Pattern at Presentation of Extremity Gunshot Injuries in Warri, Nigeria

Background Gunshot injuries (GSI) in civilian populations are becoming more common worldwide. The  result is significant morbidity, mortality and disability particularly among the young active productive  males who are often the most frequently affected. The wide spread socioeconomic down turn and small  arms proliferation particularly in developing countries might be partly responsible for this. This study  aims to further highlight the pattern, including aetiology and the emerging significance of GSI in Warri pointing out the need for urgent and appropriate action by all concerned.Methodology A prospective study of consecutive gunshot injury patients who presented at the Central Hospital and two other private health facilities in Warri between l"t of January and 31"t of December, 2011. Relevant data were collected using previously prepared forms, collated and analysed with SPSS version 17.Results Eighty five patients presented with GSI during the study period. This consisted of 78 males and 7  females giving a male: female ratio of 11.1:1. The mean age of patients was 34.23+13.22years with the most frequently affected age group being that of 16-30 years. Most patients (51. 76%) were shot by  armed robbers, traders being the most frequently affected (28.2%). Ninety six m]uries were sustained by the 85 patients with 52 fractures. High velocity weapons were used more frequently.Conclusion Gunshot injuries are common in Warri. Armed robbery is frequently responsible. Practising trauma surgeons here need to be abreast with modern treatment modalities for GSI and our health  facilities should be equipped to meet the challenges. There is also need for improvement in the  socioeconomic conditions of the people, youth reorientation and empowerment programmes and more proactive measures towards addressing security challenges.Keywords: Gunshot injuries; Extremities; Fractures

Upper Limb Congenital Anomalies in Nigeria

Background: About 1–2% of neonates have congenital anomalies; of these, 10% affect the upper limbs. Congenital anomalies are structural or metabolic defects present at birth. Objective: To review cases seen over a four-year period in a tertiary specialist hospital in Lagos and share our experience. Methodology: Case notes and theatre records of patients with congenital upper limb anomalies were retrieved and relevant data extracted. Data were analyzed with SPSS version 20. Results: 46 patients with 53 diagnoses of upper extremity congenital anomalies: 28 were males and 18 females between 5 weeks and 14 years. 17 patients (37%) presented within the first 12 months of life. Average ages of mothers and fathers were 34.1 and 37 years respectively. 26% of mothers had febrile illnesses and 28.3% used herbal products during the index pregnancies. Swanson’s group 2 was the commonest (58.4). Syndactyly was the commonest descriptive individual diagnosis (49%). Treatments were individualized according to specific diagnosis. Conclusions: Congenital anomalies of the upper extremities present as various diagnostic entities. Syndactyly was the most frequently encountered here. Keywords: Upper limbs, Congenital, Anomalie

Patients' Satisfaction With Surgical Out Patient Services At The Delta State University Teaching Hospital, Oghara, Delta State, Nigeria

Introduction Patient satisfaction refers to the extent of the patient's experience compared to his expectations. Over the years, patients are getting more aware of their rights with increasing  expectations. With more efficient and well equipped private hospitals springing up and the recent upsurge of medical tourism, the need for regular assessment of client satisfaction with public health care provider services in order to make improvements where necessary has become  imperative. This study aims to assess patient satisfaction with services provided at the Surgical Out-patient Department of the Delta University Teaching Hospital, Oghara, Delta State Nigeria.Patients and Method A cross sectional study of the satisfaction of patients with the services provided  at the Surgical Out-patient department of the Delta State University Teaching Hospital, Oghara. Delta  State, Nigeria using the short form Patient Satisfaction Questionnaire-IS (PSQ-18). Completed questionnaires from 108 randomly selected surgical out-patients were analysed using the SPSS, version 17.Results One hundred and three patients who completed their questionnaires fully were used in the study.  There were 40 males (88.8%) and 68 females (61.2%). Mean age of patients was 41 ± 15.6 with a range of 16-85 years. The overall average satisfaction score was 8.4209 (68.42%). The highest subscale score was 8.8107 (76.21%) in the area of interpersonal relationship with the doctor while the lowest score of 2.8447 (56.89%) was given by respondents for satisfaction with the financial aspect of care. In terms of response to individual questions the least score was for question 9 on waiting time [2.6408  (52.82%)]while the highest score was for question 6 which borders on doctors' thoroughness (part of  technical competence).Conclusion Most of the areas assessed for patients' satisfaction in this study will need one form of  intervention or the other in order to further improve on the satisfaction level of our patients. Even areas with relatively high percentage satisfaction need steps to be taken to maintain that level of satisfaction. In particular the waiting time at the surgical out-patient department and the fees patients pay need to be addressed.Keywords: Patient Satisfaction; PSQ- 18; Surgical Services; Nigeria