Background: Traditional bone setters apply tight splints on the limbs of patients in their practice settings. Most of the times, these tight splints will result in compartment syndrome and when they are not recognized on time, they will deteriorate into gangrene. Design: This is a retrospective study covering a period between October 2007 and September 2015 in a private orthopaedic and trauma centre in the south-east of Nigeria. Results: A total of ten patients out of sixty seven patients had amputations on account of traditional bone setters' gangrene constituting 14.9%. All of the patients with bone setters' gangrene had two stage amputations. One of the patients refused amputation and he was referred to another centre. There was zero mortality. Conclusion: Traditional bone setters' gangrene is an avoidable orthopaedic disaster that is common in our environment. Genuine efforts should be made by all the stakeholders to reduce and possibly to eliminate this catastrophe.

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Background: Peak expiratory flow rate (PEFR) reflects the strength and condition of respiratory muscles and the degree of airflow limitation in large airways. PEFR shows postural variation that follows a specific pattern in asthmatics and healthy individuals has been identified. Adequate data are not available for the postural variation in normal individuals, who are students in professional courses, and had a sedentary lifestyle. Lung volumes in normal subjects were significantly higher in a standing position. Others have reported that in healthy subjects spirometric indices were higher in the standing in comparison with the sitting position whereas other studies have reported no differences between spirometric values obtained in lying, sitting, and standing positions. Hence, this study is undertaken to study the postural variation in PEFR in healthy adult female subjects in South India. Methods: PEFR was recorded in 50 adult healthy female students aged 18-23 years and studying in professional courses (MBBS, BDS, Nursing, and MSc). Mini wright's peak flow meter was used to measure the PEFR. Three readings were taken PEFR in standing and lying posture. Best of three recordings is taken as the final value. Results: PEFR is decreased in lying posture compared to standing posture in subjects studied, and the quantum of difference was noted. Conclusion: In postural changes, PEFR measurements significantly differ based on whether the measurements are taken in the standing or in the lying posture in healthy participants. The effect of posture may be of importance in recording PEFR and changing to a better posture may be especially useful for those patients with weak expiration.

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Ventriculoperitoneal shunts are useful devices for treatment of hydrocephalus. Although effective, historically, the probability of shunt dysfunction is pretty high throughout the life. Migration of a ventriculoperitoneal shunt catheter is a rare but well-recognised complication in hydrocephalus treatment. Perforation into different organs or through natural or artificial orifices has been described. A 5-month-old baby presented to hospital with extrusion of her abdominal catheter through the umbilicus. This occurred spontaneously 2 months following placement of a ventriculoperitoneal shunt for hydrocephalus. This is the first report of this unusual complication in Abuja, Nigeria.

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Context: Concerns have been expressed about the antihypertensive prescription patterns of nonspecialist physicians who care for the majority of patients with hypertension in developing countries. Aims: The aim of the study was to assess the antihypertensive prescription pattern of nonspecialist general medical practitioners in Lagos, Nigeria. Settings and Design: This was a cross-sectional survey carried out among nonspecialist general medical practitioners within Lagos State, Nigeria. Subjects and Methods: A total of 132 doctors completed questionnaires about their demographics, duration and location of practice, and antihypertensive prescription patterns. Statistical Analysis Used: Continuous variables are presented as means or medians while categorical variables are presented as percentages. Comparison between means was done using the Student's t-test, while comparison between percentages was carried out using Chi-square test. Results: Majority (61.2%) considered thiazide diuretics their first choice antihypertensive. The most frequently prescribed antihypertensives were calcium channel blockers (CCBs) (88.6%), thiazide diuretics (85.6%), and angiotensin converting enzyme inhibitors (ACEIs) (84.8%). These were also the most frequently combined with the CCB-thiazide diuretic combination being the most frequently prescribed (81.1%) followed by the ACEIs - thiazide diuretic combination (65.9%). The most frequently considered factors when prescribing antihypertensive medications were side effects of the medications (92.4%), additional benefits beyond blood pressure (BP) lowering (90.9%), patients' BP at the time of presentation (89.4%), dosage frequency of the drug (87.9%), and available scientific evidence for efficacy in lowering BP (87.1%). Conclusions: The antihypertensive prescription pattern of nonspecialist physicians practicing in Lagos aligns with current hypertension treatment guidelines.

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