Surgical treatment of trochanteric fractures: An Ivorian experience

Background: Trochanteric fractures have become a major focus of orthopaedic interest. Surgical management is the best option for treating such fractures. Objective: To present our experience with the surgical treatment of trochanteric fractures with special attention to short-term results. Design: A retrospective study performed between 1993 and 2002. Setting: Department of orthopaedics surgery, Yopougon teaching hospital, Abidjan, Côte d'Ivoire. Patients and methods: There were 48 men and 17 women with a mean age of 44 years at the moment of the injury. Road traffic accident was the main cause of fractures accounting for 42 cases. Mean preoperative delay was 22 days. Surgical implants used were the Judet screw plate and Küntscher nail. Results: Postoperative death occurred in three cases. Fracture healing was achieved in 57 patients at an average of four months. Malunion and displacement into varus was noticed in 11.7% of patients. Infection occurred in seven patients, wound hematoma in eight and decubital ulcer in five. Conclusions: Trochanteric fractures in our environment are caused by severe trauma. These injuries could be managed surgically with simple methods that are readily available with immediate satisfactory outcome. Keywords: trochanteric fractures, surgical care Judet screw plate, Küntscher nail, complications Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 187–19

Pandemic influenza control in Europe and the constraints resulting from incoherent public health laws

© 2010 Martin et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: With the emergence of influenza H1N1v the world is facing its first 21st century global pandemic. Severe Acute Respiratory Syndrome (SARS) and avian influenza H5N1 prompted development of pandemic preparedness plans. National systems of public health law are essential for public health stewardship and for the implementation of public health policy[1]. International coherence will contribute to effective regional and global responses. However little research has been undertaken on how law works as a tool for disease control in Europe. With co-funding from the European Union, we investigated the extent to which laws across Europe support or constrain pandemic preparedness planning, and whether national differences are likely to constrain control efforts. Methods: We undertook a survey of national public health laws across 32 European states using a questionnaire designed around a disease scenario based on pandemic influenza. Questionnaire results were reviewed in workshops, analysing how differences between national laws might support or hinder regional responses to pandemic influenza. Respondents examined the impact of national laws on the movements of information, goods, services and people across borders in a time of pandemic, the capacity for surveillance, case detection, case management and community control, the deployment of strategies of prevention, containment, mitigation and recovery and the identification of commonalities and disconnects across states. Results: Results of this study show differences across Europe in the extent to which national pandemic policy and pandemic plans have been integrated with public health laws. We found significant differences in legislation and in the legitimacy of strategic plans. States differ in the range and the nature of intervention measures authorized by law, the extent to which borders could be closed to movement of persons and goods during a pandemic, and access to healthcare of non-resident persons. Some states propose use of emergency powers that might potentially override human rights protections while other states propose to limit interventions to those authorized by public health laws. Conclusion: These differences could create problems for European strategies if an evolving influenza pandemic results in more serious public health challenges or, indeed, if a novel disease other than influenza emerges with pandemic potential. There is insufficient understanding across Europe of the role and importance of law in pandemic planning. States need to build capacity in public health law to support disease prevention and control policies. Our research suggests that states would welcome further guidance from the EU on management of a pandemic, and guidance to assist in greater commonality of legal approaches across states.Peer reviewe

Bilan D’activités De 10 Ans De Pratique D’endoscopie Urologique Au Niger : Résultats, Défis Et Perspectives

