African journal of medicine and medical sciences
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Background: Walking is the most basic form of mobility and forms an important part of daily activities; however, walking could often be associated with risks. This is more so when pedestrians share a common space with motorized vehicles especially in developing countries. Despite the frequency of road traffic crashes (RTC) related pedestrian injuries in many developing countries, there is a dearth of documentation of maxillofacial injuries in victims of pedestrian road traffic crashes. The aim of this study was to determine the causes, frequency, pattern, severity, concomitant injuries and outcome of pedestrian maxillofacial injuries observed at a tertiary trauma centre in Nigeria. ⋯ Forty-six participants (22.9% of all victims of road traffic crashes seen within the study period) were victims of pedestrian RTC. Pedestrian RTC occurred in all age groups with almost 40% of the victims in their 1st and 2nd decades of life. The most severe MFISS was observed in the 21 - 30 year age group while the least severe injury observed was in the 71 - 80 years age group. Thirty participants (65.2%) were hit by a car or minibus while fourteen (30.4%) were knocked down by a motorcycle. Two (4.4%) were hit by a truck. Soft tissue injury was the most common maxillofacial injury and head injury was the commonest concomitant injury observed. The median MFISS score of victims of motorcycle was 4.0 while the median scores for victims of car/minibus pedestrian RTC was 9.0. The most severe maxillofacial injury was seen in victim of car/minibus pedestrian crashes. Seventeen percent (8) of the victims had a fatal outcome. Conclusion: Pedestrian RTC resulting in maxillofacial injuries are common in the studied environment. It is particularly common among the 11 -20 year age group and victims are usually hit by cars/minibuses. These injuries are often severe and fatal outcome is not infrequent. Therefore, definitive preventive measures are imperative.
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Case Reports
Cervical ectopic pregnancy managed with methotrexate and tranexamic acid: A case report.
Cervical pregnancy is a rare life-threatening form of ectopic pregnancy and when it occurs, it is challenging to decide the management options. Surgical intervention has been documented to be complicated by intractable haemorrhage and most often necessitating hysterectomy. We hereby report a case of cervical pregnancy managed conservatively with medical agents prior to surgical intervention. CASE PRESENTATION AND MANAGEMENT: A 29 year old primiparous woman with gestational diabetes mellitus who presented at 10 weeks gestation with 5 days history of brownish vaginal discharge and 2 days history of painless vaginal bleeding. On pelvic examination the cervix was disproportionately larger than the uterus with a closed internal os. Transvaginal and abdominal ultrasound scanning confirmed a live cervical pregnancy. She had intramuscular methotrexate and tranexamic acid followed by suction evacuation combined with balloon tamponade. Examination at 6 weeks post procedure revealed a normal cervix. ⋯ Cervical pregnancy still occurs in this environment despite its rarity. Surgical intervention usually results in hysterectomy and adopting medical management as a first line treatment option offers the benefit of uterine preservation.