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A large number of patients seek help for musculoskeletal conditions. Students and doctors have been noted to have a poor cognitive mastery of the subject area. This study aims to determine the adequacy of orthopedic learning of final year medical students. Freedman and Bernstein’s validated basic cognitive examination was administered to final year medical students who had completed their orthopaedic surgery course work and clinical rotations. Overall scores and responses to the individual questions were analyzed using SPSS. The recommended passing score of 73.1 per cent was employed. Forty undergraduate medical students took part in the study. None of the students attained the passing score of ≥73.1%. The mean score was 21.2%. The students performed best in general orthopaedics with a mean score of 11.4%. They scored 5.3% and 4.6% in anatomy and trauma respectively. The final year undergraduate students had a poor knowledge of orthopaedics. Considering the huge burden of musculoskeletal complaints, further studies are needed to assess interventions that will lead to curriculum improvement in the school.

Joint replacement therapy (JRT) commonly performed in advanced countries is being introduced in some developing countries. The objective of this study was to assess anaesthesia used and the outcome of the first 17 cases performed at a young teaching hospital in Nigeria. This was a cross-sectional descriptive study of patients for JRT at Benue State University Teaching Hospital, Makurdi, Nigeria from 23/6/2014 to 31/8/2016. Data analyzed from the anaesthetic/surgical records included age, sex, ethnicity, ASA classification, Ficat and Arlet classification of avascular necrosis, Gardens classification of fracture neck of femur, indication/type of surgery, packed cell volume (PCV), anaesthesia type, estimated blood loss, transfusions, duration of surgery and hospital stay, post-operative PCV, pain management, complications and surgical outcome. Results were summarised as means, median and percentages using SPSS version 21.0 for Windows®. One-way test of ANOVA was used for statistical significance (p= 0.05). Seventeen patients aged 27-90 years (mean 54.71±19.69). Indications were femoral neck fracture (47%), chronic osteoarthritis (35%), avascular necrosis (18%). The commonest procedure was hemiarthroplasty (41%), total hip replacement (35%), and total knee (24%). All were under regional anaesthesia with spinal (53%) and combined spinal-epidural (47%). Multimodal post-operative analgesia was used. There was no significant difference between pre and post-operative PCV (t = 0.708, p=0.05). Mean duration of hospital stay was 19.44±9.61 days. The outcome was good in all. JRT can be established in a new center with proper planning. Regional anaesthesia with multimodal analgesia is recommended. With relevant surgical skill, patient outcome is good.

With expanding indications for operative fracture treatment, removal of orthopaedic implants has become a frequent elective orthopaedic procedure in developing countries. The clinical indications for implant removal are not well established and there are no specific indications despite the morbidity associated with implant removal operations.To determine the frequency, indications and complications of removal of orthopaedic implants with a view to guiding implant removal protocol among surgeons.Retrospective data was obtained over a 5-year-period in NKST Rehabilitation Hospital, Mkar, Nigeria. One hundred and twenty-eight patients aged 4-88 years met the criteria for inclusion. Patients were followed up for at least 1 year and all complications recorded. Data was analysed using SPSS version 21.A total of 128 patients were studied. There were 84(55%) males and 44(45%) were females. The mean age was 40.0±15.5 years. The commonest indication for implant removal was infected implant in 29(22.6%) patients, followed by patient's demand 22(17.2%). Femoral plate was the commonest [29(22.6%)] implant removed, followed by tibia plate [20(15.6%)] and humeral shaft plate [7(5.5%)]. The mean duration of hospital stay was 21.7±24.1 days. Twenty-five (19.5%) patients had post-operative complications.The commonest indication for implant removal was infected implant followed by patients demand. Femoral plate was the commonest implant removed. Post-operative complications included fractures, bleeding, nerve injuries and infection. Findings from this study suggest that implant removal operation may be associated with substantial morbidity. Therefore, not all orthopaedic implants require removal. Strict implant removal policy is advocated to guide the surgeon.

