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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: The interplay between right ventricular dysfunction (RVD) and respiratory failure in septic shock is a critical determinant of outcome. Data on this interaction, particularly from resource-limited settings in sub-Saharan Africa, are scarce. This study aimed to determine the respiratory profile, management strategies, and prognosis of patients with septic shock and concomitant RVD. Methods: We conducted a single-center, prospective, observational cohort study in the intensive care unit (ICU) of Douala General Hospital, Cameroon, from December 2020 to August 2021. We included patients aged ≥21 years with septic shock. Data on demographics, clinical features, respiratory parameters (respiratory rate, SpO2, PaO2/FiO2), ventilator settings, and outcomes were collected. Patients were stratified by the presence of RVD. Results: Of 75 patients screened, 53 were included (mean age 53±16 years, sex ratio 1:1). Pulmonary involvement was present in 96.7% of patients with RVD. Acute Respiratory Distress Syndrome (ARDS) was diagnosed in 30.2% of the cohort. The mean respiratory rate was 29±22 breaths/min, and the mean PaO2/FiO2 ratio was 279±181. Invasive mechanical ventilation (IMV) was required in 50% of patients with RVD, and non-invasive ventilation (NIV) in 46.6%. Mortality for patients on IMV for over two days was catastrophically high at 92.9%. In contrast, the survival rate for patients managed with spontaneous breathing was 23.3% (p<0.005). The most common pathogens were Klebsiella pneumoniae (17.0%) and Staphylococcus aureus (15.0%). Conclusion: In patients with septic shock and RVD in our resource-limited setting, the development of respiratory failure is nearly universal and portends a dismal prognosis. The requirement for invasive mechanical ventilation is associated with extremely high mortality. These findings highlight the lethality of this clinical syndrome and underscore the urgent need for management strategies that protect the right ventricle and a

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Background: The American Society of Anesthesiologists (ASA) Physical Status classification is a critical preoperative risk assessment tool. Its predictive utility for outcomes in the high-acuity, resource-constrained environment of an emergency surgical setting, such as for emergency Cesarean Section (CS) in Sub-Saharan Africa (SSA), requires validation. This study aimed to evaluate the correlation between the ASA status score and the therapeutic outcomes (maternal and neonatal) of patients undergoing emergency CS at Douala General Hospital (DGH). Methods: This was a single-center, prospective, descriptive cohort study conducted on 36 consecutive patients who underwent emergency CS at DGH from January 2024 to July 2025. Patients were stratified into ASA physical status categories I to III based on preoperative assessment. Data collected included demographics, CS indications, intraoperative complications (e.g., hemorrhage, hemodynamic instability), postoperative maternal outcomes (ICU admission, length of stay), and neonatal outcomes (Apgar scores, resuscitation needs). Statistical analysis used ANOVA and Chi-square tests, with p<0.05 considered significant. Results: The mean age was 28.5±5.2 years. The cohort comprised 13.9% ASA I, 61.1% ASA II, and 25.0% ASA III patients. Fetal distress (41.7%) was the leading indication, followed by severe pre-eclampsia/eclampsia (22.2%), which heavily drove the ASA III classification. A higher ASA score significantly correlated with worse outcomes. ASA III patients had a significantly longer mean hospital stay (8.5±2.8 days vs. 6.5±2.0 days for ASA II, p<0.05), higher incidence of hemodynamic instability (55.6% vs. 13.6% for ASA II, p<0.01), and were the only group requiring postoperative ICU admission (22.2%, p=0.03). Neonates of ASA III mothers had significantly lower 5-minute Apgar scores (6.8±1.6, p<0.01) and higher NICU admission rates (55.6%, p<0.01). Conclusion: The ASA physical status classification is a robust, practical

