The Pan African medical journal
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Regional anesthesia is a safe alternative to general anesthesia. Despite benefits for perioperative morbidity and mortality, this technique is underutilized in low-resource settings. In response to an identified need, a regional anesthesia service was established at the University Teaching Hospital of Kigali (CHUK), Rwanda. This qualitative study investigates the factors influencing implementation of this service in a low-resource tertiary-level teaching hospital. ⋯ While the establishment of regional anesthesia in Rwanda is challenged by human and resource shortages, collaboration with local stakeholders in an academic institution is pivotal to sustainability.
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In November 2015 a measles outbreak was detected in several clustered settlements during the Northern Measles Supplementary Immunization Activities (SIAs) campaign in Gwagwalada, Nigeria, a measles outbreak was detected. Six weeks later another outbreak with 17 cases was reported in a different settlement in the same area council in December 2015 and January 2016. An outbreak investigation was initiated to characterize the outbreak in terms of time and person and implement prevention and control measures. ⋯ There had been cases of measles from January 2015 to November 2015 prior to the reported measles outbreak. However there was an unusual increase in the number of measles cases during the measles SIAs in communities where children were missed. Vaccination of all eligible children in the affected wards was carried out. The area council authorities and primary healthcare team need to create awareness on the importance of measles vaccination and ensure that these communities are targeted and covered during subsequent SIAs.
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Twiddler's syndrome is a rare but potentially lethal complication of pacemaker implantation. It is usually diagnosed within 1 year after implantation. It is characterized by device malfunction caused by pacemaker lead displacement due to twisting of the box on part of the patient. ⋯ It has also been reported after defibrillator implantation and cardiac resynchronization therapy. We here report the case of a 89-year old female patient admitted with Twiddler's syndrome leading to pacemaker malfunction secondary to pacemaker lead displacement. She underwent lead repositioning and received appropriate advice.
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Review Case Reports
Strangulated obturator hernia: a case report with literature review.
Obturator hernia is rare. It occurs when part of the pelvic contents protrude through the obturator foramen. It is a diagnostic challenge in the emergency department since the signs and symptoms are non-specific. ⋯ We report the case of an 83-year-old woman with a strangulated obturator hernia. The hernia was discovered early by computed tomography and was treated by emergency laparotomy. We emphasize on the rule of CT scan to establishing a prompt preoperative diagnosis of an obturator hernia, appropriate planning of surgical intervention and thus optimizing the outcome.
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Dyslipidemia confers excess atherosclerotic cardiovascular risk in type 2 diabetes mellitus (DM) patients, and this requires prompt identification and management to reduce morbidity and mortality. This study assessed the prevalence and pattern of dyslipidemia in type 2 DM patients in Zaria, Northwestern Nigeria. ⋯ The prevalence of dyslipidemia is high in the newly diagnosed type 2 DM patients and therefore, initial management should incorporate measures to control dyslipidemia.