This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat...This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat (ENT) and cervico-facial (CF) cancers in Mauritania. Over a period of two years, from January 1, 2019 to December 31, 2020, we noted 36 histologically confirmed cases, they represented 15.47% of all patients consulted in ENT and CF cancers affected the age group between 25 and 70 years, the age group most affected was that of 50 and 59 years, with 33.33% of cases. More affected in the proportion of 2 men to women, which can be explained by the risk factors mainly found in men, including smoking. First rank was cancers of the upper aero-digestive tract, the pharyngolarynx in head. Histologically, ENT and CF cancers were dominated by squamous cell carcinomas 78%, well ahead of papillary carcinomas 8% and vesicular thyroid carcinomas 5%, UCNTs, adenosquamous carcinomas and lymphomas each represented 3%.展开更多
The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 &...The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 <i>Acinetobacter baumannii</i>., 528 <i>Pseudomonas aeruginosa</i>, 741 <i>Escherichia coli</i>, and 352 <i>Klebsiella pneumoniae</i> strains were identified and antimicrobial susceptibility was by Vitek system and Etest method. The multi-drug resistance (MDR) was major proportion of four common bacteria. In particular, there is a tendency to shift from MDR to Extended drug resistance (XDR) or possibly Pan drug resistant (pPDR). <i>A. baumannii</i> had the highest level of antibiotic resistance, namely, carbapenem (61.5% - 82.5%) and cephalosporin (72.7% - 88.7%). <i>P. aeruginosa</i> resisted most of commonly antibiotics, ranging from 50% to 70%. <i>E. coli</i> had a high resistance with antibiotics like ampicillin (87.2% - 97.6%) and the 3rd generation cephalosporins (up to 79.6%). <i>K. pneumoniae</i> resisted carbapenem from 14.7% to 44.4%, and other antibiotics with the higher rate of 40%. The collected data will be a prerequisite for further studies on mechanisms and factors related to antibiotic resistant bacteria, in order to find out a rational and effective using strategy of antibiotics.展开更多
Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million ...Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million with only 21 Plastic Reconstructive and Burn surgeons. Moreover, the country can boast of only 3 major Burn centres. This notwithstanding the country in particular and Africa, in general, carries an extraordinary burden of Burn injuries with devastating consequences. Burn data from the 37 Military Hospital were analyzed from March 2018 to September 2019—a period of 18 months. In all, 217 burn cases were seen representing about 2.1% of all trauma and surgical cases. Our burn data analyzed the peculiarities of epidemiology, types of burn, the pattern of injuries, and the outcome of burn care at the 37 Military Hospital. Flame is emerging as the predominant cause of burns, most frequently occurring from the use of Liquid Petroleum Gas. In the pediatric population, however, the most frequent cause of burns is hot water burns. The mortality rate among the burn population was 1.8% (4 mortalities). This paper aims to point out management methods adopted by our unit which helped to improve burn outcomes and to reduce mortality.展开更多
<strong>Introduction:</strong> Coblation<sup>®</sup> is a low temperature-controlled tissue ablation technique widely used in human surgery. Its development in otorhinolaryngology has allo...<strong>Introduction:</strong> Coblation<sup>®</sup> is a low temperature-controlled tissue ablation technique widely used in human surgery. Its development in otorhinolaryngology has allowed a spectacular advance in the management of diseases of the nasal and oral cavities. The objective of our work was to study the indications for radiofrequency in ENT, to describe the technical aspects and to evaluate the results of his practice at the HMO. <strong>Patients and Methods: </strong>This is a retrospective study carried out in the ENT and Head and Neck Surgery department of the Ouakam Military Hospital (MHO) over a period of 3 years (from January 2015 to the end of December 2017), involving 37 patients who received radiofrequency treatment in the ENT sphere. <strong>Results:</strong> The study was carried out on 37 patients. The sex ratio of 0.19. The mean age of the patients was 33.3 years. The indications were dominated by chronic caseous cryptic tonsillitis with or without halitosis with 24 cases (64.9%) followed by recurrent tonsillitis in 5 cases (13.5%) then we have obstructive hypertrophy of the palatal tonsils with syndrome sleep apnea (OSAS) in 4 cases (10.8%) followed by nasal obstruction (hypertrophy of the inferior turbinates) and hypertrophy of the soft palate and uvula in 2 cases (5.4%). The complication rate was 8.1% and dominated by transient dysgeusia in 1 case or 2.7%, uvula edema in 1 case or 2.7% and bleeding in 1 case or 2.7%. The postoperative follow-up was done one week, 1 month, 3 months, 6 months and 12 months after radiofrequency. Volumetric reduction begins to set in from 1 month (62.5%) and becomes maximum in 3 months (74.3%). <strong>Conclusion:</strong> Coblation<sup>®</sup> is a controlled tissue ablation technique at low temperature, patented by ArthroCare<sup>®</sup> Corporation in 1997. Very widespread in human surgery. Its development in otorhinolaryngology was later, but allowed a spectacular advance in the management of diseases of the nasal and oral cavities.展开更多
Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and manag...Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.展开更多
The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of...The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of automated external defibrillator are increasing,the likelihood of survival to hospital discharge is no more than 8%.To date,various devices and methods have been utilized in the initial CPR approach targeting to improve survival and neurological outcomes in OHCA patients.The aim of this review is to discuss strategies that facilitate resuscitation,increase the chance to achieve return to spontaneous circulation and improve survival to hospital discharge and neurological outcomes in the prehospital setting.展开更多
Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent compl...Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.展开更多
Urinary tract infection （UTI） remains one of the most common bacterial infections seen in hospitalized patients of all ages. Prevalence of UTIs increases with age and is often accompanied by higher resistance rates....Urinary tract infection （UTI） remains one of the most common bacterial infections seen in hospitalized patients of all ages. Prevalence of UTIs increases with age and is often accompanied by higher resistance rates. The aim of this study was to determine the degree of resistance of most common enterobacterial uropathogens isolated from patients at Central Military Hospital and compare this resistance with the results found by the North America and Europe Study for Monitoring Antimicrobial Resistance Trends （SMART） study during 2009-2010.展开更多
Introduction: Omphalocele is an embryopathy of the first ten weeks of gestation. It corresponds to a defect in the abdominal wall through which viscera contained in a sac constituted by the amniotic membrane and cente...Introduction: Omphalocele is an embryopathy of the first ten weeks of gestation. It corresponds to a defect in the abdominal wall through which viscera contained in a sac constituted by the amniotic membrane and centered by the umbilical cord are exteriorized. The objective of this work was to study the diagnostic modalities and the impact of our therapeutic choices on the outcome of the management. Material and Methods: We carried out a prospective study on patients with omphalocele admitted to the pediatric surgery departments of the HND, during a period spread over 4 years, between January 2017 and December 2020. Results: we collected 55 files (i.e., 13.7 cases/year). There were 38 boys and 17 girls (sex ratio 2.2) with an average age of 1.9 days. We found 15 cases (27%) of type I and 40 cases (73%) of type II according to the AITKEN classification. Fifteen cases (27%) benefited from surgical treatment and 45 cases (73%) benefited from conservative treatment (Grob). Two surgical methods were used: Primary parietal closure, which was used in 10 cases (66.7%), and the GROSS method, which was used in 5 cases (33.3%). We obtained an improvement of 40 cases (73%) and 15 cases (27%) of death. Conclusion: our work reported our experience in the management of omphalocele and the difficulties of postoperative resuscitation.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
The aim of this study was to report a case of multi-visceral sarcoidosis at the Mother-Child Hospital Center (CHME) “Le Luxembourg” in Bamako, Mali. Observation: This is a patient aged 62 at the time of consultation...The aim of this study was to report a case of multi-visceral sarcoidosis at the Mother-Child Hospital Center (CHME) “Le Luxembourg” in Bamako, Mali. Observation: This is a patient aged 62 at the time of consultation, a housewife, residing in the Banconi district, who was referred to us for thoracic-abdominopelvic imaging for chronic liver disease. After several diagnostic errors, the thoracic-abdominopelvic CT scan and liver MRI performed in our center showed, at the thoracoabdominal level, bilateral diffuse pulmonary micronodules and bilateral mediastinal-hilar lymphadenopathy;on the abdominal level, a dysmorphic liver with plaques of steatosis and a granular appearance of the liver parenchyma without periportal fibrosis. These imaging data combined with those from the liver nodule biopsy and biology confirmed the diagnosis of sarcoidosis type II. Treatment with corticosteroids gave satisfactory results and the patient recovered after 18 months. Clinical and CT monitoring 2 years from the start of the disease and 2 months from the end of treatment showed complete resolution of the lesions. Conclusion: The multi-visceral location of sarcoidosis is an entity whose diagnosis remains difficult;diagnostic and interventional imaging has an important place in its management.展开更多
