The relative associations of the paediatric trauma score and revised trauma score with the severity of childhood trauma.

BACKGROUND: Children are prone to unintentional injuries and various scoring systems have been used to triage these injuries. The aim of this study is to determine the associations between paediatric trauma score (PTS), revised trauma score (RTS) and the length of hospital stay as an indicator of injury severity. METHODS: This is a descriptive cross-sectional study conducted in the University of Calabar Teaching Hospital, Calabar and National Orthopaedic Hospital, Enugu from February 2018 to March 2020. A structured questionnaire was used to collect personal, injury-specific and treatment-specific data. The relationship between PTS, RTS and the length of hospital stay was evaluated using the one-way analysis of variance (ANOVA). RESULTS: A total of 212 patients were included in the study. Majorities (129, 60%) of the injured children were male and most of the injuries were due to falls from height (54%). The mean PTS was 5.36 ± 1.9, while the mean RTS was 7.10 ± 0.9. The Pearson's product momentum correlation coefficient shows that there was weak but statistically significant correlation between the PTS and the RTS (r = 0.22, P = 0.02). The one-way ANOVA showed a statistically significant decrease in the RTS with increasing duration of hospital admission (F-statistic = 6.654, df = 3, P = 0.000). The PTS showed a less obvious decrease with no trend. CONCLUSION: In this study, the RTS showed an inverse relationship with the length of hospital stay.

Tropical Diabetic Hand Syndrome-Report of 2 Cases.

Tropical diabetic hand syndrome (TDHS) is not a commonly reported complication of diabetes mellitus. It was first reported in Nigeria in 1984[1] but prior to that time, in 1977, it was described in the United States of America.[2] Several other cases are now being reported in other countries of Africa and India. It is termed TDHS because it affected patients with diabetes mellitus in the tropics. It presents with cellulitis, ulceration, and fulminant sepsis of the hand, which may progress to gangrene, and many have lost the digits as seen in one of our patients or sometimes the whole hand. Many of these patients present very late as the onset of the condition is usually due to minor trauma to the hand like a pin prick or little scratches, which result in cellulitis are treated by patent medicine dealers until the sepsis and possibly gangrene in some cases sets in.

Impact of transportation policy on injury characteristics in a teaching hospital, Calabar, Nigeria.

INTRODUCTION: The global burden of road traffic injury (RTI)-related trauma is enormous and has the highest impact in low income economies. Loss of lives in the most productive age groups and the socio-economic costs to these weak economies, coupled with poor infrastructure for management of the severely injured dictate that well executed preventive measures be instituted in these countries. Low and middle income economies account for 90% RTI-related deaths in the world, yet in these regions, public health regulations on road safety hardly exist and where they do, are hardly enforced. AIM: To document variations in injury frequency, severity and outcomes following the ban on the use of motorcycles as a means of public transportation in Calabar. PATIENTS AND METHODS: A prospective study of RTI patients who presented in our Emergency center over a 12 month period. Information recorded included biodata, anatomic location of injury, injury-arrival time, mode of transportation to hospital and final disposition at discharge. Chest injuries were excluded as there were no data for comparison. Results were analyzed by SPSS version 20 and compared with the 2005 Trauma Study Group results. RESULTS: There were 366 road traffic injuries out of 5612 emergency room presentations during the period. There were 237 males and 99 females (M: F= 2.4: 1), mean age of patients was 30.13±12.62 years. Businessmen were the most commonly involved occupational group (n= 138; 38.7%) and the mean injury-arrival interval was 16.57±56.14 hours. Only 12 (3.6%) patients arrived by ambulance and 108 (32.1%) left against medical advice. CONCLUSION: RTIs constitute a major socioeconomic burden in the developing world. Lack of research, high risk behaviors and lack of enforceable road use regulations contribute to high rates of RTI-related mortality and morbidity. Preventive interventions and appropriate research to identify risk factors will reduce the burden of RTIs in low and middle income economies.