ABSTRACT
Introduction: The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) creates a global pandemic and affects more than 200 countries/regions. As of July 30, 2020, the cumulative number of confirmed cases of COVID-19 in the world exceeded 16 million. SARS-CoV-2-infected patients are more likely to be admitted to the hospital and enter the intensive care unit, with high mortality. The most common symptoms of COVID-19 patients are fever and cough. Objective: To assess the magnesium sulfate extended infusion as an adjunctive treatment for covid-19 infected for anaesthesia. Materials and Methods: The prospective study was undertaken Department of Anesthesiology, Medical College for women and Hospital, Uttara, Dhaka, Bangladesh from July to December 2021. Of the 157 anesthesiologists who responded to this survey, 57 (36.0%) reported using magnesium sulfate in anesthesia. All patients received standard therapy for asthma, while the treatment group received an intravenous magnesium sulfate bolus of 50-75 mg/kg (0.2-0.3 mmol/kg) followed by 40 mg/kg/h (0.16 mmol/kg/h) for 4 h. Patients were monitored for cardiorespiratory complications. The treatment group underwent four blood draws to assess pharmacokinetic parameters. Results: Of the 157 anesthesiologists who responded to this survey, 57 (36.0%) reported using magnesium sulfate in anesthesia. The highest participants 50 years above 48(30.5%), 31-40 years 28(17.8%) and 0-10 years 04(2.5%). The frequency of use of adjuvant drugs in anesthesia is described. The number and percentage of clinical effects (n/%) for the use of magnesium sulfate in anesthesia were (in descending order, more than one response per participant allowed): postoperative analgesia (41/71.9%), reduction of anesthetic consumption (59/68.4%), prevention and treatment of preeclampsia and seizures in eclampsia (36/63.1%), prevention and treatment of arrhythmias (29/50.8%), reduction of the dose .......

ABSTRACT
Nurses are key health professionals involved in the frontline care of elderly patients. WHO predicted that the proportion of people aged over 60 years will increase from 11% to 22% between 2000 and 2050. Aligned with this increase in the ageing population is a greater demand for nursing care. Nurses’ perceptions of caring for elderly is of global interest because of many reported negative perceptions and limited number of qualified nurses interested in the field of caring for elderly patients. This study aimed at exploring the nurses’ perceptions of caring for elderly patients at University Teaching Hospital and Levy Mwanawasa University Teaching Hospital in Lusaka. The study used a mixed methods approach. Data were obtained from 148 randomly and 18 purposively sampled nursing staff. Binary Logistic Regression and content analysis of main themes were used to identify factors associated with perceptions of caring for elderly patients. Majority of the nurses (81%) had negative perceptions towards care of elderly patients. There was no statistical significance between social demographic data, knowledge of caring, availability of resources, staffing levels and management support and perceptions of caring for elderly patients. This could have been due to a small sample size which was used. The negative perceptions about caring for elderly patients in this study could be associated with the lack of knowledge specific on care of elderly patients, training units and geriatric specific guidelines for care of elderly patients. Therefore, the nursing curriculum content should be reviewed to include care of elderly patients, guidelines including hospital infrastructure, staffing and equipment friendly to care of elderly patients should be developed.

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Introduction: The intensive care unit (ICU) is a health care delivery service for patients who are in critical condition with potentially recoverable diseases. This study was aimed to determine the admission patterns, clinical outcomes among patients admitted in the intensive care unit (ICU). Methods: A retrospective review of all patients admitted into the ICU at Babcock University Teaching Hospital (BUTH) from 2016 to 2021. Data was collected from individual patient case notes and the ICU admission and discharge registers. Results: A total of 137 patients were included in this study, consisting of 78 (57.4%) males and 58 (42.6%) females. Ages ranged from 4 to 90 years with a mean age of 47.60 ± 19.52 years. The most common cases admitted were general surgery patients of which there were 58 (42.6%). Neurological cases were however the major causes of death (6.6%), followed by sepsis (4.4%) and respiratory diseases (4.4%).The overall mortality rate of the ICU was 27.2%. Deceased patients spent longer days in ICU (5.73 days) as compared to patients who were discharged. Conclusions: The overall mortality was considerably high and general surgery and neurological cases were the most common causes of admission in ICU and mortality respectively.