Fractures constitute a significant component of paediatric trauma. Paediatric fractures account for significant morbidity. This study was set to elucidate the characteristics and outcome of paediatric fractures in a university teaching hospital. Case notes were reviewed for socio-demographic and clinical variables. Statistical analysis was carried out using the software Statistical Package for Social Sciences for Windows, Version 21.0. The correlation between development of complications and prior treatment by traditional bone setters was determined using chi-squared tests. Fifty four long bone fractures were studied in 52 children. Their ages ranged from 1 day to 16 years with a mean of 8.85 ± 3.86 years. There were 29 males (55.8%) and 23 females (44.2%). The aetiology of childhood fractures included road traffic crashes (n=30, 57.7%), falls (n=10, 19.3%), sports injuries (n=8, 15.4). The long bones fractured were tibia (n=19, 35.2%), femur (n=14, 25.9%), distal radius (n=14, 25.9%) and supracondylar part of the humerus (n=7, 13.0%). Non-operative treatment modalities were the most frequent means employed in treating children with fractures in this study. Limb gangrene following prior treatment by traditional bone setters was the most common complication. There was a statistically significant correlation between development of complications and prior traditional bone setters treatment (p

Septic arthritis is a relatively common condition in the paediatric population. It is both a medical and a surgical emergency with potential high morbidity. This disabling disease requires early diagnosis and prompt management for optimal outcome.This study determined the epidemiological pattern of septic arthritis and analysed factors affecting morbidity and mortality in the paediatric population.Retrospective data was obtained over a 5-year period in NKST rehabilitation hospital, Mkar, Nigeria. Forty patients aged 0-17 years met the criteria for inclusion. Joint aspirates were taken for microbiologic investigation. Data was analysed using SPSS version 21.A total of 40 patients with 48 septic joints were studied. Twenty-two (55.0%) were males and eighteen (45.0%) were female with a male to female ratio of 1.2:1. The hip was the commonest 24(50.0%) joint involved; followed by the knee joint 18(37.5%), shoulder joint 4 (8.4%) and ankle joint 2(4.2%). Result of aspirate cultures yielded Staphylococcus aureus in 34 (70.8%) cases, Escherichia coli in 8 (16.7%), Haemophillus influenzae in 2(4.2%) and no growth was obtained in 4(8.3%) cases. Complications encountered after follow up include stiffness in 8(16.6%) joints, pain and stiffness in 2(4.1%) joint and bony ankylosis in 4(8.4%) joints and limb shortening in 2(4.1%) joints.The keys to proper management are a high index of suspicion in any child with painful joint dysfunction and strict adherence to the principles of treatment. With prompt treatment, all complications might be avoided, and normal joint function and future growth may be preserved.

Aim: The aim of this study was to assess the perceived educational value of orthopaedic and surgery learning opportunities among medical students and to evaluate the students' motivating factors in pursuing a future career in the specialty. Methodology: A questionnaire was designed to assess undergraduate medical students' perception of learning environments in orthopaedic and trauma surgery, career intent and motivation towards a future career in the specialty. A 5-point Likert scale was employed. Results: Seventy-four students completed the questionnaire. Learning opportunities considered useful for orthopaedic and trauma surgery were bedside teaching with a consultant (n = 39, 52.7%), seeing patients in clinic (n = 36, 48.6%) and formal lectures (n = 35, 47%). Fifteen respondents (20.3%) expressed an interest in pursuing a career in the specialty, with watching or assisting open surgery being the most significant motivating factor (P = 0.001) for choice of the specialty. Conclusion: Bedside teaching with a consultant and seeing patients in outpatient clinics were found to be the most useful learning environments. A fifth of the respondents indicated an interest in a future orthopaedic and trauma surgery career, with watching or assisting open surgery being the most statistically significant motivating factor. Students may be better served incorporating the findings in future curriculum design.

