Serum levels of monocyte chemoattractant protein-1 has no correlation with gender and age in polytrauma

Background: Trauma is one of the commonest causes of death among young people with significant increase in morbidity and mortality. Following injuries to tissues, the body responds in an attempt to cause repair of the damaged tissue. Although its significance depends on the interplay of various factors involving neurohormonal and immune responses. Monocyte chemoattractant protein-1 (MCP-1) is a pro-inflammatory chemoattractant produced by the monocyte and causes the further release of chemokines and cytokines needed at the site of tissue injury. It therefore plays a critical role in tissue healing.Methods: This was a prospective hospital-based study carried out at University College Hospital (UCH), Ibadan. Polytrauma patients admitted through the accident and emergency department that met a defined criteria were recruited and had their blood samples taken into an endotoxin free test tube at 48±2 hours after trauma. MCP-1 levels in the serum were estimated though the human MCP-1 enzyme-linked immunosorbent assay (ELISA) kit. This process was carried out using the ELISA technique based on the producer’s guide.Results: 110 patients were recruited for the study. There was no significant difference in gender variations in MCP-1 level (t=-0.935, p=0.351). For the male and female variations in MCP-1 levels, it ranges from 10 to 2841 and 22 to 2687 respectively. Likewise, there was no significant relationship in age variations in MCP-1 values (f=0.959, p>0.05).Conclusions: This study demonstrated no correlation between serum level of monocyte chemoattractant protein-1 with age and gender in polytraumatized patient according to age and gender

Incidence and reasons for leave against medical advice among orthopedic and trauma patients at the university college hospital Ibadan

Background: Leave against medical advice (LAMA) of hospitalized patients is an adverse clinical event in which a patient chooses to leave the hospital before it is medically advisable to do so and it negatively affects the treatment outcome. Because of this, the study was designed to determine the incidence of and indications for LAMA among orthopedic patients who presented at the accident and emergency department of the university college hospital, Ibadan.Methods: This was a prospective hospital-based study determining the incidence of LAMA among orthopedic patients who presented at the accident and emergency department of the university college hospital, Ibadan between September 2019 and March 2020.Results: A total of 289 patients with orthopedic conditions presented within the study period and about 12.46% of these LAMA. The male to female ratio observed in this study is 2:1. The age range was between 8 and 93 years. Trauma from motorbike and motor vehicle accidents accounted for over 80% of the etiology. The most important factor influencing LAMA is financial constraints (63.9%) and LAMA was signed mostly by the patients (25%).Conclusions: LAMA among orthopedic patients in Ibadan is mostly due to financial reasons, therefore, factors that will reduce the cost of management such as the accessibility to health insurance schemes will significantly reduce the incidence of LAMA among orthopedic patients in Nigeria.

Epidemiology of fractures of the humerus at the university college hospital Ibadan

Background: The humerus is one of the long bones of the upper limb. It may be fractured following traumatic or non-traumatic injury. Humeral shaft fractures account for 1-3% of all fractures. However supracondylar fracture of the humerus is more common amongst children accounting for about 16% of all pediatric fractures. Trauma especially from falls especially in both children and geriatric populations has been known to cause humeral fractures. Other causes had been documented also. This study was aimed at determining the incidence, cause and pattern of humeral fracture in patients who presented to the accident and emergency department of the University College Hospital, Ibadan, Oyo state, Nigeria. Methods: Patients with radiologically confirmed humeral fractures who presented to the accident and emergency department of the hospital between January 2015 and December 2019 were included in the study. Data was obtained from the electronically stored data at the department of orthopedic surgery and trauma university college hospital Ibadan using a proforma and the data generated was analyzed using Statistical Package for the Social Sciences version 16. Results: A total of 167 patients with humeral fractures were seen during the study period. Most of these patients are within the age range of 0-15 years. Male to female ratio was 1.7:1. Most humeral fractures were due to fall and the distal humerus was most commonly affected. Conclusions: Humeral fractures occur in younger people and efforts should be geared towards preventing this trend in younger population

Incidence of pediatric long bone fractures at the university college hospital Ibadan

