Paediatric burn epidemiology as a basis for developing a burn prevention program.

Burn injuries are often seen among the paediatric population. Mortality from burn injuries is high in developing countries. Poor facilities and poverty contribute to this. A look at the epidemiology of burn injuries among children from this part of the world will therefore serve as a means for developing programs for burn injury prevention. A retrospective review of burn injuries among the paediatric population was conducted. The aim was to outline common aetiologies, sex predisposition and sites of injury with a view to recommending possible ways of preventing these injuries. A total of 148 children sustained burn injuries during the period under study. There were 85 (57.4%) boys and 63 (42.6%) girls. Scald was the most common cause of injury, observed in 127 (85.8%) children, followed by flame burn in 18 (12.2%), chemical burn in 2 (1.4%), and friction burn in 1 (0.68%). Almost all of the injuries (144, 98%) occurred at home. Sources of heat were hot water, which caused injury in 109 (73.6%) children, and hot oil, hot soup and hot soya milk which were responsible for 7 (4.7%), 7 (4.7%) and 3 (2.0%) cases, respectively. Other sources were kerosene explosion (7, 4.7%), burning firewood (1, 0.6%) petrol explosion (5, 3.4%), candlelight (3, 2.0%), hot ashes (1, 0.6%), soot (1, 0.6%), burned house, chemicals and friction (1, 0.6%). Preventive methods are suggested based on aetiologies, and include education and certain precautions in the home environment. These will reduce burn injuries and associated morbidity and mortality in developing countries.

Les enfants sont une population particulièrement à risque de brûlure, grevées d'une mortalité élevée dans les pays en développement, à laquelle contribuent la pauvreté et des infrastructures défaillantes. L'étude de l'épidémiologie des brûlures dans ces pays a pour but de cibler les campagnes de prévention. Cette étude a été réalisée rétrospectivement, en recueillant les étiologies les plus fréquentes, le sexe et le site de l'accident chez 148 victimes. On comptait 85 garçons (57,4%) et 63 filles (42,6%). Un ébouillantement était observé 127 fois (85,8%), une brûlure par flamme 18 fois (12,2%), une brûlure chimique 2 fois (1,4%) et une dermabrasion 1 fois (0,68%). Presque toutes les brûlures étaient survenues au domicile (114, 98%). De l'eau chaude était en cause 109 fois (73,6%), d'autres liquides (huile 7/ 4,7%, soupe 7/ 4,7%, lait de soja 3/ 2%) 17 fois. On observait par ailleurs des explosions de kérosène (7,4%) ou de pétrole (3,4%), un feu de bois (0,6%), des bougies (2%), des braises (0,6%), de la suie, un incendie de maison (0,6% à chaque fois). Les mesures préventives suggérées comprennent l'éducation et l'adaptation de l'environnement domestique.

Higher order multiple births in Nigeria: Experiences, challenges and neonatal outcomes in a private health facility.

OBJECTIVES: The aim of this study is to describe the experience and outcome of higher order multiple (HOM) births in a private tertiary health facility in Nigeria. MATERIALS AND METHODS: This was a retrospective review of records of HOM over 3 years in a private tertiary health facility in Nigeria. Relevant data on HOM births were extracted from both the patients' case notes, admission registers and maternity ward and delivery records of the hospital using a predesigned pro forma. Data were analyzed using Statistical Package for Social Sciences Version 22.0. RESULTS: The prevalence of HOM births was 0.72% of 1950 births over the 3 years study period; while for triplets, quadruplets, and quintuplets were 0.56%, 0.1% and 0.05%, respectively. The mean gestational age was 32 ± 3 weeks, and all except three sets of triplets were by Assisted Reproductive Technology (ART). Respiratory distress syndrome, neonatal jaundice, and neonatal sepsis accounted for more than 80% of the neonatal complications noted in HOM births. However, there was no significant difference between neonatal survival of HOM as compared to twin deliveries, P = 0.08. CONCLUSION: HOM is becoming increasingly common in Nigeria. The strongest risk factor is ART, and neonatal complications are common reinforcing the need to streamline ART protocols in Nigeria.