ABSTRACT
Background: The ideal portion of dexmedetomidine for shivering control with the most un-hemodynamic disturbances is still under research. Postanesthetic shivering (PAS) is an unsavory and possibly serious difficulty. Not very many investigations have been finished in regards to the ideal compelling portion of dexmedetomidine for the counteraction of postspinal anesthesia (SA) shivering. Accordingly, we expected to look at and assess three distinct portions of intravenous dexmedetomidine and to explore the ideal portion of dexmedetomidine that successfully forestalls shivering in patients going through transurethral resection of the prostate (TURP). Materials and Methods: In this randomized, twofold visually impaired, planned study, 135 patients of the American Society of Anesthesiologists I and II booked for elective TURP under SA were selected. Patients were haphazardly apportioned into one of the three gatherings getting dexmedetomidine: Group P: 0.5 μg/kg, Group Q: 0.75 μg/kg, and Group R: 1.0 μg/kg. The essential result of the review was intraoperative rate of shivering. The optional results, like hemodynamic boundaries. Results: Shivering score of various gatherings uncovered measurably huge lower occurrence and seriousness of shivering in Group Q and Group R when contrasted with Group P(P = 0.0395). Occurrences of sickne, bradycardia, and hypotension were more in Group R when contrasted with Group P and Group Q. Axillary temperature and sedation scores were equivalent among various gatherings (P > 0.05). Conclusion: Dexmedetomidine in the dose of 0.75 μg/kg furnishes sufficient antishivering impact with added advantage of sedation and less hemodynamic disturbance.

ABSTRACT
Maternal mortality is a major health problem in developing countries. Critical care of the obstetric patient has been recognized as a useful tool in the reduction of maternal morbidity and mortality. The study is a five year retrospective review of the clinical characteristics and outcome of all obstetric admissions into the ICU. Data collected and analyzed included demographics, diagnosis at admission, mode of delivery, ante natal booking status, duration of admission into the ICU, mechanical ventilatory support, duration of stay on the ventilator and outcome of ICU admission. There were 170 obstetric admissions accounting for 25.3% of total ICU admissions during the period of review. The mean age of patients was 30.2±29.2 years. Hypertensive disorders of pregnancy accounted for the highest cause of obstetric admission diagnosis 51.7%. Majority of the patients 94.7% were admitted postpartum. The mean length of ICU stay was 2.7 ± 2.8days. Mortality was 26.5% with a significantly higher percentage of deaths in unbooked/referred patients (66.7%). There is a high rate of ICU admission of obstetric patients in our hospital. Mortality is also high especially among unbooked late referrals. Timely referrals and early recourse to ICU care by booked patients may provide some improvement in the standard of care received in the ICU with a subsequent lower mortality.

ABSTRACT
Significant differences exist between airways of the neonate and the adults. Anaesthetic management of airway may be challenging in neonates and young infants with large neck masses like cystic hygroma because these patients are at risk for sudden complete airway occlusion resulting in hypoventilation and hypoxemia. Cystic hygroma are benign, but can be disfiguring. It is a condition which usually affects children. Treatment is surgical excision under general anaesthesia either one or multistage resections.

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Background: Head injuries constitute a real public health problem in Low Income Countries. The aim of this study is to evaluate the management of severe head trauma. Patients and methods: A prospective study was conducted for a period of six months, from 1st February to 31th July 2018 at Niamey National Hospital. Were been Included all patients victims of head injury with Glasgow Coma Scale (GCS) less than 8. The following variables were studied: age, sex, cause of trauma, deadline admission, means of transport used, Glasgow Coma Scale, CT Scan results, management and evolution. Results: Out of 1,918 patients admitted; 243 were head trauma, of which 76 patients had a GCS less than 8 (3.96%). Male predominance was found with a sex ratio of 24.33, young people was the most concerned (mean age:29.88 ± 16.37 years). Predominant age group was 16 to 30 years old, with 43.42% of patients. The circumstances of the trauma were road traffic accidents (86.84%). Transportation was medicalized in 15%. GCS was between 6 to 8 in 74.02% and the admission deadline was less than 6 hours in 77.63%. Respiratory distress was found in 28.95% and circulatory distress in 14.47%. Cranio-cerebral CT scan was performed in 82.89%. Seven patients (9.21%) were intubated and ventilated. Death rate was 53.94%. Conclusion: Head injury concerns a young male patient, the cause was a road traffic accident, this situation could be improved by raising the population's awareness of road safety and greater efficiency in taking in medical charge.