Risk Factors Associated with Limb Amputation in a Referral Hospital in Benue State Nigeria.

Background: Trauma, diabetes mellitus and peripheral vascular disease are age old known risk factors associated with amputation. However, at the Nongu Kristi U Sudan hen Tiv (NKST) Rehabilitation hospital, Mkar, Gboko, Benue state Nigeria, HIV/AIDS is increasingly becoming a major risk factor for upper limb amputation, and this is investigated in this study. Objectives: To determine the risk factors involved in amputation in a referral hospital located in Benue State Nigeria. Methods: A Descriptive cross sectional study design was adopted for this study where the pre-operative assessments for HIV testing, serum Fasting Blood Sugar (FBS) level, Full Blood Count (FBC), CD4 counts, Hepatitis B and C antigens were carried out using standard laboratory investigation techniques. Dopplar ultrasonographic assessment of the affected limb was done preoperatively to determine the nature and level of vascular obstruction while post-operative histocytology of the amputated stump was performed to determine the pathology at the Benue State University. Data obtained were entered into a profoma already designed for the study while statistical analysis was performed with the aid of SPSS (Version 20) with level of significance set at 95%. Results: A total of 60 patients booked for amputation within the study period were enrolled for this study. Majority were Males 41 (68.3%), out of which amputation cases in individuals below 10 years of age were mainly due to trauma (8.3%). The age range of 21-40 years recorded the highest number of amputations 24 (40%). In the female patients, trauma was responsible for 8 (42.1%) cases while HIV was associated with 1 (5.3%) of all amputations. In males trauma and HIV/AIDS were indications in 25 (61%) and 10 (24.4%) respectively. Other risks factors in males responsible for amputation were diabetes 2 (4.9%) and vascular diseases 1 (2.4%). In females, diabetes mellitus was associated with 6 (31.5%) of amputations. There is a statistically significant difference in the indication for limb amputation in male and female patients where HIV/AIDS was significantly higher in males 10 (24.4%) than in females (x2 = 13.1; p= 0.01). Lower limbs 49 (81.7%) amputations were more than upper limbs 11 (18.3%) amputations. This study revealed that HIV/AIDS ranked second as an indication for upper limb amputations although trauma was the main indication for most upper limb amputations. Conclusion: This study showed that trauma remains the predominant risk factor for amputation, however HIV/AIDS is emerging as a major indication for upper limb amputation.

Voltaren emulgel: a non-steroidal anti-inflammatory drug in the management of acute painful conditions

Encountered during the daily activities of the individuals are injuries resulting in acute painful conditions. Among such injuries are sprains; strains; bruises; contusions; superficial thrombophlebitis; and localised rheumatic conditions. The management of painful conditions that was investigated in this study is topical therapy using Voltaren emulgel; a non-steroidal anti-inflammatory drug; a product of CIBA-GEIGY. This drug otherwise described as diclofenac; consists of an active substance of diethylamine salt of an 0-aminophenylacetic acid; namely diethylamonium -(0-(2;6-dichlorophenyl) - amino-phenyl) acetate. The procedure of physiotherapeutic application of this drug is by massage manipulation

SAMADHI TANK : A floatcell for enhancement of learning and management of stress and some painful conditions

The main objective of the present investigation was to study the Samadhi tank; a technologically and controlled relaxation environment and its effects on the African blacks within the tropics. Other objectives were to investigate the effects of flotation in the Samadhi tank on the human of cardiovascular and cardiorespiratory systems; the body temperature; intellectual learning; relief of tension and the therapeutic response of some patients having hypertension and other painful conditions

The management of shoulder pain of musculo-sekeletal origin using Feldene gel (PIROXICAM)

From the results of this research study; it can be concluded that topical application of Feldene gel (i.e. Piroxicam) in conjunction with other physiotherapeutic modalities such as short-wave diathermy; ultrasonic therapy and physical exercise is very effective in the relief of shoulder pain of musculo-skeletal origin

The gross body weight; following the treatment of traumatically ruptured tendon by electrical stimulation

The purpose of this study was to investigate the effect which pulsed galvanic current stimulation of traumatically ruptured Achilles tendons has on their calf muscles; and on the gross body weight of each subject. The effect of current polarity (i.e. anodal and cathodal currents) on these variables were also studied. To achieve these the total body weights and the calf circumferences of the subjects prior to the traumatic rupture of their Achilles tendons and following treatment with the two currents (i.e. after the traumatic rupture of their tendons) were therefore compared to each other and to those measures in a group where healing took place without electrical stimulation

Community Physiotherapy: Curriculum of Instruction and Clinical Practice in Primary Health Care System in Nigeria

Considering the population of this country and the spread of her communities; the only means by which physiotherapy for ALL the citizens can be achieved is through Community Physiotherapy practice. In introducing this paper; some past activities of some pioneer physiotherapists and those of the Nigerian Society of Physiotherapy were reviewed. The major part of this paper has been devoted to the curriculum of instruction in Community Physiotherapy and its clinical practice. The pioneering activities of the College of Medicine; University of Lagos in the training of Community Physiotherapists was cited. That other Universities offering courses of study in Physiotherapy should follow the Lagos example has been recommended. Other recommendations given include the direction and utilization of Community Physiotherapy services by the State Governments through State Health Councils or Health Management Boards. Creation of a Directorate of Physiotherapy in the Federal Ministry of Health for supervising; co-ordinating and aiding of the state activities in Community Physiotherapy has also been recommended