The routine removal of orthopaedic fixation devices after fracture healing is a common practice among surgeons; however, its benefits Vis-a-vis risks remainan issue of debate. Thisstudy evaluated surgeons' perceptions about the indications, priority of implants removal, effectiveness, and risks of removal of orthopaedic implants in Nigeria. A 44-item questionnaire was distributed to 110 attendees of the Annual General Meeting and Scientific Conference of the Nigerian Orthopaedic Association, Lokoja- 2013. Data was analysed using SPSS version 21.The response rate was78/90 (86.7%), representing 70.9% ofattendees. Majority of surgeons did not agree that asymptomatic orthopaedic implants should be routinely removed for all patients (disagreement: 91.0%, agreement: 6.5%). The major indications for removals were breakage/mechanical failure, infected implants and allergic disposition with mean rating on a 5- point scale of 4.56±0.948, 4.37±0.937 and 4.15±1.139 respectively. Most surgeons accrued highest priority to removal of implants in children with a mean rating of 4.14±0.954, followed by forearm rush nails 3.82±1.079.Without a strict implant removal policy, a remarkable portion of the resources allocated for elective orthopaedic operations would be spent on routine hardware removal procedures. General recommendation for hardware removal is not justified; overall, implant removal should not be considered a routine procedure.

BACKGROUND: Motorcycle-related injuries lead to considerable morbidity and mortality. The aim of this study is to determine the pattern and outcome of motorcycle-related injuries at Benue State University Teaching Hospital, Makurdi, Nigeria. PATIENTS AND METHODS: Case records of all patients who presented to the accident and emergency department with motorcycle-related injuries between July 2012 and June 2013 were analysed for age, gender, injury host status (i.e. rider, pillion or pedestrian), nature of collision (motorcycle versus other vehicles, motorcycle versus motorcycle, motorcycle versus pedestrian or lone riders), body region injured, injury severity score (ISS) at arrival, length of hospital stay (LOS) and mortality. RESULTS: Seventy - nine patients with motorcycle-related injuries were included in the study. They consisted of 63 males (61.8%) and 16 females (15.7%). The age range was 5-65 years with a mean of 32.4 ± 14.0. Motorcycle versus vehicle collisions were the most common mechanism of injury (n = 46, 58.2%). Musculoskeletal injuries constituted the most common injuries sustained (n = 50, 47.6%) and the tibia was the most frequently fractured bone (n = 14, 35.9%). The majority of patients (57.0%) sustained mild/moderate injuries (ISS ≤ 15). There was no statistically significant difference between the sexes for sustaining mild/moderate injuries or severe/profound injuries (P > 0.05). Mortality rate was 6.3% with head injuries being involved in all cases. CONCLUSION: Young males were mostly injured in motorcycle-related trauma. Musculoskeletal injuries were the most common injuries sustained and head injuries were involved in all the deaths. Enforcement of motorcycle crash bars and helmet usage is recommended. Language: en

Intentional injuries are a common presentation to Accident and Emergency (A&E) Departments and make a significant contribution to theglobal injury burden. This descriptive study aims to determine the pattern and treatment outcome of intentional injuries presenting to the A&E Department of Benue State University Teaching Hospital, Makurdi, Nigeria (BSUTH). Case records of all patients who presented to the A&E Department between July 2012 and December 2013 were analyzed for age, gender, circumstance surrounding injury, weapon used, body region injured, injury sustained, treatment offered, and outcome of treatment. Sixty patients with intentional injuries were included in the study. They consisted of 50 males (83.3%) and 10 females (16.7%) with ages ranging from 15 to 65 years with a modal age group of 20-29 years. The extremities were the most predominantly injured body regions (n=26, 43.3%) and firearms were the most common weapons employed (n=31, 51.7%). While armed robbery (n=31, 51.7%) was the most common reason for the injuries, attempted suicide (n=2, 3.3%) was the least.Soft tissue injuries and debridement were the most common injury type and treatment modality encountered respectively.The death rate was 8.3% with majority of deaths (80%) resulting from firearm injuries. Keywords: Intentional injury, violence, Accident and Emergency, Nigeria

