Browsing by Author "Bolaji, Benjamin Olusomi"
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Item Critically ill obstetric admissions into a tertiary hospital’s intensive care unit.(Medical Research Society and College of Medicine and Health Sciences, Abia State University, 2015) Fawole, AA; Bolaji, Benjamin Olusomi; Oyedepo, Olanrewaju Olubukola; Adeniran, ASBACKGROUND: Intensive Care Unit (ICU) management is a critical care and may be life saving in critically ill obstetric patients, but mortality remains high in low-resource countries. OBJECTIVE: To review obstetric admissions into a tertiary hospital ICU. DESIGN: Retrospective descriptive study. SETTING: The ICU of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. SUBJECTS: Women admitted to the ICU during pregnancy or within 42 days of the end of the pregnancy. MATERIALS AND METHODS: A list of all eligible participants was compiled, the case files were retrieved and relevant data extracted; the results were presented in tables and percentages. RESULTS: Obstetric patients constituted 12.3% of the total ICU admissions and 0.84% of all deliveries with 45.6% mortality; the mean age was 29.2 ± 5.4 years (range 18 – 42 years), mean parity was 2.0 ± 1.5 (range 0-6), 15 (28.8%) had no formal education, 39 (75.0%) were of low social class, 22 (42.3%) had no antenatal care, 41 (78.9%) were admitted for obstetric reason, and post partum haemorrhage was the most common indication for admission (19[36.5%]). In all 44 (84.6%) were admitted post partum, 45 (86.5%) had organ dysfunction at ICU admission, 36 (69.2%) had mechanical ventilation while most common drugs administered were antibiotics. CONCLUSION: Obstetric patients are important intensive care users, but maternal mortality remains high among them in low-resource countries despite the care received.Item Reasons for cancellation of elective surgery in Ilorin.(The Surgical Sciences Research Society, Zaria and Association of Surgeons of Nigeria, Zaria, Nigeria., 2002) Kolawole, Isaac Kayode; Bolaji, Benjamin OlusomiThe rising cost of healthcare and dwindling economic resources necessitate the need to encourage cost-effectiveness in patient care. Cancellation of cases on the scheduled day of surgery leads to inefficient utilization of theatre space, waste of valuable manpower and scarce resources for patients and hospital. Avoidance of unnecessary cancellations of cases may therefore be an important way of ensuring efficient utilization of resources. METHODS: This is a prospective study. Record was taken of all patients whose names appeared on the routine elective surgical operations lists. The names of all those who could not have their surgery done were compiled. The age, sex, diagnosis, specialty of surgery, proposed surgery and reasons for cancellation were collated and analysed. RESULTS: Out of the 1,175 patients scheduled for surgery during the study period, 272 (23.15%) were cancelled for various reasons. The highest incidence of cancellation 130 (11.06%) was recorded in orthopaedic specialty, even though it ranked second to General Surgery in the total number of cases booked. Cardiothoracic unit recorded the lowest incidence of cancellations (1.84%), but it also had the lowest number of cases scheduled for surgery. The commonest cause of cancellations was time constraints (22.59%). Patients absconded from surgery for personal reasons not communicated to the surgeons in 13.60% of cases, while unanticipated logistic problems accounted for another 9.93%. Other causes of cancellations included industrial action embarked upon by members of the hospital community, staff auditing exercise, uncontrolled medical illness and unresolved laboratory abnormalities. CONCLUSION: The incidence of cancellation of cases on the scheduled day of surgery is still high in our hospital. Most of the causes of the cancellations are preventable. In order to enhance cost-effectiveness, efforts should be made to prevent unnecessary cancellations through careful planning and closer interactions between surgeons and patients, and amongst members of the surgical team.