scholarly journals Anesthesia-Related Mortality in Children: A Surgeon’s Perspective

2021 ◽  
Vol 3 (3) ◽  
pp. 152-157
Author(s):  
Chukwubuike Kevin Emeka
Keyword(s):  
Causes Of Death ◽  
Developed Countries ◽  
University Teaching ◽  
State University ◽  
Related Complication ◽  
Middle Income ◽  
Male Predominance ◽  
Airway Problem ◽  
Common Etiology ◽  
Related Mortality

Background: Anesthesia-related mortality refers to death resulting from the complications of anesthesia or death due to at least one anesthesia-related complication happening as a cause among the multiple causes of death. The aim of this study was to evaluate the incidence and causes of anesthesia-related mortality in pediatric patients, as experienced by a surgeon.  Materials and Methods: This was a retrospective study of children aged 15 years and younger who died at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria following administration of anesthesia between January 2010 and December 2019. Results: A total of 31,210 pediatric anesthesias/surgeries were performed during the study period; out of which 78 mortalities occurred due to anesthesia. There was male predominance and the median age of the patients was 4 years with a range of 1 week to 12 years. Mortality occurred more in neonates and during emergency surgeries. Airway complications and intussusception were the most common etiology of mortality and pathology in the children respectively. About two-thirds of the deaths occurred in the operating room before commencement of the surgery. Conclusion: Anesthesia-related deaths in children in middle income country like Nigeria are higher than what is obtainable in developed countries. The risk factors for anesthesia-related mortality include male gender, neonates and emergency surgeries. Airway problem is a common cause of mortality.

Malaria Infection as a Leading Cause of Febrile Seizures among Children with Seizures in Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria

2019 ◽  
Author(s):  
Oluwasola Oke ◽  
Adebukola Ajite ◽  
Oluwadare Oluwayemi ◽  
Oladele Olatunya ◽  
Ezra Ogundare ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Malaria Infection ◽  
Febrile Seizures ◽  
Developed Countries ◽  
Pediatric Emergency ◽  
University Teaching ◽  
State University ◽  
Common Cause ◽  
Index Study ◽  
A Prospective Study

Febrile seizure (FS) is among the leading cause of pediatric admissions in developing countries.The etiologic patterns of FS among children attending Pediatric Emergency of Ekiti State Teaching Hospital in Ado Ekiti were studied. A prospective study of children who had FS was carried out. A prevalence of 2.9% was found and malaria was the leading cause of FS in 111 (85.4%) patients. Seventy-eight (60%) of the 130 patients with FS had their seizure occurring within the first 24 hours of onset of fever. Malaria was the most common cause of fever precipitating FS in the index study. Prevention of malaria and prompt management of fever will reduce the prevalence and improve the outcome of FS. The overall prevalence of FS is similar to developed countries and the etiology is similar to other studies from Nigeria.

scholarly journals Prevalence and predictors of episiotomy and perineal tear at a tertiary hospital in Port-Harcourt, Nigeria

2020 ◽  
Vol 9 (11) ◽  
pp. 4595
Author(s):  
Peter A. Awoyesuku ◽  
Dickson H. John ◽  
Basil O. Altraide
Keyword(s):  
Birth Weight ◽  
Head Circumference ◽  
Developed Countries ◽  
Tertiary Hospital ◽  
University Teaching ◽  
State University ◽  
Perineal Tear ◽  
Vaginal Deliveries ◽  
Fetal Birth Weight ◽  
The Mean

