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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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Background and Aim: Dexmedetomidine, a selective alpha-2 adrenergic agonist, has been used to blunt various stress responses during general anaesthesia including that of pneumoperitoneum. It also has synergistic effects when used as an adjuvant with anaesthetic agents. Our study aimed to assess the efficacy of dexmedetomidine without any initial bolus at an infusion dose of 0.5 mcg/kg/hour, in attenuating the haemodynamic stress response to pneumoperitoneum in laparoscopic surgeries and evaluate the efficacy of its synergistic effects at this dose. Methods: 60 American Society of Anaesthesiologists physical status I/II patients, 18-60 years, undergoing elective laparoscopic surgery were randomized into 2 groups: Group I received dexmedetomidine and group II normal saline @ 0.5 mcg/kg/hour intravenously, started before premedication till the end of pneumoperitoneum. Heart rate and blood-pressure were monitored continuously. Anaesthetic agents and analgesics were titrated to maintain entropy of 40-60. Results: Compared to group II, group I showed significant blunting of HR and BP rise during entire duration of pneumoperitoneum (p<0.05). There was reduced requirement for propofol, fentanyl and isoflurane, showing significant MAC sparing effect (p<0.0001) in group I vs group II. Patients in group I also exhibited earlier emergence, without residual sedation (p<0.0001). Conclusion: Without any initial bolus, Dexmedetomidine infusion @0.5 mcg/kg/hour, when started timely before induction of pneumoperitoneum, effectively attenuated the hemodynamic stress response to pneumoperitoneum, significantly reduced anaesthetic/analgesic requirements exhibiting good synergistic effect, while maintaining depth of anaesthesia, resulting in early and smooth emergence. This dose achieves maximum efficacy with minimal side effects.

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Introduction: The perioperative management of an elderly patient is significantly particular due to age-related physiological and pharmacological changes. Emergency surgery in the elderly patient corresponds to a major and disturbing life event for the patient. Objective: To evaluate the perioperative management of abdominal surgical emergencies in elderly patients. Methodology: This is a retrospective, descriptive and analytical study conducted over 3 years from January 1st, 2022 to December 31th, 2024. We included in the study all patients aged 60 years and older who were operated on for a non-traumatic abdominal surgical emergency. Results: We collected and included 74 medical recording, representing a frequency of 2.5%. The sex ratio was 1.04. The average age was 71.5 years with extremes of 60 to 91 years. Patients were classified as ASA 2u in 59.4% and ASA 1u in 32.4%. Charlson’s index was on average 3.1 with extremes from 2 to 6. Surgeries were rated Altemeier 4 in 39.2%. The preoperative indications were dominated by acute bowel occlusions in 43.2%, strangulated abdominal wall hernias in 25.6%, acute peritonitis in 12.1% and acute appendicitis in 12.1%. Preoperative acute kidney injury was found in 27%. In the postoperative phase, 36.4% of patients were admitted to intensive care unit. The reasons for admission to intensive care unit were delayed awakening (64%), hypovolemic shock (9.5%) and respiratory distress (5.4%). The state of hypovolemic shock (12.1%), postoperative acute kidney injury (5.4%) and acute respiratory distress syndrome (5.4%) were the main postoperative complications. The evolution was favorable in 78.4% and the mortality was 21.6%. The causes of death were septic shock in 68.7% and cardiogenic shock in 31.3%. Factors associated with mortality were age, ASAu score, Charlson index, preoperative acute kidney injury (AKI), perioperative anuria, pulmonary inhalation, admission to intensive care unit, septic shock, postoperative AKI,

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Objective: To report on the experience of the anesthesia-intensive care unit of the Conakry University Hospital concerning the practice of ultrasound-guided peripheral nerve blocks (PBB). Methods: This was a descriptive retrospective study carried out over a period of 24 months, from October 2022 to September 2024, in the operating room of the University Hospital of Conakry. We included all records of patients aged 18 years and older, who received ultrasound-guided BNP for scheduled or emergency surgery and gave informed consent to participate in the study. Results: The frequency of peripheral blocks was 8.7%. The average age of the patients was 40 years, with a predominance of women (60%). The operating rooms were mainly performed for patients in the traumatology-orthopedics department (34.3%). The most frequent operative indication was fracture of the two bones of the forearm (26.2%). ASA Class I was the most represented (74.8%). The average duration of the blocks was 10 ± 1.8 minutes. Analgesic blocks predominated (63.1%), followed by anesthetic blocks (36.8%). TAP block (33.1%) and axillary block (27.5%) were the most common. Bupivacaine 0.25% was the most commonly used anesthetic (47.3%), followed by Xylocaine adrenalin (34.1%). Conclusion: Although recent in Guinea, the practice of ultrasound-guided NPPs offers promising potential, particularly in traumatology-orthopedics. Their development requires increased investment in equipment and training to maximize their benefits.

