Anteroinferior versus superior plating techniques for displaced midshaft clavicle fractures: A retrospective single centre cohort study from Northern Nigeria.

BACKGROUND: Clavicle fractures are common injuries accounting for up to 5% of all fractures in adults. Most clavicle fractures heal well with nonoperative treatment, some however, require surgical intervention especially when they are displaced. While plating remains the most popular and most successful method of clavicle fixation; the optimal position of the plate is yet to be agreed upon. PURPOSES: The purpose of this study was to compare the functional outcomes of displaced clavicle fractures fixed with superior and anteroinferior plating techniques. PATIENTS AND METHODS: This retrospective cohort study of 69 patients (45 males and 24 females) was carried out between January 2014 and December 2018 at a government orthopaedic hospital in north-western part of Nigeria. The study involved all consecutive patients who sustained a displaced mid-shaft clavicle fracture and had open reduction and internal fixation (ORIF) with either superior plating (SP) or anterior-inferior plating (AIP) and were followed up for at least one year. Data analyzed include: age, sex, laterality, mode of injury, the time from initial injury to surgery, type of plate used, position of the plate, union rate, functional outcome and peri-operative complications. RESULTS: Fourty-two patients had SP and twenty seven patients had AIP. Fourty one (97.6%) patients had fracture union in SP group while all the twenty seven patients (100%) in the AIP group had fracture union. The mean QuickDASH scores was 3.2 ± 4.6 and 3.6 ± 4.7 in AIP and SP groups respectively. There was no significant difference in the union rates and functional outcome between the two groups. CONCLUSION: Both superior and anteroinferior plating techniques are safe and effective in the surgical management of displaced mid-clavicle fractures. LEVEL OF EVIDENCE: Level 3, retrospective cohort study.

Old unreduced elbow dislocation: Patients' perspectives on outcome of open reduction.

INTRODUCTION: Old unreduced elbow dislocation is not uncommon in developing countries. Many authors have reported outcome of open reduction in the management of this problem. However, we did not find any study that document patient reported outcome. OBJECTIVE: the objective of this study was to determine the patients' perspectives of outcome of open reduction in the management of old unreduced elbow dislocation. METHODS: This was a prospective interventional study of 49 consecutive patients with old unreduced simple elbow dislocation who were treated with open reduction at the National Orthopaedic Hospital, Dala - Kano, Nigeria and Albarka Clinic Kano, Nigeria between January 2015 and December 2019. RESULTS: Fourty nine patients were studied with median age of 31.0 years (range: 19-60 years). The majority of the patients were within 31-40 years age group. The male to female ratio was 6:1. Using the Mayor Elbow Performance Scale (MEPS) and Patients specific Functional scale (PSFS); there are significant improvements in postoperative functional capability of the patients (P = 0.000). With the short assessment for patient satisfaction (SAPS), 93.3% of patients were either satisfied or very satisfied with the outcome of open reduction. CONCLUSION: The outcome of open reduction for old unreduced elbow dislocation is good and is well accepted by the patients.

Insights into the gut microbiota of Nigerian elderly with type 2 diabetes and non-diabetic elderly persons.

Type 2 diabetes (T2D) is a prevalent non-communicable disease among the world's growing elderly population. The contribution of the gut microbiota to T2D in several Westernized countries has been established. However, there is little information on the role of the gut microbiota in T2D from the African continent where lifestyle and life expectancy are different. AIMS: This study sought to investigate gut microbiota variation in relation to elderly people living with T2D. in Nigeria. METHODS: Whole microbial community DNA were derived from the stool samples of healthy urban-dwelling elderly individuals and urban-dwelling elderly individuals with T2D. The V4 region of the 16S rRNA gene was Illumina-sequenced and analyzed using QIIME2. RESULTS: Beta taxonomic diversity was significantly different between healthy elderly individuals and elderly individuals with T2D. However, no difference in the alpha taxonomic diversity and predicted functional alpha diversity of the gut microbiota was observed. The genus Ruminococcus (T2D versus Healthy: 2.89% vs 2.21%), families Coriobacteriaceae (Collinsella, T2D versus Healthy: 2.62 % vs 1.25%) and Bifidobacteriaceae were enriched in elderly individuals with T2D, while members of Clostridiaceae (Clostridium, Healthy versus T2D: 5.6% vs 3.2%) and Peptostreptococcaceae (Healthy versus T2D: 3.45% vs 1.99%) were enriched in healthy volunteers. Pathways involved in amino acid biosynthesis were enriched in elderly individuals with T2D, while pathways involved in respiration and the biosynthesis of vital building blocks were enriched in healthy volunteers. CONCLUSIONS: The study demonstrated for the first time in an African elderly population that the abundance of Bifidobacteriaceae, Collinsella, and Ruminococcus within the gut varies in relation to T2D. Findings from this study suggest that the restoration of features associated with healthiness via the way of gut microbiota modification could be one step needed to improve elderly patient care.

