The relationship between obesity and peripheral arterial disease in adult Nigerian diabetics.

AIMS AND OBJECTIVES: The aim was to identify any relationship between obesity and peripheral arterial disease (PAD) in diabetic subjects. SUBJECTS AND METHODS: Male and female diabetic subjects aged 50-89 years. Body mass index (BMI) was used to estimate total body weight and the waist-to- hip ratio (WHR) as well as waist circumference (WC) were used for abdominal fat distribution estimation. Peripheral arterial disease was defined by an ankle brachial index <0.9. RESULTS: Peripheral arterial disease (PAD) was observed in 52.5% of the subjects. BMI, WHR and WC did not correlate with PAD. CONCLUSION: None of the parameters (i.e BMI, WHR and WC) used to assess the relationship between obesity and PAD was found to correlate with PAD.

Infection complicating locked intramedullary nailing of open lower-extremity fractures: incidence, associated risk factors, and lessons for improving outcome in a low-resource setting.

Introduction: Infection is the chief complication that makes open fractures difficult to treat. Most low- and middle-income countries (LMICs) are missing out on modern management techniques developed to achieve better outcomes in high-income countries (HICs). One of these is the use of locked intramedullary (IM) nails. This study aimed to determine the factors associated with infection of open fractures treated with the surgical implant generation network (SIGN) nail at a Nigerian tertiary hospital. Methods: Data were collected prospectively on 101 open fractures of the femur and tibia over an 8-year period. Active surveillance for infection was done on each patient. Infection was diagnosed as the presence of wound breakdown or purulent discharge from (or near) the wound or surgical incision. Potential risk factors were tested for association with infection. Results: There were 101 fractures in 94 patients with a mean age of 37.76 years. The following treatment-related factors demonstrated significant associations with infection - timings of antibiotic administration (p<0.001) and definitive fracture fixation (p=0.002); definitive wound closure (p<0.001), fracture-reduction methods (p=0.005), and surgery duration (p=0.007). Conclusions: Although this study has limitations precluding the drawing up of final conclusions, the findings suggest that the risk factors for infection of nailed open fractures in LMICs are similar to those in HICs. Consequently, outcomes can potentially improve if LMICs adopt the management principles used in HICs in scientifically sound ways that are affordable and socially acceptable to their people. Further studies are suggested to establish our findings.