The Nigerian postgraduate medical journal
-
Indications for using central venous catheters (CVC) for haemodialysis include patients with: exhausted vascular access sites, no suitable vessels, failed peritoneal dialysis or short life expectancy. Catheter design and technology have changed in recent years to address the perennial problems of poor flow and infection. Permanent CVC offer a real alternative to arteriovenous access as 11-22% of long-term haemodialysis patients use CVC as their permanent vascular access. ⋯ CVC provide mean flow rates of 274-525 ml/min with a one year cumulative catheter survival of 47-93%. Tunnelled CVC provide a safe and effective long-term access for haemodialysis and are particularly suitable for use in developing countries. They are cheaper to maintain and remove the temptation to re-use disposable dialysis needles.
-
Niger Postgrad Med J · Jun 2001
Comparative StudyA comparative study of induction and recovery characteristics of propofol and midazolam.
Propofol and midazolam were compared in 40 adult patients in A. S. A. 1 or 2 presenting for short surgical procedures (< 70 minutes) with respect to induction time, pain on injection, apnoea, heart rates, blood pressure, oxygen saturation, time to eye opening on command. ⋯ Local reaction (phlebitis) was absent in the midazolam compared with 20% incident rate observed in the midazolam group. Propofol lowered blood pressure more than midazolam after three minutes of induction at a statistically significant level (P < 0.05). Recovery was significantly more rapid following propofol (P < 0.05).
-
Niger Postgrad Med J · Jun 2001
Case ReportsRight lobar pneumonia complicated by sub-phrenic abscess in a child.
A 14-year old boy presented with chest and abdominal pain and fever for one week. He had been treated with several antibiotics at home and in a peripheral hospital for respiratory infection. Physical examination showed features of right lobar pneumonia and peritonitis. ⋯ Subphrenic abscess complicating pneumonia is unusual but can be the cause of poor response to treatment. The diagnosis should be excluded in a child with pneumonia and persisting abdominal symptoms. Prompt treatment is necessary to avoid morbidity and mortality.