CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, car...CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, cardiovascular surgery, plastic and endocrinology surgery. As a reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. <b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer </span><span style="font-family:Verdana;">o</span><span style="font-family:;" "=""><span style="font-family:Verdana;">r 50.79% of digestive cancers. The mean age of the patients was 57.21 ± 13 years. Male sex represented 55% (n = 106). Eating habits were dominated by the consumption of t<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">ô</span> with potash (cereal paste) with 64.76% (n = 185). The main methods of preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n = 5). The low socio-economic class represented 126 cases or 65.38%. Housewives and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20% (n = 39) had a history of epigastric pain. Epigastralgia was the most common functional sign with 84.5% of cases (n = 169). An epigastric mass was found in 72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188). Palliative surgery concerned the majority of our patients with 64.8% of patients (n = 79). The postoperative consequences were simple in 28.57% of cases (n = 28), the postoperative morbidity and mortality were respectively 33.61% (n = 41), and 23.77% (n = 29). The overall survival rate after surgery was 10.81% at 2 years and 2.94% at 5 years. This rate was 58.83% at 2 years and 28.50% at 5 years after curative surgery. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The risk factors for stomach cancer are many and varied. Some are particularly present in Africa. Delay in diagnosis due to a belief in traditional healers is common in our community.</span></span>展开更多
<strong>Introduction:</strong><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">Acute myocardial infarction (IDM) occupi...<strong>Introduction:</strong><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">Acute myocardial infarction (IDM) occupies the first place in terms of mortality, among ischemic pathologies. Thrombolysis in the case of medical treatment for acute myocardial infarction (AMI) is undoubtedly the most revolutionary performed to date in this context, with a significant reduction in the mortality rate. The aim of our study was to describe the epidemiological aspects, the criteria for myocardial reperfusion post thrombolysis, the complications during thrombolysis and the complications of acute myocardial infarction in the cardiology department of the CHU Ernesto Guevara De La Serna of Las Tunas (Cuba)</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methods:</span></b></span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">A retrospective cross</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">sectional descriptive study was carried out from June 2009 to December 2011. The patients hospitalized during this period in the USIC (coronary intensive care unit) for SCA ST(+) were included in the study. The variables studied were: Age, sex, myocardial reperfusion criteria, complications during thrombolysis and complications of myocardial infarction.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 207 patients were included. The male sex represented 72.5% of the cases, giving a sex ratio of 2.63. The age group > 60 years was predominant with 54.2% of the cases. Thrombolysed patients represented 65.2% of the cases. Myocardial reperfusion criteria were observed in the majority of thrombolysed patients: relief of precordial pain (77%), regression of the ST segment to 50% of its previous level (81.5% of patients). Bleeding was observed in 1.5% of thrombolysed cases. Complications were encountered in 57% of non thrombolysed patients with a lethality of 5.6%.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">The male sex was the most affected. Thrombolysis was effective in the majority of patients. The post thrombolysis bleeding rate was low. More than half of the cases of SCA ST(+) not thrombolysed presented complications.</span>展开更多
<strong>Introduction:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""> The metabolic syndrome is a clinical entity defined by the association ...<strong>Introduction:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""> The metabolic syndrome is a clinical entity defined by the association in the same subject of four of the following five factors: abdominal obesity (or android), type 2 diabetes, hypertension, hypo HDL cholesterolemia, hypertriglyceridemia. The aim of the work was to study the epidemiological, clinical-biological profiles and complications of patients in the cardiology and internal medicine department of the Mother-Child CHU “Luxembourg”. <b>Materials and Methods:</b> We carried out a cross-sectional study, from September 2019 to June 2020 in the cardiology and internal department of the mother-child CHU “Luxembourg”. All patients with metabolic syndrome admitted to the two departments who agreed to participate during the study period were included in the study. These patients meet the 2009 harmonization attempt criteria (IDF 2009). The variables studied were: socio-demographic characteristics (sex, age, profession), pathological history, clinical signs (functional signs, BMI, waist size), paraclinical signs (ECG, cardiac ultrasound, laboratory assessment) and complications. <b>Results:</b> A total of 104 patients were included. The female sex represented 58.65% of cases. The 60 to 69 age group was the majority with 40.78%, housewives occupied 41.34% of cases. Diabetes, arterial hypertension and dyslipidemia were the most represented cardiovascular risk factors with respectively: 80.77%, 79.81% and 53.85%. Visual blurring was the most common functional sign with 23.08% of cases. Moderate obesity was observed in 34% of patients. Waist circumference was high in 39.53% of male patients and 37.70% of female patients. Cardiac ultrasound found a severely collapsed ejection fraction in 25% of patients. HDL-c levels were low in 64.52% of male patients and 75% of female patients. The most observed complications were: dyslipidemia (53.85%), stroke and renal failure with 23% respectively</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">. </span><span style="white-space:normal;font-size:10pt;font-family:;" "=""><b>Conclusion:</b> The metabolic syndrome remains a real public health problem, constantly increasing in our populations and constitutes a danger by its constituent ele</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ments.</span>展开更多
Aim: Review of early postoperative deaths in the surgical intensive care unit at CHU-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postope...Aim: Review of early postoperative deaths in the surgical intensive care unit at CHU-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postoperative death linked to numerous risk factors. Methodology: This was a retrospective descriptive study conducted on the records of patients who died within 48 hours after surgery from November 1, 2019 to April 30, 2021. The study was conducted in the surgical intensive care unit and in the operating room. Results: Thirty-two early postoperative deaths or 2.22% out of 1442 operated with 30 deaths retained for the study. Male gender predominated (70%). The average age was 31.22 years. Farmers were more concerned (66.67%). The time to surgery was 1.6 days. ASA1 patients (40%) predominated followed by ASA IV (30%). 80% of patients were operated on as an emergency. Digestive pathologies 80% were more represented. General anaesthesia 86.66% was more practiced associating Propofol, Fentanyl, Ketamine and Atropine more frequently. The average duration of the procedures was 132.5 minutes. Intraoperative complications were associated with cardiac arrest and hemorrhage (33.34%). ASA class higher than 2, dirty surgery (46.67%), and delayed recovery (13.34%) were the incriminating risk factors. Death by hemodynamic shock and respiratory distress were the main causes 26.66%. Conclusion: Early postoperative mortality was high and involved all ages. Anesthesia and surgery, the low level of qualification of the intraoperative actors, the lesser intraoperative security;the association of anesthetic effects, the complexity of intraoperative lesions led to the increase of mortality. The combination of two or more factors was pejorative for the deaths.展开更多
Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school ch...Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school children aged 5 to 15 at CHU-IOTA. Patients and Method: This is a prospective, descriptive cross-sectional study carried out in the ophthalmic-pediatrics department of CHU-IOTA, from October to November 2023. Results: We received 340 school children aged 5 to 15, among whom 111 presented ametropia, i.e. a prevalence of 32.65%. The average age was 11.42 ± 2.75 years and a sex ratio of 0.59. The average visual acuity was 4/10 (range 1/10 and 10/10). We found refractive defects: astigmatism 73.87%, hyperopia 23.87% of cases and myopia 2.25%. The decline in distance visual acuity was the most common functional sign. Ocular abnormalities associated with ametropia were dominated by allergic conjunctivitis (26.13%) and papillary excavation (6.31%) in astigmatics;allergic conjunctivitis (9.01%) and papillary excavation (7.20%) in hyperopic patients;turbid vitreous (0.90%), myopic choroidosis (0.45%) and allergic conjunctivitis (0.45%) in myopes. Conclusion: Refractive errors constitute a reality and a major public health problem among school children.展开更多
Introduction: Pain assessment is an essential step towards pain relief. In our context, however, it is insufficient in emergency departments. The aim was to assess the nature and effectiveness of the analgesia used in...Introduction: Pain assessment is an essential step towards pain relief. In our context, however, it is insufficient in emergency departments. The aim was to assess the nature and effectiveness of the analgesia used in the emergency department of the CHU-Donka. Method: This was a single-centre prospective observational study conducted over one month (November 2020) in the medical-surgical emergency department of CHU-Donka. All patients aged 18 or over admitted to the emergency department with moderate to severe acute pain were included. Results: We enrolled 880 patients, 615 of whom (69.88%) were in pain. Males predominated (65.2%), with a sex ratio of 1.87. The average age was 44.78 ± 16.41 years, with extremes ranging from 18 to 85 years. The most represented age group was 18 - 34 years, with 66.18%. Initial assessment of pain by nursing staff in 3 cases. Initial assessment of pain by the investigator was 100%, 74% moderate and 26% severe. No reassessment of pain by nursing staff. Reassessment by the interviewer was 100% and found 5% no pain, 61% mild pain, 24% moderate pain and 10% severe pain. With an average numerical scale of 3.77 ± 2.61 and extremes from 0 to 10. Average length of stay was 2.85 ± 1.48 hours, with extremes ranging from 45 minutes to 8 hours. Analgesia was administered with paracetamol alone (43.58%), combined with tramadol or nefopam. No patient received morphine. Conclusion: This study revealed a lack of pain assessment in our department.展开更多
The authors bring back 70 cases of pericarditis brought together between 2012 and 2017 in the service of surgery B of the CHU Point G and to the Hospital Mother-Child, the Luxembourg in Mali. The average age of the pa...The authors bring back 70 cases of pericarditis brought together between 2012 and 2017 in the service of surgery B of the CHU Point G and to the Hospital Mother-Child, the Luxembourg in Mali. The average age of the patients is 31.5 years with extremes of 2 years and 84 years. The tubercular etiology widely comes to mind with 49 cases. The diagnostic contributions of the echocardiography are analyzed. The accent is put on good tolerance hemodynamic of the tubercular pericarditis. The forecast depends essentially on the etiology and on the diagnostic delay;indeed the tamponade pericardium can be inaugural or complicated;the evolution of the pericarditis is burdened of a heavy mortality (4.2% in our series). On the other hand the passage in the chronicity complicates essentially pericarditis seen late (8.6% in our series).展开更多
This case report is about a 61 years old woman who consulted for hematuria, the cystoscopy performed revealed an intra-diverticular bladder tumor. After tumor resection, an anatomopathological exam revealed the urothe...This case report is about a 61 years old woman who consulted for hematuria, the cystoscopy performed revealed an intra-diverticular bladder tumor. After tumor resection, an anatomopathological exam revealed the urothelial carcinoma pT1. A few months later she presented with a local reccurence of bladder tumor. We proposed her anterior pelvectomy but she refused it and she was lost to follow-up. The aim of this study is to show the anatomopathological and evolutionary characteristics and the therapeutic difficulties of IDBT. These tumors are in the majority of cases infiltrating from the outset with a high potential for recurrence after transurethral resection of bladder (TURB). The standard treatments are TURB and total cystectomy.展开更多
Introduction: Leontiasis ossea is the most severe bone complication of the maxillae of chronic renal failure. The objective of this work is to determine the clinical, paraclinical and therapeutic aspects of this condi...Introduction: Leontiasis ossea is the most severe bone complication of the maxillae of chronic renal failure. The objective of this work is to determine the clinical, paraclinical and therapeutic aspects of this condition. Observation: A 42-year-old patient with chronic anuric terminal renal failure dialysis for 12 years had consulted for multiple maxillo-mandibular swelling evolving for 2 years deforming the face with discomfort to chewing. The biological assessment was: PTH: 5252 pg/mL, Ca<sup>2+</sup>: 2.86 mmol/L, free T3: 4.16 pmol/L, free T4: 6.55 pmol/L, TSH: 3.13 U/mL, serum protein: 61 g/L, Creatinine: 835 μmol/L. The maxillofacial CT noted heterogeneous diffuse thickening of the cranial vault and bones of the facial massif evoking leontiasis ossea with right mandibular brown tumor. The biopsy diagnosed fibrous gingival epulis. The patient had undergone modeling surgery, under general anesthesia after dialysis, of the right mandibular tumor whose histological result was Leontiasis ossea. Conclusion: Treatment is modeling surgery under hemostatic control.展开更多
Perforation of a pseudo appendicular tumor of bilharzial origin (bilharzia) is a rare etiology of acute peritonitis. His diagnosis is histopathological. The existence of comorbid malaria and surgical pathology is freq...Perforation of a pseudo appendicular tumor of bilharzial origin (bilharzia) is a rare etiology of acute peritonitis. His diagnosis is histopathological. The existence of comorbid malaria and surgical pathology is frequent in having a positive thick drop with <em>Schistosoma mansoni</em> eggs in his stool. After 3 months, the patient is doing well. In conclusion, we recommend the histopathological analysis of the surgical specimen after appendectomy and the detection of haematozoa for malaria in any case of fever in a surgical environment.展开更多
Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically...Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically search for it in patients with multiple comorbidities. The objective of this study was to determine the prevalence of orthostatic hypotension;describe their socio- demographic profile, the various clinical and paraclinical aspects and the predisposing factors of orthostatic hypotension in treated hypertensives, controlled or not. Method: This was a descriptive cross-sectional study, from January 2 to June 30, 2022 in the cardiology department of the Ignace Deen National Hospital. Included in this study were all patients who presented with orthostatic hypotension under antihypertensive treatment, regardless of age and sex, and who agreed to participate in the study. The non-inclusion criteria were hypertensive patients without OH and those who had not agreed to participate in the study. Each patient had blood pressure and heart rate measured in the supine position at room temperature and with an empty bladder. Then the measurement is taken again three (3) minutes after the switch to orthostatism. We retained the diagnosis of OH if the SBP drops by at least 20 mmHg and/or the PAD by at least 10 mmHg three (3) min after the transition to orthostatism. Our data obtained were analyzed in the Epi-info 7.4.0 software. Results: During our study period, we investigated 385 presented with OH, 12.2%. The mean age of the patients was 60.83 years ± 10.01 years and hypertensive patients, 47 of whom the M/F sex ratio was 0.81. In our study, blood pressure was not controlled in 36.2% of our patients with a predominance of grade 3 hypertension, a rate of 55.32%. Renal failure, anemia, heart failure and stroke were the main comorbidities associated with the occurrence of HO. The most incriminated factors were age with a frequency of 74.47%, followed by obesity at 44.68% and diabetes at 27.66%. BP was normally controlled with a rate of 68.8% in treated hypertensive patients with OH. It is found much more in patients using triple therapy, a rate of 61.71%. Conclusion: The prevalence of OH is high in our department. It is found much more in patients using triple therapy. The most incriminated factors were age followed by obesity and diabetes.展开更多
Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to deter...Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to determine the extent of this prescription. Patients and Methods: This was a cross-sectional study with retrospective data collection of patients hospitalized in the infectious diseases department in the period from January 1, 2005 to December 31, 2020. The records of patients who received probabilistic antibiotic therapy were included. Results: During the study period, 330 patients had received probabilistic antibiotic therapy. The majority of patients were male (53%), with a sex ratio of 1.12. The mean age of the patients was 33 years ± 14. The age range of 20 to 40 years was the most represented (42%). Fifteen percent (15%) of patients were living with HIV. The majority of patients were from urban areas (56.4%). Forty-nine percent (49%) of the patients worked in the informal sector. Clinically, the reasons for consultation were dominated by fever, alteration of general condition, neurological disorders, digestive disorders, respiratory signs, urinary signs and diffuse pain. The physical examination showed that 48.1% of the patients had meningeal irritation syndrome, 10% had convulsions and 10% had focal signs, trismus was present in 4% of the patients and facial paralysis in 3%. In the digestive system, hepatomegaly was present in 29% of patients and digestive candidiasis in 31%. Respiratory examination showed crepitus and fluid effusion syndrome in 26.83% and 20.62% of patients respectively. The presumptive diagnosis was dominated by bacterial meningitis, salmonellosis and bronchopneumonia with banal germs. In terms of treatment, the beta-lactam family of drugs was the most prescribed. They were followed by aminoglycosides and fluoroquinolones. The evolution was marked by the death of 50 patients (15%). Conclusion: The most prescribed molecules belong to the family of Beta-lactam. And this prescription improved the outcome of patients. Bacterial susceptibility studies will allow better orientation of probabilistic antibiotic therapy in order to limit the emergence of multi-resistant bacteria.展开更多
The objectives were to determine the frequency of pain in cancer patients and its intensity in cancer pathologies and to evaluate the evolution of pain intensity after analgesic treatment;the effectiveness of its mana...The objectives were to determine the frequency of pain in cancer patients and its intensity in cancer pathologies and to evaluate the evolution of pain intensity after analgesic treatment;the effectiveness of its management study involved 121 cases of operated gastrointestinal cancers, which accounted for 85.82% (141) of operated cancers and 16.78% (721) of all operated patients;the average age of our patients was 49.93 years with extremes 17 and 78 years. Standard deviation: 15.75;with a sex ratio of 1.46. The majority of our patients had WHO III (54/121) or 44.6%;46.3% (56/121) of patients were in stage IV of the TNM classification. The main digestive cancers were cancer of the esophagus 4 cases (3.3%);of the stomach 61 cases (50.4%);of the pancreas 7 cases (5.8%);of the liver 4 cases (3.3%);gall bladder 2 cases (1.6%);colon 33 cases (27.3%);rectum 6 cases (4.9%) and hail 4 cases (3.3%). The average pain intensities were 3 to 6 hour;2 to 24 hour;1.6 to 48 hour;and 1.2 to 72 hour. The majority of our patients had a treatment protocol involving nefopam, and paracetamol was 58%. The pain was exacerbated especially during exercise. Vomiting and vein burning were the main side effects encountered.展开更多
Introduction: Schizoaffective disorder is a chronic psychotic disorder. It is characterized by the simultaneous presence of symptoms of a characterized mood disorder and symptoms of schizophrenia. Data on this disorde...Introduction: Schizoaffective disorder is a chronic psychotic disorder. It is characterized by the simultaneous presence of symptoms of a characterized mood disorder and symptoms of schizophrenia. Data on this disorder are almost non-existent in West Africa. The objective was to describe the epidemiological, clinical and therapeutic aspects of schizoaffective disorder at the Campus University Hospital Centre (CHU-Campus) of Lomé in Togo. Framework and Method: This was a retrospective study with a descriptive aim on patients hospitalized at the Clinic of Psychiatry and Medical Psychology (CPPM) of CHU-Campus from January 1st, 2013 to December 31, 2018. Results: A total of 46 patients were included in this study. Their mean age was 39.5 years with extremes ranging from 14 to 65 years. Females had predominated at 52.18% or a sex ratio of 0.91. Married people represented 47.83%. Primary education represented 34.80%. The unemployed were in the majority at 32.92%. Sixty-five point twenty two percent (65.22%) of the patients had a personal psychiatric history. All patients had presented with delusions plus other psychotic and mood symptoms. Almost all patients (97.82%) had received a thymoregulator associated with a first generation antipsychotic (95.65%). Conclusion: More studies should be done in our countries to describe the cultural aspects of this disease.展开更多
Infection with the defective hepatitis D virus (HDV) co-infects or superinfects a patient carrying hepatitis B virus (HBV). Delta virus infection is relatively common. The seriousness of infection with the hepatitis D...Infection with the defective hepatitis D virus (HDV) co-infects or superinfects a patient carrying hepatitis B virus (HBV). Delta virus infection is relatively common. The seriousness of infection with the hepatitis D virus (HDV), a virus defective in a patient carrying the hepatitis B virus (HBV), lies in its aggravating effect on the associated viral hepatitis B. Our aim was to study the serological profile of HDV in HBsAg-positive patients. As this study was fragmentary, we initiated this study with the aim of investigating the serological profile of HDV in HBsAg-positive patients. This was a descriptive and analytical cross-sectional study that ran from March 2019 to February 2020, a 12-month period. It focused on the population of patients seen and screened positive for HBsAg. We obtained a frequency of 10%. The mean age of our patients was 41.8 ± 13.09 years. The sex ratio was 4.5. VHD RNA was detected in 50% of patients. In 100% of cases, the presence of VHD RNA was associated with advanced fibrosis according to the APRI score, but without any statistically significant link. All HBV-infected patients should be screened for anti-HDV Ac. HDV infection leads to rapid progression to complications of liver disease.展开更多
Goal: To determine hospital frequency, to describe the clinical and therapeutic aspects and to determine the prognosis. Patients and Methods: This was a retrospective and prospective study carried out in the General S...Goal: To determine hospital frequency, to describe the clinical and therapeutic aspects and to determine the prognosis. Patients and Methods: This was a retrospective and prospective study carried out in the General Surgery Department from 1 January 1999 to 31 December 2015. Inclusion criteria: 1) open or closed trauma of the abdomen with perforation of the small bowel;2) clinical examination (abdominal pain, vomiting, fever, abdominal contracture, evisceration, intraoperative findings);3) paraclinical examinations: pneumoperitoneum on the abdominal X-ray without preparation (ASP) and CT scan. Exclusion Criteria: Abdominal trauma without perforation of the small bowel. We selected 128 patients operated for traumatic perforation of the small bowel. The data was entered and analyzed using Word, Excel 2007 and Statistical Package and Social Science Windows 16.0. The statistical analysis consisted in the calculation of the different frequencies of the variables studied. We used the Khi2 test with significance level P Results: We recorded 119 men versus 9 women and the sex ratio was 13.22. The mean age was 25 years with extremes varying between 15 and 70 years. The majority of patients 57.7% (74 cases) came from the capital, 46.1% (59 cases) were workers, 26.6% (34 cases) of the students. The average time to admission was 29 hours. The main etiologies were road traffic accidents 36.7% (47 cases), stabbing 21.9% (28 cases), firearm 14.8% (19 cases), and sports accidents 10.1% (13 cases). The main clinical signs were abdominal pain 48.44% (62 cases), abdominal contracture 60% (76 cases), disappearance of pre-liver dullness 66.36% (84 cases), and Douglas painful 74.4% (94 cases). The abdominal X-ray without preparation (A.S.P) allowed to objectify a pneumoperitoneum in 45.31% and the scanner a liquid effusion in 45.31% with the associated lesions in 37.5% (48 cases). The surgical treatment consisted of 60.15% suture excision (77 cases), 25% anastomosis resection (32 cases) and a 15% stoma (19 cases). The average length of hospital stay was 9 days with extremes of 1 to 60 days. The morbidity was 10.15% at the site of surgical site (OS) infection 17.4% (8 cases), postoperative peritonitis 3.1% (4 cases) and evisceration 0.8% (1 case). Mortality was 17.18% due to septic shock and multivisceral failure. Conclusion: Traumatic perforation of the small bowel is an emergency. Young people are more victims. The prognosis depends on the speed of diagnosis and management. Emphasis should be placed on prevention.展开更多
