Background : Typhoid perforation is a condition commonly seen in developing countries including those of sub-Saharan Africa. Anesthetic management for surgery in typhoid perforation poses great challenges to the anesthetist practicing in Africa, especially in the face of limited resources. Materials and Methods : The anesthetic management of patients who underwent surgery for typhoid perforation at the SIM Hospital in Galmi, Niger Republic, between December 2004 and December 2005, was retrospectively reviewed. Results : There were 56 patients who had surgery for typhoid perforation during the period. Forty-one were males while 15 were females with a male:female ratio of 2.7:1. Their age ranged between 3 and 62 years with a mean of 23 years. Of these, 19 (33.9%) were children aged 15 years and below. Twenty-eight of the patients (i.e. 50%) were assessed as American Society of Anesthesiologists (ASA) physical status class IV, while 22 (39%) were ASA III and 6 (11%) were ASA V. Thirty surgeries (i.e. 53.6%) were done under spinal anesthesia, 9 (16%) under general inhalational anesthesia using halothane, 11 (19.6%) under ketamine anesthesia and 6 (10.7%) had drainage of intra-abdominal abscesses under local anesthesia. The overall mortality rate was 26.8%. The mortality rates following the different techniques of anesthesia were: spinal anesthesia 20%, general inhalational anesthesia 22%, ketamine anesthesia 18% and local anesthesia 83.3%. ASA III patients had a mortality rate of 9%, while the mortality rate was 28.6% in ASA IV patients and 83.3% in ASA V patients. Mortality was significantly related to the ASA status of the patient, while there was no correlation between mortality and anesthetic technique used. Conclusion: Proper preoperative resuscitation and a well-conducted anesthesia, using a technique that the anesthetist is well conversant with, appear to be the key to successful anesthesia in patients with typhoid perforation. Anesthetists practicing in rural Africa should be encouraged to acquire skill in the art of spinal anesthesia since it is cheap, easy to administer and can be safely utilized in these patients.

Background : Abnormal lipid levels, especially elevated total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) and decreased high density lipoprotein cholesterol (HDL-C), contribute additional risk to patients with diabetes mellitus (DM) and coronary heart disease (CHD). Reports on the pattern of lipid profile abnormality in blacks are scanty and inconsistent. The aim of the present study has been to carry out a retrospective analysis of lipid profile investigation in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Materials and Methods : A total of 448 patients with different disease conditions, such as type II DM, CHD, renal disorders, liver diseases and other abnormalities, who were referred to the chemical pathology laboratory from various clinics and hospitals for lipid profile analysis were assessed. The subjects were made up of 312 (69.67%) males and 136 (30.33%) females. The mean age for the total (combined males and females) was 58 (ranged 45-72) years and the mean age values for males and females were 62 (ranged 51-73) and 53 (ranged 35-65) years respectively. Results : The results show that abnormal lipid profile was found in 51 (11.38%) patients who were consisted of 33 (67.71%) males and 18 (35.29%) females. These also consisted of 35 (68.63%) patients with cardiovascular diseases (CVD), 5 (9.80%) patients with type II diabetes mellitus (DM) and 11 (21.57%) patients with other clinical conditions such as liver and renal diseases. Hypercholesterolemia and hypertriglyceridemia alone were observed in 8 and 15 patients respectively. Low density lipoprotein cholesterol (LDL-C) levels were elevated in 11 patients. Thirty six (36) patients had reduced levels of HDL-C only, with concomitant high levels of TC/HDL-C ratio. Combined hyperlipidemia was observed in only five patients. The results revealed that abnormal lipid profile pattern was higher in patients with CVD (68.60%) than in other cases. Conclusion : The results of the present study demonstrate that low HDL-C levels seemed to be more prevalent in this population. This report could contribute to the ongoing work on lipid research in Nigeria and the world at large.

