The Yangtze River Economic Belt is the main rice producing area in China.The rice industry chain is the agricultural pillar industry chain of this economic belt and it is the key to ensuring national food security and...The Yangtze River Economic Belt is the main rice producing area in China.The rice industry chain is the agricultural pillar industry chain of this economic belt and it is the key to ensuring national food security and promoting comprehensive rural revitalization.This study discusses the entire rice industry chain in the Yangtze River Economic Belt from the national rice production functional zones,agricultural product quality and safety,national famous and excellent new agricultural products,national specialty agricultural products,"China's good grain and oil"products,and national advantageous characteristic industrial clusters.Then,it discusses the geographical indications of rice and its products in this economic belt from geographical indication products,geographical indication trademarks,agricultural geographical indications,geographical indication standards,geographical indication special indications,national geographical indication product protection demonstration zones,and Chinese geographical indication products protected by the European Union.In addition,it analyzes the five main problems between geographical indications and public brands,such as the limited use of geographical indication specific signs and the imperfect intellectual property protection system for geographical indications.Finally,it proposes eight strategies,including promoting the high-quality development of the entire rice industry chain,creating a geographical indication regional public brand for rice and its products,and implementing geographical indication protection projects.展开更多
Background It has been reported that the mitochondrial respiratory dysfunction (MRD) is important mechanisms affecting the heart failure (HF) pathogenesis.We sought to evaluate the potential role of MRD of peripheral ...Background It has been reported that the mitochondrial respiratory dysfunction (MRD) is important mechanisms affecting the heart failure (HF) pathogenesis.We sought to evaluate the potential role of MRD of peripheral blood mononuclear cells (PBMC) in HF severity prediction in patients with cardioverter-defibrillator implantation indications.Methods In this single-center study patients with HF of New York Heart Association (NYHA) Ⅰ-Ⅲ functional class (FC) and cardioverter-defibrillator implantation indications underwent transthoracic echocardiography (TTE) and MRD assessment using PB-MC.Mitochondrial respiration rate (MRR) indicators (pyruvate+malate+adenosine diphosphate;succinate+adenosine diphosphate;pyruvate+malate–adenosine diphosphate[V4.1];succinate–adenosine diphosphate) were calculated.Correlations between HF NYHA FC,TTE and MRR indicators were evaluated.Based on our data,we developed a risk model regarding HF severity.Results Of 53 (100.0%) HF patients,33 (62.3%) had mild exercise intolerance (1stgroup) and 20 (37.7%) had moderate-to-severe exercise intolerance (2ndgroup).Patients with mild exercise intolerance were likely to have a higher V4.1(P<0.001) values.V4.1was independently associated with moderate-to-severe exercise intolerance in univariate and multivariate logistic regression (OR=0.932,95%CI:0.891–0.975,P<0.001).Conclusions The severity of HF is associated with PBMC mitochondrial respiratory dysfunction in patients with cardioverter-defibrillator implantation indications.Our HF severity risk model including V4.1parameters is able to distinguish patients with mild and moderate-to-severe exercise intolerance.Further investigations of their predictive significance are warranted.展开更多
São Paulo State has witnessed CO_(2)storage-based investigations considering the availability of suitable geologic structures and proximity to primary CO_(2)source sinks related to bioenergy and carbon capture an...São Paulo State has witnessed CO_(2)storage-based investigations considering the availability of suitable geologic structures and proximity to primary CO_(2)source sinks related to bioenergy and carbon capture and storage(BECCS)activities.The current study presents the hydrocarbon viability evaluations and CO_(2)storage prospects,focusing on the sandstone units of the Rio Bonito Formation.The objective is to apply petrophysical evaluations with geochemical inputs in predicting future hydrocarbon(gas)production to boost CO_(2)storage within the study location.The study used data from eleven wells with associated wireline logs(gamma ray,resistivity,density,neutron,and sonic)to predict potential hydrocarbon accumulation and fluid mobility in the investigated area.Rock samples(shale and carbonate)obtained from depths>200 m within the study location have shown bitumen presence.Organic geochemistry data of the Rio Bonito Formation shale beds suggest they are potential hydrocarbon source rocks and could have contributed to the gas accumulations within the sandstone units.Some drilled well data,e.g.,CB-1-SP and TI-1-SP,show hydrocarbon(gas)presence based on the typical resistivity and the combined neutron-density responses at depths up to 3400 m,indicating the possibility of other hydrocarbon members apart from the heavy oil(bitumen)observed from the near-surface rocks samples.From the three-dimensional(3-D)model,the free fluid indicator(FFI)is more significant towards the southwest and southeast of the area with deeper depths of occurrence,indicating portions with reasonable hydrocarbon recovery rates and good prospects for CO_(2)injection,circulation and permanent storage.However,future studies based on contemporary datasets are required to establish the hydrocarbon viability further,foster gas production events,and enhance CO_(2)storage possibilities within the region.展开更多
