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Comparison of the Outcome of Treatment of Chronic Osteomyelitis by surgical Debridement with and without Local Antibiotic Delivery System: Experience from a Nigerian teaching hospital

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International Journal of Clinical Medicine 2013年第7期4卷 313-318页

作者： Ikpeme A. Ikpeme Enembe O. Oku Ngim E. Ngim Iniabasi U. Ilori Innocent E. Abang Department of Anaesthesiology University of Calabar Teaching Hospital Calabar Nigeria. Department of Com- munity Medicine University of Calabar Teaching Hospital Calabar Nigeria Department of Orthopaedics and Traumatology University of Calabar Teaching Hospital Calabar Nigeria

Background: Chronic osteomyelitis is still common in the developing world and presents a continuing therapeutic challenge. Antibiotics cannot penetrate the dense fibrotic scar tissue that surrounds infected and avascular bone which perpetuates the infection. surgical debridement/sequestrectomy is the cornerstone to treatment and aims to create a viable, vascularized base which promotes healing. surgical debridement necessarily creates a dead space which must be dealt with to prevent re-infection. Local antibiotic delivery systems serve the dual purpose of obliterating dead space and creating a sterile local environment with high bactericidal concentrations. Aim: To determine the outcomes in patients with chronic osteomyelitis who received debridement/sequestrectomy alone, and those who received the procedure combined with a local antibiotic delivery system in the University of Calabar teaching hospital. Patients and Methods: A prospective descriptive analysis of patients managed surgically for chronic osteomyelitis from July 2007 to December, 2012. Patients’ biodata, aetiology, organisms, treatment options and outcomes were analysed. Results: Forty-four patients presented with the condition and accepted surgery. Male:Female ratio was 2.1:1, and mean age was 27.27 ± 17.48 years. The tibia was the most commonly affected bone (45.5%), Staphylococcus aureus was the commonest organism (56.8% of sinus cultures;73% of marrow/sequestral cultures) and previous acute haematogenous osteomyelitis was the commonest mechanism. The use of a local antibiotic delivery system improved cure rates from 57.7% to 77.8%). Conclusion: Multiple surgical interventions increase the socioeconomic costs of treating this condition and have a direct impact on the economies of individuals especially in the developing world. surgical interventions should aim at achieving maximum impact with minimum repetition of the processes. Adequate surgical debridement combined with a local antibiotic delivery

关键词： Chronic Osteomyelitis Debridement/Sequestrectomy Local Antibiotic Systems Outcomes

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surgical Activities in the Gynecology-Obstetrics Department of the teaching hospital Yalgado-Ouédraogo of Ouagadougou: Assessment of One Year of Practice from January 1<sup>st</sup>, 2015 to December 31<sup>st</sup>, 2015

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Open Journal of Obstetrics and Gynecology 2018年第14期8卷 1501-1509页

作者： Dantola Paul Kain Issa Ouédraogo Yobi Alexis Sawadogo Evelyne Komboigo Sibraogo Kiemtoré Adama Ouattara Hyacinthe Zamané Blandine Thiéba Department of Obstetrics and Gynecology Yalgado Ouedraogo Teaching Hospital in Ouagadougou Ouagadougou Burkina Faso Department of Obstetrics and Gynecology Teaching Hospital in Ouahigouya Ouahigouya Burkina Faso

Objective: The objective of our study was to study the surgical activities carried out in the gynecology-obstetrics department of the CHU-YO (teaching hospital Yalgado Ouédraogo) from January 1st 2015 to December 31st, 2015. Patients and Methods: This dealt with a cross-cutting descriptive and analytic study with retrospective data collection. Our study has included the female patients who underwent surgery in the operating room and whose medical records were usable. Results: 45% of female patients admitted in the concerned department underwent a surgery. The average age of patients was estimated at 28.02 years ±7 years with extremes of 13 years and 80 years. Obstetrical surgery has involved 89.9% of cases. Female patients have received a loco-regional anesthesia in 92.7% of cases. Emergency surgical operations accounted for 88.8% and caesarean section was the main surgical operation carried out in 87.1% of cases. The mortality rate of the overall surgical operations was 1.04%. Conclusion: A better availability of labile blood products is more likely to reduce the mortality rate of surgical operations under the threshold of 1%.

