Conjoined Twins in Red Sokoto Goat

ΔΕΝ ΔΙΑΤΙΘΕΤΑΙ ΠΕΡΙΛΗΨΗA case of female conjoined twins was found in Red Sokoto goat, delivered alive along with a free male kid without obstetrical assistance. The abnormal twins were examined clinically and at postmortem. Based on morphological features, they could be classified as thoraco-omphalopagus symmetrical conjoined twins. Autopsy showed that fusion occurred at ventral-midline from the cranial region of the thorax to abdomen caudal to the umbilicus; thus, only head, neck and pelvis were separated. Genetic factors could be suspected in this case. This is the first report of thoraco-omphalopagus symmetrical twinned goat in Nigeria

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Corneal dermoid in a 3-month old Sokoto gudali cross calf

Ocular dermoid is a skin or skin-like appendage usually arising on the limbus, conjunctiva, and cornea. It can be unilateral or bilateral and has been reported in different domestic species of animals including cattle. Three months old Sokoto Gudali/Rahaji cross calf weighing 60kg body weight was presented to the Veterinary Teaching Hospital of Usmanu Danfodiyo University, Sokoto with the complaint of an observed hairy growth and excessive lacrimation of the left lateral eye. Clinical examination revealed a hairy skin-like growth measuring about 1.5cm by 2cm, extending from 4 o’ clock to 7 o’ clock on the left globe. The calf was sedated with xylazine hydrochloride at 0.25 ml/ 100kg IM and restrained on lateral recumbency. Auriculopalpebral block (ring block) was achieved with 2% lignocaine hydrochloride and superficial keratectomy was performed to excise the tissue. Temporary tarsorrhaphy was performed to aid healing and medial canthus area was left open for topical administration of drugs. Postoperatively, Terra-cotril eye drop (Oxytetracyclin and hydrocortisone) trice daily for three days was administered. Temporary tarsorrhaphy sutures were removed on the 10th day postoperatively. The calf successfully recovered and did not present signs of recurrence on re-examination two months later.Keywords: Calf, Ocular dermoid, Sokoto gudali, Rahaji, Superficial keratectom

Human death from suspected rabid dog bite in Zamfara State, Nigeria

Rabies is a neglected zoonotic disease occurring mostly as a result of dog bites and with a case fatality rate approaching 100% in humans. We describe here a suspected case of human rabies from a stray dog bite in a 52-year-old woman in Zamfara State, northwest Nigeria. In response to the exposure, a team of researchers was set up to investigate further the possible contacts between the rabid dog and the subjects at risk. Rabies was identified based on clinical signs observed on the victim, in addition to exposure history and incubation period. Rabies is becoming a rising public health problem in Nigeria. Coordinated efforts from various partners guided by one-health approach in the control and prevention of rabies should be prioritized at a wider scale in the country.Keywords: Dog bite, Human rabies, Nigeria, Zamfara, Zoonosi

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran