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Compliance with Hand Hygiene among Health Professionals in the Medical-Surgical Emergency Department of the Donka National Hospital

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Open Journal of Internal Medicine 2022年第1期12卷 29-37页

作者： Sylla Djibril Kaké Amadou Camara Toumin Diakhaby Mamadou keita Mory Filany Sako Fodé Bangaly Medical and Surgical Emergency Department of the Donka National Hospital Conakry Guinea Internal Medicine Department of the Donka National Hospital Conakry Guinea Department of Infectious and Tropical Diseases of the Donka National Hospital Conakry Guinea

Introduction: The transmission of infectious agents through the hands of nursing staff during care is the main cause of nosocomial infections. Hand hygiene has been recognized for over a century as an effective measure to prevent healthcare associated infections in healthcare settings, the objective of this study was to appreciate the practice of hand hygiene during care by health professionals in the medical-surgical emergency department of the Donka National Hospital. Methods: It was a cross-sectional, analytical study. Data collection took place from March 1 to April 30, 2021. The study covered all health professionals, namely doctors, nurses, laboratory technicians, radiography technicians, pharmacists, students, stretcher bearers, surfactants who were present at the time of the study period. Results: During the study period, out of a total of 104 registered health professionals, we surveyed 99, which is a rate of 95%. The most represented age group was [30 - 39 years] with an average of 37.17 ± 10.34 years, and extremes of 22 years to 65 years. The male sex was the most dominant or 59.60% compared to the female sex or 40.40% with a sex ratio of 1.47. The hand hygiene compliance rate was low at 21%. The practice of hand hygiene during care for 100% of health professionals was very low, at 8.08%. No factors influence the observance of the practice of hand hygiene and the socio-professional characteristics of the conditions of provision of care activities. Conclusion: Hand hygiene during care is an essential aspect that must be considered as an essential measure in the prevention of infections in this period of the COVID-19 pandemic.

关键词： Hand Hygiene Compliance Health Professionals Donka Emergencies

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Recent evidence for subcutaneous drains to prevent surgical site infections after abdominal surgery:A systematic review and metaanalysis

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2879-2889页

作者： Tomohiro Ishinuki Hiroji Shinkawa keita Kouzu Seiichi Shinji Erika Goda Toshio Ohyanagi Masahiro Kobayashi Motomu Kobayashi Katsunori Suzuki Yuichi Kitagawa Chizuru Yamashita Yasuhiko Mohri Junzo Shimizu Motoi Uchino Seiji Haji Masahiro Yoshida Hiroki Ohge Toshihiko Mayumi Toru Mizuguchi Department of Nursing Surgical SciencesSapporo Medical UniversitySapporo 060-8556HokkaidoJapan Department of Hepatobiliary-Pancreatic Surgery Osaka Metropolitan University Graduate School of MedicineAbeno-Ku 545-0051Japan Department of Surgery National Defense Medical CollegeTokorozawa 359-8513Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical SchoolTokyo 113-8602Japan Department of Nursing Japan Health Care UniversitySapporo 062-0053Japan Department of Liberal Arts and Sciences Center for Medical EducationSapporo Medical UniversitySapporo 060-8556Japan Department of Clinical Pharmacokinetics Research and Education Center for Clinical PharmacyKitasato UniversityTokyo 108-8641Japan Department of Anesthesiology Hokushinkai Megumino HospitalEniwa 061-1395Japan Department of Infectious Disease Medicine School of MedicineUniversity of Occupational and Environmental HealthKitakyushu 807-8555Japan Department of Gastrointestinal Surgery National Center for Geriatrics and GerontologyObu 474-8511Japan Department of Anesthesiology and Critical Care Medicine Fujita Health UniversityToyoake 470-1192Japan Department of Gastrointestinal Surgery Mie Prefectural General Medical CenterYokkaich 510-8561Japan Department of Surgery Toyonaka Municipal HospitalToyonaka 560-8565Japan Department of Gastroenterological Surgery Hyogo Medical UniversityNishinomiya 663-8501Japan Department of Surgery Soseikai General HospitalKyoto 612-8473Japan Department of Hepato-Biliary-Pancreatic&Gastrointestinal Surgery International University of Health and WelfareIchikawa 272-0827Japan Department of Infectious Disease Hiroshima University HospitalHiroshima 734-8551Japan Department of Intensive Care Unit Chukyo HospitalJapan Community Health Care OrganizationNagoya 457-8510Japan

BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical impact in abdominal surgery remains unclear.AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.METHODS The database search used PubMed,MEDLINE,and the Cochrane Library.The following inclusion criteria were set for the systematic review:(1)Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains;and(2)Studies that described clinical outcomes,such as SSIs,seroma formation,the length of hospital stays,and mortality.RESULTS Eight studies were included in this meta-analysis.The rate of total SSIs was significantly lower in the drained group(54/771,7.0%)than in the control group(89/759,11.7%),particularly in gastrointestinal surgery.Furthermore,the rate of superficial SSIs was slightly lower in the drained group(31/517,6.0%)than in the control group(49/521,9.4%).No significant differences were observed in seroma formation between the groups.Hospital stays were shorter in the drained group than in the control group.CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation.The timing of drain removal needs to be reconsidered in future studies.

关键词： Abdominal surgery Mortality Seroma formation Subcutaneous drain Surgical site infections

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Contribution of Imaging in the Diagnosis and Management of Type 1 Autoimmune Pancreatitis Associated with Main Bile Duct Cholangitis: A Case Report

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Case Reports in Clinical Medicine 2022年第5期11卷 175-181页

作者： keita Aboubacar Sidiki Camara Mamoudou Diallo Mamadou Dembele Adama Bah Ousmane Aminata Cisse Mamadou Medical Imaging Department H&ocirc pital Nord Franche Comté Trévenans France Faculty of Health Sciences and Techniques the Gamal Abdel Nasser University of Conakry Conakry Guinea Medical Imaging Department Centre Hospitalier Intercommunal Elbeuf Louviers Elbeuf France Medical Imaging Department Centre Hospitalier de Blois Blois France

Introduction: Autoimmune pancreatitis type 1 (AIP) is a rare condition characterized by inflammatory and fibrosing involvement of the pancreas, associated with elevated serum IgG4 and potential involvement of other organs. It often mimics a malignant tumor with which the differential diagnosis is often difficult. Observation: We report a case of AIP type 1, in a 70-year-old patient, with a heavy history of arterial hypertension, insulin-induced type II diabetes, overweight, gastric ulcer, ischemic heart disease with triple bypass, COPD, revealed by intense abdominal pain and acute evolution. The diagnosis was evoked on imaging, in front of an aspect of “sausage pancreas”, with delayed contrast enhancement of the pancreas, loss of lobulations, and the presence of a fibrous peripancreatic shell. The biological and histological assessment confirmed the diagnosis and avoided inappropriate surgical treatment. Conclusion: AIP type 1 is a rare pathology whose diagnosis is difficult. Only a perfectly interpreted imagery can evoke it. The biological assessment, in particular, the elevation of the serum level of IgG4 and the histology make it possible to confirm the diagnosis. The challenge in its management is to avoid unnecessary surgery and/or inappropriate treatments. Imaging, in this context, plays a preponderant role, in particular, thanks to the dynamic injection sequences of gadolinium chelates on MRI which suggest the fibro-inflammatory nature of pancreatic lesions.

关键词： Autoimmune Pancreatitis CT MRI

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Ocular Manifestations in Severe Acute Malnutrition in Children under 60 Months in a Secondary Health Center

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Open Journal of Ophthalmology 2023年第3期13卷 288-294页

作者： Amadou Boro Foune keita Fatoumata Tata Sidibe Fatoumata Traore Daniel Thera Ibrahim Kourekama Abdoulaye Napo Centre de santé de référence de Kita Kita Mali Centre de santé de référence de Niono Niono Mali CHU-Institut d’Ophtalmologie Tropicale de l’Afrique (CHU-IOTA) Bamako Mali Libéral Doctor Bamako Mali

