Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowl...Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% r展开更多
Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a ra...Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.展开更多
Tuberculosis (TB) is a serious infectious disease and its control is considered a challenge, particularly among vulnerable populations such as prisoners. The prevalence of TB in prisons is an alarming public health pr...Tuberculosis (TB) is a serious infectious disease and its control is considered a challenge, particularly among vulnerable populations such as prisoners. The prevalence of TB in prisons is an alarming public health problem in many countries. The aim of this study is to describe the epidemiology of tuberculosis and the strategies for controlling this disease in the Chadian prison population. During the course of our study, the prevalence of tuberculosis in prisons was 9.64%. The age group between 55 years and over (43.33%) was the most represented in this study, and all patients were men with a frequency of 62.66%. The cross-tabulation of Culture_7H9G and Culture_7H9P showed that out of our total positive sample, we found a total of 87 positive strains and 63 negative strains. Our study shows that it is essential to know the prevalence of tuberculosis in all the country’s prisons. Indeed, this can serve as an indication of the need for action in prisons to reduce TB rates, in particular by improving the structure of prison environments, diagnosing new cases quickly and accurately, identifying drug-resistant strains and implementing effective, direct treatment observed in people with tuberculosis.展开更多
Introduction: Urogenital fistula is the existence of an abnormal pathway between a urinary organ and a genital organ. It is a public health problem because of its frequency and social aspect. The aim of this study was...Introduction: Urogenital fistula is the existence of an abnormal pathway between a urinary organ and a genital organ. It is a public health problem because of its frequency and social aspect. The aim of this study was to analyse the management of urogenital fistulas by the upper route at the National Fistula Treatment Centre in N’Djamena. Material and Methods: This was a 10-year retrospective descriptive and analytical study from May 2011 to April 2021. The records of all patients who had received fistula treatment during this period were identified and analysed. Results: During the study period 2369 patients were managed for cure of urogenital fistula including 84 by the upper route, i.e. 3.5%. The mean age was 28.5 ± 8.13 years. Loss of urine was the most common reason for consultation (71.4%). Primigravida were represented in 50% (n = 42). The average gestational age was 3.2 ± 2.8 with extremes of 0 to 9 pregnancies. Obstetric aetiology was the most common (92.8%). Ureterovaginal fistulas were the most common anatomoclinical type (36.9%). Uretero-vesical reimplantation was the main surgical procedure (41.7%). Late postoperative follow-up was successful in 85.7% of cases. Conclusion: Urogenital fistulas are common in our practice. The only way to combat this scourge is through prevention through information, education and communication.展开更多
The aim of this study to investigate the physico-chemical properties of soils from Diguel and Koudalwa Tchad,and phytoremediation potentials of acasia and kinkeliba plants in removing Cr and Cu from these soils.Soil w...The aim of this study to investigate the physico-chemical properties of soils from Diguel and Koudalwa Tchad,and phytoremediation potentials of acasia and kinkeliba plants in removing Cr and Cu from these soils.Soil was sampled from the tannery plant in Diguel and agricultural land around crude oil activities in Koudalwa.Soils were characterized by the following properties:pH,(Electrical Conductivity),TDS(Total Dissolved Solids),salinity,bulk density,OM(Organic Matter),nitrate,phosphate,clay,silt,sand,and textural class.The acasia and kinkeliba plants were used to decontaminate Cu and Cr from sample soils for 30 days period.The bulk density of all the soil samples from Kouldawa was higher compared to Diguil,ranging from 1.421 to 1.64 g/cm^(3)compared to 1.21 to 1.51 g/cm^(3)for Diguel.Most of the soils in Kouldawa are mineral soils,while those of Diguel are mostly mineral soil with some organics.Diguel soils are richer in nitrate(577.9 to 2,687.32 mg/kg in Diguel and 33.64 to 197.64 mg/kg in Kouldawa)and phosphate than soils from Kouldawa.Soils from the studied areas are not saline except for a subsurface soil in Diguel(salinity,4.21;EC,4.280 dS/m;TDS,3,040 mg/L).The highest amount of Cr and Cu removed by acasia is 78%and 53.12%compared to 73.8%and 52.21%by kinkeliba.Diguel soil can be very suitable for agriculture and Kouldawa soils for construction.Acasia and kinkeliba can be effectively used to decontaminate the studied soils from heavy metal pollution.展开更多
Reinforced concrete (RC) constructions are the innovation of sustainable constructions replacing masonry constructions. Despite this, the use of concrete and steel to improve the performance of structural members in s...Reinforced concrete (RC) constructions are the innovation of sustainable constructions replacing masonry constructions. Despite this, the use of concrete and steel to improve the performance of structural members in service is a recurring problem due to the immediate or overtime appearance of cracks. The objective of this work was therefore to assess the damage phenomena of the steel-concrete interface in order to assess the performance of an RC structure. Samples of approximately 30 cm of reinforcement attacked by rust were taken from broken reinforced concrete columns and beams in order to determine the impact of corrosion on high adhesion steel (HA) and therefore on its ability to resist. The experimental results have shown that the corrosion degradation rates of reinforcing bars of different diameters increase as the diameter of the reinforcing bars decreases: 5% for HA12;23.75% for HA8 and 50% for HA6. Using the approach proposed by Mangat and Elgalf on the bearing capacity as a function of the progress of the corrosion phenomenon, these rates made it possible to assess the new fracture limits of corroded HA steels. For HA6 respectively HA8 and HA12, their initial limit resistances will decrease by 4/4, 3/4 and 1/4. Based on the results of this study and in order to guarantee their durability, an RC structure can be dimensioned by taking into account the effects of reinforcement corrosion.展开更多
Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by ot...Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ED. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ED) seen at the University Hospital of Abeche. Erectile function was assessed using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed to take part in the study. Only 40 patients correctly completed the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented 74%. Diabetes was poorly controlled in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.展开更多
The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity o...The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity of Detarium Senegalense extracts. For this purpose, sequential extraction using solvents of increasing polarity was essential. The various extracts obtained underwent phytochemical and biochemical analyses. Phytochemical screening revealed the presence of flavonoids, alkaloids, tannins, polyphenols, anthocyanins and steroids/terpenes. Quantitative analysis of total polyphenols, total flavonoids and total anthocyanins yielded the following results: total flavonoids (0.803 ± 0029 mg EQ/100g P for acetone extract of roots and 0.871 ± 0.401 mg EQ/100g P for methanol extract of leaves);total polyphenols (23.298 ± 12.68 mg EAG/100g P for acetone extract of roots and 24.69 ± 0.49 401 mg EAG/100g P for methanol extract of leaves);total monomeric anthocyanins (44.697 ± 0.939 mg EC3G/100g P and 16.699 ± 0.193 mg EC3G/100g P respectively for acetone and methanol extracts of stem bark). DPPH free radical scavenging activity was 1.674 ± 0.023 mg/mL for the acetone extract and 0.934 ± 0.24 mg/mL for the methanol extract of roots. .展开更多
The evolution of global mobile data over the past decades in broadcasting, Internet of Things (IoT), education, healthcare, commerce, and energy has put strong pressure on 3G/4G mobile networks to improve their servic...The evolution of global mobile data over the past decades in broadcasting, Internet of Things (IoT), education, healthcare, commerce, and energy has put strong pressure on 3G/4G mobile networks to improve their service offerings. These generations of mobile networks were initially invented to meet the requirements of the above-mentioned applications. However, as the requirements in these applications continue to increase, new mobile technologies such as 5G (fifth generation), 5G and beyond (B5G, beyond fifth generation), and 6G (sixth generation) are still progressing and being experimented. These networks are very heterogeneous generations of mobile networks that will have to offer very high throughput per user, good energy efficiency, better traffic capacity per area, improved spectral efficiency, very low latency, and high mobility. To meet these requirements, the radio interface of future mobile networks will have to be flexible and rationalized the available frequency resources. Therefore, new modulation methods, access techniques and waveforms capable of supporting these technological changes are proposed. This review presents brief descriptions of the types of 5G, B5G, and 6G waveforms. The 5G consists of OFDM including its transmission techniques: generalized frequency division multiplexing (GFDM), filter bank based multi-carrier (FBMC), universal filtered multi-carrier (UFMC), and index modulation (IM). Meanwhile, the 6G covers orthogonal time frequency space (OTFS), orthogonal chirp division multiplexing (OCDM) and orthogonal time sequence multiplexing (OTSM). The networks’ potentialities, advantages, disadvantages, and future directions are outlined.展开更多
Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteris...Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteristics of the epidemiological, clinical, biological, etiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective and descriptive study from January 2021 to December 2021 which took place in the pediatrics department of the Mother and Child University Teaching Hospital of N’Djamena (CHU-ME). All the children in whom we observed abnormal involuntary movements whose age was less than or equal to 15 years were concerned. Result: there were three female children. The average age was 7.5, of which the two are 7 years old and the third is 8 years old. Two had a history of angina. A notion of polyarthralgia and dental caries was found in the third. The diagnosis of post-streptococcal chorea was retained on the basis of clinical arguments: observation of abnormal movements of the limbs and the face, which are involuntary, sudden with an insidious and progressive onset, muscular hypotonia, and psychic disorder. Medical imaging, in particular echocardiography, which objectified two cases of associated rheumatic valvular disease. Remission was observed in all three children after two weeks of treatment with haloperidol, penicillin. Those with associated rheumatic valve disease also received corticosteroid therapy. Complete remission of chorea was observed in all three girls. Prophylaxis in two patients based on Penicillin V was instituted. Conclusion: Although less frequent, post-streptococcal chorea is still seen in our country and is still an important health problem that needs more real medical efforts.展开更多
Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the De...Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the Department of Mayo-Boneye. Methodology: This is a prospective observational study that took place from October to December 2021, including 168 patients with their sociodemographic characteristics. The venous blood of the patients was collected in dry tubes and centrifuged to obtain the serum. The Chlamydia IgG Rapid Test Cassette was used for the detection of antibodies to Chlamydia infection. The Epi Info 7<sup>TM</sup> software was used to perform the statistical analyses. Results: A total of 168 patients were included in this study. The average age was 26.36 ± 9.21 years, the median was 25.5 years with the extremes of 14 years and 70 years. Among these patients, 46.43% were illiterate, 5.95% and 20.83% were primary and secondary school students, respectively, and 26.79% university students. For marital status, 66.67% were single, 16.67% married, 10.71% divorced and 5.95% widowed. Regarding the profession, 26.79% were traders, 8.93% were employees and 64.29% unemployed. In this study, the 168 patients had performed Chlamydia trachomatis serology among whom 02 (1.19%) were excluded for invalid results and 10.71% presented positive cases. The city of Bongor was the most infected with 61% of cases. Among these patients, 54.22% were linked to risk factors for Chlamydia trachomatis. The most infected age group was between 25 and 35 with a seroprevalence of 5.36% of cases. Conclusion: In this study, Chlamydia trachomatis was positive for 10.71% of diagnosed cases. The most affected age groups are young, sexually active women. The State should emphasize the screening of women, the awareness of students and academics.展开更多
