Critical Care in Sub-Saharan Africa, Where Are We? A Review.

Critical care services in sub-Saharan Africa have not gained much grounds despite becoming part of modern clinical practice in the 1950s. Managing patients with potentially recoverable illnesses and injuries is still not at par with evidence-based practices in developed climes, and most die from many preventable causes. Many hospitals in Africa do not have an intensive care unit, leaving critically ill patients being treated mostly in the general wards.

Characteristics of Critically Ill Elderly Patients Admitted to a Tertiary Intensive Care Unit in Nigeria and Outcome of Management.

Background: The management and outcome of elderly patients aged 65 years and above admitted to the intensive care unit (ICU) are often complicated by the presence of co-morbidities and reduced physiological reserve.

Methodology: This was a retrospective, case-control study. Patients aged 65 years and above admitted to the unit from January 2012 to June 2013 were included in the study.

Idiopathic Cerebrospinal Fluid Rhinorrhoea (An Uncommon Diagnosis): A case report and a Review of the Literature.

Cerebrospinal fluid (CSF) rhinorrhoea is often seen among head injured patients from road traffic crashes or physical assault, and sometimes it is a complication of nasal surgical procedures. Intracranial tumours may also result in CSF leakage. Blood stained rhinorrhoea often occur at the time of initial insult or injury, while CSF rhinorrhea may be a delayed manifestation.

Investigating management choices for canine heartworm disease in northern Mississippi.

Background: There are concerns that the chronic use of macrocyclic lactone preventives to kill adult heartworms ("soft-" or "slow-kill") may have contributed to the development of macrocyclic lactone resistance. This prospective analysis was designed to expand our understanding of currently employed treatment decisions, protocols utilized in a "slow-kill" methodology, and trends in heartworm prevention in a region with concerns about macrocyclic lactone resistance. We tested the hypothesis that practitioners underestimate the actual percentage of heartworm-positive dogs treated with "slow-kill" therapy.

A comparative study of ketamine gargle and lidocaine jelly application for the prevention of postoperative throat pain following general anaesthesia with endotracheal intubation.

Background: Postoperative throat pain is an established complication of general anaesthesia with endotracheal intubation. We thus sought to determine the incidence of postoperative throat pain and the efficacy of lidocaine jelly and ketamine gargle in the prevention of postoperative throat pain.

Materials And Method: One hundred and fifty ASA I or II, male: female ratio of 1:2 patients, aged18 -64 year, scheduled for elective general surgery requiring general anaesthesia with endotracheal intubation were randomly recruited into two groups, ketamine (K group) and lidocaine (L group).

CardioPulmonary Resuscitation in Children: Outcome in a General Intensive Care Unit in Nigeria.

Background: Cardiopulmonary resuscitation (CPR) is the initiation of basic and advanced life support to restore spontaneous circulation after cardiac arrest. It is one of the most frequently performed procedures in the intensive care unit both in the adult and paediatric population. There are, however, significant differences in the aetiology of cardiac arrest and CPR in both age groups.

Cardio-pulmonary resuscitation in the intensive care unit: An experience from a tertiary hospital in Sub-Saharan Africa.

Background: Cardiopulmonary resuscitation (CPR) is one the most commonly performed procedures in the intensive care unit (ICU). However, success rate of CPR vary widely from 3.1% to 16.

BLOOD TRANSFUSION IN CRITICALLY ILL PATIENTS IN AN INTENSIVE CARE UNIT OF A TERTIARY HOSPITAL IN NIGERIA.

Objective: To evaluate the use of whole blood and blood products in our ICU to determine patterns and outcome after transfusion.

Design: A retrospective, case-control study.

Setting: The Intensive care unit (ICU) of the University of Benin Teaching Hospital, a seven-bed open unit for the management of surgical, medical and paediatric patients.

The effects of dexamethasone and metoclopramide on early and late postoperative nausea and vomiting in women undergoing myomectomy under spinal anaesthesia.

Background: Post-operative nausea and vomiting (PONV); early or late, has detrimental effects on surgical patients such as surgical wound disruption, esophageal tear and delayed discharge from the post anesthetic care unit. This study evaluated the effects of dexamethasone-metoclopramide (DM) in the prevention of early and late PONV in women undergoing myomectomy under subarachnoid block.

Materials And Methods: Following approval from the Research and Ethics Committee of the Hospital, informed consent was obtained from each prospective patient.

THE NEED FOR FAMILY MEETING IN THE MANAGEMENT OF PATIENTS ADMITTED INTO THE INTENSIVE CARE UNIT: EXPERIENCE FROM A TEACHING HOSPITAL IN NIGERIA.

Objective: To evaluate the knowledge of family members of patients admitted into the Intensive Care Unit (ICU) in terms of their patients' clinical state, reasons for admission and progress of treatment.

Design: Prospective, cross-sectional study.

Setting: General Intensive Care Unit of the University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.

Effectiveness of heat moisture exchangers (hmes) in preventing perioperative hypothermia among adult patients undergoing abdominal surgery under general endotracheal anaesthesia.

Background: Heat Moisture Exchangers (HMEs) conserve heat and moisture during expiration and make this available to inspired gases during subsequent inspiration. We sought to evaluate the effectiveness of HMEs in the prevention of perioperative hypothermia in patients scheduled for abdominal surgery under general anaesthesia relaxant technique with endotrachael intubation (GART.)

Setting: Lagos University Teaching Hospital, in Modular theatre, Anaesthesia unit.

Characteristics and outcome of stroke patients with cerebrovascular accident at the intensive care unit of a tertiary hospital in Nigeria.

Background: Patients with severe stroke defined as NIHSS score >17 constituting about 15-20% of cerebrovascular accident require admission into the Intensive Care Unit (ICU). However the benefit of ICU admission for stroke patients remains controversial. Aim & Objectives: To determine the characteristics and outcome of patients with cerebrovascular accident managed at the Intensive Care Unit of University of Benin Teaching Hospital.

Tramadol effects on perioperative shivering in lower limb orthopaedic surgeries under spinal anaesthesia.

Background: Shivering is one of the common complications of regional technique. Although shivering may have beneficial thermoregulatory effects, it places the patient under increased physiological stress.

Aims And Objectives: The study evaluated the efficacy of intravenous tramadol in the prevention and treatment of post-anaesthetic shivering following subarachnoid block for lower limb orthopaedic procedures.