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Biomedical subjects

S G Akpan

Publications and source records attributed to S G Akpan.

5 recordsLinked to original sources

Knowledge, attitude and practices of Nigerian anaesthetists in HIV infected surgical patients: a survey.

In the light of increasing prevalence of the human immunodeficiency virus (HIV), anaesthetists are likely to see more patients with this virus in their practice. This study evaluated, using a questionnaire format, the knowledge, attitude and practices of anaesthetists in the management of HIV infected surgical patients. The questionnaire sought demographic information, the knowledge of risks involved as well as attitude and practices. One hundred (66.7%) out of 150 questionnaires distributed amongst members of the Nigerian Society of Anaesthetists were completed and returned. Fifty-five per cent (55%) of the respondents confirmed their willingness to be screened but only 45% had had a personal HIV screening test. Even though 23% of all the respondents will transfuse unscreened blood in an emergency, only 1(8.3%) of the consultants will do so. This trend was also reflected in gloving behaviour as 11(91.6%) of consultants will routinely wear gloves whilst only 12(70.5%) of the senior house officers will routinely glove for venepuncture despite the availability of gloves. Other precautionary facilities such as goggles, sharp disposal bins, routine screening of all surgical patients were more available in private than in government hospitals. Ninety- six per-cent of all respondents will initiate an action after a needle stick injury whilst 4% will ignore. General Anaesthesia was the choice of anaesthetic in an HIV/AIDS infected patient by 43% of respondents whilst 22% of respondents would choose regional technique. However, only 85% of respondents were willing to anaesthetise an infected patient. This study suggested a dearth of knowledge and perception of risks of HIV/AIDs amongst Nigerian Anaesthetists. Appropriate training and greater education is highly recommended. Rigorous infection control policy is imperative and hospital authorities must ensure availability of protective facilities.

Adult↗

The non-physician anaesthetist in a teaching hospital.

There is an overall shortage of physician anaesthetists in the West African Subregion. The non-physician anaesthetist (nurse anaesthetist) is used to provide adequate clinical service. However, in a teaching hospital setting it usually lead to the frustration of the efforts of resident physician anaesthetists. The Society of Anaesthetists of West Africa has therefore recommended that where possible nurses should not be involved in the administration of anaesthetics in the Teaching Hospitals. They should be placed out into intensive therapy units and recovery rooms.

Africa, Western↗

Recognition of the difficult airway in normal Nigerian adults (a prospective study).

Difficulty with laryngoscopy and intubation is known to be the most frequent cause of anaesthetic related deaths. Awareness of the possibility of difficulty would enable the anaesthetist to be adequately prepared. 57 "normal" adult patients were examined pre-operatively and at laryngoscopy using the Mallampatti (1985) and the Cormack (1984) classification respectively. The result showed that none of the patients was in the IV Mallampatti nor IV Cormack groups. Four patients with class III Mallampatti features were seen, two of which were classified Cormack III at laryngoscopy. Intubation failed in these two patients. The majority of patients were classified as Mallampatti class I (68.42%) and Cormack grade I (63.16%). This in effect demonstrates that in most "normal" patients laryngoscopy and intubation should be fairly easy.

Adult↗

Subglottic stenosis in a child: a complication of prolonged endotracheal intubation.

A 1 1/2 year old Nigerian child sustained traumatic rupture of the diaphragm which was repaired under endotracheal anaesthesia. A red rubber endotracheal tube was used for the surgery and a nasotracheal tube was let in situ for 4 days. A post intubation subglottic stenosis which developed was managed with a tracheostomy and a series of 8 tracheal dilatations under hatothane within a period of 5 months. Appropriate choice of tubes and attention to details of humidification may have prevented this serious complication.

Accidents, Traffic↗