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Background: Prior to the commencement of neurosurgical services in our new centre, in 2006, the awareness of and perceptions about this specialty amongst the health workers were studied. One year after, having experienced first-hand the activities of the unit, these perceptions were again re-evaluated amongst the same workers to determine the impact of the unit on the opinions about the specialty. Methods and Materials: This study was carried out with a questionnaire designed with the 5-point Likert scale, and the respondents comprised of doctors, nurses, students, paramedics and administrators, randomly selected. The same questionnaire was used in the first study but was slightly modified for the present study. Results: Out of 400 questionnaires distributed randomly, 342 were completed and returned. Most of the respondents 282 [82.5%] were aged 20 - 30years, mostly students 220 [64.3%], and majority 318 [93%] have heard of neurosurgery prior to the establishment of our unit. The service need was rated very necessary by most 286[83.6%], availability of services in Nigeria rated inadequate by 177 [51.8%], and the quality of services rated fair 155[45.3%]. The services in our centre were rated fair 138 [40.4%] and lack of equipment/facilities was adjudged the greatest hindrance to practice 216 [63.2%], and majority 289 [84.5%] strongly recommended that services continue. Conclusion: Neurosurgical services are still significantly inadequate in Nigeria, and though the establishment of new units has positively changed the perception of health workers about the specialty, provision of more manpower and modern facilities remains the major challenge. [ABSTRACT FROM AUTHOR]

Background: Pressure ulcers are lesions caused by unrelieved pressure over bony prominences, resulting in damage to underlying tissues. The etiology is multifactorial including prolonged immobility. They usually complicate spinal cord injuries with long periods of bed confinement. The use of bed replacements markedly reduces the incidence of pressure ulcers, but the unaffordability of these replacements in low-income countries has necessitated the need to explore cheaper alternatives., Aim and Objective: The aim of this study was to ascertain whether the use of our cheap and locally improvised waterbeds would reduce the incidence of pressure ulcers in patients on prolonged bed confinement due to spinal injury., Methodology: Over a 16-month period, 51 patients (age range 1-80 years) with spinal injuries were managed conservatively in our service using improvised waterbeds in 21 (41.2%), while using the regular hospital bed/foam in 30 (58.8%). Biodata, the time interval between injury and presentation to the hospital, nature of the injury, use of improvised waterbed and development of pressure ulcer, were collected, collated, and analyzed. Statistical significance was calculated with the Chi-square test., Results: Most were males (98%), in the age range of 21-30 years (25.5%), and due to fall from heights (35.3%). Of 21 patients who were managed on improvised waterbeds, 6 (28.6%) had pressure ulcers, and of the 30 who did not use the waterbed, 17 (56.7%) developed ulcers. The χ(2) = 3.9381, while P = 0.0472. This difference was statistically significant., Conclusion: The improvised waterbed, which is much cheaper than the standard waterbed, was observed to have significantly reduced the incidence of pressure ulcers among our patients. Nonetheless, further studies would still be needed to confirm this observation.