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Severe Head Trauma in a 39-Week Pregnant Woman with Amenorrhea (SA) Apropos of a Case at CHU Ignace Deen in Conakry

Open Journal of Emergency medicine 2023年第3期11卷 87-99页

作者： Abdoulaye Touré Amadou Yalla camara Donamou Joseph Almamy Bangoura m’mah lamine camara Anesthesia-Resuscitation Department University Hospital of Ignace Deen of Conakry Conakry Guinea medical and Surgical Emergency Department Donka University Hospital Conakry Guinea Anesthesia-Resuscitation Department Donka University Hospital Conakry Guinea

Objective: Was to present the management of a pregnant woman at 39 SA received for severe head trauma in the emergency room. Severe trauma in pregnant women can have serious maternal and especially fetal consequences in the absence of a diagnostic and therapeutic strategy. We report the case of serious trauma in a 39 WA pregnant woman, nulliparous. Admitted to the emergency room for serious head trauma following a public road accident. The clinical picture was dominated by impaired consciousness with a Glasgow score of 8/15, right otorrhagia, desaturation at 89% AA and respiratory rate at 36 cycles/min. The obstetrical examination noted a fundal height of 32 cm, a fetal heart sound (BCF) of 167 beats/min, a cephalic presentation, a cervical opening of 3 cm and uterine contractures. Imaging examinations outside the hospital because not available. The abdominopelvic ultrasound shows a monofetal pregnancy without placental abruption. The cerebral scanner shows an edemato-haemorrhagic contusion intra parenchymatous frontotemporal left. Respiratory support and an indication for caesarean section allowed the extraction of a live male child, Apgar at one minute 10/10 to five minutes 10/10, weighing 3000 g without abnormality on clinical examination. The evolution was favorable after 27 days of resuscitation. Conclusion: The care of a severely traumatized pregnant woman relies above all on good multidisciplinary coordination, based on close collaboration between emergency physicians, anesthetists-resuscitators, obstetricians, pediatricians, neonatologists and biologists.

关键词： Trauma Emergencies Pregnancy Resuscitation

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The Reasons for Admission of Elderly Subjects in Intensive Care at the CHU Ignace Deen

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Open Journal of Emergency medicine 2023年第3期11卷 100-109页

作者： Abdoulaye Touré Amadou Yalla camara Almamy Bangoura Donamou Joseph m’mah lamine camara Anesthesia-Resuscitation Service University Hospital of Ignace Deen of Conakry Conakry Guinea medical and Surgical Emergency Department Donka University Hospital Conakry Guinea Anesthesia-Resuscitation Service Donka University Hospital Conakry Guinea

Objective: To determine the reasons for admission of elderly subjects and the prognosis in general intensive care. Patients and methods: Observational descriptive and analytical study with prospective collection of data over a period of one year from January 1 to December 31, 2021. Patients aged 65 or over were included. Abstract: During the study period, 223 cases were collected out of 587 patients admitted, giving a prevalence of 37.9%. The average age was 74.127.39 ± years with extremes of 65 and 96 years and a male predominance (58.7%). The comorbidities were dominated by arterial hypertension (71.3%). The patients were: transferred from medical and surgical emergencies (75.8%). The average admission time was 48.8 ± 29.8 hours. One hundred and eight patients had a Glasgow score between 3 and 7. The reasons for admission were dominated by vascular causes (51.6%). Strokes of any type accounted for 43.9% of these reasons for admission. The average time for carrying out the biological assessments and imaging was 41.8 ± 27.3 hours with the extremes of 3 and 89 hours, 37.2% had a complete assessment within 24 hours. The average duration of hospitalization was 7.10 ± 8.87 days with extremes of 1 and 72 days. The mortality rate was 71.7%. Conclusion: This study has made it possible to take stock of the reasons for the admission of elderly subjects to intensive care. It appears that vascular causes are the main reasons for admission with heavy comorbidities which results in high mortality.