Groundwater is the main source of drinking water for large cities in most African countries. In Moundou, for example, the conventional groundwater supply system is failing. To compensate for this state failure, the po...Groundwater is the main source of drinking water for large cities in most African countries. In Moundou, for example, the conventional groundwater supply system is failing. To compensate for this state failure, the population is building boreholes and wells, most of which tap the surface water table, generally referred to as the “water table”. The aim of this study is to characterize these waters in order to assess their level of contamination and, by extension, the degree of pollution of the water table. Major elements such as: Chloride (Cl<sup>-</sup>), Sulfate (SO<sub>4</sub><sup>2-</sup>), Nitrate (NO<sub>3</sub><sup>-</sup>), Calcium (Ca<sup>2+</sup>), magnesium (Mg<sup>2+</sup>), sodium (Na<sup>+</sup>) and potassium (K<sup>+</sup>) were analysed by Liquid Chromatography and the Bicarbonate ion (HCO<sub>3</sub><sup>-</sup>) was determined by the titrimetric method. The methodology applied is based on a combination of hydrochemical techniques and statistical analysis (PCA and CHA). A sampling campaign was carried out during high-water periods. The results of the physico-chemical analyses show mineralization ranging from 7.29 to 3670 μS/cm, with an average of 487.44 μS/cm. The groundwater studied is generally acidic, with a pH ranging from 3.26 to 6.41. Based on their anions, they are classified into four main hydrochemical facies: chloride and sulphate facies, calcium and magnesium facies, sodium and potassium facies and bicarbonate facies. The various correlations between major ions and statistical analyses have enabled us to identify three hydrogeochemical processes involved in water mineralization. The dominant process is silicate hydrolysis, followed by cation exchange, then anthropogenic input, which influences mineralization by polluting the water.展开更多
Introduction: Urolithiasis in children is not sufficiently documented in Chad. Objectives: The aim of this work was to report the epidemiological, clinical and therapeutic aspects of urolithiasis in children in our en...Introduction: Urolithiasis in children is not sufficiently documented in Chad. Objectives: The aim of this work was to report the epidemiological, clinical and therapeutic aspects of urolithiasis in children in our environment. Patients and methods: This was a descriptive retrospective study of patients aged 0 - 15 years treated for urolithiasis between January 2015 and July 2020. The variables studied were age, gender, clinical, paraclinical and therapeutic aspects. Results: Among the 191 children, there were 164 boys (85.9%) and 19 girls (9.9%). The sex ratio was 8.63. The average age was 5.86 years with extremes (1 and 15 years). The symptomatology was dominated by dysuria. The ASP-ultrasound pair allowed the diagnosis in 183 cases (95.8%). The site of the calculus was bladder in 128 cases (67%). The average calculation size was 2.81mm. A supporting cause was found in only 1 case (posterior urethral valve). Treatment was surgical and dominated by cystolithotomy. The postoperative course was marked by 5 cases of parietal infections (2.6%) and 3 cases of vesico-cutaneous fistulas (1.6%). No case of death has been reported. Conclusion: Lithiasis is more common in boys in the lower urinary tract. Open surgery remains the only one practiced. Etiological research must be carried out to develop prevention strategies.展开更多
Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains l...Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains low, and situation makes the bed of unwanted pregnancies leading easily to the induced abortions. The objective was to determine frequency of clandestine induced abortions and to know the motivations of women that practice these abortions in order to find a solution to minimize this practice. Patients and method: We conducted a prospective, descriptive and multicenter survey for three months from November 1st, 2015 to January 31st, 2016 achieved at N’Djamena Mother and Child hospital which is national reference structure in terms reproduction health, Moundou Regional Hospital and Abéché Regional Hospital about the epidemiological aspects and complications clandestine induced abortions. The population of survey was constituted of patients admitted in a maternity of these hospitals for clandestine induced abortion. Every patient having practiced a documented induced abortion and having agreed to participate in the survey was included. Results: During the survey period, we recorded 94 cases of clandestine induced abortions among 2759 deliveries giving a frequency of 3.4%. The age group between 20 - 24 years was the most represented with 42.7%. The average age was 25.4 years, with the extremes ranging from 15 to 42 years. Singles (66%) dominated marital status. Sixty patients (63.9%) were of secondary. These patients were for the most part students or pupils (55.3%). Concerning the parity, nulliparous were the most numerous to practice the abortion (40.5%). More than half our patients (58.7%) knew no contraceptive method. The principal reason evoked to realize the abortion was further studies (38.2%). Means of abortion most used was the misoprostol (36 cases that is 38.2%). In this series, we observed 29 cases of complications, which is 30.8%. The complications were dominated by the anaemia (62.1%). C展开更多
