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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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Fascia iliaca compartment block (FICB) can be performed using anatomical landmarks or ultrasound guidance for analgesia after femoral fractures. This prospective, parallel-group, randomised controlled trial at Irrua Specialist Teaching Hospital, Nigeria, enrolled adults with femoral neck or shaft fractures and pain between 15 November 2021 and 14 January 2023. Participants were randomised 1:1 to landmark-guided or ultrasound-guided FICB, with 30 mL of plain 0.25% bupivacaine administered in each group. Co-primary outcomes were needle-tip precision and block effectiveness at 1 h; secondary outcomes included Numerical Rating Scale (NRS) pain scores, procedural time, time to block onset, time to first rescue analgesia, complications and satisfaction. Ninety participants were randomised and 89 were analysed. Needle-tip placement was confirmed in 44/44 participants (100.00%) with ultrasound and 29/45 (64.44%) with landmarks; the reported Fisher’s exact test statistic was 19.073 (P = 0.050). Effective block at 1 h occurred in 41/44 (93.18%) and 41/45 (91.11%), respectively. Median NRS scores were lower with ultrasound at 30 min (2 vs. 3; P = 0.009) and 1 h (1 vs. 2; P = 0.001). Landmark-guided FICB was faster to perform (901 vs. 2,414 s; P = 0.050), while time to first rescue analgesia did not differ (P = 0.608). No clinically apparent complications were observed. Ultrasound guidance improved needle-tip localisation and was associated with lower early pain scores, whereas landmark-guided FICB remained a feasible and efficient alternative. The aggregate data do not establish universal differences in overall analgesic effectiveness or safety.

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Introduction: Leptospirosis is a bacterial zoonosis of worldwide distribution. Its clinical presentation is highly variable in terms of signs and severity. Weil's disease is characterized by the association of conjugated hyperbilirubinemia, sometimes severe, with hemorrhagic manifestations including hemoptysis and gastrointestinal bleeding. Case presentation: We report the case of a 27-year-old woman admitted to the intensive care unit for management of a hemorrhagic syndrome. She initially presented with an influenza-like illness treated by self-medication with paracetamol. On admission, the patient presented with febrile hepatonephritis associated with multiorgan failure, together with the classic triad of Weil's disease: conjugated hyperbilirubinemia, and hemorrhagic manifestations including hemoptysis and gastrointestinal bleeding. Leptospira IgM serology was positive, confirming the diagnosis. She was treated with ceftriaxone and supportive care. The clinical course was favorable, with discharge from the intensive care unit after 10 days of hospitalization. Conclusion: The presence of a hemorrhagic syndrome in the setting of febrile hepatonephritis should raise suspicion of human leptospirosis. Patient history-taking is essential and may reveal exposure to animals capable of transmitting the pathogen to humans. Definitive diagnosis relies on isolation of the organism or rapid IgM serological testing.

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Objective: To describe the epidemiological, therapeutic, and mortality factors of acute kidney injury (AKI) in the multi-specialty intensive care unit (ICU) of the Brazzaville University Hospital (BHC). Patients and Methods: The study was cross-sectional, conducted from January 1 to June 30, 2023, in the multi-specialty ICU of the BHC. We included all patients aged 18 years and older with AKI. Epidemiological, clinical, and therapeutic variables were analyzed using Epi-info version 7.2 and IBM-SPSS 20. Results: Of 220 adult admissions, 91 patients had AKI (40.6%). The mean age was 46.8 ± 19.4 years with sex ratio of 0.9. The presence of comorbidity was observed in 57.1% and dominated by arterial hypertension and diabetes mellitus. Admissions were surgical (50.6%), including 39.6% from the operating room. The reasons for admission were dominated by arterial hypotension (48.4%), respiratory distress (34.0%) and impaired consciousness (30.8%). The main diagnoses were dominated by acute generalized peritonitis (25.3%) and severe preeclampsia (8.8%). AKI was parenchymal (70.3%) and classified as KDIGO stage 3 (49.4%). Anuria (82.1%) and hyperkalemia (37.5%) were the observed consequences. Management consisted of ultrasound-guided fluid replacement (33.0%), catecholamine therapy (58.2%), mechanical intubation-ventilation (61.5%), and dialysis (17.6%). The mortality rate was 50.5% by multi-organ failure. The mortality associated factors were: Glasgow Coma Scale score ≤ 8, oligoanuria, liver failure, KDIGO stages 2 and 3, and mechanical ventilation. Conclusion: AKI is common and carries a high mortality rate in ICU. The most common diagnoses were generalized peritonitis and eclampsia. Management is difficult due to the lack of a dialysis unit at the BHC.

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Objective: To describe the workload and burnout among intensive care nurses in hospitals in Conakry. Methods: This was a descriptive, multicenter, cross-sectional study conducted from November 1, 2025, to January 31, 2026, in the Anesthesia and Intensive Care Units of Donka University Hospital, Ignace-Deen University Hospital, and the Sino-Guinean Hospital. Nurses working in intensive care for at least six months, present during data collection, and who provided informed consent were included. Results: The study included 92 nurses, most of whom were under 30 years of age, with a mean age of 32.3 ± 6.8 years and a female predominance (sex ratio: 0.38). State-registered nurses (IDE) accounted for 91% of participants, while State-registered nurse anesthetists (IADE) accounted for 9%. A weekly working time exceeding 48 hours was reported by 66.3% of participants, and 76.1% considered staffing levels insufficient. Perceived workload was high among 77.2% of nurses. Hierarchical support was considered moderate or insufficient by 93.5% of participants. Job satisfaction was low among 60.9%, while 56.5% considered leaving the intensive care unit. An impact of work on mental health was reported by 95.7% of nurses. Burnout was present in 46.7% of participants, with high emotional exhaustion in 30.54%, high depersonalization in 26.78%, and low personal accomplishment in 24.69%. The overall NASA-TLX score was 15.95 ± 1.97. Conclusion: Workload and burnout are substantial among intensive care nurses in Conakry, highlighting the need to improve staffing levels, working conditions, and professional support.

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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.

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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.