ABSTRACT
Takotsubo syndrome (TTS) is an acute reversible cardiomyopathy mimicking acute coronary syndrome (ACS), characterized by transient left ventricular dysfunction. It usually occurs after intense emotional or physical stress. Few cases of TSS in a perioperative setting have been described in the literature. However, recent literature data show an increase in its incidence in the perioperative period in recent years. The prognosis is generally favorable, but the outcome can often be rapidly fatal. We report a case of Takotsubo syndrome that occurred immediately after surgery in a 55-year-old patient with chronic coronary artery disease who underwent right middle lobectomy with lymph node dissection. The event was triggered by an episode of severe hypoxia and an injection of adrenaline. The diagnosis was confirmed by echocardiography (LVEF 25%, circumferential apical akinesis) and coronary angiography (chronic bifocal stenosis without acute occlusion). The outcome was favorable after symptomatic treatment and hemodynamic suppor, with complete recovery of left ventricular function. This observation illustrates the possibility of TST in a surgical setting in coronary patients. We also describe the diagnostic and therapeutic aspects of this rare perioperative complication.

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This essay uses the narrative approach to reflect on Luke 24:13-35 in relation to the ministry of healthcare Chaplains besides its application to various theological and pastoral paradigms. It illustrates how the text inspires spiritual accompaniment, informs spiritual assessment, directs pastoral interventions, and guides boundaries in pastoral care for the sick in healthcare settings. It encourages Chaplains to foster and evoke the attitude of compassionate curiosity in patients to aid them engage with the truth of their own health conditions, no matter what, to find meaning, strength and hope in their own sufferings and pain. It finally invites Chaplains to consider their role as a prophetic witness to the truth of the mystery of the human being. Against the backdrop of the story, the article ignites the reader to search for answers to the questions: What is the context of hospital chaplaincy ministry discovered in Luke 24:13-35? What pastoral attitudes of Jesus are evident in the gospel pericope? And how do these pastoral attitudes serve as the “Jesus-factor" to inform the decision and skills of Christian Chaplains on the one hand and inspires Healthcare Chaplaincy Ministry in general on the other hand?

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Objectives: To analyze the epidemiology of maternal deaths in the Far North Region of Cameroon. Materials and Methods: This was a retrospective cross-sectional descriptive study covering the period from January 1, 2019, to December 31, 2025. The study focused on deaths occurring among pregnant women, during childbirth, or in the postpartum period. For in-hospital data, we used death and delivery registries to calculate the maternal mortality ratio and notification forms to identify the causes of death. For regional data, we consulted the DHIS2 database. Results: At the Maroua Regional Hospital (MRH), we identified 217 maternal deaths, representing an estimated maternal mortality rate of 1,330 per 100,000 live births. Across the entire Far North region, there were 1,507 maternal deaths, for a rate of 275 per 100,000 live births. At the MRH, the trend showed the lowest rates between 2022 and 2023, periods when the department had the largest number of staff (at least 4 obstetrician-gynecologists and 30 midwives). Deaths at the regional hospital represented 20.11% of all in-hospital deaths in the entire Far North region. The most affected age group was 20-29 years old, at 44.7%; the unemployed accounted for 89.3%. The highest percentage of women was unschooled (63.3%). The majority (53.9%) had not received any antenatal care. Deliveries took place at home in 10.7% of cases. 74.65% of these women were referred. The direct causes of death were hypertensive disorders (24,42%), followed by septicemia, and postpartum hemorrhage (20.28% each)The leading indirect cause was severe anemia, observed in 11.52% of cases. Conclusion: The maternal mortality rate, although decreasing, remains high in the Far North region. The affected women are young and referred by lower-level health facilities. Hypertensive disorders are the leading direct cause of these deaths. Each death should be systematically audited to better understand the related dysfunctions and to reduce this rate in the F