Background: Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) is the dominant mode of acquisition of HIV infection for children, currently resulting in more than 200 new pediatric HIV infections each year worldwide. In most cases, MTCT of HIV is believed to occur close to or during childbirth. Materials and Methods : A hospital-based descriptive cross-sectional study was carried out among pregnant women attending the antenatal clinic at General Hospital Minna, Nigeria, to elicit their sociodemographic characteristics and determine their HIV status. Structured questionnaires and interviews were the tools used for the collection of data. Results: The mean age and age range of the respondents were 20 years and 20-42 years, respectively. Of the 231 samples collected, 18 (7.8%) tested positive for HIV, and 11 (18.2%) of these were students. Conclusion: The study showed a significant HIV prevalence, which could serve as a baseline data for subsequent monitoring of the disease among pregnant women in Minna. And, there is need for sensitization of people on voluntary counselling and testing and other core interventions of prevention of maternal to child transmission (PMTCT) of HIV, such as anti-retroviral prophylaxis, safer delivery and infant-feeding practices in view of its advantages.

Objectives : To determine the current knowledge and awareness of undergraduate dental students of Rural Dental College regarding the Hepatitis B infection. Materials and Methods : This cross-sectional observational study was conducted among the students of Rural Dental College, Maharashtra, India. Predesigned questionnaire which assessed knowledge and awareness about Hepatitis B infection and transmission was the tool of data collection. Results : A total of 150 students participated. The male female ratio was 1:2; mean age of respondents was 20.66 ± 1.01 years. On an average, 59.23 and 40.67% had correct and incorrect knowledge about Hepatitis B infection, respectively. A total of 81.55% exhibited adequate level of awareness while 18.45% exhibited incorrect level of awareness about transmission of Hepatitis B infection Conclusion : Results indicate that students had adequate awareness and perception level about awareness of Hepatitis B infection.

Background : Widespread outbreaks, particularly of communicable diseases and weak surveillance systems, across the African sub-region led to the adoption of Integrated Disease Surveillance and Response (IDSR) as a regional strategy for strengthening national surveillance systems and effective response to priority communicable diseases. One of the goals of IDSR is to improve the ability of Local Government Areas (LGAs) to detect and respond to diseases and conditions that lead to high morbidity and mortality. The aim of the study was to assess the emergency preparedness and capability to identify outbreaks in Sabon Gari LGA. Methodology : A cross-sectional descriptive study was carried out in Sabon Gari LGA in October 2007. Key informant interviews of the key personnel conducted using structured interviewer administered questionnaires were used to obtain information about the emergency preparedness and the capability of the LGA to identify outbreaks. The results obtained were compared to the recommendations of the National Technical Guidelines for IDSR 2002. Results : There were no prepositioned stock of drugs and vaccines available; 8% of staff was trained in disease surveillance. There is a budget line available for emergency response. The LGA relies on reports from health facilities and communities to identify outbreaks; no threshold or markers are used. No form of analysis is carried out on data collected at the LGA level. Timeliness of monthly reporting for May and June 2007 was 26.5 and 22.5% respectively; completeness of monthly reporting was 32.7%. Conclusion: The emergency preparedness and capability to identify outbreaks in Sabon Gari LGA is poor based on the selected criteria from the National Technical Guidelines for IDSR; less than 50% of the criteria are met. There is a need for Sabon Gari LGA to fully adopt the National Technical Guidelines on IDSR to be better positioned to prepare for and identify outbreaks.

Ketamine, a phencyclidine derivative, is a very popular and commonly used parenteral anesthetic agent. It is a safe drug in unskilled hands and a drug of choice in high-risk patients. We report an unusual allergic reaction to Ketamine in a 2.5-year-old child with bilateral congenital inguinal hernia. This is to alert all practitioners to some of the rare but potentially fatal side effects of Ketamine. Anaphylactic reactions to Ketamine are a rare but potentially fatal occurrence. Management includes treatment of acute reactions and avoidance of future reactions. There is no known antidote or reversal agent to Ketamine. So, once it is administered, one must be ready for it to complete full duration of its action. Facilities for resuscitation must be available any time an anesthetic is being administered, no matter how short or minor the surgery is.