Background: Individuals within the paediatric age group sustain different types of fractures, as such the need to determine the incidence and pattern of long bone fractures among patients 16 years and below admitted through the different wards of admittance of the university college hospital Ibadan.Methods: This was a retrospective hospital-based study involving patients 16 years and below admitted through the accident and emergency department, the children emergency department, the neonatal ward and labour ward of the hospital between January 2013 and December 2018 at the university college hospital Ibadan. Using a proformal completed from the electronically stored data that captured the patient’s history, examination findings, X-ray film and treatment offered which was collected on a weekly basis.Results: 25.13% of the patients reviewed within the study period were paediatric patients. A total of 337 paediatric patients were reviewed. There were 124 female and 213 males with ratio (F:M-1:1.7). The fractures were mostly secondary to fall and road traffic crash accounting for 68.54% and 23.15% respectively. 65.12% of the fractures involve the bone of the upper limbs while 34.98% occur in the bones of the lower limbs. The radius and the ulnar bones are the most affected. Transverse fracture is the most common pattern observed.Conclusions: More than 20% of the reviewed population was in the paediatric age group and the radius and ulnar bones were the most commonly fractured bone in this age group. They usually follow trivial falls

The incidence and pattern of geriatric limb fractures in Ibadan, Nigeria

Background: Individuals within the geriatric age group sustained different types of fractures as such the need to determine the incidence and pattern of limb fractures among patients 65 years and above admitted through the accident and emergency department of the University College Hospital Ibadan.Methods: A retrospective hospital-based study in which patients 65 years and above admitted through the accident and emergency department of the University College Hospital Ibadan over a 42-month period were involved in the study. Using a proformal completed from the electronically stored data that captures the patient’s history, examination findings, X-ray film and treatment offered which was collected on a weekly basis.Results: 12.58% of the patients reviewed within the study period were geriatric patients. A total of 98 geriatric patients were reviewed. There were 59 female and 39 male with a ratio 1.5:1. The fractures were mostly secondary to a trivial fall within their homes (68.37%) while traumatic injury from motor vehicle and motor bike crashes accounted for 11.22% and 16.33% respectively. The most commonly fractured bone is the femur and the proximal third is the most affected part. Comminuted fracture is the most common pattern observed.Conclusions: More than 10% of the reviewed population was in the geriatric age group and the proximal femur was the most commonly fractured bone in this age group. They usually follow trivial falls

Pattern of childhood injury in a tertiary centre

Introduction: Childhood injury and death have been projected to be a disease of public health significance, however, the trend in many developing countries of which Nigeria is one is still unknown. We, therefore, examine the pattern of childhood traumatic injury in our institution. Materials and Methods: The information of patients aged 16 years and below who presented with trauma was extracted from the trauma registry of the emergency units of University College Hospital, Ibadan, from 2015 to 2020. Data were analysed using the SPSS version 20. Results: A total of 3146 children were managed for trauma in the accident and emergency departments of the hospital. Most of them were males (61.2%) and within the under-five age group (36.4%). The majority of the injuries were secondary to fall (41.8%). Male child was more likely to be involved in any mechanism of injury and children between 11 and 16 years were commonly involved in machine hand injury (80%). Following intervention in the accident and emergency department, 44.1% were discharged in the emergency units, 21.5% required admission into the specialist ward, 6.0% died, 5.0% discharged against medical advice and 2.6% were referred. Conclusion: The burden of childhood injury is becoming significant thus demands more attention

Sideswipe injury of the knee: The new face of an old foe?

The term “sideswipe injury” has become synonymous and used interchangeably with the term “traffic elbow.” However, with the continuous rise in the use of the tricycle as a means of public transportation in some developing countries, a rise in sideswipe injuries of various severities is being experienced. We report a case of sideswipe injury to the left knee region of a 45‑year‑old female who was a passenger in the backseat of a tricycle. She sustained a severe injury to the soft tissues and bones around the knee and the popliteal region, with disruption of the neurovascular bundles in the popliteal fossa necessitating an above‑knee amputation