Introduction: External otitis (OE) is an acute or chronic inflammation or infection of the external ear resulting from an imbalance in the external auditory canal secondary to microtrauma, maceration, eczema, or a for...Introduction: External otitis (OE) is an acute or chronic inflammation or infection of the external ear resulting from an imbalance in the external auditory canal secondary to microtrauma, maceration, eczema, or a foreign body in the external auditory canal. Objective: To study cases of external otitis at the Mamou Regional Hospital. Materials and Methods: This was a prospective descriptive study conducted over a period of six (6) months from July 1st to December 31st, 2016. It included all patients admitted to the ENT department of the Mamou Regional Hospital. Results: During the study period, 712 patients were admitted to the department for various pathologies, of which 103 met our selection criteria, representing a frequency of 14.46%. The mean age of the patients was 33.74 years with a range of 1 to 90 years. Males predominated in the sample, accounting for 59.22%. The vast majority of patients resided in urban areas, constituting 61.17% of the sample. In our study, all patients consulted for otalgia (100%), and over half (53.39%) for hypoacusis. We formally identified rhinitis in 66.66% of cases, while diabetes was found in only 4 patients (11.11%). Otomycosis was the most commonly identified condition (53.39%), followed by furuncles (33.98%). Ear drops containing antibiotics were administered to all patients, although 66.60% received antibiotic therapy. Conclusion: External otitis is a relatively common condition, particularly among children and the elderly. Diagnosis can be made based on pain upon traction of the pinna and pressure on the tragus.展开更多
Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the st...Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.展开更多
BACKGROUND The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects,especially those caused by infection.Here,we report a case of chronic osteomyelitis of th...BACKGROUND The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects,especially those caused by infection.Here,we report a case of chronic osteomyelitis of the radius associated with a 9 cm bone defect,which was filled with a large allogeneic cortical bone graft from a bone bank.Complete bony union was achieved after 14 months of follow-up.Previous studies have used autogenous bone as the primary bone source for the Masquelet technique;in our case,the exclusive use of allografts is as successful as the use of autologous bone grafts.With the advent of bone banks,it is possible to obtain an unlimited amount of allograft,and the Masquelet technique may be further improved based on this new way of bone grafting.CASE SUMMARY In this study,we reported a case of repair of a long bone defect in a 40-year-old male patient,which was characterized by the utilization of allograft cortical bone combined with the Masquelet technique for the treatment of the patient's long bone defect in the forearm.The patient's results of functional recovery of the forearm were surprising,which further deepens the scope of application of Masquelet technique and helps to strengthen the efficacy of Masquelet technique in the treatment of long bones indeed.CONCLUSION Allograft cortical bone combined with the Masquelet technique provides a new method of treatment to large bone defect.展开更多
Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment challenges.The recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into...Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment challenges.The recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into this uncommon enti-ty,revealing striking geographical variations and questioning current treatment paradigms.This editorial commentary analyzes the study's key findings,inclu-ding the predominance of solid pseudopapillary neoplasms and their younger age of onset,which contrast sharply with Western data.It explores the implications for clinical practice and research,emphasizing the need for population-specific approaches to diagnosis and treatment.The revealed limited institutional expe-rience and surgical management patterns prompt a reevaluation of optimal care delivery for these complex cases,suggesting benefits of centralizing healthcare services.Furthermore,the commentary advocates for international collaborative studies to elucidate the genetic,environmental,and lifestyle factors influencing the development and progression of pediatric pancreatic tumors across diverse populations.It also outlines future directions,calling for advancements in precision medicine and innovative care delivery models to improve global patient outcomes.Unraveling Makita et al's findings within the broader landscape of pediatric oncology can stimulate further research and clinical advancements in managing pancreatic and other rare tumors in children.展开更多
