The Nigerian postgraduate medical journal
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Niger Postgrad Med J · Mar 2004
Profile of and control measures for paediatric discharges against medical advice.
Children are minors in health decision- making and discharges against medical advice (DAMA) may portend adverse health, social and psychological consequences . This study was aimed at ascertaining the prevalence rate and the determining clinical, sociodemographic factors as well as caregivers' perceptions associated with paediatric DAMA with the view of proferring possible control measures. ⋯ DAMA is of multifactorial aetiology, involving clinically heterogeneous patients who may be critically ill or partially recovered. Socioeconomic, quality and cost of health care are implicated. This study recommends some control measures.
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Niger Postgrad Med J · Mar 2004
Frequency and predictors of autonomic dysfunction in Parkinson's disease: a study of African patients in Lagos, Nigeria.
The degenerative changes in PD also affect the autonomic nervous system. The frequency and predictors of such involvement in Africans with PD has not been reported. ⋯ Autonomic dysfunction was found to be common in Africans with PD, particularly those above 65 years and tends to affect the parasympathetic system. However, the abnormality may be detectable even before symptoms appear. As such, we recommend that cardiovascular tests of autonomic function be a routine aspect of the evaluation of PD patients, especially with advancing age.
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We report a case of fractured internal jugular catheter, a rare but life threatening complication of the use of intravascular catheter in a 73 year-old man. He had an internal jugular catheter in-situ for nine months, much longer than the manufacturer's recommended duration.
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Niger Postgrad Med J · Sep 2003
Case ReportsNegative pressure pulmonary oedema following tracheal tube obstruction in a paediatric patient: a preventable anaesthesia related morbidity.
The purpose of this study is to describe negative pressure pulmonary oedema due to undetected tracheal tube obstruction in a paediatric patient. A healthy 6 week-old scheduled for release of tongue-tie under general anaesthesia was noticed to be diagnosed at the preparation of the surgical site. The patient was quickly assessed, and ventilation with 100% oxygen was commenced. ⋯ Clinical examination after 8 hours of oxygen therapy indicated stable vital signs and was discharged to the ward. Undetected tracheal obstruction due to unsupervised patient positioning may result in negative pressure pulmonary oedema in a paediatric patient. Improved communication between the surgical and the anaesthetic teams may prevent this morbidity.
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Niger Postgrad Med J · Sep 2003
Impact of maximal cervical dilatation at primary caesarean delivery on mode of delivery in the following pregnancy.
The maximum cervical dilatation achieved by parturients who went through labour prior to their primary caesarean births were related to the mode of delivery in the subsequent birth to ascertain if there is a link between the two. The success rates of vaginal births after primary Caesarean sections (VBAC) for arrest and non-arrest disorders were also compared using information derived from the birth records of the hospital. ⋯ The maximum cervical dilatation reached before primary caesarean section did not significantly affect the success rate of VBAC in the subsequent delivery (x2 [trend] = 0.78, p = 0.68). Patients who had primary caesarean section for arrest disorder require full evaluation before being allowed to attempt vaginal birth in a subsequent pregnancy but the maximum cervical dilatation reached before primary caesarean section need not be factored into a decision for VBAC.