Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of t...Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of this study was to identify the factors of the failure of its treatment by the Ponseti method. Material and Method: We carried out a retrospective and descriptive study of cases of congenital equinus clubfoot varus at the Reference Health Care Center of Commune III of Bamako over 26 months from September 2020 to November 2022. Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23 bilateral;among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of 24%, and 7 children with secondary clubfeet with 71 % recurrence. There was no recurrence in the postural type. Among the recurrences, 38.5% started treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2 years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method are mainly non-compliance with treatment, secondary clubfeet, and a high Pirani score at the start of treatment.展开更多
PURPOSE: Our aim was to present the diagnostic and therapeutic aspects of urological emergencies in a regional hospital. MATERIAL AND METHODS: We conducted a prospective study over a period of 6 months (April 2021 to ...PURPOSE: Our aim was to present the diagnostic and therapeutic aspects of urological emergencies in a regional hospital. MATERIAL AND METHODS: We conducted a prospective study over a period of 6 months (April 2021 to September 2021) collecting all the emergencies received by the on-call urology team at the Nianankoro Fomba Hospital in Segou. This team was led by a DES in urology under the supervision of a urological surgeon. We were interested in age, sex of patients, diagnosis, number of patients hospitalised and type of surgery performed in emergency. RESULTS: We registered 72 patients. The mean age of our patients was 58.8 years with extremes of 6 and 90 years. Acute bladder retention was represented in 61% and total haematuria in 24%. Renal colic was reported in 8%. Acute prostatitis was reported in 4% of cases, and acute pyelonephritis in 1%. Urogenital trauma accounted for 6%. CONCLUSION: Although underestimated, in our context, the management of urological emergencies remains a regular activity of the urology department in view of the number of patients managed. Bladder drainage remains the most frequent procedure.展开更多
文摘Clubfoot malformation is the most common serious congenital anomaly affecting the foot in children. Its treatment by the Ponseti method is simple, profitable and widely used in the world. Objective: The objective of this study was to identify the factors of the failure of its treatment by the Ponseti method. Material and Method: We carried out a retrospective and descriptive study of cases of congenital equinus clubfoot varus at the Reference Health Care Center of Commune III of Bamako over 26 months from September 2020 to November 2022. Data were treated with the utmost anonymity. Result: This study was performed on 44 children seen for clubfoot: male (68%) and female (32%), with a sex ratio of 2.1. We obtained 13 cases of recidivism including 7 boys and 6 girls. We found 21 cases of unilateral and 23 bilateral;among which 9 recurrences were found against 4 in the unilateral forms. 85% of recurrences did not have good adherence to the splint and 62% did not come regularly for follow-up consultation. We obtained 33 children with idiopathic clubfeet (75%) with a recurrence of 24%, and 7 children with secondary clubfeet with 71 % recurrence. There was no recurrence in the postural type. Among the recurrences, 38.5% started treatment between 1 and 6 months, 23.1% from 0 to 1 month and 15.4% at 2 years and more. 85% of recurrences had a Pirani score between 4.5 to 6 at the start of treatment and 15% at a score of 2.5 to 4. Conclusion: The factors of the failure of the Ponseti method are mainly non-compliance with treatment, secondary clubfeet, and a high Pirani score at the start of treatment.
文摘PURPOSE: Our aim was to present the diagnostic and therapeutic aspects of urological emergencies in a regional hospital. MATERIAL AND METHODS: We conducted a prospective study over a period of 6 months (April 2021 to September 2021) collecting all the emergencies received by the on-call urology team at the Nianankoro Fomba Hospital in Segou. This team was led by a DES in urology under the supervision of a urological surgeon. We were interested in age, sex of patients, diagnosis, number of patients hospitalised and type of surgery performed in emergency. RESULTS: We registered 72 patients. The mean age of our patients was 58.8 years with extremes of 6 and 90 years. Acute bladder retention was represented in 61% and total haematuria in 24%. Renal colic was reported in 8%. Acute prostatitis was reported in 4% of cases, and acute pyelonephritis in 1%. Urogenital trauma accounted for 6%. CONCLUSION: Although underestimated, in our context, the management of urological emergencies remains a regular activity of the urology department in view of the number of patients managed. Bladder drainage remains the most frequent procedure.