scholarly journals Anesthetic Techniques for Urological Surgeries in Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria

2020 ◽  
Vol 2 (5) ◽  
Author(s):  
M. E. Efu ◽  
E. I. Ogwuche ◽  
B. A. Ojo ◽  
B. A. Eke
Keyword(s):  
Local Anesthesia ◽  
Relevant Information ◽  
Epidural Block ◽  
University Teaching ◽  
University Hospital ◽  
Anesthetic Technique ◽  
Anesthetic Techniques ◽  
State University ◽  
Female Ratio ◽  
Urological Surgery

Background: Urological surgery entails operating on the urinary system. Like every other surgery, they require anesthesia for the elimination of surgical pain. The organ to be operated as well as surgical approach determines the choice of anaesthesia used. This may be in the form of regional (including neuroaxial anesthesia) or general or even local anesthesia. This study was conducted to ascertain the anesthetic techniques employed for urological surgeries in the Benue State University Hospital (BSUTH), Makurdi, Nigeria. Methodology: This was a three-year retrospective study carried out in BSUTH, Makurdi, Nigeria. A total of 125 case files of eligible patients were retrieved from the records department following approval of an application. Relevant information was extracted from the patients’ folders and transferred into a prepared proforma. The data collected were analyzed using SPSS version 25 using simple statistics. Results: The age group with the highest number is that between 61 and 70 years, recording 40 (32.0%). The mean age was 54.0±20.4 Males were a clear majority with 119 cases accounting for 95.2% while only 6 cases (4.8%) involved females. The male to female ratio was 19.8:1. Most of the patients belonged to ASA II which recorded 70 (56.0%). Of the total of 125 diagnoses made, cancer of the prostate (CaP) was the highest with 63 (50.4%). The most common surgical procedure was prostate biopsy which was undertaken 58 times accounting for 46.4% of the procedures. Caudal block was employed most with 59 (47.2%). This was followed by Local infiltration with 30 (24.0%). Eighty-eight patients had surgery on day case basis while 37 patients underwent surgery as in-patients representing 70.4% and 29.6% of the study group respectively. Conclusion: Urological procedures are mostly infra-umbilical and are thus quite amenable to either regional or local anesthesia. This study has shown that caudal epidural block is the anesthetic technique of choice in urological surgery in this centre. Local anesthesia and sub-arachnoid block are next in that order. GA is not often employed. LA and regional techniques involve fewer disturbances to the respiratory system, and these were the anaesthetic methods mostly employed as established in this study.

Enterostomies for acute abdominal surgical condition in children: An experience in a developing country

2020 ◽  
pp. 1-4
Keyword(s):  
Damage Control ◽  
Intestinal Atresia ◽  
University Teaching ◽  
Salvage Procedure ◽  
State University ◽  
Female Ratio ◽  
Peritoneal Contamination ◽  
Surgical Conditions ◽  
Age Range ◽  
Surgical Condition

Background: Pediatric abdominal surgical condition that is complicated by gross peritoneal contamination may require enterostomy as a damage control or salvage procedure. Late presentations mostly seen in developing countries make creation of enterostomy a relatively common surgical procedure. The aim of this study was to evaluate the creation of enterostomy in children who presented with acute abdominal surgical conditions. Methods: This was a retrospective study of children that had enterostomy in the pediatric surgery unit of Enugu State University Teaching Hospital, Enugu, Nigeria. Medical records of pediatric patients that had enterostomy over a 10-year period were assessed. Results: There were 32 cases of enterostomies performed during the study period. There were 25 males (78.1%) and 7 females (21.9%) with a male to female ratio of 3.6:1. The age range of the patients was 3 weeks to 180 months, with a median age of 96 months. There were 1 neonate (3.1%), 10 infants (31.3%) and 21 children (65.6%) older than 1 year. The primary diagnoses were typhoid intestinal perforation in 21 patients (65.6%), intussusception 10 (31.3%) and intestinal atresia 1 (3.1%). Ileostomy was performed in 31 patients (96.9%) and jejunostomy in 1 patient (3.1%). Enterostomy was created at the time of initial laparotomy (damage control) in 21 patients (65.6%) while 11 patients (34.4%) had their enterostomy as a salvage procedure at the time of re-exploration. Peristomal skin complication was the most common complication recorded in our patients. Mortality was 12.5%. Conclusion: Enterostomy is lifesaving in the management of acute abdominal surgical condition when there is gross peritoneal contamination in severely ill children. Proper surgical technique and electrolyte derangements are important considerations when enterostomies are created.

