Objectives:To determine the burden of preventable rehospitalization for decompensated heart failure in the elderly.Methods:This was a retrospective study performed in a Nigerian University Teaching Hospital,. Demographic variables, etiology, and participants of heart failure were retrieved from data of elderly patients with heart failure admitted between January 2014 and December 2015. The participants were classified and described as either preventable, or unpreventable to determine whether the hospitalizations were preventable or not. The frequency of the groups with preventable participants (hospitalization) was derived.Results:Five groups of participants were preventable (55.5%), while 4 groups (44.5%) were unpreventable. The preventable participants were poor drug compliance (24 [23.4%]), uncontrolled hypertension (7 [6.9%]), infectious (34 [33.3%]), pulmonary thromboembolism (1 [1%]), and anemia (1 [1%]). The unpreventable participants include arrhythmias (19 [18.6%]), acute kidney injury (2 [2%]), acute coronary syndrome (1 [1%]), and progressive ventricular dysfunction (13 [12.7%]).Conclusion:Multiple rehospitalization for heart failure is a challenge for the elderly, but 55.5% of these readmissions are preventable. Poor drug compliance and pulmonary infections were the most common preventable participants. Multidisciplinary measures involving patient education, home based care, and physician training will reduce the number of hospitalizations for heart failure in the elderly.

Pin-track infection (PTI) is a common complication of external fixation. Antimicrobial dressings of the pin-site interface should reduce the severity and incidence of PTI. This study is aimed at determining the efficacy of 1 % silver sulphadiazine dressings in preventing PTI in external fixation. We compared the incidence of PTI between group A (dry sterile gauze dressing) and group B (1 % silver sulphadiazine impregnated gauze dressing). PTI was diagnosed when there was: (1) redness around any pin-site, (2) tenderness near a pin-site and (3) serous or purulent discharge from the pin-skin interface. With infection, swab was obtained for microscopy, culture and sensitivity. Pin-track infections were diagnosed in 22.5 and 4.1 % of patients in groups A and B, respectively. This difference was statistically significant. The commonest organism isolated from swabs was Staphyloccus aureus. In patients with external fixation, 1 % silver sulphadiazine lowered PTI. This further underlines the need for antimicrobial dressings of pin-sites. We recommend the use of 1 % silver sulphadiazine impregnated ribbon gauze for pin-site dressings.Level of evidence II.

Background: Blount disease is frequently associated with deformities that may not be adequately corrected by a single metaphyseal osteotomy. This study evaluated the outcome of a combined metaphyseal and epiphyseal osteotomy in severe cases. Methods: We prospectively evaluated the outcome of combining the antero-posterior inverted-U metaphyseal osteotomy with a medial open-wedge hemi-epiphyseal osteotomy in eighteen patients (27 tibiae) with Stage IV to VI Blount disease. Results: The average age of patients was 9 years (ranging from 5 to 17). The tibio-femoral angle improved from 43˚ varus (Range: 34˚ -78˚) to 2˚ varus (Range: 5˚ valgus to 8˚ varus). The metaphyseal-diaphyseal angle improved from 36˚ to 8˚ varus. Internal tibial torsion improved from 39˚ to 2˚. All the patients were able to achieve 110˚ of knee flexion in a year. Conclusion: In conclusion, the combined metaphyseal and epiphyseal osteotomy satisfactorily corrected tibiofemoral and

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