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Ergonomic standards to be used in engineering design are at present being developed throughout the world. However, not much is known about how ergonomic criteria function in an organizational setting. This study investigates how engineering designers in two large-scale engineering projects evaluate ergonomic criteria that are part of the design requirements in the projects. The designers state a clear preference for specific criteria. We also show how all design criteria are subject to organizational constraints, and that specific formulations are not a guarantee for the implementation of ergonomic criteria. Emphasising a few specific criteria might have an educational impact on the designers. The active involvement of an HF specialist is also critical to ensure a positive outcome for ergonomic criteria in the design negotiation process. [ABSTRACT FROM AUTHOR]

In engineering design projects ergonomics criteria may be supplied to project members along with other design requirements. A formal organization for human factors (HF) is set up where responsibilities pertaining to HF are specified. It is then assumed that the project functions according to this, and that the ergonomics criteria are known among project members. We have investigated the management of human factors in two large-scale offshore development projects. Our study shows that neither organization of HF nor ergonomics criteria were well known among project members. To be effective, the criteria have to be supported by one or more HF specialists who engage themselves actively in design. [ABSTRACT FROM AUTHOR]

Spinal cord involvement is a rare complication of the schistosomiasis manifesting as myeloradiculopathy, medullary or conus-cauda equina syndrome which can lead to potentially serious long-term disability. Computed tomography and magnetic resonance imaging coupled with biochemical parameters have become the mainstay of diagnosis. Biopsy which is the gold standard of diagnosis demonstrating the organism is usually reserved for cases of diagnostic challenge. We report a rare case of upper thoracic spinal cord schistosomiasis diagnosed by biopsy in an 18-year-old male migrant presenting to a spine and orthopaedic centre in Ghana with complaints of upper back pain and associated myeloradiculopathy symptoms. Initial suspicion of intramedullary cord tumour was made based on magnetic resonance imaging findings warranting biopsy which revealed schistosoma spp. He was treated with anthelminthics and corticosteroids with a resolution of symptoms., Competing Interests: The authors declare no conflicts of interest., (Copyright: © 2024 Journal of the West African College of Surgeons.)

Study Design: Retrospective review of consecutive series., Objective: The study sought to assess the effect of prolonged pre-operative halo gravity traction (HGT) on the c-spine radiographs., Methods: Data of 37 pediatric and adult patients who underwent ≥ 12wks pre-op HGT prior to definitive spine surgery from 2013-2015 at a single site in West Africa was reviewed. Radiographic assessment of the c-spine including ADI, SVA and C2-C7 Lordosis were done at pre HGT and at 4 weekly intervals. Paired T-Test was performed to evaluate changes in these parameters during HGT., Results: 37pts, 18/19 (F/M). Average age 18.2yrs. Diagnoses: 22 idiopathic, 6 congenital, 3 Post TB, 2 NM and 4 NF. Average duration of HGT: 125 days. Baseline coronal Cobb:130 deg, corrected 30% in HGT; baseline sagittal Cobb:146 deg, corrected 32% post HGT. Baseline ADI (3.17 ± 0.63 mm) did not change at 4wks ( P > 0.05) but reduced at 8wks (2.80 ± 0.56 mm) and 12wks (2.67 ± 0.51 mm) post HGT ( P < 0.05). Baseline HGT SVA (20.7 ± 14.98 mm) significantly improved at 4wks (11.55 ± 10.26 mm), 8wks (7.54 ± 6.78 mm) and 12wks (8.88 ± 4.5 mm) ( P < 0.05). Baseline C2-C7 lordosis (43 ± 20.1 deg) reduced at 4wks (26 ± 16.37 deg), 8wks (17.8 ± 14.77 deg) and 12wks (16.7 ± 11.33 deg) post HGT ( P < 0.05). There was no incidence of atlanto-axial instability on flexion extension radiographs at any interval., Conclusion: Prolonged HGT, while providing partial correction of severe spine deformities, also appeared to have no adverse effect on atlanto-axial stability or cervical alignment. Therefore, HGT can be safely applied for several weeks in the preoperative management of severe spine deformities in pediatric/adult patients.