scholarly journals Patient Satisfaction with General versus Local Anesthesia during Carotid Endarterectomy

2019 ◽  
Vol 80 (05) ◽  
pp. 341-344
Author(s):  
Jan Mracek ◽  
Jakub Kletecka ◽  
Irena Holeckova ◽  
Jiri Dostal ◽  
Jolana Mrackova ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Carotid Endarterectomy ◽  
Local Anesthesia ◽  
Postoperative Nausea And Vomiting ◽  
Anesthetic Technique ◽  
Anesthetic Techniques ◽  
Advantages And Disadvantages ◽  
Future Preference ◽  
Intraoperative Pain ◽  
Optimal Approach

Background and Study Aims Both general and local anesthesia are used in our department for carotid endarterectomy (CEA). The decision as to which anesthetic technique to use during surgery is made individually. The aim of our study was to evaluate patient satisfaction and preference with the anesthesia type used. Material and Methods The satisfaction of a group of 205 patients with regard to anesthesia used and their future preferences were evaluated prospectively through a questionnaire. The reasons for dissatisfaction were assessed. Results CEA was performed under general anesthesia (GA) in 159 cases (77.6%) and under local anesthesia (LA) in 46 cases (22.4%). In the GA group, 148 patients (93.1%) were satisfied; 30 patients (65.2%) in the LA group were satisfied (p < 0.0001). The reason for dissatisfaction with GA were postoperative nausea and vomiting (7 patients), postoperative psychological alteration (3), and fear of GA (1). The reasons for dissatisfaction with LA were intraoperative pain (9 patients), intraoperative discomfort and stress (5), and intraoperative breathing problems (2). Of the GA group, 154 (96.9%) patients would prefer GA again, and of the LA group, 28 (60.9%) patients would prefer LA if operated on again (p < 0.0001). Overall, 172 patients (83.9%) would prefer GA in the future, and 33 patients (16.1%) would prefer LA. Conclusion Overall patient satisfaction with CEA performed under both GA and LA is high. Nevertheless, in the GA group, patient satisfaction and future preference were significantly higher. Both GA and LA have advantages and disadvantages for CEA. An optimal approach is to make use of both anesthetic techniques based on their individual indications and patient preference.

scholarly journals Pediatric Discharges Against Medical Advice: A Review of Cases in Ado-Ekiti, Nigeria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Adefunke Olarinre Babatola ◽  
Oladele Simeon Olatunya ◽  
Ezra Olatunde Ogundare ◽  
Ayotunde Emmanuel Ajibola ◽  
Temitope Olumuyiwa Ojo ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Age Groups ◽  
Complete Information ◽  
Relevant Information ◽  
Medical Advice ◽  
University Teaching ◽  
State University ◽  
Cross Sectional ◽  
Against Medical Advice ◽  
Common Diagnosis

Background: Knowledge of the profile of pediatric discharge against medical advice (DAMA) may help design interventions to reduce its prevalence. Objectives: This study aimed to assess the profile of pediatric DAMA at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Ekiti State, Nigeria. Methods: This retrospective cross-sectional descriptive study included all pediatric cases of DAMA from January 2012 to December 2018. Relevant information was extracted from the patients’ case notes. Data was analyzed using the statistical package for social sciences (SPSS) version 23. Results: The overall prevalence of pediatric DAMA was 3.8%. Of the 233 pediatric DAMA with complete information, 127 (54.5%) were males. Severe malaria (27.3%) was the most common diagnosis among DAMA cases at the children emergency ward (CEW), while severe perinatal asphyxia (25.0%) and neonatal sepsis (25.0%) were the most common at the special care baby unit (SCBU). Only 1 (0.4%) patient was enrolled in the National Health Insurance Scheme (NHIS). Moreover, 43 (18.5%) parents took DAMA due to financial constraints, and 55% of the patients had their DAMA form signed by their fathers. In addition, among the patients who referred for follow-up, 11 (4.7%) patients fully recovered, 2 (0.8%) recovered with disability, 1 (0.4%) was readmitted, and 1 (0.4%) died. The highest and lowest DAMA rates were in the months of May and December, respectively. Patients aged under five years old who took DAMA significantly had infectious diseases compared to older age groups (P

