Methods Study design and setting This was a five year descriptive prospective study of animal related injury patients that presented

to the Accident and Emergency of Bugando Medical Centre (BMC) between September 2007 and August 2011. Bugando Medical Centre (BMC) is a referral, consultant and teaching hospital for the Catholic University of Health and Allied Sciences-Bugando (CUHAS-Bugando) and other paramedics and it is located in Mwanza city in the northwestern part of the United Republic of Tanzania. It is situated along the shore of Lake Victoria and has 1000 beds. BMC is one of the four largest referral hospitals in the country and serves as a referral centre for tertiary specialist care for a catchment click here population of approximately 13 million people from neighboring. There is no trauma centre or established advanced pre-hospital care in Mwanza

city as a result all trauma patients are referred to BMC for expertise management. Study subjects The subjects of this study included all patients of all age group and gender that presented to BMC with animal related injuries during the study period. Patients who failed to give proper LXH254 solubility dmso information and those who had no relative to consent for the study were excluded from the study. Recruitment of patients to participate in the study was done at the A & E department. Patients were screened for inclusion criteria and those who met the inclusion criteria were, after informed consent to participate in the study, consecutively enrolled into the study. Patients with severe injuries were first resuscitated in the A&E department according to Advanced Trauma Life Support (ATLS). From G418 nmr the A & E department, patients were taken into the surgical wards or the intensive care unit (ICU) from where necessary investigations were completed and further treatment was PDK4 instituted. Patients with open wounds and those with evidence of abdominal visceral injuries were taken to theatre for surgical intervention. Severe head injury patients with evident of space occupying lesions were also taken to theatre for possible craniotomy or burr holes and evacuation of haematoma. The severity of injury was determined

using the Kampala trauma score II (KTS II) [19]. Severe injury consisted of a KTS II ≤ 6, moderate injury 7-8, and mild injury 9-10. Patients with head injuries were classified according to Glasgow Coma Scale (GCS) into: severe (GCS 3-8), moderate (GCS 9-12) and mild (GCS 13-15). An initial systolic blood pressure (SBP) on each patient was also recorded on admission. Routine investigations including hematological (hemoglobin, blood grouping & cross-matching), biochemical (serum creatinine & serum electrolytes) and radiological (x-rays of the chest & abdomen, abdominal ultrasound and CT scan) were performed on admission. Depending on the type of injury, the patients were treated either conservatively or by surgery. All patients were followed up till discharged or death.