Olufemi K Ogundipe, Gabriel Elekwachi, Odunayo Babatola
African Journal of Trauma 2016 5(2):31-35
Background: This report describes treatment outcome following delayed miniplate osteosynthesis (MPO) of maxillofacial fractures. Materials and Methods: The records of patients who underwent delayed MPO of facial fractures from January 2011 to December 2014 at the Oral and Maxillofacial surgery Unit of the Federal Medical Centre, Owo, Nigeria were retrospectively reviewed. Data retrieved were age, gender, etiology of trauma, site of fractures, and time lapse from injury to treatment. Follow-up at postoperative intervals consisted of clinical and radiographic examinations. Outcome variables such as wound infection, wound dehiscence, malocclusion, hardware failure, fracture stability, and neurosensory disturbance were recorded. Results: Thirty-one patients with 52 facial fractures were treated. There were 18 (58.1%) mandibular, 8 (25.8%) maxillary fracture while 5 (16.1%) fractures occurred in both jaws. All patients had a stable fixation and normal healing. Thirteen complications occurred in 11 patients representing 35.5% of the total. Malocclusion and wound infection were the most common complication. More complications occurred in late treatment group. Conclusion: MPO with or without postoperative intermaxillary fixation is effective in the delayed facial fracture. Treatment delay may increase the incidence of complications.
http://ift.tt/2uu6HTj
Πέμπτη 10 Αυγούστου 2017
Fatal traumatic slicing injuries of the chest: An industrial death and safety concerns
Sunday S Soyemi, John O Obafunwa, Francis A Faduyile, Oluseun O Williams, Festus E Emiogun, Fadesewa O Osuolale, Oluwayemisi O Kila
African Journal of Trauma 2016 5(2):54-57
A 36-year-old male truck driver of a mattress manufacturing company in Lagos was allegedly found dead on the rotary conveyor belt of a foam slicing machine in the factory. A visit to the scene of the event including examination of the conveyor belt and interrogation of the industrial nurse and chief security officer was made. Postmortem examination revealed single transverse incised wound on the chest, left and the right arms. Internal examination revealed incision on the 6th rib anteriorly, right hemothorax and a linear incision on the base of the left ventricle. Other findings included incision on the liver, the left hemidiaphragm, and hemoperitoneum. Death was ascribed to multiple injuries following sharp force trauma to the chest and abdomen in an industrial accident. Due to lack of toxicological facilities, blood level analysis of alcohol, other intoxicants, or substance abuse could not be checked for. This would have ruled out alcohol intoxication, substance abuse, or drug overdose. Suicide was ruled out judging from the decedent's medical and social history. The manner of death, in this case, was in our opinion accidental. This case has brought to the fore one of many occurrences of industrial deaths following inadequacy of safety measures and equipment in the company. There has never been a situation where culpable individual in charge of safety is brought to book in this environment. It has also highlighted the problems that could be faced by forensic pathologist in deciding manner of death in this type of situation.
http://ift.tt/2uMtrJ7
African Journal of Trauma 2016 5(2):54-57
A 36-year-old male truck driver of a mattress manufacturing company in Lagos was allegedly found dead on the rotary conveyor belt of a foam slicing machine in the factory. A visit to the scene of the event including examination of the conveyor belt and interrogation of the industrial nurse and chief security officer was made. Postmortem examination revealed single transverse incised wound on the chest, left and the right arms. Internal examination revealed incision on the 6th rib anteriorly, right hemothorax and a linear incision on the base of the left ventricle. Other findings included incision on the liver, the left hemidiaphragm, and hemoperitoneum. Death was ascribed to multiple injuries following sharp force trauma to the chest and abdomen in an industrial accident. Due to lack of toxicological facilities, blood level analysis of alcohol, other intoxicants, or substance abuse could not be checked for. This would have ruled out alcohol intoxication, substance abuse, or drug overdose. Suicide was ruled out judging from the decedent's medical and social history. The manner of death, in this case, was in our opinion accidental. This case has brought to the fore one of many occurrences of industrial deaths following inadequacy of safety measures and equipment in the company. There has never been a situation where culpable individual in charge of safety is brought to book in this environment. It has also highlighted the problems that could be faced by forensic pathologist in deciding manner of death in this type of situation.