Study Design: Retrospective review of consecutive series., Objectives: This study sought to assess the incidence, risk factors, and outcomes of pulmonary complication following complex spine deformity surgery in a low-resourced setting in West Africa., Methods: Data of 276 complex spine deformity patients aged 3 to 25 years who were treated consecutively was retrospectively reviewed. Patients were categorized into 2 groups during data analysis based on pulmonary complication status: group 1: yes versus group 2: no. Comparative descriptive and inferential analysis were performed to compare the 2 groups., Results: The incidence of pulmonary complication was 17/276 (6.1%) in group 1. A total of 259 patients had no events (group 2). There were 8 males and 9 females in group 1 versus 100 males and 159 females in group 2. Body mass index was similar in both groups (17.2 vs 18.4 kg/m 2 , P = .15). Average values (group 1 vs group 2, respectively) were as follows: preoperative sagittal Cobb angle (90.6° vs 88.7°, P = .87.), coronal Cobb angle (95° vs 88.5°, P = .43), preoperative forced vital capacity (45.3% vs 62.0%, P = .02), preoperative FEV 1 (forced expiratory volume in 1 second) (41.9% vs 63.1%, P < .001). Estimated blood loss, operating room time, and surgery levels were similar in both groups. Thoracoplasty and spinal osteotomies were performed at similar rates in both groups, except for Smith-Peterson osteotomy. Multivariate logistic regression showed that every unit increase in preoperative FEV 1 (%) decreases the odds of pulmonary complication by 9% (OR = 0.91, 95% CI 0.84-0.98, P = .013)., Conclusion: The observed 6.1% incidence of pulmonary complications is comparable to reported series. Preoperative FEV 1 was an independent predictor of pulmonary complications. The observed case fatality rate following pulmonary complications (17%) highlights the complexity of cases in underserved regions and the need for thorough preoperative evaluation to identify high-risk patients.

Objectives: To assess the safety and clinical benefits of intraoperative acute normovolaemic haemodilution (ANH) in complex spine surgery., Design: Prospective comparative cohort study., Setting: A private orthopaedic hospital in Ghana., Patients: Seventy-six patients who underwent complex spine deformity surgery., Interventions: Patients were randomly assigned to two groups. 45 patients to the acute normovolaemic haemodilution (ANH) or Group 1 and 31patients to the non-ANH or Group 2. Following anesthetic administration and before incision, autologous blood was collected from patients in Group1 and was reinfused during/shortly after surgery while patients in Group2 were transfused with compatible allogeneic blood intraoperatively., Main Outcome Measures: Changes in haemodynamic parameters and incidence of allogeneic transfusions and related complications., Results: The mean age (years), gender ratio, deformity size and aetiology, fusion levels, and operative times were similar in both groups. Blood loss (ml) of patients in groups 1 and 2 were 1583ml± 830.48 vs 1623ml ± 681.34, p=0.82, respectively. The rate of allogeneic blood transfusion in groups 1 and 2 were 71% vs 80.65%, p=0.88, respectively. Haemoglobin levels (g/dL) in groups 1 and 2 were comparable in both groups at Post-operative Day (POD) 0 and POD 1. Incidence of minor allogeneic transfusion reaction was 1/45 vs 1/31, p=0.80, group-1 and group-2, respectively., Conclusion: Acute normovolaemic haemodilution can be safely performed in complex spine surgery in underserved regions. However, its use does not obviate allogeneic transfusion in patients with complex spine deformities in whom large volumes of blood loss is expected., Funding: None declared., Competing Interests: Conflict of Interest: OB-A (grants, personal fees and other from K2M, other from WEIGAO, outside the submitted work). For the remaining authors none were declared., (Copyright © The Author(s).)

Anaesthesia has been provided for pigs for the Advanced Trauma Operative Management Course which was first held at the Korle Bu Teaching Hospital in February 2005. As of January 2006, 16 animals have been anaesthetized. Acepromazine (1mg/kg) and atropine (0.05mg/kg) were used for premedication. IM ketamine (30mg/kg) and isoflurane (in oxygen) were used for the anaesthesia and the animals were intubated and ventilated with positive pressure ventilation. No neuromuscular blocking agents were used. Morphine (average 3 doses of 10mg) was used for analgesia. Systolic blood pressure ranged between 80mmHg and 115mmHg and diastolic pressure ranged between 45mmHg and 80mmHg. Large amounts of IV fluids were given during the procedure. At the end of surgery, the animals were euthanized by increasing the concentration of isoflurane and administering potassium chloride. Out of the 14 cases reported on, 13 animals survived to the end of all the surgical procedures. 1 animal had a cardiac arrest during the last procedure (inflicting a laceration to the heart) and could not be resuscitated.