关键词： Surgery Caesarean Section Prognosis Mortality Rate

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surgical Site Infections in Trauma and Orthopaedics at Bouaké teaching hospital (Côte d’Ivoire)

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Open Journal of Orthopedics 2024年第9期14卷 381-390页

作者： Loukou Blaise Yao Koffi Léopold Krah Aya Adelaïde Natacha Kouassi Kouamé Innocent M’bra Kouamé Jean-Eric Kouassi Michel Kodo Department of Trauma and Orthopaedics Bouak Teaching Hospital Bouak Cte dIvoire

Background: surgical site infections are serious healthcare problems. The aim was to describe the epidemiological, diagnostic, therapeutic, and prognostic aspects of surgical site infections in Trauma and Orthopaedics at Bouaké teaching hospital. Method: This retrospective, descriptive, and analytical study was conducted from January 2019 to December 31, 2021. The data studied included prevalence, initial lesions, type of surgical intervention, type of SSI, bacteria involved, treatment, and outcomes. Results: Forty-four (11%) of the 399 patients included in the study developed a surgical site infection. The mean age was 27 years, with 36 male and 8 female. Initial lesions were predominantly open fractures (n = 31;70%), with a mean delay of 48 hours for surgical management. Emergency interventions accounted for 70% (n = 31) of cases. The NNISS infection risk score was 1 in 80% (n = 35) of cases. Superficial infections (n = 34;77%) appeared early, on a mean 6 days postoperatively. Bacteriological analysis primarily identified Pseudomonas aeruginosa (n = 10;23%), sensitive to Imipenem and Chloramphenicol but resistant to Amoxicillin-clavulanic acid, Ceftriaxone, Gentamicin, and Ciprofloxacin. Multidrug-resistant bacteria were found in 89% (n = 8) of cases, with all bacteria resistant to Ceftriaxone. surgical revision was performed in 10 patients (23%), primarily involving debridement with hardware retention (n = 7;70%). Chloramphenicol was the most commonly used antibiotic post-antibiogram (61%). Outcomes were favourable in 98% of cases. Identified risk factors included the type of lesion according to NRC classification, the delay in managing open fractures, and the NNISS score. Conclusion: The prevalence of surgical site infection was 11%, favoured by the delayed operation of open fractures.

关键词： surgical Site Infection Open Fractures Pseudomonas aeruginosa Ceftriaxone

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Acute Intestinal Invagination of the Child at the teaching hospital of Bouaké: Ultrasound Diagnosis and Clinical-Echo-surgical Correlation

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Open Journal of Medical Imaging 2021年第1期11卷 18-28页

作者： Bouassa Davy Melaine Kouakou Konaté Issa Kouamé Paul Bonfils Kouassi Adoubs Cé lestin Bé nié Tsri Akoli Baudouin Bravo Kesse Emile Tanoh Allou Florent Kouadio Brou Lambert Yao Achie Jean-Ré gis Akobe Sara Carole Sanogo Malick Soro Kouadio N’Dri Medical Imaging and Radiodiagnostic Departement of the teaching hospital of Bouaké Bouak&#233 Ivory Coast Training and Research Unit Medical Sciences Alassane Ouattara University Bouak&#233 Ivory Coast Pediatric Surgery Unit of the teaching hospital of Bouaké Bouak&#233 Ivory Coast

Background: Acute intestinal invagination or intussusception is the most common abdominal surgical emergency in infants, but it can occur at any age. Performing an ultrasound scan at the slightest clinical suspicion contributes to early diagnosis and therapeutic management. Objective: To show the relevance of ultrasound in the therapeutic management of the child’s intussusception through a correlation between the ultrasound diagnosis and the clinical and/or per operative diagnosis. Patients and Methods: It was a retrospective study of 24 cases from July 2017 to September 2020 (30 months) in the Medical Imaging and Paediatric Surgery departments of teaching hospital of Bouaké. We included only patients from 0 to 15 years old who had digestive symptoms, an abdominal ultrasound scan. These patients were eligible for surgery. Data analysis was performed with Epi info 7 software. Results: Median age was 17.2 months [02 - 120]. Male gender predominated (83.3%). Clinico-biological data were dominated by abdominal pain (79.2%), vomiting (75%) and rectorragies (33.3%), with Ombredanne’s triad in 33.3% and hyperleukocytosis (70.8%). Ultrasonography showed invaginated coves (95.8%) sitting in the right angl iliac fossa, peri-umbilical and right flank in 73.9%. Cockade image coupled with the sandwich image accounted for 95.6%. Superficial adenopathies (45.8%) and peri-lesional fluid effusion (20.8%) were associated with it. An occlusive syndrome complicating intussusception was observed in 41.67% associated with intra-peritoneal effusion of fluid (25%). There was a significant diagnostic agreement between the clinic, ultrasound and surgery according to the Fisher’s exact test (p = 0.002). That between ultrasound and surgery was calculated at 95.4%. Conclusion: This study allowed us to show a good clinical-echo-surgical concordance. Ultrasound is therefore an undeniable diagnostic, prognostic an

