The Civilian Vascular Trauma in a Low‑Income Country: The Determinant Factors of Morbidity and Mortality

Background: Civilian vascular injury is relatively common in the West African subregion, but it is highly underreported. Aim/Objective: The aim of the study was to evaluate the patients managed for civilian vascular surgeries and to determine the factors causing morbidity and mortality in low‑income countries. Materials and Methods: This is a retrospective study spanning a period of 13 years (2007–2019) of civilian vascular injuries managed in a tertiary hospital in a low‑income country. We obtained data from our hospital record department. Data obtained and analyzed were demography, etiology, vessels affected, pattern of presentation, stratification, and treatment. Results: Within the envisaged period, 58 patients were affected in civilian vascular trauma with a mean of 4.5 cases per year. The male‑to‑female ratio was 0.9:0.1. The age range of patients affected was from 0–10 to 71–80, with the age group of 21–30 years being the most affected. Male was more affected (87.9%). Motor vehicle crashes were the most common etiology agent (42.0%). The femoral artery was the most commonly injured vessel (31.3%). In the pattern of presentation, bleeding with shock was dominant (49.8%). Lateral tarsorrhaphy accounted for the major vascular treatment interventions (30.2%). Conclusion: The outcome was very variable and depended on warm ischemic time, type and/or mechanism of injury, collateral blood supply at the site of injury, and comorbidity. Keywords: Amputation, civilian, injury, vascular, warm ischemic tim

Management of Spontaneous Pneumothorax in Pregnancy in a Low‑Income Country during COVID‑19 Pandemic

Spontaneous pneumothorax is a rare and life-threatening emergency. When it occurs in pregnancy, it poses a serious danger for both the mother and the fetus. A high index of suspicion, early diagnosis, and proper management are recommended. We present the case of a 35‑year‑old pregnant woman at the 34th week of gestation who presented via the emergency department complaining of sudden onset of dyspnea and chest pain. The clinical and radiologic evaluation confirmed the right‑sided pneumothorax. She had a closed tube thoracostomy drainage (CTTD) following which the patient’s condition improved. She subsequently had chest tube removal with no recurrence beyond delivery as she had a good outcome. Keywords: Chest tube, COVID‑19, pregnancy, spontaneous pneumothora

Assessment of Ecological Status and Tree Diversity in Watershed Area of Dandi Local Government Area in Kebbi State, Nigeria

This study assessed the ecological and tree diversity status of watershed area of Dandi local government area in Kebbi state using systematic sampling technique. Three transects of 300 m long were laid at 100 m intervals. On each transect, six sample plots of size 50 m x 50 m (0.25ha) were alternately laid at 50 m intervals. A total of 18 sample plots will be used for the study. Diameters at breast height (Dbh) of all the trees found in the plot with Dbh ≥ 5cm will be measured. Fourteen tree species belonging to 10 genera and 8 families were identified. Borassus aethiopum of the family Arecaceae was the most abundant species in the area with a relative density (RD) and diversity index (DI) of 0.296 and 0.08728 respectively. This was followed by Cocos nucifera in the Arecaceae family also, with RD and DI of 0.192 and 0.03662 respectively. Daniella oliveri of the family Fabaceae was the least represented species with RD and DI of 0.0018 and 0.00002 respectively. The overall tree species richness in the area was 0.0052

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population