It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follo...It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follow-up,in terms of the management of these cases.Some STS are associated with bone and major neurovascular structures.Bone-associated STS are generally relatively large and relatively deep-seated.Additionally,the tendency for metastasis is high.In some cases,the decision about which structures to resect is difficult.These cases are often accompanied by poor oncological and surgical outcomes.Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field.The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery.Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.展开更多
Introduction: Intestinal resection is the disconnection or removal of part of the intestine with its meso. The aim was to describe the indications and prognostic factors for intestinal resections at the surgical depar...Introduction: Intestinal resection is the disconnection or removal of part of the intestine with its meso. The aim was to describe the indications and prognostic factors for intestinal resections at the surgical department of Kankan Regional Hospital. Patients and Methods: This was a retrospective descriptive study covering the files of patients who had undergone intestinal resections in the surgery department of the Kankan regional hospital over a period of 4 years from 1st January 2019 to December 31, 2022. Results: We collected 164 cases of intestinal resection representing 4.19% of all surgical procedures. (N = 3909). The average age of our patients was 37.78 years with extremes of 1 and 90 years. The male gender was predominant (64.6%) and the sex ratio was 1.8. The majority of patients consulted after 72 hours. Acute intestinal obstruction was the pathology motivating the most intestinal resection 42.90% followed by acute peritonitis 33%, digestive fistula 4.3%, tumors 3.6% and wounds 2.4%. Intestinal necrosis with 91 cases (56.5%) constituted the first indication for resection in our study followed by intestinal perforations 41 cases (24.9%). We performed an anastomotic resection of the small intestine in 70 cases (42.9%), an ileostomy in 4 cases (2.4%), a right hemi colectomy in 26 cases (15.9%), a left hemi colectomy in 2 cases (1.2%), segmental colectomy plus immediate anastomosis in 57 cases (34.2%) and 5 cases of colostomy. We recorded 48 deaths (29.3%). Conclusion: Intestinal resection is a common procedure in our context. These indications are multiple. An improvement in the prognosis should be achieved by reducing the diagnostic and treatment time associated with the training of surgical staff.展开更多
Introduction: The aim of this study was to report the indications and evaluate the results of vulvectomy in the general surgery department of Ignace Deen Hospital, CHU Conakry. Materials and Methods: This was a retros...Introduction: The aim of this study was to report the indications and evaluate the results of vulvectomy in the general surgery department of Ignace Deen Hospital, CHU Conakry. Materials and Methods: This was a retrospective descriptive study, conducted over a period of five (05) years from January 1, 2018 to December 31, 2022, in the general surgery department of Ignace Deen Hospital, CHU Conakry. We included in our study all patient records in whom vulvectomy was performed. Results: We recorded 15 cases of vulvectomy out of 453 perineal surgeries, i.e. 3.31%, with a mean age of 43.56 years and extremes of 35 and 69 years. Vulvar cancer was the most common diagnosis (46.67%), followed by Buschke-Lowenstein (33.33%) and anal canal cancer extending to the vulva (20%). Six patients had undergone biopsy (40%). Vulvectomy with lymph node dissection was performed in only 9 patients (60%), and all surgical specimens were sent to anatomical pathology (100%). Conclusion: Vulvectomy is a surgical technique most often indicated for the treatment of vulvar cancer.展开更多
Introduction: Splenectomy is the surgical removal of the spleen. It can be performed during various pathologies, ranging from abdominal trauma to hemoglobinopathies. The progress made in the knowledge of the immune fu...Introduction: Splenectomy is the surgical removal of the spleen. It can be performed during various pathologies, ranging from abdominal trauma to hemoglobinopathies. The progress made in the knowledge of the immune functions of the spleen and the fear of post-splenectomy infectious complications have favored the development of surgical or non-surgical splenic preservation techniques calling into question the dogma of splenectomy. The aim of this study was to determine the indications for splenectomy. Methodology: This was a retrospective, descriptive study lasting 5 years in the general surgery department of the Ignace Deen National Hospital. All