Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine t...Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of Gabriel Toure University Hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians’ Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context.展开更多
Introduction: A fracture is a solution in the continuity of a bone. Pelvic limb fractures may involve one or more of the bones. They constitute a real public health problem, which requires the identification of the fa...Introduction: A fracture is a solution in the continuity of a bone. Pelvic limb fractures may involve one or more of the bones. They constitute a real public health problem, which requires the identification of the factors inherent to this phenomenon for better prevention, but also for quality management of fractures and sequelae. Objectives: Were to describe the epidemiological, clinical and therapeutic profile of pelvic limb fractures in Timbuktu Hospital. Patients and Method: We conducted a prospective, descriptive study in the Surgery Department of Timbuktu Hospital, covering a period of one year from January 1 to December 31, 2017. We collected 39 patients who presented with fractures of the pelvic limbs, who were hospitalized and monitored throughout our study. Results: We obtained a hospital frequency of 2.86% limb fractures. Among the 39 patients included in our study, the male sex was predominant in 69.2% of cases, the average age of our patients was 20.5 years. Pupils and students were in the majority in 48.7% of cases. Road traffic accidents were the most common cause of fracture with 59.0% of cases. The tibia was the most affected segment in 38.5% of cases. Surgical treatment was predominant in 64.0% of cases. We obtained very good results in 94.87% of cases. Conclusion: Limb fractures remain frequent due to road traffic accidents. Osteosynthesis treatment provides a good result with fewer complications.展开更多
Cerebral venous thrombosis has an unfavorable prognosis. It is a rather rare pathology concerning 3 to 5 cases per million inhabitants. The clinical symptomatology also varies according to the topography of the venous...Cerebral venous thrombosis has an unfavorable prognosis. It is a rather rare pathology concerning 3 to 5 cases per million inhabitants. The clinical symptomatology also varies according to the topography of the venous thrombosis and, in some cases, the CVT can have an unusual presentation. Progress and accessibility of non-invasive imaging currently allow early diagnosis of CVT. Brain MRI is the reference method for the diagnosis of CVT. We report a case of transverse sinus thrombosis in a 32-year-old male patient who consulted for headaches through which we want to study the etiological, clinical, paraclinical, therapeutic aspects as well as the evolutionary profile. The clinical history dates back to 2 weeks ago with frontal headaches radiating to the occipital region, throbbing of severe intensity, progressive onset and permanent evolution associated with right unilateral anterior purulent rhinorrhea. He had no nasal obstruction, epistaxis, hearing loss or other otological symptoms;no neurological deficit or notion of head trauma. Cerebral and maxillofacial computed tomography showed right maxillary sinusitis and right transverse sinus thrombosis. We carried out medical treatment based on antibiotics and analgesics without the use of anticoagulants. The evolution was favorable after four weeks of treatment. Conclusion: Transverse sinus thrombosis has a non-specific and heterogeneous clinical presentation. Headaches are the first sign. MRI and CT can help establish the diagnosis. The treatment is both etiological and symptomatic.展开更多
文摘Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of Gabriel Toure University Hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians’ Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context.
文摘Introduction: A fracture is a solution in the continuity of a bone. Pelvic limb fractures may involve one or more of the bones. They constitute a real public health problem, which requires the identification of the factors inherent to this phenomenon for better prevention, but also for quality management of fractures and sequelae. Objectives: Were to describe the epidemiological, clinical and therapeutic profile of pelvic limb fractures in Timbuktu Hospital. Patients and Method: We conducted a prospective, descriptive study in the Surgery Department of Timbuktu Hospital, covering a period of one year from January 1 to December 31, 2017. We collected 39 patients who presented with fractures of the pelvic limbs, who were hospitalized and monitored throughout our study. Results: We obtained a hospital frequency of 2.86% limb fractures. Among the 39 patients included in our study, the male sex was predominant in 69.2% of cases, the average age of our patients was 20.5 years. Pupils and students were in the majority in 48.7% of cases. Road traffic accidents were the most common cause of fracture with 59.0% of cases. The tibia was the most affected segment in 38.5% of cases. Surgical treatment was predominant in 64.0% of cases. We obtained very good results in 94.87% of cases. Conclusion: Limb fractures remain frequent due to road traffic accidents. Osteosynthesis treatment provides a good result with fewer complications.
文摘Cerebral venous thrombosis has an unfavorable prognosis. It is a rather rare pathology concerning 3 to 5 cases per million inhabitants. The clinical symptomatology also varies according to the topography of the venous thrombosis and, in some cases, the CVT can have an unusual presentation. Progress and accessibility of non-invasive imaging currently allow early diagnosis of CVT. Brain MRI is the reference method for the diagnosis of CVT. We report a case of transverse sinus thrombosis in a 32-year-old male patient who consulted for headaches through which we want to study the etiological, clinical, paraclinical, therapeutic aspects as well as the evolutionary profile. The clinical history dates back to 2 weeks ago with frontal headaches radiating to the occipital region, throbbing of severe intensity, progressive onset and permanent evolution associated with right unilateral anterior purulent rhinorrhea. He had no nasal obstruction, epistaxis, hearing loss or other otological symptoms;no neurological deficit or notion of head trauma. Cerebral and maxillofacial computed tomography showed right maxillary sinusitis and right transverse sinus thrombosis. We carried out medical treatment based on antibiotics and analgesics without the use of anticoagulants. The evolution was favorable after four weeks of treatment. Conclusion: Transverse sinus thrombosis has a non-specific and heterogeneous clinical presentation. Headaches are the first sign. MRI and CT can help establish the diagnosis. The treatment is both etiological and symptomatic.