BACKGROUND: Trauma leads to considerable morbidity and mortality. The aim of this study is to elucidate the pattern and characteristics of trauma at Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria. MATERIALS AND METHODS: Case records of all patients who presented to the Accident and Emergency (A and E) Department with trauma between January and December 2013 were analyzed for demographic data, types of injuries sustained, causes and circumstances of injuries, as well as outcome of treatment were extracted from the case files and entered onto a computerized questionnaire. Data were analyzed using the software Statistical Package for Social Sciences for Windows version 15.0 (SPSS Inc; Chicago, Illinois). RESULTS: A total of 250 traumatized patients were studied consisting of 203 (81.2%) males and 47 (18.8%) females with a modal age group of 21-30 years. Unintentional injuries were the most predominant form of trauma (n = 209, 83.6%) with road traffic accidents being the leading cause (n = 180, 72.0%). Open wounds (n = 95, 28.2%) were the most common form of injury sustained and the extremities (n = 148, 43.5%), the most frequently injured body region. Most patients (n = 133, 53.2%) were treated and discharged home without permanent disabilities, while death occurred in 15.2%. CONCLUSION: Trauma in Makurdi is a predominantly young adult male occurrence with road traffic accidents being the leading etiological factor. Reducing road traffic accidents will likely reduce mortality and morbidity due to trauma. Language: en

There is paucity of reports describing the pattern of surgical mortality in Nigeria. The aim of this study was to determine the incidence and pattern of mortality associated with surgical care in our hospital and to identify areas of improvement. The records of all patients who died after admission for surgical care at the Federal Medical Centre Makurdi between January 2009 and December 2011 were studied retrospectively. Data extracted were patients’ demographics, surgical diagnosis, co-morbidity, surgical procedures performed, duration of hospital admission and outcome of treatment. Data were analyzed with SPSS version 17. There were 2,273 admissions into the surgical wards within the study period. During this period, there were 151 deaths with a crude mortality rate of 6.6 %. Ninety-four (62.3 %) patients were males and 57 (37.7 %) were females (M:F = 1.6:1). The age of the patients ranged from 8 days to 95 years with a mean age of 36.1 ± 20.1 years. Acute abdomen (37, 24.5 %), traumatic brain injury (32, 21.2 %) and malignancy (28, 18.5 %) were the commonest surgical diagnosis. Trauma-related deaths accounted for 48 (31.8 %) of all the deaths. Road traffic crash (89.6 %) was the commonest cause of injury. Surgical operations were performed in 75 (49.7 %) of the patients who died, while 76 (50.3 %) did not have any operative intervention. Mortality in patients admitted into the surgical ward was 6.6 %. Trauma-related death was the commonest. Traumatic brain injury, typhoid perforation of the bowel and malignancy were the leading causes of surgical death in our centre.

International audience; We describe the radio science experiment proposed for the Rosetta cometary mission. The experiment consists in the transmission of electromagnetic waves between the landers and the orbiter through the comet to study its internal structure. In the paper, the electromagnetic model of the comet is presented and used to evaluate the potentiality of the experiment. Various modellings of the radio wave propagation are discussed. Finally, a description of the experiment and the instrument is made.

Program MARS GLOB provides step-by-step deployment of an international network of Mars surface stations by association the MESUR NETWORK (USA), INTERMARSNET (ESA) programs with the network of small stations and penetrators now under developing in Russia jointly with international cooperation in frameworks of the MARS-96 Project. It is offering also delivery on Mars surface two penetrators and Mars Rover. Now penetrators and Rover are developing by Russia with participation of other countries in frameworks of the MARS-98 (or MARS TOUR) Project.

Objective: To document the clinico-pathological characteristics of skin malignancies seen at Benue State University Teaching Hospital, Makurdi. Materials and Methods: A 3-year retrospective study of patients with histologically-confirmed skin cancers presenting to our institution from April 1, 2012 to March 31, 2015 was done. Relevant data was extracted from the patients' records and subjected to statistical analysis. Results: Records were available for 43 patients with a mean age of 46 ± 18 years. There were 21 males and 22 females with a male:female ratio of approximately 1:1. Squamous cell carcinomas were the most common histologic type seen (44.2%) followed by melanoma and Kaposi's sarcoma (25.6% each) while basal cell carcinomas accounted for 4.7%. Farmers (37.2%) and artisans (23.3%) were the most common occupations seen. Human immunodeficiency virus (HIV)-positive patients accounted for 27.9% of the total and albinos 18.6%. Majority of the patients (60.4%) had history of prolonged exposure to sunlight with little regard for protective measures. The average duration of symptoms before presentation was 28 ± 33 months. Conclusion: The study suggested an association between skin cancer and prolonged, unprotected exposure to sunlight on one hand and HIV infection on the other. It highlights the need to promote basic preventive measures.

