Introduction:While previous studies only focused on the arrhythmic risk associated with specific correction strategies,this study evaluates this risk in a large cohort of paediatric patients with all phenotypes of PA-...Introduction:While previous studies only focused on the arrhythmic risk associated with specific correction strategies,this study evaluates this risk in a large cohort of paediatric patients with all phenotypes of PA-IVS after surgical repair.Methods:In this single centre observational cohort study,we retrospectively evaluated 165 patients with a diagnosis of PA-IVS and we excluded those with an exclusively percutaneous treatment,patients lost or with insufficient follow-up and those affected by other arrhythmic syndromes.Surgical history and clinical outcomes were reviewed.Results:86 patients were included in the study(54 male[62.8%],mean age 16.4±6.1 years),with median follow-up from definitive repair of 12.8 years(6.4–18.9 years).They underwent three different final repairs:23 patients(26.7%)univentricular palliation,43(50%)biventricular correction,and 20(23.3%)one and a half ventricle correction.Thirteen patients(15%)developed arrhythmia:6 patients(all the subgroups)sinus node disfunction(SND);2(biventricular repair)premature ventricular complexes;2(one and a half ventricle repair)non-sustained ventricular tachycardia;1(biventricular repair)intra-atrial re-entrant tachycardia;1(one and a half ventricle repair)supraventricular tachyarrhythmia;1(biventricular repair)atrial fibrillation.Three patients with SND needed a pacemaker implantation.Only Fontan circulation showed an association with SND,while the other two groups heterogeneous types of arrhythmias.Conclusions:The low arrhythmic risk is related to surgical repair,it does not appear to be associated with native cardiomyopathy,and it appears to increase with length of follow up.Continuous follow-up in specialized centres is necessary to make an early diagnosis and to manage the potential haemodynamic impact at medium-long term.展开更多
Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Doual...Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Douala. When the vertebral fractures were diagnosed, the 3 patients had back pain and kyphosis deformities of the dorsal spine. Treatment with an infusion of biphosphonates (zoledronic acid at a dose of 0.5 mg·per·kg) was offered to all three patients. Two out of three patients received treatment with biphosphonates with a successful outcome. Profound vitamin D deficiency is associated with increased bone remodeling and a history of fractures. In sickle cell anemia, vertebral fractures may also result from bone fragility, which is often overlooked as aseptic osteonecrosis and osteomyelitis, which are very often suspected.展开更多
Introduction: Musculoskeletal injuries are common in children but rarely severe. Their treatment varies according to the type of injury observed. The aim was to describe the epidemiological and therapeutic aspects of ...Introduction: Musculoskeletal injuries are common in children but rarely severe. Their treatment varies according to the type of injury observed. The aim was to describe the epidemiological and therapeutic aspects of severe musculoskeletal injuries in children during play. Patients and Methods: This was a retrospective descriptive study conducted in the Orthopaedic-Traumatology Department and the Paediatric Surgery Unit of the University Hospital of Bouaké between January 2018 and December 2020. It concerned patients less than 16 years of age hospitalised for more than 24 hours for a musculoskeletal trauma following a gambling accident. The variables studied were epidemiological and therapeutic. Results: A total of 53 patients were collected. The frequency was 2.9%. The mean age was 9 ± 3.99 years. There were 38 (71.7%) boys and 15 (28.3%) girls. The sex ratio was 2.5. The patients were attending school in 79.3% (n = 42). The circumstances of occurrence were dominated by falls during play accidents (n = 35;66%). Football was observed in 93.5% (n = 49). The thoracic limb (n = 35;66%) was the preferred site of these injuries. The injuries were closed (86.7%) with a predominance of forearm fractures (n = 22;41.6%). The average hospital stay was 2.8 ± 1.4 days. Most of the patients were treated orthopedically (n = 37;69.9%). The evolution was favourable without complications. Conclusion: Musculoskeletal injuries during play were infrequent (2.9%). The circumstances were dominated by falls during play. The injuries were mainly closed fractures, most of which were treated orthopedically.展开更多