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Introduction: Accidental intrathecal injection of tranexamic acid (TXA) is a rare but potentially fatal medication error responsible for severe neurotoxicity. It most often results from drug ampoule confusion during spinal anesthesia. Case Presentation: We report the case of a 40-year-old ASA II woman admitted for semi-urgent cesarean section under spinal anesthesia. Due to a medication error, 150 mg of tranexamic acid was inadvertently injected intrathecally after confusion with hyperbaric bupivacaine. General anesthesia was immediately induced to allow fetal extraction. Approximately forty-five minutes after the accidental injection, the patient developed generalized tonic–clonic seizures refractory to midazolam. Management consisted of a combination of thiopental, midazolam, a volatile anesthetic agent, and cerebrospinal fluid lavage–drainage. The clinical outcome was favorable, with a normal neurological examination one month later. Conclusion: This case highlights the severity of accidental intrathecal tranexamic acid injection and emphasizes the need for strict preventive measures to avoid medication errors in anesthesia.

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Point-of-care ultrasound (POCUS) has become a key diagnostic tool in resource-limited settings. We report a case of severe left ventricular (LV) systolic dysfunction in the immediate postpartum period in a patient with severe pre-eclampsia and progressive dyspnoea at the end of pregnancy. In a setting with limited access to specialised cardiac imaging, POCUS enabled rapid diagnostic orientation towards peripartum cardiomyopathy and guided initial management. This case underscores the essential role of POCUS in emergency and critical care medicine in sub-Saharan Africa.

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Objective: The aim of this study was to investigate the clinical profile and therapeutic aspects of traumatic brain injuries in the intensive care unit. Patients and Methods: We conducted a retrospective and descriptive study over a period of January 2021 to December 2023 (24 months) in the multi-purpose intensive care unit of Thierno Birahim Ndao Hospital in Kaffrine, Senegal. The study involved analyzing the medical records of patients admitted for isolated or combined traumatic brain injury. The parameters studied were epidemiological and clinical data, treatments administered, and patient outcomes. Results: During our study period, 38 patients presented with traumatic brain injury, representing a frequency of 5.20% of hospitalizations. The mean age of the patients was 27 years (range 4-65 years), with a male-to-female ratio of 8.5. Road traffic accidents were the major cause of the injuries (86.84%). Patient transport was medically supervised in 10.52% of cases. In our study, 12 patients (31.57%) had a Glasgow Coma Scale (GCS) score of 8 or lower. Traumatic brain injury was associated with chest trauma in 26.31% of cases. All patients underwent brain and cervical computed tomography (CT) scans. Mechanical ventilation and sedation were administered in 39.47% of cases. Eighteen patients (47.36%) received osmotic therapy with mannitol (20%). The mortality rate was 40.3%. Conclusion: Traumatic brain injury is serious, especially when associated with deep coma and chest trauma. The prognosis can be improved with good organization and adequate facilities for patient care.

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Introduction: The anesthetic strategy for esophageal surgery has evolved thanks to optimization of patient care from the preoperative phase to postoperative rehabilitation. The objective of this study was to describe the anesthetic management of esophagectomies for esophageal cancer at the Aristide Le Dantec University Hospital. Patients and Methods: We conducted a retrospective and descriptive study from January 2014 to December 2021. We included all patients who underwent anesthesia for esophagectomy for esophageal cancer. We studied the epidemiology, the anesthetic technique, analgesia and postoperative complications. Results: We collected data on 18 patients with a mean age of 45 years and a male-to-female ratio of 0.63. Patients were classified as ASA I (American Society of Anesthesiologists) in 27.77%, ASA II in 56.66% and ASA III in 16.66% of cases. General anesthesia was combined with epidural analgesia in 61.11% of cases. Intraoperative analgesia was maintained with fentanyl in 11 patients. The mean intraoperative blood loss was 150 ml. The mean duration of surgery was 3 hours and 40 minutes (range: 2 hours and 50 minutes to 6 hours and 30 minutes). The predominant postoperative analgesia protocol was a combination of paracetamol, nefopam and epidural analgesia. Postoperative morbidity was 50%, and postoperative mortality was 16.66%. Conclusion: Perioperative management of this surgical procedure through good preoperative assessment improves patient prognosis.