Global digital topography data of the land surface is of importance in a variety of geoscientific and application disciplines. Such a database, with a spatial resolution of 150 to 500 m and height accuracy of 5 m or better can be acquired from an orbiting platform using a synthetic aperture scanning radar altimeter. Near-global coverage can be achieved within 14 days from an orbiting platform in a polar or near-polar orbit.

The primary scientific goal of the CONSERT experiment on the Rosetta space mission is to investigate the deep interior of the nucleus of comet 67/P Churyumov-Gerasimenko. This will be achieved through the use of long wavelength radio-waves, transmitted from the orbiter and returned from the lander. In this overview, a description of the instrument is presented together with a brief description of the experiment. Some important results from the tests carried out during the commissioning phase and results from a trial run in the French Alps on the temperate glacier near Argentiere are also described. During these latter tests we installed the CONSERT Lander in a tunnel under the glacier while the CONSERT Orbiter was moved along the surface. The signals received showed that the experiment is working satisfactorily. References are also provided to articles that contain a more detailed description of the instrument capabilities and in-depth analysis of the potential scientific outcome.

Ndubuisi OC Onyemaechi,1 Omolade A Lasebikan,2 Itodo C Elachi,3 Sunday O Popoola,4 Kehinde S Oluwadiya4 1Department of Surgery, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department ofOrthopaedic Surgery, National Orthopaedic Hospital, Enugu, 3Department of Surgery, Benue State University Teaching Hospital, Makurdi, 4Department of Surgery, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria Background: Despite the numerous complications associated with traditional bonesetters’ (TBS) practices, their patronage has remained high in developing countries. The aim was to study the reasons patients seek TBS treatment. Methods: This was a descriptive hospital-based study of 120 patients who were treated by TBS. The sociodemographic profile of the patients, details of injuries sustained, reasons for TBS patronage, duration of TBS treatment, the number of TBS visited, the reason for abandoning TBS treatment, patients’ belief about the TBS practice, and outcome of their treatment were studied. Results: Out of 418 patients who presented with musculoskeletal injuries, 120 patients who had been treated by TBS before presentation met the inclusion criteria. The mean age of the patients was 37.4±10.5 years. Advice of relatives and friends, as seen in 35 (29.2%) patients, was the most common reason for TBS patronage. Other reasons were cheaper cost (number [n]=30; 25%), sociocultural belief (n=17; 14.2%), easy accessibility (n=15; 12.5%), fear of amputation (n=13; 108%), and fear of operation (n=10; 8.3%). There was no correlation between these factors and age, marital status, occupation, and educational status (P=0.41). Forty-two (35%) patients believed TBS were not useful, a nuisance (n=30; 25%), useful (n=38; 31.7%), or indispensable (n=10; 8.3%). The opinion of patients about the outcome of TBS practice was: very satisfactory (n=0; 0%); satisfactory but with deficiencies (n=24; 20%); unsatisfactory (n=80; 66.7%); and no idea (n=16; 13.3%). Conclusion: Advice of relatives and friends was the main reason for patronizing TBS. The majority of patients lost confidence in the TBS practice after patronizing them due to the high complication rate. Keywords: utilization, traditional bonesetters, developing country

Summary form only given. The scientific knowledge gained from four decades of radar remote sensing of the Earth across the spectrum will guide exploration initiatives of the future. Future missions put forward to the NASA Earth Science Decadal Survey include repeat pass polarimetric interferometry radar missions at low frequency for surface deformation and biome mapping, wide swath altimeters for dense mapping of the ocean topography, global ocean wind mapping, as well as missions addressing the water cycle that use high frequency two-aperture interferometer techniques to measure the height of rivers and other inland water bodies. Long wavelength radars (L-band and longer) are being considered for mapping the sub-surfaces of the moon, Mars, Titan, and smaller bodies, penetrating the regolith and revealing the ice sequestered below if it exists, and on Europa, revealing the water below the icy shell. The key to the future of radar remote sensing will be the development of low-mass, low-volume, power-efficient systems that make the scientific need for ubiquitous radar sensing affordable, and continued research in the exploitation of archived and continuing data series by high performance data reduction, modeling, and simulation methods.

