Burn injuries in Africa are considered to be a major health care problem. Sub-Saharan Africa has the highest number of pediatric burn admissions in the world. Burn care is complicated by numerous factors such as financial constraints, lack of resources, health care personnel and modern well equipped easily accessible health care facilities. Despite these numerous obstacles, burn care professionals on the continent of Africa have delivered a sterling service. A review of 70 articles published by authors on the African continent revealed information on topics ranging from the management of the HIV + patient, burn prevention strategies and new trends in African burn care.

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Impalement injury occurs due to penetration by sharp objects during road traffic accident, fall or workplace mishaps. They usually involve the trunk, cranium, or isolated extremities. Involvement of upper and lower extremity in the same injury is rare. We report the case of a 48-year-old man who sustained a fall from 25 feet under the influence of alcohol onto a wooden fencing pole. The pole went penetrating posteriorly through the right axilla and anteriorly through the right thigh without involving the trunk.

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Aim: This is a prospective study of 30 patients with distal tibia fracture (Closed extra - articular distal third tibia fractures - 4 to 11cm from tibial plafond) who underwent surgical fixation were included in this study after excluding compound, pathological and paediatric fractures. Materials and Methods: 15 underwent closed intramedullary interlocking nail and 15 were treated with plate osteosynthesis (MIPO). Results: The age distribution ranged from 23 to 68 years with the mean age of 39.4 years. The mode of injury in all patients was due to vehicle accidents. All 30 patients were classified according to AO classification of which 15 belonged to A1, 14 belonged to A2, and 1 belonged to A3. The time of fixation from injury varied from 6 hours to 18 days. Conclusion: Plate osteosynthesis by minimally invasive technique and Intramedullary interlocking nailing are equally effective method of stabilisation for distal tibia fracture when considering the union rates and final functional outcome. However malunion, nonunion and secondary procedures were more frequent after intramedullary interlocking nail. Randomised prospective evaluation of distal tibia fractures may clarify the efficacy of plate versus nail treatment and optimize the patient care.

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Objective: The objective was to study the type and severity of ocular injuries in gun pellet victims. Materials and Methods: The study is a retrospective case series conducted in the Department of Ophthalmology, SKIMS Medical College, Bemina, Srinagar. The study included gun pellet victims admitted in our department between January 2010 and September 2013. Results: The study included 20 patients with 19 males and 1 female. Mean age of the subjects was 21.45 years. Ocular injury was unilateral in 17 cases and bilateral in 3 cases. The most common type of injuries encountered were hyphema in 82.60% of eyes, followed by corneo-scleral tear in 78.26% and vitreous hemorrhage in 47.82% of eyes. Of the 23 eyes, 18 eyes (78.26%) had an open globe injury, while only 3 eyes (13.04%) had closed globe injury at presentation in our hospital. The most commonly performed surgery was corneo-scleral repair in 18 eyes. Final corrected visual acuity (VA) remained unchanged in 34.78% and improved in 65.22% of eyes. About 47.83% of eyes had final VA < 6/60. Conclusion: Gun pellet related ocular injuries are becoming increasingly common in Kashmir Valley. In severely injured eyes, the visual prognosis remained poor despite adequate treatment. Measures toward reducing violence in our society so as to reduce avoidable visual impairment are strongly advocated.