Introduction: Severe acute malnutrition (SAM) is one of the main public health problems in the world. It is responsible in addition to the general symptoms, vitamin A deficiency which can cause serious eye damage including keratomalacia. This work aims to study possible ophthalmological lesions in severely acutely malnourished children from 0 to 60 months. Patients and Method: This study was carried out in a secondary ophthalmology center. It concerned all severely acute malnourished patients admitted for consultation in the pediatric department. Results: A total of 174 eyes of 87 children aged 0 to 60 months were examined. Two-thirds of the patients were aged between 6 and 18 months. Palpebral lesions are rare, however, we observed 12.64% blepharitis and palpebral dermatitis. Ocular involvement due to vitamin A deficiency was 6.9%, including one case of BITOT SPOT, 4 cases of conjunctival xerosis and one case of keratomalacia. Conclusion: Xerophthalmia is an ocular lesion due to a dietary intake deficient in vitamin A that occurs during severe acute malnutrition. Its occurrence is increasingly rare even in developing countries. However, some cases are observed in practice and may be responsible for profound visual impairments.

关键词： Severe Malnutrition Vitamin A Deficiency Xerophthalmia Keratomalacia

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Otological Injuries Observed in Head and Neck Trauma in a Second-Line Hospital

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第3期11卷 119-125页

作者： Ghislaine Neuilly Ngniée Tafo Koné Fatogoma Issa Samaké Djibril Timbo Samba Karim keita Mohamed Reference Health Center of Commune I of Bamako (CSREF) Bamako Mali University Hospital (CHU) Gabriel Touré Bamako Mali Reference Health Center of Commune V of Bamako (CSREF) Bamako Mali

Otological injuries are common during cervicofacial trauma. The aim of this study is to describe the epidemiological characteristics and to map otological injuries during head and neck trauma. This was an observational, descriptive, prospective study conducted at the ENT unit of the Referral Health Center Hospital in Mali from January 2017 to September 2018. Patients with middle and/or inner ear injuries due to trauma were included. The prevalence of otologic injuries was 34.54% of cases. The mean age was 25 years and the sex ratio was 1.11. Students accounted for 42.10%. The mechanism of occurrence was an intentional assault in 68.42% of the cases followed by road traffic accidents (15.79%). The most common functional signs were hearing loss (68.42%), tinnitus (57.89%), and facial paralysis in 5.26%. Otoscopy showed tympanic perforation (47.83%), otorrhagia (21.05%) and otoliquorrhea (5.26%). Rock fractures with osteodural breach (10.53%) and pneumencephaly were found on a CT scan of the rock. The evolution was marked by the regression of the facial paralysis and the healing of the tympanum in 45.45% of the cases. Sequelae persisted in the form of sensorineural deafness (17%). The otological lesions observed during cervicofacial trauma are varied. The challenges in our context are felt at three levels: the improvement of the technical platform, the long-term follow-up of patients, and the cost of care in terms of equipment. These lesions are responsible for disabling deafness, a source of difficulty in social and school integration.

关键词： Otological Lesions Trauma Sequelae Hearing Loss Disability

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Iatrogenic Urethral Stenoses: Epidemiological Aspects Clinics and Therapeutic in the Urology Department of the National Hospital of Conakry

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Open Journal of Urology 2023年第1期13卷 36-47页

作者： Demba Cisse Youssouf keita Fode Oumar keita Mamadou II Barry Alimou Diallo Thierno Mamadou Oury Diallo Mamadou Diawo Bah Mamadou Bissiriou Bah Alpha Oumar Barry Daouda Kante Ibrahima Bah Oumar Raphiou Bah The Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea

The aim is to highlight the epidemiological, clinical and therapeutic aspects of iatrogenic urethral strictures. Methodology: This was a retrospective study, descriptive type, 6 years from January 1st 2012, to December 31st 2017 carried out in the Urology-Andrology department of the National Hospital Ignace Deen of Conakry. All records of patients carrying the Diagnosis of iatrogenic urethral stricture were included in this study. Results: We collected 30 cases of iatrogenic urethral stricture, with a frequency of 2.5%. The average age of the patients was 62.33 years. The most affected age group is from 71 to 80 years (33.33%). Dysuria was the main reason for consultation. Retrograde urethrocystography plus voiding cystourethrography (RUC-VCU) allowed us to make the diagnosis. The treatment was essentially surgical and several techniques were used. Endoscopic internal urethrotomy alone was the most performed surgical technique, followed by segmental uretrectomy associated with end-to-end urethrography. Conclusion: Iatrogenic urethral stricture is easy to diagnose but difficult to manage due to the frequency of recurrences. Improving the quality of care, in particular urethral catheterizations and transurethral endoscopic maneuvers, makes it possible to prevent it.