Introduction: Heart and kidney diseases are common among patients admitted to hospital and they coexist in a significant number of cases. The interactions between the cardiovascular system and the kidney have been...Introduction: Heart and kidney diseases are common among patients admitted to hospital and they coexist in a significant number of cases. The interactions between the cardiovascular system and the kidney have been known and described for many years and have led to the description of cardio-renal syndrome. The objective of this study was to determine the frequency;to describe the clinical, etiological and prognostic aspects of acute renal failure in patients hospitalized for chronic congestive heart failure. Method: This was a descriptive retrospective study from January 2, 2018 to December 31, 2022. Included in this study were all the complete records of patients hospitalized for chronic congestive heart failure with serum creatinine ≥120 μmol/I. We’re not included in this study, incomplete files, records of patients hospitalized for other pathologies, records of patients hospitalized for chronic congestive heart failure with normal renal function. Our study variables were qualitative and quantitative divided into clinical, paraclinical and prognostic data. Our data were analyzed using the EPI-info 7.2.2.6 software. Data entry and presentation were carried out using Word, Excel and PowerPoint from the 2016 Office Pack. Results: We collected 830 files of which 114 met our selection criteria, a frequency of 13.73%. The mean age of the patients was 47 ± 19 years. The F/M sex ratio was 1.23. The dominant etiologies were hypertension followed by diabetes with respectively 60.5% and 23.7%. Toxic factors including tobacco accounted for 7.9% of cases. Dyspnea accounted for 86.8%. Most of our patients were grade 3 or 36% based on systolic blood pressure on admission with an average of 164.16 ± 33.95 mmHg and an average diastolic blood pressure of 93.24 ± 20.40 mmHg. Biologically, the serum creatinine revealed a high frequency of 201 - 400 μmol/l (33% of cases) with an average value of 586.49 ± 631.44 μmol/l with the extremes 2.960 and 2448.68 μmol/I. Anemia was moderate in 34.2% of cases. Cardiac ultrasound was performed on 81 patients, the results of which showed dilated cardiomyopathy in 48.2% of cases. Renal ultrasound was performed only by 18 patients, renal suffering was found with 8.8%. Almost all (92.11%) of the patients had an acute renal failure of functional origin. More than half (65.80%) of our patients were at risk. Diuretics were the most prescribed antihypertensives with 87.71% followed by ACE inhibitors 78.94%. The average length of hospitalization was 13.81 ± 7.66 days with extremes of 24 hours and 41 days. Conclusion:The association of acute renal failure and chronic congestive heart failure is a frequent situation. The diagnostic approach must be guided by the context and the data of a meticulous examination supplemented by an appropriate paraclinical assessment. Kidney renal failure is mostly functional.展开更多
Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We...Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We report in this observation the 1<sup>st</sup> Guinean case corrected by the surgical method as well as a review of the literature for a diagnostic and therapeutic approach. Patient and observation: We present the case of a 7-day old male newborn weighing 2700 g who was received for bilateral cleft lip and palate, lower lip fossa or sinuses, bilateral popliteal pterygium, and triangular skin fold above the hallux. The patient underwent several surgical procedures aimed at correcting these abnormalities. The correction of the pterygium of the lower limbs was ensured by excision of the fibrous band, the tenoplasty in z of the calcaneal tendon on the right side and the skin plasty in z in series then immobilized by plaster splints. The immediate postoperative follow-up was straightforward. Conclusion: Popliteal pterygium syndrome is a rare congenital malformation, the diagnosis is primarily clinical. Early soft tissue lengthening surgery and serial z-skin plasty provide better correction of the knee pterygium. Correct correction of facial abnormalities gives the child a better appearance. The management of this syndrome is multidisciplinary.展开更多
Purpose: To describe the aspects of the positive diagnosis of large goiters. Patients and Methods: We conducted a retrospective and prospective study including 115 patients from January, 2009 till December, 2014 (6 ye...Purpose: To describe the aspects of the positive diagnosis of large goiters. Patients and Methods: We conducted a retrospective and prospective study including 115 patients from January, 2009 till December, 2014 (6 years) in Central Hospital of University of Point G in Bamako (Mali). The diagnosis of large goiters was based on the measurements of the anterior neck swelling. Thus large goiter was defined as any goiter including the height or width was greater than or equal to 10 cm (centimeters). Results: We operated 115 cases of large goiters on 760 goiters operated either 15.1%. The average age of patients was 44, 43 years ±14, 3 with extremes of 9 and 80 years. There was 101 women (87.8%) and 14 men (12.2%) with a sex ratio of 7.2 in favor of women. The signs of compression were dyspnea in 40% of cases (46/115), dysphonia in 13.0% (15/115), and dysphagia in 8.6% (10/115). The average height of goiter was 12.1 cm ± 3.5 cm with extremes of 10 and 29 cm and the average width was 14.4 cm ± 5.4 cm with extremes of 10 and 32 cm. Thyroid ultrasound found large goiters multinodular in 100%. Cervical radiography found the tracheal deviation in 48.2% (42/87), tracheal compression in 20.6% (18/87), plunging goiters in 11.5% (10/87). Cytology found a benign goiter in 97.4% of cases (112/115), malignant (thyroid cancer) in 2.6% of cases (3/115). Conclusion: Diagnosis of large goiters was based on the measurement of the swelling in our context. The signs of compression are the severity of this condition.展开更多
Purpose: To describe the epidemiological, clinical and therapeutic aspects of secondary hyperparathyroidism inrenal failure chronic. Patients and methods: We collected 11 cases of hyperparathyroidism secondary to rena...Purpose: To describe the epidemiological, clinical and therapeutic aspects of secondary hyperparathyroidism inrenal failure chronic. Patients and methods: We collected 11 cases of hyperparathyroidism secondary to renal failure terminal operated in the Service of surgery B of the Central Hospital University of Point G between December 2016 and November 2018. Results: The sex ratio was 0.22 in favor of women. The average age of the patients was 43 or 27 years with extremes of 63 and 25 years. Secondary hyperparathyroidism in renal failure chronic represented 1.9% of interventions to cold in the Service of surgery B. 100% of patients (11/11) were haemodialysis. 100% of the patients had clinical and biological signs. 45.5% (5/11) had radiological signs. The average rate of parathyroid hormone was 2413.51 pg/ml with extremes of 1264 pg/ml and 3616 pg/ml. The reference value was 15 - 65 pg/ml. The surgical technique of choice was the 7/8th parathyroidectomy in 100% of cases. The postoperative were simple in 81.8%, and complicated in 18.2%. There were no death. The average duration of postoperative follow-up was 6 months. After surgery, 50% of patients (5/10) had normal levels of parathyroid hormone and 50% (5/10) made a persistent hyperparathyroidism. Conclusion: Secondary hyperparathyroidism is a frequent complication in renal insufficient chronic in hemodialysis. Surgery is indicated in the resistant cases of medical treatment. The 7/8th parathyroidectomy is the surgical technique of choice. The rate of post operative complications is higher in our context.展开更多
