Clinical presentation and short-term outcomes of multisystemic inflammatory syndrome in children in Lagos, Nigeria during the COVID-19 pandemic: A case series.

Background: Multisystemic inflammatory syndrome in children (MIS-C) has increasingly been documented globally with the progression of the COVID-19 pandemic and a significant proportion of cases have been noted in children of Black descent. There has been a noticeable discrepancy in the presentation and outcomes of COVID-19 infection in sub-Saharan Africa compared to the rest of the world. We documented the demography, clinical features, laboratory and imaging findings, therapeutic management, and short-term outcomes of paediatric patients with MIS-C diagnosed during the COVID-19 pandemic in Lagos, Nigeria.

An overview of intensive care unit services in Nigeria.

Purpose: To have a current overview of the state of critical care services in Nigeria, with a view to having information about the basic infrastructure, personnel, equipment, and processes in place to complement the acute peri-operative and medical emergencies in Nigeria.

Materials And Methods: This was a cross-sectional survey of public and private intensive care units (ICUs) in Nigeria at the instance of the Intensive and Critical Care Society of Nigeria. Structured questionnaires were sent and collated over a 4-month period.

Challenging Airway Management in a Patient with Retrosternal Goiter Presenting in Respiratory Distress.

A number of options exist for patients with anticipated difficult intubation on account of a retrosternal goiter compressing on the trachea. The chosen technique(s) to secure the airway in this delicate situation often depends on the location and degree of airway obstruction, available resources/facilities, and an anesthetist's experience and preferences. We report the case of a 68-year-old woman with severe airway obstruction from a retrosternal goiter coming for total thyroidectomy.

NEBULIZED MAGNESIUM VERSUS KETAMINE FOR PREVENTION OF POST-OPERATIVE SORE THROAT IN PATIENTS FOR GENERAL ANAESTHESIA.

Background: Sore throat is a common post-operative complaint which can cause significant distress and morbidity. We tested and compared the efficacy of nebulized Magnesium and Ketamine on the incidence and severity of sore throat within the first 24 hours after general anaesthesia.

Objective: To compare the incidence and severity of post-operative sore throat at 2, 4, 8, 12 and 24 hours after extubation following pre-induction administration of nebulized Magnesium and Ketamine.

The Effect of Single-Dose Bupivacaine on Postoperative Iliac Crest Graft Donor Site Pain.

Background: Postoperative donor site pain remains a major source of morbidity following iliac crest bone graft harvesting (ICBGH).

Aim: The aim of this study was to investigate the effect of single-dose infiltration of bupivacaine on donor site pain following ICBGH.

Subjects And Methods: This study was a double-blind randomized controlled trial of 30 adult individuals that required an ICBG as part of the treatment for mandibular reconstruction.

RANGE OF MOUTH OPENING AMONG THREE MAJOR ETHNIC GROUPS IN NIGERIA.

Background: Maximum mouth opening (MMO) is an important parameter in the assessment of several clinical situations and its measured value is documented to have racial, gender, age and anthropometric variation.

Objective: To determine the maximal mouth opening and its predictors among the different major ethnic groups in Nigeria.

Methods: Study subjects were 449 adults (232 males, 215 females), age range 18-74 years from the three major ethnic groups in Nigeria.

Nigerian surgical outcomes - Report of a 7-day prospective cohort study and external validation of the African surgical outcomes study surgical risk calculator.

Background: Surgical outcomes study for individual nations remains important because of international differences in patterns of surgical disease. We aimed to contribute to data on post-operative complications, critical care admissions and mortality following elective surgery in Nigeria and also validate the African Surgical Outcomes Study (ASOS) surgical risk calculator in our adult patient cohort.

Materials And Methods: We conducted a 7-day, national prospective observational cohort study in consented consecutive patients undergoing elective surgery with a planned overnight hospital stay following elective surgery during a seven-day study period.

In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study.

Aims: Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level.

Methods: Prospective analysis of data collected during an international seven-day cohort study of 474 hospitals in 27 countries.

AN AUDIT OF ORAL AND MAXILLOFACIAL PROCEDURES UNDER GENERAL ANAESTHESIA AT THE UNIVERSITY COLLEGE HOSPITAL IBADAN, NIGERIA.

Background: Operating theatre time management is a constant source of tension among the healthcare professionals responsible for the use of the facility. It is important that all effort should be geared at optimal utilization of available resources and minimization of waste.

Aim: To appraise time management, frequency and duration of surgical procedures, frequency and determinants of blood transfusion in oral and maxillofacial surgery.

Inappropriate Intensive Care Unit admissions: Nigerian doctors' perception and attitude.

Background: Nonclinical factors are said to influence decisions to admit patients into the Intensive Care Unit (ICU). We therefore assessed the perception and attitude of Nigerian doctors working in the ICU about inappropriate admissions and request for admission in the setting of a full ICU.

Methods: An anonymous, self-administered questionnaire survey was carried out among doctors working in the ICU of 17 University Teaching Hospitals, in Nigeria.

Open-heart surgery programme in Nigeria: The good, the bad and the ugly.

The development of open-heart surgery (OHS) programme in Nigeria has followed the different economic phases. Starting from the oil boom era in the 70s to 80s when indigenous efforts led to the successful performance of the first set of OHS to the period of depressed economy in the 80s to 90s that witnessed a lull in the programme, the revamping of the programme that started in the mid-90s following intense collaboration with foreign groups is gradually being sustained. The aim of this article was to examine the current efforts at sustaining the development of OHS programme in Nigeria with a view to identifying various challenges and how such can be addressed.

Prevalence of Skin Diseases in Children with Human Immunodeficiency Syndrome Infection in Paediatric HIV Clinic of A Tertiary Hospital in Nigeria.

