Review of the Practice of Traditional Bone Setting in Nigeria

Background: The practice of traditional bone setting (TBS) is extensive in Nigeria and it enjoys enormous patronage by the populace. However; the outcome of the intervention of TBS treatment is usually poor with profound effects on the patient. There are many publications highlighting different aspects of this subject but none has summarized the entire practice and problems as a single publication. Objective: This work aims at reviewing the entire subject of traditional bone setting in Nigeria in a single article to enable easy understanding and appreciation of the practice and problems of traditional bone setting by orthodox practitioners. Method: A total of thirty-one relevant published original scientific research papers involving all aspects of the subject were reviewed and the practices and problems were documented. Results: The results showed that the origin of the practice is shrouded in mystery but passed on by practitioners from one generation to another. There is no formal training of bonesetters. Though the methods of treatment vary; the problems caused by them are usually similar with extremity gangrene being the worst. When attempts have been made to train the bone setters; improvement have been noted in their performance. Conclusion: In other to prevent some of the most debilitating outcomes like amputation; it is suggested that the TBS practitioners undergo some training from orthopaedic practitioners

Rhinosinusitis: A Retrospective Analysis of Clinical Pattern and Outcome in North Western Nigeria

Background/Objectives: Rhinosinusitis is the commonest viral infection in man and the commonest inflammatory disorder encountered by general practitioners; chest physicians; and otorhinolaryngologists all over the world. The clinical pattern and outcome of conventional management measures were assessed. Method: All new patients with the diagnosis of rhinosinusitis over a 2-year period from July 1999 to July 2001 were analyzed for clinical features; conventional radiological findings; and treatment modalities over a period of 3 years follow up. Results: There were 195 (11.7) new cases of rhinosinusitis out of a total number of 1661 patients seen over the period under review. Only 146 case notes were accessible for the study. Eighty-four (57.5) were males and 62 (42.5) were females. Their ages ranged from 7 months to 70 years. The main clinical symptoms and signs were nasal discharge or rhinorrhea (84.9); nasal obstruction (24.7); epistaxis (22.0); and sneezing (20.6). The duration of symptoms ranged from few days to about 10 years with 24 (16.4) being acute cases while 122 (83.6) were chronic cases giving a prevalence of 1.4and 7.3; respectively. Maxillary sinus (58.9) was the commonest sinus involved. More than one sinus involvement accounted for 37.7of the cases. Infective causes accounted for 67.1of cases followed by allergy (28.8). There were complications in 21 (14.4) cases with orbital involvement (33.3) being the commonest complication. Mode of treatment were medical (86.3); and conventional surgery was carried out in 13.7of the cases for either failed medical treatment or associated complications. Facial paraesthesia along the sites of surgery was the commonest complications; otherwise the outcome of treatment was excellent. Conclusion: Rhinosinusitis in this region was more of chronic (83.6) variety than acute (16.4) variety. Infective causes (67.1) and allergy (28.8) were the commonest etiological factors. About (86.3) were amendable to medical treatment while surgical treatment was carried out in 13.7of the cases. Rhinosinusitis should be managed medically first before recourse to surgical measures in carefully selected cases. Endoscopic sinonasal surgery is most desirable in keeping with current global trends of treatment of rhinosinusitis but where facilities do not exist; conventional surgical measures may be used

A Model for Higher Education Campus Health Services

This study was undertaken in order to develop a holistic healthcare model that would assist registered nurses who are employed at a higher education campus' health service to render a healthcare service relevant to the healthcare needs of the campus healthcare consumers. A theory-generative; qualitative; explorative; descriptive and contextual research design for theory generation was used to develop a holistic healthcare model for a higher education campus' health service. It became evident throughout the study that the participants experienced a need for a more comprehensive healthcare service on campus. The main concepts of holistic healthcare were identified from the information obtained from the in-depth; focus group interviews that were conducted with the participants. The process of theoretical model generation was conducted according to the steps of theory generation as proposed by Walker and Avant (1995:39); namely that of concept analysis; the placing of concepts in relationships; a description of the model and guidelines to operationalise the model. This model provides a structured holistic healthcare frame of reference for registered nurses employed in a campus health service at a Higher Education Institution (HEI) and could be used to assist all campus healthcare consumers to become balanced whole persons who are able to realise their dreams and maintain consistency with regard to optimal health and capacity

Factors in aetiology and clinical pattern of haematogenous osteomyelitis with special emphasis on sickle cell disease in Mulago Hospital

In this study; factors in the aetiology; clinical and radiological pattern of haematogenous osteomylitis were studied. One hundred fifty five patients participated in this study. Haematogenous osteomyelitis was found to be more common in males than females. The mean age at onset was 8.17 years. Trauma and sickle cell disease were found to be aetiological factors. Poverty; malnutrition and chronic ill health were found to be associated with increased morbidity. Sickle cell haemoglobinopathy was found in 21.1of the patients. Of these 13.5 had sickle cell trait and 8.5 had sickle cell anaemia. The majority of patients 92.2 had chronic osteomyelitis at the time of presentation. The acute phase of the disease was found to be usually missed at the time of onset of illness. No cases of sub-acute osteomyelitis. Chi square