Objective This was to assess the quality of life and clinical symptoms before and after treatment of patients with symptomatic lumbar degenerative disc disease (LDDD). It was also to determine the superior treatment for well-selected patients: conservative versus surgical treatment. Study Design Prospective interventional analytical study. Methods We studied 160 adult symptomatic patients aged 31-60 years with diagnosis of LDDD who were enrolled between May 2016 and November 2017. Their pre-and post-treatment clinical symptoms and signs and quality of life were studied using the Oswestry disability index (ODI). The data was analysed using SPSS version 24. Results One hundred fifty-three adult patients aged 31 to 60 years completed the study. The male-to-female ratio was 1:1.5 while the symptom duration ranged between one and 14 years. The treatment modalities were medical (46%), epidural steroid injection (26%) and operative treatment (28%). The responses to the treatment were worsened symptoms (10.5%), no improvement (13.1%), moderate/ slight improvement (27.5%) and significant improvement (49%). There were statistically significant improvements (p value < 0.05) in clinical symptoms, sign and ODI at six months after treatment. Surgical treatment was superior to all other form of care. Conclusion This study showed significant improvement in outcome among the participants in different treatment modalities with surgical treatment being the superior. We recommend surgical treatment for well-selected adult patients with symptomatic LDDD and assessment of quality of life and clinical symptoms before and after treatment.Keywords Symptomatic lumbar degenerative disc disease . Quality of life and clinical symptoms * Lukman Olalekan Ajiboye

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49.2%. Fifty-six percent of patients were housewives while 30.5% were civil servant. Eight-one percent of patients were overweight and obese. Pain was the predominant clinical symptoms with 79.7% and pain and swelling was present in 18.6%. Sixty-four percent of patients have had symptoms with duration of more than 12 months. The relationship between the Body mass index (BMI) with the duration of symptoms, unilateral or bilateral affectation of the knee was not statistically significant p > 0.05. Overweight and obese patients have more severe forms of the disease. Non steroidal anti-inflammatory drug (NSAIDS) was used in 47.5% of cases while in 40.4% of cases intra articular steroid administration was administered in addition to NSAIDS. CONCLUSION: Increasing age, the female gender and increased BMI are risk factors associated with the development of degenerative knee osteoarthritis.

Study Design: Prospective analytical study. Objectives: The aim was to determine the association between mental depression and symptomatic Lumbar Degenerative Disc Disease (LDDD) in patients with no previous background of mental disorder. We also aimed at determining the incidence of mental depressions in patients with LDDD and the effects of the treatment on the mental depression. Methodology: One hundred and sixty patients with no prior history of mental or behavioral disorders who presented with low back pains arising from LDDD and met inclusion criteria were studied. The clinical findings and Depression Screening Test pro-forma were completed for each. The extracted information was analyzed using Statistical Package for Social Science (SPSS) version 24.0. The statistical significance was set at P < 0.05. Results: One hundred and fifty-three patients completed the study, with a male to female ratio of 1:1.5 and the mean age of the patients was 48.5 years. The marital status was 4.4% single, 86.9% married, 3.8% divorce/separate and 5% widow/widower. Their levels of education were: no formal education (10.00%), primary school level (8.10%), secondary level (27.50%) and Tertiary level (54.40%). Conclusions: This study showed the incidence of mental depression in 32% of the patients with LDDD. We also noted a statistically significant relationship between symptomatic LDDD and level of mental depression with significant improvement in the level of depression at 6 th month after treatment. Hence, assessment of the patients' mental health is important in the management of LDDD.

Background:The use of conventional dynamic compression plates (DCPs) in osteoporotic bones is associated with higher chances of implant failure. The advent and use of locking combi-plates have ensured a stable construct during osteosynthesis of fractures in osteoporotic bones.Objectives:The study aims to assess the outcome of use of locking combi-plates in the management of fractures in osteoporotic bones in our environment.Materials and Methods:Cases of patients with nonunion and localized osteoporosis from January 2014 to December 2014 that were managed with locked combi-plates were reviewed. Outcome was assessed by time to healing, stability of implant construct after 6 and 12 months.Results:There were 10 patients with mean age of 47.4 ± 12.63 years. There were 9 males and 1 female, and road traffic crashes were the mechanism of injury in 90% (n = 9) and gunshot injuries in 10% (n = 1). Atrophic nonunion was the most common indication for osteosynthesis with 80%, followed by fibrous nonunion with 10.0%. The humerus was the most common long bone involved with 50%. Locked broad DCP was used in 62.5%, and the duration between initial injury and surgery was 6 and 48 months, with an average of 17.5 months. The outcome was such that 90% healed after 12 months on follow-up while one case had the implant backing out and delay union at 6 months.Conclusion:The use of locked plate in the management of nonunion in the presence of osteoporosis ensures stable fixation construct and healing.

