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Acute Fevers in the Medical Unit of the Medical-Surgical Emergency Department of the Donka National Hospital

Open Journal of Internal Medicine 2023年第2期13卷 95-103页

作者： Djibril Sylla Amadou Kake Thierno Amadou Wann mohamed lamine Yaya Bah Akomou Lydia Koba mohamed Cirékeita Mamadou Diakhaby Lansana Diaby Sèmèvo Claudiane Toffon Internal Medicine Department of the Donka National Hospital Conakry Guinea Medical and Surgical Emergency Department of the Donka National Hospital Conakry Guinea

Introduction: Fever is a high core temperature ≥ 37.5°C in the morning and 37.8°C in the evening. It is acute when it evolves from 0 to 20 days. Very common in clinical practice, the etiological diagnosis, particularly in developing and tropical countries, is often a challenge for clinicians due to their diversity and the limited availability of diagnostic tools. There is a wide spectrum of etiological diagnoses including infectious causes and non-infectious causes. The aim of this study was to investigate the etiology of fevers acute at the medical unit in the medico-surgical emergency department of the Donka National Hospital. Methods: This was a descriptive cross-sectional study lasting 03 months (January 01, 2022 to March 31, 2022). We included in this study all patients seen in the medical unit, whose age ≥ 18 years, without distinction of sex, from any origin, with an axillary temperature ≥ 37.5°C in the morning and 37.8°C in the evening, evolving from 0 to 20 days, hospitalized or followed on an outpatient basis, and having given verbal consent. Results: Of a total of 1087 patients seen, 466 had an acute fever. The mean age was 40.04 ± 18.91 years (18 and 96 years). The female sex (58.15%) was predominant with a sex ratio of 0.72. Malaria (50.86%) was the main diagnosis. The treatment consisted of compressed paracetamol (59.01%), arthemether + lumefantrine (50.85%). Conclusion: The incidence of acute fevers is high in the medical unit of the medico-surgical emergency department of the Donka National Hospital. Malaria was the main pathology. Treatment was etiological and symptomatic. This high incidence could be explained by the fact that Guinea is an endemic malaria zone. A study taking into account other etiological factors would be of great interest.

关键词： Acute Fever Medical Unit Emergency Department Donka National Hospital (HND)

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Abdominal Mass Revealing a Right Ovarian Cyst in a 2-Year-Old Infant: A Case Report

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Open Journal of Pediatrics 2023年第2期13卷 276-283页

作者： mohamed lamine Sadou Sacko Balla Keita Thierno Saidou Barry Mory Sangare Mamadou Madiou Barry Moussa Conde Daniel Agbo-Panzo Department of Pediatric Surgery Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Ovarian cysts are rare pathologies in infants. They represent 1% to 2% of all abdominal tumors in children. Abdominal pain is the most frequent initial sign. Sometimes the discovery is fortuitous, revealed by an abdominal ultrasound. We report here the case of an ovarian cyst in an infant in order to clarify the diagnostic and therapeutic particularities. Patient and observation: 2-year-old infant, female, weighing 12 kg and with no particular pathological history, was admitted to our department for pain plus abdominal mass evolving for 2 months. The clinical examination had noted: a mass ranging from FID to hypogastrium, painless, of firm consistency, with regular contour, with a smooth and mobile surface in relation to the deep plane. The abdominal ultrasound performed had concluded to a mesenteric cyst. The treatment consisted of a monobloc total cystectomy with preservation of the healthy ovarian tissue by a transverse laparotomy under the umbilical. The postoperative course was simple;the histological study of the surgical specimen had concluded to a serous cystadenoma. Conclusion: Ovarian cysts are benign tumors in most cases. Abdominal pain is the most common initial symptom at any age. Sometimes they can be incidentally discovered by ultrasound. The preservation of healthy ovarian tissue in the rules of oncological surgery allows the preservation of subsequent fertility.

关键词： Right Ovarian Cyst in Infants Conservative Treatment

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Pubo-Penile Testicular Ectopia (ETPP) of the Infant of 4 Months about a Case

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Open Journal of Urology 2023年第4期13卷 108-113页

作者： mohamed lamine Sadou Sacko Balla Keita Thierno Saidou Barry Mory Sangare Mamadou Madiou Barry Moussa Conde Daniel Agbo-Panzo Pediatric Surgery Department of The University Hospital of Donka Donka Guinea University Gamal Abdel Nasser of Conakry Conakry Guinea

Pubo-penile testicular ectopia is a rare congenital malformation whose etiopathogenesis remains poorly understood. It represents other testicular ectopias less than 1% of all testicular migration disorders. We report a clinical observation of a 4-month-old infant who consulted for swelling at the root of the penis associated with vacuity of the right hemi scrotum. An inguinal ultrasound was performed which confirmed the presence of the right testicle. An orchidopexy was performed at 4 months of life by an inguinal approach, the postoperative course was simple with a follow-up of 6 months.