But: Rapporter les résultats de la pratique d’endoscopie urologique au Niger, recenser les défis et annoncer les perspectives. Matériels et Méthodes : Il s’agit d’une étude descriptive rétrospective allant du 1er janvier 2010 au 31 décembre 2019 portant sur les dossiers des patients ayant bénéficié de procédures endoscopiques urologiques. L’étude s’est déroulée sur quatre sites du pays qui disposaient de matériel endoscopique urologique. Les paramètres sont : les caractéristiques sociodémographiques des patients, le type de procédure endoscopique, les indications, les résultats. Résultat: Au total 5806 gestes chirurgicaux dont 535 procédures endoscopiques ont été réalisés sur la période d’étude. Treize (13) dossiers incomplets ont été exclus. Les activités endoscopiques constituaient 9,21% de l’ensemble des activités chirurgicales. L’âge moyen des patients était de 49,60 ans avec un écart type de 18,15 et la tranche d’âge [41-60 ans] était la plus représentée avec 36,21%. Le sexe ratio était de 2,4 en faveur de l’homme. L’endoscopie était diagnostique dans 90,04%. L’urétrocystoscopie était la procédure la plus pratiquée (88,70%) suivie de l’urétrotomie interne endoscopique (UIE) (4,21%). La résection trans urétrale de la prostate (RTUP) et la résection trans urétrale de la vessie (RTUV) représentaient respectivement 0,96% et 1,34%. Les principales indications de l’urétrocystoscopie étaient l’hématurie avec 245 cas soit 52,91% suivie des SBAU avec 113 cas soit 24,40%. Les résultats de l’urétrocystoscopie étaient dominés par les tumeurs de vessie (31,10%) ; l’hypertrophie prostatique (17,71 %). Conclusion : L’urétrocystoscopie domine la pratique de l’endoscopie au Niger. Le véritable problème demeure le manque de matériels d’où la nécessité d’équiper les différents services d’urologie du pays. Aim: To report the results of the practice of urological endoscopy in Niger, identify the challenges, and to announce the prospects. Materials and Methods: This is a retrospective descriptive study from January 1, 2010 to December 31, 2019 on the records of patients who underwent urological endoscopic procedure. The study took place at four sites across the country that had urologic endoscopic equipment. The parameters studied were: the sociodemographic characteristics of the patients, the type of endoscopic procedure, the indications, and the results. Results: A total of 5,806 surgical procedures, including 535 endoscopic procedures, were performed over the study period. Thirteen (13) incomplete files were excluded. Endoscopic activities constituted 9.21% of all surgical activities. The mean age of the patients was 49.60 years with a standard deviation of 18.15 and the age group [41-60 years] was the most represented with 36.21%. The sex ratio was 2.4 in favor of the male. Endoscopy was diagnostic in 90.04%. Urethrocystoscopy was the most frequently performed procedure (88.70%) followed by endoscopic internal urethrotomy (EIU) (4.21%). Transurethral resection of the prostate TURP and transurethral resection of the bladder (TURB) accounted for 0.96% and 1.34%, respectively. The main indications for urethrocystoscopy were hematuria with 245 cases (52.91%), followed by lower urinary tract symptoms (LUTS) with 113 cases (24.40%). Urethrocystoscopy findings were dominated by bladder tumors (31.10%) and prostatic hypertrophy (17.71%). Conclusion: Urethrocystoscopy dominates the practice of endoscopy in Niger. The real problem remains the lack of materials. Hence, there is the need to equip the various urology services in the country

Limb Amputations in Adults in an Ivorian Teaching Hospital

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Ipsilateral dislocation of the shoulder and elbow: A case report

Ipsilateral dislocation of the shoulder and elbow is uncommon. Shoulder dislocation is often misdiagnosed on admission. We report the case of an 31-year old male whose dislocations were both recognised at the initial examination. Diagnosis pitfalls, mechanism, and management of this rare injury are reviewed. Keywords: dislocation, elbow, ipsilateral Nigerian Journal of Surgical Research Vol. 7(3&4) 2005: 319-32

Medial subtalar dislocation: Approach to prompt care

A 27- year old female patient suffered from a closed medial subtalar dislocation treated by conservative means. This relatively rare injury is reported to outline the problems encountered in diagnosis and management of such troublesome pattern of dislocation in developing countries. Keywords: dislocation, peritalar, subtalar, developing countries Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 196–19