文摘CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, cardiovascular surgery, plastic and endocrinology surgery. As a reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. <b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. </span><b><span style="font-family:Verdana;">Patients and Methods:</span></b><span style="font-family:Verdana;"> We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer </span><span style="font-family:Verdana;">o</span><span style="font-family:;" "=""><span style="font-family:Verdana;">r 50.79% of digestive cancers. The mean age of the patients was 57.21 ± 13 years. Male sex represented 55% (n = 106). Eating habits were dominated by the consumption of t<span style="font-family:Verdana, Helvetica, Arial;white-space:normal;background-color:#FFFFFF;">ô</span> with potash (cereal paste) with 64.76% (n = 185). The main methods of preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n = 5). The low socio-economic class represented 126 cases or 65.38%. Housewives and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20% (n = 39) had a history of epigastric pain. Epigastralgia was the most common functional sign with 84.5% of cases (n = 169). An epigastric mass was found in 72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188). Palliative surgery concerned the majority of our patients with 64.8% of patients (n = 79). The postoperative consequences were simple in 28.57% of cases (n = 28), the postoperative morbidity and mortality were respectively 33.61% (n = 41), and 23.77% (n = 29). The overall survival rate after surgery was 10.81% at 2 years and 2.94% at 5 years. This rate was 58.83% at 2 years and 28.50% at 5 years after curative surgery. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The risk factors for stomach cancer are many and varied. Some are particularly present in Africa. Delay in diagnosis due to a belief in traditional healers is common in our community.</span></span>
文摘<strong>Introduction:</strong><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">Acute myocardial infarction (IDM) occupies the first place in terms of mortality, among ischemic pathologies. Thrombolysis in the case of medical treatment for acute myocardial infarction (AMI) is undoubtedly the most revolutionary performed to date in this context, with a significant reduction in the mortality rate. The aim of our study was to describe the epidemiological aspects, the criteria for myocardial reperfusion post thrombolysis, the complications during thrombolysis and the complications of acute myocardial infarction in the cardiology department of the CHU Ernesto Guevara De La Serna of Las Tunas (Cuba)</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methods:</span></b></span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">A retrospective cross</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">sectional descriptive study was carried out from June 2009 to December 2011. The patients hospitalized during this period in the USIC (coronary intensive care unit) for SCA ST(+) were included in the study. The variables studied were: Age, sex, myocardial reperfusion criteria, complications during thrombolysis and complications of myocardial infarction.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 207 patients were included. The male sex represented 72.5% of the cases, giving a sex ratio of 2.63. The age group > 60 years was predominant with 54.2% of the cases. Thrombolysed patients represented 65.2% of the cases. Myocardial reperfusion criteria were observed in the majority of thrombolysed patients: relief of precordial pain (77%), regression of the ST segment to 50% of its previous level (81.5% of patients). Bleeding was observed in 1.5% of thrombolysed cases. Complications were encountered in 57% of non thrombolysed patients with a lethality of 5.6%.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">The male sex was the most affected. Thrombolysis was effective in the majority of patients. The post thrombolysis bleeding rate was low. More than half of the cases of SCA ST(+) not thrombolysed presented complications.</span>
文摘<strong>Introduction:</strong><span style="white-space:normal;font-size:10pt;font-family:;" "=""> The metabolic syndrome is a clinical entity defined by the association in the same subject of four of the following five factors: abdominal obesity (or android), type 2 diabetes, hypertension, hypo HDL cholesterolemia, hypertriglyceridemia. The aim of the work was to study the epidemiological, clinical-biological profiles and complications of patients in the cardiology and internal medicine department of the Mother-Child CHU “Luxembourg”. <b>Materials and Methods:</b> We carried out a cross-sectional study, from September 2019 to June 2020 in the cardiology and internal department of the mother-child CHU “Luxembourg”. All patients with metabolic syndrome admitted to the two departments who agreed to participate during the study period were included in the study. These patients meet the 2009 harmonization attempt criteria (IDF 2009). The variables studied were: socio-demographic characteristics (sex, age, profession), pathological history, clinical signs (functional signs, BMI, waist size), paraclinical signs (ECG, cardiac ultrasound, laboratory assessment) and complications. <b>Results:</b> A total of 104 patients were included. The female sex represented 58.65% of cases. The 60 to 69 age group was the majority with 40.78%, housewives occupied 41.34% of cases. Diabetes, arterial hypertension and dyslipidemia were the most represented cardiovascular risk factors with respectively: 80.77%, 79.81% and 53.85%. Visual blurring was the most common functional sign with 23.08% of cases. Moderate obesity was observed in 34% of patients. Waist circumference was high in 39.53% of male patients and 37.70% of female patients. Cardiac ultrasound found a severely collapsed ejection fraction in 25% of patients. HDL-c levels were low in 64.52% of male patients and 75% of female patients. The most observed complications were: dyslipidemia (53.85%), stroke and renal failure with 23% respectively</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">. </span><span style="white-space:normal;font-size:10pt;font-family:;" "=""><b>Conclusion:</b> The metabolic syndrome remains a real public health problem, constantly increasing in our populations and constitutes a danger by its constituent ele</span><span style="white-space:normal;font-size:10pt;font-family:;" "="">ments.</span>
文摘Aim: Review of early postoperative deaths in the surgical intensive care unit at CHU-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postoperative death linked to numerous risk factors. Methodology: This was a retrospective descriptive study conducted on the records of patients who died within 48 hours after surgery from November 1, 2019 to April 30, 2021. The study was conducted in the surgical intensive care unit and in the operating room. Results: Thirty-two early postoperative deaths or 2.22% out of 1442 operated with 30 deaths retained for the study. Male gender predominated (70%). The average age was 31.22 years. Farmers were more concerned (66.67%). The time to surgery was 1.6 days. ASA1 patients (40%) predominated followed by ASA IV (30%). 80% of patients were operated on as an emergency. Digestive pathologies 80% were more represented. General anaesthesia 86.66% was more practiced associating Propofol, Fentanyl, Ketamine and Atropine more frequently. The average duration of the procedures was 132.5 minutes. Intraoperative complications were associated with cardiac arrest and hemorrhage (33.34%). ASA class higher than 2, dirty surgery (46.67%), and delayed recovery (13.34%) were the incriminating risk factors. Death by hemodynamic shock and respiratory distress were the main causes 26.66%. Conclusion: Early postoperative mortality was high and involved all ages. Anesthesia and surgery, the low level of qualification of the intraoperative actors, the lesser intraoperative security;the association of anesthetic effects, the complexity of intraoperative lesions led to the increase of mortality. The combination of two or more factors was pejorative for the deaths.