files of splenectomized patients were included, our variables were clinical, therapeutic and progressive. Results: We collected 42 cases of splenectomies out of the 2478 surgical procedures performed, representing 1.7% of the department’s surgical activities. The average age was 44 years. The age group of 41 to 50 years was the most represented, i.e. 26% (n = 11) of cases. Sex ratio = 1. Abdominal pain was the reason for consultation in patients, i.e. 100% (n = 42) of cases. The antecedents were dominated by recurrent malaria with 52.3% (n = 22) of cases, then recurrent anemia in 21% (n = 9), and 16.7% (n = 7) had sickle cell disease. Splenomegaly was found in 31 patients, or 73.6%. Ultrasound was performed in all patients. The indications for splenectomy were: isolated splenomegaly with risk of rupture (38%, n = 16), hypersplenism (26%, n = 11) and trauma to the spleen (19.04%, n = 8). Total splenectomy was performed in all cases. The surgical consequences were favorable in 85.7%, (n = 36) with morbidity of 14% (n = 6) and mortality of 9.52% (n = 4). The average length of hospitalization was 10.4 days with extremes of 1 and 22 days. Conclusion: Splenectomy constitutes a relatively common surgical procedure in our context. The indications for splenectomy were isolated splenomegaly with risk of rupture, hypersplenism and trauma to the spleen and total splenectomy was the rule.展开更多
Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hosp...Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena Mother and Child University Hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.展开更多
Introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital na...Introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital national Ignace Deen/CHU de Conakry. Methodology: This was a retrospective study, of seven (07) years (January 1, 2016 - August 31, 2023), in the General Surgery Department of the Ignace Deen National Hospital-CHU in Conakry. We included all records of patients admitted and operated on for thyroidectomy and with up-to-date medical records. The variables were epidemiological, clinical and therapeutic. Results: During the study period, we recorded 3221 cases of surgery, including 40 thyroidectomies (1.24% of cases). The average age was 42.4 years. Women were the most represented, with a sex ratio of 0.16. The reason for consultation was anterior cervical swelling in 86% (n = 25) of cases, followed by signs of cervical compression 21% (n = 6) and signs of thyrotoxicosis 31% (n = 9). Indications for thyroidectomy were dominated by homogeneous goitres in 69% (n = 20) of cases, basedow’s disease in 20.7% (n = 6) and nodular goitres in 6.9% (n = 2) of cases. The surgical procedures were lobo-isthmectomies in 72.4% (n = 21), subtotal thyroidectomies 13.8% (n = 4), total thyroidectomies 10.3% (n = 3). Postoperative follow-up was straightforward in 69% (n = 20). Complications included haemorrhage in 20.7% (n = 6) and recurrence in 6.9% (n = 2). The average hospital stay was 7 days. Conclusion: Thyroidectomy is a relatively frequent surgical procedure in our department. Indications are dominated by homogeneous goitres. Morbidity is related to hemorrhage. Rigorous hemostasis could improve the quality of thyroidectomy.展开更多
Objective: To determine the indications and immediate maternal and fetal outcomes of caesarean section performed at primary health facilities in 2020. Design: Discriptive cross-sectional study. Setting: Lushoto Distri...Objective: To determine the indications and immediate maternal and fetal outcomes of caesarean section performed at primary health facilities in 2020. Design: Discriptive cross-sectional study. Setting: Lushoto District Council is located in the northeastern in Tanga region, Tanzania. Participants: All women who underwent caesarean section at primary health facilities from January to December 2020, 782 included in this study and 72 files were missing. Main outcome Measures: Indications and immediate maternal and fetal outcomes of caesarean section at primary health facilities. The difference in indications and outcomes of caesarean section between district hospital and upgraded health centres. Results: The commonest indications were obstructed labor 29.0%, previous scar(s) 19.9% and fetal distress 17.0%. Obstructed labour indication was more at the upgraded health centres. Most, 89% of women had no post-operative complications. The common maternal complications were hemorrhage 5.7%, transfusion 5.2%, prolonged stay 1.7%. Most babies were alive 95%, term 90% with Apgar score > 7 at 5 minutes 96% and 94% had birth weight ≥ 2500 g. There were no statistically significant differences in immediate maternal and fetal outcomes between health centres and district hospital. Conclusions: Obstructed labour was the commonest indication for caesarean section. The immediate maternal and fetal outcomes at the upgraded health centers were comparable to the district hospital level. Clinical audits of indications for caesarean section and prospective studies for late maternal and fetal outcomes of caesarean section performed at primary health facilities to be conducted.展开更多
基金Supported by Social Science Foundation of Hubei Province (HBSKJJ20243227),Doctoral Initiation Project of Hubei University of Science and Technology (BK201819).