ABSTRACT
Thrombosis of the dural venous sinus or cerebral veins is a complete or partial occlusion that can affect one or more main sinuses. Involvement of the feeding cortical veins can lead to heterogeneous manifestations (headaches, altered consciousness, behavioral abnormalities, convulsions, speech difficulties and focal or generalized neurological deficits). The incidence of CVT is estimated at 5 per 1million. Venous thromboembolism [TE] is a multifactorial disease, and protein S deficiency [PSD] constitutes a major risk factor. Treatment of CVT with Heparin followed by VKA is recommended by current guidelines and should be started as soon as the diagnosis of CVT is confirmed we will report the case of a 17-year-old male with a medical history of anemia that was admitted in our ICU ward for a cerebral veinous thrombosis complicated with thrombo-embolic pattern. The initial treatment of TE followed the treatment guidelines of the American society of stroke. However, there are no guidelines of long-term treatment in children with PS deficiency. The actual recommendations didn’t state the best moment to introduce an anticoagulant.

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Cesarean section is the most common surgical procedure performed in hospitals worldwide. It can lead to persistent postoperative pain. Numerous analgesic techniques exist for the prevention and treatment of pain after a cesarean section. Transverse abdominal block (TAPB) and quadratus lumborum block (QLB) have proven effective. The aim of this study was to compare the analgesic effect of the TAP block versus the QLB after a cesarean section. This was a prospective, comparative, randomized, single-blind study conducted at the Abdou Aziz Sy Dabakh University Hospital in Tivaouane. All patients undergoing cesarean section under spinal anesthesia, excluding emergency cases, were included. At the end of the procedure, a TAP block and a QLB with bupivacaine were performed randomly under ultrasound guidance. Postoperative static and dynamic pain was assessed immediately postoperatively and at 1, 3, 6, 12, and 24 hours after surgery by a nurse unaware of the medication, using a numerical rating scale (NRS) from 0 to 10. Statistical analysis was performed using R software. Fisher's exact test was used to compare proportions, while Student's t-test was used to compare means. The mean ASA score was similar between the two groups. The duration of the block was significantly longer in the QLB group than in the TAP group, with a statistically significant difference (p < 0.001). The assessment of postoperative static and dynamic pain, measured using the NRS, did not show a statistically significant difference between the QLB and TAP groups at the different assessment time points. The TAP block and the quadratus lumborum (QLB) block significantly reduce postoperative pain intensity rating scales by avoiding the use of opioid analgesics. These results support the role of regional analgesia in postoperative pain management after cesarean section.

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Surgery is made easy with the application of anaesthesia that makes the patients not to feel pains during the surgery. However, due to certain complications that occur during and after surgery, most women have expressed fear and passed through certain psychological trauma before and after surgery. This study aimed to Assess Psychological Trauma from Application of Anaethesia During Caesarean Section (CS) among Women In Urban Areas of South-South, Nigeria. This was a cross-sectional study involving 250 women. Participants’ age is between 18 to 47 years. A well-structured questionnaire was administered to participants. The study lasted for a period of 2 months. Statistical analysis was done using SPSS version 25.0 and p < 0.05 was significant. The results revealed that 28% of the participants were single, 56% married, 12% divorced, 4% widowed, 72% had tertiary level of education, 48% were civil servants, 76% have 1 child, 76 have undergone previous caesarean section, 80% agreed that they were not informed of the possible side effects of anaesthesia, 76% developed anxiety, 80% had fear, 80% had emotional stress, and 80% are uncomfortable during CS. The results revealed that majority of the participants experienced worry, fear, stress and pain each time they were booked for CS.