文摘Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school children aged 5 to 15 at CHU-IOTA. Patients and Method: This is a prospective, descriptive cross-sectional study carried out in the ophthalmic-pediatrics department of CHU-IOTA, from October to November 2023. Results: We received 340 school children aged 5 to 15, among whom 111 presented ametropia, i.e. a prevalence of 32.65%. The average age was 11.42 ± 2.75 years and a sex ratio of 0.59. The average visual acuity was 4/10 (range 1/10 and 10/10). We found refractive defects: astigmatism 73.87%, hyperopia 23.87% of cases and myopia 2.25%. The decline in distance visual acuity was the most common functional sign. Ocular abnormalities associated with ametropia were dominated by allergic conjunctivitis (26.13%) and papillary excavation (6.31%) in astigmatics;allergic conjunctivitis (9.01%) and papillary excavation (7.20%) in hyperopic patients;turbid vitreous (0.90%), myopic choroidosis (0.45%) and allergic conjunctivitis (0.45%) in myopes. Conclusion: Refractive errors constitute a reality and a major public health problem among school children.
文摘Introduction: Pain assessment is an essential step towards pain relief. In our context, however, it is insufficient in emergency departments. The aim was to assess the nature and effectiveness of the analgesia used in the emergency department of the CHU-Donka. Method: This was a single-centre prospective observational study conducted over one month (November 2020) in the medical-surgical emergency department of CHU-Donka. All patients aged 18 or over admitted to the emergency department with moderate to severe acute pain were included. Results: We enrolled 880 patients, 615 of whom (69.88%) were in pain. Males predominated (65.2%), with a sex ratio of 1.87. The average age was 44.78 ± 16.41 years, with extremes ranging from 18 to 85 years. The most represented age group was 18 - 34 years, with 66.18%. Initial assessment of pain by nursing staff in 3 cases. Initial assessment of pain by the investigator was 100%, 74% moderate and 26% severe. No reassessment of pain by nursing staff. Reassessment by the interviewer was 100% and found 5% no pain, 61% mild pain, 24% moderate pain and 10% severe pain. With an average numerical scale of 3.77 ± 2.61 and extremes from 0 to 10. Average length of stay was 2.85 ± 1.48 hours, with extremes ranging from 45 minutes to 8 hours. Analgesia was administered with paracetamol alone (43.58%), combined with tramadol or nefopam. No patient received morphine. Conclusion: This study revealed a lack of pain assessment in our department.
文摘The authors bring back 70 cases of pericarditis brought together between 2012 and 2017 in the service of surgery B of the CHU Point G and to the Hospital Mother-Child, the Luxembourg in Mali. The average age of the patients is 31.5 years with extremes of 2 years and 84 years. The tubercular etiology widely comes to mind with 49 cases. The diagnostic contributions of the echocardiography are analyzed. The accent is put on good tolerance hemodynamic of the tubercular pericarditis. The forecast depends essentially on the etiology and on the diagnostic delay;indeed the tamponade pericardium can be inaugural or complicated;the evolution of the pericarditis is burdened of a heavy mortality (4.2% in our series). On the other hand the passage in the chronicity complicates essentially pericarditis seen late (8.6% in our series).
文摘This case report is about a 61 years old woman who consulted for hematuria, the cystoscopy performed revealed an intra-diverticular bladder tumor. After tumor resection, an anatomopathological exam revealed the urothelial carcinoma pT1. A few months later she presented with a local reccurence of bladder tumor. We proposed her anterior pelvectomy but she refused it and she was lost to follow-up. The aim of this study is to show the anatomopathological and evolutionary characteristics and the therapeutic difficulties of IDBT. These tumors are in the majority of cases infiltrating from the outset with a high potential for recurrence after transurethral resection of bladder (TURB). The standard treatments are TURB and total cystectomy.
文摘Introduction: Leontiasis ossea is the most severe bone complication of the maxillae of chronic renal failure. The objective of this work is to determine the clinical, paraclinical and therapeutic aspects of this condition. Observation: A 42-year-old patient with chronic anuric terminal renal failure dialysis for 12 years had consulted for multiple maxillo-mandibular swelling evolving for 2 years deforming the face with discomfort to chewing. The biological assessment was: PTH: 5252 pg/mL, Ca<sup>2+</sup>: 2.86 mmol/L, free T3: 4.16 pmol/L, free T4: 6.55 pmol/L, TSH: 3.13 U/mL, serum protein: 61 g/L, Creatinine: 835 μmol/L. The maxillofacial CT noted heterogeneous diffuse thickening of the cranial vault and bones of the facial massif evoking leontiasis ossea with right mandibular brown tumor. The biopsy diagnosed fibrous gingival epulis. The patient had undergone modeling surgery, under general anesthesia after dialysis, of the right mandibular tumor whose histological result was Leontiasis ossea. Conclusion: Treatment is modeling surgery under hemostatic control.
文摘Perforation of a pseudo appendicular tumor of bilharzial origin (bilharzia) is a rare etiology of acute peritonitis. His diagnosis is histopathological. The existence of comorbid malaria and surgical pathology is frequent in having a positive thick drop with <em>Schistosoma mansoni</em> eggs in his stool. After 3 months, the patient is doing well. In conclusion, we recommend the histopathological analysis of the surgical specimen after appendectomy and the detection of haematozoa for malaria in any case of fever in a surgical environment.
文摘Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically search for it in patients with multiple comorbidities. The objective of this study was to determine the prevalence of orthostatic hypotension;describe their socio- demographic profile, the various clinical and paraclinical aspects and the predisposing factors of orthostatic hypotension in treated hypertensives, controlled or not. Method: This was a descriptive cross-sectional study, from January 2 to June 30, 2022 in the cardiology department of the Ignace Deen National Hospital. Included in this study were all patients who presented with orthostatic hypotension under antihypertensive treatment, regardless of age and sex, and who agreed to participate in the study. The non-inclusion criteria were hypertensive patients without OH and those who had not agreed to participate in the study. Each patient had blood pressure and heart rate measured in the supine position at room temperature and with an empty bladder. Then the measurement is taken again three (3) minutes after the switch to orthostatism. We retained the diagnosis of OH if the SBP drops by at least 20 mmHg and/or the PAD by at least 10 mmHg three (3) min after the transition to orthostatism. Our data obtained were analyzed in the Epi-info 7.4.0 software. Results: During our study period, we investigated 385 presented with OH, 12.2%. The mean age of the patients was 60.83 years ± 10.01 years and hypertensive patients, 47 of whom the M/F sex ratio was 0.81. In our study, blood pressure was not controlled in 36.2% of our patients with a predominance of grade 3 hypertension, a rate of 55.32%. Renal failure, anemia, heart failure and stroke were the main comorbidities associated with the occurrence of HO. The most incriminated factors were age with a frequency of 74.47%, followed by obesity at 44.68% and diabetes at 27.66%. BP was normally controlled with a rate of 68.8% in treated hypertensive patients with OH. It is found much more in patients using triple therapy, a rate of 61.71%. Conclusion: The prevalence of OH is high in our department. It is found much more in patients using triple therapy. The most incriminated factors were age followed by obesity and diabetes.