Total or severe teratospermia affects the prognosis of fertility and causes serious problems for patients undergoing assisted reproduction[1].The pathophysiological mechanism of teratospermia is unclear.It has been sh...Total or severe teratospermia affects the prognosis of fertility and causes serious problems for patients undergoing assisted reproduction[1].The pathophysiological mechanism of teratospermia is unclear.It has been shown that patients with sperm parameters abnormalities and abnormal morphology have a high rate of fragmentation and sperm DNA decondensation[2,3],and that sperm DNA fragmentation analysis could be used as a predictor factor of fertility potential[4].展开更多
BACKGROUND Tacrolimus(TAC)is metabolized primarily by the CYP3A-encoded enzyme family(CYP3A4,CYP3A5,and CYP3A7).Individuals expressing the CYP3A51 allele are considered fast metabolizers and generally require higher T...BACKGROUND Tacrolimus(TAC)is metabolized primarily by the CYP3A-encoded enzyme family(CYP3A4,CYP3A5,and CYP3A7).Individuals expressing the CYP3A51 allele are considered fast metabolizers and generally require higher TAC doses to reach therapeutic levels.AIM To evaluate the predictive value of the TAC concentration-to-dose(C0/D)ratio for identifying CYP3A5 poly-morphisms in renal transplant recipients.METHODS Eighty-six de novo kidney transplant recipients with TAC-based immunosuppression from the Department of Nephrology and Dialysis at Military Hospital 103(Hanoi,Vietnam)were included in this retrospective study.Blood samples were collected within the first week post-transplantation to monitor TAC levels and to perform genotyping for CYP3A5 genetic polymorphisms.RESULTS The CYP3A53/3 genotype was identified in 37 patients(43%),CYP3A51/3 in 40 patients(46.5%),and CYP3A51/1 in 9 patients(10.5%).Patients carrying the CYP3A51/3 or CYP3A51/1 genotype,classified as fast metabolizers(CYP3A5 expressers),had significantly lower TAC C0 concentrations and C0/D ratios compared to slow meta-bolizers(CYP3A53/3 genotype)at multiple time points during follow-up(all P<0.001).Notably,the TAC C0/D ratio obtained on day 1(0.91)was shown to predict CYP3A5 polymorphism with a sensitivity of 84.6%and a specificity of 84.6%.CONCLUSION This study demonstrates that the TAC C0/D ratio provides a reliable predictive value for CYP3A5 polymorphisms,which can be used to individualize TAC dosing in renal transplant recipients in Vietnam and other low-income countries.展开更多
Proliferative diabetic retinopathy(PDR)affects approximately 6%of diabetic patients globally.The overall prevalence of diabetic retinopathy is around 22%.Wet age-related macular degeneration(ARMD),the sight-threatenin...Proliferative diabetic retinopathy(PDR)affects approximately 6%of diabetic patients globally.The overall prevalence of diabetic retinopathy is around 22%.Wet age-related macular degeneration(ARMD),the sight-threatening type of ARMD,affects approximately 1.2%-1.3%of the general population and represents 15%of total ARMD cases.While intravitreal anti-vascular endothelial growth factor injections are still the mainstay therapy,there are a few challenges,such as frequent administration,cost burden,and compliance barriers that prompt the need for exploration into systemic oral alternative drugs like fenofibrate,candesartan,and vorolanib.These oral therapies have the advantage of being noninvasive and systemically accessible with few logistical burdens.This review highlights current evidence supporting the use of oral therapies in PDR and wet ARMD management,along with practical limitations and future prospects.展开更多
This editorial narrative review discussed Budd-Chiari syndrome(BCS),which re-presents a rare but critical vascular liver disease resulting in an obstruction of he-patic venous outflow.Despite having a unifying mechani...This editorial narrative review discussed Budd-Chiari syndrome(BCS),which re-presents a rare but critical vascular liver disease resulting in an obstruction of he-patic venous outflow.Despite having a unifying mechanism,the syndrome shows a large heterogeneity across presentation,cause,and disease trajectory,compli-cating diagnosis and management.Based on established prognostic scoring systems,the New Clichy Score,the BCS-transjugular intrahepatic portosystemic shunt Index,the Zeitoun Score,and the Pediatric End-stage Liver Disease score were examined.These scoring systems are used for risk stratification and thera-peutic decision-making.Although these models deliver suitability information,their static parameters,narrow validation,and limited generalizability reduce their usefulness in diverse populations.Specific challenges are highlighted in pediatric patients,pregnant females,and individuals with myeloproliferative neoplasms for whom current tools often fall short.Moreover,there remains uncertainty regarding the durability of Pediatric End-stage Liver Disease score response and longer-term risks,such as hepatocellular carcinoma.There is a need to have a dynamic prognostic model that uses imaging and genetic factors in future studies.The article discussed enhancing recruitment to improve research.Overall,this article provided a contemporary,evidence-based approach for cli-nicians to aid in the evaluation and treatment of BCS.展开更多
