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Maxillofacial fractures in a budding teaching hospital: a study of pattern of presentation and care.

ABSTRACT: Previous reports indicated that there is geographic and sociodemographic variation in the epidemiology of maxillofacial fractures. Audit of maxillofacial injuries managed at any institution is therefore necessary to understand the trends and proffer strategies for prevention. We therefore embarked on this study to determine the pattern of maxillofacial fractures and concomitant injuries in our institution.We carried out a retrospective review of information on demography, aetiology and type of maxillofacial fracture, patients' status, type of crash, level of consciousness and concomitant injuries. The data collected was analysed with SPSS Version 20.A total of 233 patients aged 2 to 66 years were reviewed. A higher male preponderance (M:F 3.4:1) was observed. Road traffic crashes (RTC) accounted for 78.5% of injuries. Motorcycle related crashes were responsible for 69.4% of RTC and 54.5% of all fractures. Fracture of the mandible (63.2% n=172) was the most predominant skeletal injury and the body (25% n=43) was the most common site of fracture while the zygoma (29%) was predominantly affected in the midface. Ninety three patients (40%) suffered loss of consciousness. The relationship between aetiology of injuries and consciousness level of the patients was statistically significant (p=0.001). Of the 43 patients who had concomitant injuries, craniocerebral affectation (60.5%) was the commonest.RTC remains the major aetiology of maxillofacial fractures. The mandible was mostly affected and nearly half of the patients have associated loss of consciousness. There is need for continual advocacy and enforcement of laws on preventive measures among road users.

SUBMITTER: Obimakinde OS

PROVIDER: S-EPMC5491718 | biostudies-other | 2017

REPOSITORIES: biostudies-other

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Project description:Introduction Each year, an estimated 25000 rabies death occurs in Africa. Post-exposure prophylaxis (PEP) remains the only proven approach in preventing rabies deaths. Most of rabies deaths occur among those who delayed, did not receive, or complete rabies PEP. The aim of this study was to determine the pattern of animal bite, factors associated with delays in initiating, and nonadherence to rabies PEP regimen. Method Data on clients reporting for rabies PEP in a tertiary hospital setting in Ghana were collected from 2013 to 2016. Demographics, place, and source of exposure were collected. Other information obtained included adherence to the PEP protocol and GPS coordinates of the town of animal bites. The shortest distance between the GPS coordinates of town of animal bite and the site of administration of the rabies PEP was calculated. A total of 1030 individuals received rabies PEP over the period. Results Overall, 52.9% (545) were males while 47.1% (485) were females. Majority of the cases were between the age group 1–10 years accounting for 29.2%. Dog bites accounted for 96.5% (n?=?994). Cats, nonhuman primates, human bites, respectively, accounted for 1.8% (n?=?18), 1.2% (n?=?12), and 0.6% (n?=?6) of all bites. Majority of bites occurred at home (66.2% (n?=?646)). Also, 31.6% (n??=?308) and 2.3% (n?=?22) of bites occurred on the streets and neighbors/friends' homes, respectively. Only, 18.7% initiated PEP within 24 hours of bite. Rabies PEP regimen completion rate was 95.2% (n?=?976). The median distance travelled to access rabies PEP was 7.87?km (IQR, 3.58–16.27) km. Overall, 34.7% (n?=?344) had the animal bite within 4.99?km radius of the treatment room of KBTH. Clients who delayed in initiating rabies PEP were 2.6 (95% CI, 1.3–5.1) times more likely to be males and 2.0 (1.1–3.9) times more likely to receive bites in a location more than 5?km radius from the KBTH treatment room. Gender, age, and distance of bite from the treatment room were not associated with the likelihood of not completing rabies PEP schedule. Discussion. Bites from suspected rabies infected animals remain a problem in southern Ghana. There are significant delays in initiating PEP for rabies prevention. Most animal bite victims are children ten years and below. Male gender and bites more than 5?km radius from the site of rabies PEP administration were most significant factors associated with delays in initiating rabies PEP. There is the need for adopting strategies to encourage prompt initiation and adherence to PEP.

Project description:BackgroundDespite the apparent benefits of organophosphate compounds (OPCs) acute organophosphate (OP) pesticide poison is an increasing problem worldwide. In a country like Ethiopia, where agriculture is a major component of the economy, these compounds are readily available to the general public. There is paucity of evidence from Ethiopia showing the pattern of organophosphate poisoning (OPP) in healthcare facilities. The objective of this study was to evaluate retrospectively the pattern of acute OPP at the University of Gondar Teaching Hospital in northwest Ethiopia, during September 2010 through December 2014 was conducted. Data was collected through chart review of patients who were admitted due to poisoning. Data was analysed using SPSS 20.ResultsOrganophosphate poisoning in University of Gondar teaching hospital accounts for about 38.46% of all emergency room admissions for poisoning. Out of the 90 cases studied 60% (54) were women, with male to female ratio of 1:1.5. The mean age of the patients was 25.5 with a standard deviation of 9.45. 56.7% of the cases studies lived in an urban environment compared to 43.3% who lived rurally. In the vast majority of patients, 90% (81) patients had ingested OP as an act of suicide. Regarding the route of exposure, oral ingestion was most common in suicidal cases (88.9%). The elapsed time between the time of poison ingestion and the start of the treatment, ranged from 13 min to 1 day. Health care professionals' useds decontamination methods such as gastric lavage and activated charcoal (45.6%) and 36.7% use atropine for OPP treatment. The mean hospital stay was 0.74 days. In the present study family problems were a leading cause of suicides and accounted for 45.8% of all cases.ConclusionAs a developing nation who economy relies heavily on agriculture, Ethiopia continues to have OP compounds remain a common cause of acute poisonings. This is particularly concerning for younger generation who have high rates of OPP and whose numbers continue to raise. This data suggests that it is essential to strengthen Ethiopians regulatory policy concerning the availability of OPCs. Additionally, it will be important to design an appropriate health education program for the prevention of both suicidal and accidental OPPs for the benefit of the public at large.

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Maxillofacial fractures in a budding teaching hospital: a study of pattern of presentation and care.

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