关键词： Reasons for Admission Elderly Subject Resuscitation

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Peritonitis: Perioperative Care in Surgical Emergencies CHU Ignace Deen

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Open Journal of Anesthesiology 2023年第4期13卷 85-94页

作者： Abdoulaye Touré Amadou Yalla camara Almamy Bangoura m’mah lamine camara marie Paul Sidohon Okou Anesthesia-Resuscitation Service Ignace Deen Hospital Conakry Guinea Department of medical and Surgical Emergency Donka University Hospital Conakry Guinea Anesthesia-Resuscitation Service Donka University Hospital Conakry Guinea

Objective: Describe the perioperative management of peritonitis in surgical emergencies. methodology: This was a prospective observational study of the descriptive type over a period of 12 months from January 01 to December 31, 2020 in the surgical emergency room at the CHU Ignace Deen. Included in the study were all patients admitted for peritonitis aged greater than or equal to 18 years. The parameters were epidemiological, clinical and anesthetic. Results: Of the 653 admissions to surgical emergencies in 2020, 185 cases presented with peritonitis, i.e. 29.3%. The average age was 38.6 ± 16.64 years with extremes of 18 and 90 years. The sex ratio was 1.89. The comorbidities were dominated by gastritis and hypertension, i.e. 22%. The patients were classified as ASA 3U (52.4%), ASA2 U (39.5%) and ASA 4 U (8.1%). Preoperative resuscitation was provided only with 100% saline. 25.5% of patients had received a blood transfusion. The response time was less than 48 hours, i.e. 77.6%. General anesthesia was performed for all patients. Ketamine was the most used IV hypnotic (56.3%) combined with 100% halothane. The curares used were suxamethonium at (81.6%), Atracurium (81.6%) and rocuronium at (18.3%). Fentanyl was the only morphine used. Senior anesthesia technicians provided anesthesia in (63.2%). Intraoperative incidents were dominated by hypotension, difficult intubation, cardiac arrest, respectively 10.3%, 8% and 0.5%. The immediate postoperative incidents were arterial hypotension, nausea and desaturation, respectively 52.9%, 80% and 32.4%. mortality was 3.4%. Conclusion: The perioperative management of peritonitis in the emergency room must be as early as possible in order to reduce morbidity and mortality.

关键词： Surgical Emergencies Peritonitis Anesthesia Perioperative

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Cerebral malaria: Epidemiological, Clinical and Prognosis Aspects in the Anesthesia-Resuscitation Department CHU Ignace Deen

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Open Journal of Emergency medicine 2023年第4期11卷 162-173页

作者： Abdoulaye Touré Amadou Yalla camara Almamy Bangoura m’mah lamine camara mohamed Soumah Saramba Nabe Department of Anesthesia-Resuscitation University Hospital of Ignace Deen of Conakry Conakry Guinea Department of medical and Surgical Emergency Donka University Hospital Conakry Guinea Department of Anesthesia-Resuscitation Donka University Hospital Conakry Guinea

Objective: To describe the epidemiological, clinical, paraclinical and prognostic aspects of cerebral malaria received in the anesthesia-resuscitation department. methodology: This was a prospective descriptive type study carried out in the anesthesia-resuscitation department over a period of three (03) months (June 01 to August 31, 2022). All patients admitted for cerebral malaria were included. Sociodemographic, clinical and prognostic parameters were studied. Results: We collected 25 cases out of 105 admitted patients (23.8%). The average age was 27.6 ± 9.5 years with extremes of 11 and 50 years. The sex ratio was 0.7 (m/F). Students and housewives were in the majority, i.e. 52% and 24%. Neurological disorders were found on admission in all patients, dominated by impaired consciousness at 100% followed by convulsion (60%), prostration (44%), confusion (36%) associated with deep coma in (68%). Gross hemoglobinuria was present in (84%) of cases. On the blood count, anemia was present in (70%) of the patients followed by thrombocytopenia in more than half of the cases (60%) and transfusion was necessary in 19 cases. P Falciparum malaria was found in all patients (100%), the average parasite density was 60342.8 ± 30425.6 trophozoites/μl with extremes of 9000 to 100000 trophozoites/μl. All our patients were treated with intravenous injectable artesunate. Transfusion was performed in 76% of our patients. Eighty percent of the patients had benefited from dialysis. High oxygen therapy was performed in (92%) of cases. The average duration of hospitalization was 5.74 ± days with extremes of 1 to 17 days. mortality was 48%. Conclusion: Cerebral malaria can take different clinical forms, the most important of which is cerebral involvement. Prompt initiation of appropriate resuscitation can reduce mortality.