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Background: Intensive care units (ICUs) are vital for managing life-threatening conditions. In many developing countries, critical care delivery is constrained by bed and equipment shortages, insufficient skilled personnel, and cost. Admission patterns have also changed with increase in prevalence of non-communicable diseases. Mortality rates in African ICUs remain high, about 30% in Nigeria and 60% in Kenya. Rivers State University Teaching Hospital (RSUTH) ICU faces staffing shortages and inconsistent application of admission criteria. Characterizing the local epidemiology of ICU admissions at RSUTH is essential to guide resource allocation, improve patient outcomes, and strengthen critical care delivery. Objective: To evaluate the pattern of ICU admission in RSUTH over a 31-month period. Methods: This retrospective cohort study reviewed all patients admitted to RSUTH’s 8-bed mixed medical-surgical ICU from June 2023 through January 2026. Following Ethical approval, data was extracted from the admission and discharge register and nurses’ records. Data obtained included patients biodata, diagnosis, interventions received and outcome. Data analysis was done using appropriate statistical methods. Results: 367 patients were admitted, with a mean age of 47.9 ± 19.8 years and a male preponderance (52.6%). Neurological conditions accounted for the highest indication for ICU admission (34.9%), while renal conditions were the least (1.9%). Forty two percent (42.5%) had invasive mechanical ventilation, while 41.1% had inotropic support. Duration of stay ranged from 1 hour to 32 days, with a mean of 6.5 ± 5.3 days. One hundred and eighty-one (49.3%) of the patients were transferred from the ICU to another ward of the hospital, while 159 (43.3%) died while in the ICU. Conclusion: This review shows that neurological conditions dominate ICU admissions at RSUTH, with a mortality of 43.3%, highlighting need for enhanced critical care resources to reduce mortality in this resource

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Introduction: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in intensive care units. Non-fermenting Gram-negative bacilli (NGNB), particularly Pseudomonas aeruginosa, are frequently implicated in late-onset and recurrent cases. These infections are associated with repeated antibiotic exposure, the emergence of bacterial resistance, and high mortality. The objective of this study was to describe the bacterial ecology, the appropriateness of probabilistic antibiotic therapy, and the outcomes of patients with recurrent VAP caused by GNNB. Methods: A multicenter retrospective study was conducted in the intensive care units at the Meaux, Jossigny, and Coulommiers sites of the Grand Hôpital de l’Est Francilien. Adult patients with at least three documented episodes of BGNNF-associated PAVM between January 2021 and December 2025 were included. Clinical, microbiological, therapeutic, and clinical course characteristics were analyzed. Results: Among 293 recorded episodes of PAVM with BGNNF, 166 episodes involved 51 patients with at least three infectious episodes. The mean age was 64.5 years, and 67.5% of patients were male. The mean IGS II score was 64 and the mean Charlson score was 7.1. Most PAVMs were late-onset (87.3%). Pseudomonas aeruginosa accounted for 89.1% of isolates. Probabilistic antibiotic therapy was based primarily on piperacillin-tazobactam. It was appropriate in only 50.6% of cases. The 28-day mortality rate was 35.5%. Conclusion: Recurrent BGNNF-associated PAVM occurs in patients who are particularly critically ill and have significant comorbidities. The predominance of Pseudomonas aeruginosa and the low rate of appropriate probabilistic antibiotic therapy underscore the need to better account for the local epidemiology in order to optimize initial management.

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Aim: To describe the practice of regional anesthesia (RA) pediatric surgery at the Brazzaville University Teaching Hospital (CHU-B). Patients and Methods: The study was retrospective, observational and cross-sectional over 18 months including all the records of children aged 0 to 16 years operated on by pediatric surgeons under RA, with or without general anesthesia (GA), in the operating room of the CHU-B. Epidemiological, surgical, and anesthetic variables were analyzed using Excel 2016. Results: During the study period, 320 children underwent surgery, 43 of whom were operated on under RA (13.4%). The median age was 5 years, with a range from 2 months to 16 years (quartiles: 3 to 10 years). The sex ratio was 2.07. The main surgical indication was digestive wall surgery (69.8%), followed by urological surgery (30.2%). 81.4% of the surgeries were classified as Altemeier I. 60.5% of the children were classified as ASA 1. Preoperative hemostasis testing was performed in 69.8% of the children. Preoperative preparation was carried out in 11.6% of cases. GA was administered in 83.7% of cases. Caudal block (46.5%) was the most frequently used technique, followed by wall blocks (27.9%). Ultrasound was used in 15 children (34.9%), including one with neurostimulation. Bupivacaine (95.3%) was the most frequently used local anesthetic. We noted five cases of failure block (11.6%). The mean surgery time was 55.6 ± 34.8 minutes. Conclusion: RA is part of the early postoperative rehabilitation strategy. However, it remains very rarely performed at the CHU-B, particularly pediatric surgery.

