Subarachnoid lavage following inadvertent intrathecal injection of tranexamic acid

Tranexamic acid (TXA) is a commonly used antifibrinolytic drug during surgical procedures to reduce blood loss. An Inadvertent intrathecal injection of TXAmay lead to serious side effects including seizures and ventricular fibrillation with reported fatalities. We report a case of an inadvertentintrathecal injection of TXAwhich occurred as a result of similarities in appearance between TXAand heavy bupivacaine ampoules. The patient had subarachnoid lavage after experiencing back pain, systemic hypertension followed by generalized tonic clonic seizures

Screening for eye diseases in a University community in Southwest Nigeria

Background ­ University, a subset of the general population, will expectedly have common ocular problems as prevalent in the population. Knowing these problems as done through screening and health education during WSD activities in 2017 thus raise awareness for their prevention. This study was aimed at determining the types of eye defects in a university community. Methodology ­ A descriptive cross-sectional survey utilizing purposive serial selection to examine inhabitants of a university community. Socio-demographic information and detailed ocular examinations were carried out. Data analysis using SPSS Version 20 and cross tabulations with statistical significance derived using paired sample t-test at p values < 0.05 were done. Results ­ With n=140, 79(56.4 %) were males. Mean age was 26.7 + 11.5years. Majority were staffs (77.1%) with 62.1% having tertiary education. Normal vision was reported in (92.9%), while 5.7% had visual impairment with 1.4% uniocular blindness. Common ocular findings were allergic conjunctivitis (12.9%), glaucoma suspects (10.0%), Pterygium (3.6%), glaucoma/corneal opacity (2.1% respectively), and optic atrophy (1.4%). Conclusion ­Disorders seen were mostly avoidable. Incorporating eye health services into University Healthcare will control their occurrence allowing optimal job performance.

Evaluation of the role of bedside lung ultrasound versus chest x-ray in critically ill patients

Background: Although chest X-ray is the main imaging approach in many settings, many limitations for it exist. Ultrasound has quite similar performances to CT with many advantages. Methods: From January 2017 till May 2018, a prospective cohort study conducted in emergency ICU at Zagazig university hospitals including 124 critically ill patients older than 18 years with respiratory distress, cough, fever, or hypoxemia. We excluded from the study pregnant females, patients with massive chest wall emphysema or hematoma, morbidly obese and finally patients with risk of transportation. All patients underwent thorough physical examination, history, laboratory investigations & Chest radiology (X-rays, chest ultrasound & CT). We measured the sensitivity and specificity of chest ultrasound and chest X-rays in comparison with CT with measurement of the learning curve of chest US. Results: 124 patients were assessed for eligibility. 24 patients were excluded for different causes and 100 patients (69 males & 31 females) completed the study with mean age of 49.22±11.52 years. Regarding all study population, whatever diagnosis, sensitivity and specificity of chest ultrasound and chest X-rays were 91.4%, 98.3% and 61.7%, 96.2% respectively. Concordance of the results of ultrasound with results of X-rays and clinical diagnosis increased sensitivity, specificity and overall accuracy to highly comparable results with chest computed tomography. Sensitivity, specificity and accuracy of chest ultrasound increased with time and with number of patients. Conclusions: Chest ultrasound is reliable, quick, bedside, low-cost, non-invasive, non-ionizing, more accurate, and easily educated for early detection of chest diseases and their follow up

Age at Menarche among School Girls in Sokoto; Northern Nigeria

Background/Objectives: Menarche; the first menstrual period; is influenced by many factors including socio-economic status and rural or urban dwelling. The aims of the study were to compare the age at menarche between rural and urban girls and evaluate the anthropometric indices at menarche. Materials and Methods: A cross-sectional study of rural secondary school girls and urban school girls. A structured questionnaire was used to obtain information on their age at menarche and other relevant data. Their weights and heights were measured using computerized scales and calibrated walls. Results: Two hundred and twenty eight (228) rural girls and four hundred and eighty (480) urban girls that had attained menarche within a year were studied. Mean age at menarche for all the girls was 15.26 years. Mean menarcheal age for the rural and urban girls were 15.32 years and 15.20 years; respectively. Mean weight and height were 47.6 kg and 156.76 cm; respectively for the rural girls and 48.12 kg and 156.8 cm; respectively for the urban girls. There was no significance difference in age of menarche among the groups (P 0.05). Conclusion: The mean age at menarche for the school girls is 15.26 years. There was no difference in menarcheal age between the rural and urban school girls. Further longitudinal studies to compare rural school girls and urban school girls in private schools are required

