East African medical journal
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Open simple prostatectomy has long been associated with large blood losses; hence allogeneic blood transfusion in this procedure is a standard practice world over. A review of literature suggests significant association between perioperative blood loss accompanying open simple prostatectomy and certain patient factors. The shortage of blood and blood products in our blood transfusion centres as well as the alarming risks of transfusion reactions and disease dissemination demanded a review of these factors with the aim of reducing morbidity associated with peri-operative blood loss and blood transfusion. ⋯ Open simple prostatectomy performed under spinal anaesthesia using Millin's (retropubic) technique is associated with minimal blood loss. The perioperative blood transfusion rate was 36.8%.
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To describe early postoperative complications of prostatectomy. ⋯ Open prostatectomy is the most performed procedure for the relief of lower urinary tract obstruction due to benign prostatic hyperplasia at Kenyatta National Hospital. Wound sepsis is the commonest early postoperative complication and the presence of diabetes mellitus significantly increases the risk of development of wound sepsis.
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Road Traffic Accidents (RTAs) are a major cause of morbidity and mortality in Kenya. Victims may suffer multiple injuries including maxillofacial injuries. In most developing countries RTAs are the leading cause of maxillofacial injuries. In an attempt to reduce RTAs, the government of Kenya has enacted a legislation requiring mandatory fitting of speed governors and safety belts by passenger service vehicles. ⋯ Interventional programmes targeting pedestrians and those in the third and fourth decades of life should be enacted.
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Case Reports
Neurological manifestations following partial excision in spinal meningioma: case report.
Presented here is a 16-year-old girl who was referred on 30th January 1996 with diagnosis of cord compression with spastic paraplegia with sensory level at T7/T8. CT scan myelogam confirmed soft tissue density mass displacing cord to the left with no dye being seen beyond T3. Thoracic spine decompressive laminectomy was performed on 1st January 1996 at Nairobi West Hospital extending from T3 to T6 level, which revealed a fibrous haemorrhagic tumour. ⋯ She was followed up by the author and other medical personnel in Mwea Mission Hospital where she eventually succumbed in 2005, nine years after her first surgery. This case is presented as a case of incompletely excised spinal meningioma to highlight some of the problems of managing spinal meningiomas when operating microscope and embolisation of tumours are not readily available. Also the family experienced financial constraint in bringing the patient for regular follow-up, and getting access to appropriate antibiotics, catheters and urine bags.
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To determine the rate of blood loss and its restitution during Caesarean section and make recommendations to improve our practice. ⋯ The rate of blood transfusion during Caesarian section is high. Antepartum haemorrhage and pre-eclampsia were predictable indications for major blood loss and transfusion. Major blood loss and transfusion rate were negligible in patients presenting with foetal distress, cephalo-pelvic disproportion and breech presentation.