关键词： Stenosis Urethra Iatrogenic Conakry

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Management of Tracheal Stenosis in Sub-Saharan Medicalized Context: Real Challenge about Two Clinical Cases

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第3期12卷 151-162页

作者： Kassim Diarra Demba Coulibaly Nfaly Konaté Boubacary Guindo Adama Coulibaly Mahamadou Sidibé Adama Dao Naoma Cissé Fatogoma Issa Koné Kalifa Coulibaly Youssouf Sidibe Siaka Soumaoro Moussa Bourama keita Doumbia Kadidiatou Singaré Mohamed Amadou keita ENT and Head and Neck Surgery Department University Hospital Center “Gabriel Touré” Bamako Mali Department of Anesthesia Resuscitation University Hospital Center Gabriel Toure Bamako Mali Imaging Department University Hospital Center “Gabriel Touré” Bamako Mali ENT and Head and Neck Surgery Department University Hospital Center “Le Luxembourg” Bamako Mali

Introduction: Post-intubation tracheal stenosis (STPI) is a complication of ventilatory assistance by intubation and/or tracheotomy. Her frequency is estimated between 10% to 20%. The treatment of choice remains surgery. It is based on tracheal resection-anastomosis which guarantees satisfactory and reliable long-term results. Objectives: To determine the frequency of post-intubation tracheal stenosis, to specify the diagnostic and therapeutic methods, to determine the complications and the evolution. Material and methods: This was a study carried out in the ENT and head and neck surgery department of the University Hospital Center Gabriel TOURE. Our study focused on two (02) cases of post-intubation tracheal stenosis (STPI) collected during a period of 1 year (January 2021 to December 2021). Results: They are all acquired, secondary to an intubation. The two (02) cases benefited from a tracheal anastomosis resection, the indications of which were specified and the results and complications evaluated. Conclusion: Our results show that resection anastomosis remains the reference treatment for STPI.

关键词： Tracheal Stenosis Intubation Tracheostomy

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Immunologic Thrombocytopenic Purpura Associated with Helicobacter Pylori Infection: A Case Report from Senegal

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Open Journal of Blood Diseases 2022年第4期12卷 98-102页

作者： Mohamed keita Mouhamed Dieng Serigne Saliou Mbacké Ibrahima Thioune Mouhamadou Sidibé Baidy Sy Kane Clinical Hematology Unit of the National Blood Transfusion Center Dakar Senegal Internal Medicine Department of Aristide Le Dantec Hospital Dakar Senegal Department of Neurology CHU Fann Dakar Senegal Department of Nephrology Aristide Le Dantec Hospital Dakar Senegal Hepato-Gastroenterology Department of Aristide Le Dantec Hospital Dakar Senegal

We present a 27-year-old female patient received for epistaxis associated with gingivorrhagia. In her medical history, she had undergone an oesogastroduodenal fibroscopy one year earlier, which revealed a bulbar ulcer with gastritis. On admission, she presented with a bleeding syndrome, an anemic syndrome with poor hemodynamic tolerance, and epigastric sensitivity. The blood count performed in the emergency on the citrate tube showed a bicy-topenia (regenerative anemia + thrombocytopenia). The HELIKIT test was positive. Thus, the hypothesis of an acute immunological thrombocytopenic purpura associated with a Helicobacter pylori infection seemed to us the most probable with a Khellaf hemorrhagic score of 8. She had benefited from a bolus of methyl prednisone: 15 mg/kg/day for 3 days then relay per os with prednisone 1 mg/kg/day (and adjuvant treatment);the eradicating treatment of Helicobacter pylori had been simultaneously started.