Split-hand/split-foot malformation (SHFM), also known as ectrodactyly or lobster claw hand deformity, is a rare congenital limb malformation characterized by a median cleft of hands and/or feet due to the absence of the central rays. SHFM has a reported incidence of 1 in 90,000 live births. It may occur either as an isolated anomaly or as part of a syndrome. We present a rare case of a 9-year-old boy with SHFM who underwent surgical correction of the cleft hand, with improved cosmetic and functional outcome.

Optimum threshold conditions for oscillations of transversely bounded distributed-feedback (DFB) lasers are derived and discussed for the case of a fiber guide and diffused guide.

A frequency selective coupler which consists of two thin film waveguides imbedded in a periodic medium is studied using the Brillouin diagram. Detailed results for the relative bandwidth and the coupling factor are plotted as a function of normalized frequency for a representative case.

The most recent Cassini RADAR images of Titan show widespread regions (up to 1500 kilometers by 200 kilometers) of near-parallel radar-dark linear features that appear to be seas of longitudinal dunes similar to those seen in the Namib desert on Earth. The Ku-band (2.17-centimeter wavelength) images show approximately 100-meter ridges consistent with duneforms and reveal flow interactions with underlying hills. The distribution and orientation of the dunes support a model of fluctuating surface winds of approximately 0.5 meter per second resulting from the combination of an eastward flow with a variable tidal wind. The existence of dunes also requires geological processes that create sand-sized (100- to 300-micrometer) particulates and a lack of persistent equatorial surface liquids to act as sand traps.

International audience; The Cassini RADAR instrument is a multimode 13.8 GHz multiple-beam sensor that can operate as a synthetic-aperture radar (SAR) imager, altimeter, scatterometer, and radiometer. The principal objective of the RADAR is to map the surface of Titan. This will be done in the imaging, scatterometer, and radiometer modes. The RADAR altimeter data will provide information on relative elevations in selected areas. Surfaces of the Saturn's icy satellites will be explored utilizing the RADAR radiometer and scatterometer modes. Saturn's atmosphere and rings will be probed in the radiometer mode only. The instrument is a joint development by JPL/NASA and ASI. The RADAR design features significant autonomy and data compression capabilities. It is expected that the instrument will detect surfaces with backscatter coefficient as low as -40 dB.

The surface of Saturn's haze-shrouded moon Titan has long been proposed to have oceans or lakes, on the basis of the stability of liquid methane at the surface1, 2. Initial visible3 and radar4, 5 imaging failed to find any evidence of an ocean, although abundant evidence was found that flowing liquids have existed on the surface5, 6. Here we provide definitive evidence for the presence of lakes on the surface of Titan, obtained during the Cassini Radar flyby of Titan on 22 July 2006 (T16). The radar imaging polewards of 70° north shows more than 75 circular to irregular radar-dark patches, in a region where liquid methane and ethane are expected to be abundant and stable on the surface2, 7. The radar-dark patches are interpreted as lakes on the basis of their very low radar reflectivity and morphological similarities to lakes, including associated channels and location in topographic depressions. Some of the lakes do not completely fill the depressions in which they lie, and apparently dry depressions are present. We interpret this to indicate that lakes are present in a number of states, including partly dry and liquid-filled. These northern-hemisphere lakes constitute the strongest evidence yet that a condensable-liquid hydrological cycle is active in Titan's surface and atmosphere, in which the lakes are filled through rainfall and/or intersection with the subsurface 'liquid methane' table.

International audience; Cassini's Titan Radar Mapper imaged the surface of Saturn's moon Titan on its February 2005 fly-by (denoted T3), collecting high-resolution synthetic-aperture radar and larger-scale radiometry and scatterometry data. These data provide the first definitive identification of impact craters on the surface of Titan, networks of fluvial channels and surficial dark streaks that may be longitudinal dunes. Here we describe this great diversity of landforms. We conclude that much of the surface thus far imaged by radar of the haze-shrouded Titan is very young, with persistent geologic activity.