Background: Pediatric brain tumors (PBT) are among the most common childhood neoplasms worldwide, but their management in low- and middle-income countries (LMICs) remains under-documented. Limited access to specialize...Background: Pediatric brain tumors (PBT) are among the most common childhood neoplasms worldwide, but their management in low- and middle-income countries (LMICs) remains under-documented. Limited access to specialized care, diagnostic tools, and adjuvant therapies poses significant challenges in sub-Saharan Africa, including Togo. Objective: This study reviews the management of pediatric brain tumors in Togo. Methods: We conducted a retrospective study in the neurosurgery department at Sylvanus Olympio Teaching Hospital between November 2017 and December 2022. Demographic, clinical, radiographic, operative, pathology, and outcome data were collected and analyzed. Results: Eighteen patients had histologically verified brain tumors. Ages ranged from 1 to 15 years (mean: 7.73 ± 4.28), with a sex ratio of 1. Symptoms of raised intracranial pressure were present in 83.4% of cases. The mean interval to presentation was 22 ± 5.32 months. Tumors were supratentorial in 66.7% of cases. Total tumor removal was achieved in 61.1%. Astrocytoma was the most common histological diagnosis, followed by ependymoma and medulloblastoma. Five patients (27.8%) died within the first month post-surgery. The estimated 5-year survival rate was 43% ± 5.4%. Conclusion: Delayed diagnosis, insufficient infrastructure, and limited access to radiotherapy and chemotherapy contribute to poor outcomes. Improving neurosurgical capacity, infrastructure, and financial support could enhance survival and outcomes for pediatric brain tumor patients in Togo.展开更多
文摘This retrospective study, the first of its kind in Mauritania, was carried out at the military hospital of Nouakchott. We sought to approximate the epidemio-logical, anatomopathological profile of Ear, Nose and Throat (ENT) and cervico-facial (CF) cancers in Mauritania. Over a period of two years, from January 1, 2019 to December 31, 2020, we noted 36 histologically confirmed cases, they represented 15.47% of all patients consulted in ENT and CF cancers affected the age group between 25 and 70 years, the age group most affected was that of 50 and 59 years, with 33.33% of cases. More affected in the proportion of 2 men to women, which can be explained by the risk factors mainly found in men, including smoking. First rank was cancers of the upper aero-digestive tract, the pharyngolarynx in head. Histologically, ENT and CF cancers were dominated by squamous cell carcinomas 78%, well ahead of papillary carcinomas 8% and vesicular thyroid carcinomas 5%, UCNTs, adenosquamous carcinomas and lymphomas each represented 3%.
文摘The study is to identify trends and levels of antibiotic resistance of some common Gram-negative strains over time. The samples were collected from Vietnam Military Hospital 103 between 2014 and 2019. A total of 405 <i>Acinetobacter baumannii</i>., 528 <i>Pseudomonas aeruginosa</i>, 741 <i>Escherichia coli</i>, and 352 <i>Klebsiella pneumoniae</i> strains were identified and antimicrobial susceptibility was by Vitek system and Etest method. The multi-drug resistance (MDR) was major proportion of four common bacteria. In particular, there is a tendency to shift from MDR to Extended drug resistance (XDR) or possibly Pan drug resistant (pPDR). <i>A. baumannii</i> had the highest level of antibiotic resistance, namely, carbapenem (61.5% - 82.5%) and cephalosporin (72.7% - 88.7%). <i>P. aeruginosa</i> resisted most of commonly antibiotics, ranging from 50% to 70%. <i>E. coli</i> had a high resistance with antibiotics like ampicillin (87.2% - 97.6%) and the 3rd generation cephalosporins (up to 79.6%). <i>K. pneumoniae</i> resisted carbapenem from 14.7% to 44.4%, and other antibiotics with the higher rate of 40%. The collected data will be a prerequisite for further studies on mechanisms and factors related to antibiotic resistant bacteria, in order to find out a rational and effective using strategy of antibiotics.
文摘Burn injuries have been and remain a very significant source of mortality and morbidity in low- and middle-income countries. As a country in this category, Ghana, is not exempted. Ghana has a population of 31 Million with only 21 Plastic Reconstructive and Burn surgeons. Moreover, the country can boast of only 3 major Burn centres. This notwithstanding the country in particular and Africa, in general, carries an extraordinary burden of Burn injuries with devastating consequences. Burn data from the 37 Military Hospital were analyzed from March 2018 to September 2019—a period of 18 months. In all, 217 burn cases were seen representing about 2.1% of all trauma and surgical cases. Our burn data analyzed the peculiarities of epidemiology, types of burn, the pattern of injuries, and the outcome of burn care at the 37 Military Hospital. Flame is emerging as the predominant cause of burns, most frequently occurring from the use of Liquid Petroleum Gas. In the pediatric population, however, the most frequent cause of burns is hot water burns. The mortality rate among the burn population was 1.8% (4 mortalities). This paper aims to point out management methods adopted by our unit which helped to improve burn outcomes and to reduce mortality.