关键词： Immunological Thrombocytopenic Purpura Helicobacter Pylori Corticosteroids

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Occult hepatitis B virus infection and surgical outcomes in non-B, non-C patients with curative resection for hepatocellular carcinoma

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World Journal of Hepatology 2017年第35期9卷 1286-1295页

作者： Hiroki Koga keita Kai Shinichi Aishima Atsushi Kawaguchi Koutaro Yamaji Takao Ide Junji Ueda Hirokazu Noshiro Department of Surgery Saga University Faculty of Medicine Department of Pathology Saga University Hospital Department of Pathology and Microbiology Saga University Faculty of Medicine Center for Comprehensive Community Medicine Saga University Faculty of Medicine

AIM To investigate the prevalence, clinicopathological characteristics and surgical outcomes of occult hepatitis B virus(HBV) infection(OBI) in patients with non-B, non-C(NBNC) hepatocellular carcinoma(HCC).METHODS This study retrospectively examined the cases of 78 NBNC patients with curative resection for HCC for whom DNA could be extracted from formalin-fixed paraffin-embedded tissue. OBI was determined by the HBV-DNA amplification of at least two different sets of primers by TaqM an realtime polymerase chain reaction. Possibly carcinogenetic factors such as alcohol abuse, diabetes mellitus, obesity and non-alcoholic steatohepatitis(NASH) were examined. Surgical outcomes were evaluated according to diseasefree survival(DFS), overall survival(OS) and diseasespecific survival(DSS).RESULTS OBI was found in 27/78 patients(34.6%) with NBNC HCC. The OBI patients were significantly younger than the non-OBI cases at the time of surgery(average age 63.0 vs 68.1, P = 0.0334) and the OBI cases overlapped with other etiologies significantly more frequently compared to the non-OBI cases(P = 0.0057). OBI had no impact on the DFS, OS or DSS. Only tumorrelated factors affected these surgical outcomes.CONCLUSION Our findings indicate that OBI had no impact on surgical outcomes. The surgical outcomes of NBNC HCC depend on early tumor detection; this reconfirms the importance of a periodic medical examination for individuals who have NBNC HCC risk factors.

关键词： Hepatocellular carcinoma Non-B non-C Occult hepatitis B virus infection Surgery Surgical outcome

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Didactic surgical experience of thyroid metastasis from renal cell carcinoma: A case report

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World Journal of Clinical Cases 2018年第15期6卷 1018-1023页

作者： Moriyasu Yamauchi keita Kai Natsuko Shibamiya Rintaro Shimazu Mikio Monji Kumiko Suzuki Hiroaki Kakinoki Shohei Tobu Yuichiro Kuratomi Department of Otolaryngology Head and Neck Surgery Saga University Faculty of Medicine Department of Pathology Saga University Hospital Department of Urology Saga University Faculty of Medicine

BACKGROUND The optimal therapeutic strategy in treating thyroid metastasis from renal cell carcinoma(RCC) has not been clearly established. Here we describe a case of didactic surgical experience of the disease which caused massive intraoperative bleeding.CASE SUMMARY A 59-year-old male patient presented with a thyroid left lobe soft mass detected by chest computed tomography scans prior to the surgical treatment of RCC of the left kidney. The thyroid mass was initially considered to be benign, then he underwent left radical nephrectomy. One year after the nephrectomy, stereotactic radiosurgery was performed for brain metastasis. During follow-up, the thyroid nodule gradually grew, and the patient manifested swallowing discomfort. Under a clinical diagnosis of thyroid follicular neoplasm, left hemithyroidectomy was performed. Although hemithyroidectomy is usually a safe and straightforward procedure, massive bleeding from markedly developed tumor vessels made the operation very difficult. The thyroid tumor was finally diagnosed as metastasis from clear cell RCC. CONCLUSION For proper timing of the surgery, a clinician should take into consideration the possibility of thyroid metastasis of RCC when a thyroid lesion is found in patients with RCC or in patients with a previous history of RCC. We recommend that thyroid metastasis of RCC should be resected as early as possible even if a patient has other metastatic sites.

关键词： Renal cell carcinoma Thyroid metastasis Hemorrhage Thyroidectomy Case report

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