African journal of medicine and medical sciences
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Advances in surgery have been possible worldwide largely due to specialized manpower, innovations in modern anaesthetic techniques and drugs. Shortage of specialist manpower in anaesthesia has continued in West Africa despite various available local postgraduate training programmes. This paper examines the impact of the West African Postgraduate Medical College (WAPMC) training programme on anaesthetic manpower development in the West Africa subregion. ⋯ The end point of the training produced 292 Fellows in the five-year period with only six in anaesthesia, i.e., 1 anaesthetist to 49 surgeons. Although the diploma programme of the same College produced 56 graduates in the study period, 53.6% of them were pursuing the Fellowship programme in tertiary institutions. Suggestions are proposed to redress the ever-widening gap between the number of specialist surgeons and anaesthetists in the West Africa subregion.
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Lead is a toxic trace metal but useful in a number of industries and occupations. In view of its wide usage appropriate attention to precautionary measures against excessive exposure is desirable. The study was carried out in two phases; one based in Southwest Nigeria involving 137 subjects comprising 86 occupationally exposed subjects and 51 controls. ⋯ Phase 2 study revealed that excessive use of alcohol and tobacco, undue exposure to exhaust from vehicles using leaded gasoline, exclusive use of wells as sources of drinking water and increased consumption of the Nigerian table salt may all be pathways for increased Pb burden in this environment. These data suggest Pb poisoning of a high magnitude arising from occupational and environmental factors probably largely due to high gasoline Pb. Precautionary measures appear desirable by all who are occupationally or environmentally exposed to Pb.
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The economic implications of safety precautions in laboratory practice make compliance difficult especially for laboratories in countries with poor economies. However, economic factors are not the only determinants of a safe work environment. Worker's perception of health and safety also influence compliance with safety guidelines. ⋯ The poor coverage of hepatitis B immunization among health care workers in an endemic area is currently a cause for concern among medical and paramedical staff. There is a need for education programmes to increase awareness on safety. Occupational health workers in this setting face the challenge of promoting safe work practices among workers in the face of the lack of funding and apathy among poorly paid junior workers.
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Comparative Study
Comparison of body temperatures taken at different sites and the reliability of axillary temperature in screening for fever.
This prospective study was carried out to compare temperatures taken at different sites and also to determine the reliability of axillary temperatures in screening for fever in healthy and febrile children under 10 years of age. The difference between the mean rectal and axillary temperatures was not significant in both healthy and febrile neonates (P > 0.05). However, in healthy and febrile children beyond the neonatal period the mean rectal temperature was significantly higher than the mean axillary temperature (P < 0.001), the difference between the mean axillary and oral temperatures was significant (P < 0.001) but there was no significant difference between the mean oral and mean rectal temperatures (P < 0.05). ⋯ It is concluded that unlike in older children axillary temperature in neonates correlates well with the core temperature and it is sensitive enough to detect fever. Axillary temperatures rather than rectal temperatures should be taken in neonates, while rectal or oral temperatures be taken in older children. When the axillary route is used, the thermometer should be left in place for at least 4 minutes.
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Comparative Study
Outbreak of neonatal Klebsiella septicaemia: a review of antimicrobial sensitivities.
A 10-week prospective study was undertaken to document the antibiotic susceptibilities of klebsiella organisms which were responsible for an outbreak of septicaemia on the neonatal units of the University College Hospital, Ibadan, Nigeria. The thirty-nine isolates obtained comprised K. pneumoniae, 18 (46.2%), K. aerogenes, 17 (43.6%), K. edwardsii, 3 (7.7%), and K. oxytoca, 1(2.5%). ⋯ Quantitative sensitivities of the three most commonly isolated sub-types to netilmycin were 63%, 36%, and 33%, respectively. A comparison with a previous antibiotic susceptibility study still showed persistent resistance to the available aminoglycosides.