关键词： Cerebral malaria mortality Resuscitation

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Evaluation of the Effectiveness and Nature of Analgesia in the medical-Surgical Emergency Department of CHU-Donka

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Open Journal of Emergency medicine 2023年第4期11卷 155-161页

作者： Amadou Yalla camara Abdoulaye Touré Almamy Bangoura m’mah lamine camara Thierno Sadou Diallo Boubacar Atigou Dramé Joseph Donamou Department of medical and Surgical Emergency CHU-Donka National Hospital Conakry Guinea Anesthesia and Intensive Care Unit Ignace Deen National Hospital Conakry Guinea Department of Anaesthesia and Intensive Care Donka National Hospital Conakry Guinea

Introduction: Pain assessment is an essential step towards pain relief. In our context, however, it is insufficient in emergency departments. The aim was to assess the nature and effectiveness of the analgesia used in the emergency department of the CHU-Donka. method: This was a single-centre prospective observational study conducted over one month (November 2020) in the medical-surgical emergency department of CHU-Donka. All patients aged 18 or over admitted to the emergency department with moderate to severe acute pain were included. Results: We enrolled 880 patients, 615 of whom (69.88%) were in pain. males predominated (65.2%), with a sex ratio of 1.87. The average age was 44.78 ± 16.41 years, with extremes ranging from 18 to 85 years. The most represented age group was 18 - 34 years, with 66.18%. Initial assessment of pain by nursing staff in 3 cases. Initial assessment of pain by the investigator was 100%, 74% moderate and 26% severe. No reassessment of pain by nursing staff. Reassessment by the interviewer was 100% and found 5% no pain, 61% mild pain, 24% moderate pain and 10% severe pain. With an average numerical scale of 3.77 ± 2.61 and extremes from 0 to 10. Average length of stay was 2.85 ± 1.48 hours, with extremes ranging from 45 minutes to 8 hours. Analgesia was administered with paracetamol alone (43.58%), combined with tramadol or nefopam. No patient received morphine. Conclusion: This study revealed a lack of pain assessment in our department.

关键词： Pain Assessment Emergencies Numerical Scale CHU-Donka

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Case Report for Two Hemodialysed Patients Diagnosed for COVID-19 at the Donka National Hemodialysis Center

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Open Journal of Nephrology 2020年第3期10卷 241-244页

作者： mamadou Saliou Baldé Abdoulaye Touré Amadou Yalla camara Joseph Donamou Aly Traoré Boubacar Atigou Drame m’mah lamine camara Almamy Bangoura mariam mohamed camara mohamed lamine Kaba Department of Nephrology-Hemodialysis Hospital National Donka Conakry Guinea Department of Reanimation Hospital Ignace Deen Conakry Guinea Department of Reanimation Hospital National Donka Conakry Guinea

In December 2019, coronavirus disease (COVID-19) due to infection with the novel SARS-CoV-2 virus began to break out. Hemodialysis patients are at high risk because of the co-morbidities. We report the clinical and biological characteristics of two patients who developed COVID-19 infection in our dialysis center in Donka National Hospital. None of the patients had contact with an infected person. The age was 38 and 54 years. The symptoms common to both patients were: fatigue, diarrhea, fever. Lymphopenia was present in both patients. None of them had a chest X-ray or chest scan because they were positive for the test before admission.

