West African journal of medicine
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This paper describes the anaesthetic management of a neonate with a posterior encephalocoele and discusses the management of problems encountered. The problems were difficult tracheal intubation, cardiac arrest and dislodgement of the endotracheal tube.
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Comparative Study
Recognition of the difficult airway in normal Nigerian adults (a prospective study).
Difficulty with laryngoscopy and intubation is known to be the most frequent cause of anaesthetic related deaths. Awareness of the possibility of difficulty would enable the anaesthetist to be adequately prepared. 57 "normal" adult patients were examined pre-operatively and at laryngoscopy using the Mallampatti (1985) and the Cormack (1984) classification respectively. The result showed that none of the patients was in the IV Mallampatti nor IV Cormack groups. ⋯ Intubation failed in these two patients. The majority of patients were classified as Mallampatti class I (68.42%) and Cormack grade I (63.16%). This in effect demonstrates that in most "normal" patients laryngoscopy and intubation should be fairly easy.
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In 914 consecutive medical admissions to Komfo Anokye Teaching Hospital, the prevalence of infection with Human Immunodeficiency Virus type I (HIV-I) and Human Immunodeficiency Virus type 2 (HIV-2) was 12.6%. The prevalence in females was twice that found in males. The infection rate was maximum in the age group 25-29 years for females (45%) and 30-34 years for males (29%). ⋯ The cases with HIV-2 infection tended to be older than those with HIV-I infection. For detecting HIV seropositivity in our patients the World Health Organization recommended case definition for AIDS in Africa gave a sensitivity of 32%, a specificity of 93% and a positive predictive value of 42%. The case definition gave the highest specificity and positive predictive values when cases of tuberculosis were not included in the analysis.
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This study evaluated, the influence of mode of delivery, obstetric analgesia and anaesthesia on the maternal plasma renin angiotension system (RAS) in the normotensive primigravidae (n-10) and those with Pregnancy Induced Hypertension (PIH) (n-18). A total of 56 plasma samples from these subjects were assayed for Plasma Renin Concentration (PRC) and Plasma Renin Activity (PRA), using the radio-immunoassay technique. The normotensive subjects had normal delivery, while their hypertensive counterparts were delivered vaginally under lumbar epidural analgesia (n = 10) and with Caesarean Section (n = 8). ⋯ The mean pre-labour PRC and PRA levels for the normotensive subjects were 5.73 +/- 0.25, and 3.56 +/- 0.13 ngml.1hr-1; and the post-delivery PRC and PRA values were 4.43 +/- 0.18 and 2.1 +/- 0.05ngml-1hr-1 respectively. The mean pre-labour PRC and PRA levels for the hypertensive subjects, who were delivered under epidural analgesia were 6.38 +/- 0.52 and 3.64 +/- 0.09 ngml-1hr-1 and the post-delivery values for this group were 5.04 +/- 0.21 and 2.34 +/- 0.07 ngml-1hr-1 respectively. The mean pre-labour PRC and PRA levels for the hypertensive subjects who were delivered by Caesarean Section were 5.87 +/- 0.36 and 3.83 +/- 0.36 ngml-1hr-1 and their post-delivery PRC and PRA values were 4.55 +/- 0.30 and 2.30 +/- 0.09 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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A radiology end of course assessment for 48 (60%) of 90 students in 3rd year medical course shows that 9 (19%) passed the pathological traumatic films, 36 (75%) passed the radiographic anatomy of oblique lumbar spine, 12 (25%) passed the normal contrast study of the female reproductive organ--Hysterosalpingogram, and an equal number passed the pathological rachitic bone. The poor performance results from lack of exposure to radiographic anatomy during course of traditional anatomy, inadequate time for teaching of clinical radiology and the relative under-estimation of the importance of radiology in medicine by students as well as the Medical Education Planners. Measures to correct these are presented.