9 research outputs found
Plastron appendiculaire: intervention en urgence ou diffĂ©rĂ©e: Ă propos dâune sĂ©rie de 27 cas dans la clinique chirurgicale de lâHĂŽpital Aristide Le Dantec
Le but de notre Ă©tude Ă©tait dâĂ©valuer les rĂ©sultats du traitement chirurgicale du plastron appendiculaire aprĂšs appendicectomie diffĂ©rĂ©e ou immĂ©diate. Il sâagit dâune Ă©tude rĂ©trospective de type descriptif allant de Janvier 2000 au 31 DĂ©cembre 2007 portant sur 27 patients reçus et traitĂ©s pour plastron appendiculaire. Le diagnostic Ă©tait clinique par la prĂ©sence dâune masse Ă la fosse iliaque droite, Ă©chographique, ou per opĂ©ratoire. Tous les patients opĂ©rĂ©s en urgence ont Ă©tĂ© classĂ©s dans le groupe I et ceux opĂ©rĂ©s Ă froid, groupe II. Nous avons notĂ© 18 hommes et 9 femmes avec un sex-ratio homme /femme = 3. LâĂąge moyen de nos patients Ă©tait de 33 ans avec des extrĂȘmes de 19 et 57 ans. Les signes cliniques Ă©taient dominĂ©s par la douleur Ă la fosse iliaque droite et la fiĂšvre respectivement 25 (92,6%) et 15 (55,6%) des cas. Dans le groupe I, lâappendicectomie nâa pu ĂȘtre rĂ©alisĂ©e pour 7 patients (n = 15) dĂ» aux difficultĂ©s opĂ©ratoires. Dans les autres cas, lâappendicectomie Ă©tait possible au prix de lâĂ©largissement de lâincision de Mac Burney et une durĂ©e de sĂ©jour plus longue. Le groupe II a concernĂ© 12 patients (n = 12) avec 9 abords laparoscopiques et dans 3 cas, la voie de Mac Burney a Ă©tĂ© empruntĂ©e. Trois cas dâadhĂ©rences pĂ©ritonĂ©ales ont Ă©tĂ© notĂ©s lors de la coelioscopie. Lâappendicectomie Ă froid du plastron appendiculaire est un procĂ©dĂ© sĂ»r et efficace. Elle permet dâĂ©viter les cicatrices inesthĂ©tiques et les fistules digestives iatrogĂšnes. Lâappendicectomie immĂ©diate doit ĂȘtre abandonnĂ©e chez les patients porteurs de plastron appendiculaire car elle engendre beaucoup de morbiditĂ©
La fermeture prĂ©coce des stomies digestives: Ă propos de 66 cas colligĂ©s dans la clinique chirurgicale de lâHĂŽpital Aristide Le Dantec
La stomie constitue un véritable handicap dans nos régions. Nous reportons une série de patients bénéficiant d'un rétablissement précoce. Il s'agit d'une étude rétrospective descriptive sur une période de six ans. Elle concernait tous les patients qui avaient bénéficié dans le service de chirurgie générale du CHU Aristide Le Dantec de Dakar d'une fermeture de stomie dans un délai maximum de 30 jours. Il s'agissait de 66 patients: 43 colostomies et 23 ileostomies. Le délai moyen de rétablissement de la continuité digestive était de 21 jours. La morbidité était de 9% et la mortalité de 1,5%. Le rétablissement précoce de la stomie digestive est réalisable avec des résultats comparables au rétablissement conventionnel.Pan African Medical Journal 2016; 2
Feasibility of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa: First Evidence from Studies in Mali and Senegal
The control of onchocerciasis, or river blindness, is based on annual or six-monthly ivermectin treatment of populations at risk. This has been effective in controlling the disease as a public health problem, but it is not known whether it can also eliminate infection and transmission to the extent that treatment can be safely stopped. Many doubt that this is feasible in Africa. A study was undertaken in three hyperendemic onchocerciasis foci in Mali and Senegal where treatment has been given for 15 to 17 years. The results showed that only few infections remained in the human population and that transmission levels were everywhere below postulated thresholds for elimination. Treatment was subsequently stopped in test areas in each focus, and follow-up evaluations did not detect any recrudescence of infection or transmission. Hence, the study has provided the first evidence that onchocerciasis elimination is feasible with ivermectin treatment in some endemic foci in Africa. Although further studies are needed to determine to what extent these findings can be extrapolated to other areas in Africa, the principle of onchocerciasis elimination with ivermectin treatment has been established
Les bas-fonds dans le réseau hydrographique du fleuve Gambie : cartographie, régime hydrologique, valorisation agricole et typologie
Faisabilité et pertinence de la check-list de sécurité au bloc opératoire central du Centre Hospitalier Régional de Saint Louis du Sénégal
