Tropical doctor
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A retrospective study of the management of gynaecological patients admitted to the general intensive care unit (ICU) of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria, over a 6-year span was carried out. Out of a total of 816 patients admitted to the ICU during the study period, 21 (2.6%) were gynaecological patients with the following diagnoses: generalized sepsis, postoperative respiratory distress, hypovolaemic shock, preoperative anaemia and mennorhagia, and major surgery with potential for major complications. The mortality rate was 28.6% with six deaths, sepsis being the major cause of death (four fatalities).
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The records of 168 children managed for burns in a teaching hospital in northwestern Nigeria, between April 1998 and March 2003, were assessed to determine the factors that are responsible for high rates of morbidity and mortality in paediatric burns. The causes of burns were hot water in 86 cases (51.2%), flame in 45 (26.8%), hot soup in 32 (19%) and electricity in five (3%). The main complications were wound infections in 109 (64.9%) patients, anaemia in 68 (40.5%), malnutrition in 54 (32.1%), contracture in 50 (29.8%), persistent hypothermia in 27 (16.1%), tetanus in 14 (8.3%) and one case (0.6%) of massive upper gastrointestinal bleeding, possibly as a result of Curling's ulcer.
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A population-based cross-sectional inquiry was carried out in Delhi to assess the practice of fetal sex determination, sex-selective abortions and awareness about the related law. A total of 1514 respondents, selected through multistage cluster sampling from all across Delhi, were interviewed using a pretested, semistructured questionnaire. Legal awareness (73.6%) was significantly better among the male and urban respondents. ⋯ However, this comparison also shows a marginal increase in the practice of fetal sex determination (2.1-2.6%). In all cases of feticide, a qualified doctor was involved. A number of couples abandoned the abortion plan midway, even after detecting that the fetus was female, and there were occasional cases where the doctor refused to abort the female fetus.
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A retrospective study of 32 patients managed for cow gore injuries. The abdomen was involved in 16 (50%) patients, scrotum in six (18.9%), neck in three (9.3%) and other sites in seven (22.8%). All injuries were penetrating in nature and laparotomy was done on 17 (53%) patients.
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There were 58,858 road traffic crashes, 39,111 casualties and 8,504 fatalities reported in Malawi between 1987 and 1995. This represented a 31% increase in the number of road traffic crashes, 42% increase in the number of casualties and 105% increase in the number of fatalities during the study period. ⋯ Despite a 34% increase in the population of Malawi from 8 million to 10.7 million between 1987 and 1995, only minimal changes were reported in both the number of road traffic crashes per 10,000 population and the casualties per 10,000 population. But the number of road traffic fatalities per 100,000 population increased by 55%, from 6.9 to 10.7.