ABSTRACT
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.

ABSTRACT
Objective: To describe the profile of patients admitted to the emergency department’s shock unit of the Niamey National Hospital (HNN). Patients and Methods: This was a prospective descriptive study conducted over a 3-month period, from December 15, 2023, to March 15, 2024. All patients admitted to the resuscitation units of the medical and surgical emergency departments were included. The variables studied were: age, sex, occupation, origin, mode and reason for admission, clinical and paraclinical data, management, and outcome. Data were entered and analyzed using Microsoft Office 2016 and Sphinx v5 software. Statistical tests were considered significant for any p-value <0.05. Results: Three thousand four hundred and twenty (3420) patients were triaged in the emergency department, of whom 100 were admitted to the resuscitation unit, representing an overall frequency of 2.92%. Males accounted for 72% (n=72) of cases, with a male-to-female ratio of 2.57. The mean age of our patients was 34.23 years, ranging from 2 to 94 years. Hypertension was the predominant comorbidity in 32% (n=32) of cases. Stroke was the most common diagnosis, accounting for 34.48% (n=20) of cases. Among patients admitted to the surgical resuscitation unit, 52.38% (n=22) had multiple traumas. Oxygen therapy was administered to all patients. Ninety-eight percent (n=98) of patients received crystalloid fluid resuscitation. During our study, 54.76% of patients underwent surgical intervention. Thirty percent (n=30) of patients were transferred to a short-stay unit. The length of hospital stay was less than 48 hours in 53.00% of cases. Conclusion: The resuscitation room plays a crucial rôle in an emergency department, as it is the place where life-threatening or potentially life-threatening situations are managed. To optimize patient care, it must be well-equipped and staffed with trained personnel.

ABSTRACT
Objective: To take stock of the Anesthesia practice in maxillofacial surgery at the National Hospital of Niamey. Patients and methods: This was a prospective, descriptive study over 5 months from january 2,2024 to May 30,2024. All patients who had received scheduled anesthesia in the operating room for maxillofacial surgery were included in the study. The variables studied were: Age, sex, origin, profession, medical and surgical history, ASA classification, Mallampati classification, anesthetic drugs used, tracheal intubation, intraoperative incidents and accidents and patient outcome. Data were entered and analyzed by Microsoft 2016 and Sphinx.v5 Software. The statistical tests used were considered significant for any p-value <0.05. Results: Fifty-seven (57) patients were included; a frequency of 5.42%. Male sex predominated with a sex ratio of 2.27. The average age of our patients was 26,95 ± 3,28 years. The opening of the oral cavity was limited in 19.30% (n=11). The Mallampati class was not appreciable in 43,86% (n=25) of cases. Patients were classified ASA 1 in 75.44% (n=43). Surgery was scheduled in 98.25% (n=56) of cases. Traumatic and tumor pathologies were the most indicated surgeries in 40.35% (n=23) and 38.60% (n=22) of cases respectively. General anesthesia was the anesthetic technique in all our patients. Propofol was the most used hypnotic in 49.12%(n=28). Celocurine was used for induction in 85.96% (n=44). Orotracheal intubation was perfoomed in 71.93% (n=41) of our patients; it was difficult in 38.64%(n=16) of cases. Nasotracheal intubation was performed in 22.18% (n=13). Primary tracheotomy was performed in three of our patients; that is, 5.26%. Tachycardia and hypotension were the most frequent incidents in 33.33% (n=19) and 24.56% (n=14) respectively. Cardiopulmorary arrest occurred in 1.75%(n=1) of cases. Thirty-one point fifty-eight (n=18) of our patients had received a blood transfusion. The duration of surgery was 86 +/- 6 min with extremes ra

ABSTRACT
Aim: To describe the practice of regional anesthesia (RA) pediatric surgery at the Brazzaville University Teaching Hospital (CHU-B). Patients and Methods: The study was retrospective, observational and cross-sectional over 18 months including all the records of children aged 0 to 16 years operated on by pediatric surgeons under RA, with or without general anesthesia (GA), in the operating room of the CHU-B. Epidemiological, surgical, and anesthetic variables were analyzed using Excel 2016. Results: During the study period, 320 children underwent surgery, 43 of whom were operated on under RA (13.4%). The median age was 5 years, with a range from 2 months to 16 years (quartiles: 3 to 10 years). The sex ratio was 2.07. The main surgical indication was digestive wall surgery (69.8%), followed by urological surgery (30.2%). 81.4% of the surgeries were classified as Altemeier I. 60.5% of the children were classified as ASA 1. Preoperative hemostasis testing was performed in 69.8% of the children. Preoperative preparation was carried out in 11.6% of cases. GA was administered in 83.7% of cases. Caudal block (46.5%) was the most frequently used technique, followed by wall blocks (27.9%). Ultrasound was used in 15 children (34.9%), including one with neurostimulation. Bupivacaine (95.3%) was the most frequently used local anesthetic. We noted five cases of failure block (11.6%). The mean surgery time was 55.6 ± 34.8 minutes. Conclusion: RA is part of the early postoperative rehabilitation strategy. However, it remains very rarely performed at the CHU-B, particularly pediatric surgery.