scholarly journals Pattern of Injuries in Fatal Motorcycle Accidents Seen in Lagos State University Teaching Hospital: An Autopsy-Based Study

2017 ◽  
Vol 5 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Francis Faduyile ◽  
Festus Emiogun ◽  
Sunday Soyemi ◽  
Olugbenga Oyewole ◽  
Uche Okeke ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Road Traffic ◽  
University Teaching ◽  
Public Health Issue ◽  
Craniocerebral Injury ◽  
State University ◽  
Female Ratio ◽  
Motorcycle Accident ◽  
Lagos State ◽  
Motorcycle Accidents

BACKGROUND: Deaths from motorcycle accident injuries have remained a major public health issue in Nigeria over the years.AIM: The study is to determine the age and gender distribution of the victims and to identify the cause of death and the anatomical pattern of injuries seen.METHODOLOGY: This is a 5-year autopsy-based study of all motorcycle accident deaths seen in Lagos State University Teaching Hospital between December 2009 and November 2014. The data were retrieved from autopsy reports, hospital case notes extracts from police diary and were analysed using SPSS version 20.RESULTS: Motorcycle accidents accounted for 156 (2.8%) of all the autopsies done (5,661), and 156 (18.4%) of all Road Traffic Accidents (RTA) autopsies (849) performed over the study period, with a male: female ratio of 6:1. The peak age of victims was 31-40 years (30.9%). Head injuries accounted for most (41.4%) of the injuries seen, and the majority of the victims died of craniocerebral injury 53 (50.7%).CONCLUSION: This study showed that males in the fourth decade of life are the major victims of motorcycle accident death. The majority of the victims were the rider of the motorcycle. Most of them died of the craniocerebral injury.

scholarly journals Prevalence, Risk Factors and Outcome of Perinatal Asphyxia in Newborns at Benue State University Teaching Hospital Makurdi

2021 ◽  
Vol 2 (1) ◽  
pp. 17-24
Author(s):  
M O Ochoga ◽  
E U Ejeliogu ◽  
A Michael ◽  
A O Ajeh ◽  
R O Abah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Data ◽  
Teaching Hospital ◽  
Perinatal Asphyxia ◽  
University Teaching ◽  
Neurologic Complications ◽  
State University ◽  
Apgar Scores ◽  
Female Ratio ◽  
Birth Attendants

Perinatal asphyxia is a global neonatal problem, which significantly contributes to both neonatal morbidity and mortality. This study was therefore undertaken to determine the prevalence, risk factors and outcomes of perinatal asphyxia in Makurdi, Nigeria. A retrospective review of clinical data of all newborns managed at the Special Care Baby Unit of the Benue State University Teaching Hospital over a 5 year period (January 2015-December 2019) was carried out using the research clinical data form. Maternal information including biodata, obstetric history, perinatal events as well as neonates' presentation and outcomes were reviewed. All inborn neonates with Apgar scores <7 at 5 min or out-born neonates with no recorded Apgar scores but with history of poor cry/inability to cry at birth were classified as asphyxiated. Out of the 1142 neonates admitted during the study period, 127 neonates had perinatal asphyxia with prevalence of 11.1%. Eighty-four (66.1%) of the newborns were males, while 43(33.9%) were females with male to female ratio of 1.95:1 Majority of the newborns(89.1%) were managed and discharged without early neurologic complications; eight survived with early neurologic complications, eight were discharged against medical advice, while 7 newborns died, giving a case fatality rate of 5.5%.Risk factors significantly associated were Meconium-stained amniotic fluid(P=0.002) ,fetal presentation (P=0.030),and birth attendants (P=0.001). The burden of perinatal asphyxia still persists in our environment. Associated factors in this study were meconium-stained liquor and unskilled birth attendants. Hence pregnant women should be encouraged to attend antenatal care and should ensure skilled birth attendants attend delivery with capacity to conduct safe delivery and institute neonatal resuscitation when necessary.