关键词： Ultrasound Acute Intestinal Invagination Child

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Skin and Soft Tissue Infections in the surgical Area at the Kara teaching hospital

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surgical Science 2024年第2期15卷 48-53页

作者： Tamegnon Dossouvi Tchaa Hodabalo Towoezim Efoé-Ga Olivier Amouzou Kokou Kouliwa Kanassoua Irokoura Kassagne Ayi Amavi Abossisso Sakiye Komlan Adabra Ekoué David Dosseh Department of General Surgery Dapaong Regional Hospital Center Dapaong Togo Department of Orthopedic and Traumatology Kara Teaching Hospital Kara Togo Department of General Surgery Kara Regional Hospital Center Kara Togo Department of General Surgery Sylvanus Olympio University Hospital Lomé Togo

Objective: To report the management of skin and soft tissue infections in the surgical area of Kara University hospital in Togo. Material and Methods: This study was conducted retrospectively from January 1, 2021, to December 31, 2022, in the general surgery and orthopedic trauma departments. The study focused on soft tissue infections of the pelvic and thoracic limbs and analyzed epidemiological, clinical, paraclinical, therapeutic, and evolutionary data. Results: We registered 165 patients, comprising 109 men and 56 *** sex ratio (F/H) were 0.51. The mean age was 45 years with extremes ranging from 23 to 90 years. Farmers (64.8%) followed by housewives (34.0%) were the social strata most affected. The consultation period varied between 1 and 90 days. The pathologies found were necrotizing fasciitis (53.3%), erysipelas (18.2%), infected limb wounds (12.1%), pyomyositis (9.7%), and necrotizing dermo-hypodermitis (1.8%). The main procedures performed were necrosectomy and grafting (62.9%), sample necrosectomy (18.8%), drainage (9.7%), and pelvic limb amputation (1.2%). Follow-up was favorable in 86.7% of cases. The study noted a death rate of 13.3% due to septic shock secondary to a delay in consultation. Conclusion: Skin and soft tissue infections were a common reason for surgical hospitalization at Kara University hospital, with a high mortality rate due to delayed consultations.

关键词： Skin and Soft Tissue Infections Necrotizing Fasciitis Erysipelas Emergency

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Successful Pregnancy after Novel Uterine Prolapse surgical Technique: A Case Report at Sinnar Maternity teaching hospital

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Open Journal of Obstetrics and Gynecology 2024年第11期14卷 1702-1706页

作者： Isam Mohamed Babbiker Hatim Tagalsir Osman Ali Majdolin Ali Elnur Kheir Elseed Sabah Mohammed Ibrahim Department of Obstetrics and Gynecology University of Sinnar Sinnar Sudan Department of Obstetrics and Gynecology King Khalid University Abha Saudi Arabia Sinnar Maternity teaching hospital Sinnar Sudan

Procidentia is one of complications of pregnancy and childbirth. The challenge of treatment is to preserve fertility if needed and to find effective methods with rapid learning curve. Our technique—Isam technique—fulfills these needs with a short hospital stay, very low risk of complications and relapse, a rapid learning curve as well, and no need for long contraceptive methods after operation.

关键词： Procidentia Learning Curve Pregnancy Fertility Isam Technique

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Changing clinical profile,management strategies and outcome of patients with biliary tract injuries at atertiary care center in SriLanka

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Hepatobiliary & Pancreatic Diseases International 2011年第5期10卷 526-532页

作者： Jasin Arachchige Saman Bingumal Jayasundara Waradana Mohan Malith de Silva Ajith Aloka Pathirana University surgical Unit Colombo South Teaching Hospital Kalubowila Sri Lanka