ABSTRACT
Introduction: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in intensive care units. Non-fermenting Gram-negative bacilli (NGNB), particularly Pseudomonas aeruginosa, are frequently implicated in late-onset and recurrent cases. These infections are associated with repeated antibiotic exposure, the emergence of bacterial resistance, and high mortality. The objective of this study was to describe the bacterial ecology, the appropriateness of probabilistic antibiotic therapy, and the outcomes of patients with recurrent VAP caused by GNNB. Methods: A multicenter retrospective study was conducted in the intensive care units at the Meaux, Jossigny, and Coulommiers sites of the Grand Hôpital de l’Est Francilien. Adult patients with at least three documented episodes of BGNNF-associated PAVM between January 2021 and December 2025 were included. Clinical, microbiological, therapeutic, and clinical course characteristics were analyzed. Results: Among 293 recorded episodes of PAVM with BGNNF, 166 episodes involved 51 patients with at least three infectious episodes. The mean age was 64.5 years, and 67.5% of patients were male. The mean IGS II score was 64 and the mean Charlson score was 7.1. Most PAVMs were late-onset (87.3%). Pseudomonas aeruginosa accounted for 89.1% of isolates. Probabilistic antibiotic therapy was based primarily on piperacillin-tazobactam. It was appropriate in only 50.6% of cases. The 28-day mortality rate was 35.5%. Conclusion: Recurrent BGNNF-associated PAVM occurs in patients who are particularly critically ill and have significant comorbidities. The predominance of Pseudomonas aeruginosa and the low rate of appropriate probabilistic antibiotic therapy underscore the need to better account for the local epidemiology in order to optimize initial management.

ABSTRACT
Background: Intensive care units (ICUs) are vital for managing life-threatening conditions. In many developing countries, critical care delivery is constrained by bed and equipment shortages, insufficient skilled personnel, and cost. Admission patterns have also changed with increase in prevalence of non-communicable diseases. Mortality rates in African ICUs remain high, about 30% in Nigeria and 60% in Kenya. Rivers State University Teaching Hospital (RSUTH) ICU faces staffing shortages and inconsistent application of admission criteria. Characterizing the local epidemiology of ICU admissions at RSUTH is essential to guide resource allocation, improve patient outcomes, and strengthen critical care delivery. Objective: To evaluate the pattern of ICU admission in RSUTH over a 31-month period. Methods: This retrospective cohort study reviewed all patients admitted to RSUTH’s 8-bed mixed medical-surgical ICU from June 2023 through January 2026. Following Ethical approval, data was extracted from the admission and discharge register and nurses’ records. Data obtained included patients biodata, diagnosis, interventions received and outcome. Data analysis was done using appropriate statistical methods. Results: 367 patients were admitted, with a mean age of 47.9 ± 19.8 years and a male preponderance (52.6%). Neurological conditions accounted for the highest indication for ICU admission (34.9%), while renal conditions were the least (1.9%). Forty two percent (42.5%) had invasive mechanical ventilation, while 41.1% had inotropic support. Duration of stay ranged from 1 hour to 32 days, with a mean of 6.5 ± 5.3 days. One hundred and eighty-one (49.3%) of the patients were transferred from the ICU to another ward of the hospital, while 159 (43.3%) died while in the ICU. Conclusion: This review shows that neurological conditions dominate ICU admissions at RSUTH, with a mortality of 43.3%, highlighting need for enhanced critical care resources to reduce mortality in this resource

ABSTRACT
Surgery is made easy with the application of anaesthesia that makes the patients not to feel pains during the surgery. However, due to certain complications that occur during and after surgery, most women have expressed fear and passed through certain psychological trauma before and after surgery. This study aimed to Assess Psychological Trauma from Application of Anaethesia During Caesarean Section (CS) among Women In Urban Areas of South-South, Nigeria. This was a cross-sectional study involving 250 women. Participants’ age is between 18 to 47 years. A well-structured questionnaire was administered to participants. The study lasted for a period of 2 months. Statistical analysis was done using SPSS version 25.0 and p < 0.05 was significant. The results revealed that 28% of the participants were single, 56% married, 12% divorced, 4% widowed, 72% had tertiary level of education, 48% were civil servants, 76% have 1 child, 76 have undergone previous caesarean section, 80% agreed that they were not informed of the possible side effects of anaesthesia, 76% developed anxiety, 80% had fear, 80% had emotional stress, and 80% are uncomfortable during CS. The results revealed that majority of the participants experienced worry, fear, stress and pain each time they were booked for CS.