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Purpose: To evaluate functional results of bipolar hemiarthroplasty for unstable intertrochanteric fracture in elderly patient. Materials and Methods: Between 2005 and 2012 20 elderly patients more than 65 years with intertrochanteric fractures <3 weeks old, having associated medical comorbidities like diabetes mellitus, hypertension, chronic bronchitis and emphysema were included. And patients with open intertrochanteric fractures, poly-trauma, pathological fractures, and aged <65 years were excluded from study. Results: There were 11 male and 9 female patients with mean age of 78.1 years treated by cemented bipolar hemiarthroplasty. The average surgery time was 123 min with an average intraoperative blood loss of 431.5 ml. Eleven patients were transfused a pint of blood. Grade 1 bedsores in two patients healed with regular dressing, regular change of position and antibiotics. One patient developed deep wound infection for whom implant removal and excision arthroplasty was done. Limb length discrepancy was <1 cm in six patients. No case of dislocation, rotational deformities or subsidence of the prosthesis was seen during the follow-up. Functional results were graded as per Harris Hip Scoring System, mean Harris Hip Scorewas 78.2 at 6 months and 83.25 at 24 months. Conclusion: Careful restoration of neck length, offset and version maximizes the stability of the hip joint and increases the durability of the prosthesis which is very essential in achieving a good outcome. The procedure offered faster mobilization, rapid return to pre injury level and gave a lasting solution in elderly patients with intertrochanteric fractures of the femur. Level of Study: Level 4 case series.

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Burns are devastating injuries that may occur during altered levels of consciousness in an epileptic seizure. There is a paucity of literature on the profile of epileptic patients with severe burns of the face. This article reports the avoidable risk factors in burn injuries of the face in patients with epilepsy. A review of the medical records for all burn admissions in patients with epilepsy was undertaken from January 2010 to December 2013. Demographic and clinical data of the patients were collected and analyzed. Grading of facial appearance was based on the classification of facial soft-tissue deformities in post-burn patients by Zan et al. All the patients were female and the mean age was 27 years. Age range was 18 - 35 years. Carbamazepine was the commonest antiepileptic drug utilized. Three patients reported the use of herbal medications in addition to antiepileptic drugs while one patient admitted to the use of only herbal medications. Three of these patients presented with full thickness burns of the face and had Type IV post burn facial deformity. There are trends that accord to female gender, low socioeconomic status and poor adherence to antiepileptic drugs in this study. The use of the electronic media (television and radio) is suggested as an effective strategy to increase awareness.

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Injury to the superior sagittal sinus is the most common dural sinus injury which carries a high risk of morbidity and mortality. In this article, we report a case of 21-year male patient who sustained head injury while he was riding on a motorcycle, he lost balance, and his head struck against the road divider. The patient had massive injury to the superior sagittal sinus, underlying brain parenchyma, and probably laceration of draining venous channels surrounding the superior sagittal sinus. In spite of the elevation of the depressed fragments, injury to the superior sagittal sinus resulted in the bifrontal massive venous infarction and fatal outcome in the present case.

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Background: Horsewhip is a thong made from animal hide and is commonly used among African population to strike commonly, erring children as a form of corporal punishment to correct wrong doings especially at homes and in schools'. This practice is against International law (1989, Convention on the Rights of the child, UN) which sought to protect children from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation. Its use is associated with a myriad of vision threaten conditions including ruptured globe. Aim : The aim was to evaluate the prevalence and severity of eye injuries caused by horsewhip and recommend ways to reduce it. Materials and Methods : A 9 years retrospective study of horsewhip ocular trauma was carried out. The following information were extracted from patient's medical records: Sociodemographic record, circumstance of trauma, extent of eye injury, visual acuity (VA) at admission and at the time of discharge. The data were analyzed with SPSS version 18. Results: Horsewhip ocular injuries constituted 20 of a total number of 930 cases of ocular trauma seen during the study periods . There were 13 males and 7 females. Most patients were students 15 (75%). Left eye was mostly affected 11 (55%). Half of the injuries occurred at schools 10 (50%, 8 in Quranic and 2 in formal), followed by home 7 (35%). Cornea was the most affected part by the trauma 7 (35%). At the presentation to our hospital 11 (55%) had visual acuities of 6/18 or worse in the affected eye. The overall visual outcome of the patients as at the last hospital visit shows 50% attained a VA of 6/12 or better, and 50% had VA of 6/60 or worse. Conclusion: Horsewhip ocular trauma is an important cause of ocular morbidity, and the importance of ocular health education as a form of preventive measure is underscored.

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