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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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Prevalence of Metabolic Syndrome in the Medical-surgical Emergency department of the Donka National Hospital

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Open Journal of Internal Medicine 2023年第2期13卷 85-94页

作者： Djibril Sylla Amadou Kake Thierno Amadou Wann Mohamed Lamine Yaya Bah Mhamed Ciré Keita Alhassane Barry Mamadou Diakhaby Lansana Diaby Internal Medicine department of the Donka National Hospital Conakry Guinea Medical and surgical Emergency department of the Donka National Hospital Conakry Guinea

Introduction: The metabolic syndrome (MS) corresponds to the coexistence of several metabolic disorders including three (3) factors out of five (5) in the same individual. These five (5) major criteria are central or abdominal obesity, hypertriglyceridemia, low High-Density Lipoprotein cholesterol (HDLc), hyperglycemia, and elevated blood pressure. It has been the subject of various definitions over the past 10 years. It is a clinical-biological entity recognized by the World Health Organization (WHO) in 1998, the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) in 2001, the International Diabetes Federation (IDF) in 2005, then the IDF Harmonization Consensus in 2009. The objective of this study was to determine the prevalence of metabolic syndrome in the medico-surgical emergency department of the Donka national hospital. Methods: This was a descriptive study, data collection took place from February 5 to July 5, 2022 and, covering all patients aged 16 and over, without distinction of sex, origin received in consultation in the medical unit in the emergency department of Donka and having agreed to participate in the study. Anthropometric, clinical and biological data were recorded. Results: We recruited 107 patients whose age ranged from 20 to 94 years with a mean age of 58.92 ± 13.78 years. The prevalence of metabolic syndrome in our study population was 6.30% with a female predominance of 73.83%. The most frequent components of the metabolic syndrome were abdominal obesity (100%) followed by hyperglycemia (85.98%) and hypertension (85.05%). Among the complications related to the metabolic syndrome, diabetes was found with (46.73%), hypertension (43.93%) and stroke (16.93%). Conclusion: Our results show a significant prevalence of the metabolic syndrome and its main complications, which were diabetes, hypertension and stroke. These data justify early detection and treatment strategies.

关键词： Prevalence Metabolic Syndrome Medicine Unit Donka National Hospital

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Unraveling the landscape of pediatric pancreatic tumors:Insights from Japan

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 34-38页

作者： Savvas Lampridis Faculty of Medicine Imperial College LondonLondon SW72AZUnited Kingdom department of surgical Oncology 424 General Military Training HospitalThessaloniki 56429Greece

Pediatric pancreatic tumors,though rare,pose significant diagnostic and manage-ment *** recent,22-year nationwide survey on pediatric pancreatic tumors in Japan by Makita et al offers valuable insights into this uncommon enti-ty,revealing striking geographical variations and questioning current treatment *** editorial commentary analyzes the study's key findings,inclu-ding the predominance of solid pseudopapillary neoplasms and their younger age of onset,which contrast sharply with Western *** explores the implications for clinical practice and research,emphasizing the need for population-specific approaches to diagnosis and *** revealed limited institutional expe-rience and surgical management patterns prompt a reevaluation of optimal care delivery for these complex cases,suggesting benefits of centralizing healthcare ***,the commentary advocates for international collaborative studies to elucidate the genetic,environmental,and lifestyle factors influencing the development and progression of pediatric pancreatic tumors across diverse *** also outlines future directions,calling for advancements in precision medicine and innovative care delivery models to improve global patient *** Makita et al's findings within the broader landscape of pediatric oncology can stimulate further research and clinical advancements in managing pancreatic and other rare tumors in children.

关键词： Child Epidemiology Japan Pancreatic endocrine tumors Pancreatic neoplasms Pancreatoblastoma Pediatric oncology Solid pseudopapillary neoplasm surgical management Survey

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Internal hernia as a rare cause of small bowel obstruction:An insight from 13 years of experience

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World Journal of Clinical Cases 2025年第7期13卷 21-27页

作者： Payal Kaw Anu Behari Supriya Sharma Ashok Kumar Rajneesh K Singh department of surgical Gastroenterology Sanjay Gandhi Post Graduate Institute of Medical SciencesLucknow 226014UPIndia

BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improper treatment,and subsequent morbidity and *** To determine the clinico-demographic profile,radiological and operative findings,and postoperative course of patients with IH and its association with *** Medical records of 586 patients with features of SBO presenting at a tertiary care centre at Lucknow,India between September 2010 and August 2023 were *** Out of 586 patients,7(1.2%)were diagnosed with *** these,4 had congenital IH and 3 had acquired *** male-to-female ratio was 4:*** median age at presentation was 32 ***-enhanced computed tomography(CECT)was the most reliable investigation for preoperative identification,demonstrating mesenteric whirling and clumped-up bowel *** paraduodenal hernia and transmesenteric hernia occurred with an equal frequency(approximately 43%each).Intraoperatively,one patient was found to have bowel ischemia and one had associated malrotation of *** follow-up,no recurrences were *** IH,being a rare cause,must be considered as a differential diagnosis for SBO,especially in young patients in their 30s or with unexplained abdominal pain or discomfort post-surgery.A rapid imaging evaluation,preferably with CECT,is necessary to aid in an early diagnosis and prompt intervention,thereby reducing financial burden related to unnecessary investigations and preventing the morbidity and mortality associated with closed-loop obstruction and strangulation of the bowel.