文摘Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to determine the extent of this prescription. Patients and Methods: This was a cross-sectional study with retrospective data collection of patients hospitalized in the infectious diseases department in the period from January 1, 2005 to December 31, 2020. The records of patients who received probabilistic antibiotic therapy were included. Results: During the study period, 330 patients had received probabilistic antibiotic therapy. The majority of patients were male (53%), with a sex ratio of 1.12. The mean age of the patients was 33 years ± 14. The age range of 20 to 40 years was the most represented (42%). Fifteen percent (15%) of patients were living with HIV. The majority of patients were from urban areas (56.4%). Forty-nine percent (49%) of the patients worked in the informal sector. Clinically, the reasons for consultation were dominated by fever, alteration of general condition, neurological disorders, digestive disorders, respiratory signs, urinary signs and diffuse pain. The physical examination showed that 48.1% of the patients had meningeal irritation syndrome, 10% had convulsions and 10% had focal signs, trismus was present in 4% of the patients and facial paralysis in 3%. In the digestive system, hepatomegaly was present in 29% of patients and digestive candidiasis in 31%. Respiratory examination showed crepitus and fluid effusion syndrome in 26.83% and 20.62% of patients respectively. The presumptive diagnosis was dominated by bacterial meningitis, salmonellosis and bronchopneumonia with banal germs. In terms of treatment, the beta-lactam family of drugs was the most prescribed. They were followed by aminoglycosides and fluoroquinolones. The evolution was marked by the death of 50 patients (15%). Conclusion: The most prescribed molecules belong to the family of Beta-lactam. And this prescription improved the outcome of patients. Bacterial susceptibility studies will allow better orientation of probabilistic antibiotic therapy in order to limit the emergence of multi-resistant bacteria.
文摘The objectives were to determine the frequency of pain in cancer patients and its intensity in cancer pathologies and to evaluate the evolution of pain intensity after analgesic treatment;the effectiveness of its management study involved 121 cases of operated gastrointestinal cancers, which accounted for 85.82% (141) of operated cancers and 16.78% (721) of all operated patients;the average age of our patients was 49.93 years with extremes 17 and 78 years. Standard deviation: 15.75;with a sex ratio of 1.46. The majority of our patients had WHO III (54/121) or 44.6%;46.3% (56/121) of patients were in stage IV of the TNM classification. The main digestive cancers were cancer of the esophagus 4 cases (3.3%);of the stomach 61 cases (50.4%);of the pancreas 7 cases (5.8%);of the liver 4 cases (3.3%);gall bladder 2 cases (1.6%);colon 33 cases (27.3%);rectum 6 cases (4.9%) and hail 4 cases (3.3%). The average pain intensities were 3 to 6 hour;2 to 24 hour;1.6 to 48 hour;and 1.2 to 72 hour. The majority of our patients had a treatment protocol involving nefopam, and paracetamol was 58%. The pain was exacerbated especially during exercise. Vomiting and vein burning were the main side effects encountered.
文摘Introduction: Schizoaffective disorder is a chronic psychotic disorder. It is characterized by the simultaneous presence of symptoms of a characterized mood disorder and symptoms of schizophrenia. Data on this disorder are almost non-existent in West Africa. The objective was to describe the epidemiological, clinical and therapeutic aspects of schizoaffective disorder at the Campus University Hospital Centre (CHU-Campus) of Lomé in Togo. Framework and Method: This was a retrospective study with a descriptive aim on patients hospitalized at the Clinic of Psychiatry and Medical Psychology (CPPM) of CHU-Campus from January 1st, 2013 to December 31, 2018. Results: A total of 46 patients were included in this study. Their mean age was 39.5 years with extremes ranging from 14 to 65 years. Females had predominated at 52.18% or a sex ratio of 0.91. Married people represented 47.83%. Primary education represented 34.80%. The unemployed were in the majority at 32.92%. Sixty-five point twenty two percent (65.22%) of the patients had a personal psychiatric history. All patients had presented with delusions plus other psychotic and mood symptoms. Almost all patients (97.82%) had received a thymoregulator associated with a first generation antipsychotic (95.65%). Conclusion: More studies should be done in our countries to describe the cultural aspects of this disease.
文摘Infection with the defective hepatitis D virus (HDV) co-infects or superinfects a patient carrying hepatitis B virus (HBV). Delta virus infection is relatively common. The seriousness of infection with the hepatitis D virus (HDV), a virus defective in a patient carrying the hepatitis B virus (HBV), lies in its aggravating effect on the associated viral hepatitis B. Our aim was to study the serological profile of HDV in HBsAg-positive patients. As this study was fragmentary, we initiated this study with the aim of investigating the serological profile of HDV in HBsAg-positive patients. This was a descriptive and analytical cross-sectional study that ran from March 2019 to February 2020, a 12-month period. It focused on the population of patients seen and screened positive for HBsAg. We obtained a frequency of 10%. The mean age of our patients was 41.8 ± 13.09 years. The sex ratio was 4.5. VHD RNA was detected in 50% of patients. In 100% of cases, the presence of VHD RNA was associated with advanced fibrosis according to the APRI score, but without any statistically significant link. All HBV-infected patients should be screened for anti-HDV Ac. HDV infection leads to rapid progression to complications of liver disease.
文摘Goal: To determine hospital frequency, to describe the clinical and therapeutic aspects and to determine the prognosis. Patients and Methods: This was a retrospective and prospective study carried out in the General Surgery Department from 1 January 1999 to 31 December 2015. Inclusion criteria: 1) open or closed trauma of the abdomen with perforation of the small bowel;2) clinical examination (abdominal pain, vomiting, fever, abdominal contracture, evisceration, intraoperative findings);3) paraclinical examinations: pneumoperitoneum on the abdominal X-ray without preparation (ASP) and CT scan. Exclusion Criteria: Abdominal trauma without perforation of the small bowel. We selected 128 patients operated for traumatic perforation of the small bowel. The data was entered and analyzed using Word, Excel 2007 and Statistical Package and Social Science Windows 16.0. The statistical analysis consisted in the calculation of the different frequencies of the variables studied. We used the Khi2 test with significance level P Results: We recorded 119 men versus 9 women and the sex ratio was 13.22. The mean age was 25 years with extremes varying between 15 and 70 years. The majority of patients 57.7% (74 cases) came from the capital, 46.1% (59 cases) were workers, 26.6% (34 cases) of the students. The average time to admission was 29 hours. The main etiologies were road traffic accidents 36.7% (47 cases), stabbing 21.9% (28 cases), firearm 14.8% (19 cases), and sports accidents 10.1% (13 cases). The main clinical signs were abdominal pain 48.44% (62 cases), abdominal contracture 60% (76 cases), disappearance of pre-liver dullness 66.36% (84 cases), and Douglas painful 74.4% (94 cases). The abdominal X-ray without preparation (A.S.P) allowed to objectify a pneumoperitoneum in 45.31% and the scanner a liquid effusion in 45.31% with the associated lesions in 37.5% (48 cases). The surgical treatment consisted of 60.15% suture excision (77 cases), 25% anastomosis resection (32 cases) and a 15% stoma (19 cases). The average length of hospital stay was 9 days with extremes of 1 to 60 days. The morbidity was 10.15% at the site of surgical site (OS) infection 17.4% (8 cases), postoperative peritonitis 3.1% (4 cases) and evisceration 0.8% (1 case). Mortality was 17.18% due to septic shock and multivisceral failure. Conclusion: Traumatic perforation of the small bowel is an emergency. Young people are more victims. The prognosis depends on the speed of diagnosis and management. Emphasis should be placed on prevention.
