ABSTRACT
Introduction: Direct oral anticoagulants (DOA) are recent drugs prescribed for their anticoagulant properties. When an invasive procedure is planned for a patient under DOA, the challenge for the anaesthetist is to assess the risk of bleeding and thromboembolism secondary to the medication withdrawal. In certain situations, ultrasound, with its advantages of guidance and location, is an important tool that can reduce the peri-procedural bleeding risk. Method: We illustrate this problem with this clinical case. Observation: This is an 18-year-old female patient with a history of recent deep vein thrombosis treated with direct oral anticoagulants in an underlying pulmonary tuberculosis condition under treatment; received in the intensive care unit for management of respiratory distress due to a hydro-pneumothorax confirmed on pleuropulmonary ultrasound. Amain this urgent indication for thoracic drainage, the patient benefited from a decision by the referral team to withdraw the DOAs for 3 days, a relay with curative LMWH, an exsufflation of the pneumothorax and an evacuation puncture of the effusion under ultrasound guidance and location. Chest drainage was performed successfully and uneventfully after 3 days of DOA withdrawal. Conclusion: When an invasive procedure has to be performed in the emergency department or when the thromboembolic risk is very high, validated strategies for the peri-procedural management of DOAs have not been the subject of consensus. Our case-report highlighted the value of thoracic ultrasound in the intensive care unit, which facilitates the performance of minimally traumatic procedures in the emergency department. This tool allows to postpone a procedure of bleeding risk while promoting good drug management.

ABSTRACT
Background: Clonidine stimulates the α2 receptors of the sympathetic nervous system which have a negative presynaptic feedback effect inducing a reduction in the secretion of adrenaline and noradrenaline. The main objective of our study was to evaluate the beneficial effects of clonidine on the hemodynamic response to surgical incision. Patients and Methods: This was a prospective, single-center, randomized, single-blind clinical trial that took place over a period of 4 months in the anesthesia department of the Essos hospital center in Yaoundé. All patients over the age of 18, ASA I or II, admitted for scheduled surgery were included in the study. The patients were randomly divided into two groups by drawing lots: group A (clonidine) and group B (non-clonidine). All patients in group A received clonidine IV (3μg/kg). Heart rate, systolic blood pressure, and diastolic blood pressure were observed at different times during the surgical procedure. Results: During the study period, 35 met the inclusion criteria: 20 patients for group A and 15 patients for group B. The average age was 34 years. The sex ratio was in favor of the male gender in both groups: 2.3 in group A and 2.7 in group B. ASA class 1 was the most represented (74.3%); visceral surgery most performed of all specialties in the two groups 55% (n=11) for group A and 53% (n=8) for group B. The systolic and diastolic arterial pressure curves are parallel in the two groups. There is a slight variation in PAS and PAD in group A "clonidine" compared to the baseline values. A tendency towards systolic arterial hypertension is observed in the “non-clonidine” control group. The heart rate remains stable in group A, while tachycardia is observed at the same time for the participants in group B. Conclusion: Clonidine is an alpha 2 adrenergic receptor agonist which makes it possible to limit the hypersecretion of catecholamines, potentially deleterious for the fragile patient, at the surgical incision.

ABSTRACT
Plateau pressure and peak airway pressure are directly related to the poor outcome of ventilator supported patients. Monitoring of these parameters helps clinicians in early identification of impending mortality and initiation of measures to prevent the same. This is a retrospective study in which 100 patients who were on ventilator support for >24 hours and died there after were studied. Here patient’s ventilatory parameters like plateau pressure and peak airway pressure were collected at base line, 1 hour, 30 min, 15 min, 5 min prior to cardiac arrest. Other ventilatory parameters like tidal volume and positive end expiratory pressure (PEEP) were also collected. In all the studied patients plateau pressure and peak airway pressure at 1hour, 30min, 15min, and 5min prior to cardiac arrest were high compared to base line values. These values were statistically significant as ‘P’ value was < 0.05. We conclude that a continuous, sustained rise in plateau and peak airway pressure above the baseline is useful in predicting mortality in mechanically ventilated patients.

ABSTRACT
Crop enhancement programs mostly depends on the genetic variability and the heritability of desirable traits for a successful breeding program. The degree and type of genetic variability aid the breeder in deciding the selection benchmarks and breeding schemes to be used for improvement purposes. This research was carried out at the Nasarawa State University, Faculty of Agriculture Teaching and Research Farm, to study the inter-relationships among ten (10) designated traits of cowpea comprising, plant height, Plant weight, number leaves per plant, number of branches, no. of pods per plant, number of seeds per plant, number of root noodles, weight of biomass, weight of pod, and 100-seed weight. Results from this study indicated the significance among the studied traits. The study indicates the magnitude of correlation coefficient among the studied traits. The positive correlation among most of the traits indicates the presence of strong relationship among them due to preponderance of genetic variance and genetic factors in the expression of traits. The result of grain yield showed high significant and positive correlation with plant weight, no of leave per plant, number of seeds per pod, weight biomass, seeds weight, and plant height which indicates that the traits are important in the improvement of cowpea yield through direct selection.

ABSTRACT
Background: Any anaesthetic procedure, either regional or general, has some potential for complications. For this reason, careful preoperative assessment and adequate planning of appropriate anesthetic are the cornerstones in safe pediatric anesthetic practice. But in Bangladesh, we have very limited research-based information regarding the complication of anaesthesia in children. Aim of the Study: The aim of this study was to assess the complications of anesthesia in children. Methods: This was a prospective observational study. The study was conducted in Department of Aneaesthesia, ICU & Pain Medicine, Shaheed Suharawardy Medical College and Hospital, Dhaka, Bangladesh during the period from January 2018 to December 2018. In total 62 children, aged between 1 day and 15 years prepared for anesthesia associated surgery were selected as the study subjects. The incidence of intra-operative as well as post- anesthesia recovery room complications was recorded and analyzed. Data were analyzed and by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, in analyzing the complications among the participants we observed that, bronchospam and bradycardia and hypotension were the most common intraoperative complications which were found in 11%, 10% and 8% cases respectively. On the other hand, tachycardia, prolonged unconsciousness and hypoventilation were found as the most common postoperative complications among the participants which were found in 19%, 10% and 8% cases respectively. Besides those complications some cases with restlessness, respiratory arrest, pain, shivering, hypertension, hemorrhage and laryngospasm were found in both the periods. Conclusion: Anesthesia-related morbidity and mortality can be minimized with early identification and prompt management of any complication. In this current study we observed that, preterm infants are major prone to develop respiratory complications because of using anesthesia.

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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.

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 ..........