scholarly journals Determinants of Successful Tuberculosis Treatment Outcome in a State University Teaching Hospital in South East, Nigeria: A 5 Year Retrospective Study

2019 ◽  
pp. 1-8
Author(s):  
Chinonyelu J. Orji ◽  
Onyinye H. Chime ◽  
Edmund N. Ossai
Keyword(s):  
Treatment Outcome ◽  
Teaching Hospital ◽  
Treatment Success ◽  
Tuberculosis Treatment ◽  
University Teaching ◽  
World Health ◽  
State University ◽  
Female Ratio ◽  
X Ray ◽  
Chest X Ray

Aim: The 2018 World Health Organization Global Tuberculosis Report enlisted Nigeria as one of the seven countries worldwide that accounted for 64% of all new cases of tuberculosis. The aim of this study was to assess the magnitude and determinants of tuberculosis treatment outcomes at a Tertiary Hospital in South East, Nigeria. Study Design: Retrospective cohort. Place and Duration: The Enugu State University Teaching Hospital Directly Observed Treatment Center, between April 2009 and March 2013. Methods: Completely filled data were extracted from tuberculosis treatment cards and registers of 445 clients (255 males, 190 females; age range 0-90 years) who assessed care at the DOTS clinic.  Tuberculosis treatment success outcome is defined as cured or completed TB treatment. Results: Of 445 registered patients, majority was males (57.3%), lived in urban areas (68.1%), and were newly diagnosed (97.8%). Of the 93.7% with pulmonary tuberculosis, 62% were smear negatives cases (62%). While the male to female ratio of the clients was 1.3:1, their mean age was 42 ± 16.7 years. About half (50.6%) had chest x-ray findings that were not diagnostic of Tuberculosis. While TB/HIV co-infection rate was 32.8%; 16% and 19.3% had commenced anti -retroviral and co-trimoxazole preventive treatment respectively. Treatment success was reported in 67.9% of all clients and was associated with being older than 14 year (AOR=12.0, 95% CI: 2.5 – 58.0) and having positive chest findings (AOR = 2.6, 95% CI: 0.3-0.6). Conclusions: The TB success rate in was 67.9% Being older than 14 years, having PTB and positive chest x ray findings were the predictors of good treatment outcome in this study. There is an urgent need to track and report the treatment outcome of patients who are lost to follow up since they constitute 20% of missed cases in this center.

scholarly journals Post Operative Diagnosis of Early Gastric Cancer in a Low Risk Population and the Possibility of Risk Stratified Screening

2015 ◽  
Vol 12 (1) ◽  
pp. 32-37
Author(s):  
B Ghimire ◽  
YP Singh ◽  
S Timalsina
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Early Gastric Cancer ◽  
Screening Program ◽  
Tertiary Care ◽  
Survival Rates ◽  
University Teaching ◽  
University Hospital ◽  
Female Ratio ◽  
Gastric Cancers