Background: Despite many years of it being practiced, episiotomy has remained a controversial operation. The rate is on the decline in developed countries but remains high in developing countries. This study seeks to determine the prevalence of episiotomy and perineal tear, and to assess the associated factors, at the Rivers state university teaching hospital (RSUTH).Methods: A retrospective study over a two-year period, from 01 January 2018 to 31 December 2019, was carried out. All women who had singleton spontaneous vaginal deliveries (SVD) with episiotomy or perineal tear at the RSUTH with complete records were included, those with twin delivery and incomplete data were excluded. Data was retrieved from the birth registers and case notes using a proforma. Information on maternal age, parity, gestational age (GA), type of injury, birth weight, head circumference and Apgar scores were extracted. Data were analyzed using statistical package for the social sciences (SPSS) version 20.Results: There were 2150 vaginal deliveries, with 440 (20.5%) receiving episiotomy, while 21 (1.0%) had perineal tear. The mean age±standard deviation (SD) was 29.52±4.97 years, median parity was 1, and mean GA±SD was 37.35±1.71 weeks. The mean birth weight±SD was 3.33±0.52 kg and mean head circumference±SD was 34.76±1.90 cm. There was significant association between maternal parity and fetal birth weight with the occurrence of episiotomy and perineal tears.Conclusions: The rate of episiotomy and perineal tear was higher than recommended, with an increasing trend. The lower the parity and the higher the fetal birth weight, the likelihood to receive an episiotomy. More efforts are needed to reduce the rate.

scholarly journals Characterization of the intensive care unit (ICU) admissions in the Benue State University Teaching Hospital.

2019 ◽  
Vol 6 (4) ◽  
pp. 126-128
Author(s):  
Michael Enokela Efu ◽  
Babarinde Ojo ◽  
Barnabas Agaba Eke ◽  
Gabriel Okpotu Anefu ◽  
Martha Amaka Ozoagu
Keyword(s):  
Intensive Care ◽  
Head Injury ◽  
Teaching Hospital ◽  
Oxygen Therapy ◽  
Developed Countries ◽  
University Teaching ◽  
Haemodynamic Monitoring ◽  
State University ◽  
Anaesthesia Department ◽  
Study Population

Today, intensive care units (ICUs) of most hospitals in developed countries have become separate departments staffed by career intensive care physicians or intensivists from various fields of medicine. In Nigeria, however, ICUs are still part of the anaesthesia department and critical care constitutes a significant part of the workload and responsibilities of anesthetists. This study was carried out to ascertain the types of disease conditions that were brought into the ICU for management at the Benue State University Teaching Hospital (BSUTH), interventions undertaken as well as the outcome of such admissions. A total of 125 patients were evaluated. The age bracket between 21 and 30 years recorded the highest figure of 28 accounting for 22.4% of the study population. This was followed by the age bracket between 31 and 40 years with 24 representing 19.2%. The study population was made up of 81 males and 44 females making up 64.8% and 35.2%, respectively. The most frequent conditions occasioning ICU admissions are post laparotomy (24.8%), head injury (18.4%), and burns (11.2%). A total of 289 interventions in various combinations were carried out on these patients. Of these, monitoring of the patients was undertaken 106 times, representing 36.7%. Oxygen therapy followed closely with 102 (35.3%). The lowest number of days spent by patients in the ICU in this study, was 1, while the longest was 35 with a mean of 5.97 days ± 7.76 days. Majority of the patients, 68, were discharged from the ICU to the wards making up 54.4% of the study population. This was closely followed by those that died, 50, accounting for 40.0% of the study population. This study has established that in our ICU, the most common indications for admission were post-laparotomy, head injury and burns. Also, it has been observed that most of the patients underwent haemodynamic monitoring and oxygen therapy. Finally, while most patients admitted were discharged to the wards, a good number also died in the ICU.

scholarly journals Are Fresh Stillbirths from Caesarean Sections Associated with Socioeconomic Status? A Case Control Study at the University Teaching Hospital in Lusaka, Zambia

2020 ◽  
Vol 4 (2) ◽  
pp. 1-5
Author(s):  
Kenneth Chanda ◽  
◽  
Bellington Vwalika ◽  
Aubrey Shanzi ◽  
◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Caesarean Section ◽  
Low Socioeconomic Status ◽  
Developed Countries ◽  
University Teaching ◽  
Middle Income ◽  
Low Socioeconomic ◽  
Middle Income Countries ◽  
The University ◽  
Control Study

