Presentation of Undescended Testis to a Paediatric Referal Centre in Jos

Background: Undescended testis is the commonest disorder affecting the male urogenital tract. Late presentation has significant socio-medical impact on the individual’s quality of life. Aim: To evaluate the presentation of undescended testis and age at surgery in our centre. Methods: A 9-year retrospective analysis of the clinical records of patients < 18 years managed for undescended testis in our centre. Results: A total of 73 records were analysed, 58 (79.5%) presented > 1 year. Median age at presentation was 4 years, range 1 day - 16 years. Males 73 (100%), only 17 (23.3%) were referred by health personnel, while 56 (76.7%) self-referred. Commonest site involved was the left 33 (45.2%), 29 (39.7%) right and 11 (15.1%) bilateral. There were 13 (17.4%) who had associated congenital malformations. Hypospadias 7 (53.8%), isolated micropenis 4 (30.8%) and 1 each (7.7%) had myelomeningocele and hernia. Median age at presentation for bilateral involvement was 30 days, with associated hypospadias was 12 days, while those with isolated micropenis was 7.5 years. Median age at surgery for bilateral involvement was 2 years, overall median age at surgery was 4 years. Surgery Findings: Supra-scrotal testis 47, canalicular 25 (34.2%), and bilateral abdominal 1 (1.4%). Outcome: Wound infections 4 (5.5%), scrotal wound breakdown 1, Recurrence 3 and testicular atrophy 1. Conclusion: Our patients presented very late beyond the recommended age for surgery, evaluating for DSD also contributed to delay in intervention even when these patients presented early. We advocate for early screening at birth, during routine child immunization and school enrollment, with prompt referral.

Unpowered Scooter-Related Injuries among Adolescents and Adults in the United States 2007-2017

United States Consumer Product Safety Commission (CPSC) reported a 700% increase in Emergency Department (ED) visits for injuries attributed to unpowered scooter use from January through October 2000. Our objective is to investigate injuries associated with the use of unpowered scooters among adolescents from the age of >9 years to 20 years in the National Electronic Injury Surveillance Study (NEISS) data set from 2007-2017. We analyzed unpowered scooter-related injuries in the NEISS data set using variables: SCOOTER, INJURED, AFTER, OFF, AT and IN;the product code for injuries related to unpowered scooters is 1329, and age ≥9 years and 9 - 19 - <99 years. Distribution by race: White 39.65%, Not Specified (NS) 38.94%, Black/African American 13.98% and Others (Asian, American Indians, Alaskan natives, Native Hawaiians, and Pacific Islanders) 7.43%. Body parts injured: head 16.19%, followed by face 8.49%, finger 8.30%, lower trunk 8.30%, ankle 5.60%, upper trunk 5.35%, internal injuries 0.99% and others 14.28%. Most of the injuries were mild: Treated and Discharged 89.80%, Hospitalized 7.68%, and Death in ED 0.05%. The locations of injuries were: Occurred at Home 43.47%, UNK 29.78%, Sports 12.63%, Public 6.49%, School 5.35%, and Street 2.22%. Injury trend: a rise until 2010, a decline until 2015 and, then a sharp rise through 2017. Injuries from the use of unpowered scooters are a rising threat that should be given attention. Outcome: Most of the injuries 69.80% were mild treated and discharged, 7.68% were hospitalized, while death in ED was 0.05%. Whereas: Transfer to referral hospital was about the same as in adults. Although most of these injuries were minor, head injuries could lead to more serious problems, and severe injuries could be life-threatening.