Epidemiology of armed robbery‑related gunshot injuries in Maiduguri, Nigeria

Background and Objectives: Gunshot Injuries used to be rare in Nigeria until the civil war of 1967–1970. Unfortunately, it has become very rampant recently. The objective of this paper is to look at the epidemiology of armed robbery‑related gunshot injuries as seen in the University of Maiduguri Teaching Hospital over a five‑year period. Materials and Methods: Data on patients that presented with gunshot injuries within the study period (January 2002 to December 2006) were collected and analyzed retrospectively. Results: We studied 129 patients with gunshot injuries that were managed during the study period. This comprises of 117 males and 12 females (M:F=9.8:1). Eighty four (65.1%) were young males between 20 and 40 years. One hundred and fifteen (89.2%) of the 129 victims were shot by armed robbers, the remaining 14 (10.8%) were shot under other circumstances not related to armed robbery. Analysis of the time of attack revealed 72% of victims were attacked at night. Over 80% of victims were shot along the highway. The anatomical sites of gunshot entry wound show the extremities having the highest of 46.1%. Ninety one (79.1%) victims were treated operatively while 16 (13.9%) were treated nonoperatively. Conclusion: Armed robbery is the motive behind most gunshot injuries in Nigeria. Most of these attacks are preventable if the government would support and motivate the security apparatus responsible. There is also need for the government to support the victims by shouldering their treatment and subsequent rehabilitation.Nigerian Journal of Clinical Practice • Jan-Mar 2012 • Vol 15 • Issue

Missed Diagnosis of a Delayed Diaphragmatic Hernia as Intestinal Obstruction: A Case Report

Penetrating diaphragmatic injury rarely occurs in isolation. Diagnosis of traumatic diaphragmatic hernia resulting from penetrating diaphragmatic injury may be delayed or missed with attendant high morbidity and mortality. We reported a 28-year-old man who presented with features of subacute intestinal obstruction which became severe over the last four days. He had a stab injury to his left lower chest wall that was sutured 31/2 years prior to the development of symptoms. Emergency laparotomy with incidental findings of missed diaphragmatic hernia with gangrenous jejunal segment was found. The hernia was reduced, gangrenous segment  resected with end to end anastomosis, and repair of diaphragmatic rentdone. He had an uneventful recovery and follow up. There is the need to maintain high index of suspicion of Traumatic Diaphragmatic Hernia (TDH) in a patient with recent or previous thoraco-abdominal injury that will reduce the rate of missed or delayed diagnosis.Key words: penetrating chest injury, diaphragmatic hernia, delayed, missed diagnosis

Tuberculous Ileal Perforation In A HiV Positive Patient A Case Report And Review Of Literature

Tuberculosis is prevalent worldwide. Even in developed countries there is a resurgence of tuberculosis mainly due to increasing HIV infection. Tuberculous ileal perforation is uncommon. It is, however, a potentially fatal complication of intestinal tuberculosis especially inHIV/AIDS patient. To highlight tuberculous ileal perforation as an underestimated complication of intestinal tuberculosis in anHIVpatient presentingwith acute abdomen. A 42 year old HIV positive long distance truck driver with tuberculous ileal perforation is presented and related literatures reviewed. Intestinal perforation due to abdominal tuberculosis is an aetiological factor in acute HIV abdomen.High index of suspicion remains the key to diagnosis.Keywords: Tuberculosis, Ileal Perforation,HIV Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 386-38

Isolated gallbladder rupture following blunt abdominal trauma

The gallbladder is a relatively well‑protected organ; consequently its rupture following blunt abdominal injury is rare and usually associated with other visceral injuries. Isolated gallbladder rupture is extremely rare. We report a healthy Nigerian adult male who sustained isolated gallbladder rupture following blunt abdominal injury from riding a motor cycle (Okada). A high index of suspicion with positive bile aspirate might lead to early diagnosis. Open cholecystectomy is a safe option of treatment in a resource poor centre especially in delayed presentation and has a good outcome.Key words: Blunt abdominal trauma, gallbladder rupture, isolate

Bacterial pathogens associated with wound infections at the university of maiduguri teaching hospital, Maiduguri, Nigeria

Wound infection is a significant health problem in many parts of the world especially, Africa. It complicates the recovery of the patient, increases trauma care, prolongs hospital stay and has economic consequences on the patient. It also undermines the cost-effectiveness of wound management objectives in health settings. Objective: The study aims at investigating bacterial pathogens associated with wound infections at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. Methods: Each of the 165 various wound specimens included in the study were streaked on blood and MacConkey agar plates, incubated aerobically at 37oC for 24 hours and colonies were identified and characterized using conventional methods. Result: Out of the 165 wound samples cultured and examined bacteriologically, 98.8% were positive for bacterial growth. Pure culture was obtained in 139 (84.2%), mixed growth of two organisms in 24 (14.5%) and 2 (1.2%) were negative for isolate. The most prevalent (57%) of gram positive organisms was Staphylococcus aureus and of the gram negative organisms, Proteus spp (16.4%). Twenty (83.3%) out of 24 polymicrobial infections were between Staphylococcus aureus and other organisms and 4(16.7%) were among gram negative organisms.Conclusion: It is hoped that reports of this type will create greater awareness in the selection of prophylactics and suitable antibiotic therapy for prompt healing of wounds and reduction of emergence of resistant strains

The prevalence of hyperthyroidism at university of maiduguri teaching hospital (UMTH), Maiduguri.

