Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.

Background: Globally, the population of the elderly is increasing and the greatest increase is occurring in the developing and middle income countries because of falling death rate and high birth rate. The ageing of the population in developing countries may result in increasing requirement for health care facilities including ICU care for the elderly. This study was aimed at assessing the pattern and outcome of elderly patients' admissions into the ICU of our hospital and identifies the determinants of outcome. Method: This was a retrospective study covering a 5 year period (January1 st 2010 to 31 st December 2014) in the ICU of a sub-Saharan tertiary hospital. Data was obtained from the review of ICU admission records over this period. We included as elderly patients aged 65years and above. Results: During the period under review, 90 cases were identified but only 62 cases were available for review (68.9%). There were 40 males and 22 females with ages ranging between 65 and 92years. Surgical admissions accounted for 75.8% of admissions while medical admissions were 24.2%. The overall ICU mortality in the elderly was 58.1%.The major predictors of mortality were: need for endotracheal intubation (p=0.001), mechanical ventilation (p=0.001), vasopressor (p=0.001), electrolyte derangement (p=0.001), sepsis on admission (p=0.001), shock on admission (p=0.001). Conclusion: Elderly patients admitted into the ICU are a population with an increased risk of mortality. The predictors of high risk of death are sepsis on admission, septic shock, need for vasopressor, endotracheal intubation and or mechanical ventilation and the presence of electrolyte derangement. The outcome of this study calls for a need to pay more attention to this rapidly expanding group of the population.

Background: Open prostatectomy (OP) is still relatively common in developing countries and remains a useful benchmark against which the minimal access surgical techniques are compared. This study aims to document the indications and outcomes of OP in a typical developing economy. Method: The records of patients with benign prostate hyperplasia (BPH) who had OP in our university teaching hospital between July 2004 and June 2014 were retrospectively reviewed. Some analyzed parameters include the demographic characteristics, indications, pre-operative work-up, anaesthetic techniques, OP type, complications, histopathology results and follow-up duration. Results: A total of 247 cases were studied. Mean age was 67 years while the commonest surgery indication was recurrent acute urinary retention. Average prostate specific antigen (PSA) was 8.4 ng/ml while hypertension was the most common co-morbidity (44.1%). Regional anaesthesia was mainly used (79.4%) while retropubic prostatectomy was the commonest OP type done (58.7%). The enucleated specimen weighed above 60 g in 91.9% of cases. All our patients were able to micturate spontaneously with urine stream above 20 mls/second on follow-up one week after discharge. Mean duration of hospital admission and follow-up were 7 days and 9 months respectively. Complications occurred in 90 patients (36.4%), of which surgical site infections were the commonest (9.8%). There was 0.4% mortality. Histopathology results showed BPH (95.5%), (incidental) prostate adenocarcinoma (2.4%) or prostatic intra-epithelial neoplasia (2.1%). Conclusion: OP remains an important therapeutic option for management of BPH in developing countries partly due to relatively large prostate size and presence of BPH complications from late presenta-#

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Our data suggest that PRO sedation is safe when used for outpatient diagnostic colonoscopy in low-resource settings with better patients and physician satisfaction. The synergistic sedative effect of midazolam and/or opioids combined with PRO help reducing the dose of PRO used with better recovery.