Background: HIV infection/AIDS being a multi-systemic disease affects the skin at various stages in course of the illness. A knowledge of the common skin diseases associated with HIV infection can lead to early detection, appropriate staging and commencement of appropriate care in the infected patients.

Objective: The study was to document the prevalence and pattern of skin diseases in children with HIV infection seen at the Paediatric department of a tertiary centre in Nigeria.

Prolonged intensive care unit stay after coronary artery bypass graft surgery: Role of perioperative factors.

Introduction: Long stay in the Intensive Care Unit (ICU) after coronary artery bypass graft (CABG) surgery has been found to result in increased hospital mortality, poor long-term prognosis, prolonged hospital stay, and consequently, high cost and expenses. We, therefore, reviewed CABG surgery performed at the Madras Medical Mission Chennai, India, during a 3-month period to determine perioperative factors that are significant predictors of prolonged ICU admission.

Methods: We retrospectively studied patients who had elective CABG surgery from November 2008 to January 2009.

Randomized Controlled Trial comparing Dressing and No Dressing of Surgical Wound after Cleft Lip Repair.

Background: Cover wound dressings are regarded as important postoperative care following surgical intervention. Opinions differ on whether the cleft lip repair wound should be routinely covered by dressings or not. Therefore, a well designed randomized controlled trial is required to determine if routine cover dressing offers a better outcome.

Hemodynamic monitoring in Nigerian patients undergoing high-risk surgery.

Background: Hemodynamic monitoring (HM) and optimization of cardiac output and parameters of dynamic fluid responsiveness is said to improve perioperative outcome in high-risk surgical patients (HRSP). There is insufficient data to determine the burden of care and HM practices in HRSP in Nigeria. Hence, the need to assess and document the current hemodynamic management practices of anesthetists in Nigeria regarding patients undergoing high-risk surgery.

Intra-Operative Airway Management in Patients with Maxillofacial Trauma having Reduction and Immobilization of Facial Fractures.

Background: Despite advancements in airway management, treatment of fractures in the maxillofacial region under general anesthesia remains a unique anesthetic challenge. We reviewed the pattern of airway management in patients with maxillofacial fractures and assessed those challenges associated with the different airway management techniques employed.

Materials And Methods: The anesthetic chart, theatre and maxillofacial operations records of patients who had reduction and immobilization of various maxillofacial fractures over a 2-year period were reviewed.

Do abnormal findings on hystero-salphingographic examination correlate with intensity of procedure associated pain?

The aim of this study is to determine if the intensity and nature of pain during Hystero-Salphingography could give a clue to the presence of abnormal finding/s. Eighty-two patients were recruited over a six-month period. Procedural pain was assessed using the numeric rating scale.

Quality of Referral Letters to the Paediatric Department of a Tertiary Hospital in Nigeria.

Background: The referral letter is a flexible means of transmitting information about the care of patients from one healthcare worker to another. In developing regions of the world like Africa, where it may serve as the only means of transferring patient's information, the referral letter has infrequently been studied.

Objective: The study is to assess the quality of referral letters to the Paediatric department of a tertiary hospital in Nigeria.

Effects of varying doses of tramadol on gastric pH.

Background: Tramadol is licensed primarily as an analgesic, but has additional properties, one of which is the ability to increase gastric pH. However, it has not been established if this action is dose related, hence we set out to provide further evidence about this action of tramadol.

Patients And Methods: Fifty-five female adult patients presenting for gynecological surgery were randomized into three groups.

Paediatric acute kidney injury in a tertiary hospital in Nigeria: prevalence, causes and mortality rate.

Background: The modest decline in child mortality in Africa raises the question whether the pattern of diseases associated with acute kidney injury (AKI) in children in Nigeria has changed.

Methods: A database of children, aged between one month and 16 years, with AKI (using modified pediatric RIFLE criteria) was reviewed. The cause of AKI was defined as the major underlying disease.

PERCEPTION OF NIGERIAN ANAESTHETISTS ON INTRA-OPERATIVE DEATH.

Background: Intra-operative death is an unusual devastating occurrence in anaesthetic practice, and it is of serious concern when it happens.

Objectives: To assess the causes, the effects and the perception of Nigerian anaesthetists to intra-operative death.

Design: A cross-sectional and questionnaire-based study.

ICU Cutilization by Cardio-Thoracic Patients in a Nigerian Teaching Hospital: Any Role for HDU?

Background: The underlying pathological conditions in cardio-thoracic patients, anesthetic and operative interventions often lead to complex physiological interactions that necessitate ICU care. Our objectives were to determine the intensive care unit (ICU) utilization by cardio-thoracic patients in our centre, highlight the common indications for admission; and evaluate the interventions provided in the ICU and the factors that determined outcome.

Materials And Methods: The intensive care unit (ICU) records of University College Hospital, Ibadan for a period of 2 years (October 2007 to September 2009) were reviewed.

Anaesthesia for emergency Caesarean section in a patient with peripartum cardiomypathy.

Peripartum cardiomyopathy (PPCM) is defined as the onset of acute heart failure without demonstrable cause in the last trimester of pregnancy or within the first six months after delivery. We report a case of PPCM (LVEF < 39%) in a 30-year-old housekeeper requiring emergency Caesarean section, who was successfully managed with combined spinal-epidural anesthesia, using low-dose fentanyl for the spinal anesthesia.

Clinical audit of knowledge and practice of epidural labour analgesia amongst obstetricians in south-west Nigeria.

Epidural analgesia (EA) is the most ideal method for pain relief during labour. We sought to highlight the current knowledge and practice of the obstetricians regarding epidural labour analgesia (ELA). An audit was conducted amongst obstetricians in two teaching hospitals in the south west of Nigeria.