ABSTRACT
Admission to the ICU is relatively common in lung transplant recipients. The ICU mortality rate has been reported to be around 37% per admission. The aim of our study was to assess patient characteristics, ICU outcomes and QOL of lung transplant patients who required ICU readmission. ICU data from the first ICU readmission were collected retrospectively. QOL was assessed using SF36v2 tool prospectively. Cardiopulmonary transplant centre Participants: 63 lung transplant recipients who were readmitted to ICU formed the study group. 66 patients selected by computer random number generator software who underwent transplant at the same time but were not readmitted to ICU after transplant formed the control group. The response rate to the questionnaire was 70%. Mean ICU LOS was 4.53 (SD 4.68) days. Mean duration of mechanical ventilation was 3.83 (SD 4.03) days. Overall mortality was 21% in the study group and 9% in the control group (p = 0.08). SF36v2 scores were lower in the study population compared to Australian norms. The mean PCS summary scores for study group and control groups were 42.21 (SD 12.81) and 45.32 (SD 11.28) respectively (p = 0.267) and that for the mean MCS were 45.68 (SD 12.37) and 47.79 (SD 9.25) respectively (p= 0.410). Lung transplant patients requiring ICU readmission had higher overall mortality (p= 0.08). Those patients who survived had good ICU outcomes and similar QOL scores compared to those who did not require ICU readmission.

ABSTRACT
Background: One of the most important safety measures during the surgical procedure is preoperative fasting, which is defined as deprivation of food and liquid intake for the hours preceding anesthesia. The general objective of our study was to describe the means and methods of compensating for preoperative fasting in children under 15 years of age in a hospital that occasionally performs pediatric surgery. Patients and methods: This is an observational, prospective descriptive study that took place over a period of 12 months, in the anesthesiology department of the Essos Hospital Center. All children whose age was <15 years, operated during the above period were included in the study. The variables studied were: the characteristics of the study population, the indication for surgery, preoperative fasting, and the means of compensation for preoperative fasting. Results: During the survey period, 162 patients met our inclusion criteria. The median age was 5 years. The sex ratio was 1.8 in favor of the male gender. General anesthesia was the most practiced technique (96.3%), ENT surgery the most represented specialty (65.4%). The mean duration of the preoperative fast was 5.8 ± 1.9 hours. One third of the study population (31.48%) observed prolonged fasting. Holliday and Segar's rule was the compensation formula regularly used (96%), ringer's lactate solution (93.8%) represented the reference infusion solution. Fasting compensation began on the operating table in all cases. Conclusion: The respect and observance of the preoperative fasting in the pediatric population is a delicate and laborious step. The mastery of the anatomical, physiological and pharmacological particularities of the child constitutes the basis of pediatric anesthesia for a safe practice.

ABSTRACT
Background: Pancreatic cancer is a formidable health problem worldwide with increasing incidence. Debilitating pain is very common in patients with pancreatic cancer. The aim of this study is to observe the effectiveness of neurolytic coeliac plexus block for the relief of pain due to carcinoma of pancreas. Methods: This randomized comparative study carried out in the Department of Anaesthasia, Analgesia and Intensive Care Medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka with a period from July 2008 to June 2010 for two (2) years. Result: All patients of carcinoma pancreas >18 years of age with both sexes, who were needed palliation for their end stage carcinoma, were included in this study and were divided into two groups of which group A was taken the CPB and group B was taken the conventional treatment. A total number of 30 patients were enrolled in this study of which 15 were in the group A who were treated with the neurolytic celiac plexus block (NCPB) and 15 were in the group B who were treated with conventional analgesic drugs. Maximum were from the age group of 40 to 60 years (60.0%) in group A followed by more than 60 years (26.6 %). The mean age in the group A and group B patients were 48.73 14.26 years and 51.47 ± 12.35 years respectively (p=0.579). Both in group A and B male is predominant than female which were 12 (80%) cases and 3(20%) cases respectively (p=0.999) in each group. In group A mostly were service holder which was 8(53.3%). In group A, the mean (±SD) pain VAS before treatment is 8.80±0.86 and in group B, it is 8.07 ±1.44. The difference between this two group is not statistically significant (p=0.101). Conclusion: tthe findings of this study permit to conclude that in patients with unresectable pancreatic cancer, neurolytic celiac plexus blockade (NCPB) was associated with improved pain control, and reduced narcotic usage and constipation compared with standard treatment with clinical significance. Along with higher ..........

ABSTRACT
Background: The aim of this study was to evaluate the practice of pediatric anesthesia in an adult operating theater in sub-Saharan Africa. Patients and Methods: This was an observational, prospective descriptive study that took place over a period of 12 months in the anesthesiology department of the Essos hospital center in Yaounde (Cameroon). Children <15 years old, seen in anesthesia consultation and operated on for scheduled surgery during the above- mentioned period were included in the study. The variables studied were the variables studied were: the characteristics of the study population, the anesthetic and surgical data, as well as the patient's postoperative itinerary. Results: During the study period, 162 patients were included out of a total of 1205 patients operated on during the same period. The median age was 5 years, the sex ratio 1.8. ASA class 1 was the most represented (98.1%). The combination midazolam and atropine was the premedication of choice (87.1%). General anesthesia was the most practiced technique (96.3%). Induction of general anesthesia was inhalation in 69% of cases, sevoflurane was the hypnotic used in this indication. General anesthesia was performed by a senior anesthesiologist in 67.3% of children. The majority of surgical procedures belonged to otolaryngology surgery (57%). The electrocardiogram (ECG), blood pressure, SpO2 and heart rate constituted the main part of the intraoperative monitoring. Conclusion: In low-income countries, pediatric anesthesia is still performed by personnel who are not specialized in pediatric anesthesia. In order to improve the safety of children in the operating room, health policies must encourage training and specialization in this highly delicate area, which will make it possible to reduce perioperative infant morbidity and mortality.