Introduction: Stillbirths occur worldwide at a rate of 3.2 million per year. There is however lack of interest in stillbirths especially those from caesarean sections. The discrepancy of high stillbirth rates from caesarean sections in low to middle-income countries as compared to developed countries may indicate the influence of socioeconomic status. This study was designed to investigate if socioeconomic status is associated with caesarean section fresh stillbirths. Methods: The study involved 330 women who underwent emergency caesarean sections from October 2013 to August 2014. Of these, 110 were cases and 220 were controls. Data collection was done using an interviewer-administered questionnaire in the immediate postoperative period. Results: Low socioeconomic status was associated with increased odds of caesarean section fresh stillbirths. The association was however not statistically significant.

scholarly journals Spectrum of Congenital Abdominal Wall Defects in Neonates in a Teaching Hospital in Enugu, Nigeria

2021 ◽  
Vol 2 (1) ◽  
pp. 01-05
Author(s):  
Chukwubuike Emeka
Keyword(s):  
Abdominal Wall ◽  
Teaching Hospital ◽  
Abdominal Wall Defect ◽  
University Teaching ◽  
Abdominal Wall Defects ◽  
State University ◽  
Male Predominance ◽  
Congenital Origin ◽  
Low Incidence ◽  
Congenital Abdominal Wall Defects

Objective: To evaluate our experience on the pattern and treatment outcome of neonates who presented with congenital abdominal wall defects (CAWD) in a teaching hospital in Enugu, Nigeria. Methodology: This was a retrospective study of neonates who presented with abdominal wall defect of congenital origin between January 2014 and December 2018 at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria. Results: A total of 236,231 neonates were seen during the study period. Out of this number, 48 neonates had CAWD. This gave a prevalence of 0.02% or 2 babies per 10,000 births. There was male predominance and majority of the neonates were delivered preterm through the vaginal route. Omphalocele and gastroschisis were the most common CAWD and about 50% of the CAWD were diagnosed prenatally through maternal ultrasound. There was a low incidence of associated anomalies and only one-tenth of the mothers gave a history of a possible risk factor. Treatment of CAWD depended on the specific anomaly and sepsis was the most common post-operative complication. Mortality occurred in 8 (16.7%) neonates. Conclusion: Omphalocele and gastroschisis were the most common types of CAWD recorded in the present study. Most of the neonates were delivered vaginally as preterm babies. Treatment was based on the type of CAWD and majority of the neonates survived.

scholarly journals Decision-Delivery Interval for Emergency Caesarean Section at the Rivers State University Teaching Hospital

2020 ◽  
pp. 1-2
Author(s):  
S. Eli ◽  
D. G. B. Kalio ◽  
A. Dan- Jumbo ◽  
J. Ikimalo
Keyword(s):  
Caesarean Section ◽  
Teaching Hospital ◽  
Developed Countries ◽  
Fetal Outcome ◽  
Emergency Caesarean Section ◽  
University Teaching ◽  
State University ◽  
Cephalopelvic Disproportion ◽  
Emergency Caesarean ◽  
Rivers State

Decision-Delivery interval when carrying out emergency caesarean section (EmCS) cannot be over-emphasized especially with regards to maternal and fetal outcome. There are variety of factors that may contribute to these intervals such as logistics, personal delay, delay in obtaining of informed consent, lack of blood, and availability of theatre space. Aim: To determine the decision-delivery interval and causes of delay in EmCS at the Rivers State University Teaching Hospital (RSUTH). Methods: It was prospective study conducted at the RSUTH between July 1, 2018 to January 31, 2019. Information was obtained using a self structured questionnaire and analyzed using version SPSS 25. Results: There were 481 patients admitted into labour ward for the period under review of which 71(14.8 %) had EmCS. The mean age was 31 years. The commonest indication for EmCS was Cephalopelvic disproportion (CPD) represented by 23 (32.4%) of the subjects. The average time for decision - delivery interval was 1 to 2 hours represented by 29 (40.8%). The shortest decision - delivery interval was less than 30 minutes 1(1.3%).The decision – delivery interval time greater than 5 hours were 9 (12.7%). The 3 commonest reasons for delay with respect to average decision – delivery intervals were personal delay 21 (20.8%), logistics 19 (18.8%) and lack of blood 13 (12.9%). Conclusion: The study revealed that the average decision - delivery interval was 1 – 2 hours represented by 40.5% of the subjects. This was relatively long when compared to developed countries of the world. The commonest reason for delay in carrying out EmCS was personal delay (20.8%). The commonest indication for EmCS was CPD (32.4%). Addressing the reasons for the decision – delivery interval will help improve our practice and reduce adverse effects to mother and baby.

