Annals of African Medicine最新文献

{"title":"Pathogenesis and Current Treatment Strategies in Rheumatoid Arthritis: A Systematic Review Article.","authors":"Debajani Deka","doi":"10.4103/aam.aam_11_24","DOIUrl":"https://doi.org/10.4103/aam.aam_11_24","url":null,"abstract":"<p><strong>Abstract: </strong>Rheumatoid arthritis (RA) is a chronic, symmetrical, and inflammatory autoimmune disease that initially affects small joints, progressing to larger joints, and eventually the skin, eyes, heart, kidneys, and lungs. It has been recorded that RA affects 0.5%-1% of the adult population of developed regions. It initially affects small joints, progressing to larger joints, and eventually the skin, eyes, heart, kidneys, and lungs. Often, the bone and cartilage of joints are destroyed, and tendons and ligaments weaken. All this damage to the joints causes deformities and bone erosion, usually very painful for a patient. RA by producing inflammatory cytokines and proteinases, such as matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases that perpetuate joint destruction by abnormal proliferation of synovium. Under the influence of synovial cells, cytokines such as - Interleukin (IL)-1 and IL-17 chondrocytes are destroyed by apoptosis. Again the extracellular matrix secretes a proteinase called MMPs that damages the type 2 collagen fibers of the cartilage matrix causing biomechanical changes to the joint movements. This way with destruction of articular cartilage of the joint surface by hyperplastic synovium leads to a reduction of joint space. The difference between the hyaline cartilage of the articular surface and other hyaline cartilage is that articular hyaline cartilage never undergoes regeneration. With limited membrane permeability and poor gastrointestinal stability, monoclonal antibodies (mABs) do not have good oral bioavailability (<1%). For this reason, they are usually not administered orally, and parenteral administration is mostly by intravenous, subcutaneous (SC), and intramuscular (IM) injections. When mABs are injected IM or SC, the absorption process from the site of injection is through the interstitial space and into the lymphatic system, with subsequent draining into the systemic circulation. Although IM and SC routes of administration offer lower bioavailability because of proteolytic degradation in the interstitial fluid or the lymphatic system, the SC route is the most widely used due to convenience and the possibility of patient self-administration. For these last two routes of administration, the peak plasma concentration after a single dose is achieved 3-7 days after administration, due to the slow absorption into the systemic circulation. Other potential routes of administration include intravitreal, intraperitoneal, and pulmonary. CRD NUMBER-42024601637.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Compare the Efficacy of Preoperative Oral 50 g of Maltodextrin versus 50 g of Glucose in Reducing Postoperative Nausea and Vomiting, in Patients Undergoing Laparoscopic Cholecystectomy under General Anesthesia: A Randomized Controlled Double-blind Study.","authors":"Girish Bandigowdanahalli Kumararadhya, Akshay Hiryur Manjunatha Swamy, Darshini Shivaramu, Sonia Jacob, K N Archana, S Vyshnavi","doi":"10.4103/aam.aam_272_24","DOIUrl":"https://doi.org/10.4103/aam.aam_272_24","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting (PONV) is the second most common complaint following general anesthesia. Despite multimodal strategies to reduce PONV, it still occurs in 20%-30% of patients. Major surgery induces metabolic changes, resulting in insulin resistance. Oral carbohydrate (CHO) loading 2 h before surgery modifies insulin resistance and improves postoperative patient comfort including reduction of PONV.</p><p><strong>Patients and methods: </strong>The present study was a prospective, randomized controlled double-blinded study. 105 patients aged 18-60 years undergoing laparoscopic cholecystectomy under general anesthesia were randomized into three groups: M (50 mg of oral maltodextrin in 100 ml water), G (50 mg of oral glucose in 100 ml water), and C (100 ml of plain water). Each group received the samples 2 h before induction and underwent routine induction and intervention. Their vital parameters were monitored perioperatively and were also evaluated for PONV and perioperative comfort levels.