Poliomyelitis: Pattern and Treatment Outcome in Niger Delta; Nigeria

Background: Poliovirus is an enterovirus in the family of Picornaviridae and consists of three antigenic types; 1; 2; and 3. All three types cause paralysis. It is a major cause of musculoskeletal deformity in many African communities including Nigeria. The deformities include muscle weakness; contractures; grotesque foot deformities and angular deformities around the knee; amongst others. Aim: To highlight 20 children with musculoskeletal deformities due to poliomyelitis treated in a private hospital in Port Harcourt. Methods: Twenty children with musculoskeletal deformities due to poliomyelitis were retrospectively studied. Results: The patients' ages ranged from1 to 16 years; with 95of them under 15 years of age. More than 50of the study group had poor immunisation status as 6 of them were unimmunised (30) and 5 (25) of them were incompletely immunised. Even though all school strata were represented; most of them were not schooling. The commonest deformity was contracture of the knees (100) and muscle wasting in the affected limbs. All of them had loss of muscle power in the lower limbs. Surgical correction was achieved by soft tissue release in 95of them and osteotomy in 5. The outcome was good; as acceptable extension of the knee was achieved post operatively. Conclusion: The musculoskeletal abnormalities of poliomyelitis contribute highly to physical disability. All patients affected by paralytic poliomyelitis become disabled to some extent and this increases the disease burden in Nigeria

Epidemiology of open Tibial Fractures in a Teaching Hospital

) were males and the majority had at least a secondary education (86.7) and were single (95.1). Most of them (82.2) were aware of sexually transmitted infections; and 77.9were aware that condoms prevent transmission of HIV. Seventy-one percent of the young persons were sexually experienced (i.e. previously had sex); 12.9admitted they had previously had sex in exchange for money; and 63.4reported ever using a condom. Median age of sexual debut (sexarche) was 15.7 years. Most (82.1) of the sexually experienced were currently sexually active reporting sexual intercourse within the 6 months preceding survey. Nearly half (47.1) of these had sex with a casual and/or commercial sex worker without a condom.Conclusion: Young people are adopting sexual practices that are essentially high-risk; with severe implications for regional and national socio- economic development. This underscores the fact that they know only little and lack skills to protect themselves from being infected with HIV infections; even when they are sexually active. There is therefore need to advocate for and support initiatives that address reproductive health needs of young people in the Niger Delta region

Gunshot injuries in the Niger Delta region of Nigeria

Background: Violent trauma especially by gunshot injuries appears to be on the increase worldwide. There is inadequate data from many centres in Nigeria to support this observation. Aim: To determine the pattern of gunshot injuries in the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective study covering a period of three years (January 2002-December 2004). A standard proforma was used to record all cases of gunshot injuries reporting to the UPTH. Details sought were age, gender, occupation, gun type, anatomic region of the body involved and treatment given. Other information recorded were time of injury, duration of hospital stay, injury time before presentation, assailant and outcome. Information was obtained directly from victims, relations, the police or those accompanying the victim. Where surgical operations were done or patients were admitted to the wards, relevant information or findings were then retrieved from theatre and ward records. Results: There were 135 patients (120 males and 15 females) between the ages of 1½ -67 years. Students and civil servants constituted the largest number. Seventy-one injuries were due to high velocity missiles while 64 were low velocity. Armed robbery and attacks by "unknown assailants" were the commonest modes of attack with 47 and 41 victims respectively. The lower limbs, abdomen and chest were the most frequent anatomic regions involved recording 38, 28 and 27 cases respectively. There were 9 cases in which multiple anatomic sites were affected. The majority of patients (56) presented within 12-18 hours after injury; only 9 cases presented within 6 hours. Twenty-nine patients underwent laparotomy while 14 had thoracostomies. Forty-nine patients were treated and discharged. Minor surgery (like wound debridement) was the commonest treatment in 43 patients. All cases of fracture among these were subsequently referred to the trauma unit for appropriate treatment. Thirty patients died giving a mortality rate of 22.2%. Conclusion: Gunshot injuries constitute a major cause of violent trauma in the Niger Delta Region of Nigeria with a high and disturbing level of morbidity and mortality