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Background: Point-of-care ultrasound (POCUS), and particularly the Focused Assessment with Sonography in Trauma (FAST), is widely used for the rapid detection of life-threatening internal injuries in trauma settings. In low-resource environments, where access to whole-body computed tomography may be limited, FAST plays a pivotal role in early triage and therapeutic decision-making. This study aimed to assess the diagnostic contribution of FAST in the initial evaluation of polytrauma patients admitted to the Emergency Department of Gabriel Touré University Hospital. Methods: We conducted a prospective, observational, descriptive study over six months (July–December 2022) in the Emergency Department of CHU Gabriel Touré, Mali. All trauma patients presenting with hemodynamic instability (systolic blood pressure ≤ 90 mmHg) were eligible. Non-consenting patients or those who died before undergoing FAST were excluded. Ultrasound examinations were performed using a Siemens Acuson X300 device equipped with cardiac, linear, and convex probes. Clinical, epidemiological, FAST findings, CT scan results, therapeutic interventions, orientation, and outcomes were collected and analyzed using SPSS 26.0, applying chi-square and logistic regression tests (significance threshold p < 0.05). Results: A total of 42 polytrauma patients were included among 9050 trauma admissions (frequency 0.46%). Road traffic accidents predominated (80.95%), with high-energy mechanisms commonly observed: projection (35.71%), crushing (26.19%), and vehicle ejection (23.80%). Chest pain (90.50%) and dyspnea (42.85%) were the most frequent symptoms. FAST was pathological in 64.28% of patients, mainly showing hemoperitoneum (40.48%). Thoracic lesions detected on FAST included pneumothorax (9.52%), hemothorax (4.76%) and hemopneumothorax (9.52%). CT scans confirmed numerous severe injuries, including rib fractures (38.10%), flail chest (26.19%), and abdominal injuries in 78% of cases. Emergency interventions w

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Introduction: Renal Failure Represents Approximately 1% Of Emergency Admissions. In Our Setting, The Vast Majority of Chronic Renal Failure Patients Are Under-Dialyzed, And Access to Emergency Extracorporeal Renal Replacement Therapy Is Not Always Available. Objective: To Report the Clinical, Therapeutic, And Evolutionary Characteristics of Renal Failure in the Emergency Department of A Tertiary Hospital in Africa. Patients And Methods: This was a Cross-Sectional Prospective Study from January to December 2024, Including All Patients Presenting with Renal Failure Either at Admission or During Management of Another Condition in The Emergency Department. Results: During The Study Period, 160 Patients Were Diagnosed with Renal Failure, Giving A Prevalence Of 3.55%. The Mean Age Was 50 Years [16,7]. There Was A Male Predominance Of 54.4%. The Main Reasons for Consultation Were: Respiratory Distress 24.38%; Altered Consciousness 23.75%; Infectious Syndrome 12.50%; Arteriovenous Fistula Rupture 5%; Deep Vein Thrombosis 3.13%. A Total Of 33.1% Of Patients Were Known Chronic Renal Failure Patients, and 23% Were on Chronic Dialysis. In Addition, 29.4% Of Patients Were Diabetic, And 59.4% Hypertensive. A History of Nephrotoxic Drug Intake Within the Three Months Prior To Admission Was Found In 30.6% Of Patients. At Admission, 40% Had A GCS < 15; Mean Spo₂ Was 89% [8.4]; Mean MAP Was 102 Mmhg. Mean Hemoglobin Level Was 8 G/Dl [2.5]; Creatinine 627 µmol/L [526]; Sodium 127 Mmol/L [10.46]. Life-Threatening Hyperkaliemia Was Present In 8.8% Of Patients. Oxygen Therapy Was Initiated In 55% Of Patients. Ten Percent Were Transfused. Emergency Renal Replacement Therapy Was Performed In 70% Of Cases. Major Complications Included: Infectious Pneumonia 25.6%; Uremic Coma 8.1%; Hemorrhagic Syndrome 5%; Status Epilepticus 2.6%. Mortality Was 31.3%. Mean Length of Stay Was 6 Days [3.5]. Conclusion: Under-Dialysis Is Responsible for Decompensations and High Mortality.

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Background: Red blood cell (RBC) aggregability and deformability are determining factor of blood viscosity, microcirculatory flow, and oxygenation of tissues. These hemorheological properties can be modified by different pharmacological agents such as anesthetics. This study explored the impact of two widely used anesthetic drugs, ketamine and lidocaine, on aggregability and deformability of the RBCs in male Wistar rats. Methodology: The male Wistar rats (N= 35) were subdivided into five groups of six each. Group 1 was a control which was subjected to distilled water. Group 2 got 2 mg/kg lidocaine (plain), Group 3 got 2mg/kg lidocaine with adrenaline, Group 4 experienced 5mg/kg ketamine and Group 5 had a combination of 5mg/kg ketamine with 2mg/kg lidocaine. The treatments were done on two days. At the termination of treatment rats were sacrificed and blood samples were taken through cardiac puncture. The deformability of the RBCs was determined through diffraction ektacytometry and automated rheoscopy, and the aggregability indices were determined through rheoscopes based on light transmission at rest. Analysis of data was done through ANOVA where the significance was p < 0.05. Results and Discussion: The results indicated that there were no significant changes in RBC aggregability and deformability of all treatment groups against the controls. The ketamine alone or the combination of ketamine and lidocaine had no effect on the erythrocyte rheological behaviour. These findings are in line with the past studies that have shown that these anesthetics have insignificant effects on blood viscosity, hematocrit or plasma rheology. Conclusion: Ketamine and lidocaine do not negatively impact on RBC aggregability and deformability of male Wistar rats. Their application seems to be hemorheologically secure with no threat of causing the blood viscosity and microcirculatory flow disruption.