An Audit of Anaesthetic Record Charts in the Orthopaedic Theatre of a Nigerian Teaching Hospital

Objective: The anaesthetic record is an essential part of a patient's record; providing useful information for the management of the patient. It is of medico-legal importance and can be used for quality assurance and researchpurposes. An analysis of anaesthetic record charts from a satellite operating theatre of the University of Port-Harcourt Teaching Hospital (UPTH) was undertaken to determine their legibility; correctness and completeness. Method: A retrospective analysis of the anaesthetic record charts from March 2003 to February 2004 of the orthopaedic theatre of the UPTH was undertaken. Results : A total of 232 anaesthetic record charts were analyzed. All entries were manually-written. Of these; 141 (60.9) were filled by anaesthetic registrars; the rest were filled by senior registrars 85 (36.5) and consultants 6 (2.6). One hundred and twenty-one charts (52.2) were legible; completely and correctly filled; but 47.8were incompletely filled; and 47.7had at least an illegible parameter. Conclusion: It is concluded from this analysis that the standard of anaesthetic record-keeping needs to be improved and consideration given to the use of computer-generated records which will eliminate the problems of illegible records

Total Intravenous Anaesthesia in a Developing Environment

Background: Total intravenous anaesthesia (TIVA) is a technique of anaesthesia which has become widely popular in the developed world with the availability of computerized infusion devices and appropriate drugs making its use easy and safe for the practitioner; and acceptable; tolerable and cost-effective for the patient. Such infusion devices and new drugs are not readily available in the developing world; although in Nigeria today; infusion devices may be obtained through medical equipment companies now established in the country; and opioids are available through the National Agency for Food; Drug; Administration and Control (NAFDAC).Aim: This paper aims to discuss TIVA giving insights into its practice in a developing economy without the use of sophisticated equipment and drugs; in order to encourage practitioners to use the technique. Method : At the 1st South-South regional anaesthesia conference in Calabar in July 2004; a symposium on TIVA in a developing economy was held as part of the conference. This review utilized literature from relevant texts and that obtained through Medline search. Results: This paper discusses TIVA highlighting aspects of its use in the developed world; and presenting its rather peculiar practice in our environment without the use of sophisticated equipment and opioid analgesics. Conclusion: TIVA is a unique technique of anaesthesia which is easy to master. It is cost-effective and safe. Hence; it is possible to use what is available in the developing environment to obtain what is necessary

Total intravenous anaesthesia in a developing environment

Background: Total intravenous anaesthesia (TIVA) is a technique of anaesthesia which has become widely popular in the developed world with the availability of computerized infusion devices and appropriate drugs making its use easy and safe for the practitioner; and acceptable; tolerable and cost-effective for the patient. Such infusion devices and new drugs are not readily available in the developing world; although in Nigeria today; infusion devices may be obtained through medical equipment companies now established in the country; and opioids are available through the National Agency for Food; Drug; Administration and Control (NAFDAC).Aim: This paper aims to discuss TIVA giving insights into its practice in a developing economy without the use of sophisticated equipment and drugs; in order to encourage practitioners to use the technique.Method: At the 1st South-South regional anaesthesia conference in Calabar in July 2004; a symposium on TIVA in a developing economy was held as part of the conference. This review utilized literature from relevant texts and that obtained through Medline search.Results: This paper discusses TIVA highlighting aspects of its use in the developed world; and presenting its rather peculiar practice in our environment without the use of sophisticated equipment and opioid analgesics.Conclusion: TIVA is a unique technique of anaesthesia which is easy to master. It is cost-effective and safe. Hence; it is possible to use what is available in the developing environment to obtain what is necessary

Abdominal actinomycosis; an unusual cause of intestinal obstruction

Background: Actinomycosis is a rare inflammatory disease caused by an anaerobic bacterium; Actinomyces israelii. Aim: To report a case of abdominal actinomycosis presenting as intestinal obstruction. Setting: University of Port Harcourt Teaching Hospital; Port Harcourt. Case report: A 54-year-old gentleman was involved in a road traffic accident in which he sustained fractures of the right humerus and pubic rami. A month later; he developed signs and symptoms of intestinal obstruction. At operation; a retroperitoneal mass obstructing the transverse colon and the proximal ileum was found and resected. Histological examination confirmed the mass to be due to actinomycosis infection. The patient was therefore placed on a parenteral therapy of 20 mega units of crystalline penicillin daily for three weeks and then a maintenance therapy of oral Amoxycillin for another six months. He recovered fully from the infection. Conclusion: Abdominal actinomycosis infection is an uncommon disease entity. Careful and expert histopathological analysis is essential in post operative diagnosis

Atlanto-occipital gap in Nigerians: Its relationship to difficult intubation

Background: Half of persons living with HIV/AIDS are below 25 years and majority of the remaining are believed to have been infected in their youth. The impact of HIV on young people has continued to generate increasing global medical; social; economic; political and academic interests. Aim: This paper reviews the pattern of existing documentation on HIV/AIDS regarding young people in Nigeria in presentations on this subject at international meetings and conferences. Methods: The review relied on a bibliography of 364 presentations from 17 books of abstracts and several solicited submissions; spanning 18 years; collated; indexed and published by the Nigerian Institute of Medical Research and the National Action Committee on AIDS. A matrix was constructed to categorize and tally the abstracts by several technical themes against the characteristics of the young people; aged 10 to 24 years that they reported on. Results: Eighty-five (23.5) out of the 364 were articles on adolescent/youths; the 18-year period; giving a rate of 4.7 articles per year. Regarding the context; 67 (78.8) concerned adolescents/ youths of both sexes. About half (47 or 55.3) were conducted among schooling adolescents/youths; and 23 (27.1) involved out-of-school youths. Twenty-three (27.1) titles were socio-medical research exploring knowledge; attitude; behaviour and practice; while three (3.5) were studies of biomedical nature; involving serologic investigations. Reports of interventions accounted for over half (47 or 55.3) of the presentations; most of which were on HIV awareness and prevention programmes. Conclusion: A low rate of reports on HIV/AIDS specific to young people at international conferences was observed; which does not reflect the level of importance and impact of the infection on this group of individuals. Amongst them; socio-medical studies; and interventions featuring awareness and prevention among schooling youths predominate. Interventions involving testing; treatment and care; and bio-medical studies especially involving vulnerable non-schooling youths; remain a challenge that must be faced