Gunshot Wound to the Chest With Retained Epicardial Bullet.

Gunshot wounds remain the most common cause of penetrating injuries in children and adolescents and the second leading cause of death among youth in the United States. Penetrating cardiac injuries carry a significantly increased mortality rate. The extent of damage caused depends on the type of firearm, the bullet used, the velocityand the trajectory. Therefore, rapid diagnosis and treatment is of the utmost importance. We report a case of a 19-year-old boy who presented to ouremergency department (ED) after sustaining a gunshot wound (GSW) to the right chest. In the ED, the patient was stabilized and a large hematoma was evacuated during a resuscitative thoracotomy. Further thoracotomy in the operating room was done with repairs of the penetrating injuries to the heart and lungs. No bullet was identified after careful inspection of the entire chest in the operating room. However, upon further postoperative imaging, a bullet was identified on chest X-ray and CT, lodged in the anterior aspect of the subepicardial right ventricular outflow tract. After a complicated hospital course, the patient was discharged by hospital day 30 in a stable condition with outpatient follow-up. The decision to leave or retrieve a bullet should be made on a case-by-case basis depending on the clinical picture. In this case report, we have shown that leaving the bullet in place with close observation and appropriate imaging is feasible for selected patients

Gene frequencies of ABO and Rh blood groups in Nigeria: A review

Background : ABO and Rhesus factor (Rh) blood type are germane in human life in genetics and clinical studies. Aim of the study : The review was undertaken with the objective to provide data on the ABO and Rh(D) blood group distribution and gene frequency across Nigeria which is vital for blood transfusion and susceptibility to disease. Materials and methods: Literature search for ABO/Rh blood distribution in Nigeria was done and allele frequencies of A, B, O, D and d were calculated from the frequency recorded from six geopolitical zones in Nigeria. We reported frequency of ABO and Rhesus blood type from 318,940 and 280,514 individuals respectively. Prevalence were reported as percentage and Hardy-Weinberg equilibrium was tested using Chi square test and p was set at 0.05 unless otherwise stated. Results : We reported ABO blood group frequencies in the order O > A > B > AB (52.93%, 22.77%, 20.64% and 3.66%) while prevalence of Rh+ was 94.90% from total population studied. Our reported frequencies did not differ from Hardy-Weinberg equilibrium (goodness-of-fit X 2 for ABO = 1.74 df = 3, p < 0.05). Allelic frequencies for A(p), B(q) and O(r) are 0.143, 0.130 and 0.728 respectively. Conclusion : The study provides information on the distribution/frequency of ABO/Rh(D) blood group and their corresponding allelic proportion in a large Nigeria study. It also revealed how the Nigerian populations in the North, South, West and East vary with respect to genetic traits. This vital information will be important for population genetics and anthropology studies and may be helpful in planning for future health strategy and blueprint, particularly planning with regards to disease management and blood transfusion medicine

Relationship between Ratio of Second and Fourth Digit and Obesity Traits among Different Ethnic Groups in Ilorin, North Central Nigeria

Digit ratio (2D:4D) denotes the relative length of the second and fourth digits. There are contradicting reports on its relationship with ethnicity/race, whereas convincing studies show it is related to obesity. This cross-sectional study was undertaken to demystify ethnic difference in 2D:4D ratio and to analyze its relationship with obesity among adults in Ilorin Nigeria. The cross-sectional study included 701 individuals. Finger lengths were measured with electronic calipers and other anthropometric traits were measured with standard procedure. Student t test and one-way ANOVA were used to detect differences among groups and relationship was computed with Pearson correlation. The receiver operator characteristic curves were used to detect the diagnostic effect of 2D:4D for obesity. The obtained results showed sexual dimorphism in 2D:4D ratio and other anthropometrics at p 0.05); this result proved that there was no ethnic specificity in 2D:4D ratio among study' participants. Thus, it can be reported that the digit ratio was related to high 2D:4D, but this cannot be said for different ethnic groups. The results imply that 2D:4D might be a good surrogate indicator for obesity, but not ethnicity