http://ift.tt/2uMtrJ7
Changing pattern in the treatment of mandibular fractures in North-Western Nigeria
Adebayo Aremu Ibikunle, Abdurrazaq Olanrewaju Taiwo, Ramat Oyebunmi Braimah, Olalekan Micah Gbotolorun
African Journal of Trauma 2016 5(2):36-42
Background: Maxillofacial fractures constitute a significant proportion of fractures seen at tertiary hospitals. Management of maxillofacial fractures is challenging and often associated with reduced quality of life among patients if not properly managed. This study was designed to analyze the trend in management of maxillofacial fractures at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Northwest Nigeria between 2011 and 2016. Materials and Methods: Data on the sociodemographic characteristics, etiology, type of fracture, and treatment done were retrieved. Data analysis was done with SPSS and comparisons were made using Chi-square and t-test. Statistical significance was set at P < 0.05. Results: A total of 341 fracture sites were observed in 201 patients, the majority were males giving a male to female ratio of 6.2:1. The overall modal age group at presentation was the 21–30 year age group accounting for 78 (36.3%) of all cases seen. Road traffic accident (RTA) was the principal etiological factor accounting for 137 (63.7%) of the fracture cases seen. The mandibular body and dentoalveolar sites were the most frequently occurring fracture sites on the mandible accounting for 69 (20.2%) and 42 (12.3%) of all fractures. A comparison of the etiological factors among groups of patients based on the year of presentation and gender was statistically significant (P = 0.02). A comparison of the mode of treatment (open reduction and internal fixation [ORIF] or closed reduction) among patients based on the year of treatment was statistically significant (P < 0.001). Conclusion: RTA remains the foremost cause of maxillofacial fractures in our environment. Despite a variety of challenges, ORIF is gradually being embraced as a viable mode of treatment in our center.
http://ift.tt/2uuAafu
African Journal of Trauma 2016 5(2):36-42
Background: Maxillofacial fractures constitute a significant proportion of fractures seen at tertiary hospitals. Management of maxillofacial fractures is challenging and often associated with reduced quality of life among patients if not properly managed. This study was designed to analyze the trend in management of maxillofacial fractures at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Northwest Nigeria between 2011 and 2016. Materials and Methods: Data on the sociodemographic characteristics, etiology, type of fracture, and treatment done were retrieved. Data analysis was done with SPSS and comparisons were made using Chi-square and t-test. Statistical significance was set at P < 0.05. Results: A total of 341 fracture sites were observed in 201 patients, the majority were males giving a male to female ratio of 6.2:1. The overall modal age group at presentation was the 21–30 year age group accounting for 78 (36.3%) of all cases seen. Road traffic accident (RTA) was the principal etiological factor accounting for 137 (63.7%) of the fracture cases seen. The mandibular body and dentoalveolar sites were the most frequently occurring fracture sites on the mandible accounting for 69 (20.2%) and 42 (12.3%) of all fractures. A comparison of the etiological factors among groups of patients based on the year of presentation and gender was statistically significant (P = 0.02). A comparison of the mode of treatment (open reduction and internal fixation [ORIF] or closed reduction) among patients based on the year of treatment was statistically significant (P < 0.001). Conclusion: RTA remains the foremost cause of maxillofacial fractures in our environment. Despite a variety of challenges, ORIF is gradually being embraced as a viable mode of treatment in our center.
