The cause of preeclampsia remains unknown and calcium and magnesium supplement are being suggested as means of prevention. The objective of this study was to assess magnesium and calcium in the plasma and cerebrospinal fluid of Nigerian women with preeclampsia and eclampsia.Setting was University of Benin Teaching Hospital, in Nigeria. It was a cross-sectional study comprising of eleven patients and twenty-three controls. The mean, standard deviation and Standard Error of Mean (SEM) were calculated. Student 't' test method was applied.Plasma calcium was significantly lower in patients than controls (9.2 ± 1.02 Vs 9.98 ± 0.87mg/dl, P 0.043) "t" test. The CSF calcium and magnesium levels were lower in patients than controls, (5.66 ± 1.22 vs 6.67 ± 1.15mg/ dl, P 0.043 and 1.75 ± 0.56 vs 1.91 ± 0.19mg/dl, P 0. < 0.0001) respectively.There is extracellular calcium and magnesium reduction in patients with preeclampsia and eclampsia. This reduction may have a cause and effect relationship with these disorders. RÉSUMÉLe calcium extracellulaire et le magnésium au cours de la rééclampsie et l'éclampsie On ne connaìt pas toujours la cause de l'éclampsie et le calcium et le supplément de magnésium ont été suggérés comme moyens de prévention. Cette étude a pour objectif d'évaluer le magnésium et le calcium dans le plasma et dans le liquide céphalo -rachidien chez les femmes nigérianes qui souffrent de la prééclampsie et de l'éclampsie. Le cadre était le Centre Hospitalier Universitaire (UBTH) à Benin, au Nigéria. Il s'agissait d'une étude transversale qui comprenait onze patientes et vingt-trois témoins. L'écart type de la moyenne et l'Erreur Type de la Moyenne (ETM) ont été calculés. La méthode de test de 't' de l'étudiant a été appliqué. La calcium du plasma était moins élevé chez les patientes que chez les témoins (9,2±, 02 Vs 9,98 ± 0, 87mg/dl) le test de "t". Les niveaux du calcium et du magnésium du liquide céphalo-rachidien (LLR) étaient moins élevés chez les patientes que chez les témoins (5,66 ± 1, 22 Vs 6,67 ± 1, 15mg/dl, P 0,043 et 1, 75 ± 0, 56 Vs 1,91 ± 0, 19mg/dl, P 0, < 0, 0001) respectivement. Il y a une réduction du calcium extracellulaire chez les patientes souffrant de la prééclampsie et de l'éclampsie. Cette réduction pourrait avoir un rapport de cause et d'effect avec ces troubles. (Rev Afr Santé Reprod 2007; 11[2]:80-85).

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PPER airway patency is essential for normal respiratory function. The maintenance of a patent airway is dependent on the pharyngeal and laryngeal structures. However, during speech, deglutition, regurgitation and eructation, the laryngeal and epiglottis do close momentarily. This is a protective mechanism that occurs during normal respiratory activities. The morphologic structure of the upper airway is important in the maintenance of the patent airway during sleep and wakefulness. The nasal passage has a bony architecture with the cartilaginous larynx and extrathoracic trachea, which helps produce a conduit for inspiration and expiration of air during sleep and wakeful state. However, in some individuals, there is a loss of this protective mechanism. In these individuals, obstruction to airflow does occur during sleep. The degree and extent of the obstruction and the ensuing clinical state is variable but critically dependent on the dilator muscles of the pharynx. The pharynx due to its characteristic structures remains a potential zone for the interruption of airflow. The three anatomic segments of the pharynx (nasopharynx, oropharynx, hypopharynx) have compliant structures, are liable to collapse resulting in obstruction to airflow during sleep (obstructive sleep apnea). The objective of this course therefore, is to provide a synopsis of the anesthetic management of this rather challenging clinical syndrome.

