Traitement Chirurgical de la Maladie Hémorroïdaire: Indications et Résultats au Service de Chirurgie Générale de l’Hôpital Général Idrissa Pouye

Introduction: La maladie hémorroïdaire est une pathologie bénigne due à une anomalie des plexus hémorroïdaires. Sa prise en charge peut être médicale, instrumentale et/ou chirurgicale. Patients et méthodes: Le but de ce travail était de préciser les indications et les résultats de l’hemorroidectomie dans notre pratique. Nous avons réalisé une étude rétrospective allant de Janvier 2010 à Décembre 2015. Quatre-vingt-un dossiers étaient  colligés au service de chirurgie générale de l’hôpital général Idrissa Pouye. Tous les patients avaient  bénéficié d’un traitement chirurgical à type d’hémorroïdectomie selon Milligan et Morgan. Résultats: Il s’agissait de 58 hommes et 23 femmes dont l’âge moyen était de 42,4 ans avec des extrêmes de 18 et 84 ans. Le tableau clinique était dominé par la rectorragie avec 41 patients (50,6%) suivie de la douleur anale chez 37 patients (45,7). Les indications opératoires étaient les formes évoluées (stade 3 et 4), les formes résistant au traitement médical, les formes compliquées ou associées à une fistule ou fissure. L’hemorroidectomie selon Milligan et Morgan était la technique la plus utilisée chez 63 patients (78%). Soixante-deux malades (76,5%) ont eu des suites immédiates simples. Quatorze cas de douleur anale résiduelle (16%), deux cas d’hémorragie (2,5%) et quatre cas de rétention d’urine (4,9%) ont été notés. A un an de suivi, quatre patients (4,9%) présentaient une sténose anale et deux patients (2,5%) avaient un retard de cicatrisation. Aucun cas de récidive n’a été enregistré et la mortalité était nulle dans notre série. Conclusion: La MH est une pathologie bénigne. La chirurgie garde une place très importante dans la prise en charge et elle donne de très bons résultats avec une morbidité faible.   Introduction: Hemorrhoidal disease is a benign condition caused by an abnormality of the hemorrhoidal plexuses. Its management can be medical, instrumental and / or surgical. Patients and methods: The aim of this work was to clarify the indications and outcomes of hemorroidectomy in our practice. We conducted a retrospective study from January 2010 to December 2015. Eighty-one cases were collected at the general surgery department of the Idrissa Pouye General Hospital. All patients had undergone surgical treatment such as hemorrhoidectomy according to Milligan and Morgan. Results: There were 58 men and 23 women with a mean age of 42.4 years and extremes of 18 and 84 years. The clinical picture was dominated by rectal bleeding in 41 patients (50.6%) followed by anal pain in 37 patients (45.7%). The indications for surgery were advanced forms (stage 3 and 4), forms resistant to medical treatment, complicated forms or those associated with a fistula or fissure. The hemorroidectomy according to Milligan and Morgan was the most used technique in 63 patients (78%). Sixty-two patients (76.5%) had simple immediate after-effects. Fourteen cases of residual anal pain (16%), two cases of bleeding (2.5%) and four cases of urine retention (4.9%) were noted. At one year follow-up, four patients (4.9%) had anal stenosis and two patients (2.5%) had delayed healing. There were no cases of recurrence and no mortality in our series. Conclusion: Hemorrhoidal disease is a benign pathology. Surgery is still very important in the management of this disease and it gives very good results with a low morbidity

Traitement Chirurgical de la Maladie Hémorroïdaire: Indications et Résultats au Service de Chirurgie Générale de l’Hôpital Général Idrissa Pouye

