African journal of medicine and medical sciences
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Case Reports
Pseudoangiosarcomatous squamous cell carcinoma in an old surgical scar of an African woman.
Squamous cell carcinoma, a malignant proliferation of keratinocytes, can be found in many regions of the body covered by stratified squamous epithelium and in areas covered by other epithelia but which had undergone squamous metaplasia. Squamous cell carcinoma has many variants. ⋯ This tumour can be found in Africans and in an old surgical scar. It can coexist with other variants of squamous cell carcinoma. There may be need in the future to add a new mixed variant to the current classification scheme.
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Randomized Controlled Trial
Analgesic effect of intrathecal neostigmine combined with bupivacaine and fentanyl.
The spinal route of analgesia has consolidated its place as a major modality in the management of both acute and chronic pain. The search for ideal additives to local anaesthetic agents to prolong the analgesic effects poses a challenge to the anaesthetists. Neostigmine, an anticholinesterase, presents a novel approach to providing analgesia. Neostigmine, when given intrathecally, inhibits breakdown of an endogenous spinal neurotransmitter, acetylcholine, thereby inducing analgesia. We aimed to determine the analgesic and adverse effects of intrathecal neostigmine combined with hyperbaric bupivacaine and fentanyl. ⋯ This study showed that spinal neostigmine 25 microg added to hyperbaric bupivacaine and fentanyl provided a significantly longer surgical analgesia and insignificant adverse effects in male adults who had lower abdominal surgery under spinal anaesthesia.
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This study presents the costs of injury from road crashes sustained by commercial motorcyclists in Oyo state, Nigeria. ⋯ The study showed that the costs of injuries were considerable. Efforts to prevent road crashes must be intensified to reduce the ensuing economic losses.
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Randomized Controlled Trial
Effects of intrathecally administered fentanyl on duration of analgesia in patients undergoing spinal anaesthesia for elective caesarean section.
Intrathecal opioids have gained popularity in obstetrics; they augment the analgesia produced by local anaesthetic agents. The aim of this study is to determine the duration of analgesia following addition of fentanyl to bupivacaine during elective Caesarean section. ⋯ We conclude that the addition of 25 microg of fentanyl to bupivacaine intrathecally for elective Caesarean section increases the duration of complete and effective analgesia thereby reducing the need for early postoperative use of analgesics.
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Validity and test re-test reliability of the neck disability index in the Nigerian clinical setting.
The neck disability index (NDI) is a valid and widely used clinical instrument, which enjoys the recommendation of the World Health Organization for outcome assessment in neck pain. Its psychometric properties have not been investigated in the Nigerian clinical setting. This study investigated the content validity and test-retest reliability of the NDI in order to encourage its integration in the Nigerian clinical setting. ⋯ Twenty four (75%) participants had mild to moderate disability, 7 (21.9%) had severe to complete disability and one individual had no disability. There was a significant correlation (r = 0.969, P=0.01) between the scores obtained from the first administration of the NDI and the second administration. The NDI is a valid and reliable outcome measure and it is recommended for integration into the assessment of neck pain in the Nigerian clinical setting.