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Introduction: Nosocomial infections (NI) are common conditions among hospitalized patients. This study aimed to evaluate healthcare workers' knowledge and practices regarding infection prevention measures in intensive care units. Method: This was a descriptive, cross-sectional study conducted from April 13to June 10, 2022, among 45 healthcare workers in three university teaching hospitals of Abidjan. The parameters studied were: the theoretical and practical knowledge of healthcare workers regarding the prevention of nosocomial infections. Results: 45 healthcare workers participated. 74.7% knew the definition of a nosocomial infection and 43% identified the main risk factors for its occurrence. Sixty-five percent identified staff hands as the main mode of cross-transmission of germs between patients. Sixty-four percent of staff reported using non-sterile gloves during urinary catheter insertion. Compliance with hand hygiene before patient contact was low (31.8%) while gloves changes between patients were observed in 87.2% of cases. Deficiencies were noted in adherence to aseptic techniques before performing invasive procedures. Non-compliance was mainly attributed to shortages of supplies and personnel, and insufficient knowledge of preventive measures. Conclusion: healthcare workers’ knowledge and adherence to hygiene practices in intensive care units were insufficient.

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Objective: To assess the anesthetic management of surgical abdominal emergencies at Donka National Hospital. Patients and Methods: This was a retrospective descriptive study conducted over a 2-year period, from January 1, 2024, to December 31, 2025. It included all medical records and operating room reports of patients of all ages who underwent emergency surgery for a surgical abdominal condition at Donka National Hospital. Obstetric surgical emergencies and incomplete medical records were excluded. Patient recruitment was exhaustive. Results: A total of 159 patients were included, representing a frequency of 35%. The mean age was 36 ± 15.2 years (range: 16–82 years), with a male-to-female sex ratio of 1.9. Generalized acute peritonitis was the most common surgical indication (50.3%), followed by acute intestinal obstruction (20.7%). ASA II-U was the predominant classification (40.9%). All patients were considered to have a full stomach. General anesthesia was administered in 98% of cases, with rapid sequence induction performed in 94% of cases and the Sellick maneuver in 98% of cases. Oropharyngeal endotracheal intubation provided airway control in 98% of cases. Intraoperative hypotension (18.9%) and delayed postoperative emergence (3.8%) were the most frequent complications. Peri-anesthetic mortality was 0.6%. Conclusion: Surgical abdominal emergencies account for a substantial proportion of operative activity at Donka National Hospital and predominantly affect young adult males. Standardized anesthetic management, rigorous preoperative resuscitation, and close interdisciplinary collaboration are essential to improve outcomes in these patients.

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Background: Pharmacogenetic variability in drug-metabolizing enzymes influences individual response to analgesics, affecting both efficacy and adverse-effect risk. Health care workers' knowledge of this variability is central to safe, individualized pain management. This study assessed their knowledge, attitudes, and practices regarding analgesic pharmacogenetics, with emphasis on knowledge relevant to individualized pain management. Methods: Descriptive cross-sectional study among 112 health care workers using a self-administered, bilingual (French/English) questionnaire. A nine-item objective knowledge score was built; attitudes and practices were rated on four-point scales. Associations were tested with the Kruskal-Wallis test, the Mann-Whitney U test, and Spearman correlation. Results: Mean knowledge score was 5.0 ± 1.2/9, moderate in 57.1% of participants and good in only 8.9%. While 93.8% recognized a link between pharmacogenetics and analgesic efficacy, only 8.9% identified the four metabolizer phenotypes and 27.7% understood that identical dosing may be inappropriate across patients. Knowledge score differed by qualification (p=0.027) and was strongly associated with prior awareness (p<0.001). Attitudes were favorable to neutral in 93.8% of respondents, while practice scores remained low in 60.7%. Conclusion: Health care workers understand the principle of pharmacogenetics but not its practical application (metabolizer phenotypes, dose adjustment), limiting the safety of pain management. Targeted training is needed.

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Introduction: Metformin intoxication, although uncommon, represents a significant cause of admission to intensive care units. This study aims to assess the clinical and therapeutic characteristics of patients admitted to the ICU at CHI Evreux for metformin intoxication. Objectives: To describe the clinical presentation and therapeutic management of patients with metformin intoxication. Patients and Methods: This retrospective study was conducted over a three year period and included 20 patients admitted to the ICU for metformin intoxication. Clinical data and management parameters were collected and analyzed. The findings were compared with previously published studies. Results: The hospital frequency of metformin intoxication was 1.56%. Patients were predominantly elderly males, with a median age of 69.5 years. The main presenting symptoms were abdominal pain, anorexia, and nausea/vomiting. All patients exhibited acute kidney injury and severe metabolic acidosis. Management required aggressive fluid resuscitation, vasopressor support, and renal replacement therapy in many cases. The mortality rate was 11.11%. Conclusion: Metformin intoxication is a severe condition requiring intensive management. The results of this study are consistent with existing literature, although some variations were observed.