BACKGROUND: Biliary tract injuries are mostly iatrogenic Related data are limited in developing countries. There are lessons to be learned by revisiting the clinical profiles management issues and outcome of patients referred to a tertiary care center in Sri Lanka, compared with the previous data from the same center published in 2006. Such a review is particularly relevant at a time of changing global perceptions of iatrogenic biliary injuries. This study aimed to analyze and compare the changes in the injury pattern, management and outcome following biliary tract injury in a Sri Lankan study population treated at a tertiary care center. METHODS: A retrospective analysis was made of 67 patients treated between May 2002 and February 2011. The profiles of the last 38 patients treated from October 2006 to February 2011 were compared with those of the first 29 patients treated from May 2002 to September 2006. Definitive management options included endoscopic biliary stenting, reconstructive hepaticojejunostomy with creation of gastric access loops and biliary stricture dilation. Post-treatment jaundice cholangitis and abdominal pain needing intervention were considered as treatment failures. RESULTS: In the 67 patients, 55 were women and 12 men Their mean age was 40.6 (range 19-80) years. Five patients had traumatic injuries. Thirty-seven injuries (23 during the second study period) were due to laparoscopic cholecystectomy and 25 (10 during the second study period) to open cholecystectomy The identification rate of intra-operative injury was 19% in the laparoscopic group and 8% in the open group. Bismuth typeI, II, III and IV injuries were seen in 18, 18, 15 and 12 patients, respectively. Endoscopic stenting was the definitive treatment in 20 patients. In 35 patients who had hepaticojejunostomy, 33 underwent creation of the gastric access loop. Twenty- two reconstructions were performed during the second study period. A gastric access loop was used for endotherapy in t

关键词： gastric access loop hepaticojejunostomy endoscopic biliary stenting biliary tract injuries

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Incidence and Risk Factors of surgical Site Infections in Urological Surgery at Brazzaville teaching hospital

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Open Journal of Urology 2019年第2期9卷 42-50页

作者： A. M. Ondongo Atipo S. A. Ondziel A. W. S. Odzébé M. R. Banga Y. Lere P. A. Bouya Urology-Andrology Department University Hospital of Brazzaville Brazzaville Republic of the Congo

Aim: To evaluate the incidence of surgical site infection in the Urology Department of Brazzaville teaching hospital. Methods: This was a prospective study performed in the Urology Department and operating room of the Brazzaville teaching hospital during six months from February 2nd to July 2nd 2017. The study concerned all patients who had undergone surgery, selected during the operating program and those who had been in emergency and then hospitalized in the urology department. These patients were followed for one month after the intervention date. Results: 209 patients were operated on of whom 48 had surgical site infection, a cumulative incidence of 22.96%. The average age of infected patients was 58.3 years ± 17.73 ds (extremes from 13 to 85 years). 43.75% infected patients had co-morbidity factors. The SSI rate was 70% in patients with positive urine culture. Urinary catheters were found in 33.33% of patients. The average length of preoperative hospital stay was two days. The rate of SSI in patients classified Asa I was 10.41%, Asa II 37.5% and Asa III 52.09%. The SSI rate was respectively 5.21%, 56.76% and 38.03%. The infected patients operated first in the operative program accounted for 10.42%. The group of patients who underwent prostatic surgery accounted for 42.58% of patients with an SSI rate of 47.91%. The practice of aseptic measures by staff was found in 70% of cases. The infection rate in patients with drain was 73.23%. The infection rate in patients with catheters was 54.26%. The SSI was superficial in 66.67% of cases, deep in 25% of cases and organ in 8.33% of cases. Escherichia coli was the most frequently isolated germ 50%. Conclusion: surgical site infection (ISO) is a common feature in our practice. The advanced age of patients and comorbidity factors are associated with a high risk of occurrence of SSI. These infections were not inevitable, their incidence can be greatly reduced by specific preventive measures.

关键词： surgical Site Infection Urology Brazzaville teaching hospital

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Bidirectional regulation of the brain-gut-microbiota axis following traumatic brain injury

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Neural Regeneration Research 2025年第8期20卷 2153-2168页

作者： Xinyu You Lin Niu Jiafeng Fu Shining Ge Jiangwei Shi Yanjun Zhang Pengwei Zhuang National Key Laboratory of Chinese Medicine Modernization Tianjin University of Traditional Chinese MedicineTianjinChina Haihe Laboratory of Modern Chinese Medicine Tianjin University of Traditional Chinese MedicineTianjinChina First teaching hospital of Tianjin University of Traditional Chinese Medicine TianjinChina National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion TianjinChina