The purpose of this work is to study the vulnerability of the Quaternary aquifer that lies beneath the N’Djamena city Chad. The subsoil of N’Djamena city Chad is made up of a multilayered aquifer in which there are ...The purpose of this work is to study the vulnerability of the Quaternary aquifer that lies beneath the N’Djamena city Chad. The subsoil of N’Djamena city Chad is made up of a multilayered aquifer in which there are two main aquifers located respectively at a depth of about 10 and 60 m, between the two there is an intermediate aquifer at about 30 m depth. It is this latter water table, generally captured by human-powered pumps, that is the subject of this study. Because of anarchic garbage dumping, wastewater discharge, latrines scattered throughout the city, chemical fertilizers and herbicides used on the banks of Chari River and its tributary the Logone for market gardening, the quality of the water in this aquifer is highly threatened. Moreover, it has been noting that the sources of pollution are constantly increasing in conjunction with the growth of the population, so the knowledge and protection of groundwater are necessary. We have therefore carried out a study of intrinsic vulnerability using two mapping methods (GOD and SI), as mapping is recognized as an effective tool for decision support in the case of safeguarding water resources. The results obtained by the GOD method show that 38% of the study area is covered by high vulnerability, 29% by moderate vulnerability, 21% by low vulnerability and 21% by the very low vulnerability. With the SI method, 54% of the study area is covering by low vulnerability and 46% by the low and moderate vulnerability. The coincidence rate of low nitrate values in groundwater with areas of very low and low vulnerability is 91% and 76% for the GOD and SI methods, respectively. Although these observations validated the different maps obtained, the SI approach seems to be the most adequate for vulnerability tracing in our study area.展开更多
Bilateral ectopic pregnancy is the rarest form of ectopic pregnancy. We report a case of spontaneous bilateral tubal ectopic pregnancy diagnosed intra operatively. A 30-year-old patient was admitted to the emergency r...Bilateral ectopic pregnancy is the rarest form of ectopic pregnancy. We report a case of spontaneous bilateral tubal ectopic pregnancy diagnosed intra operatively. A 30-year-old patient was admitted to the emergency room of N’Djamena mother and child hospital complaining of vaginal bleeding and abdominal pain. Salpingectomy left tube and salpingotomy right tube were performed without complication and that histopathological report confirmed the diagnosis.展开更多
Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one m...Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one million inhabitants per year and its evolution can be fatal. Materials and Methods: We report the observation of a 60-year-old patient, with no significant pathological history, admitted to our intensive care unit at the Renaissance University Teaching Hospital in N’Djamena for the treatment of Toxic Epidermal Necrolysis. In whom the onset of symptoms dates back to few hours after vaccination against COVID-19 with Ag Johnson and Johnson. Results: An ophthalmology opinion was requested and the patient was put on Fucithalmic. In our case, in addition to the advanced age of the patient (60 years old), her SCORTEN was ≥5. Conclusion: The late management as well as the absence of a specific department for severe burns, which condition the presence of a technical plate was fatal to her despite multidisciplinary care: Resuscitators, Traumato-Orthopedist and ophthalmologist.展开更多
Although open leg fractures are very common in orthopedics and traumatology, bilateral open leg fractures are extremely rare and are usually associated with an increased risk of complications. We report a case of a si...Although open leg fractures are very common in orthopedics and traumatology, bilateral open leg fractures are extremely rare and are usually associated with an increased risk of complications. We report a case of a simultaneous, asymmetrical, comminuted and bilateral open fracture of the tibia and fibula by a firearm that occurred during an escape attempt in a 29-year-old prisoner. The pre-operative radiological assessment found an open fracture of both legs of the ballistic type;multiple traumatic gunshot wounds with a narrow entry hole and a wide exit hole. Early surgical intervention of intravenous antibiotics, tetanus prophylaxis and open fracture irrigation and debridement was performed within the 6 hour rule. The treatment consisted of a posterior splint followed by trimming andosteosynthesis using a FESSA external fixator from the military health service. A second operation was not needed. Evolution was favorable with ambulation starting from the 45th day. Simultaneous and bilateral tibia-fibula fractures by a firearm are exceptional, therefore, the treatment was surgical with the pre-operative and post-operative protocols well managed.展开更多
<strong>Introduction:</strong> Buschke Lowenstein Tumor (BLT) is a tumor, belonging to the group of verrucous carcinomas. It is endowed with an unpredictable potential of recurrence and degeneration. The a...<strong>Introduction:</strong> Buschke Lowenstein Tumor (BLT) is a tumor, belonging to the group of verrucous carcinomas. It is endowed with an unpredictable potential of recurrence and degeneration. The aim of the work is to present the anatomical and therapeutic characteristics of BLT at the University Hospital of National Reference of N’Djamena in Chad. <strong>Patients and Method:</strong> Prospective descriptive study of 13 patients with BLT, from May 2009 to April 2019 in the department of urology was included. The patients more than 15, carriers of TBL located at: external genitalia, perineum and anal margin whose clinical, paraclinical assessment allowed the diagnosis of BLT, management and follow-up at the said service. Respect for the patient’s identity and consent, the patient’s consent is obtained and the anonymity of the photographs is observed. <strong>Result:</strong> A total of 13 patients had BLT, 11 males and 2 females. The average age of the patients was 32.5 years. The lesions were cauliflower-like and located on the vulva (n = 2), the penis, the perineum, the anorectal region in men (n = 11). Serology was positive for: HIV (n = 3), chlamydia (n = 4). The management was surgical by cauterization and excision. Cystoscopy and rectoscope were normal. The cure was obtained in all patients. Two patients had a recurrence at 5 months requiring a second successful cure. <strong>Conclusion:</strong> BLT is a frequent pathology in the urology department of the University Hospital of National Reference of N’Djamena in Chad. The surgical treatment by “cauterization exeresis” gives a better treatment.展开更多
