ABSTRACT
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
Subject(s)
Humans , Injections, Spinal , Back Pain , Tranexamic Acid , Intracranial Pressure , Therapeutic IrrigationABSTRACT
Background: This study was aimed at comparing the duration and quality of epidural analgesia between plain bupivacaine alone with plain bupivacaine and tramadol in lower limb orthopaedic surgeries. Method: This was a prospective randomized double blinded control study involving 74 ASA I and II patients scheduled for elective lower limb orthopaedic surgeries. Group A (n=37) received 19mls of 0.5% epidural plain bupivacaine with 1 ml of water for injection, while group B received 19mls of 0.5% epidural plain bupivacaine with 1ml (50mg) of preservative freetramadol. The duration of analgesia was from the time of epidural block to the time of rescue analgesia. While, the quality of block was measured with Visual Analogue Scale (VAS) and Bromage scale. Results: Thestudy ages were between 16-60years,consisting of 22(60%) male and 15(40%) female in group A, while in group B 20 (54%) were male and 17(46%) female. It showed the mean duration of analgesia were 189.05±21.92min and 254.19±32.78min in group A and B respectively with p <0.01.The intra-operative VAS scores between the two groups did not show any significant difference between study groups (P> 0.05).The differences of grades of motor block and maximum sensory block height were not statistically significant (P=0.26) among the study groups. Conclusion: The addition of 50mg (1ml) of tramadol to plain bupivacaine epidurally prolonged the duration of analgesia and improved the quality of analgesia when compared to the use of bupivacaine alone
Subject(s)
Analgesia , Analgesia, Epidural , Bupivacaine , Comparative Study , Injections, Epidural , Nigeria , Orthopedics , Quality Control , Quality of Health Care , TramadolABSTRACT
Sickle cell disease is a global public health problem. L-arginine is an amino acid that helps in improving blood in the arteries of the heart and improved symptoms of clogged arteries, chest pain or angina and coronary arteries disease. Nitric oxide is a powerful neurotransmitter that helps blood vessels relax and improve circulation. The l-arginine and nitric oxide levels of sickle cell disease (SCD) subjects with steady stages were also significantly low. The objective of this study was to evaluate L-arginine and Nitric oxide levels in children with sickle cell disease at steady state for 8 weeks. This study included children with a confirmed HbSS electrophoretic pattern aged 1-14 years presented to the sickle cell clinic unit of Federal Teaching Hospital Gombe. The L-arginine and nitric oxide levels were significantly higher post supplementation compared to baseline levels (p = 0.002 and 0.000 respectively). It is recommended that L-arginine supplementation be included in the management of patients with sickle cell disease. L-arginine supplement should be made available in the paediatric emergency unit, clinic and pharmacy department as given to patients with sickle cell disease to prevent the adverse effects during the crisis and potentially reduce the length of stay in the hospital.
ABSTRACT
Background: The number of people found to be exposed to gasoline is of public health concern. In developed countries, unlike developing countries, measures are taken to dispense gasoline quickly and safely to reduce exposure. In Nigeria, roadside dispensers are a common sight, often with no any form of protection. This leads to high levels of exposure with the consequences including oxidative injuries. As cofactors in antioxidant reactions, antioxidant trace metals are consumed in the process of converting the free radicals generated by petrol. Methods: Antioxidant trace metals (zinc, manganese, copper, and selenium) were compared between 90 road side dispensers of gasoline and 90 matched controls. Plasma zinc, selenium, manganese and copper ware analyzed using Atomic Absorption Spectrophotometer (AAS). Results: The mean age of the exposed and control groups are 29.03±3.7 and 29.24±3.5 years respectively. Antioxidant trace metals zinc (64.7±6.09 µg/dl), manganese (7.93±1.32 µg/dl) and copper (77.8±7.38 µg/dl) of the exposed were significantly (p< 0.001) lower than the controls (100.2±9.58 µg/dl, 9.22±1.19 µg/dl and 103.8±20.09 µg/dl respectively). Selenium (0.03±0.008 µg/dl) was significantly (p< 0.001) higher in the exposed group compared to the controls (0.01±0.0023 µg/dl). Conclusion: This study has demonstrated lower level of antioxidant trace metals in roadside dispensers of gasoline compared to the controls. This indicates that those exposed are probably at greater risk of developing chronic diseases associated with increase oxidative stress. Enforcing legislation on roadside gasoline dispensing may reduce the risk.
ABSTRACT
Aim: The effects of infection with Trypanosoma brucei on renal and hepatic functions in early phase of disease were studied in experimentally infected pigs. The aim of this study was to identify serum biochemical changes that could serve as biomarkers of early renal and hepatic dysfunctions and also serve as basis for therapeutic management of T. brucei infections in man and animals. Study Design: A total of 15 growing pigs aged between 6 and 12 months old were used for the study. The pigs were selected at random into two groups. Group one was made up of seven animals and served as the infected group. The pigs were each infected with 1 x 106 parasites in 2mls of normal saline subcutaneously. The second group, made up of six animals, served as the un-infected control group. Place and Duration of Study: The pigs were housed in insect proof pens for two months while the experiment lasted. Methodology: Blood for serum obtained through venipuncture of the anterior venacava was used for determination of the serum total proteins, albumin, creatinine and urea concentrations as well as activities of alanine and aspartate aminotransferase post infection. Results: After infection there was a sharp increase in Total proteins (P = .05) accompanied by decrease in albumin but increase in globulin concentrations on Day 5. Increases in, serum creatinine and Blood Urea Nitrogen (BUN) concentrations and, activities of Alanine and Aspartate aminotransferases also occurred from this day. Conclusion: It was concluded that decrease in serum albumin concentration alongside increase in creatinine and urea levels as well as those of alanine and aspartate aminotransferase activities may be biomarkers of early onset of renal and hepatic pathology and determinants of ability to achieve self-cure from anemia in T. brucei infections of man and animals. This underscores the relevance of erythropoietin use in chemotherapy of African trypanosomiasis and the roles of renal and hepatic integrity in trypanotolerace.
ABSTRACT
The psychopharmacological effects of a saponin-rich fraction (SFG) obtained from crude methanolic extract of Ficus platyphylla stem bark were studied on spontaneous motor activity (SMA); pentobarbitalinduced sleep; motor coordination; amphetamine-induced hyperactivity and stereotyped behaviour; catalepsy; forced swim and tail suspension tests in rodents. SFG reduced SMA dose dependently; suggesting that it may contain psychoactive principles with sedative effects. The fraction shortened the onset and prolonged the duration of pentobarbital-induced sleep; which confirmed its sedative properties. The fraction diminished immobility time in forced swim and tail suspension tests; which is indicative of antidepressant properties. It attenuated amphetamine-induced hyperactivity and stereotyped behaviour; induced catalepsy and exacerbated haloperidol-induced catalepsy in rodents; but had no effect on motor coordination in the treadmill experiment at the doses tested. These effects were similar to those of classical neuroleptics and antidepressants. Our study provides scientific evidence of psychopharmacological effects of the saponin fraction of Ficus platyphylla stem bark and therefore supports further development of its psychoactive components as antipsychotics and antidepressants