文摘<strong>Introduction:</strong> Coblation<sup>®</sup> is a low temperature-controlled tissue ablation technique widely used in human surgery. Its development in otorhinolaryngology has allowed a spectacular advance in the management of diseases of the nasal and oral cavities. The objective of our work was to study the indications for radiofrequency in ENT, to describe the technical aspects and to evaluate the results of his practice at the HMO. <strong>Patients and Methods: </strong>This is a retrospective study carried out in the ENT and Head and Neck Surgery department of the Ouakam Military Hospital (MHO) over a period of 3 years (from January 2015 to the end of December 2017), involving 37 patients who received radiofrequency treatment in the ENT sphere. <strong>Results:</strong> The study was carried out on 37 patients. The sex ratio of 0.19. The mean age of the patients was 33.3 years. The indications were dominated by chronic caseous cryptic tonsillitis with or without halitosis with 24 cases (64.9%) followed by recurrent tonsillitis in 5 cases (13.5%) then we have obstructive hypertrophy of the palatal tonsils with syndrome sleep apnea (OSAS) in 4 cases (10.8%) followed by nasal obstruction (hypertrophy of the inferior turbinates) and hypertrophy of the soft palate and uvula in 2 cases (5.4%). The complication rate was 8.1% and dominated by transient dysgeusia in 1 case or 2.7%, uvula edema in 1 case or 2.7% and bleeding in 1 case or 2.7%. The postoperative follow-up was done one week, 1 month, 3 months, 6 months and 12 months after radiofrequency. Volumetric reduction begins to set in from 1 month (62.5%) and becomes maximum in 3 months (74.3%). <strong>Conclusion:</strong> Coblation<sup>®</sup> is a controlled tissue ablation technique at low temperature, patented by ArthroCare<sup>®</sup> Corporation in 1997. Very widespread in human surgery. Its development in otorhinolaryngology was later, but allowed a spectacular advance in the management of diseases of the nasal and oral cavities.
文摘Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.
文摘The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of automated external defibrillator are increasing,the likelihood of survival to hospital discharge is no more than 8%.To date,various devices and methods have been utilized in the initial CPR approach targeting to improve survival and neurological outcomes in OHCA patients.The aim of this review is to discuss strategies that facilitate resuscitation,increase the chance to achieve return to spontaneous circulation and improve survival to hospital discharge and neurological outcomes in the prehospital setting.
文摘Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.
文摘Urinary tract infection （UTI） remains one of the most common bacterial infections seen in hospitalized patients of all ages. Prevalence of UTIs increases with age and is often accompanied by higher resistance rates. The aim of this study was to determine the degree of resistance of most common enterobacterial uropathogens isolated from patients at Central Military Hospital and compare this resistance with the results found by the North America and Europe Study for Monitoring Antimicrobial Resistance Trends （SMART） study during 2009-2010.
文摘Introduction: Omphalocele is an embryopathy of the first ten weeks of gestation. It corresponds to a defect in the abdominal wall through which viscera contained in a sac constituted by the amniotic membrane and centered by the umbilical cord are exteriorized. The objective of this work was to study the diagnostic modalities and the impact of our therapeutic choices on the outcome of the management. Material and Methods: We carried out a prospective study on patients with omphalocele admitted to the pediatric surgery departments of the HND, during a period spread over 4 years, between January 2017 and December 2020. Results: we collected 55 files (i.e., 13.7 cases/year). There were 38 boys and 17 girls (sex ratio 2.2) with an average age of 1.9 days. We found 15 cases (27%) of type I and 40 cases (73%) of type II according to the AITKEN classification. Fifteen cases (27%) benefited from surgical treatment and 45 cases (73%) benefited from conservative treatment (Grob). Two surgical methods were used: Primary parietal closure, which was used in 10 cases (66.7%), and the GROSS method, which was used in 5 cases (33.3%). We obtained an improvement of 40 cases (73%) and 15 cases (27%) of death. Conclusion: our work reported our experience in the management of omphalocele and the difficulties of postoperative resuscitation.
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The aim of this study was to report a case of multi-visceral sarcoidosis at the Mother-Child Hospital Center (CHME) “Le Luxembourg” in Bamako, Mali. Observation: This is a patient aged 62 at the time of consultation, a housewife, residing in the Banconi district, who was referred to us for thoracic-abdominopelvic imaging for chronic liver disease. After several diagnostic errors, the thoracic-abdominopelvic CT scan and liver MRI performed in our center showed, at the thoracoabdominal level, bilateral diffuse pulmonary micronodules and bilateral mediastinal-hilar lymphadenopathy;on the abdominal level, a dysmorphic liver with plaques of steatosis and a granular appearance of the liver parenchyma without periportal fibrosis. These imaging data combined with those from the liver nodule biopsy and biology confirmed the diagnosis of sarcoidosis type II. Treatment with corticosteroids gave satisfactory results and the patient recovered after 18 months. Clinical and CT monitoring 2 years from the start of the disease and 2 months from the end of treatment showed complete resolution of the lesions. Conclusion: The multi-visceral location of sarcoidosis is an entity whose diagnosis remains difficult;diagnostic and interventional imaging has an important place in its management.