<strong>Introduction:</strong> Penile cancer is a rare primary malignancy that occurs in patients in their 60s and 70s. The aim of the study was to describe the anatomical aspects of penile cancer and to r...<strong>Introduction:</strong> Penile cancer is a rare primary malignancy that occurs in patients in their 60s and 70s. The aim of the study was to describe the anatomical aspects of penile cancer and to report the difficulties of its management. <strong>Materials and Methods:</strong> This was a retrospective descriptive study of patients with penile tumors from January 2007 to December 2019. Patients of sexual age with an ulcerated lesion of the penis, who came to our department and whose clinical and paraclinical workup led to the diagnosis of penile cancer, were included. The variables studied were clinical, paraclinical and therapeutic. <strong>Results:</strong> In 12 years, we diagnosed and managed 8 patients with penile cancer, an incidence of 0.7 per year. The reason for consultation was the chronic ulcerating wound of the penis with a “cauliflower” aspect. The first medical consultation was late (n = 8) after a long latency period lost to traditional healers. The lesion was located in the glans penis (n = 6) and/or in the corpus cavernosum (n = 2). Histological analysis of the cores concluded to a squamous cell carcinoma. Patients were classified as T2N+M+ (n = 3) and T2N0M0 (n = 5). One patient had accepted partial amputation of the penis. <strong>Conclusion:</strong> Penile cancer is a rare tumor. Partial amputation of the penis is the only alternative in our practice context, an alternative often refuted.展开更多
文摘Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% r
文摘Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.
文摘Tuberculosis (TB) is a serious infectious disease and its control is considered a challenge, particularly among vulnerable populations such as prisoners. The prevalence of TB in prisons is an alarming public health problem in many countries. The aim of this study is to describe the epidemiology of tuberculosis and the strategies for controlling this disease in the Chadian prison population. During the course of our study, the prevalence of tuberculosis in prisons was 9.64%. The age group between 55 years and over (43.33%) was the most represented in this study, and all patients were men with a frequency of 62.66%. The cross-tabulation of Culture_7H9G and Culture_7H9P showed that out of our total positive sample, we found a total of 87 positive strains and 63 negative strains. Our study shows that it is essential to know the prevalence of tuberculosis in all the country’s prisons. Indeed, this can serve as an indication of the need for action in prisons to reduce TB rates, in particular by improving the structure of prison environments, diagnosing new cases quickly and accurately, identifying drug-resistant strains and implementing effective, direct treatment observed in people with tuberculosis.
文摘Introduction: Urogenital fistula is the existence of an abnormal pathway between a urinary organ and a genital organ. It is a public health problem because of its frequency and social aspect. The aim of this study was to analyse the management of urogenital fistulas by the upper route at the National Fistula Treatment Centre in N’Djamena. Material and Methods: This was a 10-year retrospective descriptive and analytical study from May 2011 to April 2021. The records of all patients who had received fistula treatment during this period were identified and analysed. Results: During the study period 2369 patients were managed for cure of urogenital fistula including 84 by the upper route, i.e. 3.5%. The mean age was 28.5 ± 8.13 years. Loss of urine was the most common reason for consultation (71.4%). Primigravida were represented in 50% (n = 42). The average gestational age was 3.2 ± 2.8 with extremes of 0 to 9 pregnancies. Obstetric aetiology was the most common (92.8%). Ureterovaginal fistulas were the most common anatomoclinical type (36.9%). Uretero-vesical reimplantation was the main surgical procedure (41.7%). Late postoperative follow-up was successful in 85.7% of cases. Conclusion: Urogenital fistulas are common in our practice. The only way to combat this scourge is through prevention through information, education and communication.
文摘The aim of this study to investigate the physico-chemical properties of soils from Diguel and Koudalwa Tchad,and phytoremediation potentials of acasia and kinkeliba plants in removing Cr and Cu from these soils.Soil was sampled from the tannery plant in Diguel and agricultural land around crude oil activities in Koudalwa.Soils were characterized by the following properties:pH,(Electrical Conductivity),TDS(Total Dissolved Solids),salinity,bulk density,OM(Organic Matter),nitrate,phosphate,clay,silt,sand,and textural class.The acasia and kinkeliba plants were used to decontaminate Cu and Cr from sample soils for 30 days period.The bulk density of all the soil samples from Kouldawa was higher compared to Diguil,ranging from 1.421 to 1.64 g/cm^(3)compared to 1.21 to 1.51 g/cm^(3)for Diguel.Most of the soils in Kouldawa are mineral soils,while those of Diguel are mostly mineral soil with some organics.Diguel soils are richer in nitrate(577.9 to 2,687.32 mg/kg in Diguel and 33.64 to 197.64 mg/kg in Kouldawa)and phosphate than soils from Kouldawa.Soils from the studied areas are not saline except for a subsurface soil in Diguel(salinity,4.21;EC,4.280 dS/m;TDS,3,040 mg/L).The highest amount of Cr and Cu removed by acasia is 78%and 53.12%compared to 73.8%and 52.21%by kinkeliba.Diguel soil can be very suitable for agriculture and Kouldawa soils for construction.Acasia and kinkeliba can be effectively used to decontaminate the studied soils from heavy metal pollution.
