The Pan African medical journal
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Intranasal fentanyl provides rapid and powerful analgesia which is particularly interesting in patients without intravenous access. We propose to use it for analgesia in adults presenting renal colics. ⋯ Intranasal fentanyl seems to be efficient for analgesia in adult patients with renal colic.
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The recent Ebola Virus Outbreak had a devastating effect on West Africa's already feeble national health systems. We suggest that such an impact turned out to be catastrophic because it hit particularly hard human resources for health and the delivery of primary healthcare services, which are cross-sectional to any health system. ⋯ Such patchwork and vertical intervention strategy was always going to fail to tackle a system-wide problem, particularly in already fragile systems. We suggest that future interventions will have to learn from the experience of past initiatives for the introduction of HIV-AIDS services, which started as vertical programs and ended up including ever growing health system strengthening components.
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The Ebola Virus Disease (EVD) in West Africa has stimulated investments in EVD research. While these research efforts are most welcome, we are concerned about the potential to ignore effective community ethics engagement programmes and critical government regulatory agencies in light of the urgency to conduct clinical trials for EVD therapies and vaccines. We discuss the reasons why community engagement with various research stakeholders is essential, how community engagement should be conducted, and the potential consequences of failing to engage both communities and regulatory agencies by drawing on past experiences in the field of HIV research. We highlight the importance of a) capacity building to enable local researchers design and implement EVD research for future epidemics, b) the need to support community research literacy, and c) the need to build the competency of research regulatory agencies on the continent to address EVD therapy and vaccine research.
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Early seizures (ES) may complicate the clinical course of patients with acute stroke. The aim of this study was to assess the frequency and the predictive factors for early seizures as well the clinical outcome in patients with first-ever stroke. A total of 352 consecutive patients with first-ever stroke, admitted to our department, were included in this retrospective study. ⋯ Early seizures occurred in about 13% of patients with acute stroke. In these patients hemorrhagic transformation is a predictive factor for ES. ES seem to be associated with a worse outcome after acute stroke.
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Road traffic injuries continue to exert a huge burden on the health care system in Kenya. Few studies on the pattern of road traffic injuries have been conducted in Kenya. We therefore carried out a retrospective study to determine the pattern of road traffic injuries seen in a public hospital in Naivasha district, Kenya. ⋯ Thirty one percent were pedestrians, 27.7% cyclists, 24.6% passengers and 16.9% motor vehicle drivers at the time of injury. Road traffic crashes are a growing pandemic, leading to high morbidity and mortality. Efforts need to be taken to prevent injuries, long term complications and loss of lives that are robbing communities off loved ones, bread winners and productive manpower.