West African journal of medicine
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In a review of 94 paediatric patients treated for post-neonatal tetanus over a period of 11 years at the University College Hospital, Ibadan, Nigeria, reliable data regarding the care received for wounds that eventually resulted in tetanus was available in 58 patients. Seventeen of these patients had orthodox medical care for their wounds before developing tetanus. ⋯ All the 3 victims of road traffic accidents were given tetanus toxoid but none of the 6 patients with chronic suppurative otitis media had any form of tetanus prophylaxis. The findings highlight the adverse consequences of failure to adhere to basic guidelines for management of the tetanus-prone wound.
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A 5 year retrospective survey of deaths at the Accident and Emergency Unit was carried out to determine the demographic pattern, causes and time spent before demise. There were 475 deaths, annual rate of 95 cases. Males in 279 (58.8%) and 186 females (41.2%), age ranged from 15-90 years, mean 44 SD +/- 21 years. ⋯ Surgical acute abdomen with peritonitis occurred in 18 (36%) cases, pyomyositis with septicaemia in 7(133%), gastrointestinal bleeding 5 (10%) and burns in only 3 (6.7%) cases In conclusion, over two-thirds of deaths in accident and emergency unit were due to medical problems. The means of the age were in late thirties- mid forties, there was no significant difference in the mean age of those who died of medical, trauma and surgical problems. Trauma victims spent the shortest mean time in accident and emergency before death, the longest staying were the victims of medical diseases.
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Randomized Controlled Trial Clinical Trial
The effect of parental presence at induction of anaesthesia on the behaviour of unsedated Nigerian children presenting for day-case anaesthesia.
The effect of parental presence at induction of anaesthesia on one hundred and eighteen children presenting for day-case inguinal operations and the behaviour of the attending parents at induction were studied. Of the 24 children aged 5 years and below whose parents at were present at induction, 25% were distressed, while 80% of 36 children of this age group whose parents were absent showed distress. ⋯ In both age groups induction heart rates were significantly higher in the children whose parents were absent. All parents except one who cried and another one who was too anxious, were helpful at induction and they would welcome the same opportunity to be present at the children's induction.
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Case Reports
Matchet cut injury at the wrist as a cause of traumatic radial artery aneurysm: a case report.
A sixty year old Yoruba farmer presented at Ela Memorial Medical Centre, Ilorin with recurrent spontaneous bleeding from traumatic left radial artery aneurysm. This was due to a clash between a Fulani Cattle rearer and the Yoruba farmer. This sort of situation is rampant across Nigeria. ⋯ Careless treatment of vascular damage could result into aneurysm formation. Medical personnel treating injuries should be aware of vascular injuries and refer the patient promptly for appropriate management. Communal disputes should be settled quickly before they lead to communital clashes which could lead to vascular injuries for which surgeons who could cope with such injuries are far-in-between in Nigeria.
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This is a review of patients who had cardiac arrest in the operating suites at the University College Hospital (UCH), Ibadan between January 1994 and December 1998. The main objectives of the study were to evaluate the incidence of intraoperative cardiac arrests, identify associated factors and, in particular, those factors that might be essential for better prognosis. The study was retrospective, descriptive and cross-sectional. ⋯ Of the 11(31.4%) elective cases, 5 (41.7%) made full recovery. Ten patients (28.6%) were ASA I & II, while 25 (71.4%) were graded ASA status III to V. The factors associated with cardiac arrest in this study included emergency operation and the ASA status.