Hyperthyroidism and hypothyroidism are the two common thyroid disorders but there is paucity of information on the prevalence of hyperthyroidism in Nigeria in general and in Northeast of Nigeria in particular. Objective: To determine the prevalence of hyperthyroidism at University of Maiduguri Teaching Hospital. Method: A retrospective study done over a period of one year that reviews the results of serum TSH, T4 and T4 from 203 patients. Results: Eighty-nine (43.8%) and 79 (38.9%) patients had elevated serum levels of T3 and T4 respectively (i.e. were hyperthyroid), 114 (56.2%) and 112 (55.2%) patients had normal serum levels of T3 and T4 respectively (i.e. were euthyroid) while 12 (5.9%) patients had low serum levels of T4 only (i.e. were hypothyroid). The female to male ratio of hyperthyroidism was 4 and 1[T3 — female 68 (35.4%), male — 17(89%); T 4— female 59 (30.7%), male 15(7.8%)]. Age —group from 25—34 years was the most frequent. (51 patients) and with the highest prevalence of hyperthyroidism [T4- 19(14.2%); T4 18(13.4%)].The study further revealed a decline in the prevalence of hyperthyroidism as age increased. The finding of high prevalence of low TSH (20.8%) against high prevalence of elevated T3 and T4 [89(44.1% and 79(38.9%) respectively] in this study could suggest that the hyperthyroidism in the studied patients could have been largely caused by Graves' disease. Conclusion: This study revealed that thyroid disorders are not uncommon in our environment and the finding of high prevalence of low TSH above high TSH, suggested that the hyperthyroidism discovered in our study may have been largely caused by Grave's disease. We recommend that more laboratory diagnostic centre should be established in our environment where thyroid disorders can be diagnosed

The role of anaesthetist in the management of patients due to insurgency in the North-eastern Nigeria.

The roles played by the team of Anaesthetists in the management of patients due to insurgency are enormous and very vital in the survival of the patients and indeed in the reduction of the possible morbidities and mortalities due to injuries from the insurgency. Objective: This study is aimed at giving an overview of the role of Anaesthetist in important areas of patient's management due to insurgency and to suggest ways of improvement. Method: This is a prospective study of 1,339 patients managed for various injuries sustained due to insurgency in the University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria, for the period of five years (January, 2010 and December, 2014). Results: One thousand three and thirty nine (1,339) patients who were injured directly due to the insurgency were included in the study during the period under review. Their ages ranged from 1 month to 80 years with the mean age of 38.6±18.3 years. Most of the injuries occurred among the age group 18 - 35 years. Patients were resuscitated, had anaesthesia for surgeries and also had intensive care management. Conclusion: The roles played by the Anaesthetist are so vital in the survival of the patients due to insurgency. However, there is a need for an increase in the number of Anaesthesia manpower and for the training and re-training of these Anaesthetists in the management of mass casualties

A genome-wide genetic map of NB-LRR disease resistance loci in potato

Like all plants, potato has evolved a surveillance system consisting of a large array of genes encoding for immune receptors that confer resistance to pathogens and pests. The majority of these so-called resistance or R proteins belong to the super-family that harbour a nucleotide binding and a leucine-rich-repeat domain (NB-LRR). Here, sequence information of the conserved NB domain was used to investigate the genome-wide genetic distribution of the NB-LRR resistance gene loci in potato. We analysed the sequences of 288 unique BAC clones selected using filter hybridisation screening of a BAC library of the diploid potato clone RH89-039-16 (S. tuberosum ssp. tuberosum) and a physical map of this BAC library. This resulted in the identification of 738 partial and full-length NB-LRR sequences. Based on homology of these sequences with known resistance genes, 280 and 448 sequences were classified as TIR-NB-LRR (TNL) and CC-NB-LRR (CNL) sequences, respectively. Genetic mapping revealed the presence of 15 TNL and 32 CNL loci. Thirty-six are novel, while three TNL loci and eight CNL loci are syntenic with previously identified functional resistance genes. The genetic map was complemented with 68 universal CAPS markers and 82 disease resistance trait loci described in literature, providing an excellent template for genetic studies and applied research in potato