P Pu ur rp po os se e: : To illustrate the anesthetic management of a term parturient with a large brain tumour scheduled for Cesarean section.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : A 26-yr-old woman presented at 33 weeks gestation with a generalized grand mal seizure. Magnetic resonance imaging demonstrated a 5-cm multi-lobulated extra axial mass compatible with an epidermoid cyst, arising from the left temporal lobe associated with shift of the midline structures and compression of the brainstem. She remained stable neurologically until elective Cesarean section at 38 weeks. Immediately prior to induction of general anesthesia, the proposed incision site was infiltrated with lidocaine and the supraglottic structures anesthetized with bilateral superior laryngeal nerve blocks. Remifentanil, thiopentone sodium and succinylcholine were administered in a rapid sequence fashion following voluntary hyperventilation to an endtidal CO 2 of 28 mmHg. Anesthesia was maintained with desflurane in oxygen/air and an infusion of remifentanil. Postoperative pain control was achieved using a multi-modal approach which included intraperitoneal deposition of local anesthetic, im ketorolac and rectal acetaminophen prior to emergence followed by regular administration of naproxen and acetaminophen for 72 hr.

There is a vast body of evidence to suggest that osteoarthritis is a heterogenous condition that involves not only the articular cartilage but also an adaptive response of the bone and the synovium to a variety of environmental, genetic and biomechanical stresses. 5-11 There is also growing evidence pointing towards long term potentiation as the most likely mechanism for the transition of acute nociception to a chronic pain (CP) state. The complexity and plasticity of the nociceptive system not only serve survival needs but also provide research opportunities for pharmacologic modulation of human suffering resulting from osteoarthritis.

Purpose:To evaluate the magnitude of subjective cognitive failure in the three days following general anesthesia (GA) for ambulatory surgery. Methods:After Research Ethics Board approval, 258 patients undergoing general anesthesia (GA) and 250 patients scheduled for local anesthesia (LA) were recruited from our ambulatory surgical unit. Following the method of Tzabar, Asbury and Millar, patients were asked to complete the cognitive failures questionnaire (CFQ) before their procedure (with respect to the previous three days) and on the third postoperative day (with respect to their recovery period).Results: General anesthesia and LA groups were similar in demographic make-up, except that the LA group contained more patients of American Society of Anesthesiologists physical status I (64.5% vs 52.7%, P < 0.05) and had significantly shorter procedure duration (25 vs 51 min, P < 0.01) than the GA group. Median preoperative CFQ scores (interquartile range) were 26 (18) for the LA group and 26 (18) for the GA group. Postoperative CFQ scores were 25 (20) for the LA group and 28 (22) for the GA group. There was no significant difference in preoperative CFQ score between groups (Mann-Whitney U). When preoperative and postoperative CFQ scores were compared, the small increase seen in the GA group was statistically significant (P < 0.05, Wilcoxon). Conclusion:A statistically significant impairment of cognitive function in the three days following GA, but not LA was found. However, the magnitude of this impairment was small, and is of doubtful clinical significance. Modern ambulatory anesthesia may cause less delayed cognitive impairment than was previously thought. Objectif

Osteoarthritis (OA) has been described "as a condition characterized by userelated joint pain experienced on most days in any given month, for which no other cause is apparent". The primary problem in OA is the damage to the articular cartilage which triggers a series of other events that culminate in pain and loss/limitation of function in the affected joint. OA is estimated to affect 70% to 80% of people older than 55 years. There is a vast body of evidence to suggest that OA is a heterogenous condition that involved not only the articular cartilage but also an adaptive response of the bone and the synovium to a variety of environmental, genetic and biomechanical stresses. Undoubtedly, pain which is the most prominent and disabling presentation of OA is an increasingly important public health problem especially with an increasing aging population.

P Pu ur rp po os se e: : To compare patient controlled inhalational induction (PCI) with the most commonly used sevoflurane induction technique, vital capacity inhalational induction (VCI).