Improving maternal mortality at a university teaching hospital in Nnewi, Nigeria.

Objective: To evaluate the impact of the introduction of the Service Compact with all Nigerians (SERVICOM) contract on maternal health at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.

Methods: A retrospective and comparative study of maternal deaths between 2004 and 2010 was carried out. The main outcome measures were yearly maternal mortality ratio (MMR), relative risk (RR) of maternal mortality, and presentation-intervention interval.

Open arthrolysis for functional restoration in post-traumatic elbow stiffness.

A prospective study of nine patients who had elbow stiffness after trauma and had open arthrolysis to restore function is presented: seven were children aged 6-10, two were adults--six males and three females. Five patients had supracondylar fracture as the initial lesion, one had posterior dislocation of the elbow and three had elbow sprains. They were all previously treated by native bonesetters and presented with elbow stiffness and fixed extension of the elbow.

Congenital longitudinal deficiency of the tibia--report of two cases, both siblings of same parentage.

Two cases of type IV congenital longitudinal deficiency of the tibia are reported. The patients aged three months and eleven years are siblings of the same parentage, female and male respectively. Autosomal dominance inheritance is the probable mode of inheritance.

Hypoglycaemic shock: normal or abnormal response to injury?

We report a case of hypoglycaemic shock which occurred in a patient 18 h after injury. The patient was involved in a road traffic accident and sustained multiple rib fractures and bruising in the (R) lumbar region. Eleven hours after his last meal he developed sudden weakness, profuse sweating, air hunger, thirst, disorientation and suddenly lapsed into coma 18 h after admission.