Post-anaesthetic Respiratory Complaints Following Endotracheal Anaesthesia In Lower Abdominal Obstetric And Gynaecology Surgery

Background: Postanaesthetic respiratory complications represent a significant negative aspect of surgical care. Objective: To assess the incidence and possible associated risk factors for postanaesthestic respiratory complaints following endotracheal anaesthesia in lower abdominal surgery in obstetric and gynecology patients in our hospital. Setting: A Teaching Hospital in Nigeria. Design: Prospective study Methodology: All consenting adult patients, aged 16-45years, undergoing caesarean section and major gynaecological abdominal operations, under general anaesthesia with endotracheal intubation, over a period of 8months, were studied. Postoperative respiratory symptoms, (sorethroat, hoarseness and cough), were assessed in the ward, by direct questioning method, daily for 5days. Those presenting with cough had their chest examined, and fever (T0 > 370C), was noted. Patients with positive chest signs had radiological examinations of the chest done for confirmation. Results: A total of 202 patients were studied. Out of these, 152(75.2%) patients had various forms of postoperative respiratory complaints. Overall, it was observed that caesarean section patients were more likely, than gynaecology patients, to report these respiratory complications in the postoperative period (88.4% vs. 58.9%). This difference was statistically significant (p < 0.05). The incidence of sorethroat directly correlated with the size of the endotracheal tube used (r = 0.936). There was a statistically significant difference in the incidence of sorethroat between the caesarean section patients and gynaecology patients (p< 0.00), particularly with endotracheal tube sizes larger than 7.5mm ID (p< 0.03). Duration of intubation, which was slightly longer in gynaecology patients (mean =72.48±30.62), and number of intubation attempts, did not have statistically significant effect on the incidence of respiratory complaints. Conclusion: The use of small endotracheal tube sizes

Heterotopic gestation with subsequent live birth in a Jehovah's witness: A case report

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Health related quality of life and psychological variables among a sample of asthmatics in Ile-Ife South-Western Nigeria

Background: Assessment of health related quality of life (HRQL) has become central to assessing the selfperceived impact of physical and mental impairment on patient&rsquo;s health. Studies have reported a high rate of psychological disturbances among asthmatics; however, the impact of these psychological factors on HRQL remains unexplored. Objectives: To assess the health related quality of life among a sample of asthmatics and to identify the psychological and clinical variables that affect quality of life among asthmatics. Method: A total of 81 patients attending the clinic were assessed using the Mini-Asthma Quality of Life questionnaire (Mini-AQLQ), and the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and clinical variables were also obtained from the patients, the lung function was assessed using Peak Expiratory Flow Rate (PEFR). Results: Mean age of all the patients was 35.22 (SD&plusmn;14.36) with a mean duration of asthma symptoms of 17.5 (SD&plusmn;14.4) years. Mean peak expiratory flow was 336 l/min (SD&plusmn;74.12). Anxiety was present in 44.4% of respondents, while 40% of respondents reported the presence of depressive symptoms, 48.1% of the respondents reported low scores on the asthma quality of life questionnaire. Poor quality of life was associated with the presence of psychological symptoms, female sex, and lower educational level. Conclusion: Psychosocial variables are just as important as clinical variables as determinants of health related quality of life among asthmatics.Keywords: quality of life; asthma; anxiety; depression; psychosocia

A Preliminary Assessment of Groundwater Samples around a Filling Station in Diobu, Port Harcourt, Rivers State, Nigeria.