Total Reconstruction of the Upper Lip Using Bilateral Nasolabial Flaps, Submental Flap, and Mucosa Graft following Complete Resection for Squamous Cell Carcinoma.

Lip reconstruction following resection for tumour or following extensive trauma may pose a challenge. This is more so when the resection is total and a complete lip has to be constructed. We present a case of lip reconstruction following a total resection of the upper lip. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal graft lining. We believe that this provides an alternative method of total upper lip reconstruction with minimal disruption of the facial aesthesis.

Antioxidative and antidiabetic activities of watermelon (Citrullus lanatus) juice on oxidative stress in alloxan-induced diabetic male Wistar albino rats.

BACKGROUND: The nutritional and medicinal importance of watermelon has been emphasized and its diseases preventive and curative power must be evaluated. Hence, this study was designed to evaluate the antioxidative and antidiabetic potentials of watermelon. MATERIALS AND METHODS: The in vivo assay was carried out on 15 male albino rats which were divided into groups of three stages. In stage I, all animals received normal feeds and water for 1-week after, which five animals were selected and sacrificed for biochemical analyses which form the nondiabetic control, group. The remaining animals were fasted for 24 h before injected intra-peritoneally with a freshly prepared solution of alloxan at a dosage of 35 mg/kg body weight. Five out of the 10 rats were sacrificed as diabetic group while last five animals were fed with water melon juice for a week after, which they were sacrificed to form the treated group animals. In all the groups, body weights, fasting blood sugar, total protein level in the blood, and other biochemical parameters such as reduced glutathione (GSH), glutathione peroxidase (GPx), malondialdehyde (MDA) concentration; catalase, and superoxide dismutase (SOD) % inhibition activities were determined. RESULTS: The results of the biochemical analyses showed a significant increase in the concentration of blood glucose level after treatment with alloxan, which indicates that diabetic was induced. Hence, watermelon juice caused increased in weight, hypoglycemia; and increases in GSH, GPx, catalase, and SOD % inhibition activities with reduced MDA concentration after treatments. CONCLUSION: The watermelon juice resulted in the restoration of impaired conditions of the rats.

Nurses' reported practice and knowledge of wound assessment, assessment tools and documentation in a selected hospital in Lagos, Nigeria.

BACKGROUND: Complete wound assessment and accurate documentation are two pivots on which effective wound care is based and wound care is the traditional role of nurses. This study was designed to assess nurses' reported practice and knowledge of wound assessment, assessment tools and documentation. METHODS: Cross sectional descriptive design was adopted and the study was conducted in National Orthopaedic Hospital, Igbobi (NOHIL) Lagos, Nigeria which was selected because of high incidence of orthopaedic conditions with accompanying wounds of various types. A purposive sample of 251 nurses participated in the study. RESULTS: Findings show less than adequate reported practice and knowledge. Some of the respondents, 83 (33.1%) reported that they were familiar with wound assessment methods. However, only 18 (7.2%), 29 (11.6%) and 7 (2.8%) correctly cited photographic method, physical observation, and tape rule respectively while 21 (25%) of them cited wrong methods such as evaluation of PH and chemical method, and the rest could not cite any method. Majority, 144 (57.4%) reported they were not quite or not at all familiar with Pressure Ulcer Status Tool, and none of the respondents who claimed to be familiar with these tools could answer any questions that tested their knowledge on specific aspects of the tool. What respondents claimed they included in their documentation varies from wound dressing done/wound is clean/wound is healing by 111(44.2%) while 40(16%) of them reported no idea of what to document. Modifiable variables like rank (NOII) and years of experience (1-5 years) were found to significantly affect their reported knowledge of wound assessment and reported practice of wound documentation. CONCLUSION: Participants in this study are deficient in knowledge and practice of wound assessment and documentation. Utilization of wound assessment tools and continuing professional development for nurses are necessary to improve care outcomes for all patients living with wounds.

