Anesthetic and surgical predictors of treatment outcome in re-do craniotomy

Introduction: Craniotomy is a neurosurgical operation done to remove brain tumor, repair vascular lesion, and relieve intracranial pressure. Complications can arise which may necessitate re-do craniotomy. The study is planned to find out the relationship between variables such as age, American Society of Anaesthesiologist (ASA), Glasgow coma score (GCS), frequency of re-do craniotomy, and surgical outcome of re-do craniotomy. Materials and Methods: This is a retrospective study of all the patients who had re-do craniotomy over a 4-year period. The data that were collected included age, sex, ASA classification, indication for re-do craniotomy, GCS, frequency of re-do craniotomy, postoperative complications, and outcome. Results: Twenty-five patients had indication for re-do craniotomy within the study period. Forty percent were male and 60% were female, and their mean age was 38.56 ± 17.38 years. The indications for re-do craniotomy were removal of residual tumor, evacuation of clot, and cerebrospinal fluid leakage. Seventy-six percent had good outcome, while 24% had poor outcome. Outcome was good for patients who had re-do craniotomy done once, while poor outcome was for patients with second and third craniotomies. Ninety percent of patients with ASA 2 had good outcome, while 9.1% had poor outcome; but 64.3% had good outcome with ASA 3, while 37.7% had poor outcome with a P-value of 0.18. Seventy-five percent had poor outcome in patients with GCS of less than 9, while 25% had good outcome; but 14.3% had poor outcome in patients with GCS above 9, while 85.7% had good outcome with a P-value of 0.031. Conclusions: Increasing frequency of re-do craniotomy and lower GCS were major factors affecting outcome in re-do craniotomy in our center. The outcome of these patients is valuable in the management of other patients with re-do craniotomy in future

Comparative Study of Teenage Pregnancy in Lagos State University Teaching Hospital

Teenage pregnancy is a topic that will need to be revisited time and again because of the continuously evolving and changing social and moral norms in different parts of the world. This informed a comparative study of the obstetric performance of primiparous teenagers and nonteenage primiparas within a two-year period (1st January, 2006-31st December, 2007) in Lagos State University Teaching Hospital,Ikeja. Fifty six(56) case notes of teenagers who delivered in this hospital were available for analysis. Three hundred and thirty (330) non-teenage primiparous case notes were selected with ages ranging from 20 and 36 years using stratified random sampling, out of which two hundred and ninety five (295) case notes were suitable for analysis. The incidence of teenage pregnancy in the study population was 1.01% with majority of them in the age range 17 to 19 years. Pregnancy and delivery complications that were commoner and statistically significant in the teenagers were hypertensive disorders of pregnancy (x2=7.07 p=0.0078), anaemia in pregnancy([x2=5.71,p =0.0168) and cephalopelvic disproportion ( x2=4.54, p=0.0330). The mode of delivery that was statistically significant was lower segment caesarean section ( x2 =4.64, p=0.0297). The incidence of complications were more in the teenage mothers who were unbooked for antenatal care. Irrespective of the problems peculiar to primiparas, teenagers have been shown to be at increased risk of hypertensive disorders of pregnancy, anaemia, cephalopelvic disprorportion and caesarean section. They will therefore require additional efforts and resources to manage them to ensure a favourable pregnancy outcome. Prevention of teenage pregnancy will go a long way in reducing the incidence.Keywords: Teenage, Pregnancy, complications, developing countryNigerian Medical Practitioner Vol. 63 No 1-2, 201

Soft rot Pectobacteriaceae: A Brief Overview

Bacterial soft rot diseases devastate a wide range of crops, vegetables and ornamental plants worldwide. Amongst the most damaging agents of these diseases are members of the Pectobacterium and Dickeya genera belonging to the family Pectobacteriaceae in the order Enterobacterales. As an introduction to the topics of this book, this chapter presents a brief overview on taxonomy history, presence in multiple environments, disease characteristics, population dynamics, management and economic impact of these bacteria