The Practices of Anaesthesiologists in the Management of Patients with Sickle Cell Disease: Empirical Evidence from Cameroon

Patients with sickle cell disease are more likely to undergo surgery during their lifetime, especially given the numerous complications they may develop. There is a paucity of data concerning the management of patients with sickle cell disease by anaesthesiologists, especially in Africa. This study aimed to describe the practices of anaesthesiologists in Cameroon concerning the perioperative management of patients with sickle cell disease. A cross-sectional study was carried out over four months and involved 35 out 47 anaesthesiologists working in hospitals across the country, who were invited to fill a data collection form after giving their informed consent. The data were analysed using descriptive statistics and a binary logistic regression model. Among the 35 anaesthesiologists included in the study, most (29 (82.9%)) had managed patients with sickle cell disease for both emergency and elective surgical procedures. Most of them had never asked for a haematology consultation before surgery. Most participants (26 (74.3%)) admitted to having carried out simple blood transfusions, while 4 (11.4%) carried out exchange transfusions. The haemoglobin thresholds for transfusion varied from one practitioner to another, between <6 g/dL and <9 g/dL. Only 6 (17.1%) anaesthesiologists had a treatment guideline for the management of patients with sickle cell disease in the hospitals where they practiced. Only 9 (25.7%) prescribed a search for irregular agglutinins. The percentage of haemoglobin S before surgery was always available for 5 (14.3%) of the participants. The coefficient (0.06) of the occurrence of a haematology consultation before surgery had a significant influence on the probability of management of post-operative complications (coefficient 0.06, 10% level of probability). This study highlights the fact that practices in the perioperative management of patients with sickle cell disease in Cameroon vary greatly from one anaesthesiologist to another. We disclosed major differences in the current recommendations, which support the fact that even in Sub-Saharan countries, guidelines applicable to the local settings should be published

The practices of anaesthesiologists in the management of patients with sickle cell disease: Empirical evidence from cameroon

Patients with sickle cell disease are more likely to undergo surgery during their lifetime, especially given the numerous complications they may develop. There is a paucity of data concerning the management of patients with sickle cell disease by anaesthesiologists, especially in Africa. This study aimed to describe the practices of anaesthesiologists in Cameroon concerning the perioperative management of patients with sickle cell disease. A cross-sectional study was carried out over four months and involved 35 out 47 anaesthesiologists working in hospitals across the country, who were invited to fill a data collection form after giving their informed consent. The data were analysed using descriptive statistics and a binary logistic regression model. Among the 35 anaesthesiologists included in the study, most (29 (82.9%)) had managed patients with sickle cell disease for both emergency and elective surgical procedures. Most of them had never asked for a haematology consultation before surgery. Most participants (26 (74.3%)) admitted to having carried out simple blood transfusions, while 4 (11.4%) carried out exchange transfusions. The haemoglobin thresholds for transfusion varied from one practitioner to another, between <6 g/dL and <9 g/dL. Only 6 (17.1%) anaesthesiologists had a treatment guideline for the management of patients with sickle cell disease in the hospitals where they practiced. Only 9 (25.7%) prescribed a search for irregular agglutinins. The percentage of haemoglobin S before surgery was always available for 5 (14.3%) of the participants. The coefficient (0.06) of the occurrence of a haematology consultation before surgery had a significant influence on the probability of management of post-operative complications (coefficient 0.06, 10% level of probability). This study highlights the fact that practices in the perioperative management of patients with sickle cell disease in Cameroon vary greatly from one anaesthesiologist to another. We disclosed major differences in the current recommendations, which support the fact that even in Sub-Saharan countries, guidelines applicable to the local settings should be published.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Incidence of Post-Operative Complications and Factors Influencing Their Occurrence in Patients with Sickle Cell Disease in a Low-Income Country: A Case Study of Cameroon

