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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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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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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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A novel flexible nerve guidance conduit promotes nerve regeneration while providing excellent mechanical properties

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Neural Regeneration Research 2025年第7期20卷 2084-2094页

作者： Tong Li Quhan Cheng Jingai Zhang Boxin Liu Yu Shi Haoxue Wang Lijie Huang Su Zhang Ruixin Zhang Song Wang Guangxu Lu Peifu Tang Zhongyang Liu Kai Wang department of Orthopedics the Fourth Medical Center of Chinese PLA General HospitalBeijingChina department of Training and Sports Medicine Characteristic Medical Center of Chinese People’s Armed Police ForceTianjinChina medical School of Chinese PLA BeijingChina Key Laboratory of Bioactive Materials for the Ministry of Education College of Life SciencesNankai UniversityTianjinChina department of Orthopedics Tianjin HospitalTianjinChina department of Rehabilitation Medicine Er Quan Hospital of PAPWuxiJiangsu ProvinceChina

Autografting is the gold standard for surgical repair of nerve defects>5 mm in length;however,autografting is associated with potential complications at the nerve donor *** an alternative,nerve guidance conduits may be *** ideal conduit should be flexible,resistant to kinks and lumen collapse,and provide physical cues to guide nerve *** designed a novel flexible conduit using electrospinning technology to create fibers on the innermost surface of the nerve guidance conduit and employed melt spinning to align ***,we prepared disordered electrospun fibers outside the aligned fibers and helical melt-spun fibers on the outer wall of the electrospun fiber *** presence of aligned fibers on the inner surface can promote the extension of nerve cells along the *** helical melt-spun fibers on the outer surface can enhance resistance to kinking and compression and provide *** novel conduit promoted nerve regeneration and functional recovery in a rat sciatic nerve defect model,suggesting that it has potential for clinical use in human nerve injuries.

关键词： aligned fibers anti-kinking helical fibers nerve guidance conduit nerve regeneration peripheral nerve injury topological guidance

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surgical Intervention on Uterine Fibromyoma in a Country with Limited Resources: Case of the Gynaecology-Obstetrics department of the Communal medical Centre of Ratoma Conakry-Guinea

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Open Journal of Obstetrics and Gynecology 2020年第5期10卷 615-625页

作者： M. H. Diallo I. S. Baldé A. D. Diallo O. Baldé F. B. Diallo M. S. Fofana A. Sow A. B. Barry T. Sy N. Keita department of Gynaecology-Obstetrics Donka National Hospital Conakry Guinea department of Gynecology-Obstetrics Ignace Deen National Hospital Conakry Guinea Visceral Surgery department Donka National Hospital Conakry Teaching Hospital Conakry Guinea department of Gynecology-Obstetrics Ratoma Communal Medical Centre Conakry Guinea

In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform.?Objectives: The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management.?Patients and Method:?It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from January 1, 2015 to December 31, 2018 and a 1-year prospective study from January 1, 2019 to December 31, 2019.?Results: We collected 135 cases of uterine fibromyomas operated on out of a total of 260 cases of gynaecological pathologies, i.e.?a frequency of 51.92%.?Nulliparous women were the most concerned (45.18%), and women who attended school (60%) and those who did not attend school (40%). Women at home and housewives accounted for 42.20% and 54.07% respectively. Clinically, the circumstances of discovery were dominated by menometrorrhagia and menorrhagia respectively 77.77% and 68.14%. The large uterus was the most frequent physical sign found in 96.29% of cases. Uterine fibromyomas were recorded in 86.6% of cases in women with genital activity. The operative indications were dominated by the large polymyomatous uterus (64.44%), followed by hemorrhagic fibroma (18.52%).?The surgical treatment was conservative in 92.60%. The total hysterectomy performed in 7.40.?Lethality was 1.4%.?Conclusion: The surgical management of fibroids contrasts conservative treatment (myomectomy) with radical treatment (hysterectomy) with multiple possible approaches (hysteroscopy, vaginal surgery, laparoscopy or laparotomy). In our context, only laparotomy was possible due to lack of equipment. Laparoscopy and hysteroscopy equipment is necessary for less invasive

关键词： Fibromyoma Myomectomy Hysterectomy Ratoma

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Precision surgical approach with lymph-node dissection in early gastric cancer

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World Journal of Gastroenterology 2019年第14期25卷 1640-1652页

作者： Shinichi Kinami Naohiko Nakamura Yasuto Tomita Takashi Miyata Hideto Fujita Nobuhiko Ueda Takeo Kosaka department of surgical Oncology Kanazawa Medical University

The gravest prognostic factor in early gastric cancer is lymph-node metastasis,with an incidence of about 10% overall. About two-thirds of early gastric cancer patients can be diagnosed as node-negative prior to treatment based on clinicpathological data. Thus, the tumor can be resected by endoscopic submucosal dissection. In the remaining third, surgical resection is necessary because of the possibility of nodal metastasis. Nevertheless, almost all patients can be cured by gastrectomy with D1+ lymph-node dissection. Laparoscopic or robotic gastrectomy has become widespread in East Asia because perioperative and oncological safety are similar to open surgery. However, after D1+ gastrectomy,functional symptoms may still result. Physicians must strive to minimize postgastrectomy symptoms and optimize long-term quality of life after this *** on the location and size of the primary lesion, preservation of the pylorus or cardia should be considered. In addition, the extent of lymph-node dissection can be individualized, and significant gastric-volume preservation can be achieved if sentinel node biopsy is used to distinguish node-negative *** the surgical treatment for early gastric cancer may be less radical than in the past, the operative method itself seems to be still in transition.

关键词： Stomach neoplasms surgery Gastrectomy methods Recovery of function Sentinel lymph node surgery Gastric cancer

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Improving postoperative outcomes in patients with pancreatic cancer:Inflammatory and nutritional biomarkers

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World Journal of Clinical Oncology 2025年第1期16卷 59-64页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng department of medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305Taiwan Division of Cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei 23561Taiwan Division of Cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002Taiwan department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404328Taiwan

This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic *** et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term *** biomarkers were albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,nutritional risk index,and geriatric nutritional risk *** PNI was found to be a strong predictor of both overall and recurrence-free survival,underscoring its clinical relevance in managing patients with pancreatic cancer.

关键词： Pancreatic cancer Prognostic nutritional index Systemic immune-inflammation index Postoperative recovery Prognosis

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Simultaneous surgery for critical aortic stenosis and gastric cancer:A case report

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World Journal of Gastroenterology 2010年第9期16卷 1161-1164页

作者： Jacek Zielinski Radoslaw Jaworski Rafal Pawlaczyk Maciej Swierblewski Pawel Kabata Janusz Jaskiewicz Jan Rogowski department of surgical Oncology Medical University of Gdansk department of Cardiovascular Surgery Medical University of Gdansk

We describe simultaneous surgery performed on a 71-year-old woman with critical aortic stenosis and gastric cancer that were diagnosed at the same *** patient qualified for simultaneous surgery for both these *** early outcome was *** is a lack of standards for treatment of patients with coexistence of two life-threatening *** discuss surgical tactics and potential benefits of such management.

关键词： Aortic stenosis Aortic valve replacement Gastric cancer Gastric resection

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