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1.
Ann Afr Med ; 14(2): 114-7, 2015.
Article in English | MEDLINE | ID: mdl-25693820

ABSTRACT

BACKGROUND: When there is an insurgency, the use of force in the form of weaponry, is employed. This may lead to the total breakdown of law and order, resulting in destruction of life and property. Health workers may be killed or captured, and, health facilities destroyed or stretched beyond their functional capacity. This is a report of experience with injuries seen in a tertiary hospital in north eastern Nigeria, under an insurgency situation. MATERIALS AND METHODS: After obtaining clearance from the medical Ethics Committee of UMTH, we reviewed the case files of all patients treated for injuries sustained as a result of the Boko Haram insurgency from January 2009 to December 2013. Those brought in dead, were not included in the study. RESULTS: We reviewed the case files, theatre notes, admission and discharge registers of 1339 cases. 1223 (91.3%) of the victims were males, while 116 (8.7%) were females. Gunshot wounds accounted for 1229 (91.8%) of the injuries, bomb blast 90 (6.7%), others 15 (1.1%) knife (Cut throat) 4 (0.3%) and road traffic accident 1 (0.01%). Casualties were made up of civilians 1144 (85.4%), the joint task force (a force made up of the Military, Police, Customs and Immigration, against the insurgents) 117 (8.7%), and insurgents 22 (1.6%). The ages of the patients ranged from 1 to 80 years, peaking at the 21-40 age brackets (796 or 59.4%). The extremities were most affected, 734 (54.8%), followed by the torso 423 (31.6%), multiple injuries 93 (6.9%) and head and neck 89 (6.6%). 1226 (91.6%) of the victims survived while 113 (8.4%) died from their injuries. This followed massive blood loss from injuries to the torso 69 (61.1%) multiple injuries 15 (13.3) and extremities 6 (5.3%). Others causes were fatal injuries to the head and neck 22 (19.5%) and 90% burns following bomb blast 1 (0.9%). CONCLUSION: Injuries resulting from insurgency will continue to be a problem in many developing countries because their health facilities in terms of personnel and materials are ill prepared for such a situation .


Subject(s)
Terrorism , Wounds and Injuries/epidemiology , Accidents, Traffic/mortality , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Blast Injuries/epidemiology , Burns/epidemiology , Burns/therapy , Cause of Death , Child , Child, Preschool , Explosions , Extremities/injuries , Female , Hemorrhage/etiology , Hemorrhage/mortality , Humans , Infant , Male , Middle Aged , Neck Injuries , Nigeria , Pharynx/injuries , Sex Distribution , Treatment Outcome , Wounds and Injuries/classification , Wounds and Injuries/therapy , Wounds, Gunshot/epidemiology , Young Adult
2.
Niger J Med ; 18(2): 168-71, 2009.
Article in English | MEDLINE | ID: mdl-19630322

ABSTRACT

BACKGROUND: Violent assault injuries are a frequent occurrence in the native communities of the North Eastern Nigeria. The injuries are mostly unreported, and therefore no policy towards prevention. We hope to highlight the common causes and pattern of such injuries, as well as suggest control measures in order to reduce the incidence. METHODS: A retrospective review of 208 assault injury cases seen at the Accident and Emergency department of the Federal Medical Center, Nguru, between January 2002 and December 2006. RESULTS: All but 12 were males, giving a male to female ratio of 16:1. Most of the patients are illiterate herdsmen and farmers. The age ranged from 12 to 70 years, with a mean of 30.9 +/- 11.2 years. The peak age incidence was 30-40 years. Fighting was the most common cause, accounting for 124 (59.6%), followed by armed robbery assaults, which accounted for 75 (36.1%). Domestic abuse was the cause in 9 cases (4.3%). Arrow shot was the commonest form of assault injury in 55 (26.4%) cases, followed by matchet in 49 (23.6%), gunshot in 37 (17.8%), club/stick in 32 (15.4%) and stab wounds in 26 (12.5 %). Quarrel over farmlands used for grazing by herdsmen was the leading cause of fighting resulting in assault injuries (87), followed by quarrel over women (32)! CONCLUSION: Assault injuries are a common occurrence in the native communities of the North Eastern Nigeria. Addressing the root causes such as mapping out grazing lands in the region, community policing as well as mandatory reporting of all assault injuries to the police for appropriate legal action, will help reduce the incidence of assault injuries.


Subject(s)
Violence/statistics & numerical data , Wounds and Injuries/epidemiology , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Nigeria/epidemiology , Violence/psychology , Wounds, Penetrating/epidemiology , Young Adult
3.
Niger J Med ; 18(1): 73-4, 2009.
Article in English | MEDLINE | ID: mdl-19485153

ABSTRACT

BACKGROUND: There is increased tendency towards double-gloving by general surgeons in our practice, due probably to awareness of the risk of contamination with blood or other body fluids during surgery. The aim of the study was to compare the relative frequency of glove puncture in single-glove versus double glove sets in general surgical procedures, and to determine if duration of surgery affects perforation rate. METHOD: Surgeons at random do single or double gloves at their discretion, for general surgical procedures. All the gloves used by the surgeons were assessed immediately after surgery for perforation. RESULTS: A total of 1120 gloves were tested, of which 880 were double-glove sets and 240 single-glove sets. There was no significant difference in the overall perforation rate between single and double glove sets (18.3% versus 20%). However, only 2.3% had perforations in both the outer and inner gloves in the double glove group. Therefore, there was significantly greater risk for blood-skin exposure in the single glove sets (p < 0.01). The perforation rate was also significantly greater during procedures lasting an hour or more compared to those lasting less than an hour (p < 0.01). CONCLUSION: Double-gloving reduces the risk of blood-skin contamination in all general surgical procedures, and especially so in procedures lasting an hour or more.