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Objective: To describe the profile of patients admitted to the emergency department’s shock unit of the Niamey National Hospital (HNN). Patients and Methods: This was a prospective descriptive study conducted over a 3-month period, from December 15, 2023, to March 15, 2024. All patients admitted to the resuscitation units of the medical and surgical emergency departments were included. The variables studied were: age, sex, occupation, origin, mode and reason for admission, clinical and paraclinical data, management, and outcome. Data were entered and analyzed using Microsoft Office 2016 and Sphinx v5 software. Statistical tests were considered significant for any p-value <0.05. Results: Three thousand four hundred and twenty (3420) patients were triaged in the emergency department, of whom 100 were admitted to the resuscitation unit, representing an overall frequency of 2.92%. Males accounted for 72% (n=72) of cases, with a male-to-female ratio of 2.57. The mean age of our patients was 34.23 years, ranging from 2 to 94 years. Hypertension was the predominant comorbidity in 32% (n=32) of cases. Stroke was the most common diagnosis, accounting for 34.48% (n=20) of cases. Among patients admitted to the surgical resuscitation unit, 52.38% (n=22) had multiple traumas. Oxygen therapy was administered to all patients. Ninety-eight percent (n=98) of patients received crystalloid fluid resuscitation. During our study, 54.76% of patients underwent surgical intervention. Thirty percent (n=30) of patients were transferred to a short-stay unit. The length of hospital stay was less than 48 hours in 53.00% of cases. Conclusion: The resuscitation room plays a crucial rôle in an emergency department, as it is the place where life-threatening or potentially life-threatening situations are managed. To optimize patient care, it must be well-equipped and staffed with trained personnel.

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Objective: To take stock of the Anesthesia practice in maxillofacial surgery at the National Hospital of Niamey. Patients and methods: This was a prospective, descriptive study over 5 months from january 2,2024 to May 30,2024. All patients who had received scheduled anesthesia in the operating room for maxillofacial surgery were included in the study. The variables studied were: Age, sex, origin, profession, medical and surgical history, ASA classification, Mallampati classification, anesthetic drugs used, tracheal intubation, intraoperative incidents and accidents and patient outcome. Data were entered and analyzed by Microsoft 2016 and Sphinx.v5 Software. The statistical tests used were considered significant for any p-value <0.05. Results: Fifty-seven (57) patients were included; a frequency of 5.42%. Male sex predominated with a sex ratio of 2.27. The average age of our patients was 26,95 ± 3,28 years. The opening of the oral cavity was limited in 19.30% (n=11). The Mallampati class was not appreciable in 43,86% (n=25) of cases. Patients were classified ASA 1 in 75.44% (n=43). Surgery was scheduled in 98.25% (n=56) of cases. Traumatic and tumor pathologies were the most indicated surgeries in 40.35% (n=23) and 38.60% (n=22) of cases respectively. General anesthesia was the anesthetic technique in all our patients. Propofol was the most used hypnotic in 49.12%(n=28). Celocurine was used for induction in 85.96% (n=44). Orotracheal intubation was perfoomed in 71.93% (n=41) of our patients; it was difficult in 38.64%(n=16) of cases. Nasotracheal intubation was performed in 22.18% (n=13). Primary tracheotomy was performed in three of our patients; that is, 5.26%. Tachycardia and hypotension were the most frequent incidents in 33.33% (n=19) and 24.56% (n=14) respectively. Cardiopulmorary arrest occurred in 1.75%(n=1) of cases. Thirty-one point fifty-eight (n=18) of our patients had received a blood transfusion. The duration of surgery was 86 +/- 6 min with extremes ra