</p><p><strong>Results: </strong>Statistically significant relationship between the groups and postoperative comfort score (χ2 = 34.56, P ≤ 0.001, Cramé's V = 0.41). Analysis of variance test showed difference between the different groups and postextubation General Random Blood Sugar (GRBS) (F = 16.11, P ≤ 0.001). No significant difference was seen among the three groups in preoperative comfort scores (χ2 = 0.72, P = 0.699, Cramé's V = 0.08) and preoperative GRBS (P = 0.055).</p><p><strong>Conclusion: </strong>It was concluded that the oral intake of CHO drink 2 h before surgery improves the comfort of patients by reducing preoperative hunger and thirst along with smaller postoperative glucose spike in the maltodextrin group.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of STOP-BANG and Berlin Questionnaire in the Prediction of Overweight and Obese Patients Developing Desaturation during Induction of General Anesthesia: A Prospective Observational Study.","authors":"Srinivas Hebbal Thammaiah, Akshitha Jayakumar, Rashmi Hosahalli Sreenath, K N Archana, Vyshnavi Sriram","doi":"10.4103/aam.aam_240_24","DOIUrl":"https://doi.org/10.4103/aam.aam_240_24","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea increases perioperative risk due to compromised airway patency. This study compared the predictive capabilities of the STOP-BANG and Berlin Questionnaires for intraoperative desaturation among overweight and obese patients undergoing general endotracheal anesthesia.</p><p><strong>Aims: </strong>The study primarily aimed to compare desaturation onset time and time to reach 93% oxygen saturation on room air during induction of general anesthesia. Secondary objectives included assessing associated airway complications.</p><p><strong>Settings and design: </strong>A prospective observational study was conducted at a tertiary hospital with overweight and obese patients undergoing elective surgeries under general endotracheal anesthesia.</p><p><strong>Subjects and methods: </strong>Hundred patients aged 18-60 years, body mass index ≥ 25 belonging to the American Society of Anesthesiologists Physical Status Class I-II, divided based on assessment by STOP-BANG (Group S) and Berlin (Group B) Questionnaire participated in the study. Standard anesthesia protocols were followed. SpO2, heart rate, and blood pressure were monitored. Desaturation onset, duration, and airway complications were recorded.</p><p><strong>Statistical analysis used: </strong>Comparisons were made using t-tests and Chi-square tests, with significance set at P < 0.05.</p><p><strong>Results: </strong>Group S had significantly lower SpO2 during induction (P = 0.001) and intubation (P = 0.007), shorter desaturation onset (1.12 vs. 1.55 min, P = 0.00089), and shorter desaturation duration (1.56 vs. 2.21 min, P = 0.013). More patients in Group S required advanced airway equipment (6 vs. 4), and 18% had postoperative desaturation versus none in Group B (P = 0.002). Higher STOP-BANG scores showed stronger correlations with lower SpO2, earlier desaturation onset, longer desaturation periods, and increased airway complications. Conclusions: The STOP-BANG questionnaire is a superior tool for predicting desaturation among overweight and obese patients during induction of general endotracheal anesthesia.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Effective Wound Healing in Surgical Site Infection Following Cesarean Section.","authors":"Devyani Misra, Vandana Gautam, Mariyam Faruqui, Manodeep Sen","doi":"10.4103/aam.aam_189_24","DOIUrl":"https://doi.org/10.4103/aam.aam_189_24","url":null,"abstract":"<p><strong>Background: </strong>Cesarean section (CS) is the most common surgical procedure worldwide and although usually safe is sometimes associated with morbidity and mortality. Surgical site infection (SSI) post-CS is a frequently encountered cause of prolonged hospitalization and financial burden on the healthcare system. The reported incidence is 9%-17%. Risk factors are poor antenatal care, comorbidities, chorioamnionitis, prolonged labor, improper use of antibiotics, and emergency delivery. Although enormous data are available regarding the risk factors for SSI, not much information exists about factors affecting wound healing.</p><p><strong>Aim: </strong>The aim is to evaluate the barriers to effective wound healing and response after primary management in SSI among women undergoing CS.