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Postoperative Analgesia for Abdominal Laparoscopic Surgery: Tap Block vs Peri-Orificial Infiltrations

Open Journal of Anesthesiology 2023年第10期13卷 187-196页

作者： Moustapha Diedhiou Ndiamé Sarr elhadji boubacar ba Abdourahmane Ndong Fallou Galass Niang Jacques Noel Tendeng Ibrahima Konaté Mohamed Lamine Fall Health Sciences Training and Research Unit (UFRSS) Gaston Berger University Saint Louis Senegal Faculty of Medicine and Pharmacy Cheikh Anti Diop University Dakar Senegal

Introduction/Purpose: The “transverse abdominal plane block” or TAP block was described by Rafi in 2001. It describes an approach to the neurofascial plane of the transverse abdominal muscle via the Jean-Louis Petit triangle and provides analgesia of the entire homolateral hemi abdomen. The aim of our study was to compare post-operative analgesia and post-operative morphine requirements between transverse abdominal plane block (TAP) and peri-orificial infiltration during laparoscopic abdominal surgery. Material and method: Prospective, randomized study conducted over a 2-year period. The study was conducted in the operating theatre of the Saint Louis Regional Hospital in Senegal. All adult patients undergoing laparoscopic abdominal surgery were included. Clinical aspects, pain scales and morphine consumption were analyzed. Results: A total of 60 patients were enrolled: 30 patients in the TAP group and 30 patients in the infiltration group. The average age was 32.9 years. The indications for laparoscopy were acute appendicitis in 50% of cases, gallbladder stones in 16% and inguinal hernia in 8%. For the TAP group, the mean numerical pain scale was 3.9 at 6 hours post-operatively and 2.1 at 24 hours post-operatively. For the infiltration group, the mean numerical pain scale was 4.3 at 6 hours post-op and 3 at 24 hours post-op. Morphine consumption at 6 hours post-op was on average 0.4 mg/patient for the TAP group and 0.9 mg/patient for the infiltration group. Discussion/conclusion: Analgesia provided by ultrasound-guided TAP block for laparoscopic abdominal surgery appears to be identical to periorificial infiltration. However, the simplicity and reproducibility of ultrasound-guided TAP block gives it a definite advantage.

关键词： Loco-Regional Anesthesia Post-Operative Analgesia Infiltrations Laparoscopy TAP-Block

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Acute Leukemia in Niger: Epidemiological, Diagnostic and Therapeutic Aspects

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Open Journal of Blood Diseases 2024年第3期14卷 81-90页

作者： Amadou Djibrilla-Almoustapha badé Malam-Abdou Abdourahamane Yacouba Moussa Souley Moustapha Maman Brah Moustapha elhadji-Chefou boubacar Marou-Soumana Samaila Aboubacar Ousseini Fanta Maman Rabiou badé Oumarou Adamou-Chaibou Department of Hematology-Oncology National Hospital of Niamey Niamey Niger Faculty of Health Sciences University of Abdou Moumouni Niamey Niger Department of Medicine Zinder Hospital Regional Niger Departtment of Biology Amirou Boubacar Diallo National Hospital Niamey Niger Faculty of Health Sciences University of Dan Dicko Dankouloudo of Maradi Maradi Niger Laboratory of Biology National Hospital of Niamey Niamey Niger

