West African journal of medicine
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Burns are a common home accident world-wide. Sixty-six patients in the Paediatric Department were treated by closed dressing and were followed up for a period of two months. The peak age was between 2-5 years with the causative agent being hot water. ⋯ Three patients died from sepsis (one patient) and probable electrolyte imbalances (2 patients). Other complications were few. The result show that closed dressing of burns in our experience definitely has advantages over the traditional open methods and is to be preferred.
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We review the development of anaesthesia in The Gambia from 1977 to 1992 and the role of nurse anaesthetists. The anaesthetists service provided over a one year period at the Royal Victoria Hospital, Banjul shows that 58.3% are for Obstetrics and Gynaecology (O & G) procedures, 38.06% for Surgical and Dental while 3.164% was Ophthalmology. ⋯ However anaesthesia for 65.6% of the general surgical and dental procedures required the expertise of a physician anaesthetist. The major problems associated with anaesthetic service delivery in The Gambia are highlighted and suggestions made on the future development of the specialty of anaesthesia.
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A case of Thecoma-fibroma secreting oestrogen to cause insulin intolerance in a post-menopausal woman is presented. Blood levels of sugar became normal 24 hours after removal of the tumor. The possible mechanism is presented.
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Case Reports
Problems in extubation of endotracheal tube in anaesthesia in the West African sub-region.
Three Retrospective Case Studies of the problems often faced with extubation of endotracheal tube during routine endotracheal anaesthesia is reported to alert anaesthetists about endotracheal tubes with intact and inflatable cuffs which could pose potential dangers to safety of patients in Anaesthetic practice, especially in the West-African Sub-region because of our practice of re-using both re-usable and disposable endotracheal tubes.
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Severe anaemia has remained a major cause of morbidity and mortality in children of Southern Ghana since the early 1960s. 71.1% of 15450 children attending the Korle Bu Teaching Hospital, Accra referred to the laboratory for haematological studies had haemoglobin (HB) levels below 11.0 Gm/dl while 27.7% of anaemic patients had Hb levels below 7.0 gm/dl. Indeed, 71.1% of children with severe anaemia had Hb levels below 5.0 gm/dl, thus requiring urgent blood transfusion. ⋯ Iron deficiency was the commonest cause of anaemia and contributed further to the anaemias of sickle cell disease and protein--energy malnutrition. In the light of the significant decline in the prevalence of childhood anaemia in the developed world following improved counseling in nutrition, fortification of foods with iron, and iron supplementation to infants and school children, and the documented attendant improvement in growth velocity and intellectual performance we support the planned national anaemia survey and recommend for early consideration iron supplementation to older infants and pre-school children at risk.