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Background: Anterior mediastinal masses in children pose significant anesthetic challenges because of the potential for airway compression, cardiovascular compromise, and acute cardiorespiratory collapse during induction of anesthesia. Careful preoperative assessment, appropriate planning of airway and vascular access, and maintenance of spontaneous ventilation are important considerations in these patients. Case Presentation: We report the perioperative anesthetic management of a 8 years old pediatric patient with a large anterior mediastinal mass who presented for thoracotomy and surgical resection. Preoperative evaluation included clinical assessment, imaging, and evaluation for evidence of airway and cardiovascular compression. Appropriate preparation was made for difficult airway management and emergency cardiopulmonary support. Anesthesia was induced intravenously, with continuous monitoring of respiratory and cardiovascular status. After securing the airway and confirming adequate manual ventilation, there was difficulty in controlled ventilation due to compression of the airway, so the patient was immediately reversed with sugammadex and the rest of case done under spontaneous ventilation with sevoflurane with oxygen-air mixture, and thoracic epidural was placed for adequate analgesia. The mass was successfully resected through thoracotomy without major intraoperative cardiorespiratory complications. Postoperative care included close respiratory and hemodynamic monitoring, with appropriate analgesia and subsequent recovery. Conclusion: Anesthetic management of children with anterior mediastinal masses requires meticulous preoperative risk stratification and preparation for sudden airway or cardiovascular compromise. Maintaining spontaneous ventilation during the critical phase of induction, minimizing factors that can worsen airway compression, and ensuring immediate availability of advanced airway and cardiopulmonary rescue strategies are important principl

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Introduction: Leptospirosis is a bacterial zoonosis of worldwide distribution. Its clinical presentation is highly variable in terms of signs and severity. Weil's disease is characterized by the association of conjugated hyperbilirubinemia, sometimes severe, with hemorrhagic manifestations including hemoptysis and gastrointestinal bleeding. Case presentation: We report the case of a 27-year-old woman admitted to the intensive care unit for management of a hemorrhagic syndrome. She initially presented with an influenza-like illness treated by self-medication with paracetamol. On admission, the patient presented with febrile hepatonephritis associated with multiorgan failure, together with the classic triad of Weil's disease: conjugated hyperbilirubinemia, and hemorrhagic manifestations including hemoptysis and gastrointestinal bleeding. Leptospira IgM serology was positive, confirming the diagnosis. She was treated with ceftriaxone and supportive care. The clinical course was favorable, with discharge from the intensive care unit after 10 days of hospitalization. Conclusion: The presence of a hemorrhagic syndrome in the setting of febrile hepatonephritis should raise suspicion of human leptospirosis. Patient history-taking is essential and may reveal exposure to animals capable of transmitting the pathogen to humans. Definitive diagnosis relies on isolation of the organism or rapid IgM serological testing.

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Fascia iliaca compartment block (FICB) can be performed using anatomical landmarks or ultrasound guidance for analgesia after femoral fractures. This prospective, parallel-group, randomised controlled trial at Irrua Specialist Teaching Hospital, Nigeria, enrolled adults with femoral neck or shaft fractures and pain between 15 November 2021 and 14 January 2023. Participants were randomised 1:1 to landmark-guided or ultrasound-guided FICB, with 30 mL of plain 0.25% bupivacaine administered in each group. Co-primary outcomes were needle-tip precision and block effectiveness at 1 h; secondary outcomes included Numerical Rating Scale (NRS) pain scores, procedural time, time to block onset, time to first rescue analgesia, complications and satisfaction. Ninety participants were randomised and 89 were analysed. Needle-tip placement was confirmed in 44/44 participants (100.00%) with ultrasound and 29/45 (64.44%) with landmarks; the reported Fisher’s exact test statistic was 19.073 (P = 0.050). Effective block at 1 h occurred in 41/44 (93.18%) and 41/45 (91.11%), respectively. Median NRS scores were lower with ultrasound at 30 min (2 vs. 3; P = 0.009) and 1 h (1 vs. 2; P = 0.001). Landmark-guided FICB was faster to perform (901 vs. 2,414 s; P = 0.050), while time to first rescue analgesia did not differ (P = 0.608). No clinically apparent complications were observed. Ultrasound guidance improved needle-tip localisation and was associated with lower early pain scores, whereas landmark-guided FICB remained a feasible and efficient alternative. The aggregate data do not establish universal differences in overall analgesic effectiveness or safety.