Assessment of Existing Practices in the Operating Theatre in the Khartoum North Teaching Hospital; Sudan

This study; assessing existing practices in the operating theatre regarding hand washing; disinfection and sterilisation; was conducted at Khartoum North Teaching Hospital. As far as we know; this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition; planning and organising training courses in infection control should be seen as a priority

Radiological Changes and Progress in Patient with Pulmonary Tuberculosis Following Treatment with Daily Versus Intermittent Short Course Regimens

This is a prospective comparative randomized study carried out at Kosti teaching hospital 2006- 2008. Objectives: to determine the radiological findings and to evaluate the radiological progress in patient with pulmonary Tuberculosis treated with daily versus intermittent short course regimens. Methodology: A total of 275 smear positive new cases of Tuberculosis were enrolled and randomized in to two groups; intermittent group (A) and daily regimen group (B) .X-Ray film was done initially and at the end of treatment for each patient. Results: It was found that 31of the X-Ray films were normal. Concerning the progress of minimal lesion significantly high percentage improved to normal X-Ray 58in group A and 53in group B ; 42in group A and 40in group B stayed as minimal lesion. The results of far minimal lesion ; 8.3to moderate lesion; 33.3moderately advanced lesion and 25remained unchanged; while in the daily regimen ; 21improved to normal and minimal lesion ; 5.2to moderate lesion ; 27to moderately advanced lesion and 27.6. Statistical analysis revealed a significant difference between the two groups. Conclusion: Conversion of minimal lesions to normal X-Ray was significantly higher in the intermittent group and the conversion of far advanced lesions to normal was significantly higher in the daily regimen

Fractures pathologiques des membres; a propos de 43 cas Colliges sur 49 mois au service d'orthopedie-traumatologie de l'Hopital National Lamorde Niamey (Niger)

Introduction : Une fracture pathologique est une solution de continuite osseuse qui survient sur un os remanie. La fracture pathologique pose un double probleme : la gestion de la fracture et celle du processus pathologique fragilisant l'os. But : Le but de cette etude travail etait de contribuer a une meilleure connaissance des fractures pathologiques afin d'ameliorer la prise en charge. Materiels et Methode : Il s'agissait d'une etude prospective et retrospective lineaire; qui avait ete menee de Janvier 2003 a Janvier 2007.Durant cette periode de 49 mois ; qui avait concerne 43 patients. L'etude retrospective avait concerne 15 patients ; et l'etude retrospective 28 patients. Ont ete inclus dans cette etude les patients souffrants de fracture pathologique des membres; qui ont ete traites dans la periode de l'etude et qui avaient des dossiers exploitables. Resultats : Les fractures pathologiques touchent en grande majorite les adultes (age moyen 43 ans 5 mois).Le sexe masculin est legerement predominant; la couche socioprofessionnelle la plus affectee par ces fractures pathologiques est representee par les menageres. La douleur; la tumefaction et l'impotence constituent les principaux signes cliniques. La radiographie standard; face et profil; et la biopsie sont des examens permettant de faire le diagnostic. Le femur est le principal os touche : 26 cas sur 43. Les principales etiologies demeurent : les tumeurs osseuses malignes (37;2); l'osteoporose (23;2); l'osteomyelite 23;2; le rachitisme (6;2); l'osteogenese imparfaite (6;9) et la tumeur osseuse benigne (2;3). Le traitement a ete chirurgical dans 81;4des cas et orthopedique dans 18;6des cas. Conclusion : La prise en charge de la fracture pathologique des membres est souvent multidisciplinaire; et son but est de donner un meilleur confort au malade et de prendre en charge la maladie causale