La gangrène de Fournier compliquant un empalement

La gangrène de Fournier (GF) est une fasciite bactérienne nécrosante rapidement progressive du périnée et des organes génitaux externes. Elle est secondaire à une infection polymicrobienne. Elle représente une urgence médico-chirurgicale nécessitant une prise en charge multidisciplinaire. L'étiologie est identifiée dans 95% des cas. La source de l'infection est cutanée, urogénitale ou colorectale. Des facteurs favorisants, comme l'âge, le diabète et l'immunodépression, sont souvent présents. La clinique est fulminante. La mortalité reste élevée, de l'ordre de 20 à 80%, souvent en raison du retard de diagnostic et de prise en charge. Nous rapportons l'observation d'un patient de 44 ans sans antécédents, maçon, qui avait présenté un empalement anorectal accidentel sur une tige de fer à béton. Il a été vu dans un hôpital régional où il a eu simplement des soins locaux. Trois jours plus tard, il consulte pour douleur périnéale. Il était fébrile à 40°C, son état général était très altéré avec tendance au collapsus. Il existait un érythème périnéal, périanal et du scrotum avec des crépitations neigeuses à la palpation. La plaie périanale faisait sourdre du pus de couleur jaune verdâtre et d'odeur nauséabonde. Le diagnostic de GF a été retenu. Une rééquilibration hydro-électrolytique, avec une antibiothérapie à large spectre suivie rapidement par un débridement chirurgical agressif ont été réalisées. A l'exploration, il exsistait une plaie rectale sus-anale qui a été suturée et protégée par une colostomie qui sera fermée six mois plus tard. Des soins locaux ont permis une cicatrisation dirigée obtenue au bout de 3 mois

Experimental study on the reuse of a dredging sludge from west of Algeria in brick fabrication

The siltation as a natural phenomenon threatens the performance of harbors by reducing their docking volume compared to dams in terms of water storage, as well as their life span. An alarming rate of siltation is noted in the various basins requires an urgent cleaning operations. In a context of valorization of the sludge resulted from the dredging operations of the basins of the Oran’s port and those of the Bouhanifia’s dam which are  located in Western Algeria, it is a question of studying possibilities which are offered by the use of these vases in the design of bricks building. The followed methodology is based on a physicochemical and mineralogical characterization of the two vases to reveal the one closest to the standards recommended for the manufacture of the baked brick. After analyzing sediments dredged in the port of Oran, it turned out that there is a dominance of sandy sediments, which are not recoverable in the areas of bricks we have targeted. Sustainability tests were performed on several sludge dam samples at different temperatures and percentages of water. The results gave a satisfaction in mechanical strength and durability for a firing temperature of 850 ° C and a percentage of water of 20%

Evaluation de la formation des résidents en chirurgie générale et digestive en Tunisie

Introduction: De nombreux moyens sont mis à disposition des résidents en chirurgie générale et  digestive pour assurer leur formation théorique et pratique. Cependant, le niveau d'utilisation de ces différents outils et leur impact sur la formation des résidents n'ont jamais été évalués. L'objectif de notre étude était d'étudier l'état des lieux des moyens de formation utilisés par les résidents pour évaluer leurs degrés de satisfaction et leurs propositions en vue d'améliorer leur formation. Méthodes: Un questionnaire anonyme a été distribué aux résidents de chirurgie générale et digestive de l'année  2012-2013. Ce questionnaire portait sur les caractéristiques démographiques, les ressources   pédagogiques, ainsi que le cursus médical et universitaire. Une évaluation de la formation ainsi qu'un  recueil des propositions faites en vue d'améliorer leurs formations étaient réalisées.Résultats: Cinquante résidents sur 83 ont répondu au questionnaire. L'orientation de carrière la plus  fréquente était l'hospitalouniversitaire dans 70% des cas. La pratique quotidienne et l'internet étaient les deux ressources pédagogiques les plus utilisées. La formation chirurgicale était jugée satisfaisante par  seulement 10% des répondants. Parmi l'ensemble des propositions faites, l'apprentissage sur simulateurchirurgical, l'existence d'un ouvrage national de référence, et l'institution d'un tutorat par un chirurgien  senior recueillaient plus de 80% d'avis favorable.Conclusion: La majorité des résidents jugent leur formation non satisfaisante. Une meilleure information sur les ressources déjà existantes, un renforcement du compagnonnage et un accès plus large à un  apprentissage sur simulateur chirurgical permettraient de diminuer ce sentiment d'insatisfaction.Key words: Résidanat, chirurgie, pédagogie médicale, formation, recherch

Experimental study on the reuse of a dredging sludge from west of Algeria in brick fabrication