关键词： Pubo-Penile Testicular Ectopia Infant Early Orchidopexy

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Prognostic Materno-Fetal Types of Arterille Hypertension during Pregnancy at the Maternity of Donka, National Hospital Donka, Chu of Conakry, Guinea

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Open Journal of Obstetrics and Gynecology 2019年第5期9卷 722-729页

作者： Boubacar Siddi Diallo Mamadou Sambakeita Ibrahima Sory Balde Oumar Diawara Telly Sy mohamed lamine Kaba Yolande Hyjazi Namory Keita University Department of Gynecology-Obstetrics Donka National Hospital Conakry Guinea University Department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea

Objectives: The objectives of this work were to calculate the frequency of arterial hypertension during pregnancy, describe the epidemiological profile, and identify the most common type of hypertension and establish the maternal and fetal prognosis. Methodology: This was a six-month descriptive prospective study performed in the Obstetrics and Gynecology Department of Donka National Hospital, CHU, Conakry. The study took place from July 1st to December 31st, 2015. Results: The frequency of arterial hypertension during pregnancy was 8.82% in the service. The epidemiological profile was that of a teenager (32.8%), nulliparous (56%), coming from home (69.2%), not having performed CPN (52%), no schooling (68%) and housewives. The primary factor was the risk factor (52.4%). Gestational age greater than 37 was the most concerned (62%). The reasons for consultation are dominated by headache (76%) and vertigo (68%). The main type of hypertension was pre-eclampsia (48%) followed by Transient HTA (28%). The predominant clinical form at admission was pre-eclampsia (47.2%) followed by eclampsia (23%). Eclampsia was the major complication (48%), with 6 deaths, or 2.4%. At the first minute, 35.68% of newborns had an APGAR score of less than 7 and 25.5% had a score of less than 7. Fetal morbidity was dominated by fetal hypotrophy (30.19%) followed by prematurity (23.92%). We recorded 30 cases of MFIU and 7 cases of neonatal death out of 255 births, i.e. 14.50%. Conclusion: The detection of risk factors by a good prenatal follow-up and the regular training of the care providers for an adequate and multidisciplinary care (obstetrician, intensive care nephrologist and pediatrician) of hypertensive pregnant women and their newborns can improve the maternal and fetal prognosis.

关键词： Prognostic Arterille Hypertension Pregnancy

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State of Shock: Epidemiological, Etiological and Therapeutic Aspects at the Pediatric Unit of the Medical and Surgical Emergencies of the Donka National Hospital

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Open Journal of Pediatrics 2019年第4期9卷 302-308页

作者： Diallo mohamed lamine Barry Ibrahima Koolo Camara Emmanuel Ondima Hermann Laurent Marion Sossouadouno Elisabeth Sita Diallo Saliou Bella Emergencies Pediatric Donka National Hospital Conakry Guinea Institute of Nutrition and Child Health (INSE) Donka National Hospital Conakry Guinea Pediatric Department Donka National Hospital Conakry Guinea

Introduction: The objective of this study was to write the epidemiological, etiological and therapeutic aspects of shock in children in the paediatric medico-surgical emergency unit of the National Donka Hospital. Method: This was a forward-looking, descriptive 6-month study, including all children aged 0 to 15 who were received in the paediatric medico-surgical emergency unit at The Donka National Hospital, where the shock diagnosis was retained and the patients received care. Results: In our study, 26 out of 1123 patients were received in a state of shock. Hypovolemic shock was more common at 24 (92%). Vascular filling by Ringer’s milk was the basic treatment. The 6 to 11 month age group was the most affected and the sex-ratio M/F was 1.6. The acute febrile gastroenteritis and dehydration status were the most frequent causes. The outcome was favorable in 25 patients (96%). Conclusion: Rapid and effective management would improve the vital and functional prognosis of children in shock.

关键词： Choc Children Urgences Paediatrics Donka

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

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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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Severe External Genitalia Lesion by Firearm: A Case Report

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Open Journal of Urology 2015年第10期5卷 188-191页

作者： Mahamat Ali Mahamat Sidi Sougui Choua Ouchemi Olivier Ngaringuem mohamed Jalloh lamine Niang Serigne M. Gueye University of N’Djaména and National General Reference Hospital (HGRN) N’Djaména Tchad Grand Yoff General Hospital (HOGGY) of Dakar Dakar Senegal

Gunshot wounds to external genitalia are rare either in war field and civilian setting accounting for 2% - 4% of all injuries with often a lesion to the urinary tract. We report a case of external genital injury in a 27 years old man, accidentally injured by his own arm when he pressed the trigger of his gun placed in his pants. He had no past medical or surgical history, he presented to the emergency room (ER) with hemorrhagic scrotal and penile injuries with adjacent urethral tissue damage. He underwent a scrotal flap urethroplasty, and realignment of the corpus cavernosa and the tunica albugina. The patient lost his Foley catheter at post-operative day 3 and subsequently developed a urethral stenosis. Gunshot wounds to external genitalia are rare. A good reconstruction is necessary to avoid an impact on sexual and voiding function.

