Predictors of Outcome in Management of Paediatric Head Trauma in a Tertiary Healthcare Institution in North-Central Nigeria.

OBJECTIVE: Trauma is a leading causes of death and disability in all ages. The aim of this study was to describe the demography and characteristics of paediatric head trauma in our institution and examine the predictors of outcome and incidence of injury related mortality. METHODS: We examined our institutional Trauma Registry over a 2 year period. RESULTS: A total of 1100 trauma patients were seen over the study period. Of the 579 patients who had head injury 99 were in the paediatric age group. Of the paediatric head trauma patients 79 had documented Glasgow coma score (GCS), 38 (48.1%), 17 (21.5%) and 24 (30.4%) had mild, moderate and severe head injury respectively. The percentage mortality of head injury in the paediatric age group was 6.06% (6/99). There is an association between mortality and GCS (p=0.008), necessity for intensive care unit (ICU) admission (p=0.0001), associated burns (p=0.0001) and complications such as aspiration pneumonia (p=0.0001). The significant predictors of outcome are aspiration (p=0.004), the need for ICU admission (p=0.0001) and associated burns (p=0.005) using logistic binary regression. During the study period 46 children underwent surgical intervention with extradural haematoma 16 (34.8%), depressed skull fracture 14 (30.4%) and chronic subdural haematoma five (10.9%) being the commonest indication for surgeries. CONCLUSION: Paediatric head injury accounted for 9.0% (99/1100) of all trauma admissions. Majority of patients had mild or moderate injuries. Burns, aspiration pneumonitis and the need for ICU admission were important predictors of outcome in children with traumatic brain injury.

Problems with administration of international prostate symptom score in a developing community.

BACKGROUND: The IPSS form has been found useful for assessing symptom severity, which assists in treatment choice and in monitoring patients on therapy. The form should be self-administered and requires some level of literacy. We assessed the problems associated with its administration in a developing community. MATERIALS AND METHODS: The IPSS form was administered to patients with benign prostatic hyperplasia at the Urology Clinic of the Jos University Teaching Hospital from November 2004 to October 2005. Those who did not understand the questions or who could not read English required explanations. RESULT: There were a total of 70 patients who agreed to fill out the forms. Their ages ranged from 40 to 104 years with a mean of 63.6. The IPSS scores ranged from 3 to 35 with a mean of 18.3. About 56.7% of the patients had quality of life scores of ≥ 5. Only 2 (2.9%) patients were initially uncooperative in filling out the forms. Twenty-four (34.3%) did not understand English. Of the 46 (65.7%) that understood English, 28 (40.0%) could speak but could not read English, thus 52 (74.3%) could not read English. Ten (14.3%) patients thought the questions were either not comprehensive or clear enough. CONCLUSION: Illiteracy is a major drawback with the administration of the IPSS form, with 74.3% of patients unable to read English. Attempts should be made to draft the forms in the main language(s) spoken or read in a particular locality so as to gain maximally from the benefits of the IPSS. Relevant bodies should improve on the education of the populace.

Problems with Administration of International Prostate Symptom Score in a Developing Community

Background: The IPSS form has been found useful for assessing symptom severity; which assists in treatment choice and in monitoring patients on therapy. The form should be self-administered and requires some level of literacy. We assessed the problems associated with its administration in a developing community.Materials and Methods: The IPSS form was administered to patients with benign prostatic hyperplasia at the Urology Clinic of the Jos University Teaching Hospital from November 2004 to October 2005. Those who did not understand the questions or who could not read eng required explanations.Result: There were a total of 70 patients who agreed to fill out the forms. Their ages ranged from 40 to 104 years with a mean of 63.6. The IPSS scores ranged from 3 to 35 with a mean of 18.3. About 56.7 of the patients had quality of life scores of ? 5. Only 2 (2.9) patients were initially uncooperative in filling out the forms. Twenty-four (34.3) did not understand eng. Of the 46 (65.7) that understood eng; 28 (40.0) could speak but could not read eng; thus 52 (74.3) could not read eng. Ten (14.3) patients thought the questions were either not comprehensive or clear enough.Conclusion: Illiteracy is a major drawback with the administration of the IPSS form; with 74.3 of patients unable to read eng. Attempts should be made to draft the forms in the main language(s) spoken or read in a particular locality so as to gain maximally from the benefits of the IPSS. Relevant bodies should improve on the education of the populace