文摘The Yangtze River Economic Belt is the main rice producing area in China.The rice industry chain is the agricultural pillar industry chain of this economic belt and it is the key to ensuring national food security and promoting comprehensive rural revitalization.This study discusses the entire rice industry chain in the Yangtze River Economic Belt from the national rice production functional zones,agricultural product quality and safety,national famous and excellent new agricultural products,national specialty agricultural products,"China's good grain and oil"products,and national advantageous characteristic industrial clusters.Then,it discusses the geographical indications of rice and its products in this economic belt from geographical indication products,geographical indication trademarks,agricultural geographical indications,geographical indication standards,geographical indication special indications,national geographical indication product protection demonstration zones,and Chinese geographical indication products protected by the European Union.In addition,it analyzes the five main problems between geographical indications and public brands,such as the limited use of geographical indication specific signs and the imperfect intellectual property protection system for geographical indications.Finally,it proposes eight strategies,including promoting the high-quality development of the entire rice industry chain,creating a geographical indication regional public brand for rice and its products,and implementing geographical indication protection projects.
文摘Background It has been reported that the mitochondrial respiratory dysfunction (MRD) is important mechanisms affecting the heart failure (HF) pathogenesis.We sought to evaluate the potential role of MRD of peripheral blood mononuclear cells (PBMC) in HF severity prediction in patients with cardioverter-defibrillator implantation indications.Methods In this single-center study patients with HF of New York Heart Association (NYHA) Ⅰ-Ⅲ functional class (FC) and cardioverter-defibrillator implantation indications underwent transthoracic echocardiography (TTE) and MRD assessment using PB-MC.Mitochondrial respiration rate (MRR) indicators (pyruvate+malate+adenosine diphosphate;succinate+adenosine diphosphate;pyruvate+malate–adenosine diphosphate[V4.1];succinate–adenosine diphosphate) were calculated.Correlations between HF NYHA FC,TTE and MRR indicators were evaluated.Based on our data,we developed a risk model regarding HF severity.Results Of 53 (100.0%) HF patients,33 (62.3%) had mild exercise intolerance (1stgroup) and 20 (37.7%) had moderate-to-severe exercise intolerance (2ndgroup).Patients with mild exercise intolerance were likely to have a higher V4.1(P<0.001) values.V4.1was independently associated with moderate-to-severe exercise intolerance in univariate and multivariate logistic regression (OR=0.932,95%CI:0.891–0.975,P<0.001).Conclusions The severity of HF is associated with PBMC mitochondrial respiratory dysfunction in patients with cardioverter-defibrillator implantation indications.Our HF severity risk model including V4.1parameters is able to distinguish patients with mild and moderate-to-severe exercise intolerance.Further investigations of their predictive significance are warranted.
基金sponsored by Fundação de Amparoa Pesquisa do Estado de São Paulo(FAPESP)(2014/50279-4,2020/15230-5,2021/06158-1)Shell Brasil.