关键词： Paraduodenal hernia Internal hernia Mesenteric whirling Bowel obstruction Computed tomography

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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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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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Correlation analyse between thyroid hormone levels and severity of schizophrenia symptoms

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World Journal of Psychiatry 2025年第1期15卷 63-71页

作者： Qi-Hui Jiang Wei-Dong Gong department of Endocrinology and Metabolism Hengyang Central HospitalHengyang 421000Hunan ProvinceChina Breast Tumor surgical Outpatient Hengyang Central HospitalHengyang 421000Hunan ProvinceChina

BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid *** To study the relationship between triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH)and *** In this study,100 schizophrenia patients were selected from our hospital between April 2022 and April *** clinical data were analyzed *** on the Positive and Negative Syndrome Scale(PANSS)score,patients were divided into mild(1-3 points,n=39),moderate(4 points,n=45),and severe groups(5-7 points,n=16).Additionally,55 healthy individuals served as a control *** blood samples were collected to measure T3,T4,FT3,FT4,TSH,and cortisol concentrations,analyzing their relationship with PANSS *** The serum levels of T3,FT3,FT4,TSH and cortisol in the schizophrenia group were lower than those in the control group(P<0.05).With the increase of the severity of the disease,the concentrations of T3 and T4 decreased,while the con-centrations of TSH and cortisol increased(P<0.05).The concentrations of TSH and cortisol were positively correlated with the PANSS score,while T3 and T4 were negatively correlated with the PANSS score(P<0.05).The receiver ope-rating characteristic curve results showed that T3,T4,TSH,and cortisol had good efficacy in the diagnosis of *** results showed that decreased T3 level,decreased T4 level,decreased TSH level and increased cortisol level may be independent risk factors for *** Thyroid hormone levels are associated with the severity of schizophrenia symptoms,which can provide new solutions for the diagnosis and treatment of schizophrenia.

关键词： Thyroid hormone Schizophrenia Symptom severity Positive and Negative Syndrome Scale score Cortisol

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Brachioradialis tendon transfer and palmaris longus tendon graft for thumb avulsion:A case report and review of literature

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World Journal of Clinical Cases 2025年第4期13卷 48-55页

作者： Pierre Curings Sonia Ramos-Pascual Kinga Michalewska Nicolas Gibert Lionel Erhard Mo Saffarini AlexisNogier department of Hand Surgery Clinique TrenelSainte-Colombe 69560France Medical Research ReSurg SANyon 1260VaudSwitzerland department of Hand Surgery Hand and Upper Limb Surgical InstituteVilleurbanne 69100France department of Orthopaedics Clinique TrenelSainte-Colombe 69560France

BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous *** treatments include direct tendon suture or tendon transfer,most commonly from the ring *** optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon *** SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a *** patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and *** patient was treated with two stage thumb *** first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon *** second intervention consisted of PL tendon graft and BR tendon ***-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 *** Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.

关键词： Brachioradialis tendon transfer Flexor pollicis longus Palmaris longus tendon graft Replantation Thumb amputation Thumb avulsion Case report

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Endoscopic techniques for the diagnosis of pancreatic cystic lesions

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World Journal of Gastroenterology 2025年第1期31卷 1-7页

作者： Sahib Singh Saurabh Chandan Rakesh Vinayek Jahnvi Dhar Jayanta Samanta Gabriele Capurso Ivo Boskoski Cristiano Spada Jorge D Machicado Stefano Francesco Crinò Antonio Facciorusso department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States department of Gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Division of Pancreato-Biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRoma 00168Italy department of Gastroenterology and Endoscopy Catholic UniversityRoma 00168Italy department of Gastroenterology University of Michigan HealthAnn ArborMI 48107United States department of Endoscopy University of VeronaVerona 37121VenetoItaly Gastroenterology Unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other *** accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced *** studies have reported varying diagnostic and adverse event rates with these *** addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different *** this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

关键词： Endoscopic ultrasound Fine needle aspiration Needle confocal laser endomicroscopy Through-the-needle biopsy Contrast-enhanced endoscopic ultrasound

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Corticosteroid-free immunosuppression in liver transplantation: An evidence-based review

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World Journal of Gastroenterology 2014年第31期20卷 10703-10714页

作者： George Sgourakis Georgia Dedemadi 2~(nd) surgical department and surgical Oncology Unit "Korgialenio-Benakio" Red Cross Hospital surgical department of "Amalia Fleming" General Hospital

Thirty-six randomized controlled trials and two metaanalyses were reviewed. With respect to adult patients undergoing first orthotopic liver transplantation(OLT), steroid replacement resulted in fewer cases of overall acute rejection in the corticosteroid free-immunosuppression arm. Initial steroid administration for two weeks and early tacrolimus monotherapy is a feasible immunosuppression regimen without steroid replacement, although further investigations are needed in view of chronic rejections. No significant differences were noted between the treatment groups in terms of patient and graft survival independently of steroid replacement. Renal insufficiency, de novo hypertension, neurological disorders and infectious complications did not differ significantly among steroid and steroidfree groups. Diabetes mellitus, cholesterol levels and cytomegalovirus infection are more frequent in patients within the steroid group. With respect to diabetes mellitus and hypercholesterolemia, the difference was independent of steroid replacement. In relation to transplanted hepatitis C virus patients, mycophenolate mofetil does not appear to have a significant antiviral effect despite early reports. Male gender of donors and recipients, living donors, cold ischemia times, acute rejection, and early histological recurrence were related to the development of advanced hepatitis. There is sufficient scientific clinical evidence advocating avoidance of the ab initio use of steroids in OLT.

关键词： Meta-analysis Evidence based Hepatitis C virus recurrence Liver transplantation Steroid withdrawal Orthotopic liver transplantation

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