Epidemiological African Day for Evaluation of Patients at Risk of Venous Thrombosis in Acute Hospital Care Settings : Cardiovascular Topic

Introduction : This study aimed to identify patients at risk for venous thromboembolism (VTE) among all patients hospitalised; and to determine the proportion of at-risk hospital patients who received effective types of VTE prophylaxis in sub-Saharan Africa (SSA). Methods: A multinational; observational; cross-sectional survey was carried out on 1 583 at-risk patients throughout five SSA countries. Results: The prevalence of VTE risk was 50.4 overall; 62.3 in medical and 43.8 in surgical patients. The proportion of at-risk patients receiving prophylaxis was 51.5 overall; 36.2 in medical and 64 in surgical patients. Low-molecular weight heparin was the most frequently used prophylactic method in 40.2 overall; 23.1 in medical and 49.9 in surgical patients. Discussion: This study showed a high prevalence of VTE risk among hospitalised patients and that less than half of all at-risk patients received an American College of Clinical Pharmacy-recommended method of prophylaxis. Conclusion: Recommended VTE prophylaxis is underused in SSA

Total hip replacement in Nigeria: a preliminary report

The first total hip replacement [THR] in Nigeria was performed in 1974. But due to infrastructural decay in public institutions, arthroplasty outcome was poor. National Orthopedic Hospital, Enugu [NOHE] - a regional trauma and orthopedic centre took the initiative in 2008. This paper presents our preliminary results and lists our challenges in establishing this service in a resource- constrained economy. Prospective. NOHE, Nigeria. Fifty-two patients who had primary hip arthroplasty between November 2008 and November 2010. Details of demographic data, joints affected, etiology, co-morbidities, anesthesia, postoperative treatment, complications, and follow-up were recorded, analyzed and challenges noted. Total hip replacement. Improvement in patient's function and re-operation rate. Fifty-four THRs were done in fifty-two patients. Twenty nine [53.7%] patients were male. The mean age was 52 +/- 2.4 years. Two patients had staged bilateral hip replacement. Twenty five [48.1%] patients had primary osteoarthritis. The commonest complaint at presentation was incapacitating hip pain. Half of the patients 26 [49.9%] had this pain for over four year. Trauma related secondary arthritis was responsible for 21 cases and old unreduced hip dislocation in five [9.6%] patients. Six patients had previous hip surgeries. Implant dislocation occurred in three [5.5%] patients. The functional status improved in all patients as shown by Harris Hip scores. There is an absolute need to develop arthroplasty service in Nigeria. A good number of the cases were complex primary arthroplasties. Most of the patients were relatively young and will outlive their implant