This civil crisis involved mostly young males. Injuries were mainly lacerations from machete and gunshot injuries. Majority of the victims did not require formal surgical operations beyond initial care. Maintaining continuity in the positions of the Incident commander and the mass casualty commander ensure a smooth disaster response with fewer challenges.

Background. The COVID 19 pandemic affected healthcare delivery systems worldwide. There was a redistribution of health care resources in order to deal with the effects of the pandemic, with a corresponding consequence on other clinical services rendered. The extent of this effect on other non COVID 19 related services has been reported in other centres worldwide. In our own setting, health care resources are limited with suboptimal access even in normal situations. Objective. We sought to evaluate the effects of the COVID 19 pandemic on elective surgical services in our hospital. Methods. This was a cross sectional comparative study carried out at the Jos University Teaching hospital, (North central, Nigeria) of the elective surgical services rendered during the first wave of the COVID 19 pandemic lockdown covering the period April to June 2020 with a corresponding period of the preceding year 2019. Data was obtained from the hospital records department, theatres and service areas for clinic attendance, elective surgeries and ward occupancy. The paired sample t-test was used to compare the assessed variables across the three months of both years with a level of significance of P < 0.05. Results. There was mean clinic attendance of 2859.33 ± 223.36 covering the three months in 2019 as against a mean attendance of 648.67 ± 578.24 covering a similar period in 2020, P = 0.037. The elective surgical procedures carried out across the surgical specialties over the period in 2019 gave a mean of 352.33 ± 44.60 as opposed to 64.001 ± 7.32 over the corresponding period in 2020, P = 0.018. Ward occupancy over April to June 2019 was a mean 297.33 ± 18.58 across the various surgical wards and 158.33 ± 25.70 in the same period in 2020, P = 0.007. Conclusion. There was a significant reduction in the elective surgical services rendered in the hospital during the first wave of the COVID 19

Polydactyly is a duplication of the digits of the hands or feet. It is a congenital anomaly and can manifest as a single disorder or as a component of a syndrome. It is typically an autosomal dominant inherited condition with variable expression and incomplete penetrance. It is genetically heterogenic being caused by mutations in different genes. It manifests in different forms, based on the position of occurrence of the extra digit. It can occur as a single disorder as a component of a syndrome. Its presentation ranges from just a skin tag to a complete digit with the accompanying metatarsal or metacarpal bone. It can result in functional impairment or it may just be a cosmetically unacceptable digit with no functional impairment. Treatment depends on the nature of the extra digit as well as any functional impairment it may be causing. Surgical excision is employed and various reconstruction procedures are also employed in treatment, and must be well planned out to avoid a worsening of function. We present two cases; a 3-month-old baby girl presenting with a hereditary preaxial polydactyly (PPD) (Wassel type V) of both feet and a 29-year-old man with isolated postaxial polydactyly of the right foot with which was symptomatic.

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BACKGROUND Spine pathologies are a common presentation to Orthopaedicians and Neurosurgeons and include degenerative diseases of the spine, spine tumours, traumatic spine injuries, spine infections and spine deformities. Non-operative and operative treatment modalities are employed in the treatment of these conditions. The increasing ageing population worldwide has resulted in an increase in the degenerative spine conditions presenting to the clinician. Many surgical procedures are employed in the treatment of these conditions.The aim of this study was to evaluate the procedures carried out and attendant outcomes. MATERIALS AND METHODSThis was a case series of spine surgeries carried out over a 2-year period (2015 to 2017) in hospitals in Jos Nigeria. The data was reviewed retrospectively. They were analysed for spine pathologies; operative procedures were carried out. Duration of procedures, outcomes and complications were observed. The outcome was assessed using numeric pain scale. Data was analysed using the Epi Info statistical software. RESULTS25 patients in total were operated within the said period. Ages ranged between 35 and 77 years, with a mean of 60.8 years. Maleto-female ratio was 1:1.5. Pathologies operated on were lumbar spondylosis with canal stenosis and instability 8 patients (32%), lumbar spondylosis with canal stenosis without instability 6 patients (24%), canal stenosis 4 patients (16%), severe cervical spondylosis 3 patients (12%), spondylolisthesis 2 patients (8%) and metastatic tumour spread to the spine 2 patients (8%). Operative procedures carried out were laminectomy with instrumented posterolateral fusion (PLF) 8 (56%), laminectomies and non-instrumented posterolateral fusion 9 (36%) and anterior cervical decompression and fusion (ACDF) 3 (12%). 21 patients had a reduction by 6 or more points on the numeric pain scale (84%). One patient had cerebrospinal fluid leak which was treated nonoperatively; 2 patients had superficial surgical site infection and one patient was reoperated for persistent radiculopathy and improved thereafter. CONCLUSIONSpine surgery is a safe and effective means of treating various spine pathologies with minimal risks and more of these procedures will be employed in view of the increasing number of patients with degenerative spine disease.