Introduction: La maladie hémorroïdaire est une pathologie bénigne due à une anomalie des plexus hémorroïdaires. Sa prise en charge peut être médicale, instrumentale et/ou chirurgicale. Patients et méthodes: Le but de ce travail était de préciser les indications et les résultats de l’hemorroidectomie dans notre pratique. Nous avons réalisé une étude rétrospective allant de Janvier 2010 à Décembre 2015. Quatre-vingt-un dossiers étaient  colligés au service de chirurgie générale de l’hôpital général Idrissa Pouye. Tous les patients avaient  bénéficié d’un traitement chirurgical à type d’hémorroïdectomie selon Milligan et Morgan. Résultats: Il s’agissait de 58 hommes et 23 femmes dont l’âge moyen était de 42,4 ans avec des extrêmes de 18 et 84 ans. Le tableau clinique était dominé par la rectorragie avec 41 patients (50,6%) suivie de la douleur anale chez 37 patients (45,7). Les indications opératoires étaient les formes évoluées (stade 3 et 4), les formes résistant au traitement médical, les formes compliquées ou associées à une fistule ou fissure. L’hemorroidectomie selon Milligan et Morgan était la technique la plus utilisée chez 63 patients (78%). Soixante-deux malades (76,5%) ont eu des suites immédiates simples. Quatorze cas de douleur anale résiduelle (16%), deux cas d’hémorragie (2,5%) et quatre cas de rétention d’urine (4,9%) ont été notés. A un an de suivi, quatre patients (4,9%) présentaient une sténose anale et deux patients (2,5%) avaient un retard de cicatrisation. Aucun cas de récidive n’a été enregistré et la mortalité était nulle dans notre série. Conclusion: La MH est une pathologie bénigne. La chirurgie garde une place très importante dans la prise en charge et elle donne de très bons résultats avec une morbidité faible.   Introduction: Hemorrhoidal disease is a benign condition caused by an abnormality of the hemorrhoidal plexuses. Its management can be medical, instrumental and / or surgical. Patients and methods: The aim of this work was to clarify the indications and outcomes of hemorroidectomy in our practice. We conducted a retrospective study from January 2010 to December 2015. Eighty-one cases were collected at the general surgery department of the Idrissa Pouye General Hospital. All patients had undergone surgical treatment such as hemorrhoidectomy according to Milligan and Morgan. Results: There were 58 men and 23 women with a mean age of 42.4 years and extremes of 18 and 84 years. The clinical picture was dominated by rectal bleeding in 41 patients (50.6%) followed by anal pain in 37 patients (45.7%). The indications for surgery were advanced forms (stage 3 and 4), forms resistant to medical treatment, complicated forms or those associated with a fistula or fissure. The hemorroidectomy according to Milligan and Morgan was the most used technique in 63 patients (78%). Sixty-two patients (76.5%) had simple immediate after-effects. Fourteen cases of residual anal pain (16%), two cases of bleeding (2.5%) and four cases of urine retention (4.9%) were noted. At one year follow-up, four patients (4.9%) had anal stenosis and two patients (2.5%) had delayed healing. There were no cases of recurrence and no mortality in our series. Conclusion: Hemorrhoidal disease is a benign pathology. Surgery is still very important in the management of this disease and it gives very good results with a low morbidity

The first Forecasters Handbook for West Africa

Bridging the gap between rapidly moving scientific research and specific forecasting tools, Meteorology of Tropical West Africa: The Forecasters' Handbook’, gives unprecedented access to the latest science and combines this with pragmatic approaches to forecasting. It is set to change the way forecasters, researchers and students learn about tropical meteorology and will serve to drive demand for new forecasting tools. The Handbook builds upon the legacy of the AMMA project, making the latest science applicable to forecasting in the region. By bringing together, at the outset, researchers and forecasters from across the region, and linking to applications, user communities and decision-makers, the Forecasters’ Handbook provides a template for finding much needed solutions to critical issues such as building resilience to climate change in West Africa

Advancing research for seamless Earth system prediction

Whether on an urban or planetary scale, covering time scales of a few minutes or a few decades, the societal need for more accurate weather, climate, water, and environmental information has led to a more seamless thinking across disciplines and communities. This challenge, at the intersection of scientific research and society’s need, is among the most important scientific and technological challenges of our time. The “Science Summit on Seamless Research for Weather, Climate, Water, and Environment” organized by the World Meteorological Organization (WMO) in 2017, has brought together researchers from a variety of institutions for a cross-disciplinary exchange of knowledge and ideas relating to seamless Earth system science. The outcomes of the Science Summit, and the interactions it sparked, highlight the benefit of a seamless Earth system science approach. Such an approach has the potential to break down artificial barriers that may exist due to different observing systems, models, time and space scales, and compartments of the Earth system. In this context, the main future challenges for research infrastructures have been identified. A value cycle approach has been proposed to guide innovation in seamless Earth system prediction. The engagement of researchers, users, and stakeholders will be crucial for the successful development of a seamless Earth system science that meets the needs of society

Trend in the Co-Occurrence of Extreme Daily Rainfall in West Africa Since 1950

International audienceWe propose in this paper a statistical framework to study the evolution of the co‐occurrence of extreme daily rainfall in West Africa since 1950. We consider two regions subject to contrasted rainfall regimes: Senegal and the central Sahel. We study the likelihood of the 3% largest daily rainfall (considering all days) in each region to occur simultaneously and, in a 20 year moving window approach, how this likelihood has evolved with time. Our method uses an anisotropic max‐stable process allowing us to properly represent the co‐occurrence of daily extremes and including the possibility of a preferred direction of co‐occurrence. In Senegal, a change is found in the 1980s, with preferred co‐occurrence along the E‐50‐N direction (i.e., along azimuth 50°) before the 1980s and weaker isotropic co‐occurrence afterward. In central Sahel, a change is also found in the 1980s but surprisingly with contrasting results. Anisotropy along the E‐W direction is found over the whole period, with greater extension after the 1980s. The paper discusses how the co‐occurrence of extremes can provide a qualitative indicator on change in size and propagation of the strongest storms. This calls for further research to identify the atmospheric processes responsible for such contrasted changes in storm properties

