British Journal of Medical and Health Research

Pain, an unpleasant sensory and emotional experience associated with actual or potential tissue damage, is a significant global health concern, affecting orthopaedic patients in both developed and developing nations. Acute post-surgical pain is an important predictive factor of chronic postoperative pain. Inadequate pain management remains a prevalent issue for surgical patients, with estimates ranging from 20% to 80%. Locally, the growing number of patients presenting with chronic pain and poor rehabilitation post musculoskeletal surgery in orthopedic clinics is partly attributed to inadequately managed acute post-surgical pain. Consequently, assessing the prevalence of severe postoperative pain and the adequacy of analgesic prescriptions among musculoskeletal surgery patients is crucial. This research will assist orthopedic surgeons in developing effective post-surgical pain management protocols, potentially reducing the incidence of severe uncontrolled pain in wards and eventually chronic pain in the clinics. To establish the prevalence of severe post-surgical pain at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. This study is a hospital based prospective study based at MTRH theatre and orthopedic wards carried out between June, 2024 and December, 2024. A total of 320 patients scheduled for major orthopedic surgery who met the inclusion criteria were enrolled. Every fourth patient scheduled for orthopedic surgery was systematically sampled for assessment of post-surgical pain using numerical rating scale (NRS) Descriptive statistics were used for continuous variables and frequency and percentages for categorical data. The overall prevalence of severe post-surgical pain was 56.88% in the initial 72 hours. Severe pain was recorded at 37.19%, 23.44%, 27.19%, 10.31% and 6.25% in 2 hours, 12 hours, 24 hours, 48 hours and 72 hours respectively. Majority of the patients received multimodal analgesics at 57.81%. Prevalence of severe post-surgical pain in orthopedic patients was relatively high in the initial 72 hours. Introduction of pain assessment scales for regular assessment of pain scores in the initial 72 hours of surgery in orthopedic wards. Utilization of strong opioids and nerve blocks for control of post-surgical pain in the initial 72 hours. Keywords: Postoperative pain; severe pain; orthopedic surgery; pain prevalence; pain assessment

Statistical analysis forms the basis of evaluating biomedical research. Medical research has flourished over recent decades leading to continued advancements in understanding of theoretical and applied statistical methods in biomedicine and related fields. This article reviews and provides practical understanding of various theoretical statistics and research methodology and designs. The review deals with measures of central tendency and variability, “confidence intervals, p-values, risk factors, correlation and regression, randomization, sample size, bias and errors, and reporting. Other methodologies and techniques of clinical research and trial designs, such as, blinding, missing data, sensitivity analysis and trial adaptations, are reviewed. The review considers diverse emerging research methods, including Bayesian and other innovative research paradigms, to test medical hypotheses. It reviews methods to exploit digital and other pioneering biomarkers, as well as integrated research and evolution of the biomedical sciences. The focus of this review is to maintain the central role of theory, practice, and methods of medical statistics to research and advances in biomedicine and other related disciplines. The role of technology is to facilitate medical research and provide a framework for scientific inquiry and disciplined pursuit of new knowledge.

Background: Traumatic spinal injuries (TSI) are a significant cause of morbidity, disability, and socioeconomic burden, particularly in low- and middle-income countries where access to specialized care and rehabilitation remains limited. This study evaluated theclinical presentation, injury patterns, and management ofTSI at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. A prospective descriptive study was conducted among 28 patients with TSI recruited Methods: through consecutive sampling. Data collected included demographics, injury mechanisms, anatomical levels, neurological severity, associated injuries, treatment modalities, complications, and functional outcomes. Neurological assessments was performed using the ASIA Impairment Scale. Results : The mean age was 37.9 years (SD 12.4), with males comprising 85.7% of participants. Farmers (25%) and casual labourers (17.9%) were the most represented occupational groups. Falls were the leading mechanism of injury, while the lumbar spine was the most frequently affected region. Most patients (89.3%) had incomplete or no neurological impairment (ASIA D/E). Surgical intervention was performed in 67.9% of patients, with a mean time to surgery of 3.8days (SD3.22). The mean hospitalstay was 12.8days (SD10.9). Conclusion: TSI predominantly affected economically active males, with falls being the leading cause. Strengthening occupational injury prevention, prehospital spinal care, timely referral, and comprehensive rehabilitation services may improve patient management in resource-limited settings. Keywords: Traumatic spinal injuries; Spinal trauma; Neurological impairment; Surgical management;Kenya.