关键词： Trauma External Genitalia Gunshot

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Emergency Tracheotomy: Nine Years Experiences in National Center Hospital of Nouakchott, Mauritania

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Open Journal of Emergency Medicine 2021年第2期9卷 11-17页

作者： Dahi mohamed Elmoctar Cheikh Sidi Sidi mohamed Jiyide lamine mohamedou Keita Mariem Aziza Sass Leziza Sass Sidi Brahim Ladour Abdel Vatah Jiddou S. Baba T’feil Yahya Ahmedou Moulaye Idriss Mahfoudh mohamed Vall ENT Department CHN Nouakchott Mauritania Ophthalmology Department Faculty of Medicine Nouakchott Mauritania Urology Department Medicine Faculty Nouakchott Mauritania General Surgery Department Faculty of Medicine Nouakchott Mauritania Anesthesia Department Faculty of Medicine Nouakchott Mauritania

Introduction: Tracheotomy is a commonly performed procedure, but with very large disparities according to the teams, both in terms of frequency and modality (percutaneous or surgical), tracheotomy has been evolved with medical advances. The objective of this study was to clarify the indications and complications of emergency tracheotomies at the National hospital center (CHN) in Nouakchott Mauritania. Materials and Methods: It is a retrospective study of tracheotomies performed in the ENT department of the CHN during the period from January 1, 2010 to December 31, 2018. The indications and complications were noted, as well as the modalities and time of decannulation. Results: Tracheotomy was motivated by upper airway obstruction (UAO) in 139 (94%) cases (mean age 32.5 years), or the need for prolonged ventilation in 8 patients (median age 46 years). Sixteen (7%) early complications were noted with 5 untimely decannulations including one fatal and 5 obstructive plug responsible for another death. Six pneumothorax was observed. Fifteen (26%) late complications required additional surgery;7% (n = 11) of patients were decannulated with a mean duration of tracheotomy 26 months. In 19 (28%) cases of decannulations, the persistence of a tracheocutaneous fistula required surgery. Conclusion: Emergency tracheotomy is a survival gesture that is sure to be effective. A tracheotomy is not deprived of complications. Familiarity with the technique, the right choice of equipment, perfect knowledge of the anatomical relationships of the trachea, rigorous monitoring and postoperative care represent the main conditions for minimizing the risk of complications.

关键词： Emergency Trachea Tracheotomy Complications Mauritania

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Urinary Lithiasis Secondary to Urethral Duplication: A Case Report

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Open Journal of Urology 2023年第10期13卷 453-458页

作者： mohamed lamine Sadou Sacko Balla Keita Thierno Saidou Barry Mory Sangare Mamadou Madiou Barry Moussa Conde Seydou Keita Daniel Agbo-Panzo Department of Pediatric Surgery CHU de Donka Conakry Guinea Gamal Abdel Nasser University Conakry Guinea General Surgery Department Ignace Deen University Hospital Conakry Guinea

Urethral duplication is a rare congenital anomaly, mainly involving boys, although cases in girls have been reported. The majority of duplications of the urethra are asymptomatic and the discovery of this malformation can be done at any age. Diagnosis and determination of its type are based on urethrocystography with mid-void images, which helps to guide the surgical approach. The treatment is not yet well codified and the therapeutic attitude varies from one author to another. We report a clinical observation of a urethral duplication with a calculus in a six-year-old boy who underwent a partial urethrectomy of the supernumerary urethra in whom a lithotomy and a urethrectomy were performed via a suspension approach. This observation illustrates the possibility of urinary stone formation after partial urethrectomy of the supernumerary urethra.

关键词： Urethra Duplication Calculus Child

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Uterovaginal Prolapse in the Newborn: A Case Report from the University Hospital of Conakry

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Open Journal of Pediatrics 2023年第1期13卷 69-73页

作者： Balla Keita Sacko mohamed lamine Sadou Toure Mamadou Alpha Barry Thierno Saidou Barry Mamadou Madiou Agbo-Panzo Daniel Pediatric Surgery Department Donka University Hospital Conakry Guinea Gamal Abdel Nasser University of Conaky Conakry Guinea

Uterovaginal prolapse is an exceptional pathology in the newborn. It is defined by the descent and protrusion of the uterus and vaginal walls to the outside via the vaginal orifice. It particularly affects newborns with neural tube defects. The diagnosis is usually made at birth. Different types of conservative or surgical treatment have been suggested for genital prolapse in neonates. We report the case of a newborn of 6 hours of life who was received for congenital utero-vaginal without neural tube closure anomaly. He was successfully treated with digital reduction of the mass associated with a cerclage of the vaginal orifice. Conclusion: Digital reduction of the prolapse associated with a cerclage of the vaginal orifice is simple, effective and avoids any recurrence.

关键词： Newborn Utero-Vaginal Prolapsed Congenital

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