Cure de varicocèle sous anesthésie locale : Aspects techniques et faisabilité: Varicocele surgery under local anesthesia: technical aspects and feasibilty

Contexte et objectif. Au Sénégal, la chirurgie de la varicocèle, occupe une place non négligeable dans la prise en charge de l’infertilité masculine. Cette chirurgie connait une utilisation de plus en plus fréquente de la voie inguinale ou même sous inguinale. Cette modification progressive des habitudes a été l’origine de l’étude de la faisabilité et de la sécurité de l’anesthésie locale dans notre pratique. Méthodes. Dans une série des cas, trente-cinq (35) patients ayant donné leur consentement ont été opérés sous anesthésie locale selon le même protocole par les médecins de l’équipe. Résultats. L’âge moyen des patients était de 32,5 ± 8 ans (18-54 ans). Le motif de consultation le plus fréquent était l’infertilité du couple (62,9 %). Vingt-deux patients avaient une varicocèle bilatérale et treize une varicocèle unilatérale. Tous nos patients étaient classés ASA I. La moyenne de la durée d’intervention était de 22 ± 9,48 min. La moyenne du degré de la douleur pendant l’opération était à 1,37/10 selon l’EVA chez les 35 patients. Aucun incident peropératoire lié à l’anesthésie ou à un problème technique chirurgical n’a été observé. Après la chirurgie, 94,3% ont déclaré avoir été satisfait du geste. Conclusion. La pratique de la chirurgie ambulatoire sous anesthésie locale de la varicocèle offre une part importante dans la prise en charge de cette affection.  Context and objective. In Senegal, varicocele surgery occupies a significant place in the management of male infertility. This surgery is increasingly performed via the inguinal or even sub inguinal route. This gradual change in habits was the origin of the study of the feasibility and safety of local anesthesia in our practice. Methods. In a cross sectional study, thirty-five (35) patients who gave their consent underwent the surgery under local anesthesia according to a standardized protocol by the team’s doctors. Results. The average age of the patients was 32.5 ± 8 years (18-54 years). The most frequent reason for consultation was infertility in the couple (62.9%). Twenty-two patients had bilateral varicocele and thirteen had unilateral varicocele. All our patients were classified as ASA I. The average duration of the operation was 22 ± 9.48 min. The average degree of pain during the operation was 1.37/10 according to the Visual analog Scale in the 35 patients. No intraoperative incident related to anesthesia or a surgical technical problem was observed. After surgery, 94.3% said they were satisfied. Conclusion. The practice of outpatient surgery under local anesthesia for varicocele occupies an important part in the management of this condition

Enquête sur l’Importance des Ressources Végétales pour la Population Riveraine du Parc National de la Langue de Barbarie (Sénégal)

Les espèces végétales constituent une composante essentielle de la biodiversité. Ainsi au Sénégal plusieurs études ont été effectuées sur ces espèces. Cependant celles qui portent à la fois sur les ligneux et les herbacées sont rares. Ce travail a été réalisé entre 2012 et 2014 pour évaluer l’importance des ressources végétales pour la population riveraine du Parc National de la Langue de Barbarie (PNLB). Une enquête ethnobotanique basée sur un questionnaire a été réalisée. La valeur d’usage, le facteur de consensus et le niveau de fidélité ont été évalués. L’analyse des résultats montre que Prosopis glandulosa (1,05) présente la plus grande valeur d’usage suivie d’Acacia tortilis subsp raddiana (0,83). Les usages les plus courants sont l’alimentation humaine (19,90 %), l’usage médicinal (19,40 %) et l’alimentation animale (16,50 %). Les facteurs de consensus sont plus élevés pour l’alimentation humaine et l’usage médicinal. La flore médicinale utilisée par les riverains du PNLB est plus diversifiée avec 67 espèces réparties dans 32 familles et 56 genres. Elle est suivie de l’alimentation humaine avec 52 espèces réparties dans 32 familles et 45genres. Les résultats sur le niveau de fidélité des espèces aux catégories d’usages les plus citées montrent l’existence d’espèces à usages exclusifs avec 100% de niveaux de fidélité et d’espèces à usages multiples avec moins de 100% de niveau de fidélité. Le niveau de fidélité des espèces utilisées dans l’alimentation humaine, animale ainsi que dans la médecine traditionnelle et leur valeur d’usage sont corrélés négativement. Les ressources végétales sont importantes pour la population riveraine du Parc National de la Langue de Barbarie qui les utilise dans plusieurs catégories d’usages. Cependant une étude plus approfondie sur les espèces médicinales serait bénéfique pour l’humanité.   Plant species are an essential component of biodiversity. Thus in Senegal several studies have been carried out on these species. However, those relating to both ligneous and herbaceous plants are rare. This work was carried out between 2012 and 2014 to assess the importance of plant resources for the local population of the Thongue of Barbarism National Park (TBNP). An ethnobotanical survey based on a questionnaire was carried out. Analysis of the results shows that  Prosopis glandulosa (1.05) shows the highest use value followed by Acacia tortilis subsp raddiana (0.83). The most common use are food (19.90%), medicinal use (19.40%) and animal feed (16.50%). Consensus factor are highest for human food and medicinal use. The medicinal flora used by residents of the NPLB is more diversified with 67 species distributed in 32 families and 56 genera. The families most represented in this medicinal flora are the Fabaceae (22.38%), the Malvaceae (8.95%) and the Combretaceae (5.97%). It is followed by human food with 52 species divided into 32 families and 45 genera. The results on the level of fidelity of species to the most cited use categories show the existence of species for exclusive use with 100% fidelity levels and multiple use species with less than 100% fidelity level. The level of fidelity of species used in human and animal food as well as in traditional medicine and their use value are negatively correlated. Plant resources are important for the local population of the Thongue of Barbarism National Park who use them in several categories of uses. The importance of  plant resources for the population is well known. However, further study of medicinal species would be beneficial to mankind