Objective: Improve the care of patients followed for acute leukemia in the Oncohematology department of the National Hospital of Niamey. Methods: This was a prospective study, over a period of 2 years from January 1, 2018 to December 31, 2019, in patients with acute leukemia in the Oncohematology department of the National Hospital of Niamey (HNN), whose diagnosis was made on a blood smear associated with a myelogram and immunophenotyping and who were consenting. Results: We collected 25 cases of acute leukemia confirmed by myelogram and immunophenotyping. The mean age of the patients was 31.32 years, with a predominance of women, a sex ratio of 0.92. Pupils and students were in the majority with 40% and most came from the Niamey region, i.e. 68%. Anemic syndrome was the most common clinical sign in 96%. ALL predominated in 64% of cases. On the blood count, the hyperleukocytosis was more marked in AML (mean white count: 197256.6 elts/mm3) than in ALL (137891.6 elts/mm3), it was the same for thrombocytopenia which is more marked in AML (75588.89/mm3) than in ALL (52156.25/mm3). Therapeutically, 52% of patients received chemotherapy. The mean overall survival was 16.223 ± 3.191 months, including a mean survival for AML of 6.853 ± 1200 months compared to 21.720 ± 5.920 months for ALL. Conclusion: Acute leukemia still remains a major problem in our context, due to the precariousness of limited financial, diagnostic and therapeutic resources. Thus reflecting in our results, the increasing number of cases, the diagnostic delay and the guarded prognosis. This is the reality in several other countries in the sub-region and even in certain developed countries.

关键词： Acute Leukemia ALL AML Hematology-Niamey National Hospital (HNN) Niger

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Focal Segmantal Glomerulosclerosis: Epidemiological, Clinico-Biological, Pathological, Etiological, Therapeutic and Evolutionary Profiles in Dakar

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Open Journal of Nephrology 2023年第2期13卷 174-195页

作者： Pierre Eric Gandzali Ngabe Djibrilla Bonkano baoua Aida Habi Yabana Lengani Hamadoun Yattara Adama Kama Yatte Richard Loumingou Lemrabott Tall elhadji Fary Ka Abdou Niang Boucar Diouf Department of Nephrology and Hemodialysis General Teaching Hospital Brazzaville Republic of the Congo Department of Nephrology and Hemodialysis Amirou Boubacar Diallo National Hospital Niamey Niger Department of Nephrology and Hemodialysis Yalgado Ouedraogo Ouagadougou Burkina Faso Department of Nephrology and Hemodialysis General Teaching Hospital POINT G Bamako Mali Department of Nephrology Dialysis and Kydney Transplantation ARISTIDE LE DANTEC Hospital Dakar Senegal

Introduction: Focal Segmental Glomerulosclerosis (FSGS) corresponds to a clinicopathological syndrome, manifested by generally abundant proteinuria associated with hyaline deposits on part of certain glomeruli and sparing other glomeruli, with effacement of the pedicels. The general objective was to determine the prevalence of FSGS, and to give its profiles;epidemiological, clinical, biological, pathological, etiological, therapeutic and evolutionary of FSGS. Materials and Methods: This is a retrospective analytical study over a period of six years extending from January 1, 2010 to December 31, 2015 patients aged 16 or over who were hospitalized or received consultations during the study period for primary or secondary segmental and focal hyalinosis. Patients whose records were incomplete or unusable were not included in the study. Results: We have 16.54% with 158 cases of FSGS out of 6945 patients received and/or hospitalized. Of the 955 kidney biopsies distributed, the incidences of HSF were;10.15%;14.04%;15%;17.64%;20.11%;19.58% respectively in 2010;2011;2012;2013;2014 and 2015, i.e. an annual increase of around 1.25%. Renal-type edemas were found in 93.3%, the first reason for hospitalization. And ninety-six people had impaired kidney function, or 61%. The average of 24-hour proteinuria was 6.4 ± 3.69 g/24 hours. The extremes were 0.37 and 18.50 g/24h. Patients had nephrotic proteinuria in 84.86%. Non-specific FSGS or NOS (Not Other Specificities) was found in 62 cases or 39.24%, collapsing FSGS in 48 cases or 30.40%. FSGS with found causes was associated with fibrosis in 5/35 cases. Collapsing FSGSs followed by NOS FSGSs were the most corticosteroid-resistant. The evolution of the FSGS reveals that every 8 months the proteinuria decreases by half. Conclusion: Segmental and focal hyalinosis requires histological confirmation and the epidemiological, clinico-biological, etiological, therapeutic and evolutionary profiles depend on the histological (pathological) t

关键词： Proteinuria Corticotherapy Focal Segmantal Glomerulosclerosis Senegal

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