文摘Reinforced concrete (RC) constructions are the innovation of sustainable constructions replacing masonry constructions. Despite this, the use of concrete and steel to improve the performance of structural members in service is a recurring problem due to the immediate or overtime appearance of cracks. The objective of this work was therefore to assess the damage phenomena of the steel-concrete interface in order to assess the performance of an RC structure. Samples of approximately 30 cm of reinforcement attacked by rust were taken from broken reinforced concrete columns and beams in order to determine the impact of corrosion on high adhesion steel (HA) and therefore on its ability to resist. The experimental results have shown that the corrosion degradation rates of reinforcing bars of different diameters increase as the diameter of the reinforcing bars decreases: 5% for HA12;23.75% for HA8 and 50% for HA6. Using the approach proposed by Mangat and Elgalf on the bearing capacity as a function of the progress of the corrosion phenomenon, these rates made it possible to assess the new fracture limits of corroded HA steels. For HA6 respectively HA8 and HA12, their initial limit resistances will decrease by 4/4, 3/4 and 1/4. Based on the results of this study and in order to guarantee their durability, an RC structure can be dimensioned by taking into account the effects of reinforcement corrosion.
文摘Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ED. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ED) seen at the University Hospital of Abeche. Erectile function was assessed using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed to take part in the study. Only 40 patients correctly completed the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented 74%. Diabetes was poorly controlled in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.
文摘The aim of the present work is to assess the value of Detarium Senegalense by determining the content of total phenols, total flavonoids and total anthocyanins, and by evaluating the free radical scavenging activity of Detarium Senegalense extracts. For this purpose, sequential extraction using solvents of increasing polarity was essential. The various extracts obtained underwent phytochemical and biochemical analyses. Phytochemical screening revealed the presence of flavonoids, alkaloids, tannins, polyphenols, anthocyanins and steroids/terpenes. Quantitative analysis of total polyphenols, total flavonoids and total anthocyanins yielded the following results: total flavonoids (0.803 ± 0029 mg EQ/100g P for acetone extract of roots and 0.871 ± 0.401 mg EQ/100g P for methanol extract of leaves);total polyphenols (23.298 ± 12.68 mg EAG/100g P for acetone extract of roots and 24.69 ± 0.49 401 mg EAG/100g P for methanol extract of leaves);total monomeric anthocyanins (44.697 ± 0.939 mg EC3G/100g P and 16.699 ± 0.193 mg EC3G/100g P respectively for acetone and methanol extracts of stem bark). DPPH free radical scavenging activity was 1.674 ± 0.023 mg/mL for the acetone extract and 0.934 ± 0.24 mg/mL for the methanol extract of roots. .
文摘The evolution of global mobile data over the past decades in broadcasting, Internet of Things (IoT), education, healthcare, commerce, and energy has put strong pressure on 3G/4G mobile networks to improve their service offerings. These generations of mobile networks were initially invented to meet the requirements of the above-mentioned applications. However, as the requirements in these applications continue to increase, new mobile technologies such as 5G (fifth generation), 5G and beyond (B5G, beyond fifth generation), and 6G (sixth generation) are still progressing and being experimented. These networks are very heterogeneous generations of mobile networks that will have to offer very high throughput per user, good energy efficiency, better traffic capacity per area, improved spectral efficiency, very low latency, and high mobility. To meet these requirements, the radio interface of future mobile networks will have to be flexible and rationalized the available frequency resources. Therefore, new modulation methods, access techniques and waveforms capable of supporting these technological changes are proposed. This review presents brief descriptions of the types of 5G, B5G, and 6G waveforms. The 5G consists of OFDM including its transmission techniques: generalized frequency division multiplexing (GFDM), filter bank based multi-carrier (FBMC), universal filtered multi-carrier (UFMC), and index modulation (IM). Meanwhile, the 6G covers orthogonal time frequency space (OTFS), orthogonal chirp division multiplexing (OCDM) and orthogonal time sequence multiplexing (OTSM). The networks’ potentialities, advantages, disadvantages, and future directions are outlined.
文摘Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteristics of the epidemiological, clinical, biological, etiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective and descriptive study from January 2021 to December 2021 which took place in the pediatrics department of the Mother and Child University Teaching Hospital of N’Djamena (CHU-ME). All the children in whom we observed abnormal involuntary movements whose age was less than or equal to 15 years were concerned. Result: there were three female children. The average age was 7.5, of which the two are 7 years old and the third is 8 years old. Two had a history of angina. A notion of polyarthralgia and dental caries was found in the third. The diagnosis of post-streptococcal chorea was retained on the basis of clinical arguments: observation of abnormal movements of the limbs and the face, which are involuntary, sudden with an insidious and progressive onset, muscular hypotonia, and psychic disorder. Medical imaging, in particular echocardiography, which objectified two cases of associated rheumatic valvular disease. Remission was observed in all three children after two weeks of treatment with haloperidol, penicillin. Those with associated rheumatic valve disease also received corticosteroid therapy. Complete remission of chorea was observed in all three girls. Prophylaxis in two patients based on Penicillin V was instituted. Conclusion: Although less frequent, post-streptococcal chorea is still seen in our country and is still an important health problem that needs more real medical efforts.