</p><p><strong>Methods: </strong>A prospective study was done enrolling 100 women with SSI post-CS. Swabs were taken from those with SSI and cultures were done. Wound characteristics and healing were followed. Data were collected and analyzed.</p><p><strong>Results: </strong>Most were primiparous (44%) and 66% of CS were emergency during labor. Factors which significantly affected healing were socio-economic status, emergency/elective delivery, surgery in labor or prelabor, personal hygiene, history of previous CS, anemia, Southampton wound grade, duration since membrane rupture >18 h, and day of primary wound repair since presentation (P < 0.05). Longer mean duration of day since surgery and delayed primary repair also significantly affected wound healing.</p><p><strong>Conclusion: </strong>SSI may not always be avoidable. Predicting the risk with associated factors and judicious use of antibiotics may help reduce the incidence.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors and Postpartum Hemorrhage among Women with Vaginal Delivery.","authors":"Rajani Dube, Subhranshu Sekhar Kar, Sanghamitra Satapathy, Shadha Nasser Bahutair, Haider Ali Younus, Khawla Fadil Noori Abdulsalam","doi":"10.4103/aam.aam_55_25","DOIUrl":"https://doi.org/10.4103/aam.aam_55_25","url":null,"abstract":"<p><strong>Background: </strong>This study aims to find the correlation between risk factors and the incidence of postpartum hemorrhage (PPH) in normal vaginal deliveries.</p><p><strong>Materials and methods: </strong>The present research is an observational cohort study. Two hundred and thirty-nine women undergoing normal labor who delivered vaginally were given 0.2 mg of Ergometrine or 600 μg of Misoprostol at the delivery of the anterior shoulder, as a prophylaxis to prevent PPH. The blood loss was estimated by the use of blood collection drapes during delivery. All statistical analyses were conducted through SPSS version 27. The risk factors were compared between the groups with or without PPH.</p><p><strong>Results: </strong>The majority 87 (36.4%) of the participants were in the 25-29 years' age group, 113 were nullipara (47.3%), and 93 (38.9%) were primigravida. The prevalence of PPH was 4.6% (11/239). Almost half of the cases of PPH (5/11, 45.5%) had no risk factors, whereas those with risk factors had twin pregnancy (25%), low-lying placenta (50%), grand multipara (33.3%), and previous history of PPH (33.3%). Furthermore, a moderate positive correlation between the risk factors and the incidence of PPH was observed (R = 0.512).</p><p><strong>Conclusions: </strong>In this study, women with risk factors such as twin pregnancy, low-lying placenta, grand multipara, and previous history of PPH developed PPH despite prophylaxis and close monitoring. However, almost half of the cases of PPH occurred in people where there was no risk factor. It is recommended that vigilance for the early detection and appropriate preparation for the management of PPH should be followed even in low-risk women undergoing vaginal delivery.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical Coherence Tomography Findings in Spontaneous Full-thickness Macular Hole Closure.","authors":"Olufemi Oderinlo, Adekunle Olubola Hassan","doi":"10.4103/aam.aam_309_24","DOIUrl":"https://doi.org/10.4103/aam.aam_309_24","url":null,"abstract":"<p><strong>Abstract: </strong>Spontaneous closure (SC) of a macular hole (MH) is a rare but well-documented phenomenon, particularly in small, early-stage holes. The exact mechanisms underlying SC remain unclear, but it is hypothesized to involve the interplay of vitreoretinal dynamics, glial cell proliferation, and the natural healing processes of the retina. Our study reports clinical features of two cases of full-thickness MHs (FTMHs) that closed spontaneously under different circumstances, as well as their optical coherence tomography (OCT) characteristics and effect on visual acuity, thus emphasizing the role of OCT in understanding this uncommon event. By documenting this rare outcome, we aim to contribute to the growing body of knowledge on FTMH and the potential for nonsurgical resolution in certain cases.