The siltation as a natural phenomenon threatens the performance of harbors by reducing their docking volume compared to dams in terms of water storage, as well as their life span. An alarming rate of siltation is noted in the various basins requires an urgent cleaning operations. In a context of valorization of the sludge resulted from the dredging operations of the basins of the Oran’s port and those of the Bouhanifia’s dam which are  located in Western Algeria, it is a question of studying possibilities which are offered by the use of these vases in the design of bricks building. The followed methodology is based on a physicochemical and mineralogical characterization of the two vases to reveal the one closest to the standards recommended for the manufacture of the baked brick. After analyzing sediments dredged in the port of Oran, it turned out that there is a dominance of sandy sediments, which are not recoverable in the areas of bricks we have targeted. Sustainability tests were performed on several sludge dam samples at different temperatures and percentages of water. The results gave a satisfaction in mechanical strength and durability for a firing temperature of 850 ° C and a percentage of water of 20%

Experimental study on the reuse of a dredging sludge from west of Algeria in brick fabrication

The siltation as a natural phenomenon threatens the performance of harbors by reducing their docking volume compared to dams in terms of water storage, as well as their life span. An alarming rate of siltation is noted in the various basins requires an urgent cleaning operations. In a context of valorization of the sludge resulted from the dredging operations of the basins of the Oran’s port and those of the Bouhanifia’s dam which are  located in Western Algeria, it is a question of studying possibilities which are offered by the use of these vases in the design of bricks building. The followed methodology is based on a physicochemical and mineralogical characterization of the two vases to reveal the one closest to the standards recommended for the manufacture of the baked brick. After analyzing sediments dredged in the port of Oran, it turned out that there is a dominance of sandy sediments, which are not recoverable in the areas of bricks we have targeted. Sustainability tests were performed on several sludge dam samples at different temperatures and percentages of water. The results gave a satisfaction in mechanical strength and durability for a firing temperature of 850 ° C and a percentage of water of 20%

Literature Review: Clinical Data Interoperability Models

peer reviewedA medical entity (hospital, nursing home, rest home, revalidation center, etc.) usually includes a multitude of information systems that allow for quick decision-making close to the medical sensors. The Internet of Medical Things (IoMT) is an area of IoT that generates a lot of data of different natures (radio, CT scan, medical reports, medical sensor data). However, these systems need to share and exchange medical information in a seamless, timely, and efficient manner with systems that are either within the same entity or other healthcare entities. The lack of inter- and intra-entity interoperability causes major problems in the analysis of patient records and leads to additional financial costs (e.g., redone examinations). To develop a medical data interoperability architecture model that will allow providers and different actors in the medical community to exchange patient summary information with other caregivers and partners to improve the quality of care, the level of data security, and the efficiency of care should take stock of the state of knowledge. This paper discusses the challenges faced by medical entities in sharing and exchanging medical information seamlessly and efficiently. It highlights the need for inter- and intra-entity interoperability to improve the analysis of patient records, reduce financial costs, and enhance the quality of care. The paper reviews existing solutions proposed by various researchers and identifies their limitations. The analysis of the literature has shown that the HL7 FHIR standard is particularly well adapted for exchanging and storing health data, while DICOM, CDA, and JSON can be converted in HL7 FHIR or HL7 FHIR to these formats for interoperability purposes. This approach covers almost all use cases

Open Phytotron: A New IoT Device for Home Gardening

Phytotron also called growth chambers are research installations where environmental parameters such as temperature, humidity, irrigation, conductivity, lighting, and CO2 are finely controlled. This kind of installation allows us on one hand to measure the impact of environment change and on the other hand to optimize the natural grow of plants. With the democratization of the materials, cloud computing and new possibilities offered by Internet of Things (IoT). Therefore, it is possible to develop a low-cost personal phytotron. In this paper, we propose to use connected things to develop a personal growth chamber with the aim to produce fresh vegetable in urban context

RevoCampus: a distributed open source and low-cost smart campus

Campus can be assimilate to small smart cities in which learning experience and living condition are improved by smart environment and IoT. In this paper, we present (R)evoCampus our Smart Campus solution based diverted smart Home interoperable protocol platforms, micro controllers ESP32, low-cost sensors. This architecture uses at same time principles of IoT, smart environment technologies, and smart city concepts to develop an effective use of the resources and improve the quality of life inside the whole university. Wi-Fi protocol is used for communication in indoor while outdoor communications are ensured by LoRaWAN protocol

Smart Nest Box: IoT Based Nest Monitoring In Artificial Cavities

With climate change, habitat loss, and impoverishment of food sources, several species of bird are are threatened today. It is crucial to conserve the biodiversity in ecosystems but the conservation that requires an improved knowledge of these