Introduction: La check-list (CL) de sĂ©curitĂ© au bloc opĂ©ratoire est un outil de qualitĂ© qui permet de rĂ©duire la morbimortalitĂ© pĂ©ri opĂ©ratoire. Câest une des exigences de la Haute AutoritĂ© de SantĂ© (HAS) française dans la procĂ©dure de certification des Ă©tablissements de santĂ©. Lâobjectif de ce travail est de rĂ©aliser une Ă©valuation quantitative et qualitative de lâutilisation de cet outil au sein du bloc opĂ©ratoire central du centre hospitalier RĂ©gional de Saint Louis. MĂ©thodes: Une Ă©valuation prospective des indicateurs de lâutilisation pratique de la check-list et de son apport dans lâamĂ©lioration des pratiques chirurgicales au bloc opĂ©ratoire du centre hospitalier rĂ©gional de Saint-Louis a Ă©tĂ© entamĂ©e depuis son lancement en mars 2016. RĂ©sultats: Le taux dâutilisation de la CL Ă©tait de 75%, le taux de conformitĂ© Ă©tait de 60%; le taux de renseignements Ă©tait de 99% pour les items prĂ©-induction, 93% pour les items prĂ©-incision et 88% pour les items postopĂ©ratoires. Seules 73% des CL analysĂ©es avaient Ă©tĂ© remplies avec une communication orale effective aux trois temps. La CL a permis de dĂ©tecter des dysfonctionnements matĂ©riels et/ou des Ă©vĂ©nements indĂ©sirables dans 15% des cas. Aucune erreur dâidentification de patient ni de cotĂ© opĂ©rĂ© ne furent objectivĂ©es dans notre Ă©tude. Conclusion: La CL participe au dĂ©veloppement de la culture de sĂ©curitĂ© dans les blocs opĂ©ratoires, et a dĂ©bouchĂ© sur la mise en place dâune cartographie des risques au bloc opĂ©ratoire. Certes importante, elle ne doit nĂ©anmoins pas ĂȘtre prĂ©sentĂ©e comme lâoutil magique pour Ă©viter les erreurs, mais sâintĂšgre dans lâamĂ©lioration de la qualitĂ© des soins avec dâautres programmes comme le signalement dâĂ©vĂšnements indĂ©sirables et les revues de morbi-mortalitĂ©s
Current clinical presentations of AIDS dementia in a tropical environment: study of 26 observations in the neurology department of the University Hospital of Conakry
Abstract Introduction In sub-Saharan Africa (SSA), the clinical and progressive diagnostic certainty of AIDS dementia is difficult to establish due to under-medicalization and delays in consultation and especially the diversity of etiologies of demented states. Material and methods We carried out a retrospective study of 196 patients hospitalized for dementia syndrome between 2016 and 2021 in the neurology department of the University Hospital of Conakry. The criteria labeled in this study are those retained by the DSM-IV and the classification of the American Academy of Neurology (AAN) developed in accordance with the WHO. Results HIV etiology was identified in patients aged 44â67Â years (17 women and 19 men). The clinical picture was dominated by severe cognitive disorders, slowed ideation, memory disorders and reduced motor skills associated with personality changes. Neurological examination revealed dysphoric disorders in most patients, sphincter abnormalities in 13 cases and labio-lingual tremor in 11 cases. Diagnosis was based on positive serological tests for HIV1 antibodies (25 cases) and HIV2 antibodies (1 case) using the Elisa and Western blot techniques, and the presence of discretely hypercellular CSF. Magnetic resonance imaging contributed to the diagnosis, showing diffuse white matter abnormalities with hyper signals on T2-weighted or FLAIR sequences. Conclusion This study shows a non-stereotype clinical picture of AIDS dementia requiring a differential diagnosis with other infectious dementias. These results are important for the therapeutic and prognostic discussion
The Impact of Six Annual Rounds of Mass Drug Administration on Wuchereria bancrofti Infections in Humans and in Mosquitoes in Mali
Are the Fouta Djallon Highlands Still the Water Tower of West Africa?
International audienceA large share of surface water resources in Sahelian countries originates from Guinea's Fouta Djallon highlands, earning the area the name of "the water tower of West Africa". This paper aims to investigate the recent dynamics of the Fouta Djallon's hydrological functioning. The evolution of the runoff and depletion coefficients are analyzed as well as their correlations with the rainfall and vegetation cover. The latter is described at three different space scales and with different methods. Twenty-five years after the end of the 1968-1993 major drought, annual discharges continue to slowly increase, nearly reaching a long-term average, as natural reservoirs which emptied to sustain streamflows during the drought have been replenishing since the 1990s, explaining the slow increase in discharges. However, another important trend has been detected since the beginning of the drought, i.e., the increase in the depletion coefficient of most of the Fouta Djallon upper basins, as a consequence of the reduction in the soil water-holding capacity. After confirming the pertinence and significance of this increase and subsequent decrease in the depletion coefficient, this paper identifies the factors possibly linked with the basins' storage capacity trends. The densely populated areas of the summit plateau are also shown to be the ones where vegetation cover is not threatened and where ecological intensification of rural activities is ancient