for peer reviewing an early draft of the book. Their valuable comments and suggestions were incorporated into the final draft.Many people contributed to the development of this book. Ataman Aksoy, Tassos Haniotis, Aira Htenas, and Hans Timmer provided comments and suggestions to earlier drafts of chapter 1, which also benefited greatly from seminar participants at the U.S. Department of Agriculture, the University of Georgia, Oxfam America, and the European Commission. Further inputs, comments, and suggestions for the book were provided by Mohini Datt (chapter 4); Derek Headey (chapter 5); John Finn and Cedric Pene (chapter 6); Paul Brenton (chapter 7); Donald Larson (chapter 8); and David Hallam, Jamie Morrison, Julio Nogués, and Alberto Valdés (chapter 10). Chapter 7 was the result of numerous consultations with agribusiness firms, small market traders, customs agents, commodity brokers, standards authorities, plant and animal health inspectors, food safety inspectors, transport companies, superintendent companies, clearing agents, seed and fertilizer companies, donor representatives, representatives of regional economic communities, project practitioners, and others with a detailed knowledge of food staple and crop input trade in Africa. Special thanks go to Francis K. Frempong Aidoo for his assistance with data collection in Ghana.Several chapters are based on existing reports. Chapter

An abdominal aortic aneurysm (AAA) is a disease characterized by an abnormal bulge or swelling in the aorta. It could be serious if left unobserved, and with time, it swells and eventually ruptures, resulting in massive bleeding inside, and, more likely, causes death. This report presents a case study of a 61-year-old male who presented with back pain; no other fatal symptoms such as breathlessness or rapid heart rate were seen. His abdominal ultrasound report showed the presence of a distal aortic dissecting aneurysm, resulting in rapid diagnosis and treatment.

Acute pancreatitis (AP) is a rare event in pregnancy that is characterized by a sudden and severe inflammation of the pancreas. The clinical manifestation of AP during pregnancy is highly variable ranging from a mild form to a severe and potentially life-threatening presentation. We share a case of a 29-year-old female (gravida II, para I) who presented in her 33rd gestational week. The patient complained of upper abdominal pain and nausea. Her previous history revealed that she had four episodes of vomiting (food-containing, non-projectile) at home. Her uterine tone was normal, and her cervix was closed. Her white blood cell count was 13,000/mm 3 , and her C-reactive protein (CRP) level was 65 mg/L. She underwent an emergency laparotomy due to suspected acute appendicitis; however, no peritonitis was found intraoperatively. Further blood tests showed high levels of triglyceride at 87.5 mmol/L. The electrophoretic pattern of lipoprotein was consistent with type V hyperlipoproteinemia. An abdominal computed tomography (CT) confirmed the diagnosis of acute pancreatitis. During follow-up after one month, the patient showed triglyceride levels at 4.75 mmol/L and cholesterol at 6.07 mmol/L. Acute pancreatitis due to hypertriglyceridemia is a rare finding; nonetheless, it should be considered as a potential etiology in pregnant patients with nonobstructive abdominal pain.

We present a rare case of papillary fibroelastoma (PFE) of the aortic valve diagnosed after being referred from a pre-anesthesia clinic. This patient presented in preanesthesia clinic for assessment prior to right total knee replacement. Along with other investigations, echocardiography was ordered as the patient had a previous history of ischemic heart disease with angioplasty. There was no previous echocardiogram (ECHO) in the patient records. An incidental finding of a sclerotic aortic valve with highly mobile mass was seen attached to the right coronary cusp on the aortic side with same echogenicity as the valve. Based on this rare finding, the patient was referred to an interventional cardiac center prior to an elective orthopedic surgery.Citation: Abdullah A, Fouad A, Esmat AM, Elhefnawy A, Adeel S. Pre-anesthesia clinic: skip it or not? A case report. Anaesth. pain & intensive care 2019;23(2):221-224