文摘Introduction: External otitis (OE) is an acute or chronic inflammation or infection of the external ear resulting from an imbalance in the external auditory canal secondary to microtrauma, maceration, eczema, or a foreign body in the external auditory canal. Objective: To study cases of external otitis at the Mamou Regional Hospital. Materials and Methods: This was a prospective descriptive study conducted over a period of six (6) months from July 1st to December 31st, 2016. It included all patients admitted to the ENT department of the Mamou Regional Hospital. Results: During the study period, 712 patients were admitted to the department for various pathologies, of which 103 met our selection criteria, representing a frequency of 14.46%. The mean age of the patients was 33.74 years with a range of 1 to 90 years. Males predominated in the sample, accounting for 59.22%. The vast majority of patients resided in urban areas, constituting 61.17% of the sample. In our study, all patients consulted for otalgia (100%), and over half (53.39%) for hypoacusis. We formally identified rhinitis in 66.66% of cases, while diabetes was found in only 4 patients (11.11%). Otomycosis was the most commonly identified condition (53.39%), followed by furuncles (33.98%). Ear drops containing antibiotics were administered to all patients, although 66.60% received antibiotic therapy. Conclusion: External otitis is a relatively common condition, particularly among children and the elderly. Diagnosis can be made based on pain upon traction of the pinna and pressure on the tragus.
文摘Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.
文摘BACKGROUND The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects,especially those caused by infection.Here,we report a case of chronic osteomyelitis of the radius associated with a 9 cm bone defect,which was filled with a large allogeneic cortical bone graft from a bone bank.Complete bony union was achieved after 14 months of follow-up.Previous studies have used autogenous bone as the primary bone source for the Masquelet technique;in our case,the exclusive use of allografts is as successful as the use of autologous bone grafts.With the advent of bone banks,it is possible to obtain an unlimited amount of allograft,and the Masquelet technique may be further improved based on this new way of bone grafting.CASE SUMMARY In this study,we reported a case of repair of a long bone defect in a 40-year-old male patient,which was characterized by the utilization of allograft cortical bone combined with the Masquelet technique for the treatment of the patient's long bone defect in the forearm.The patient's results of functional recovery of the forearm were surprising,which further deepens the scope of application of Masquelet technique and helps to strengthen the efficacy of Masquelet technique in the treatment of long bones indeed.CONCLUSION Allograft cortical bone combined with the Masquelet technique provides a new method of treatment to large bone defect.
文摘Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment challenges.The recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into this uncommon enti-ty,revealing striking geographical variations and questioning current treatment paradigms.This editorial commentary analyzes the study's key findings,inclu-ding the predominance of solid pseudopapillary neoplasms and their younger age of onset,which contrast sharply with Western data.It explores the implications for clinical practice and research,emphasizing the need for population-specific approaches to diagnosis and treatment.The revealed limited institutional expe-rience and surgical management patterns prompt a reevaluation of optimal care delivery for these complex cases,suggesting benefits of centralizing healthcare services.Furthermore,the commentary advocates for international collaborative studies to elucidate the genetic,environmental,and lifestyle factors influencing the development and progression of pediatric pancreatic tumors across diverse populations.It also outlines future directions,calling for advancements in precision medicine and innovative care delivery models to improve global patient outcomes.Unraveling Makita et al's findings within the broader landscape of pediatric oncology can stimulate further research and clinical advancements in managing pancreatic and other rare tumors in children.
文摘Total or severe teratospermia affects the prognosis of fertility and causes serious problems for patients undergoing assisted reproduction[1].The pathophysiological mechanism of teratospermia is unclear.It has been shown that patients with sperm parameters abnormalities and abnormal morphology have a high rate of fragmentation and sperm DNA decondensation[2,3],and that sperm DNA fragmentation analysis could be used as a predictor factor of fertility potential[4].
基金Supported by the Vietnam National Foundation for Science and Technology Development,No.NAFOSTED 04/2020/TN.