This paper is a preliminary assessment of groundwater samples around a filling station in Diobu area of Port Harcourt for four years at intervals of two years with a view to determine the level of groundwater pollution. It examines the physiochemical, major ions and heavy metal aspect of groundwater quality around the study area. Both factor and cluster analysis for the period under investigation shows that variables such as OG, NO3, PO4 that recorded high factor loadings and closer clusters may have been introduced from anthropogenic sources while Ec, TDS, Cl, Fe, TSS, salinity, hardness may be due to saltwater intrusion from the sea. The  anthropogenic factor (AF) value also indicates significant influences from natural processes.Significant influences may have been from natural process but were enhanced by over pumping/nearness to the sea and oil/agricultural activities.KEY WORDS: Multivariate Analysis; Anthropogenic Factor; Physico-Chemical; Diobu; Nigeri

Epidemiology of ovarian cancers in Zaria, Northern Nigeria: a 10-year study

Marliyya Sanusi Zayyan,1 Saad Aliyu Ahmed,2 Adekunle O Oguntayo,1 Abimbola O Kolawole,1 Tajudeen Ayodeji Olasinde3 1Gynaecological Oncology Unit, 2Department of Histopathology, 3Department of Radiation Oncology, Ahmadu Bello University, Zaria, Nigeria Background: Globally, the absence of a premalignant stage of ovarian cancer and a reliable screening tool make early diagnosis difficult. Locally, poverty, ignorance, and lack of organized cancer services make prognosis poor. We describe the epidemiological features of ovarian cancer seen at Ahmadu Bello University Teaching Hospital Zaria, Northern Nigeria, a tertiary referral center, over a 10-year period in this challenging setting. Methods: All cases of histologically diagnosed ovarian cancer between January 1, 2004 and December 31, 2013 were included in the study. Case notes were retrieved to collect clinical data including age, parity, clinical stage of disease at presentation, and known associated factors. Results were analyzed using Epi info&trade;. Results: A total of 78 patients were included in the study. About 4&ndash;13 cases were seen every year with a tendency to increasing incidence. The patients were aged 8&ndash;80 years with mean of 37 years. Sixty-two (79.5%) patients were premenopausal while postmenopausal women accounted for only seven cases or 9.0%. There were 17 cases (22.3%) of aggressive cancers in patients aged &le;20 years. A majority of the patients, 65 (83.3%), were parous with only nine (11.5%) patients being nulliparous. Serous cyst adenocarcinoma accounted for 32 (41%) cases. Granulosa cell tumor was the second commonest with 18 cases (23.1%). The mean age of occurrence of serous cyst adenocarcinoma was 31 years and for epithelial ovarian cancers in general it was 33.5 years. Endometrioid adenocarcinoma was rare with only one case in 10 years. Factors like age, parity, and premenopausal status did not appear to be protective to the occurrence of malignant ovarian tumor in this group. Conclusion: Increasing numbers of patients with ovarian cancer were seen over the 10-year period. Young, premenopausal, parous women made up the majority of cases. Serous cystadenocarcinoma was the most common histological variant. Keywords: ovarian cancer, premenopausal parous women, serous cystadenocarcinom

Retrolumbar subcutaneous ependymoma and giant bathing-trunk nevocellular nevus.

BACKGROUND. Subcutaneous ependymomas have been reported rarely in dermatologic reviews and, apparently, were never associated with other cutaneous malformations. METHODS. A 60-year-old woman with a retrolumbar subcutaneous ependymoma and a giant bathing-trunk nevocellular nevus submitted to thorough dermatologic and neurologic investigation. The surgical material was extensively analyzed with light and electron microscope. The literature was reviewed. RESULTS. The tumor fits exactly the classical prerequisites of the clinical and pathologic diagnosis. In contrast with the literature, it developed at 53 years, apparently after a trauma, within a congenital giant nevocellular nevus, at the retrolumbar level; it proved unrelated to any spinal cord alteration and so far appeared quite benign. CONCLUSIONS. The observation of a retrolumbar subcutaneous ependymoma is reported with detail; this tumor exceptionally recognized by dermatologists must be included in the differential diagnosis of lumps arising in the retrolumbar-retrosacral area. The most peculiar feature was its development within a giant bathing-trunk nevocellular nevus; such a fascinating association of two neurectodermal defects, as far as known, is presented for the first time