Comparison of Algorithms for the Detection of Enteroviruses in Stool Specimens from Children Diagnosed with Acute Flaccid Paralysis.

This study was designed to compare both the cell culture dependent and independent enterovirus detection algorithms recommended by the WHO and assess how either might impact our perception of the diversity of enterovirus types present in a sample. Sixteen paired samples (16 isolates from RD cell culture and their corresponding stool suspension, i.e., 32 samples) from AFP cases in Nigeria were analyzed in this study. All the samples were subjected to RNA extraction, cDNA synthesis, the WHO recommended RT-snPCR, and its modification. Amplicons were sequenced and strains identified. Enterovirus diversity was the same between the isolates and fecal suspension for the control and five of the samples. It was, however, different for the remaining 10 (62.5%) samples. Nine (CV-B4, E6, E7, E13, E14, E19, E29, EV-B75, and EV-B77) and five (CV-A1, CV-A11, CV-A13, EV-C99, and PV2) EV-B and EV-C types, respectively, were detected. Particularly, E19 and EV-B75 were only recovered from the isolates while E14, EV-B77, CV-A11, and CV-A13 were only recovered from fecal suspension. Both the cell culture dependent and independent protocols bias our perception of the diversity of enterovirus types present in a sample. Hence, effort should be directed at harmonizing both for increased sensitivity.

In-vitro antibacterial screening of methanol extracts of three combretum species against seven strains of methicillin resistant staphylococcus aureus (MRSA)

Background: Medicinal plants are valued as sources of natural compounds some of which are effective against several infectious diseases. Plants from the genus Combretum have been used traditionally in various African societies to treat variety of medical problems especially infectious diseases.Objective: In this study, we investigated the antibacterial activity of the methanol extracts from the leaves of three Combretum species namely Combretum hispidum, Combretum racemosum and Combretum platypterum against seven strains of methicillin resistant Staphylococcus aureus (MRSA) in vitro.Materials and methods: Methanol extract from Combretum hispidum, Combretum racemosum and Combretum platypterum were subjected to agar diffusion assay and broth micro-dilution test for the determination of antibacterial activity and minimum inhibitory concentration (MIC), all the extracts were tested against eight different strain of MRSA. Imipenem and ciprofloxacin were used as control.Results: Extract from Combretum racemosum leaves showed significant anti-MRSA activity with zone of inhibition as high as 37 mm and MIC values ranging from 0.16 - 1.25 mg/mL on all tested strains of MRSA. Extracts from the two other species did not exhibit any activity on all tested strain.Conclusion: Methanol extract from C. racemosum is highly effective against MRSA and it could be a potential source of newer antimicrobial agent against MRSA infections

Prevalence and correlates of snoring among adults in Nigeria.

INTRODUCTION: Snoring is a common sleep problem with significant public health concerns. Studies have characterized this in most developed countries. Hitherto there have been no published studies on this subject in Nigeria. OBJECTIVES: To determine the prevalence and correlates of snoring in addition to morbidity in an adult population in Nigeria. DESIGN: A cross - sectional survey of 370 young adult and adult living in Abuja, Nigeria.. Data were collected on socio- demographic characteristics, sleep pattern as well as occurrence of snoring, apneas and excessive day time sleepiness was determined using Epworth Sleepiness Scale (ESS). Body Mass Index (BMI) and blood pressure were measured. RESULTS: Of the 370 respondents, 218 (59%) were females. The overall prevalence of snoring was 31.6%; habitual snoring (14%) and moderate snoring (17%). Apnea was reported in about 2% of the respondents while the prevalence of Clinically Suspected Obstructive Sleep Apneas (CSOSA) was 1%, (1.9% in males, 0.5% in females). Snoring was significantly associated with male sex, old age, increased BMI and cigarette consumption . The severity of snoring was also associated with a higher ESS score, day time symptoms and other morbidities. CONCLUSIONS: Snoring among Nigerians is associated with multiple factors. There is a need for more awareness about this condition in order to control measures of factors associated with snoring.