Predictive factors for birth trauma in southwestern Nigeria

Birth trauma is a significant cause of neonatal morbidity and mortality. This prospective study determined the predictive factors for birth trauma as seen in a Nigerian university teaching hospital. This was a prospective descriptive evaluation of birth trauma at Wesley Guilds Hospital, Ilesa over three years. Semi-structured questionnaire was used to collect data on the age, gender, pattern of presentation, place and mode of delivery, level of birth attendants, and treatment offered. Outcome measures were factors predisposing to birth trauma. A total of 137 neonatal hospital admissions with birth related complaints were recorded between 10th December, 2002 and 9th December 2005, out of which 119(86.8%) patients had 121 birth injuries (Males: Females= 1.4: 1). The mean age was 6 ± 4.1 (range: 1-31) day. Non skeletal injuries included cephalohaematoma 30(24.8%), genital bruises/abrasion 4(3.3%), subconjuctiva haemorrhage 2(1.7%), subdural haemorrhage 1 (0.8%), nasal necrosis 1(0.8%), Erb`s`palsy 31(25.6%) and Klumpke`s palsy 2(1.7%). Skeletal injuries were mainly bone fractures 50(41.3%)with 2(1.7%)mortality. Ante natal care/delivery, level of birth attendants, mode of delivery, fetal distress, and emergency caesarian section were among the factors that determined birth trauma. The prevalence of birth trauma is high in southwestern Nigeria. The predictive factors are easily identifiable in the perinatal period; early recognition could reduce significantly birth trauma

Septic arthritis in children

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Gunshot injuries in a Nigerian hospital

Background: Gunshot injuries are major problems worldwide from the medical and economic perspectives and are associated with profound morbidity and significant mortality. Many previousstudies were focused on specific sites of injury but this study was aimed at the pattern and presentation of the gunshot injuries. Patients and Methods: This was a combined retrospective and prospective study of gunshot injuries in a Nigerian hospital. The medical records of patients with gunshot injuries between January and December 2004 were reviewed. Prospectivedata collection was done between January and October 2005. Results: Total number of patients was 38 and male: female ratio was 18:1. Thirty (78.9) were below the age of 40 years. The locally made dane gun was the instrument of attack in 24 (63.1) and 19 (50.0) of the patients were victims of armed robbery. The most frequently injured sites were the extremities of which the lower limb was 28 (73.7) and the upper limb was in 10 (26.3) patients. Conclusion: It was concluded that gunshot injuries occur more below age of forty years and the limbs were more injured. Armed robbery attack contributed to about half of the attacks and injuries results mainly from locally made dane guns. It was found that pistols were usually loaded with multiple pellets thus there could be multiple entry and exit wounds in patients attacked with pistol in our environment