The Central African journal of medicine
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The records of newborn babies with surgical conditions seen at Harare Hospital in 1988 were reviewed. Survival rates for the commonest major conditions, oesophageal atresia with tracheo-oesophageal fistula, small bowel atresia and gastroschisis, were respectively 20 percent, 50 percent and 0 percent. Avoidable or unsatisfactory factors were encountered during the hospital course of 54 percent of all babies and 76 percent of those who died. Suggestions are made for improving the outcome for babies with neonatal surgical conditions.
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A case of chronic dislocation of the manubriosternal joint (MSJ) is presented. There was no history of spinal trauma, thoracic kyphosis or rheumatic joint disease. ⋯ After a failure to fix the joint by plating and wiring, fusion was achieved by the use of artificial bone graft and a polymethylmethacrylate implant. Pathological factors leading to this condition are reviewed.
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Three hundred and seven (307) deaths were recorded out of 3,155 admissions into the Emergency Paediatric Unit of Ahmadu Bello University Teaching Hospital Zaria between January 1st and December 31st 1986, giving a percentage mortality of 9.9 percent. 67 percent of the patients who died were aged between one month and twenty four months, and the overall male: female ratio of deaths was 1:1.04. Measles with complications was the commonest cause of death (24.1 percent) closely followed by protein energy malnutrition (23 percent) and respiratory tract infection (18 percent). Over half of the patients (57.6 percent) died less than 24 hours after admission. As most deaths resulted from preventable conditions, the implications of this finding, and suggestions on how to improve the situation are discussed.