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BACKGROUND: Endometriosis is defined as the presence of endometrial tissue (stroma and functional glands) outside the uterine cavity in women of reproductive age. Ectopic sites are frequently located in the pelvis; extrapelvic sites have been reported in the gastrointestinal tract and thoracic cavity. Thoracic manifestation of endometriosis constitutes thoracic endometriosis syndrome (TES). OBJECTIVES: To examine the presentation pattern and outcome of in the management of TES. METHODS: This study is a retrospective review of medical records of patients diagnosed with endometriosis at the University of Ilorin Teaching Hospital over a 3.5-year period from January 2014 to June 2017. RESULTS: A total of 21 patients presented with endometriosis, of whom 8 (38.1%) presented with TES. The most common variety of TES was catamenial pleural effusion (CPE) accounting for 75%, followed by catamenial chest pain (37.5%). Two patients (25%) each presented with catamenial pneumothorax and catamenial haemoptysis, while 1 (12.5%) had catamenial surgical emphysema. Closed thoracostomy tube drainage plus chemical pleurodesis was the most frequent intervention technique, accounting for 62.5%. CONCLUSION: TES remains an uncommon entity, despite being the most common extrapelvic manifestation of endometriosis. CPE appeared to be the most common variant of TES in our environment. Currently available treatment options need to be improved, and more use made of video-assisted thoracoscopic surgery.

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BACKGROUND: Oral premedication for paediatric age group is an uncommon practice amongst anaesthetists in Nigeria. Both parents and the child suffer some form of emotional or psychological distress. AIM: To determine the efficacy and safety of oral formulated ketamine for premedication in children scheduled for ambulatory surgeries. METHODS: Seventy three children aged 1 - 6 years with American Society of Anesthesiologists (ASA) physical status I-II were prospectively studied. They were assigned randomly to receive either 5 mg/kg (Group A), 10 mg/kg (Group B), or no ketamine (Group C).The children were observed for acceptance of premedication, sedation and anxiolysis at 10, 20 and 30 minutes after drug administration. Behavior/response of each child at the time of separation from parents, intravenous access, and acceptance of facemask for induction, postanaesthetic arousal state and complications were also recorded. RESULTS: There were 73 children in this study with a mean age of 37.4±18.0 months. The groups were comparable in age. The studied agent was tolerated by both groups that received premedication with no significant difference (P 0.73). Adequate sedation and anxiolysis were observed in groups A and B, (52%, 84%) and (68%, 88%) respectively. However, more children in group B (82.6%) had satisfactory behaviour at separation from parents and a better acceptance of anaesthetic face mask (64%) at induction than those in groups A and C (33.3%, 21.7%, respectively). No side effect was recorded in either of the premedication groups or the control group. CONCLUSION: Oral ketamine is acceptable and safe premedication for children. It provided good sedation, relieved anxiety and had no side effect in the children at the studied doses.

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BACKGROUND: Subcutaneous or intrafascial wound infiltration of local anaesthetic with systemic opioids has been shown to enhance patient comfort with improved analgesia and reduced opioid requirements. OBJECTIVE: To demonstrate improved pulmonary function when postoperative analgesia was provided by combined bupivacaine wound infiltration and systemic opioid. METHODS: In a prospective, randomized, placebo-controlled study, 46 patients (23 per group) scheduled for elective gynaecological surgery under general anaesthesia had subcutaneous and intrafascial wound infiltration of 40 ml, 0.25% bupivacaine (study patients) or 40 ml 0.9% saline (control) just before the end of surgery. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR) were done before surgery and at 6, 12 and 24 hours postoperatively. Student's T and chi-square tests were used for tests of significance set at P < 0.05. Postoperative analgesia was provided with intramuscular morphine 0.15 mg/kg 4 hourly and 10mg/kg of intravenous paracetamol as rescue analgesia. RESULTS: PEFR, FVC and FEV1 were reduced in both the control and study groups but the reduction was greater in the control group. CONCLUSION: Bupivacaine wound infiltration produced statistically significant elevations in pulmonary function tests results at all assessment periods.

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The role of vitamins and mineral supplementation in the management of Diabetes mellitus is not well elucidated. We therefore carried out a preliminary study to assess the effect of prior administration of Magnesium on induction of alloxan diabetes, a model of type 1 diabetes mellitus. Twenty Male albino rats were used for this study. The animals were divided into 4 groups of 5 animals each. Animals in group 1 were normal rats and were not given any treatment, these served as healthy control. Animals in group 2 were diabetic rats that were not given any treatment, they served as diabetic control. Animals in group 3 were treated with magnesium (100mg/kg) intraperitoneally one hour prior to alloxan (150mg/kg) administration. Animals in group 4 were given intraperitoneal injection of magnesium (100mg/kg) once, and blood samples were obtained one hour after administration. Blood samples were obtained from all animals after 48 hours and plasma glucose levels determined using the glucose oxidase method. There was significant increase (p<0.001) in plasma glucose level in the alloxan treated group when compared with the control. There was also a significant increase (p<0.01) in magnesium-pretreated diabetic group. However, there was a significant reduction (p<0.01) in blood glucose level 48 hours after alloxan administration in the magnesium pre-treated diabetic group when compared with the diabetic controls. Magnesium pretreatment may delay the onset of alloxan induced hyperglycemia and this may be due to the scavenging effect of magnesium on the highly reactive hydroxyl radicals (OH) which was generated through alloxan reaction.

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