Background: Circumcision is the removal of the fore skin of the penis. It is one of the commonest operations performed worldwide. Meatal stenosis is an uncommon long-term complication of circumcision that can lead to ...Background: Circumcision is the removal of the fore skin of the penis. It is one of the commonest operations performed worldwide. Meatal stenosis is an uncommon long-term complication of circumcision that can lead to problems voiding. Aim: To identify the clinical presentations and management of meatal stenosis in Port Harcourt. Materials and Methods: This was a retrospective study of patients who presented with features of meatal stenosis between January 2012 and December 2021. The patients’ history, physical examination findings, investigations and treatment received were analysed. Results: A total of 52 patients with features of meatal stenosis were recruited for the study. The number of patients less than a year old, between a year and 5 years, between 6 and 10 years and greater than 11 years were 8, 12, 28 and 4 respectively. Only 8 patients presented within 6 months of onset of symptoms. The most common symptom was poor urine stream, followed by straining. Meatotomy was the most commonly performed procedure for meatal stenosis 24 (46.15%). The patients were followed up for at least 6 months. Six patients had recurrence after treatment of meatal stenosis. Three patients each had a recurrence following dilatation and meatotomy. No patient had recurrence after meatoplasty. Conclusion: Meatal stenosis is an uncommon complication post circumcision. Patients usually present late to the hospital in our study. Meatoplasty had the best outcome. After treatment of meatal stenosis patients should be followed up for 6 months.展开更多
Background: Prune belly syndrome (PBS) is a congenital anomaly that consists of a triad of abdominal wall defect, bilateral cryptorchidism, and urinary tract dilation. The disease is of varying severity. This study ai...Background: Prune belly syndrome (PBS) is a congenital anomaly that consists of a triad of abdominal wall defect, bilateral cryptorchidism, and urinary tract dilation. The disease is of varying severity. This study aims to highlight the challenges and peculiarities in the management of PBS in a resource-poor setting. Materials and Methods: This is a ten-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital’s ethical committee. The information gotten included history, duration of symptoms, examination findings, age of the patient, category of disease, and intraoperative findings. The data from the folders were collected and evaluated. Frequencies, percentages, the mean and standard deviation were used to summarize the data as appropriate. Results: Fifteen patients were included in the study. The hospital incidence of PBS was 112/100,000, twelve males and three females. The age range was from 1 day to 15 years, mean age was 14 months ± 2.3 months. Most patients presented between 3 months and 2 years and 11 months. Twelve patients had category three PBS and five patients had associated anomalies. Eleven male patients died after 5 years of follow-up from progressive renal deterioration. The female patient fared better than the males. Conclusion: PBS is rare, most patients with the condition present late. The most common cause of mortality was progressive renal deterioration.展开更多
文摘Introduction:While previous studies only focused on the arrhythmic risk associated with specific correction strategies,this study evaluates this risk in a large cohort of paediatric patients with all phenotypes of PA-IVS after surgical repair.Methods:In this single centre observational cohort study,we retrospectively evaluated 165 patients with a diagnosis of PA-IVS and we excluded those with an exclusively percutaneous treatment,patients lost or with insufficient follow-up and those affected by other arrhythmic syndromes.Surgical history and clinical outcomes were reviewed.Results:86 patients were included in the study(54 male[62.8%],mean age 16.4±6.1 years),with median follow-up from definitive repair of 12.8 years(6.4–18.9 years).They underwent three different final repairs:23 patients(26.7%)univentricular palliation,43(50%)biventricular correction,and 20(23.3%)one and a half ventricle correction.Thirteen patients(15%)developed arrhythmia:6 patients(all the subgroups)sinus node disfunction(SND);2(biventricular repair)premature ventricular complexes;2(one and a half ventricle repair)non-sustained ventricular tachycardia;1(biventricular repair)intra-atrial re-entrant tachycardia;1(one and a half ventricle repair)supraventricular tachyarrhythmia;1(biventricular repair)atrial fibrillation.Three patients with SND needed a pacemaker implantation.Only Fontan circulation showed an association with SND,while the other two groups heterogeneous types of arrhythmias.Conclusions:The low arrhythmic risk is related to surgical repair,it does not appear to be associated with native cardiomyopathy,and it appears to increase with length of follow up.Continuous follow-up in specialized centres is necessary to make an early diagnosis and to manage the potential haemodynamic impact at medium-long term.