文摘BACKGROUND Tacrolimus(TAC)is metabolized primarily by the CYP3A-encoded enzyme family(CYP3A4,CYP3A5,and CYP3A7).Individuals expressing the CYP3A51 allele are considered fast metabolizers and generally require higher TAC doses to reach therapeutic levels.AIM To evaluate the predictive value of the TAC concentration-to-dose(C0/D)ratio for identifying CYP3A5 poly-morphisms in renal transplant recipients.METHODS Eighty-six de novo kidney transplant recipients with TAC-based immunosuppression from the Department of Nephrology and Dialysis at Military Hospital 103(Hanoi,Vietnam)were included in this retrospective study.Blood samples were collected within the first week post-transplantation to monitor TAC levels and to perform genotyping for CYP3A5 genetic polymorphisms.RESULTS The CYP3A53/3 genotype was identified in 37 patients(43%),CYP3A51/3 in 40 patients(46.5%),and CYP3A51/1 in 9 patients(10.5%).Patients carrying the CYP3A51/3 or CYP3A51/1 genotype,classified as fast metabolizers(CYP3A5 expressers),had significantly lower TAC C0 concentrations and C0/D ratios compared to slow meta-bolizers(CYP3A53/3 genotype)at multiple time points during follow-up(all P<0.001).Notably,the TAC C0/D ratio obtained on day 1(0.91)was shown to predict CYP3A5 polymorphism with a sensitivity of 84.6%and a specificity of 84.6%.CONCLUSION This study demonstrates that the TAC C0/D ratio provides a reliable predictive value for CYP3A5 polymorphisms,which can be used to individualize TAC dosing in renal transplant recipients in Vietnam and other low-income countries.
文摘Proliferative diabetic retinopathy(PDR)affects approximately 6%of diabetic patients globally.The overall prevalence of diabetic retinopathy is around 22%.Wet age-related macular degeneration(ARMD),the sight-threatening type of ARMD,affects approximately 1.2%-1.3%of the general population and represents 15%of total ARMD cases.While intravitreal anti-vascular endothelial growth factor injections are still the mainstay therapy,there are a few challenges,such as frequent administration,cost burden,and compliance barriers that prompt the need for exploration into systemic oral alternative drugs like fenofibrate,candesartan,and vorolanib.These oral therapies have the advantage of being noninvasive and systemically accessible with few logistical burdens.This review highlights current evidence supporting the use of oral therapies in PDR and wet ARMD management,along with practical limitations and future prospects.
文摘This editorial narrative review discussed Budd-Chiari syndrome(BCS),which re-presents a rare but critical vascular liver disease resulting in an obstruction of he-patic venous outflow.Despite having a unifying mechanism,the syndrome shows a large heterogeneity across presentation,cause,and disease trajectory,compli-cating diagnosis and management.Based on established prognostic scoring systems,the New Clichy Score,the BCS-transjugular intrahepatic portosystemic shunt Index,the Zeitoun Score,and the Pediatric End-stage Liver Disease score were examined.These scoring systems are used for risk stratification and thera-peutic decision-making.Although these models deliver suitability information,their static parameters,narrow validation,and limited generalizability reduce their usefulness in diverse populations.Specific challenges are highlighted in pediatric patients,pregnant females,and individuals with myeloproliferative neoplasms for whom current tools often fall short.Moreover,there remains uncertainty regarding the durability of Pediatric End-stage Liver Disease score response and longer-term risks,such as hepatocellular carcinoma.There is a need to have a dynamic prognostic model that uses imaging and genetic factors in future studies.The article discussed enhancing recruitment to improve research.Overall,this article provided a contemporary,evidence-based approach for cli-nicians to aid in the evaluation and treatment of BCS.
文摘Background: Pediatric brain tumors (PBT) are among the most common childhood neoplasms worldwide, but their management in low- and middle-income countries (LMICs) remains under-documented. Limited access to specialized care, diagnostic tools, and adjuvant therapies poses significant challenges in sub-Saharan Africa, including Togo. Objective: This study reviews the management of pediatric brain tumors in Togo. Methods: We conducted a retrospective study in the neurosurgery department at Sylvanus Olympio Teaching Hospital between November 2017 and December 2022. Demographic, clinical, radiographic, operative, pathology, and outcome data were collected and analyzed. Results: Eighteen patients had histologically verified brain tumors. Ages ranged from 1 to 15 years (mean: 7.73 ± 4.28), with a sex ratio of 1. Symptoms of raised intracranial pressure were present in 83.4% of cases. The mean interval to presentation was 22 ± 5.32 months. Tumors were supratentorial in 66.7% of cases. Total tumor removal was achieved in 61.1%. Astrocytoma was the most common histological diagnosis, followed by ependymoma and medulloblastoma. Five patients (27.8%) died within the first month post-surgery. The estimated 5-year survival rate was 43% ± 5.4%. Conclusion: Delayed diagnosis, insufficient infrastructure, and limited access to radiotherapy and chemotherapy contribute to poor outcomes. Improving neurosurgical capacity, infrastructure, and financial support could enhance survival and outcomes for pediatric brain tumor patients in Togo.