文摘São Paulo State has witnessed CO_(2)storage-based investigations considering the availability of suitable geologic structures and proximity to primary CO_(2)source sinks related to bioenergy and carbon capture and storage(BECCS)activities.The current study presents the hydrocarbon viability evaluations and CO_(2)storage prospects,focusing on the sandstone units of the Rio Bonito Formation.The objective is to apply petrophysical evaluations with geochemical inputs in predicting future hydrocarbon(gas)production to boost CO_(2)storage within the study location.The study used data from eleven wells with associated wireline logs(gamma ray,resistivity,density,neutron,and sonic)to predict potential hydrocarbon accumulation and fluid mobility in the investigated area.Rock samples(shale and carbonate)obtained from depths>200 m within the study location have shown bitumen presence.Organic geochemistry data of the Rio Bonito Formation shale beds suggest they are potential hydrocarbon source rocks and could have contributed to the gas accumulations within the sandstone units.Some drilled well data,e.g.,CB-1-SP and TI-1-SP,show hydrocarbon(gas)presence based on the typical resistivity and the combined neutron-density responses at depths up to 3400 m,indicating the possibility of other hydrocarbon members apart from the heavy oil(bitumen)observed from the near-surface rocks samples.From the three-dimensional(3-D)model,the free fluid indicator(FFI)is more significant towards the southwest and southeast of the area with deeper depths of occurrence,indicating portions with reasonable hydrocarbon recovery rates and good prospects for CO_(2)injection,circulation and permanent storage.However,future studies based on contemporary datasets are required to establish the hydrocarbon viability further,foster gas production events,and enhance CO_(2)storage possibilities within the region.
文摘It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follow-up,in terms of the management of these cases.Some STS are associated with bone and major neurovascular structures.Bone-associated STS are generally relatively large and relatively deep-seated.Additionally,the tendency for metastasis is high.In some cases,the decision about which structures to resect is difficult.These cases are often accompanied by poor oncological and surgical outcomes.Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field.The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery.Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.
文摘Introduction: Intestinal resection is the disconnection or removal of part of the intestine with its meso. The aim was to describe the indications and prognostic factors for intestinal resections at the surgical department of Kankan Regional Hospital. Patients and Methods: This was a retrospective descriptive study covering the files of patients who had undergone intestinal resections in the surgery department of the Kankan regional hospital over a period of 4 years from 1st January 2019 to December 31, 2022. Results: We collected 164 cases of intestinal resection representing 4.19% of all surgical procedures. (N = 3909). The average age of our patients was 37.78 years with extremes of 1 and 90 years. The male gender was predominant (64.6%) and the sex ratio was 1.8. The majority of patients consulted after 72 hours. Acute intestinal obstruction was the pathology motivating the most intestinal resection 42.90% followed by acute peritonitis 33%, digestive fistula 4.3%, tumors 3.6% and wounds 2.4%. Intestinal necrosis with 91 cases (56.5%) constituted the first indication for resection in our study followed by intestinal perforations 41 cases (24.9%). We performed an anastomotic resection of the small intestine in 70 cases (42.9%), an ileostomy in 4 cases (2.4%), a right hemi colectomy in 26 cases (15.9%), a left hemi colectomy in 2 cases (1.2%), segmental colectomy plus immediate anastomosis in 57 cases (34.2%) and 5 cases of colostomy. We recorded 48 deaths (29.3%). Conclusion: Intestinal resection is a common procedure in our context. These indications are multiple. An improvement in the prognosis should be achieved by reducing the diagnostic and treatment time associated with the training of surgical staff.
文摘Introduction: The aim of this study was to report the indications and evaluate the results of vulvectomy in the general surgery department of Ignace Deen Hospital, CHU Conakry. Materials and Methods: This was a retrospective descriptive study, conducted over a period of five (05) years from January 1, 2018 to December 31, 2022, in the general surgery department of Ignace Deen Hospital, CHU Conakry. We included in our study all patient records in whom vulvectomy was performed. Results: We recorded 15 cases of vulvectomy out of 453 perineal surgeries, i.e. 3.31%, with a mean age of 43.56 years and extremes of 35 and 69 years. Vulvar cancer was the most common diagnosis (46.67%), followed by Buschke-Lowenstein (33.33%) and anal canal cancer extending to the vulva (20%). Six patients had undergone biopsy (40%). Vulvectomy with lymph node dissection was performed in only 9 patients (60%), and all surgical specimens were sent to anatomical pathology (100%). Conclusion: Vulvectomy is a surgical technique most often indicated for the treatment of vulvar cancer.