Background Gastric cancer is the second commonest cause of cancer related mortality worldwide. Though its incidence is more in Eastern Asia, it is increasing in the South Asian subcontinent. The diagnosis of early gastric cancer (EGC) confined to the mucosa or submucosa, is an important concern due to a better outcome at this stage where five year survival rates could increase by 90 percent. Though mass screening is done in few countries, it has not been applied in developing countries like Nepal. Preoperative diagnosis of EGC is rare in Nepal. The aim of this study is to analyze the clinico-pathological features of postoperative cases of gastric cancer managed in a tertiary care university hospital of Nepal.Methods All patients with histological diagnosis of gastric cancer admitted in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal during the three year period (September 2010 to August 2013) were analyzed retrospectively.Results Ninety two patients with endoscopic diagnosis of gastric cancers were admitted during the past three years. The mean age was 60 years ranging from 28 years to 85 years with the male to female ratio of 2.8:1. Five patients were younger than 40 years and all were in advanced stage. Thirty five percent of the patients belonged to Janajatis (Hill) community though they comprise only 23% of the population and about 65% of them belonged to an area involving 25% of the country.Seventy six cases were operated. Out of 92 patients, 4 patients were diagnosed as early gastric cancer postoperatively. All patients with early gastric cancer were above 50 years with CT Scan abdomen revealing focal thickening without lymphadenopathy.Conclusion Over the years, the incidence of gastric cancer is increasing in Nepal. Though 92% are advance gastric cancers, few have been diagnosed and treated early. A screening program in a country like Nepal with diverse ethnicity and difficult terrain might be helpful if it targets high risk people in high risk areas.Kathmandu University Medical Journal Vol.12(1) 2014: 32-37

scholarly journals Review of urological cancers in Damaturu, Nigeria

2021 ◽  
Vol 9 (2) ◽  
pp. 532
Author(s):  
Usman M. Tela ◽  
Adamu I. Adamu ◽  
Babagana M. Abubakar ◽  
Abdulkadir Abubakar ◽  
Hassan M. Dogo
Keyword(s):  
Epidemiologic Studies ◽  
University Teaching ◽  
High Morbidity ◽  
State University ◽  
Female Ratio ◽  
Pattern Frequency ◽  
Urological Cancers ◽  
Cancer Of The Bladder ◽  
Poorly Differentiated ◽  
Prostate Cancers

 Background: Urological cancers (UC) remain a major global burden and a significant cause of high morbidity and mortality. In other to plan and tackle this burden, there is need to audit the pattern of these malignancies in our locality which is currently lacking.  Hence, the objectives of our study were to describe the histological pattern, frequency and demographic characteristics of urological cancers seen in Damaturu.Methods: The reports of all the urological specimens that were histologically diagnosed as malignant between November 2017 to October 2019 in the histopathology department of Yobe state university teaching hospital, were analyzed. The department keeps newly established cancer registry for the state.Results:  Fifty-five UC were diagnosed, with male to female ratio of 13.8:1. These UC constitute 34.1% of the 161 urological specimens assessed and 26.4% of all types of medical cancers diagnosed in the period of study. Prostate cancer dominates the UC (41; 73.8%), followed by bladder cancers (11; 19.8%) and the remaining kidney, penis and testicular cancers (1; 1.8%) each.Conclusions: Urological cancers are very common in our region, particularly prostate cancers in which majority were poorly differentiated. This report though analyzed few cancers, the proportion of UC is high. Urothelial cancer of the bladder is now more frequent than squamous cell carcinoma. This study can serve as basis for future epidemiologic studies targeting at the risk factors, awareness and prevention of UC.

scholarly journals Pattern of Blood Transfusion in the Special Care Baby Unit of Benue State University Teaching Hospital in Makurdi North-Central Nigeria

2021 ◽  
Vol 2 (1) ◽  
pp. 9-16
Author(s):  
M O Ochoga ◽  
E E Eseigbe ◽  
A M Onoja ◽  
M Aondoaseer ◽  
B N Samba ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Teaching Hospital ◽  
Neonatal Jaundice ◽  
Special Care ◽  
University Teaching ◽  
State University ◽  
Female Ratio ◽  
Exchange Blood Transfusion ◽  
Special Care Baby Unit ◽  
Male Female Ratio

