Comparison of Chlorhexidine - Alcohol and Providone Iodine Skin Preparation Skin Preparation Solutions in Orthopaedic and Trauma Surgery at An African Tertiary Hospital

No Abstract

Skeletal birth injuries: presentation, management and outcome at the University College Hospital, Ibadan

No Abstract. Nigerian Journal of Paediatrics Vol. 32(1) 2005: 12-1

The burden of open fractures of the tibia in a developing economy

Background and purpose of study: Open fractures are difficult to treat particularly because of the risk of infective complications. The rudimentary emergency rescue services in a developing country like ours with attendant delays in presentation of patients amongst other factors would suggest a dismal outcome for open tibial fractures in Nigeria.Patients and methods: Ninety two patients with 98 open tibial fractures who presented to the University College Hospital(UCH), Ibadan over a 12-month period were reviewed. The aetiology and severity of these fractures were explored as well as thetreatment outcomes.Result: The mean age was 33.3 years (peak 21-40 years) with men being 2.4 times at risk. Eighty three percent were from roadtraffic injuries; pedestrian crashes led other traffic injuries with 32% of cases. A quarter of the patients presented after 8 hours of injury. Three quarters of the fractures occurred in the shaft. Gustilo type IIIb injuries was the commonest (36.7%). The methods of treatment included plaster cast (71.5%), external fixation (15.7%), plating and primary amputation (5.7% each), and  intramedullary nailing (1.4%). Average time to union was 26.2 ± 12.7 weeks. Forty six late complications occurred in 32 fractures (there were 6 cases of chronic osteomyelitis).Conclusion: The incidence and severity of open fractures in our environment calls for urgent steps geared towards reducing theincidence of road crashes. The provision of standard, prompt and affordable emergency as well as definitive health care facilitiesfor the victims should be a priority

Septic Arthritis of The Hip Joint presenting as Acute Abdomen

Septic arthritis of the hip joint in two children, originally thought to be cases of acute abdomen is presented. In one case, the discovery of extra-peritoneal purulent fluid at surgery, obviated the need for laparotomy and in the other, the true nature of the disease became apparent one week after laparotomy. These cases illustrate the maxim that any painful movement of the hip joint with associated unexplained fever should raise suspicion of septic arthritis. The close relationship of the hip joint to the pelvis sometimes confuses hip diseases with pelvic pathologies. Key Words: Septic arthritis, acute abdomen, pathological dislocation Nigerian Journal of Paediatrics 2003; 30: 67-70

Osteosarcoma of the jaws: a review of literature and a case report on synchronous multicentric osteosarcomas

<p>Abstract</p> <p>Background</p> <p>In the head and neck region, osteosarcoma is the most common primary malignant bone tumor, representing 23% of total head and neck malignancies. Osteosarcomas of the jaws are nevertheless rare lesions, representing only 2 to 10% of all osteosarcomas. This report reviews a single-center histopathology experience with craniofacial osteosarcomas, and reports the management of unusually large synchronous mandibular and maxillary osteosarcomas in a patient.</p> <p>Patients and methods</p> <p>A search of the hospital pathology database for specimens with a histological diagnosis of osteosarcomas submitted between July 1992 and May 2011 was made. A chart review of a patient with large synchronous maxillary and mandibular osteosarcomas was performed, and is reported.</p> <p>Case presentation</p> <p>A 21-year-old African man with large maxillary and mandibular tumors under palliative care presented with increasing difficulties with eating, speech, and breathing. Surgical debulking was performed, with histology confirming synchronous osteosarcomas of the mandible and maxilla. The patient is well after one year, with no evidence of recurrence, having undergone no further treatment.</p> <p>Conclusion</p> <p>Osteosarcomas of the jaw remain enigmatic, and a number of difficulties related to their diagnosis and treatment are yet to be resolved. True synchronous multicentric osteosarcomas of the jaws are extremely rare but, like other osteosarcomas of the jaws, have a favorable outcome, and palliative resection of such lesions, though challenging, can therefore lead to an enormously improved quality of life and self-image, and may even offer the opportunity for cure.</p

The World Health Organization ACTION-I (Antenatal CorTicosteroids for Improving Outcomes in preterm Newborns) Trial: a multi-country, multi-centre, two-arm, parallel, double-blind, placebo-controlled, individually randomized trial of antenatal corticosteroids for women at risk of imminent birth in the early preterm period in hospitals in low-resource countries

BACKGROUND: Antenatal corticosteroids (ACS) have long been regarded as a cornerstone intervention in mitigating the adverse effects of a preterm birth. However, the safety and efficacy of ACS in hospitals in low-resource countries has not been established in an efficacy trial despite their widespread use. Findings of a large cluster-randomized trial in six low- and middle-income countries showed that efforts to scale up ACS use in low-resource settings can lead to harm. There is equipoise regarding the benefits and harms of ACS use in hospitals in low-resource countries. This randomized controlled trial aims to determine whether ACS are safe and efficacious when given to women at risk of imminent birth in the early preterm period, in hospitals in low-resource countries. METHODS/DESIGN: The trial design is a parallel, two-arm, double-blind, individually randomized, placebo-controlled trial of ACS (dexamethasone) for women at risk of imminent preterm birth. The trial will recruit 6018 women in participating hospitals across five low-resource countries (Bangladesh, India, Kenya, Nigeria and Pakistan). The primary objectives are to compare the efficacy of dexamethasone with placebo on survival of the baby and maternal infectious morbidity. The primary outcomes are: 1) neonatal death (to 28 completed days of life); 2) any baby death (any stillbirth postrandomization or neonatal death); and 3) a composite outcome to assess possible maternal bacterial infections. The trial will recruit eligible, consenting pregnant women from 26 weeks 0 days to 33 weeks 6 days gestation with confirmed live fetuses, in whom birth is planned or expected within 48 h. The intervention comprises a regimen of intramuscular dexamethasone sodium phosphate. The comparison is an identical placebo regimen (normal saline). A total of 6018 women will be recruited to detect a reduction of 15% or more in neonatal deaths in a two-sided 5% significance test with 90% power (including 10% loss to follow-up). DISCUSSION: Findings of this trial will guide clinicians, programme managers and policymakers on the safety and efficacy of ACS in hospitals in low-resource countries. The trial findings will inform updating of the World Health Organization's global recommendations on ACS use. TRIAL REGISTRATION: ACTRN12617000476336 . Registered on 31 March 2017