Background: Diabetic foot disease is a foot that exhibits any pathology that results directly from diabetic mellitus or any long-term chronic complication of diabetes mellitus. The aim of the study was to determine the risk factors and indications for amputations in diabetics and to correlate these risks with mortality in our environment. Patients and methods: An audit of consecutive patients who were referred and had amputation as a result of diabetic foot diseases in a tertiary institution in Sokoto, northwest Nigeria over a 2-year period was done. Parameters studied using a predetermined protocol included the bio-data, socioeconomic status, vascular status, Meggit-Wagner grading status, indications for amputation and outcome. Results: There were nineteen amputations done in 19 patients with age range of 45 to 75 years and a mean age of 57.94 ± 8.92. There were more females (68%) than males (32%) giving a M:F ratio of 1:2. Forty-one percent of patients were housewives and 89.5% were of middle socioeconomic status. Seventy-three percent of the patients had no formal education while 31.6% has had diabetes for between 6 and 10 years. All the patients had comorbidity and 78.9% were Wagner's grade V. Ascending cellulitis and sepsis (68.4%) was the commonest indication for amputation. Trans femoral amputation was carried out in 47.4% and 21.1% had reamputation. A mortality rate of 15.8% was recorded and 52.6% defaulted from follow-up. There was no correlation between the risk factors and outcome in these patients (p > 0.05). Conclusions: Amputation was commonly done in the female diabetic housewife with no formal education. Educating these patients, improving their socioeconomic status will help them modify behaviours and identify foot at risk and complications.

The objective of the paper is to analyze the frequency and efficacy of experimental studies with antioxidant therapy. A search was conducted in the pubmed.gov database using the keywords "antioxidants" AND "spinal cord injury", from January 2000 to December 2015, resulting in 686 articles. Studies of non-traumatic injuries, non-antioxidant therapies, absence of neurological and functional evaluation, and non-experimental studies were excluded, leaving a total of 43 articles. The most used therapies were melatonin (16.2%), quercetin (9.3%), epigallocatechin and edaravone (6.9%). The most frequent route of administration was intraperitoneal (72.09%). The dose and mode of administration varied greatly, with a single dose being the most commonly used (39.53%). The time elapsed from trauma to treatment was 0-15 minutes (41.8%), 15-60 minutes (30%) and over 60 minutes (10.6%). Histological analysis was performed in 32 studies (74.41%). The BBB scale was the main functional measure applied (55.8%), followed by the inclined plane test (16.2%) and the Tarlov scale (13.9%). Positive outcomes were observed in 37 studies (86.04%). minutos (10,6%). A análise histológica foi realizada em 32 estudos (74,41%). O sistema de escala BBB foi a principal medida funcional aplicada (55,8%), seguida de teste com plano inclinado (16,2%) e a escala de Tarlov (13,9%). Os desfechos positivos foram observados em 37 estudos (86,04%). A heterogeneidade da terapia antioxidante com diferentes tipos, doses e medições observadas limita a comparação da eficácia. Protocolos padronizados são necessários para tornar possível a tradução clínica.Descritores: Antioxidantes; Traumatismos da medula espinal; Neurologia; Neurocirurgia; Revisão. (16,2%), quercetina (9,3%), epigalocatequina y edaravona (6,9% RESUMEN El objetivo del presente estudio es analizar la frecuencia y eficacia de los estudios experimentales con terapia antioxidante. Se realizó una búsqueda en la base de datos pubmed.gov utilizando las palabras clave "antioxidants" (antioxidantes) AND "spinal cord injury" (trauma raquimedular), de enero de 2000 a diciembre de 2015, y se encontraron 686 artículos. Se excluyeron los estudios de lesiones no traumáticas, terapias no antioxidantes, con ausencia de evaluación neurológica y funcional y los estudios no experimentales, quedando 43 artículos. Las terapias más utilizadas fueron melatonina

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