Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.

Background:Trauma injury is the leading cause of mortality and hospitalization worldwide and the leading cause of potential years of productive life lost. Patients with multiple injuries are prevalent, increasing the complexity of trauma care and treatment. Better understanding of the nature of trauma risk and outcome could lead to more effective prevention and treatment strategies.Materials and Methods:A retrospective review of 1178 trauma patients with Injury Severity Score (ISS) ≥ 9, who were admitted to the Acute and Emergency Care of an acute care hospital between January 2011 and December 2012. The statistical analysis included calculation of percentages and proportions and application of test of significance using Pearson's chi-square test or Fisher's exact test where appropriate.Results:Over the study period, 1178 patients were evaluated, 815 (69.2%) males and 363 (30.8%) females. The mean age of patients was 52.08 ± 21.83 (range 5-100) years. Falls (604; 51.3%) and road traffic accidents (465; 39.5%) were the two most common mechanisms of injury. Based on the three most common mechanisms of injury, i.e. fall on the same level, fall from height, and road traffic accident, the head region (484; 45.40%) was the most commonly injured in the body, followed by lower limbs (377; 35.37%) and thorax (299; 28.05%).Conclusion:Fall was the leading cause of injury among the elderly population with road traffic injuries being the leading cause among the younger group. There is a need to address the issues of injury control and prevention in these areas.

Anal melanoma is a rare colorectal disease, accounting for 4% of all anal malignancies. Here we report the first case of a patient with anorectal melanoma who was treated laparoscopically. He underwent a totally laparoscopic abdominoperineal resection with excellent postoperative recovery. One year postoperatively, he is now clinically recurrence free with a normal colonoscopy. The literature on anorectal melanoma has been reviewed and controversy still surrounds the optimal treatment modality. We propose that a laparoscopic approach to the management of this disease can be considered when deciding future treatment plans for patients with this condition.

Laparoscopic adjustable gastric banding (LAGB) has become a common bariatric operation, because of its safety, laparoscopic friendliness, acceptable weight loss and absence of long-term adverse nutritional sequelae. Gastric erosion is one of the troublesome complications of gastric banding. The etiology and presentation of erosion remain obscure. We present a patient who complained of persistent pain 6 months after gastric banding. Endoscopy revealed the band to be normally situated, which was also confirmed on upper GI imaging. Despite this, the patient subsequently presented with massive GI hemorrhage and circulatory collapse due to erosion, which necessitated emergency laparotomy with retrieval of the band from within the gastric lumen. This case highlights the possible urgent presentation of erosion after gastric banding, which was hitherto considered to be a more insidious complication. A high index of clinical suspicion remains the mainstay of diagnosis.

The characteristics of spinal injury in women, as opposed to men, stand out as divergent. The mechanisms of trauma and the site of injury differ significantly. We suggest this variance may be due, in part, to skeletal and muscular structure dissimilarity in women and in part to the spinal kinematics attending each group.