关键词： Hemodialysis COVID-19 Coronavirus Donka

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Post Antibiotic Grade IV Anaphylaxis: A Case Report from the Emergency Department of Chu Donka

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Open Journal of Emergency medicine 2023年第3期11卷 110-114页

作者： Amadou Yalla camara Abdoulaye Touré Ernest Ahounou Almamy Bangoura m’mah lamine camara Thierno Sadou Diallo Alhassane Barry Boubacar Atigou Dramé Joseph Donamou medical and Surgical Emergency Department CHU-Donka National Hospital Conakry Guinea Anesthesia and Intensive Care Unit Ignace Deen National Hospital Conakry Guinea Department of Anaesthesia and Intensive Care Donka National Hospital Conakry Guinea Department of Anaesthesia and Intensive Care HKM National University Hospital Cotonou Benin

Anaphylaxis is a serious systemic reaction that is part of the general pattern of potentially fatal hypersensitivity reactions requiring immediate management. We report the case of a patient presenting to emergency with signs of malaria and pneumonia who was diagnosed with grade 4 anaphylaxis following antibiotic injection in the emergency department. The patient was 30 years old, with no previous history of anaphylaxis, and presented to the emergency department with fever, dry cough, headache and dizziness associated with prostration. Physical examination showed stable hemodynamics (BP = 110/80 mmHg, HR = 95 p/min,) and respiratory function with SpO2 = 98%, HR = 22 c/min and crepitus rales at the base of the lungs. The laboratory work-up carried out in the emergency department revealed a biological inflammatory syndrome associated with hyperleukocytosis of 11,260/mm3, a positive thick drop with GE(+) dp = 1183 T/microlitre;blood glucose = 0.83 g/l;Covid 19 RDT = (negative). A diagnosis of malaria and pneumonia was made and antibiotic therapy (ceftriaxone) and artesunate were indicated. During the injection of ceftriaxone 1 g, the patient became agitated, followed by cardiorespiratory arrest, confirming the diagnosis of stage 4 anaphylaxis. Treatment consisted of stopping the ceftriaxone injection, external cardiac massage and ventilation, intravenous adrenaline and vascular filling, which enabled the patient to recover and stabilize. The diagnosis of anaphylaxis is clinical. Early administration of adrenaline is the mainstay of treatment.

关键词： Grade 4 Anaphylaxis Adrenaline Antibiotics Emergencies

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Petrographic and Structural Studies of the Guintéguéla Formations (Northwest of Côte d’Ivoire)

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Open Journal of Geology 2024年第1期14卷 29-49页

作者： mohamed Samuel moriah Conte N’guessan Nestor Houssou Oumar Barou Kaba mohamed lamine Timite Abdoulaye Kadiatou Diallo Aly Soumah mohamed camara mohamed Fofana Djibril m’mamy camara Applied Research Laboratory Fundamental Geology and Prospecting Research Unit Emergent Centre Mines and Society Higher Institute of Mines and Geology of Boké Boké Republic of Guinea Laboratory of Geology and Energy Resources (LGRmE) UFR of Earth Sciences and Mineral Resources University Felix Houphouet Boigny Abidjan Republic of Ivory Coast Applicated Research Laboratory Mining and Resource Development Research Unit Emergent Centre for Mines and Society Higher Institute of Mines and Geology of Boké Boké Republic of Guinea

Côte d’Ivoire is currently experiencing strong growth in the mining sector. Identifying the formations present in our subsoil is therefore essential for mining recovery. It is in this context that we conducted studies on the formations present in the locality of Guintéguéla. It is located in the northwest of Côte d’Ivoire in the bafing region. The aim of this work was to determine the petrographic and structural characteristics of the formations of the area. The methodology began with documentation and then followed petrography and structural analysis work on the macroscopic and microscopic levels. We observed six groups of rocks: granitoids, amphibolites, orthogneiss, quartzites (poor and rich in magnetites), volcano-sediments and filonian rocks. metamorphism is of amphibolite to granulite facies. However, volcano-sediments must be associated with the green schist facies. With regard to the structural, structures and microstructures such as foliation;fractures;sigmoidal figures reveal that the studied area was affected by ductile and also brittle tectonics whose main directions are oriented along the shear corridor, so N-S to NNW-SSE.

