IntroductionHead injury is a leading cause of mortality in Africa. We characterise the epidemiology and outcomes of head injury at an Ethiopian emergency centre.MethodsWe conducted a prospective cohort study of all head injured patients presenting to the Emergency Centre of Tikur Anbessa Specialised Hospital, Addis Ababa. Data was collected via a standardised form from the patient’s chart, radiology reports and operative reports. Patients were followed until discharge, facility transfer, death, or 7 days in hospital. Consent was obtained from the patient or substitute decision maker.ResultsAmong 204 head injured patients enrolled, the majority were <30 years old (51.0%) and male (86.8%). Forty-one percent of injuries occurred from road traffic accidents (RTAs). A significant number of patients had at least one indicator of severe injury on presentation: 51 (25.0%) had a GCS < 9, 53 (26.0%) had multi-system trauma, 95 (46.6%) had ≥1 abnormal vital sign and of the 133 patients with data available, 37 (27.8%) had a Revised Trauma Score (RTS) < 6. Patients injured by RTA were more likely to have indicators of severe injury than other mechanisms, including multi-system trauma (OR 3.2, 95% CI 1.7–6.2, p = 0.00), GCS < 9 (OR 3.7, 95% CI 1.8–7.4, p = 0.00), ≥1 abnormal vital sign (OR 2.5, 95% CI 1.4–4.6, p = 0.00) or an RTS score < 6 (OR 3.6, 95% CI 1.6–8.1, p = 0.00). Overall, 149 (73.0%) patients were discharged from hospital, 34 (16.7%) were transferred to another hospital, and 21 patients died (10.3%). In multivariable analysis, death was significantly associated with age over 60 years (aOR 68.8, 95% CI 2.0–2329.0, p = 0.02), GCS < 9 (aOR 14.8, 95% CI 2.2–99.5, p = 0.01), fixed bilateral pupils (aOR 39.1, 95% CI 4.2–362.8, p < 0.01) and hypoxia (oxygen saturation <90%; aOR 14.2%, 95% CI 2.6–123.9, p = 0.01).ConclusionHead injury represents a significant risk for morbidity and mortality in Ethiopia, of which RTA’s increase injury severity. Targeted approaches to improving care of the injured may improve outcomes.

Curcumin (Curcuma Longa Linn), the active component of turmeric, has been shown to be effective in ameliorating several stress and drug-induced disorders in rats and humans. However, it is unclear whether short term curcumin administration can prevent the abnormal oro-facial movements (AOFM) which develop following blockade of dopamine D2 receptors by antagonist such as Haloperidol. The objective of this study is to determine whether short term treatment with curcumin along with Haloperidol can prevent the development of AOFM in rats. Male Sprague Dawley rats were administered curcumin at 200 mg/kg, and Haloperidol at 2 mg/kg daily for 2 weeks, and AOFMs and locomotor activity were assessed at baseline, day 7 and day 14. By day 14, rats receiving concurrent curcumin administration had a significant reduction in the incidence of Haloperidol-induced AOFMs, but no change on the Haloperidol-induced hypolocomotion. There was no spiked increase in locomotor activity in absence of challenge with dopamine D2 receptor agonist. The exact mechanism by which curcumin attenuates AOFMs remains unknown, therefore, we performed a proteomic analysis of the striatal samples obtained from control and curcumin treated groups. A number of proteins were altered by curcumin, among them an antiapoptotic protein, Bcl-XL, was significantly upregulated. These results suggest that curcumin may be a promising treatment to prevent the development of AOFMs and further suggest some therapeutic value in the treatment of movement disorders.

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