Blood transfusion is a life-saving procedure in which whole blood or parts of blood are introduced into a patient's bloodstream intravenously. The need maybe due to physiological or pathological causes. The objective of this study was to document the pattern and indications for blood transfusion at the Special Care Baby Unit of the Benue State University Teaching Hospital (BSUTH), Makurdi. This study was a retrospective review of 126 neonates who received blood transfusion at the Special care baby unit of BSUTH from 1st January 2015 to 31st December 2019. Data was retrieved from patient's medical records and analyzed using IBM SPSS version 23. A total of 1142 neonates were admitted over the study period and 126 had blood transfusion giving a prevalence of 11.0%. Male/Female ratio of 1.57:1.Mean (±SD) Birth weight and gestational age (GA) were 2.23±0.82Kg and 35.48 ±3.95 weeks respectively. Exchange blood transfusion was the most frequent 53(42.1%) type of blood transfusion. The most common indications for blood transfusion were anaemia of prematurity, sepsis and severe neonatal jaundice. A hundred and twelve (88.9%) who received transfusion were discharged while 4(3.2%) died. The rate of blood transfusion was low, while severe neonatal jaundice and anaemia were the main indications for blood transfusion in this study. Exchange blood transfusion was the main type of transfusion.

scholarly journals Anesthetic Techniques for Gynecological Surgeries in Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
M. E. Efu ◽  
S. K. Hembah-Hilekaan ◽  
A. O. Ojabo ◽  
B. A. Ojo ◽  
U. M. Aneng Anenga
Keyword(s):  
General Anesthesia ◽  
Face Mask ◽  
Anesthetic Technique ◽  
Anesthetic Techniques ◽  
Study Group ◽  
State University ◽  
Surgical Methods ◽  
Management Of Complications ◽  
Case Files ◽  
Study Population

Background: Gynecological surgery refers to surgery on the female reproductive system usually performed by gynecologists. It includes procedures for benign conditions, cancer, infertility and incontinence.  Gynecological conditions are seen in the non-pregnant and early pregnant state up to 20 weeks gestation. . Just like every other surgery, they require anesthesia for the elimination of surgical pain and the surgical methods to a great extent, determine the choice of anesthesia employed. Anesthesia is usually in the form of regional, especially the neuroaxial type, or general anesthesia. This study was conducted to ascertain the anesthetic techniques employed for gynecological surgeries in the Benue State University Hospital (BSUTH), Makurdi, Nigeria and complications arising there from. Methodology: A retrospective and descriptive study of case files of patients that underwent gynecological surgeries between January 2016 and December 2018 in BSUH, Makurdi was carried out. A total of 156 case files of eligible patients were retrieved from the records department of BSUTH after approval from relevant authorities. Relevant information were extracted from the patients’ folders and transferred into a prepared proforma. The data collected were analyzed using SPSS version 25 using simple statistics. Result: A total of 156 cases were evaluated. The age bracket with the most number is that between 21 and 30 years which recorded 54 (34.6%). This was followed by the age group between 31 and 40 years which were 51, making up 32.7% of the study population. Uterine fibroid was the most recorded diagnosis with 36 cases accounting for 23.1% of the study population. This was followed by ruptured ectopic gestation which was observed to 23, representing 14.7% of the study group. Cancer (Ca) of the cervix recorded 22, amounting to 14.1% of the study group. Exploratory laparotomy was carried out 44 times accounting for 28.2% of the procedures. This was followed by myomectomy and examination under anesthesia (EUA) with 26, representing 14.7% of the variables each.  Of the 156 anesthetic procedures undertaken, 56 (35.9%) were sub-arachnoid block (SAB). This was followed closely by general anesthesia with endotracheal intubation (GA/ETT) with 55 (35.3%). General anesthesia with face mask (GA/FM) came third with 35 (22.4%). Twenty-four episodes of complications were observed out of which pain occurred 10 times accounting for 41.7% of the variables. Hypotension occurred 8 times representing 33.3% of the variables. Accordingly, 24 modalities were employed for the management of complications of anesthetic techniques of which IV administration of ephedrine was done 8 times representing 33.3% of the variables. This was followed by IV administration of pentazocine that was done 5 times accounting for 20.9% of the variables. Conclusion: As a result of the vast array of gynecological diseases observed in this study, GA with tracheal intubation and GA with face mask together make up the anesthetic technique of choice for gynecological surgeries. The prominence of SAB as an anesthetic technique is not unexpected because many gynecological lesions are sub-umbilical in location, thus making them amenable to the technique which also possesses a lot of advantages. In addition, complications observed were few and included mainly pain and hypotension, none of which was life-threatening.  

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