The Pattern and Outcome of Severe Trauma from a Dedicated Trauma Centre in Nigeria: An Observational Study

Background: Trauma is a leading cause of mortality and a major contributor to disability in various parts of the world. The pattern of trauma and outcome of trauma differ in various parts of the world. Despite that the Trauma burden in the country is high and there are limited published studies on the pattern and outcome of severe trauma in Nigeria presently. Aim: To evaluate the pattern and outcome of severe trauma at dedicated regional trauma centre in Port Harcourt, Nigeria. Method: Data of patients presenting with severe trauma between January 1, 2007 and December 31, 2007 at the hospital was collated and analysed. Trauma demographics, type of care and the outcome of care of the recruited patients was evaluated and presented as descriptive statistics. Result: Seven hundred and sixty two patients were seen with severe trauma but data of 746 patients had enough information was analysed. These represents 12.3% of the total number of patients with trauma seen at the hospital (n = 6180). Most of the patients with severe trauma seen at the centre were males with a mean age ± standard deviation, 28.5 ± 11.3 years. Road traffic collision was the commonest cause of injury (41.2%) but gunshot wounds contributed a sizable number of the injuries (36.7%). The median Injury Severity Score (ISS) was 20 (range = 16 – 75) while the mean Revised Trauma Score (RTS) ± SD was 7.1 ± 1.3. Mortality among patients with severe trauma was 90 (12.1%). Three hundred and forty two patients (45.1%) had satisfactory and good outcome whereas 260 patients (34.9%) had fair and poor outcome. Some patient (n=24 {3.2%}) discharged themselves from the hospital against medical advice, Head injury was the highest contributor to mortality Conclusion: Trauma burden is an identified problem in Port Harcourt Nigeria. Road traffic crashes and gunshot wounds were the highest contributor of severe trauma at the centre. Severe trauma constitutes only 12% of trauma cases seen at the centre and mortality from severe trauma was 12%. Keywords: Trauma, Severe Trauma, Trauma Pattern, Outcome, Nigeri

Road Traffic Crash as a Public Health Issue in Nigeria： Review Article

Road Traffic Crashes continues to pose significant menace globally. The burden of road traffic crashes is worse in the middle and low income countries like Nigeria despite that the region has less than 10% of global vehicles. The situation in Nigeria is even more worrisome as the country continues to rank low in World Health Organization indices for road traffic safety. Despite efforts of various government agencies towards implementation of policies and regulations to reduce the incidence of RTC on Nigerian roads, the number of crashes witnessed on various roads in Nigeria remains high. There has been reported decrease in the number of road traffic crashes, injuries and deaths from RTC from the Federal Road Safety Commission in Nigeria over the years. This reported decrease in RTC and its consequences still require validation by reliable data which is yet to be available at the moment in Nigeria. The aim of this review is to appraise the current trends in the incidence of road traffic crashes and its consequences in Nigeria and efforts to reverse the persisting pattern in the country

Spectrum of musculo-skeletal disorders in sickle cell disease in Lagos, Nigeria

<p>Abstract</p> <p>Background</p> <p>Sickle cell anemia (SCA) is a common genetic disease in Nigeria. Past studies from West Africa focused on isolated aspects of its medical and surgical presentations. To the best of our knowledge, the musculo-skeletal presentations amongst Nigerians with SCA have not been documented in a single all encompassing study. This work aims to prospectively document the musculo-skeletal disease burden among SCA patients.</p> <p>Methods</p> <p>In a prospective study of 318 consecutive patients with genotype-confirmed SCA at the Lagos University Teaching Hospital (LUTH), the musculo-skeletal pathologies, anatomic sites, grade of disease, age at presentation and management outcome were recorded over a one-year period. Data obtained were analyzed using Epi-Info software version 6.0. Data are presented as frequencies (%) and mean values (SD) as appropriate.</p> <p>Results</p> <p>The HbSS genotype occurred in 296 (93.0%), while 22 (7.0%) were HbSC. 100 (31.4%) patients with average presenting haemoglobin concentration of 8.2 g/100 ml in the study group, presented with 131 musculo-skeletal pathologies in 118 anatomic sites. Osteomyelitis 31 (31%) and septic arthritis 19 (19%) were most commonly observed in children less than 10 years. Skin ulcers and avascular necrosis (AVN) occurred predominantly in the older age groups, with frequencies of 13 (13.0%) and 26 (26.0%) respectively. 20 (71.5%) of diagnosed cases of AVN presented with radiological grade 4 disease. The lower limbs were involved in 84 (71.1%) of sites affected. Lesions involving the spine were rare 11 (0.9%). Multiple presentations occurred in 89 (28.0%) of patients; 62 (69.7%) of which were children below 10 years.</p> <p>Conclusions</p> <p>Musculo-skeletal complications are common features of sickle cell anaemia seen in 31.4%. Infectious aetiologies predominate with long bones and joints of lower limbs more commonly affected by osteomyelitis and septic arthritis. Healthcare providers managing SCA should be aware of the potential morbidity and mortality of these conditions to ensure early diagnosis and adequate management.</p

Effects of vitamin E and selenium yeast on cognitive performance of pups whose dams were subjected to prenatal noise stress

This study investigated the effects of vitamin E and selenium yeast on the cognitive performance of pups whose dams were subjected to prenatal noise stress (PNS). Twenty-five pregnant Wistar rats were divided into five groups, group 1 (negative control; received 1 mL/kg of distilled water without noise stress (NS); group 2: (positive control), received 1 mL/kg of distilled water group 3: received vitamin E; 100 mg/kg/day group 4: selenium yeast (0.4 mg/kg/day) and group 5: vitamin E (100 mg/kg/day bw) and selenium yeast (0.4 mg/kg/day). All administrations were done 30 min before the induction of white noise at 100 dB/4 h (0900–1300 h) /day for 15 days. On gestational day 21, five pups (n = 5) were randomly selected from each group. The pups were subjected to cognitive tests using the Y-maze apparatus on days 21 and 22. All experimental animals were sacrificed on day 23 for tissue processing. Data were analyzed using one-way ANOVA and a value of p˂0.05 was considered statistically significant. The serum corticosterone (CORT) levels statistically increased in group 2 (p˂0.001) compared with groups 1, 3, 4 and 5. Brain homogenate showed an increased level of Malondialdehyde (MDA), decreased levels of glutathione reeducates (Gpx), catalase (CAT) and superoxide dismutase (SOD) in group 2 compared to 1. Glial cell activation was prominient in group 2 compared to group 1. Prenatal noise stress-induced cognitive impairments in pups whose dams were exposed to NS, but this impairment was mitigated with the administration of vitamin E, selenium yeast and combined administration of selenium yeast and vitamin E