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Postmicturition Dribble in Young Saudi Males: A Mixed-methods Study.","authors":"Abdullatif Almaghlouth, Abdulrahman Almulla, Abdulelah Alshebly, Abdulmohsen Balghunaim, Saad Alwesali","doi":"10.4103/aam.aam_6_25","DOIUrl":"https://doi.org/10.4103/aam.aam_6_25","url":null,"abstract":"<p><strong>Background: </strong>Postmicturition dribble (PMD) is categorized as one of the most common symptoms that can occur in the lower urinary tract system after urination and affects nearly one-third of men worldwide. This study aimed to measure PMD prevalence in young Saudi males and explore potential associations with demographic and clinical factors, informing targeted interventions and improving quality of life (QoL).</p><p><strong>Methodology: </strong>A mixed-methods study employing both quantitative and qualitative approaches was conducted among a sample of young Saudi males. The study was conducted from August 2023 to November 2023. The data collection sheet included demographic information, the International Prostate Symptom Score, and the Hallym PMD Questionnaire to assess PMD. Key informant interviews and focus group discussions were conducted to gain insights into the lived experiences and perceived causes of PMD. The data were collected using a prestructured and validated questionnaire.</p><p><strong>Results: </strong>A total of 1758 eligible young Saudi males completed the study questionnaire. Participants' ages ranged from 18 to 35 years, with a mean age of 21.7 ± 6.4 years old. A total of 918 (52.2%) young Saudi males had PMD, where 568 (32.3%) of them experienced PMD once every three times, 10.8% experienced it two out of three times, and 160 (9.1%) experienced PMD nearly every time. Participants with PMD had a severity score of 1.7 ± 1.1, a bother score of 1.4 ± 1.1, and a QoL score of 1.3 ± 1.1.</p><p><strong>Conclusions: </strong>The study revealed a high prevalence of PMD among young Saudi males with frequent occurrence, moderate severity, and an average impact on their QoL.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcified and Impacted Cervical Fibroid in a Young Female in a Low-resource Setting Mistaken for Bladder Mass: Case Report and Literature Review.","authors":"Bernard Terkimbi Utoo, Christian A Agbo, Mattew S Iorfa, Samuel C Ukaonu","doi":"10.4103/aam.aam_180_24","DOIUrl":"https://doi.org/10.4103/aam.aam_180_24","url":null,"abstract":"<p><strong>Abstract: </strong>Female pelvic masses could be difficult to diagnose given the fact that there are so many structures within the pelvis that could be related to the mass. These benign or malignant neoplasms could be diagnosed through careful and systematic evaluation by history, biochemical, imaging, and surgical approaches. Although an ultrasound scan is often the first-line imaging modality for the evaluation of pelvic masses, it could be limited by poor acoustic windows and poor depth penetration. However, in low-resource settings, its usage is nonnegotiable. The case of a 26-year-old female with a 5-year history of lower abdominal swelling is hereby presented. The swelling was gradual in onset and associated with occasional dull lower abdominal cramps that radiate to the back, urinary retention, dysuria, and urinary frequency. An ultrasound scan diagnosed an ovarian mass and uterine fibroid with the suspicion of a bladder mass. She had a laparotomy, in which a left ovarian mass and a huge calcified pelvic mass extending from the region of the isthmus of the uterus through the posterior bladder wall and the anterior vaginal wall were discovered. Left ovariectomy and removal of the mass were done; a histologic diagnosis of mature ovarian teratoma and cervical fibroid was made. She had a smooth postoperative recovery on antibiotics and analgesics. The diagnostic challenge of pelvic masses even with the use of USS is demonstrated, and laparotomy has shown to be a diagnostic procedure here. Preoperative magnetic resonance imaging could be helpful when available and affordable.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Psychogenic Nonepileptic Seizure among Patients Evaluated for Seizures.","authors":"Mohammed Alshurem, Mohammed A BuSaad, Zainab Alhamad, Manar Alossaif, Dana Aljaafari, Modhi Alkhaldi, Majed Alabdali, Abdulla Alsulaiman, Norah A Alkhaldi, Feras Alsuliman, Erum Shariff, Azra Zafar, Shahad Alsheikh, Feras A Al-Awad, Mohammed Almuhanna, Sara Alameri, Rana Alameri","doi":"10.4103/aam.aam_155_24","DOIUrl":"https://doi.org/10.4103/aam.aam_155_24","url":null,"abstract":"<p><strong>Context: </strong>Seizures are challenging medical emergencies that can be difficult to diagnose, especially since no quick, reliable tests are available in an emergency setting. Approximately 10% of the general population will experience at least one seizure episode during their lifetime. Epilepsy mimics include several paroxysmal conditions that resemble epileptic seizures in their clinical presentation. Psychogenic nonepileptic seizures (PNES) are common mimics.