospectively reviewed the surgical outcome of under-five year old children with isolated hydrocoeles or in combination with other inguinoscrotal pathologies operated at the Ho Teaching Hospital over a 12-month period.The diagnoses, procedure performed, complications and days of hospital stay were analysed and descriptively presented. Results: Majority 17(85.0%) of the 20 patients reviewed were diagnosed with communicating and vaginal hydrocoele with surgeries been division of the patent processus or excision of tunica vaginalis respectively. Left-sided lesions were dominance for communicating hydrocoele. Hydrocoeles associated with undescended testes and the Penoscrotal fusion in 15.0% had orchidopexy and penoscrotal reconstruction. The frequent complication was wound infection. Conclusion: Wound infection was not a side effect against combine PSF reconstruction and hydrocoele operation however, it appeared to be more severe.

Purpose Inguinal hernia is a common male surgical disease. Intervention carries a wide range of complications such as scrotal haematoma and seroma which may require surgical re-intervention or predispose patients to developing infections, pains or feeling of mass. This could lead to long hospital stay. Scrotal tamponade by bandaging or wearing of tight pants and elevation are practiced to reduce bleeding and haematoma formation. These methods require prolong use. Closed suction drains are scarcely used in resource-deprived communities due to high cost and non-availability. Aim This study was to determine the effectiveness of a closed non-suction drain in preventing scrotal collection requiring further surgical intervention and the predisposition to developing surgical site infection following nylon darn repair of inguinoscrotal hernia. Methods Forty (40) participants were recruited for a preliminary study and assigned into control and interventional groups (CG, IG) for purposes of inserting flexible feeding tube (FFT) wound drain after nylon darn (ND) repair. Daily measurement of drained scrotal collection was carried out in the IG till the day drainage was zero. Residual volumes in IG and wound collection in the CG who were not candidates for re-intervention were determined at 14th and 28th post-operative days using ultrasound scan. Data were analyzed using SPSS version 25. Results Three (3) patients (15.8%) in the CG required re-intervention. Surgical site infection rates for the CG and IG were, respectively, 2/19 versus 0/21 (ρ = 0.134).There was a numerical significant difference in the mean volumes of scrotal collections between the control (0.95 ± 0.42 ml) and the intervention group (0.44 ± 0.33 ml) [p value of 0.041] but with no clinical impact. Conclusion Simple inexpensive flexible feeding tube placement significantly reduced scrotal collection which forms a base for larger sample size in subsequent studies. This could reduce the feared risk of re-intervention, wound infection and long hospital stay post-operative.

Introduction: Ureteric injuries resulting from iatrogenic causes is over 70% with about 75% of these cases diagnosed in the post-operative period with complications that increase morbidity and treatment cost.Objective: The purpose of the study is to identify risk factors for iatrogenic ureteric injuries(IUI) from open surgical procedures and the clinical outcome of interventions. Patients and methods: Clinical records of patients with IUI between 2015-2021 who were repaired at the urology units, MMCH and HTH were retrieved. Important data extracted included patients' demographics, clinical presentation, primary surgery details, time from surgery to injury types of ureteric injury, complications, and interventional outcomes data were extracted and analysed using the Statistical package for social scientists (SPSS version 24). Results: Twelve patients with 19-injuries aged between 24 - 54 years were treated. Injuries resulting from hysterectomy 83.3%, Caesarean section, and hernia repairs resulted in other 16.7%. Most were post-operative diagnoses after 48-hours(7/12). Bilateral injuries occurred in 7 cases(14/19 injuries) performed entirely by non-surgeon clinicians. Intra-operative recognition was related to unilateral damage and surgeries performed by surgeons. Ureteroneocystostomy(14/19), uretero-ureterostomy(1/19), and open suture release were the proceduresDiscussion: Open hysterectomy(83.7%) was the single surgery with many IUI. Outcome indicators related to major presenting complications, frequency, bilateral and late recognition of injuries, were those performed by general physicians on mostly elective cases. This pattern is a pre-operative predictive factor of the worst IUI occurrence.Conclusion:Mishaps during hysterectomies by none-surgeon clinicians are the single dangerous risk factor for complicated open surgery IUIs in the Volta region.

Testicular torsion is a urologic emergency that requires surgical intervention. Its diagnosis is rarely made in elderly men especially the subset of men on urethral catheter. As a result, delayed diagnosis and surgical exploration occur leading to testicular infarction with necrosis, abscess formation and ultimately orchidectomy. We report a 73-year-old urologic patient referred with a 2-month history of transurethral catheterization to relieve retention of urine with subsequent scrotal pains and fever. Physical examination showed left hemi-scrotal swelling and normal right hemi-scrotal findings. A Doppler scan done showed an intratesticular fluid collection with no blood flow in the left testes. This case illustrates the need to include testicular torsion when diagnosing geriatric men with transurethral catheter presenting with any acute scrotal pains. We, therefore, recommend a detailed history and physical examination in addition to a colour Doppler ultrasound scan in making a diagnosis.