文摘Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the Department of Mayo-Boneye. Methodology: This is a prospective observational study that took place from October to December 2021, including 168 patients with their sociodemographic characteristics. The venous blood of the patients was collected in dry tubes and centrifuged to obtain the serum. The Chlamydia IgG Rapid Test Cassette was used for the detection of antibodies to Chlamydia infection. The Epi Info 7<sup>TM</sup> software was used to perform the statistical analyses. Results: A total of 168 patients were included in this study. The average age was 26.36 ± 9.21 years, the median was 25.5 years with the extremes of 14 years and 70 years. Among these patients, 46.43% were illiterate, 5.95% and 20.83% were primary and secondary school students, respectively, and 26.79% university students. For marital status, 66.67% were single, 16.67% married, 10.71% divorced and 5.95% widowed. Regarding the profession, 26.79% were traders, 8.93% were employees and 64.29% unemployed. In this study, the 168 patients had performed Chlamydia trachomatis serology among whom 02 (1.19%) were excluded for invalid results and 10.71% presented positive cases. The city of Bongor was the most infected with 61% of cases. Among these patients, 54.22% were linked to risk factors for Chlamydia trachomatis. The most infected age group was between 25 and 35 with a seroprevalence of 5.36% of cases. Conclusion: In this study, Chlamydia trachomatis was positive for 10.71% of diagnosed cases. The most affected age groups are young, sexually active women. The State should emphasize the screening of women, the awareness of students and academics.
文摘Groundwater is the main source of drinking water for large cities in most African countries. In Moundou, for example, the conventional groundwater supply system is failing. To compensate for this state failure, the population is building boreholes and wells, most of which tap the surface water table, generally referred to as the “water table”. The aim of this study is to characterize these waters in order to assess their level of contamination and, by extension, the degree of pollution of the water table. Major elements such as: Chloride (Cl<sup>-</sup>), Sulfate (SO<sub>4</sub><sup>2-</sup>), Nitrate (NO<sub>3</sub><sup>-</sup>), Calcium (Ca<sup>2+</sup>), magnesium (Mg<sup>2+</sup>), sodium (Na<sup>+</sup>) and potassium (K<sup>+</sup>) were analysed by Liquid Chromatography and the Bicarbonate ion (HCO<sub>3</sub><sup>-</sup>) was determined by the titrimetric method. The methodology applied is based on a combination of hydrochemical techniques and statistical analysis (PCA and CHA). A sampling campaign was carried out during high-water periods. The results of the physico-chemical analyses show mineralization ranging from 7.29 to 3670 μS/cm, with an average of 487.44 μS/cm. The groundwater studied is generally acidic, with a pH ranging from 3.26 to 6.41. Based on their anions, they are classified into four main hydrochemical facies: chloride and sulphate facies, calcium and magnesium facies, sodium and potassium facies and bicarbonate facies. The various correlations between major ions and statistical analyses have enabled us to identify three hydrogeochemical processes involved in water mineralization. The dominant process is silicate hydrolysis, followed by cation exchange, then anthropogenic input, which influences mineralization by polluting the water.
文摘Introduction: Urolithiasis in children is not sufficiently documented in Chad. Objectives: The aim of this work was to report the epidemiological, clinical and therapeutic aspects of urolithiasis in children in our environment. Patients and methods: This was a descriptive retrospective study of patients aged 0 - 15 years treated for urolithiasis between January 2015 and July 2020. The variables studied were age, gender, clinical, paraclinical and therapeutic aspects. Results: Among the 191 children, there were 164 boys (85.9%) and 19 girls (9.9%). The sex ratio was 8.63. The average age was 5.86 years with extremes (1 and 15 years). The symptomatology was dominated by dysuria. The ASP-ultrasound pair allowed the diagnosis in 183 cases (95.8%). The site of the calculus was bladder in 128 cases (67%). The average calculation size was 2.81mm. A supporting cause was found in only 1 case (posterior urethral valve). Treatment was surgical and dominated by cystolithotomy. The postoperative course was marked by 5 cases of parietal infections (2.6%) and 3 cases of vesico-cutaneous fistulas (1.6%). No case of death has been reported. Conclusion: Lithiasis is more common in boys in the lower urinary tract. Open surgery remains the only one practiced. Etiological research must be carried out to develop prevention strategies.