scholarly journals Childhood intussusception: Correlation between ultrasound reports and intra-operative findings

2021 ◽  
pp. 201010582110108
Author(s):  
Kevin Emeka Chukwubuike
Keyword(s):  
Pediatric Surgery ◽  
Bowel Resection ◽  
High Accuracy ◽  
University Teaching ◽  
State University ◽  
Accuracy Rate ◽  
Male Predominance ◽  
Number Of Patients ◽  
Enugu State ◽  
Operative Findings

Background: Intussusception, a common cause of intestinal obstruction in children, is usually diagnosed through ultrasound scan. The aim of this study was to evaluate the correlation between the ultrasound report and intra-operating findings in children who had laparotomy for intussusception. Materials and methods: This was a retrospective study of children aged 12 months and below who had laparotomy for intussusception between January 2017–December 2019 at the pediatric surgery unit of Enugu State University Teaching Hospital Enugu, Nigeria. Findings at ultrasound and findings at surgery were statistically compared. Results: A total of 103 cases of intussusceptions were seen during the study period. Out of this number, 69 patients were treated by laparotomy and formed the basis of this report. There was male predominance and the median age of the patients was 8 months. Abdominal pain was the most common presenting symptom. At presentation, about one-quarter of the patients were anemic while one-half of the patients had electrolyte derangement. Comparing the findings at ultrasound and findings at surgery, ultrasound was found to have an accuracy of 89.9%. Approximately, equal number of patients had manual reduction and bowel resection. Surgical site infection was the most common post-operative complication and mortality occurred in 8 (11.6%) patients. Conclusion: Ultrasound has high accuracy rate and is quite reliable for the diagnosis of intussusception.

scholarly journals Profile of Children Treated for Uncomplicated Intussusception in a Tertiary Hospital in Enugu, Nigeria

2021 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
Chukwubuike Emeka
Keyword(s):  
Imaging Modality ◽  
Abdominal Ultrasound ◽  
Tertiary Hospital ◽  
Hemoglobin Level ◽  
University Teaching ◽  
Common Symptom ◽  
State University ◽  
Hydrostatic Reduction ◽  
Male Predominance ◽  
History Of

Background: Intussusception is a common cause of intestinal obstruction in infants. The aim of study was to evaluate our experience in the management of children who presented with uncomplicated intussusception. Materials and Methods: This was a retrospective study of children (12 months and younger) who were treated for uncomplicated intussusception (ultrasound confirmed) between January 2014 and December 2018, at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria. Results: There were 255 cases of intussusception seen during the 5-year study period. Out of this number, 85 (33.3%) patients had uncomplicated intussusception. There was male predominance and the ages of the patients ranged from 4 to 12 months with a mean age of 6 months. Abdominal pain was the most common symptom in the patients. On the average, one-fifth of the patients had a preceding history of respiratory and enteral infection. Half of the patients had a hemoglobin level of less than 10g/dl at presentation. Abdominal ultrasound was the imaging modality of choice and was diagnostic in all the patients. Three-quarters of the patients were successfully treated by hydrostatic reduction and there was recurrence of intussusception in 2 patients. There was no mortality. Conclusion: Only one-third of our patients present with uncomplicated intussusception during the study period. Non-operative (hydrostatic reduction) treatment is an effective modality of treatment for uncomplicated intussusception.

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