Review of current concept in the management of pressure ulcers

Pressure ulcers are quite distressing, and they cut across all age groups. Aside from increasingmortality, it results in protracted hospital stay and an upsurge in the consumption of healthcare resourcesPressure ulcers are considered to be essentially preventable, but in order to prevent them it is important to identify the people most at risk and deliver timely preventative care. In case of severe acute respiratory distress syndrome (ARDS), as in coronavirus dis­ease 2019 (COVID-19) affected patients, prone position and invasive ventilation improve the clinical status of this group of patients. This form of therapy is associated with an increased risk of facial pressure ulcers. When pressure ulcer occurs, appropriate documentation of each ulcer and staging of the ulcer are essential for good wound assessment.Treatment involves, assessing the nutritional needs of the patient, management of infections, removal of necrotic tissue, maintenance of a moist environment for wound healing, and possibly surgery

Risk factors and perinatal outcome of umbilical cord prolapse in Sagamu, Nigeria

Background: Umbilical cord prolapse is an obstetric emergency that threatens the life and well-being of the fetus and also increases maternal morbidity. Fetal survival in umbilical cord prolapse can be enhanced by prevention where risk factors are identified and prompt diagnosis and decisive intervention.Objective: The aim of this study was to determine the incidence, identify the risk factors associated with umbilical cord prolapse and document the perinatal outcome of cases of cord prolapse.Methods: This was a 13-year retrospective case-control study of cases of umbilical cord prolapse seen at the OOUTH, Sagamu, Southwestern Nigeria between January 1, 2000 and December 31, 2012.Result: During the study period, the incidence of umbilical cord prolapse was 1 in 122 deliveries (0.82%). The umbilical cord prolapse occurred in association with breech presentation five times (33.3%) and transverse lie eleven times (18.5%). The occurrence of breech presentation among the control cases was 8.6% (p<0.001) and that of transverse lie was 1.9% (p<0.001). There were also significant statistical differences between the cases of cord prolapse and controls in terms of prematurity, low birth weight, unbooked status and multiparity. The perinatal rate was 222/1000 (22.2%) compared to the perinatal mortality of 68/1000 (6.8%) for the control group.Conclusion: It is suggested that pregnant women should be encouraged to register early in pregnancy for antenatal care as this will enhance early identification of the risk factors and appropriate management instituted to reduce perinatal mortality

Respiratory symptoms and pattern of lung functions among commercial motorcyclists in Sagamu, Nigeria

Background: The relationship between occupational exposure to air pollutants and poor respiratory health is known. The motorcyclists commonly seek medical care for respiratory diseases in Nigeria.Objective: To determine the prevalence of respiratory symptoms and the pattern of lung functions among commercial motorcyclists compared to control subjects.Method: The controlled cross-sectional study was conducted in Sagamu, an urban town in south-western, Nigeria. The commercial motorcyclists and the controls with similar age, non-smokers and same male sex were included in the study. The riders and controls recruited were non-smokers. A structured questionnaire approved by the British Medical Research Council/ATS (American Thoracic Society) was used. The pulmonary function tests were performed according to ATS recommendation.Results: A total of 200 subjects were studied: 100 were commercial motorcyclists and 100 were non-motorcyclist controls. Compared with the controls, the prevalence of cough (71% vs 21%) and sputum (67% vs 20%) was higher among the commercial motorcyclists. Twenty-one percent of the commercial motorcyclists had an obstructive ventilatory pattern compared to 13% of the control group.Conclusion: This study provides further evidence that commercial motorcyclists are exposed to occupational hazards which predisposed them to increased frequency of respiratory symptoms and impaired lung functions. Health education strategy may assist this group of workers and reduce the burden of respiratory disorders among them