This study aimed to analyse post-operative complications and possible factors influencing their occurrence in the management of patients with sickle cell disease in a low-income country. We prospectively collected data regarding the management of patients with sickle cell disease requiring anesthesia for surgery in 11 Cameroonian hospitals from 1 May 2019 to 30 April 2021. The data were analysed using descriptive statistics and a binary logistic regression was used to determine the dependence between the variables. A total of 124 patients with sickle cell disease were enrolled; 64 were male and 60 female, giving a sex ratio of 0.93. The rate of post-operative complications was 23.4% (29/124) and the death rate was 3.2% (4/124). The female subjects had more complications than the male subjects p < 0.05. The number of vaso-occlusive crises experienced per year showed a significant impact on the occurrence of post-operative complications p < 0.05. Laparoscopic surgery had fewer post-operative complications 5/46 (10.9%) than laparotomy 14/43 (32.5%). The surgical technique for the abdominal procedures had a significant impact on the occurrence of post-operative complications p < 0.05. The type of surgery (p = 0.198) and the anaesthesia technique (p = 0.225) did not show a significant impact on the occurrence of post-operative complications. Particular attention should be paid to female patients with sickle cell disease as they are more likely to experience postoperative complications, as well as to the frequency of vaso-occlusive crises, which are also predictive of post-operative complications. Opting for laparoscopic surgery whenever possible would help to reduce post-operative complications.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Épilepsie et natation en piscine privée dans les pays en voie de développement, une pratique à haut risque vital : une observation clinique: Epilepsy and swimming in private pool in developing countries, a high risk life practice: a case report

Epilepsy is a chronic disease of the brain that affects all segments of the population around the world. It is characterized by recurrent seizures manifested by brief episodes of involuntary tremors affecting one part of the body or the whole body. These seizures are the result of excessive electrical discharges from a neuronal population. According to the World Health Organization, 50 million people are currently living with epilepsy worldwide. Almost 80 % of people with epilepsy live in low-income countries The management of this pathology remains difficult in sub-Saharan Africa for various reasons Sports activities, including swimming, are said to be beneficial in children and adolescents with epilepsy. But the practice of these activities is not without vital risk, it must be regulated accordingto the socio-economic, cultural and medical environment We report here a case of drowning in a 10-year-old adolescent girl, epileptic since earlychildhood and who takes depakine as a background treatment She was drowned while&nbsp; swimming in a private pool, following an epileptic seizure. The interest of this presentation is tounderline the need to formulate recommendations adapted to sub-Saharan Africa concerning the practice of certain sports activities, such as swimming in a private pool for adolescents with epilepsy. The second objective is to highlight the importance of the chain of survival in the event of drowning, as a guarantee of the vital prognosis. L’épilepsie est une affection chronique du cerveau qui touche toutes les tranches de la population dans le monde Selon l’organisation mondiale de la santé, 50 millions de personnes vivent actuellement avec l’épilepsie dans le monde, près de 80% de personnes souffrant d’épilepsie vivent dans les pays à revenu faible. Sa prise en charge demeure laborieuse en Afrique subsaharienne (ASS). Les activités sportives, parmi lesquelles la natation, seraient&nbsp; bénéfiques chez les adolescents épileptiques. Mais la pratique de ces activités n’est pas dénuée de risque vital, elle doit être régulée en fonction du contexte socio-economique, culturel et de l’environnement médical. Nous rapportons un cas de noyade chez une adolescente, épileptique depuis la tendre enfance et qui prend la dépakine en traitement de fond Elle a été victime de noyade en piscine privée, à la suite d’une crise d’épilepsie L’intérêt de cette présentation est de souligner la nécessité de formuler des recommandations adaptées à l’ASS au sujet de la pratique de certaines activités sportives à risque, comme la natation en piscine privée pour les adolescents épileptiques Le second objectif est de relever l’importance de la chaine de survie en cas de noyade, comme gage du pronostic vital

Prospective, randomized clinical trial of laparoscopic totally extraperitoneal inguinal hernia repair using conventional versus custom-made (mosquito) mesh performed in Cameroon: a short-term outcomes.

Adverse economic conditions often prevent the widespread implementation of modern surgical techniques in third world countries such as in Sub-Sahara Africa.info:eu-repo/semantics/publishe