Serum Cytokine Profile (Interleukin‑6) among Women with Pelvic Organ Prolapse

Background: Pelvic organ prolapse (POP) is a common gynecological problem, particularly in the grand multipara. There are indications thatserum concentration of cytokines is higher in women with POP and even more so when there is evidence of infection. This study assesses theserum cytokine level (interleukin [IL]‑6) in women with POP. Materials and Methods: This study was conducted among 96 women with POP and a control group of 96 women. A case–control study using a quota system nonprobability sampling technique was done. The serum cytokine level was determined using a commercial standard enzyme‑linked immunosorbent assay kit. Results: The mean age and parity were 53.54 ± 10.1 years and 7.04 ± 2.33, respectively. The mean level of serum IL‑6 and standard error of mean  was 95.79 ± 18.6, ±1.9 as against 17.92 ± 7.62, ±0.78 for control and as against <20 pg/ml for the general population. P values were 0.00 and 0.08,  respectively. The result showed that IL‑6 was significantly increased in women with POP. Conclusion: This study suggests that cytokine levels were significantly elevated in patients with POP. Keywords: Cytokines, interleukin‑6, pelvic organ prolaps

Epidemiology of lumbar disc herniations in adults with low back pain in Enugu, Nigeria

Background: Lumbar intervertebral disc herniation is used to describe a spectrum of anatomical abnormalities involving disc extension beyond the interspace. It follows a tear in the annulus fibrosus of the intervertebral disc. It is one of the most common causes of low back pain among adults. The study aims to assess the epidemiological pattern of lumbar disc herniations among adults with low back pain in Enugu urban.Methods: The study was a prospective study at National Orthopedic Hospital Enugu and Annunciation Specialist Hospital Enugu. Following ethical approval and written informed consent, patients who met the inclusion criteria were consecutively recruited. The MRI scans of the participants were viewed using DICOM® (Digital Imaging and Communications in Medicine) software on laptop computer. The data included the patients’ demographics, functional disability index for back pain, weight, height, the anatomical level(s) and site(s) of the herniated disc among other parameters.Results: A total of 81 subjects who met the inclusion criteria were included and analyzed using SPSS version 20.0. The mean age of the subjects is 52.99±13.13 years. The most common affected age group is 51-60 years (27.2%). Majority of the subjects (68; 84%) had multiple level herniations which usually includes L4 level(74; 91.4%).Conclusions: That multilevel lumbar disc herniation is far more common than single level herniation with a prevalence of 84% among adults with low back pain in Enugu urban. That, there is statistically significant association of lumbar disc herniation and increasing age

Assessment of complications following use of pneumatic tourniquet for elective orthopedic procedures at National Orthopedic Hospital, Enugu

Background: A pneumatic tourniquet is a constricting or compressing device with an inflatable cuff used to control venous or arterial circulation to an extremity for a period of time. Tourniquet safety is related to the cuff pressure and duration of application. The objective of this study was to determine the common complications that follow the use of pneumatic tourniquet in elective orthopaedic surgical procedures at National Orthopaedic Hospital Enugu.Methods: This was a prospective study over 18 month period (June 2014 – November 2015) at National Orthopaedic Hospital, Enugu. Following ethical approval and written informed consent, patients who met the inclusion criteria were consecutively recruited. The study was conducted using the ‘intelligent pneumatic tourniquet’ with single bladder reusable cylindrical cuff. The cuff pressure was determined in each case by addition of 100mmHg to the baseline systolic BP for the upper limbs and 150 mmHg to the baseline systolic BP for the lower limbs. The data collected included patients’ demographics, cuff pressure, cuff location, tourniquet duration and complication encountered among other parameters.Results: A total of 160 procedures in 152 patients were included and analyzed using SPSS version 20.0. The prevalence rate of 1.9% for nerve palsy, 1.3% for tourniquet pain, 1.9% for surgical site infection and 5.6% for pressure sore were found in the study. No other complication was encountered.Conclusions: From the results of this study, it is concluded that the use of pneumatic tourniquet under the prescribed conditions is associated with low prevalence of complications

Audit of blood transfusion practice during anaesthesia for spine surgeries in a regional trauma centre in Nigeria

Background: Blood loss during spine surgery is often considerable, necessitating blood transfusion. The elective nature and other peculiarities of most spine surgeries, however, make them amenable to several blood conservation techniques, such that reduction in allogeneic blood transfusion is considered high priority in spine surgery. In view of the rise in spine procedures, facilitated by availability of enhanced imaging services, surgical and anaesthetic manpower, an audit of blood transfusion practice during spine surgeries in a regional trauma centre was deemed necessary.Objective: To determine the extent of blood usage (autologous and allogeneic) during spine surgeries and evaluate the blood prescription practice in view of optimal utilization of blood cross-match services.Methodology: A retrospective review of all 107 spine surgeries done over a period of 41/2years was carried out and the blood transfusion rate, autologous blood usage and blood utilization indices were determined.Results: Forty-nine (46%) of 107 patients received blood transfusion, and only three patients received autologous blood. The cross-match /transfusion ratio, transfusion index and transfusion probability were 3.4, 0.7 and 45.8%, respectively. The maximum number of units of blood transfused to any single patient was 4units.Conclusion: Whereas blood transfusion rate in the series is considerably high, the overall blood utilization is considered optimal. Autologous blood usage is abysmally low and institutional approach to encourage its optimal use is recommended to minimize allogeneic blood transfusion with its attendant complications and cost.Keywords: Autologous, allogeneic, blood conservation, general anaesthesia, imaging facilities, prone positio