*Eclampsia ; *Infusions, Parenteral ; *Ireland ; *Maternal Mortality ; *Postpartum Hemorrhage ; *Puerperal Infection ; *Shock, Hemorrhagic ; *Pregnancy

Purpose; Delayed presentation of lateral condylar fractures of the humerus is relatively common in the developing regions of the world. These fractures are difficult to manage because of the displacement and fibrosis around the condylar fragment secondary to the delay. There is a paucity of literature concerning the management of these fractures. An oft repeated finding is the requirement of extensive dissection around the fragment for proper reduction. The purpose of this study was to assess the efficacy of surgical management of lateral condylar fractures with delayed presentation. Methods; We assessed the results of lateral condylar fracture fixation in 20 cases with delayed presentation. Results; The lateral condylar fractures in patients with a delayed presentation can be managed surgically with good results. Conclusions; Open reduction and internal fixation should continue to be the method of choice for the management of lateral condylar fractures which report late for management.
Orthopedic Procedures

Cutis verticis gyrata is characterised by hypertrophy and folding of skin of scalp leading to gyrated appearance. Polan and Butterworth1 classified it into primary and secondary forms. Secondary CVG has been described with a wide variety of causes. Congenital melanocytic neavus appears to be the most common2. However it has been described with other naevoid abnormalities like Neavus lipomatoses, connective tissue nevi, genetic disorders such as neurofibromatoses, and endocrine disorders like acromegaly.

Pre-hypertension increased the risk of morbidity and mortality from non-communicable diseases. Whereas, psychological factors such as depression, anxiety and stress have been associated with increased in blood pressure. However, previous studies more focuses on psychological determinants of hypertension than prehypertension. Thus, this study aims to determine the association between these psychological factors with pre-hypertension. A cross-sectional study was conducted in 2012 among first year students of a public Malaysian university. A random cluster sampling was used to select 5 out of 15 faculties and a total of 495 students participated in this study. The Malay version of DASS-21 was used to elicit their levels of depression, anxiety and stress. Blood pressures were measured twice using sphygmomanometer and the averages were taken. Data analyses used chi-square test and binary multiple logistic regression. The prevalence of pre-hypertension was 30.1%. The percentage of severe and extremely severe depression was 3.8% and 1.2%; both severe and extremely severe anxiety was 16.4%; and severe and extremely severe stress was 4.2% and 0.2% respectively. Severe/extremely severe depression had more than 3 times higher in getting pre-hypertension than no depression. In conclusions, almost one third of respondents had pre-hypertension and only severe/extremely depression was associated with pre-hypertension.
Prehypertension

Nodding Syndrome (NS) was recently described in children in Northern Uganda. The affected children were in the age group 5 – 15 years. They were stunted, malnourished, dehydrated, mentally retarded and get recurrent seizures. The objective of this study was to describe the cluster distribution of NS cases in Northern Uganda. We conducted a cross-sectional study using available data on the burden of NS in Northern Uganda and used GPS to map the locations of the most affected areas. The results obtained indicate that Nodding Syndrome in Northern Uganda occurs in clusters in the following locations Odek, Atiak, Angagura, Awere, Laguti, Labongo-Amida, Atanga, Pajimo, Palabek Kal and Palabek Gem sub counties and mainly along Aswa and Pager rivers and their tributaries. Nodding Syndrome in Northern Uganda occurs in clusters predominantly along two rivers; perhaps it is an indication for environmental, dietary and common epidemiological exposures for the syndrome.

HIV/AIDS is one of the commonest reasons for admission of youths in Gulu Hospital. There are no specific studies that have been carried out to determine the prevalence of HIV/AIDS among the youths in this post-conflict region. This study aimed to describe the characteristics of HIV positive youths attending care in Gulu Hospital. A cross-sectional study was conducted among youths aged 13 to 24 years in the specific clinics of Gulu Hospital from January to December 2010 to identify and describe those youths that were HIV positive. A total sample size of 280 HIV positive patients was calculated using the Kish & Leslie formula. Ethical approval was obtained from Gulu Hospital Committee. Majority of respondents 174 (62%) who re-tested for HIV knew their HIV status and most tested between April and June 90 (32%). HIV infection was more prevalent among females 252 (90%), particularly those who were single 118 (47%). HIV infection is more common among female youths in the post-conflict northern Uganda.

Talar neck fractures (TNFs) are complex injuries and treatment is fraught with complications. We retrospectively studied 18 patients with TNFs: 6 Hawkins type I, 7 type II, 4 type III, and 1 type IV. Five patients with type I and 2 with type II fractures were treated conservatively. The remaining 11 patients underwent operative treatment. Open reduction via posterolateral approach was performed in 10 patients while closed reduction was used in one patient. All operatively reduced fractures were stabilized
Orthopaedic

In this retrospective study, we present our experience using open Küntscher nailing (K-nailing) which is still performed in developing countries for femoral fractures. Of 157 acute fractures treated between January 2003 and December 2009, 100 were stable (63.7%) and 135 were located within the middle third of the shaft (86%). Comminution was absent or minimal in 135 (86%) cases. Fracture union was achieved at an average of 14 weeks (range, 10 - 25). The duration of follow-up was 17 months (range, 6 - 36). Final evaluation showed that 129 (82.2%) patients had a good result according to modified Kempf’s criteria. The predominant complications were infection (n=5; 3.2%), nonunion (n=9;5.5%), implant failure (n=11; 7%), and malunion (n=27; 17.3%). Open reduction and fixation with a tight fitting Knail can give good results in selected acute femoral shaft fractures but knowledge of potential complications is needed.

Menstrual problems like menorrhagia, dysmenorrhea and premenstrual syndrome (PMS) are common in adolescent girls. However literature regarding association between menstrual and mental health problems is limited; hence the current study was planned. Methods: It is a cross-sectional study conducted in Sangli district (Maharashtra), India among the female students from three randomly selected graduation colleges. Calculated sample size was 605 and cluster random sampling technique was applied. The study duration was June 2013 - May 2014. Study instrument was self-administered questionnaire with inventories like PSST-A, DASS-21 and SPIN. Statistical analysis was done using chi-square test and binary logistic regression. Results: Of the 707 participants; 413 (58.4%) had menstrual problems with dysmenorrhoea being the commonest. Embarrassment due to menstruation was felt by 14.9%. Menstrual problems were associated with perceived body type, body image, stress and anxiety. Embarrassment due to menstruation was associated with social phobia, stress, anxiety and depression. On binary logistic regression; body image and embarrassment due to menstruation were significant predictors for menstrual problems. Conclusions: Menstrual problems contribute to the development of various Mental Health disturbances. Hence, girls should be encouraged to seek health advice for the menstrual problems. A full time Health counsellor in schools and colleges can justify addressing adolescent health problems.

*Abortion, Legal ; *Contraceptives, Oral ; *Education, Medical ; *Gynecology ; *Obstetrics ; *Pregnancy