</p><p><strong>Aims: </strong>Studies involving PNES in Saudi Arabia are limited. Therefore, this study aimed to investigate the prevalence of PNES and associated risk factors.</p><p><strong>Settings and design: </strong>A cross-sectional study was conducted at our institution to assess the prevalence of psychogenic non-epileptic seizures in patients presenting with seizure.</p><p><strong>Methods: </strong>We retrospectively collected and analyzed the medical records of 260 patients who experienced seizures between 2019 and 2020.</p><p><strong>Statistical analysis used: </strong>Data were analyzed using SPSS (version 27).</p><p><strong>Results: </strong>PNES was diagnosed in 9.2% of the participants, with females accounting for the majority of cases (70.8%). A statistically significant difference was observed between males and females (P < 0.05). The majority (95.8%) of patients with PNES had normal EEGs, and no abnormalities were found on computed tomography and/or magnetic resonance imaging in most patients (79.1%). In addition, 58.3% of patients with PNES reported taking antiepileptic drugs.</p><p><strong>Conclusions: </strong>Determining the prevalence of psychogenic nonepileptic seizures is challenging. Our study revealed that the prevalence of PNES in patients with seizures was 9.2%. Female sex is a significant risk factor for PNES. Demographic characteristics and clinical data can help identify patients with PNES and guide appropriate management options.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Clinical Audit into the Management of Postoperative Pain in the Postanesthesia Care Unit of a Tertiary Care Teaching Hospital in Coastal Karnataka, India.","authors":"T B Jayanth, Rashmi R Aithal, Sumesh T Rao","doi":"10.4103/aam.aam_141_24","DOIUrl":"https://doi.org/10.4103/aam.aam_141_24","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical audit forms part of clinical governance, which aims to ensure that patients receive the best quality of care. Optimizing pain management in recovery involves measuring a range of processes and outcome indicators. Reducing acute pain improves patient outcomes and reduces chronic postsurgical pain incidence.</p><p><strong>Aim: </strong>The aim of the study was to assess the practice and outcomes of the management of postoperative pain in the postanesthesia care units (PACUs) of our tertiary care teaching hospital.</p><p><strong>Methodology: </strong>We studied postoperative pain and management in patients posted for elective procedures and monitored in the PACU. The study design was a prospective audit conducted in the PACU of a tertiary teaching hospital. The data collected and analyzed were based on the best practice guidelines and suggested indicators as per the New Zealand College of Anesthetists (ANCZA) postoperative analgesia protocols.</p><p><strong>Results: </strong>The planned postoperative analgesia was peri- and postoperative intravenous administration of paracetamol or other nonsteroidal anti-inflammatory drugs (NSAIDs) in the majority of patients (83.3%); four patients (6.7%) were treated with epidural infusions, three with intravenous opioid infusions (5%); only one patient (1.7%) received a bolus nerve block for pain relief. Most of the patients audited underwent general anesthesia, and parenteral analgesia with NSAIDs was effectively used in the majority of patients in the PACU. Failure in the management of acute pain in PACU resulted in severe pain (5%). A review of anesthesiologist for change in treatment protocol was required in these patients and delay of discharge from PACU was minimized. Opioids were mostly used for rescue analgesia.</p><p><strong>Conclusion: </strong>Evidence-based best practice of acute management of pain was implemented with our current treatment protocol, with emphasis on increased utilization of peripheral nerve blocks for optimal postoperative analgesia.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}