文摘Introduction: Heart and kidney diseases are common among patients admitted to hospital and they coexist in a significant number of cases. The interactions between the cardiovascular system and the kidney have been known and described for many years and have led to the description of cardio-renal syndrome. The objective of this study was to determine the frequency;to describe the clinical, etiological and prognostic aspects of acute renal failure in patients hospitalized for chronic congestive heart failure. Method: This was a descriptive retrospective study from January 2, 2018 to December 31, 2022. Included in this study were all the complete records of patients hospitalized for chronic congestive heart failure with serum creatinine ≥120 μmol/I. We’re not included in this study, incomplete files, records of patients hospitalized for other pathologies, records of patients hospitalized for chronic congestive heart failure with normal renal function. Our study variables were qualitative and quantitative divided into clinical, paraclinical and prognostic data. Our data were analyzed using the EPI-info 7.2.2.6 software. Data entry and presentation were carried out using Word, Excel and PowerPoint from the 2016 Office Pack. Results: We collected 830 files of which 114 met our selection criteria, a frequency of 13.73%. The mean age of the patients was 47 ± 19 years. The F/M sex ratio was 1.23. The dominant etiologies were hypertension followed by diabetes with respectively 60.5% and 23.7%. Toxic factors including tobacco accounted for 7.9% of cases. Dyspnea accounted for 86.8%. Most of our patients were grade 3 or 36% based on systolic blood pressure on admission with an average of 164.16 ± 33.95 mmHg and an average diastolic blood pressure of 93.24 ± 20.40 mmHg. Biologically, the serum creatinine revealed a high frequency of 201 - 400 μmol/l (33% of cases) with an average value of 586.49 ± 631.44 μmol/l with the extremes 2.960 and 2448.68 μmol/I. Anemia was moderate in 34.2% of cases. Cardiac ultrasound was performed on 81 patients, the results of which showed dilated cardiomyopathy in 48.2% of cases. Renal ultrasound was performed only by 18 patients, renal suffering was found with 8.8%. Almost all (92.11%) of the patients had an acute renal failure of functional origin. More than half (65.80%) of our patients were at risk. Diuretics were the most prescribed antihypertensives with 87.71% followed by ACE inhibitors 78.94%. The average length of hospitalization was 13.81 ± 7.66 days with extremes of 24 hours and 41 days. Conclusion:The association of acute renal failure and chronic congestive heart failure is a frequent situation. The diagnostic approach must be guided by the context and the data of a meticulous examination supplemented by an appropriate paraclinical assessment. Kidney renal failure is mostly functional.
文摘Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We report in this observation the 1<sup>st</sup> Guinean case corrected by the surgical method as well as a review of the literature for a diagnostic and therapeutic approach. Patient and observation: We present the case of a 7-day old male newborn weighing 2700 g who was received for bilateral cleft lip and palate, lower lip fossa or sinuses, bilateral popliteal pterygium, and triangular skin fold above the hallux. The patient underwent several surgical procedures aimed at correcting these abnormalities. The correction of the pterygium of the lower limbs was ensured by excision of the fibrous band, the tenoplasty in z of the calcaneal tendon on the right side and the skin plasty in z in series then immobilized by plaster splints. The immediate postoperative follow-up was straightforward. Conclusion: Popliteal pterygium syndrome is a rare congenital malformation, the diagnosis is primarily clinical. Early soft tissue lengthening surgery and serial z-skin plasty provide better correction of the knee pterygium. Correct correction of facial abnormalities gives the child a better appearance. The management of this syndrome is multidisciplinary.
文摘Purpose: To describe the aspects of the positive diagnosis of large goiters. Patients and Methods: We conducted a retrospective and prospective study including 115 patients from January, 2009 till December, 2014 (6 years) in Central Hospital of University of Point G in Bamako (Mali). The diagnosis of large goiters was based on the measurements of the anterior neck swelling. Thus large goiter was defined as any goiter including the height or width was greater than or equal to 10 cm (centimeters). Results: We operated 115 cases of large goiters on 760 goiters operated either 15.1%. The average age of patients was 44, 43 years ±14, 3 with extremes of 9 and 80 years. There was 101 women (87.8%) and 14 men (12.2%) with a sex ratio of 7.2 in favor of women. The signs of compression were dyspnea in 40% of cases (46/115), dysphonia in 13.0% (15/115), and dysphagia in 8.6% (10/115). The average height of goiter was 12.1 cm ± 3.5 cm with extremes of 10 and 29 cm and the average width was 14.4 cm ± 5.4 cm with extremes of 10 and 32 cm. Thyroid ultrasound found large goiters multinodular in 100%. Cervical radiography found the tracheal deviation in 48.2% (42/87), tracheal compression in 20.6% (18/87), plunging goiters in 11.5% (10/87). Cytology found a benign goiter in 97.4% of cases (112/115), malignant (thyroid cancer) in 2.6% of cases (3/115). Conclusion: Diagnosis of large goiters was based on the measurement of the swelling in our context. The signs of compression are the severity of this condition.
文摘Purpose: To describe the epidemiological, clinical and therapeutic aspects of secondary hyperparathyroidism inrenal failure chronic. Patients and methods: We collected 11 cases of hyperparathyroidism secondary to renal failure terminal operated in the Service of surgery B of the Central Hospital University of Point G between December 2016 and November 2018. Results: The sex ratio was 0.22 in favor of women. The average age of the patients was 43 or 27 years with extremes of 63 and 25 years. Secondary hyperparathyroidism in renal failure chronic represented 1.9% of interventions to cold in the Service of surgery B. 100% of patients (11/11) were haemodialysis. 100% of the patients had clinical and biological signs. 45.5% (5/11) had radiological signs. The average rate of parathyroid hormone was 2413.51 pg/ml with extremes of 1264 pg/ml and 3616 pg/ml. The reference value was 15 - 65 pg/ml. The surgical technique of choice was the 7/8th parathyroidectomy in 100% of cases. The postoperative were simple in 81.8%, and complicated in 18.2%. There were no death. The average duration of postoperative follow-up was 6 months. After surgery, 50% of patients (5/10) had normal levels of parathyroid hormone and 50% (5/10) made a persistent hyperparathyroidism. Conclusion: Secondary hyperparathyroidism is a frequent complication in renal insufficient chronic in hemodialysis. Surgery is indicated in the resistant cases of medical treatment. The 7/8th parathyroidectomy is the surgical technique of choice. The rate of post operative complications is higher in our context.