http://ift.tt/2uuAafu
Community-based study of road traffic accident among Almajirai in Zaria
Jerry Godfrey Makama, Tukur Dahiru, Alaji A Aliyu
African Journal of Trauma 2016 5(2):48-53
Background: Trauma is a leading cause of morbidity and mortality among people of age <45 years. Almajiri is a boy of age 5–15 years that has left his parents to a distanced place in search of Islamic knowledge. They are often left on their own to cater for themselves, roaming on roads and streets from one place to another searching for alms and food. Therefore, we aim to assess the characteristics of road traffic injury among the Almajirai in Zaria. Materials and Methods: This was a cross-sectional, descriptive study, conducted in Zaria metropolis from June to December 2012. A multistage sampling technique was used to sample clusters of Almajirai. A structured interviewer-administered questionnaire was used to obtain the data. The information obtained from the respondents included the biodata, basic understanding of the use of roads, application of traffic rules and regulations, involvement in road traffic crash (RTC), the frequency and severity of RTC, where the Almajiri was managed and the outcome of each episode. The analysis was done using SPSS version 20 for the purpose of generating frequency tables, pie and bar charts including mean and Chi-square where applicable. Results: A total of 417 Almajirai participated in the study. Of this number, three hundred and sixteen (75.8%) admitted being involved in at least one form of RTC while 101 (24.2%) were not. Most accidents (23.5%) occurred in their neighborhoods and during rush hours (25%). Only 1%–2% had basic knowledge of road signs and proper use of busy roads. The majority (41.5%) were involved as pedestrian with injury, commonly, affecting the lower extremity. Conclusion: RTC was a significant cause of injury among the Almajirai in Zaria. The most common injury was trauma to the lower extremity. Special attention needs to be paid to this group of children in our society by all road users.
http://ift.tt/2uMxXHM
African Journal of Trauma 2016 5(2):48-53
Background: Trauma is a leading cause of morbidity and mortality among people of age <45 years. Almajiri is a boy of age 5–15 years that has left his parents to a distanced place in search of Islamic knowledge. They are often left on their own to cater for themselves, roaming on roads and streets from one place to another searching for alms and food. Therefore, we aim to assess the characteristics of road traffic injury among the Almajirai in Zaria. Materials and Methods: This was a cross-sectional, descriptive study, conducted in Zaria metropolis from June to December 2012. A multistage sampling technique was used to sample clusters of Almajirai. A structured interviewer-administered questionnaire was used to obtain the data. The information obtained from the respondents included the biodata, basic understanding of the use of roads, application of traffic rules and regulations, involvement in road traffic crash (RTC), the frequency and severity of RTC, where the Almajiri was managed and the outcome of each episode. The analysis was done using SPSS version 20 for the purpose of generating frequency tables, pie and bar charts including mean and Chi-square where applicable. Results: A total of 417 Almajirai participated in the study. Of this number, three hundred and sixteen (75.8%) admitted being involved in at least one form of RTC while 101 (24.2%) were not. Most accidents (23.5%) occurred in their neighborhoods and during rush hours (25%). Only 1%–2% had basic knowledge of road signs and proper use of busy roads. The majority (41.5%) were involved as pedestrian with injury, commonly, affecting the lower extremity. Conclusion: RTC was a significant cause of injury among the Almajirai in Zaria. The most common injury was trauma to the lower extremity. Special attention needs to be paid to this group of children in our society by all road users.
http://ift.tt/2uMxXHM
Motorcycle accident mortality in Lagos, Nigeria: Impact of a traffic law
Festus Edobor Emiogun, Francis Adedayo Faduyile, Sunday Sokunle Soyemi, Olugbenga Olaide Oyewole
African Journal of Trauma 2016 5(2):43-47
Introduction: The use of the motorcycles for commercial purposes has been associated with a high rate of road traffic injuries and mortality in Nigeria. This study is to examine the effects of newly introduced traffic laws on the mortality rate as well as pattern of injury following the enforcement of the laws. Methodology: This is a 4-year retrospective autopsy study of motorcycle accident deaths in Lagos State University Teaching Hospital, Ikeja. The study period was divided into two parts; 2 years before the law, August 2010–July 2012 and 2 years after the law, August 2012–July 2014. The anatomical location of the injuries as well as the cause of death of the patients was extracted from the register and the data were analyzed using SPSS version 20. Test for statistical significance was set as P < 0.05. Results: There were 128 motorcycle death autopsies recorded during the period of study with 96 cases (75%) before the law and 32 cases (25%) after the law. The frequency of head injury was 39.8% before the law and 43.6% after the law. The proportion of road traffic accident deaths due to motorcycle crashes was from 23.4% before the law to 11.2% after the law. Conclusion: Head injury is the most frequent anatomical region of injury in both periods. There is a 3-fold decrease in the proportion of death from motorcycle crashes following the enforcement of the traffic law.