Traumatic brain injury is a prevalent disorder of the central nervous *** addition to primary brain parenchymal damage,the enduring biological consequences of traumatic brain injury pose long-term risks for patients with traumatic brain injury;however,the underlying pathogenesis remains unclear,and effective intervention methods are *** dysfunction is a significant consequence of traumatic brain *** the most densely innervated peripheral tissue in the body,the gut possesses multiple pathways for the establishment of a bidirectional“brain-gut axis”with the central nervous *** gut harbors a vast microbial community,and alterations of the gut niche contribute to the progression of traumatic brain injury and its unfavorable prognosis through neuronal,hormonal,and immune pathways.A comprehensive understanding of microbiota-mediated peripheral neuroimmunomodulation mechanisms is needed to enhance treatment strategies for traumatic brain injury and its associated *** comprehensively reviewed alterations in the gut microecological environment following traumatic brain injury,with a specific focus on the complex biological processes of peripheral nerves,immunity,and microbes triggered by traumatic brain injury,encompassing autonomic dysfunction,neuroendocrine disturbances,peripheral immunosuppression,increased intestinal barrier permeability,compromised responses of sensory nerves to microorganisms,and potential effector nuclei in the central nervous system influenced by gut ***,we reviewed the mechanisms underlying secondary biological injury and the dynamic pathological responses that occur following injury to enhance our current understanding of how peripheral pathways impact the outcome of patients with traumatic brain *** review aimed to propose a conceptual model for future risk assessment of central nervous system-related diseases while elucidating novel insights into the bidirectional effec

关键词： traumatic brain injury brain-gut-microbiome axis gut microbiota neuroimmune immunosuppression host defense vagal afferents bacterial infection dorsal root ganglia nociception neural circuitry

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Assessing healthcare workers’knowledge and confidence in the diagnosis,management and prevention of Monkeypox

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World Journal of Clinical Cases 2025年第1期13卷 38-47页

作者： Epipode Ntawuyamara Thierry Ingabire Innocent Yandemye Polycarpe Ndayikeza Bina Bhandari Yan-Hua Liang Department of Dermatology Cosmetology and VenereologyShenzhen Hospital of Southern Medical UniversityShenzhen 518101Guangdong ProvinceChina Department of Dermatology and Venereology Kamenge Teaching HospitalUniversity of BurundiBujumbura 1020Burundi Department of Infectious Diseases Kamenge Teaching HospitalUniversity of BurundiBujumbura 1020Burundi General Directorate of Healthcare Supply Modern and Traditional MedicineNutrition and RegistrationMinistry of Public Health and Fight Against HIV/AIDSBujumbura 1055Burundi Department of Epidemiology National Institute of Public HealthBujumbura 350Burundi General Directorate of Planification Ministry of Public Health and Fight Against HIV/AIDSBujumbura 1055Burundi

BACKGROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central *** To assess Burundi healthcare workers(HCWs)s’level of knowledge and confidence in the diagnosis and management of *** We conducted a cross-sectional study via an online survey designed mainly from the World Health Organization course distributed among Burundi HCWs from June-July *** questionnaire comprises 8 socioprofessional-related questions,22 questions about Mpox disease knowledge,and 3 questions to assess confidence in Mpox diagnosis and *** data were analyzed via SPSS software version 25.0.A P value<0.05 was considered to indicate statistical *** The study sample comprised 471 HCWs who were mainly medical doctors(63.9%)and nurses(30.1%).None of the 22 questions concerning Mpox knowledge had at least 50%correct responses.A very low number of HCWs(17.4%)knew that Mpox has a *** confidence level to diagnose(21.20%),treat(18.00%)or prevent(23.30%)Mpox was low among *** confidence level in the diagnosis of Mpox was associated with the HCWs’age(P value=0.009),sex(P value<0.001),work experience(P value=0.002),and residence(P value<0.001).The confidence level to treat Mpox was significantly associated with the HCWs’age(P value=0.050),sex(P value<0.001),education(P value=0.033)and occupation(P value=0.005).The confidence level to prevent Mpox was associated with the HCWs’education(P value<0.001),work experience(P value=0.002),residence(P value<0.001)and type of work institution(P value=0.003).CONCLUSION This study revealed that HCWs have the lowest level of knowledge regarding Mpox and a lack of confidence in the ability to diagnose,treat or prevent *** is an urgent need to organize continuing medical education programs on Mpox epidemiology and preparedness for Burundi *** encourage future researchers to assess potential hesitancy toward Mpox vaccination and its asso

关键词： Monkeypox Public health emergency of international concern Healthcare workers Epidemic Preparedness Knowledge Confidence

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