African journal of medicine and medical sciences
-
To determine the anaesthesia-related complications after caesarean section in a tertiary hospital, the hospital records of parturients admitted to the Intensive Care Unit (ICU) after caesarean section were studied. In a ten-year period, 2,686 women were delivered by caesarean section at the University of Benin Teaching Hospital, Benin City. Two thousand one hundred and two (78.3%) had emergency caesarean section while 584 (21.7%) had elective caesarean section. ⋯ Total maternal deaths in the ICU admissions were 11(36.7%); anaesthesia being directly the cause of death in 3 (27.3%) while non-anaesthetic factors accounted for 8 (72.7%) deaths. Emergency caesarean section and GA, were risk factors for anaesthesia-related morbidities after caesarean section. Preventable deaths due to poor laboratory support services and inadequate anaesthetic materials accounted for the anaesthesia-related mortalities.
-
Four patients treated for cut-throat injuries are the subjects of this paper. Two were self-inflicted suicide attempts while one each was for ritual killing and over disputed farmland. ⋯ Significant laryngo-tracheal stenosis was a long-term morbidity suffered by two of the patients. Management of the airway in the early and late periods following the cut-throat injuries is discussed.
-
Vaginal birth (or trial of labour) after previous Caesarean delivery represents one of the most significant changes in obstetric practice. A five-year retrospective study was carried out at the Lagos University Teaching Hospital to determine the obstetric outcome after a previous Caesarean section and also to identify significant clinical factors that are predictive of successful subsequent vaginal delivery. Hospital records of 101 patients with previous Caesarean births and 105 patients without a previous Caesarean delivery were examined, the later group serving as control. ⋯ Uterine rupture/dehiscence occurred in 3 (2.97%) patients. No maternal or perinatal death occurred. We conclude from this study that trial of labour in carefully selected patients with previous Caesarean delivery poses low level of risk for both the mother and the baby and that its use is an important component of efforts to lower the rate of repeat Caesarean birth.
-
Clinically, the commonly used routine test for assessing impaired renal function is the determination of creatinine clearance. The traditional 24 hour urine collection method is unreliable and inconvenient, particularly in ambulatory patients and outpatients because of errors in collection, timing of collection, and measurement of urine volume. The purpose of this study was to evaluate the possibility of determining creatinine clearance from urine collected for less than the traditional 24 hours. ⋯ Each of the subjects had his creatinine clearance determined from 4 hour, 20 hour and 24 hour urine collections as well as from the formula of Cockcroft and Gault. The mean creatinine clearance obtained from 4 hour urine collection (male = 92.8 ml/ min/1.73 m2 & female = 84.5 ml/min/1.73 m2) and 20 hour urine collection (male = 98.9 ml/min/1.73 m2 & female = 88.6 ml/min/1.73 m2) shows no significant difference from that obtained from the traditional 24 hour urine collection (male = 97.9 ml/min/1.73 m2 & female = 88.1 ml/min/1.73 m2) (P > 0.05). We therefore suggest that determination of creatinine clearance from fewer hours of urine collection especially in patients with renal impairment be explored towards their adaptation to routine practice.
-
We conducted this study in order to determine whether suturing the scalp wound prior to referral for definitive surgery reduces the rate of wound infection in patients with compound depressed skull fracture and to propose guidelines for the initial management of the wound. We conducted a retrospective analysis of 79 patients with compound depressed skull fractures treated surgically in our unit between January, 1987 and August, 1998 and compared the rate of infection in patients who presented with open wounds with the rate in patients whose scalps were sutured prior to presentation to us. Adults and children were nearly equally represented in this study group. ⋯ In compound depressed skull fractures, suturing the scalp laceration alone prior to referral for definitive surgery did not reduce the rate of infection of the cranial wound. We recommend haemostasis, thorough irrigation of the scalp wound and application of sterile dressings prior to transfer for definitive management, in patients who do not have immediate access to neurosurgical care. Prospective studies are required to validate these findings.