ABSTRACT
Background: Thyroid dysfunction is closely associated with psychiatric disorders, particularly Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD). Alterations in thyroid hormones may mimic or exacerbate psychiatric symptoms, leading to diagnostic and therapeutic challenges. This study assessed thyroid disorders among patients diagnosed with MDD and GAD attending a tertiary hospital in Maiduguri, Nigeria. Methods: A comparative cross-sectional study was conducted among 300 participants comprising 100 patients with MDD, 100 patients with GAD, and 100 healthy controls. Sociodemographic data, psychiatric diagnoses based on DSM-5 criteria, and thyroid function tests (TSH, FT3, FT4) were obtained. Thyroid dysfunction was categorized into hypothyroidism, hyperthyroidism, subclinical hypothyroidism, and euthyroidism. Data were analyzed using SPSS version 26. Chi-square, ANOVA, and logistic regression were applied. Statistical significance was set at p < 0.05. Results: The prevalence of thyroid dysfunction was significantly higher among MDD patients (38%) and GAD patients (29%) compared with healthy controls (10%) (p < 0.001). Subclinical hypothyroidism was the most common abnormality among MDD patients (20%), while hyperthyroidism predominated among GAD patients (12%). Mean serum TSH was significantly elevated among MDD participants compared with controls (4.92 ± 2.11 vs 2.31 ± 1.08 mIU/L; p < 0.001). Logistic regression showed that female sex, age >40 years, and severity of psychiatric symptoms independently predicted thyroid dysfunction. Conclusion: Thyroid dysfunction is significantly associated with MDD and GAD among patients attending a tertiary hospital in Maiduguri. Routine thyroid screening should be incorporated into psychiatric evaluation to improve diagnosis and treatment outcomes.

ABSTRACT
Introduction: Enhanced recovery after surgery (ERAS) protocols are effective in optimizing perioperative outcomes. This study evaluated the adoption of ERAS protocols among adult women undergoing cesarean section at a referral hospital in Senegal. Methods: This was a prospective, single-center interventional study conducted over four months at the Dalal Jamm National Hospital Center, from May 5th to September 4th. The primary objective was to reduce the length of hospital stays for patients, which averaged three days before the start of the study. Data were collected using questionnaires and analyzed using Excel 2019 and R version 4.5.0. Results: Among 102 patients (mean age: 29.4 years), 72.6% were able to leave the hospital within 48 hours. The mean pain score remained below 3 at rest; the TAP block significantly reduced pain during mobilization between 10 and 20 hours. Mobilization was possible within 6 hours in 90% of patients, and urinary catheter removal in 97.06%. Bowel function returned within 32 hours in 91.2% of patients. The complication rate was 6.8%, and 100% of mothers reported being satisfied. Conclusion: ERAS protocols following cesarean section have significantly reduced hospital stays and ensured effective pain management. Their implementation in a resource-limited setting has proven feasible, safe, and well-accepted by patients.

ABSTRACT
Introduction: The aim of this study was to contribute to improving the management of ventilator-associated pneumonia (VAP) in the Intensive Care Unit of Treichville University Hospital. Patients and Methods: This was a retrospective descriptive and analytical study conducted in the Department of Anaesthesia and Intensive Care of Treichville University Hospital over a 54-month period, from 1 January 2020 to 30 June 2024. Results: Fifty-two patients out of 1,250 admissions developed microbiologically confirmed ventilator-associated pneumonia, corresponding to an incidence of 4.16%. The mean age was 41.48 years (range : 2–80 years), with a male-to-female ratio of 1.5. The associated comorbidities were hypertension in 20 patients (38.48%), diabetes mellitus in 9 (17.31%), asthma in 3 (5.76%), HIV infection in 1 (1.92%), and pulmonary tuberculosis in 1 (1.92%). Klebsiella pneumoniae was the most frequently isolated pathogen (36.54%), followed by Pseudomonas aeruginosa (21.15%). The mean hospital stay was 27.65 days (range: 11–62 days). The mortality rate among patients with VAP was 69%. Factors significantly associated with mortality were age >40 years (P = 0.013), duration of mechanical ventilation >15 days (P = 0.006), late-onset VAP (P = 0.045), and Gram-negative bacterial infections (P = 0.032). Conclusion: Ventilator-associated pneumonia remains a frequent and serious nosocomial infection, associated with high morbidity and mortality among mechanically ventilated patients.

ABSTRACT
Introduction: Ultrasound guided axillary block is a widely used regional anaesthesia technique for upper limb surgery. Adding adjuvants to local anaesthetics can enhance block quality and prolong postoperative analgesia. This study aimed to compare onset time, duration of action, and analgesia within the first 24 postoperative hours between axillary blocks using clonidine versus dexamethasone as adjuvants. Patients and Methods: A descriptive and analytical prospective study was conducted over eight months. Patients were allocated into two groups according to the adjuvant used: clonidine or dexamethasone, combined with 0.5% ropivacaine. Outcomes included sensory and motor block onset, block duration, postoperative pain intensity, analgesic consumption, complications, and patient and surgeon satisfaction. Statistical analysis was performed using SPSS 26.0, with significance set at p < 0.05. Results: Among 109 patients undergoing upper limb surgery, 53 received an axillary block. Three were excluded, leaving 50 participants: 25 in the dexamethasone group and 25 in the clonidine group. The mean age was 43.6 ± 17.9 years, with a male predominance (76%). No statistically significant differences were found between groups regarding sensory or motor block onset, block duration, or postoperative analgesia (p > 0.05). No major complications occurred, and patient satisfaction was high. Conclusion: Ultrasound guided axillary block with either clonidine or dexamethasone as adjuvants is an effective and safe anaesthetic technique for upper limb surgery. No significant differences were observed between groups in block onset, duration, or postoperative analgesia.