Evolution of Agroclimatic Indicators in Senegal Using CMIP6 Simulations

Climate has a strong influence on agriculture, which is considered the most dependent human activity on climate variations. The future performance of the Senegalese agricultural sector will depend on its ability to adapt to the negative impacts of climate change. This study demonstrated that the impact of three climate change scenarios (ssp126, ssp245 and ssp585) on the evolution of 14 agro-climatic indicators is already evident in Senegal in the near and distant future. Indeed, the results obtained show a generalized decrease over the whole country in seasonal rainfall totals of about −10% in the near future (2020–2049; PSE horizon) up to −40% in the distant future (2070–2099) for the ssp585 scenario. This decrease in precipitation will be associated with two phenomena, namely a shortening of the rainy season due to increasingly late starts and an increase in dry spells, particularly the DSl and DSxl. The other trend observed is an increase in the frequency and intensity of extreme rainfall events (R99 and R20), which illustrates an increasingly chaotic distribution of rain in the future. Finally, this characterization of agroclimatic indicators made it possible to evaluate and classify the sensitivity of four global models corrected by the CFD-t method in order to run agronomic simulations and to explore adaptation strategies for farmer management in the future

Epidemiological, clinical, prognostic and therapeutic aspects of twin delivery in two referral maternity units in Dakar (Senegal)

Background: Twin pregnancy is the simultaneous development of two embryos and then two fetuses in the uterine cavity. Objective of present study was to assess the epidemiological, clinical, prognostic and therapeutic aspects of twin delivery in two referral maternity units in Dakar.Methods: A descriptive and analytical retrospective bi-centric study of all cases of twin deliveries recorded in two referral center in Dakar was conducted during the period January 1st, 2005-December 31st, 2015, i.e. an 11-year period. It concerned 619 pregnant women who gave birth to twins in these two referral medical structures. The epidemiological parameters, clinical, prognostic and therapeutic aspects of twin childbirth were studied. The data were entered and analysed using Epi info version 3.5.3.Results: The twinning prevalence was 1.11%. The majority of our parturient women (506 or 81.7% of the cases) came from the Dakar suburbs. The average age of the parturient women was 28 years and the gestity age 3.1. Pregnancy was well monitored for 98.5% of the parturient women with an average number of prenatal consultations of 3.6. The first prenatal consultation was performed in 52% of cases in the first quarter. In more than one third of cases (234 or 37.8%), the diagnosis was made in the third quarter of pregnancy. 113 cases (18.2%) of premature rupture of membranes, 10 cases (1.61%) of threat of premature delivery and 7 cases (11.13%) of placenta previa were registered. During labour, the diagnosis was made by clinical examination in 32.2% of cases. Bichorial biamniotic twin pregnancy was the most frequent anatomical type (62.6%). On admission, the first twin (T1) was in cephalic presentation in 56.7%, in breech presentation in 15.2%; The second twin (T2) was in breech presentation in 21.1% of the cases. Caesarean section was related to the first twin in 50.6% and the second twin in 53.8% of the cases. Caesarean section was performed in 50.6% for the first twin and in 53.8% for the second twin. The mean time interval between the delivery of T1 and that of T2 was 17.4 min. Low birth weight was more frequent for the second twin (54.3%). The stillbirth rate was 48.26 per thousand. Maternal complications were dominated by renal-vascular syndromes (4.2%), haemorrhagic causes (1.86%), perineal lesions (1.6%) and uterine rupture (0.97%). Postpartum haemorrhage was observed in 8 cases (1.29%). Maternal mortality was nilConclusions: Twin delivery poses varying difficulties due to the complexity of obstetrical mechanics and the frequency of dystocic presentations. Despite improved maternal prognosis, in recent years, perinatal mortality and morbidity, still high, remain a constant concern