http://ift.tt/2uuo4TL
African Journal of Trauma 2016 5(2):43-47
Introduction: The use of the motorcycles for commercial purposes has been associated with a high rate of road traffic injuries and mortality in Nigeria. This study is to examine the effects of newly introduced traffic laws on the mortality rate as well as pattern of injury following the enforcement of the laws. Methodology: This is a 4-year retrospective autopsy study of motorcycle accident deaths in Lagos State University Teaching Hospital, Ikeja. The study period was divided into two parts; 2 years before the law, August 2010–July 2012 and 2 years after the law, August 2012–July 2014. The anatomical location of the injuries as well as the cause of death of the patients was extracted from the register and the data were analyzed using SPSS version 20. Test for statistical significance was set as P < 0.05. Results: There were 128 motorcycle death autopsies recorded during the period of study with 96 cases (75%) before the law and 32 cases (25%) after the law. The frequency of head injury was 39.8% before the law and 43.6% after the law. The proportion of road traffic accident deaths due to motorcycle crashes was from 23.4% before the law to 11.2% after the law. Conclusion: Head injury is the most frequent anatomical region of injury in both periods. There is a 3-fold decrease in the proportion of death from motorcycle crashes following the enforcement of the traffic law.
http://ift.tt/2uuo4TL
Closed circuit refeeding biliary drainage in a complex blunt hepatobiliary trauma: A novel technique
Harish Jayaram, Preetham Poddutoor, Jyoti M Bothra, K Lalatendu Kumar
African Journal of Trauma 2016 5(2):58-61
Blunt trauma to the abdomen is common in children causing injuries of varying severity. We present a complex case of hepatobiliary, gastrointestinal, and renal artery injuries needing a tailored management strategy and a novel technique of nutrition for the best possible outcome for the patient. Our patient in this case report had extensive hepatobiliary trauma with complete biliary duct and duodenal transection and renal artery thrombosis. He was managed by staged surgeries comprising biliary diversion and duodenal repair in the first stage and undiversion of the system in the second surgery. This is a novel technique as the nutrition was maintained by a closed circuit of bile redrainage into the jejunostomy tube achieving a physiological drainage pattern and circumventing the need of parental nutrition.
http://ift.tt/2uMf8oh
African Journal of Trauma 2016 5(2):58-61
Blunt trauma to the abdomen is common in children causing injuries of varying severity. We present a complex case of hepatobiliary, gastrointestinal, and renal artery injuries needing a tailored management strategy and a novel technique of nutrition for the best possible outcome for the patient. Our patient in this case report had extensive hepatobiliary trauma with complete biliary duct and duodenal transection and renal artery thrombosis. He was managed by staged surgeries comprising biliary diversion and duodenal repair in the first stage and undiversion of the system in the second surgery. This is a novel technique as the nutrition was maintained by a closed circuit of bile redrainage into the jejunostomy tube achieving a physiological drainage pattern and circumventing the need of parental nutrition.
http://ift.tt/2uMf8oh
Otosclerosis and complications of stapedectomy: CT and MRI correlation
Publication date: Available online 10 August 2017
Source:Alexandria Journal of Medicine
Author(s): Heba Ibrahim Ali, Nivan Hany Khater
http://ift.tt/2uLVDvK
Bevacizumab in Colorectal Cancer: Current Role in Treatment and the Potential of Biosimilars
Abstract
Colorectal cancer (CRC) is a leading cause of tumor-related morbidity and mortality worldwide, with mortality most often attributable to metastatic disease. Bevacizumab, a humanized monoclonal antibody targeting vascular endothelial growth factor, has a significant role in the treatment of metastatic CRC (mCRC). However, patient access to bevacizumab may be limited in some regions or circumstances, owing to factors related to insurance coverage, reimbursement, patient out-of-pocket costs, or availability. As a result, outcomes for patients with mCRC may be worsened. Additionally, counterfeit bevacizumab has infiltrated legitimate supply chains, exposing patients to risk. Oncologists may also be affected detrimentally, since resolving access issues can be time-consuming and demoralizing. The imminent expiry of patents protecting bevacizumab provides other manufacturers with the opportunity to produce highly similar versions known as biosimilars. High-quality, safe, and effective biosimilars have the potential to expand access to bevacizumab. Most of the bevacizumab biosimilars currently in development are in clinical trials in patients with non-small-cell lung cancer, and future authorization for mCRC indications will, therefore, be based on extrapolation. This article reviews the current role of bevacizumab in the management of mCRC, the possible barriers associated with diminished access to bevacizumab, and the potential bevacizumab biosimilars in development. How biosimilars may impact the treatment of mCRC is also discussed.