Subject(s)
Equipment Failure/statistics & numerical data , Gloves, Surgical/statistics & numerical data , Occupational Exposure/prevention & control , Surgical Procedures, Operative , Blood , Humans , Prospective Studies , Random Allocation , Risk , Time Factors
4.
Niger J Clin Pract ; 10(3): 184-7, 2007 Sep.
Article in English | MEDLINE | ID: mdl-18072441

ABSTRACT

BACKGROUND: Incisional hernias (IH) represent a breakdown or loss of continuity of a fascial closure. They are thus unique as the only external wall hernias that are iatrogenic in aetiology. Incisional hernias are not uncommon complications of laparotomy closure with reported incidence of 2 to 11%. OBJECTIVES: To review our experience,with incisional hernaia identify possible risk factors and proffer preventable strategies. PATIENTS AND METHODS: All case records of adult patients managed with IH at the University of Maiduguri Teaching Hospital between January 1995 and December 2004 were retrieved from the Medical Records Department. Relevant data on age, sex, type and institution of index surgery (General Hospital or Private Hospital), premorbid factors, type of repair, post-operative complications were extracted. Case records with inadequate information were excluded. RESULTS: Between January 1995 and December 2004 a total of 440 patients with external abdominal hernias were treated at UMTH. Out of these: 38 (11.6%) were Incisional hernias and form the basis of this study. Their ages ranged between 18 and 80 years, with peak age range of 40-49 years. There were 6 males and 32 females giving a male to female ratio of 1:5.3. The commonest index surgeries were caesarean section in 12 patients (31.6%) and appendicectomy 10 patients (26.3%). Of the index surgeries 26 (68.4) and 10 (26.3) were performed in general and private hospitals respectively. Only 2(5.3%) were done at UMTH. Wound sepsis, in 18 patients (47.4%), postoperative cough, 8 (21.1%) and obesity 6 (15.8%) were the commonest risk factors. Poor surgical technique was found in 36 patients (94.7%) Most of the patients presented late; 8(21.1%) with recurrence and 6(15.8%) were giant in size. All but one were successfully repaired. Only one (2.3%) had recurrence. There was no mortality. CONCLUSIONS: Incisional hernias are not uncommon constituting 11.6% of all adult external abdominal wall hernias repaired at UMTH. Most of the causes are preventable with 94.7% of the index surgery done at peripheral hospitals where poor surgical technique was common to all. There is urgent need to re-train our general duty doctors on proper surgical techniques of abdominal wound closure.


Subject(s)
Herniorrhaphy , Postoperative Complications , Treatment Outcome , Adolescent , Adult , Aged , Aged, 80 and over , Appendectomy , Female , Health Status Indicators , Hernia/etiology , Hernia/prevention & control , Hernia, Abdominal/etiology , Hernia, Abdominal/prevention & control , Hernia, Abdominal/surgery , Hospitals, Teaching , Hospitals, University , Humans , Incidence , Male , Middle Aged , Risk Factors , Sepsis/etiology
5.
Niger J Clin Pract ; 10(1): 47-51, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17668715

ABSTRACT

BACKGROUND: Enterocutaneous fistula (ECF) remains an important surgical problem with significant morbidity and mortality. This study aims to review the aetiology and management outcome in a depressed economy like ours. METHODS: A retrospective review of 54 patients with ECF admitted into the surgical wards of the University of Maiduguri Teaching Hospital (UMTH) between January 1994 and December 2004 (11 year period). RESULTS: Thirty two (59.3%) were males and 22 (40.7%) were females giving a male/female ratio of 1.5 to 1. The age ranged from 1 to 58 years with two peak incidents of 20-29 years and 40-49 years. Eighteen cases (33%) occurred following appendicectomy, 12 (22%) following laparotomy for intestinal obstruction, 10 (18.5%) following laparotomy for abdominal malignancies, 7 (13%) followed laparotomy for penetrating abdominal injuries, 3 (5.5%) followed laparotomy for perforated typhoid enteritis, 2 (3.7%) cases were due to spontaneous rupture of strangulated and neglected inguinal hernia, 1 (1.9%) case followed chest tube insertion for pleural effusion in a PTB patient and 1 (1.9%) case followed a native healer's incision on a lumber hernia. Altogether,45 (83.3%) were referred cases from peripheral hospitals. Fourty one (76%) were high output type, while 13 (24%) were low output type. Most patients 32 (59.3%) healed spontaneously on conservative management. Eighteen (33%) had surgical intervention. Eight patients demised giving a mortality rate of 15%. The average hospital stay was 56 days. CONCLUSION: The main cause of ECF in our environment is postoperative (94.4%) with post appendicectomy cases alone accounting for 33%. Majority of our patients (66.7%) were managed conservatively.