文摘Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Douala. When the vertebral fractures were diagnosed, the 3 patients had back pain and kyphosis deformities of the dorsal spine. Treatment with an infusion of biphosphonates (zoledronic acid at a dose of 0.5 mg·per·kg) was offered to all three patients. Two out of three patients received treatment with biphosphonates with a successful outcome. Profound vitamin D deficiency is associated with increased bone remodeling and a history of fractures. In sickle cell anemia, vertebral fractures may also result from bone fragility, which is often overlooked as aseptic osteonecrosis and osteomyelitis, which are very often suspected.
文摘Introduction: Musculoskeletal injuries are common in children but rarely severe. Their treatment varies according to the type of injury observed. The aim was to describe the epidemiological and therapeutic aspects of severe musculoskeletal injuries in children during play. Patients and Methods: This was a retrospective descriptive study conducted in the Orthopaedic-Traumatology Department and the Paediatric Surgery Unit of the University Hospital of Bouaké between January 2018 and December 2020. It concerned patients less than 16 years of age hospitalised for more than 24 hours for a musculoskeletal trauma following a gambling accident. The variables studied were epidemiological and therapeutic. Results: A total of 53 patients were collected. The frequency was 2.9%. The mean age was 9 ± 3.99 years. There were 38 (71.7%) boys and 15 (28.3%) girls. The sex ratio was 2.5. The patients were attending school in 79.3% (n = 42). The circumstances of occurrence were dominated by falls during play accidents (n = 35;66%). Football was observed in 93.5% (n = 49). The thoracic limb (n = 35;66%) was the preferred site of these injuries. The injuries were closed (86.7%) with a predominance of forearm fractures (n = 22;41.6%). The average hospital stay was 2.8 ± 1.4 days. Most of the patients were treated orthopedically (n = 37;69.9%). The evolution was favourable without complications. Conclusion: Musculoskeletal injuries during play were infrequent (2.9%). The circumstances were dominated by falls during play. The injuries were mainly closed fractures, most of which were treated orthopedically.
文摘Background: Circumcision is the removal of the fore skin of the penis. It is one of the commonest operations performed worldwide. Meatal stenosis is an uncommon long-term complication of circumcision that can lead to problems voiding. Aim: To identify the clinical presentations and management of meatal stenosis in Port Harcourt. Materials and Methods: This was a retrospective study of patients who presented with features of meatal stenosis between January 2012 and December 2021. The patients’ history, physical examination findings, investigations and treatment received were analysed. Results: A total of 52 patients with features of meatal stenosis were recruited for the study. The number of patients less than a year old, between a year and 5 years, between 6 and 10 years and greater than 11 years were 8, 12, 28 and 4 respectively. Only 8 patients presented within 6 months of onset of symptoms. The most common symptom was poor urine stream, followed by straining. Meatotomy was the most commonly performed procedure for meatal stenosis 24 (46.15%). The patients were followed up for at least 6 months. Six patients had recurrence after treatment of meatal stenosis. Three patients each had a recurrence following dilatation and meatotomy. No patient had recurrence after meatoplasty. Conclusion: Meatal stenosis is an uncommon complication post circumcision. Patients usually present late to the hospital in our study. Meatoplasty had the best outcome. After treatment of meatal stenosis patients should be followed up for 6 months.
文摘Background: Prune belly syndrome (PBS) is a congenital anomaly that consists of a triad of abdominal wall defect, bilateral cryptorchidism, and urinary tract dilation. The disease is of varying severity. This study aims to highlight the challenges and peculiarities in the management of PBS in a resource-poor setting. Materials and Methods: This is a ten-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital’s ethical committee. The information gotten included history, duration of symptoms, examination findings, age of the patient, category of disease, and intraoperative findings. The data from the folders were collected and evaluated. Frequencies, percentages, the mean and standard deviation were used to summarize the data as appropriate. Results: Fifteen patients were included in the study. The hospital incidence of PBS was 112/100,000, twelve males and three females. The age range was from 1 day to 15 years, mean age was 14 months ± 2.3 months. Most patients presented between 3 months and 2 years and 11 months. Twelve patients had category three PBS and five patients had associated anomalies. Eleven male patients died after 5 years of follow-up from progressive renal deterioration. The female patient fared better than the males. Conclusion: PBS is rare, most patients with the condition present late. The most common cause of mortality was progressive renal deterioration.