关键词： mining Petrography Structural metamorphism

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Predictive Factors of Renal Damage during Sickle Cell Disease at the Hematology-Oncology Department of Donka University Hospital

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Open Journal of Nephrology 2024年第3期14卷 302-312页

作者： moussa Traoré Ansoumane Sayon Kanté marthe Sidibé mamady Diakité mohammed lamine Tégui camara Foussény Diakité mamadou Saliou Baldé Ibrahima Chérif mustapha Komrabai-Kanu mohammed lamine Kaba Nephrology-Hemodialysis Department of Donka University Hospital Conakry Guinea Hematology-Oncology Department of Donka University Hospital Conakry Guinea Hematology-Oncology Department of Ignace Deen University Hospital Conakry Guinea medical Care Clinic Freetown Sierra-Leone

Introduction: Sickle cell disease, which is the most common hereditary hemoglobinopathy in the world, attacks all body systems, particularly the kidneys. The view of this study was to investigate the predictive factors of kidney damage during sickle cell disease. materials and methods: It was a retrospective, descriptive and analytical study on files of sickle cell patients hospitalized in the Hematology-Oncology Department of Donka University Hospital during a period from January 1, 2016 to December 31, 2019. Records of sickle cell patients with one or more renal abnormalities were retained. Sickle cell patients without kidney damage were also selected for a comparative study. Only patients without sickle cell disease were excluded. Results: Seventy-five (75) medical records were collected during the study period. From these cases, thirteen (13) records with kidney disease were observed, a frequency of 17%. The mean age of patients was 24.2 years for extremes of 10 and 65 years. The sex ratio was 1.6 in favor of men. The SSFA2 form was the most represented with 92%. 24-hour proteinuria was measured in 13 patients between whom 6 patients (46.2%) had a proteinuria level ≤ 1 g. Eight (8) patients (61.5%) were in stage 1 of chronic kidney disease. The most common type of renal involvement was tubulo-interstitial nephropathy with 8 patients (61.5%). Bivariate analysis showed that elevated serum creatinine (P 2 form of the sickness (P Conclusion: After the observation of an increased serum creatinine and urea, a predominance observation of the SSFA2 form, it should be possible to target patients for whom screening for kidney damage should henceforth be systematic.

关键词： Kidney Damage Predictive Factors Sickle Cell Disease Donka

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Child Victims of Road Traffic Accidents: Epidemiological and Clinical Aspects in the medical and Surgical Emergency Department of the Donka National Hospital

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Case Reports in Clinical medicine 2024年第3期13卷 63-72页

作者： Ibrahima Sory Diallo mamadou moustapha Diop Amadou Oury Toure mamadou Aliou Doukouré Aîssata Barry m’mah Aminata Bangoura mariama Sadjo Diallo Abdoulaye Oumare Diallo Salimatou Hassimiou camara Thierno mamadou Aliou Touré Ouo Ouo Kolié mohamed lamine Diallo Fatoumata Binta Diallo Ibrahima Sory Souaré Institute of Child Nutrition and Health Conakry Guinea Department of Pediatrics Donka National Hospital Conakry Guinea UNICEF-Guinea Community Health Section Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Children involved in road accidents most often suffer head or limb injuries. The severity of these injuries varies according to the age of the child, the type of road user and whether or not protective devices are used. The aim of this study was to carry out a census of admissions and to identify the epidemiological and clinical profile of children involved in road traffic accidents at Donka National Hospital. methods: This is a descriptive cross-sectional study of children involved in traffic accidents over a 3-month period from September 1 to November 30, 2021. All children admitted to the emergency department for a traffic accident were included in the study. Results: During the study period, 435/530 children (82.1%) were victims of road accidents. Boys accounted for 54.94% of cases, compared with 45.06% for girls. The age group most affected was 12-17 years old (48.97%). October had the highest accident rate (36.4%). Pedestrians are most affected (52.87%). Bicycles and mopeds were involved in 59.77% of accidents. Head injury was the most frequent pathology (33.33%). The study showed that 12.64% of victims were referred to intensive care, pediatric surgery, etc. We recorded 8 cases of death (1.84%). Conclusion: This study highlighted the characteristics, incidence and risk factors for accidents in children admitted to emergency departments. Accident prevention, particularly serious accidents in children, requires more precise knowledge of the factors and circumstances leading to their occurrence.

关键词： Child Accident Public Highway Donka

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