Burns in pregnancy: Five-year experience in a tertiary hospital in southeastern Nigeria

BackgroundBurns in pregnancy is often associated with high maternal and fetal morbidity and mortality especially when the total burn surface area (TBSA) involved is high. This study aims to review management outcome of cases of burns in pregnancy at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA).MethodsA five year retrospective study of all pregnant women that presented at AE-FUTHA with burn injury between April 2014 and March 2019. Information was collected from the medical records using a proforma and analyzed with IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA) using descriptive statistics.ResultsA total of 222 cases of burns were managed but only 8 were pregnant, giving an incidence of 3.6%. The commonest causes were flame (62.5%), scald (25%) and friction (12.5%) occurring mostly during the harmattan season. The median age of participants was 25-34 years. The burns affected 12.5% of the patients in the first trimester and 62.5% and 25% in the 2nd and 3rd trimesters respectively. Most patients (62.5%) had superficial burns while 25% had other associated injuries in addition to burns. About 87.5% had term spontaneous vaginal delivery. There was no maternal death but, there was an early neonatal death.ConclusionThe good outcome observed in this study with a 100% survival, could be explained by inter-disciplinary management approach given, even as most cases were minor degrees of burns. Early involvement of obstetricians in all burns affecting pregnant women is advised especially in burn centres where obstetricians are hardly in the employ

Impact of COVID-19 on surgical emergency presentations in a tertiary hospital in the developing world

BACKGROUND: The COVID-19 pandemic and the institution of measures to contain the spread of the virus have disrupted patients' elective and emergency care, with scarce resources being channeled towards care of emergency presentations and containing the virus. The study aimed to assess the impact of COVID-19 on surgical accidents and emergency presentations in a major teaching hospital. METHOD: This was a comparative retrospective study. All presentations between February to July 2019 (non-COVID-19 period) were compared with the same period in 2020 (COVID-19 period). Patients' biodata, including surgical specialty that managed the patient, diagnosis, and treatment offered, were collated and analyzed with IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: I.B.M. Corp. RESULTS: We included 3463 patients in the study; 2419 (69.9%) were males, while 1044(30.1%) were females. The mean age of the patients in 2019 was 31.83 ±19.31 years, and that of 2020 was 34.93±19.99 years (P=0.001). During the lockdown period, emergency surgical presentations declined significantly by 17% (1894 versus 1569: P=0.001). There was a general decline in surgical emergency presentations across surgical specialties, with orthopedic and otorhinolaryngology (E.N.T.) having the greatest impact (313 versus 202 P=0.044). Presentation for trauma decreased by 18% (1394 versus 1144 P=0.711). Operative interventions declined by 47% (292 versus 155 P=0.001). There was a decline of 31% in the number of admissions for in-patient care (420 versus 290 P=0.019). CONCLUSION: The COVID-19 lockdown in Nigeria was associated with a reduction in the number of surgical emergency presentations and surgical interventions

Obstructed right Duari hernia

The caecum and appendix are uncommon contents of femoral hernia (Duari hernia). Diagnosis is usually intraoperative. We report a rare case of obstructed right femoral hernia in a 65-year-old woman. She was admitted into the accident and emergency department because of sudden irreducibility of a previously reducible right groin swelling of 5 years duration. She had obstructive symptoms with an irreducible right groin mass clinically diagnosed as obstructed right femoral hernia. A combination of infra-inguinal transverse incision and a lower midline laparotomy incision was used. The intraoperative findings included the herniation of the caecum and appendix into the right femoral canal. Patient had an uneventful recovery. Duari hernia is uncommon. A high index of suspicion and an experiencedsurgeon, who can handle uncommon findings should be involved in the management of obstructed femoral hernias

Case report - Lassa Fever Mimicking Ectopic Pregnancy: A Report Of Three Cases

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