Practice of Safety Measures among Inter-City Commercial Vehicle Drivers in Kwara State, Nigeria

Background: The incidence of Road Traffic Crashes (RTC) is rising world-wide, with 1.24 million people killed on the world’s roads in 2010 due to non-compliance with safety measures.The objectives of the study was to determine the practice of safety measures and prevalence of road crashes among inter-city commercial vehicle drivers in Kwara State, Nigeria.Materials and Methods: It was a descriptive cross-sectional study done by interviewer administered questionnaire and blood alcohol concentration of respondents was determined using Breathalyzers. A total of 410 respondents were involved by multi-stage sampling technique and data analysis was done using EPI INFO version 3.5.1 software package. An appropriate test of significance were used and the level of significance was < 0.05 at 95% confidence level.Results: There was statistically significant p = 0.057 relationship in good safety practices among drivers in the age group 26-55 years compared with those ≤ 25 years and > 55 years. More respondents who practiced safety measures carried out driving test before issuance of license compared with those who did not (p = 0.001). Some respondents tested positive for alcohol and the mean blood alcohol concentration was 23.28± 23.32µg/dl. About a third of the respondents had experienced road traffic crashes in the past.Conclusion: The middle age respondents had good safety practices compared with others. Safety practices were influenced by driving test before issuance of license and alcohol intake was a factor in RTC. Orientation of drivers and enforcement of laws are critical in road safety

Prevalence of operable intracranial lesions from mild traumatic brain injury in a National Trauma Centre

Abstract Background Mild traumatic brain injury (TBI) occupies majority of head traumas in most emergency units. Although patients with mild TBI can be reviewed and discharged on head injury advice, a sizeable number require admission for observation or intervention due to operable intracranial lesions. The aim of the study was to establish the prevalence of operable lesions in patients with mild TBI. Materials and methods This was a prospective study of consecutive adult patients with mild TBI who had cranial computerized tomography (CT) done at the National Trauma Centre, Abuja. All participants gave informed consent and the study had ethical clearance in the Hospital. Results One hundred and three mild TBI patients with cranial CTs were recruited aged 16–76 years with mean age of 32.25 $$\pm$$ ± 12.35 years. With intention to treat, twenty (20.4%) of them were diagnosed with operable intracranial lesions on CT scans, 19 males and 2 females. Majority of them (14; 66.7%) were young adults within 20–40 years of age. The lesions were 16 extradural haematomas (76.2%), 3 subdural haematomas (14.3%) and 2 depressed skull fractures (9.5%) of the operable cohort. Conclusions Significant number of patients with mild TBI had operable intracranial lesions. Therefore, there is need to screen patients with mild TBI appropriately in order to avoid missed operable lesions

Socio-demographic profiles and outcome of motorcycle related head injury in a Nigerian Tertiary Health Institution

Background: Motorcycle increasingly has been used for commercial transportation in many Nigerian cities with attendance increase in the rate of motorcycle crashes. Head injury is responsible for high morbidity and most mortality following such crashes. The aim of this study is to determine the socio-demographic characteristics of head injured victims of motorcycle crashes, severity of head injury and management outcome. Materials and Methods: A 1 year prospective study of head injured motorcyclists and pedestrians knocked down by motorcycle were carried out at University of Ilorin Teaching Hospital using a pre-designed proforma. Information collected included the age, gender, literacy level, alcohol consumption, license status, crash helmet use, Glasgow coma score and Glasgow outcome score. The IBM statistical package for social sciences (version 15.0) statistical package was used for statistical analysis. Results: A total of140 patients with the median age of 30 years (ranged 3-90 years) were studied. They comprised 115 (82%) males and 25 (18%) females. Most patients (66%) had at least secondary education. People of varying occupations were involved in a motorcycle crash. All riders were males and most (71.8%) were unlicensed. Only 5.8% of riders wore crash helmets at the time of the crash and they all had a favorable outcome. At both extremes of age (70 years) more patients were involved as pedestrians. The only socio-demographic variable that influence outcome of head injury was the patient age. Outcome was better in younger age group (P = 0.004). There was 26.4% mortality. Most, 23 (88.4%), of patients with severe head injury died and none of them had good recovery (P < 0.0001). Conclusion: Our findings demonstrated high mortality among non-crash helmet wearing motorcyclists with motor cycle related head injury. The outcome was significantly influenced by age and head injury severity

Management and Outcome of Infantile Hydrocephalus in a Tertiary Health Institution in Nigeria

Background: Hydrocephalus is a leading cause of disability among children worldwide. The outcome depends on morphology and whether insult is pre- or post-natal. There has been improvement in morbidity in developed countries due to improved surgical care. A paucity of trained personnel impacts negatively on care and outcome of infants with hydrocephalus in many low-income countries resulting poorer outcome. We conducted an audit of patients with hydrocephalus managed in our institution to determine common etiology and outcome. Object: The objective of this retrospective review was to conduct an audit of hydrocephalus care in our institution. Materials and Methods: Information was retrieved from case notes, ward records, imaging results, operation notes, and follow-up clinic charts. Type of hydrocephalus, onset, treatment offered, outcome, complications, and follow-up duration were documented. Results: Management of 58 infants with complete data was analyzed. Most hydrocephalus 40 (69%) were congenital with 14 (35%) occurring in association with myelomeningocele and 8 patients confirmed with aqueductal stenosis. Ventriculoperitoneal shunts insertion 53 (91%) was the most common treatment modality. Conclusions: There is need to improve surgical intervention in the form of endoscopic third ventriculostomy in suitable patients. Subsiding cost of care may be considered for indigent patients

Acute Traumatic Spinal Cord Injury; does a Low Tesla Magnetic Resonance Imaging Features Correlates with Neurological Status and Predict Early Outcome?

Background: Traumatic spinal cord injury (TSCI) is a devastating disease, hence the need to identify clinical and radiological injury features that predict neurological improvement. Aims: The aim is to determine the correlations between American Spinal Injury Association (ASIA) Impairment Scale (AIS) and magnetic resonance imaging (MRI) features in patients with TSCI and identify predictors of neurological improvement. Settings and Design: This is a prospective cohort study. Subjects and Methods: Seventy-three patients with TSCI managed over a period of 18 months were studied. Neurological assessment of these patients was done at admission and 3-month post-injury using the AIS score form. The various MRI (0.3 Tesla Machine) features of these injuries were identified and measured using a RadiAnt DICOM Viewer 4.0.3 (64-bit). Statistical Analysis: Correlation and regression analysis were done using Spearman’s rank correlation, and logistic regression, respectively. A P &lt; 0.05 was used as the level of significance. Results: Spinal cord edema (26.0%) and cord contusion (34.2%) were seen in most patients with incomplete injury, while spinal cord hemorrhage and transection were observed in patients with ASIA A injury. Asignificant correlation exists between maximum canal compromise (MCC) (ρ = −0.39, P &lt; 0.001), maximum spinal cord compression (MSCC) (ρ = −0.44, P &lt; 0.001), and length of spinal cord lesion (ρ = −0.77, P &lt; 0.001) with AIS at admission. The independent predictors of AIS improvement include MSCC, MCC, length of spinal cord signal change, and cord contusion. Conclusions: MRI features significantly correlate with the neurological status of TSCI and can be used to predict early neurological improvement in these patients