Biomedical subjects

D Ngaka Nsafu

Publications and source records attributed to D Ngaka Nsafu.

5 recordsLinked to original sources

PubMed2003

[Surgical emergencies at Libreville hospital center].

OBJECTIVE: To estimate the waiting times of surgical emergencies and identify causes of delay. Study design. - Prospective study over 36 months. MATERIAL AND METHOD: From January 1996 to December 1998, surgical emergencies arriving to the Libreville Hospital Center have been classified in absolute emergencies (AE) and relative emergencies (RE). Five parameters have been measured: waiting before the first contact with the resident (T1); waiting time for making the decision of operation (T2); waiting time for the admission in the operating block (T3); waiting before the surgical intervention (T4); total duration of waiting between admission in the operating block and the beginning of the surgical intervention (TT). Concerning each one of those stages, the abnormal lengthening causes of time for surgical emergencies have been identified. RESULTS: During that period, 325 surgical emergencies have been received. The mean duration of surgical emergency management has been 504.3 +/- 613.7 min. Among those emergencies, 114 have been classified AE (35.1%) and 211 RE (64.9%) with mean durations of 421.2 +/- 347.0 min for AE and of 549.3 +/- 722.5 min for RE. Some delays in the management of emergencies have been found among 176 patients (54.2%). Their frequency has been 58.8% for AE and 51.7% for RE. The most current cause of delays has been the waiting of complementary medical tests results (44.4%), followed by difficulties in supplying (31.1%) and by technical or staff problems (24.1%). CONCLUSION: This study has permitted to show that the waiting times of surgical emergencies management are abnormally long in Libreville hospital center. There is an important frequency in delays as well for RE as for AE. Socio-economic problems are very important. It seems necessary to organize surgical emergencies management in a specific structure and codify the prescription of complementary medical tests.

Adolescent↗

PubMed2002

[Does tropical environment influence morbidity and mortality?].

Despite enormous progress in medical science, health care coverage in poor countries remains incomplete, uncertain and minimal. The probability of death is higher in Africa. Life expectancy is only from 50 to 55 on the African continent in comparison with over 70 years in North America and Europe. The African population is predominantly young but malnutrition, deficiencies, anemia, parasitism and genetic defects (drepanocytemia) are widespread. In general treatment of acute trauma and illness is straightforward and vital or functional prognosis is good provided that proper elementary care is administered rapidly. However due to difficult field conditions and limited medical facilities, care is often delayed. Most patients are admitted with advanced, complicated disease to facilities that are often poorly equipped, undersupplied and lacking in qualified personnel, basic medication and blood products. This combination of factors accounts in part for the fact that prognosis of the same disease is poorer in tropical areas than in other areas of the world. Rational use of human resources and better organization of international cooperation would allow short-term improvement in health care in tropical areas. It is only at this price that people in the Northern and Southern hemisphere in this time of globalization can have the same chance of survival for the same disease.

Acute Disease↗

PubMed2002

[Analysis of snake bite envenomations in Gabon].

In tropical zones, snakebites are considered serious. Exotic snakes are characterised by the poisonousness of their venom and its abundance. Death is rapid in some cases and in others the sequelae are serious. Worldwide, there are more than 5 million victims per year, with 50,000 deaths registered and 400,000 amputations. The frequency and severity of snakebites in Gabon remain unknown. It is estimated that there is an average of one snakebite every 4 days, thus some 91 snakebites per year. Through a study carried out at the Libreville Hospital, we evaluated the frequency, severity, and fatality of this circumstantial pathology. A retrospective study conducted on 157 patients admitted for snakebite at the Intensive Care Unit of the Libreville Hospital was carried out between 1998 and 2001. 1.32% of all admissions were for snakebites. Signs of venom poisoning were observed in 27 patients (17%), versus 130 cases without envenomation. The majority of cases were in adults (78%) and children affected (22%) were aged mainly 6-14 years. The snakebite season usually coincided with the rainy season. During this period, 19 cases were registered. Snakebites occurred during the daytime (93%), in the fields in 20 cases (75%) or in the home courtyard (25%). The victims lived in town in 25 cases (93%). Antivenom was used in all envenomation cases, and the result was favourable in 23 cases (18%) but unfavourable in 4 (15%).

Adolescent↗

PubMed2001

[ Ambulatory laparoscopic gynecological surgery in Africa: feasibility].

We report a prospective survey conduced between March 1998 and February 1999 among 100 women classes ASA I and II who underwent laparoscopic surgery for gynecological disorders under general anesthesia. Among these laparoscopies 85 (85%) were performed for operative purposes and 12 (10.7%) for diagnostic purposes. Minimal monitoring was used (no capnography) so prophylacti fluid loading with 0.9% saline was used before insufflation to reduce hemodynamic changes induced by abdominal overpressure and to avoid potential massive air embolism. Insufflation pressure was limited to 14 mmHg. The main agent used for all procedures was propofol. Mean duration of the procedures was 55 minutes. There were no cases of complications or delayed recovery. Complete exsufflation by abdominal compression at the end of the procedures induced minimal abdominal pain and scapulalgia. Ketoprofen as effective postoperatively. Twenty-five patients (25%) complained of nausea and vomiting in the recovery room and were treated effectively with metoclopramide. All patients were discharged and accompanied to their home six hours later after a well-tolerated light meal. The postoperative course was uneventful.

Adult↗

PubMedDate not supplied

[Epidemiology of pain in Gabon].

The authors report on a prospective survey which took place from January 1999 to December 2000 - the epidemiology of pain in Gabon - to determine its distribution in the population. Ninety-eight women and eighty-four men aged 17 to 80 years old (mean age: 50) who consulted at the pain clinic were included in the study, a majority of the patients being aged between 21 and 60 years. Lower back pains and gonalgias secondary to osteo-arthritis or arthritis were more common in the North of the country, where the patients represented 57.7% of the sample, these two previous localisations along with cephalagias accounting for 52.7% of the motives for the visits. Thoracic and abdominal pains common in both men and women in the South were psychological. Patients working in the tertiary sector represented 45.3% of the patients, those of the secondary sector 24.4%, and those of the primary 20.3%. The non-steroidal anti-inflammatory analgesics (NSAI) associated with WHO grade 1 and 2 analgesics were effective in 50% of cases, some of whom also needed steroidal articular infiltration. Psychological pains were soothed by amitriptyline. A specific training of doctors and paramedics in pain treatment is necessary to improve care and assistance in this area.

Adolescent↗