文摘Introduction: Splenectomy is the surgical removal of the spleen. It can be performed during various pathologies, ranging from abdominal trauma to hemoglobinopathies. The progress made in the knowledge of the immune functions of the spleen and the fear of post-splenectomy infectious complications have favored the development of surgical or non-surgical splenic preservation techniques calling into question the dogma of splenectomy. The aim of this study was to determine the indications for splenectomy. Methodology: This was a retrospective, descriptive study lasting 5 years in the general surgery department of the Ignace Deen National Hospital. All files of splenectomized patients were included, our variables were clinical, therapeutic and progressive. Results: We collected 42 cases of splenectomies out of the 2478 surgical procedures performed, representing 1.7% of the department’s surgical activities. The average age was 44 years. The age group of 41 to 50 years was the most represented, i.e. 26% (n = 11) of cases. Sex ratio = 1. Abdominal pain was the reason for consultation in patients, i.e. 100% (n = 42) of cases. The antecedents were dominated by recurrent malaria with 52.3% (n = 22) of cases, then recurrent anemia in 21% (n = 9), and 16.7% (n = 7) had sickle cell disease. Splenomegaly was found in 31 patients, or 73.6%. Ultrasound was performed in all patients. The indications for splenectomy were: isolated splenomegaly with risk of rupture (38%, n = 16), hypersplenism (26%, n = 11) and trauma to the spleen (19.04%, n = 8). Total splenectomy was performed in all cases. The surgical consequences were favorable in 85.7%, (n = 36) with morbidity of 14% (n = 6) and mortality of 9.52% (n = 4). The average length of hospitalization was 10.4 days with extremes of 1 and 22 days. Conclusion: Splenectomy constitutes a relatively common surgical procedure in our context. The indications for splenectomy were isolated splenomegaly with risk of rupture, hypersplenism and trauma to the spleen and total splenectomy was the rule.
文摘Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena Mother and Child University Hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.
文摘Introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital national Ignace Deen/CHU de Conakry. Methodology: This was a retrospective study, of seven (07) years (January 1, 2016 - August 31, 2023), in the General Surgery Department of the Ignace Deen National Hospital-CHU in Conakry. We included all records of patients admitted and operated on for thyroidectomy and with up-to-date medical records. The variables were epidemiological, clinical and therapeutic. Results: During the study period, we recorded 3221 cases of surgery, including 40 thyroidectomies (1.24% of cases). The average age was 42.4 years. Women were the most represented, with a sex ratio of 0.16. The reason for consultation was anterior cervical swelling in 86% (n = 25) of cases, followed by signs of cervical compression 21% (n = 6) and signs of thyrotoxicosis 31% (n = 9). Indications for thyroidectomy were dominated by homogeneous goitres in 69% (n = 20) of cases, basedow’s disease in 20.7% (n = 6) and nodular goitres in 6.9% (n = 2) of cases. The surgical procedures were lobo-isthmectomies in 72.4% (n = 21), subtotal thyroidectomies 13.8% (n = 4), total thyroidectomies 10.3% (n = 3). Postoperative follow-up was straightforward in 69% (n = 20). Complications included haemorrhage in 20.7% (n = 6) and recurrence in 6.9% (n = 2). The average hospital stay was 7 days. Conclusion: Thyroidectomy is a relatively frequent surgical procedure in our department. Indications are dominated by homogeneous goitres. Morbidity is related to hemorrhage. Rigorous hemostasis could improve the quality of thyroidectomy.
文摘Objective: To determine the indications and immediate maternal and fetal outcomes of caesarean section performed at primary health facilities in 2020. Design: Discriptive cross-sectional study. Setting: Lushoto District Council is located in the northeastern in Tanga region, Tanzania. Participants: All women who underwent caesarean section at primary health facilities from January to December 2020, 782 included in this study and 72 files were missing. Main outcome Measures: Indications and immediate maternal and fetal outcomes of caesarean section at primary health facilities. The difference in indications and outcomes of caesarean section between district hospital and upgraded health centres. Results: The commonest indications were obstructed labor 29.0%, previous scar(s) 19.9% and fetal distress 17.0%. Obstructed labour indication was more at the upgraded health centres. Most, 89% of women had no post-operative complications. The common maternal complications were hemorrhage 5.7%, transfusion 5.2%, prolonged stay 1.7%. Most babies were alive 95%, term 90% with Apgar score > 7 at 5 minutes 96% and 94% had birth weight ≥ 2500 g. There were no statistically significant differences in immediate maternal and fetal outcomes between health centres and district hospital. Conclusions: Obstructed labour was the commonest indication for caesarean section. The immediate maternal and fetal outcomes at the upgraded health centers were comparable to the district hospital level. Clinical audits of indications for caesarean section and prospective studies for late maternal and fetal outcomes of caesarean section performed at primary health facilities to be conducted.