Formation and Transport of a Saharan Dust Plume in Early Summer

This research studies the capability of the Weather Research and Forecasting model coupled with the Chemistry/Aerosol module (WRF-Chem) with and without parametrization to reproduce a dust storm, which was held on 27th June 2018 over Sahara region. The authors use satellite observations and ground-based measurements to evaluate the WRF-Chem simulations. The sensitivities of WRF-Chem Model are tested on the replication of haboob features with a tuned GOCART aerosol module. Comparisons of simulations with satellite and ground-based observations show that WRF-Chem is able to reproduce the Aerosol Optical Depth (AOD) distribution and associated changes of haboob in the meteorological fields with temperature drops of about 9 °C and wind gust 20 m·s–1. The WRF-Chem Convection-permitting model (CPM) shows strong 10-meter winds induced a large dust emission along the leading edge of a convective cold pool (LECCP). The CPM indicates heavy dust transported over the West African coast (16°W-10°W; 6°N-21°N) which has a potential for long-distance travel on 27th June between 1100 UTC and 1500 UTC. The daily precipitation is improved in the CPM with a spatial distribution similar to the GPM-IMERG precipitation and maximum rainfall located at the right place. As well as raising a large amount of dust, the haboob caused considerable damage along its route

Intensity-duration-frequency (IDF) rainfall curves in Senegal

International audienceUrbanization resulting from sharply increasing demographic pressure and infrastructure development has made the populations of many tropical areas more vulnerable to extreme rainfall hazards. Characterizing extreme rainfall distribution in a coherent way in space and time is thus becoming an overarching need that requires using appropriate models of intensity-duration-frequency (IDF) curves. Using a 14 series of 5 min rainfall records collected in Senegal, a comparison of two generalized extreme value (GEV) and scaling models is carried out, resulting in the selection of the more parsimonious one (four parameters), as the recommended model for use. A bootstrap approach is proposed to compute the uncertainty associated with the estimation of these four parameters and of the related rainfall return levels for durations ranging from 1 to 24 h. This study confirms previous works showing that simple scaling holds for characterizing the temporal scaling of extreme rainfall in tropical regions such as sub-Saharan Africa. It further provides confidence intervals for the parameter estimates and shows that the uncertainty linked to the estimation of the GEV parameters is 3 to 4 times larger than the uncertainty linked to the inference of the scaling parameter. From this model, maps of IDF parameters over Senegal are produced, providing a spatial vision of their organization over the country, with a north to south gradient for the location and scale parameters of the GEV. An influence of the distance from the ocean was found for the scaling parameter. It is acknowledged in conclusion that climate change renders the inference of IDF curves sensitive to increasing non-stationarity effects, which requires warning end-users that such tools should be used with care and discernment

A gel-based PCR method to differentiate sheeppox virus field isolates from vaccine strains

Abstract Background Sheeppox (SPP) and goatpox (GTP) caused by sheeppox virus (SPPV) and goatpox virus (GTPV), respectively of the genus Capripoxvirus in the family Poxviridae, are severely afflicting small ruminants’ production systems in Africa and Asia. In endemic areas, SPP and GTP are controlled using vaccination with live attenuated vaccines derived from SPPV, GTPV or Lumpy skin disease virus (LSDV). Sometimes outbreaks occur following vaccination. In order to successfully control the spread of the virus, it is essential to identify whether the animals were infected by the field strain and the vaccine did not provide sufficient protection. Alternatively, in some cases the vaccine strain may cause adverse reactions in vaccinated animals or in rare occasions, re-gain virulence. Thus, diagnostic tools for differentiation of virulent strains from attenuated vaccine strains of the virus are needed. The aim of this study was to identify an appropriate diagnostic target region in the capripoxvirus genome by comparing the genomic sequences of SPPV field isolates with those of the most widely used SPP vaccine strains. Results A unique 84 base pair nucleotide deletion located between the DNA ligase gene and the VARV B22R homologue gene was found only in SPPV vaccines derived from the Romanian and Yugoslavian RM/65 strains and absent in SPPV field isolates originated from various geographical locations of Asia and Africa. In addition, we developed and evaluated a conventional PCR assay, exploiting the targeted intergenic region to differentiate SPPV vaccine virus from field isolates. The assay produced an amplicon size of 218 bp for the vaccine strains, while the SPPV field isolates resulted in a 302 bp PCR fragment. The assay showed good sensitivity and specificity, and the results were in full agreement with the sequencing data of the PCR amplicons. Conclusion The developed assay is an improvement of currently existing diagnostic tools and, when combined with a capripox virus species-specific assay, will enhance SPP and GTP diagnosis and surveillance and facilitate epidemiological investigations in countries using live attenuated SPP vaccines. In addition, for laboratories with limited resources, the assay provides a simple and cost-effective alternative for sequencing