Subject(s)
Intestinal Fistula/mortality , Outcome and Process Assessment, Health Care , Postoperative Complications/epidemiology , Adolescent , Adult , Appendectomy/adverse effects , Child , Child, Preschool , Female , Hospitals, Teaching , Humans , Iatrogenic Disease/epidemiology , Infant , Intestinal Fistula/etiology , Intestinal Fistula/surgery , Male , Middle Aged , Nigeria/epidemiology , Retrospective Studies , Risk Factors , Survival Analysis
6.
Trop Doct ; 36(4): 240-1, 2006 Oct.
Article in English | MEDLINE | ID: mdl-17034706

ABSTRACT

Tumoral calcinosis is a rare, benign disease that commonly affects the African blacks. We report on a 20-year-old Nigerian presenting with recurrent multiple subcutaneous masses around the scapular, elbow, hip and gluteal regions. The X-rays, fine needle aspiration cytology and tissue biopsy confirmed the diagnosis and the patient had a successful excision with good healing.


Subject(s)
Calcinosis/pathology , Soft Tissue Neoplasms/pathology , Subcutaneous Tissue/pathology , Adult , Biopsy, Fine-Needle , Buttocks/pathology , Calcinosis/diagnosis , Elbow Joint/pathology , Hip Joint/pathology , Humans , Male , Recurrence , Scapula/pathology , Soft Tissue Neoplasms/diagnosis
8.
Niger J Med ; 13(4): 407-9, 2004.
Article in English | MEDLINE | ID: mdl-15523871

ABSTRACT

BACKGROUND: We present two patients to highlight an emerging trend of suicide attempts presenting to the surgeons with penetrating abdominal injuries found to be HIV/AIDS related. METHODS: The two patients were managed at the University of Maiduguri Teaching Hospital in the year 2003. Both patients presented as emergencies with penetrating abdominal injuries and were resuscitated followed by clinical evaluation and laparotomy. RESULTS: Both patients had visceral injuries that were repaired at laparotomy and were both confirmed HIV positive. CONCLUSION: There is an emerging trend of suicide attempts in HIV/AIDS patients and the need to determine the suicide pattern that will enable all stakeholders workout a formidable HIV/AIDS and suicide prevention programmes.


Subject(s)
Abdominal Injuries/etiology , Acquired Immunodeficiency Syndrome/psychology , HIV Infections/psychology , Suicide, Attempted/trends , Wounds, Stab/etiology , Adult , Female , Humans , Male , Nigeria
9.
Niger J Med ; 12(4): 232-5, 2003.
Article in English | MEDLINE | ID: mdl-14768201

ABSTRACT

BACKGROUND: Cancer of the gall bladder is an uncommon but highly lethal disease associated with cholelithiasis and chronic cholecystitis in occurrence. METHODS: A report of three cases seen over six years at the University of Maiduguri Teaching Hospital (UMTH) is presented together with a review of the literature. RESULTS: Three cases were seen over a period of 6 years. There were two females and one male. The patients were aged 80, 50 and 65 years respectively. The 80 year old man and 50 year old female presented with right hypochondrial mass and pain. The third presented with features of multiple metastases involving the liver and omentum. The first two cases had cholecystectomy and limited resection of adjacent liver tissue. The third case had unresectable cancer with gross involvement of the liver, peritoneum and omentum; she died three weeks after exploratory laparotomy. CONCLUSION: Cancer of the gall bladder is rare in this environment. A high index of suspicion in addition to ultrasound and computerized tomography helps in making an early diagnosis. This may improve the outcome of management.


Subject(s)
Adenocarcinoma/diagnosis , Adenocarcinoma/surgery , Gallbladder Neoplasms/diagnosis , Gallbladder Neoplasms/surgery , Aged , Aged, 80 and over , Fatal Outcome , Female , Humans , Male , Middle Aged , Prognosis
10.
J Obstet Gynaecol ; 22(1): 20-2, 2002 Jan.
Article in English | MEDLINE | ID: mdl-12521721

ABSTRACT

A total of 21 cases of severe burns in pregnancy managed at the University of Maiduguri Teaching Hospital, Maiduguri, over a 10-year period, spanning January 1991-December 2000 inclusively were reviewed. The pregnancy loss was 92.9%, with the pregnancies spontaneously terminated within 10 days of sustaining the injury. Maternal mortality was 47.6% with sepsis as the most common cause of death. It is advocated that viable pregnancies should be terminated as soon as the mother is resuscitated following severe burn injury. Prophylactic systemic antibiotics should be given to minimise the development of sepsis. Patients are best managed in the obstetrics ward during the first 2 weeks of injury. A multidisciplinary approach is encouraged in managing cases of severe burns in pregnancy.


Subject(s)
Burns/therapy , Pregnancy Complications/therapy , Adolescent , Adult , Female , Humans , Pregnancy , Pregnancy Outcome , Retrospective Studies
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