Background Cadaveric dissection is essential and effective teaching method of anatomy in medical schools. In cadaveric dissection, the learner plays the central role of the teaching process and to view structures in their natural location. Cadaveric dissection is however perceived as tedious and time consuming by most students which influence their perception and attitude towards the teaching method. This study was therefore designed to evaluate UHAS medical students' perception and attitude toward dissection in the teaching and learning of human anatomy. Method This was a cross-sectional and descriptive study. A Likert-style questionnaire, comprising 26 items was sent to study population via online using google form. Ethical issues were duly dealt with approval and consent. Result Majority of the students (84.5%) perceived dissection more interesting, and the better way to really learn and understand the human body. About 87% of students also indicated that it assists in retention of what they learnt in theory. Majority of the students (74.5%) felt dissection should not be replaced by other forms of learning. Conclusion There is a strong positive perception and attitude towards the use of cadaveric dissection as a teaching and learning method of anatomy. Cadaveric dissection brings about the skills, courageous and the ability to confidently work on the human body without any fear for future practice. It is therefore, recommended that more time should be allocated to cadaveric dissection.

Introduction and importance Surgical site infection (SSI) is an inevitable occurrence in bowel perforation with faecal soiled hernia wound(s) especially in retroviral patients. Unfortunately, the increased antibiotics and wound care demands do not prevent delayed healing, increased risk of hernia recurrence, or multiple surgeries to control the infection. The standard open or endo-laparoscopic Mesh repairs are either deferred or avoided with alternative tissue-based hernia repairs after bowel surgery. The reported success of open tissue-based repairs remains mixed. Nylon monofilament that have been used in infected wounds was chosen for the patient in anticipation of wound infection. Case presentation A 48-year-old man presented with a 7-days complicated hernia at the emergency unit, Margaret Marquart Catholic Hospital. Clinical examination revealed signs of shock, intestinal obstruction, and peritonism, laboratory investigation was remarkable of anaemia, septicaemia, deranged renal function, and positive retroviral test. He had concurrent right hemicolectomy and nylon darn after optimisation. The outcome we evaluated after surgery included postoperative pain, scrotal collection, anastomotic breakdown, postoperative analgesic use, wounds infection, prolonged hospital stays, recurrence, and the need for a second surgery. Though he developed prolonged deep SSI, he has intact hernia repair after 6-years. Clinical discussion The postoperative critical clinical events presented in this case were unexpected but might have been precipitated by his retroviral status. Thus, a weight loss of over 13 kg within 2 weeks was highly unusual. Furthermore, the positive retroviral status couple with the perforated caecum and soiled peritoneum was the cause of the surgical site infection. Conclusion Nylon darning in a retro-positive patient developing prolonged SSI appeared beneficial. It should be considered in patients with anticipated long period wound infection., Highlights • Surgical site infection is a challenge in hernias with perforated viscus after repair. • Current standard modalities of hernia repairs are used in such patient's infection are not anticipated. • Patient with retroviral infection and wound contamination requires a different approach to ensure the intact repair. • Nylon darn, one of the methods was used with success. • Our patient with a prolonged infection after surgery and a 5-year post-repair success are a first of the kind reported.

Bilateral inguinal hernias are relatively rare in females compared to men. The management outcome of bilateral nylon darn, a method predominantly used in sub-Saharan Africa for same time repairs in complicated or elective hernia surgeries is largely unknown.Our aim is to report a rare case of same time bilateral inguinal hernia obstruction and review the outcome of bilateral nylon darn posterior wall repairs after herniotomy.This was a retrospective analysis of bilaterally operated inguinal hernia female patients data that was retrieved for the past 6-year period. Settings: All complete records of female patients who had same time bilateral inguinal hernia repairs at the Margaret Marquart Catholic Hospital (district hospital), for the period January 2015 to December 2020 were included in the study.Patient biodata, clinical notes on diagnosis, surgical management, postoperative care, and complications were extracted from hospital records and analysed.A total of 14 patients aged between 40 and 87 years which represented 1.85% of the total hernia repairs were female with same time bilateral inguinal hernia repairs. Seven (50%) patients presented at the emergency with hernias detected over a year. Surgical site infection and pains after surgery were the predominant complications and occurred more common after emergency repairs.Emergency bilateral inguinal hernia repairs were three times associated with surgical site infection compared to elective repairs.

Typhoid perforation is the most fatal complication of typhoid fever in developing countries and is most often caused by the bacteria Salmonella Typhi. There are conflicting views as to which type of surgical intervention gives the best outcome. The aim of this study was to determine the mortality associated with the different types of surgical interventions employed in patients with typhoid perforation.This was a retrospective review of the medical records of adult and paediatric surgical patients treated in the general and paediatric surgical units of the Korle Bu Teaching Hospital. Information was obtained from medical records at the Korle Bu Teaching Hospital in Accra, Ghana, between January 2009 and April 2012. The data was analysed using IBM SPSS Statistics version 20 and 22.133 patients (median age of 21 years, 72.2% males) with typhoid perforation were included in the study. The typhoid perforation specific mortality rate was 12.8%. Males had a significantly lower mortality rate (7.3%) compared to females (27%). Simple bowel closure (85.7% of total) was the most common surgical intervention performed and patients operated upon with this method had a significantly lower mortality rate (9.6%) compared to patients with bowel resection (31.6%).In this study, patients treated with intestinal resection were more likely to die from typhoid perforation and female gender was a risk factor for death. Simple bowel closure was the predominant surgical procedure.