Background: To determine the incidence of Postoperative nausea and vomiting (PONV) in a high risk surgical group following studies in other predominately black populations that showed a lower rate of postoperative nausea and vomiting than that reported from Caucasian and Oriental populations. Methods: A retrospective observational survey was conducted in the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria to determine the incidence of PONV within forty-eight hours of anesthesia in an obstetrical (caesarean sections only) and gynecological population that underwent regional and general anesthesia. The study took place from December 2007-April 2009 (16 months) for the gynecological population and from May 2008 to May 2010 (25 months) for the obstetrical population. The folders of 300 patients were randomly reviewed for demographics, anesthetic technique, diagnosis and documented records of PONV within 48hours of anesthesia. Results: A total of 300 obstetrical and gynecological patients were used in this study. Twelve women vomited within forty-eight hours of anesthesia (12/300 or 4.0%). Nine patients vomited in the gynecological population (9/112) or 8% of the gynecological population and (3/186) or 1.6% in the obstetric population. All patients were American Society of Anesthesiologists (ASA) 1-4 including surgical emergencies. Conclusion: The incidence of PONV in this surgical population is lower than that from most of the studies reviewed. This might be due to an inherent ethnic/racial variation. The economic implication of spending on expensive anti-emetics means more money can diverted to other needs.
Vaginitis is the fungal infection of the vulva and or vagina caused mostly by Candida albicans. Itching, abortion, irritation of the vulva and vagina and white discharges from the vagina are the common symptoms. Thirty vaginitis symptomatic pregnant women attending antenatal clinic of Anambra State University Teaching Hospital Awka, Nigeria were sampled. They were aged between twenty and forty-five years. The Candida species were isolated, characterized and identified by standard biochemical and microbiological methods. The women aged 26-30 years had the highest percentage distribution of Candida species (63.3%) while those in their third trimester of pregnancy were mostly infected, with a percentage distribution of 63.3%. The vaginal candida species isolated from the women were Candida albicans (66.7%), Candida grabrata (23.3%), Candida tropicalis (6.7%) and Candida krusei (3.3%). Candida albicans occurred in all the age groups and trimesters of pregnancy. The pregnant women at great risk of vaginitis are those aged between 26 and 30 years as well as those in their third trimester of pregnancy. This calls for commitment to routine medical examination and appropriate treatment of the infected pregnant women.
Introduction: The study aimed to perform an audit of intensive care unit admissions in the paediatric cardio-thoracic population in Enugu, Nigeria and examine the challenges and outcome in this high risk group. Ways of improvement based on this study are suggested. Methods: The hospital records of consecutive postoperative pediatric cardiothoracic admissions to the multidisciplinary and cardiothoracic intensive care units of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria to determine their Intensive Care Unit management and outcome over a 2 year span -June 2002 to June 2004 were retrospectively reviewed. Data collected included patient demographics, diagnosis, duration of stay in the intensive care unit, therapeutic interventions and outcome. Results: There were a total of thirty consecutive postoperative paediatric admissions to the intensive care unit over the 2 year study period. The average age of the patients was 5.1 years with a range of 2 weeks to 13 years. Twelve patients had cardiac surgery with cardiopulmonary bypass (CPB), three patients had colon transplant, four patients had pericardiotomy/pericardicectomy, and five patients had diagnostic/therapeutic bronchoscopy. The remaining patients had the following surgeries, thoracotomy for repair of diaphragmatic hernia/decortications, delayed primary repair of esophageal atresia and gastrostomy. Two patients had excision of a cervical teratoma and cystichygroma. The average duration of stay in the intensive care unit was 6.2 days. Ten patients (33%) received pressor agents for organ support. Five patients (17%) had mechanical ventilation, while twenty-five patients (83%) received oxygen therapy via intranasal cannula or endotracheal tube. Seven patients (23%) received blood transfusion in the ICU. There was a 66% survival rate with ten deaths. Conclusion: Paediatric cardio-thoracic services in Nigeria suffer from the problems of inadequate funding and manpower flight to better paying jobs. Government should invest in their people by introducing insurance schemes for cardiac patients.Training programmes for members of cardio-thoracic units in countries with advanced health care systems and hands on experience should be encouraged. Otherwise for a majority of children with heart disease, it will be a slow painful wait for the inevitable.
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