West African journal of medicine
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1000 patients receiving subarachnoid anaesthesia for various surgical procedures were studied. The patients were followed up postoperatively and the incidence and severity of post-spinal headache determined. The overall incidence was 2.8%. It was higher in females than in males and decreased with increasing age.
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The incidence of chest trauma has increased significantly since the turn of the century especially in developed countries where rapid means of transportation has become part of daily life. Although gunshot wounds (GSWs) were the commonest causes of chest trauma in wartime, road traffic accidents (RTAs) have become the scourge of peacetime and modern civilization. Chest trauma is more common in males during the 2nd to the 5th decades of life with an average age of 40 years reducing their life expectancy by another 40 years at the most productive and active period of their lives. ⋯ Of the remaining 85%, five percent will require emergency thoracotomy for various reasons while 80% will respond to resuscitative measures and tube thoracostomy drainage alone. The primary aims in the management of chest trauma are prompt restoration of normal cardiorespiratory functions, control of haemorrhage, treatment of associated injuries and prevention of sepsis. Although the overall survival rate of trauma has improved in recent years, deaths are often due to airway obstruction, exsanguinating haemorrhage, flail chest, tension pneumothorax, cardiac tamponade and associated intracranial, intraabdominal and skeletal injuries.
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In an attempt to determine the extent to which cerebral palsy patients complied with doctors' recommendations, by regularly attending the follow-up clinics of the Paediatric Neurology Unit of the University of Nigeria Teaching Hospital (UNTH) Enugu, the records of the CP patients seen in the Unit during three years (1985-1987) were scrutinized. A very high default rate of over 88% was noted. Of the 155 CP patients registered during the period, only 18 were still attending the clinic by the end of 1988, the follow-up period ranging from 12 to 47 months. ⋯ There was no correlation between compliance and the type of CP, or the presence of other concurrent neurological disorders. It is thought that early recognition of factors that are associated with poor compliance is important. It will result in early identification of the group at risk for default, and in efforts being made to give them the support and advice that will enable them to benefit fully from the available services.
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The supply of Oxygen to hospitals in the West African subregion has been irregular for decades. This has added to the frustrations of Anaesthetists in the subregion. ⋯ Korle Bu Hospital, Accra, has been producing its own oxygen within the hospital since 1986. Oxygen Concentrators are recommended as a solution to a chronic problem.
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There is an overall shortage of physician anaesthetists in the West African Subregion. The non-physician anaesthetist (nurse anaesthetist) is used to provide adequate clinical service. ⋯ The Society of Anaesthetists of West Africa has therefore recommended that where possible nurses should not be involved in the administration of anaesthetics in the Teaching Hospitals. They should be placed out into intensive therapy units and recovery rooms.