Accidental Peno-Scrotal Degloving Injuries in a Child. A Case Report and Literature Review.

Injury to male external genitalia is very rare because of some intrinsic factors like location, strong investing tunica albuginea and cremasteric muscles. However, when it occurs it is considered a urological emergency. Child labour with poor understanding of risks and safety precautions, especially under harsh supervision, surely poses major challenges. This case illustrates degloving injury of the penis and avulsion of the scrotum in a young boy while operating a roller type machine used in palm trees plantation. The penis was primarily regloved and avulsed skin primarily repaired. A good cosmetic outcome was observed from this treatment. This case also illustrates the importance of early presentation and emergency intervention in this condition.

Sharp injuries among hospital waste handlers.

BACKGROUND: Health care workers are generally predisposed to injuries from sharps as a health hazard. This is more pronounced among waste handlers. OBJECTIVE: It is therefore important to assess these injuries among this group of people with a view to identifying the risk factors and suggesting preventive methods. METHODS: Questionnaires were administered to People handling wastes in our hospital to assess their level of education on injury prevention, immunization status and preventive methods used by them to prevent these injuries and subsequent infections. RESULTS: Forty three waste handlers were interviewed. Twenty eight (65.8%) of them received training before commencing on the job while 14 (32.5%) never received any training. Only thirty nine (90.7%) of them always use hand gloves before carrying wastes. Only three (7.0%) of the respondents have been screened for Hepatitis B, 19 (44.2%) for HIV, while 10 (23.3%) were screened for Hepatitis B, C, and HIV. Eleven (25.6%) of them have been injured with sharps. The finger was the most injured in 7 (93%) of them. CONCLUSION: Training and re-training of health workers is important and should be encouraged. All health workers should have pre-employment immunization against Hepatitis B, C as well as other before commencing on their jobs. Workers should be screened for infective diseases that can be of legal problem while at the job and the workers should be effectively immunized.

Descriptive epidemiology of selected heritable birth defects in Texas.

BACKGROUND: Few population-based studies exist on descriptive epidemiologic characteristics of rare heritable birth defects. The number of birth defect cases in the Texas Birth Defects Registry (one of the largest active birth defects surveillance systems in the world) enabled us to examine six different heritable disorders (aqueductal stenosis, infantile polycystic kidney disease, achondroplasia, thanatophoric dwarfism, chondrodysplasia/dwarfism not otherwise specified (NOS), and osteogenesis imperfecta) for a variety of descriptive demographic variables. METHODS: The Texas Birth Defects Registry was used to identify infants or fetuses with heritable birth defects. Crude prevalence rates were calculated and Poisson regression was used to test the association of each demographic variable (e.g., maternal age) with each of the selected genetic birth defects. RESULTS: White non-Hispanics exhibited higher rates of achondroplasia and osteogenesis imperfecta than other race/ethnic groups. Lower maternal education level and to a lesser extent, paternal education level, was associated with higher rates of several disorders. The birth prevalence rate for achondroplasia decreased from 1999 through 2006. CONCLUSION: The use of a large birth defects registry provides a sufficient count of cases to perform some basic epidemiologic analysis on selected rare heritable birth defects.

Burn safety knowledge in adult nigerians.

Burn injuries remain a global problem even though they are largely preventable. Adequate knowledge is essential to good burn safety practices. This aids prevention and minimizes severity when burn injuries occur. The purpose of this study was to determine the level of burn safety knowledge among literate adult Nigerians in Ile-Ife and Ilesa, South-western Nigeria. We elicited a paucity of burn safety knowledge in the population studied, but a high level of formal education corresponded to a higher degree of burn safety knowledge. There is a need to introduce burn safety education into the school curriculum at all levels of education in order to increase burn safety awareness.