We present a female with an acute traumatic fracture dislocation of the cervical spine. She sustained bilateral facetal dislocation at the C7/T1 junction without neurological deficit. This was not diagnosed on initial X-rays of the cervical spine. We highlight the danger of this failure and conducting dynamic X-rays in such a situation. The patient presented after 4 months and was operated upon safely with anterior/posterior fixation across the fracture site. She remains neurologically intact.

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Aim: The aim of the present study is to determine the frequency of mobile phone use while driving and associated factors in a sample of road traffic among Turkish drivers in Istanbul. Design: This is a cross-sectional study design. Subjects and Methods: The study included a representative sample of 1200 drivers. However, 891 drivers agreed to participate and completed the driver behavior questionnaire (DBQ). Methods: The Manchester DBQ was used to measure the aggressive and aberrant driving behaviors causing accidents in terms of sociodemographics, driving attitudes, and behaviors, adherence to traffic laws, and mobile phone use. Results: The present study expressed that the frequency of mobile phone use while driving was very high among Turkish drivers who were involved with traffic crashes. There was a significant difference found between mobile phone users and nonusers while driving in age group (P < 0.01), education (P < 0.001), occupation (P < 0.001), seat belt use (P < 0.001), vehicle type (P < 0.001), and excessive speed (P < 0.001). Furthermore, attempting to overtake, missing give way signal, and turning right/left nearly hitting other car were reported as errors. For lapses, there was no significant association found between correct and incorrect parking for drivers in all of the DBQ items. The data showed that the drivers reported higher mean scores of violations such as driving close to the car to go faster, running a red light, disregarding speed limit at night or early in the morning. Conclusion: Together, the results provide important insights into mobile phone use and its related factors among Turkish drivers. The type of vehicle, excessive speeding, occupational status, educational level, age group, seat belt use, and crossing a red light were statistically significant associated with mobile phone use among drivers who were involved in the road crashes. When drivers use a mobile phone, there is an increased likelihood of the road accidents that result in injury. There is no doubt that hands-free phone use while driving may not minimize the risk totally. In fact, advancing technology will increase mobile phone use in motor vehicles so it may cause more crashes and fatalities.

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Background: Ovarian cancer constituted 7% of gynecological malignancies seen in Lagos, Nigeria and was the second most common cause of death among women in Lagos, Nigeria. Objectives: The aim is to determine the prevalence of ovarian cancer and characteristics of patients with ovarian cancer at a Tertiary Institution in Lagos. Patients and Methods: This was a retrospective review of all the patients with histologically confirmed ovarian cancer admitted to the gynecological ward of the hospital over a period of 5 years. Relevant information was extracted from the ward register and patients medical case records. Data were analyzed using Epi-info statistical software package and results were then presented in tables and chart. Results: Fifty cases of ovarian cancer were admitted during the period under review. This constituted 1.7% of the gynecological admission cases and 8.2% of the gynecological malignancies managed in the hospital during the study. It was the second most common gynecological malignancy. The mean age of the ovarian cancer patients was 45.7 ± 4.3 years with the majority of the patients (58%) being premenopausal, 34% being nulliparous and only 16% having one or more risk factors. The abdominal swelling was the most common presenting symptom with 80% of the patients presenting with advanced disease. Epithelial ovarian cancer was the most common histological variant. The most common treatment modality was surgery and chemotherapy. The patient default rate was 64%. Conclusion: Ovarian cancer cases are on the increase. Failure of optimal management is worsened by the delay in presentation and poor compliance to treatment with high patients' default rate.

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Background: The etiology of proptosis is diverse ranging from orbital problem to infiltrative disease and spread from contiguous sites including nasopharynx, paranasal sinuses, and sometimes distant structures. It can also be part of systemic illness affecting multiple tissues and organs. Aim: This study aims to determine the demographic pattern and etiology of proptosis in a tertiary health facility in South Western Nigeria and to discuss the management challenges. Methods: This is a clinic-based retrospective descriptive analysis of all patients that presented with proptosis at the Eye Clinic of Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun state, Nigeria, over a 13-year period from 2000 to 2012. The hospital records of patients was used which was analyzed using Statistical package for Social sciences version 15. Results: A total of 175 cases of proptosis out of 15,266 new cases gave a hospital prevalence of 1.2%. The average age of the 138 patients analyzed was 37.8 years with a male to female ratio of 1:1. Children constituted 27.5%. Eighty-one (58.7%) patients presented within 1 month of onset of proptosis. Twenty-three (16.7%) had bilateral proptosis. Half of the studied population was secondary to orbital inflammation. The common causes of proptosis were infective 38.4%, mass/tumor 18.8%, noninfective inflammation 13%, and sinonasal diseases 10.9%. Eight (5.8%) were mucocele of paranasal sinuses. Thyroid-related eye disease and proptosis of vascular etiology were common in females. Computerized tomographic scan of the orbit and/or sinus/cranium was done in 11.4% of the patients. Thirty-seven (26.8%) patients defaulted. Conclusion: Infective process is the most common cause of proptosis from orbital cellulitis. Majority were unilateral with no sex predilection. Proptosis due to thyroid eye disease and vascular abnormality were found mostly in females. The management challenges were poor record keeping and inadequate personnel. Despite the threat to life and vision posed by some etiology of proptosis, a large number of the patients were unable to fund investigation and treatment while others defaulted from the facility.

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Negligence could make an inguinal hernia to increase in size and with the passage of time; it may assume a giant size with accompanying medical and social impacts on the patient. Traction on the ilioinguinal nerve and spermatic cord causes dragging sensation in the groin with the attendant discomfort. The inability to wear fitting pants, the disturbance of sexual activities, and the consequent gait abnormality were some of the compelling reasons in this patient that made him to seek surgical consult. Nylon darn herniorrhaphy was done without a mesh and without any untoward postoperative event in a level II surgical facility. This case report illustrates mainly, ignorance, negligence and fear of surgery as mitigating factors in the management of this condition in our sub-region and less of the surgical challenges a giant inguinoscrotal hernia may pose.

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Prayer ministries that profess miracles through prayers and vigils to heal sick persons abound in our clime. In many cases, this causes so much delay before the search for appropriate medical solutions. Often, the worsening conditions of enlarging tumor masses, pain, anemia, and weight loss may be the compelling reasons for surgical consultations. By this time, a varying number of them may not respond positively to treatment because of the late presentations. This report aims to draw attention to the problems caused by these religious groups whose modus operandi are the use of prayers and miracles to solve all medical conditions and inadvertently cause delays in accessing proper medical treatment by the patients, thus resulting in more complications.

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