West African journal of medicine
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The prescription pattern for post-operative pain and patients' experience with pain relief were studied in 200 adult patients who had anaesthesia and surgery at the University College Hospital, Ibadan. Intermittent intramuscular injection of analgesics were prescribed for 192 patients (96%) while other routes were intravenous injections (2%), intravenous infusion (1%) and intermittent epidural injection (1%). ⋯ It also made patients cry (20%), feel depressed (23%), anxious (12.5%) and angry (14.5%). Despite the high incidence of pain and the associated disturbances, 178 patients (89%) still found overall pain relief satisfactory.
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Nine patients presenting with end stage renal disease needing haemodialysis underwent jugular venous access at the Obafemi Awolowo University Teaching Hospitals Complex over a two year period. There were 7 males and 2 females with age range 22-66 years. ⋯ There was only one patient with catheter thrombosis and in another catheter related infection. Haemodialysis was maintained for periods ranging from 3 to 9 months in these patients satisfactorily.
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Three unusual cases of Neuroblastoma with metastasis to the skull and orbit are presented. The bizarre clinical features which make diagnosis and subsequent management difficult are highlighted, suggesting the need for a multi-disciplinary approach.
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A one year prospective study was carried out to compare clinical diagnosis antemortem with autopsy diagnosis post-mortem in all patients coming to autopsy. In the study period a total of 612 deaths occurred in the hospital out of which 179 came to autopsy representing an autopsy ratio of 29%. ⋯ We find the autopsy ratio abysmally low and recommend that all effort be made to increase it to 75% and that autopsy audit be officially adopted as a means of quality control in hospitals. We also believe that all concerned should work towards improving our clinical diagnostic ability in order to attain and maintain a concordance rate well above 90%.
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Majority of airgun injuries in the Kingdom of Saudi Arabia are accidental and involve children and adolescents. Potentially lethal penetrating injuries to the head often result from airguns. ⋯ CT is also useful in demonstrating the fracture at the entry site of the pellet and any bone fragment which may be propelled into the brain. Although there have been a few case reports of spontaneous migration of metallic foreign body within the brain in the world literature, this case highlight the speed with which it can occur, even in a patient on complete bed rest.