http://ift.tt/2vKMbxm
The Vascular Niche Regulates Hematopoietic Stem and Progenitor Cell Lodgment and Expansion via klf6a-ccl25b
Publication date: Available online 10 August 2017
Source:Developmental Cell
Author(s): Yuanyuan Xue, Junhua Lv, Chunxia Zhang, Lu Wang, Dongyuan Ma, Feng Liu
In mammals, hematopoietic stem and progenitor cells (HSPCs) rapidly expand in the fetal liver (FL), but the underlying mechanism remains unclear. Here, we characterize zebrafish caudal hematopoietic tissue (CHT) and identify an important cellular and molecular mechanism of HSPC expansion. Time-lapse imaging showed that HSPCs localize adjacent to vascular endothelial cells (ECs), and their migration and expansion display caudal vein-specific orientation in the CHT. RNA sequencing and functional analysis identified that an EC-expressed transcription factor, Krüppel-like factor 6a (Klf6a), is essential for the CHT niche. We further demonstrated that Klf6a directly regulates the expression of the chemokine (C-C motif) ligand 25b to modulate HSPC lodgment and proliferation. Ex vivo culture results support the conserved role of Ccl21/Ccr7 signaling in promoting HSPC expansion in mammals. Together, we identify the Klf6a-Ccl25b/Ccr7 axis in controlling the complex HSPC-CHT niche interaction, which may be applicable to in vitro expansion or engraftment of HSPCs after transplantation.
Graphical abstract
Teaser
The molecular mechanisms underlying hematopoietic stem and progenitor cell (HSPC) expansion are largely unknown. Xue et al. reveal that vascular niche-derived chemokine signals are required for HSPC lodgment and expansion in the zebrafish caudal hematopoietic tissue.http://ift.tt/2vUCop1
Scholar : Beijing Journal of Stomatology, Year 2017, Issue 03 -New Issue Alert.
Scholar : Chinese Journal of Otorhinolaryngology, Year 2017, Issue 06 -New Issue Alert.
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Scholar : Chinese Archives of Otolaryngology-Head and Neck Surgery, Year 2017, Issue 06 -New Issue Alert.
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Scholar : Stomatology, Year 2017, Issue 06 -New Issue Alert.
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Scholar : Journal of Clinical Stomatology, Year 2017, Issue 06 -New Issue Alert.
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Scholar : Journal of Practical Stomatology, Year 2017, Issue 02 -New Issue Alert.
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Scholar : Chinese Journal of Otorhinolaryngology-skull Base Surgery, Year 2017, Issue 03 -New Issue Alert.
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Scholar : China Journal of Oral and Maxillofacial Surgery, Year 2017, Issue 03 -New Issue Alert.
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Scholar : chinese Journal of Practical Stomatology, Year 2017, Issue 05 -New Issue Alert.
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Scholar : Chinese Scientific Journal of Hearing and Speech Rehabilitation, Year 2017, Issue 03 -New Issue Alert.
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Scholar : Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Year 2017, Issue 06 -New Issue Alert.
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Scholar : Journal of Otology, Year 2017, Issue 02 -New Issue Alert.
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Scholar : Chinese Journal of Stomatology, Year 2017, Issue 06 -New Issue Alert.
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