文摘Background: In the world, induced abortion constitutes a preponderant cause of morbidity and maternal mortality, more particularly in developing countries. In these countries, the prevalence of contraception remains low, and situation makes the bed of unwanted pregnancies leading easily to the induced abortions. The objective was to determine frequency of clandestine induced abortions and to know the motivations of women that practice these abortions in order to find a solution to minimize this practice. Patients and method: We conducted a prospective, descriptive and multicenter survey for three months from November 1st, 2015 to January 31st, 2016 achieved at N’Djamena Mother and Child hospital which is national reference structure in terms reproduction health, Moundou Regional Hospital and Abéché Regional Hospital about the epidemiological aspects and complications clandestine induced abortions. The population of survey was constituted of patients admitted in a maternity of these hospitals for clandestine induced abortion. Every patient having practiced a documented induced abortion and having agreed to participate in the survey was included. Results: During the survey period, we recorded 94 cases of clandestine induced abortions among 2759 deliveries giving a frequency of 3.4%. The age group between 20 - 24 years was the most represented with 42.7%. The average age was 25.4 years, with the extremes ranging from 15 to 42 years. Singles (66%) dominated marital status. Sixty patients (63.9%) were of secondary. These patients were for the most part students or pupils (55.3%). Concerning the parity, nulliparous were the most numerous to practice the abortion (40.5%). More than half our patients (58.7%) knew no contraceptive method. The principal reason evoked to realize the abortion was further studies (38.2%). Means of abortion most used was the misoprostol (36 cases that is 38.2%). In this series, we observed 29 cases of complications, which is 30.8%. The complications were dominated by the anaemia (62.1%). C
文摘The purpose of this work is to study the vulnerability of the Quaternary aquifer that lies beneath the N’Djamena city Chad. The subsoil of N’Djamena city Chad is made up of a multilayered aquifer in which there are two main aquifers located respectively at a depth of about 10 and 60 m, between the two there is an intermediate aquifer at about 30 m depth. It is this latter water table, generally captured by human-powered pumps, that is the subject of this study. Because of anarchic garbage dumping, wastewater discharge, latrines scattered throughout the city, chemical fertilizers and herbicides used on the banks of Chari River and its tributary the Logone for market gardening, the quality of the water in this aquifer is highly threatened. Moreover, it has been noting that the sources of pollution are constantly increasing in conjunction with the growth of the population, so the knowledge and protection of groundwater are necessary. We have therefore carried out a study of intrinsic vulnerability using two mapping methods (GOD and SI), as mapping is recognized as an effective tool for decision support in the case of safeguarding water resources. The results obtained by the GOD method show that 38% of the study area is covered by high vulnerability, 29% by moderate vulnerability, 21% by low vulnerability and 21% by the very low vulnerability. With the SI method, 54% of the study area is covering by low vulnerability and 46% by the low and moderate vulnerability. The coincidence rate of low nitrate values in groundwater with areas of very low and low vulnerability is 91% and 76% for the GOD and SI methods, respectively. Although these observations validated the different maps obtained, the SI approach seems to be the most adequate for vulnerability tracing in our study area.
文摘Bilateral ectopic pregnancy is the rarest form of ectopic pregnancy. We report a case of spontaneous bilateral tubal ectopic pregnancy diagnosed intra operatively. A 30-year-old patient was admitted to the emergency room of N’Djamena mother and child hospital complaining of vaginal bleeding and abdominal pain. Salpingectomy left tube and salpingotomy right tube were performed without complication and that histopathological report confirmed the diagnosis.
文摘Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one million inhabitants per year and its evolution can be fatal. Materials and Methods: We report the observation of a 60-year-old patient, with no significant pathological history, admitted to our intensive care unit at the Renaissance University Teaching Hospital in N’Djamena for the treatment of Toxic Epidermal Necrolysis. In whom the onset of symptoms dates back to few hours after vaccination against COVID-19 with Ag Johnson and Johnson. Results: An ophthalmology opinion was requested and the patient was put on Fucithalmic. In our case, in addition to the advanced age of the patient (60 years old), her SCORTEN was ≥5. Conclusion: The late management as well as the absence of a specific department for severe burns, which condition the presence of a technical plate was fatal to her despite multidisciplinary care: Resuscitators, Traumato-Orthopedist and ophthalmologist.
文摘Although open leg fractures are very common in orthopedics and traumatology, bilateral open leg fractures are extremely rare and are usually associated with an increased risk of complications. We report a case of a simultaneous, asymmetrical, comminuted and bilateral open fracture of the tibia and fibula by a firearm that occurred during an escape attempt in a 29-year-old prisoner. The pre-operative radiological assessment found an open fracture of both legs of the ballistic type;multiple traumatic gunshot wounds with a narrow entry hole and a wide exit hole. Early surgical intervention of intravenous antibiotics, tetanus prophylaxis and open fracture irrigation and debridement was performed within the 6 hour rule. The treatment consisted of a posterior splint followed by trimming andosteosynthesis using a FESSA external fixator from the military health service. A second operation was not needed. Evolution was favorable with ambulation starting from the 45th day. Simultaneous and bilateral tibia-fibula fractures by a firearm are exceptional, therefore, the treatment was surgical with the pre-operative and post-operative protocols well managed.
文摘<strong>Introduction:</strong> Buschke Lowenstein Tumor (BLT) is a tumor, belonging to the group of verrucous carcinomas. It is endowed with an unpredictable potential of recurrence and degeneration. The aim of the work is to present the anatomical and therapeutic characteristics of BLT at the University Hospital of National Reference of N’Djamena in Chad. <strong>Patients and Method:</strong> Prospective descriptive study of 13 patients with BLT, from May 2009 to April 2019 in the department of urology was included. The patients more than 15, carriers of TBL located at: external genitalia, perineum and anal margin whose clinical, paraclinical assessment allowed the diagnosis of BLT, management and follow-up at the said service. Respect for the patient’s identity and consent, the patient’s consent is obtained and the anonymity of the photographs is observed. <strong>Result:</strong> A total of 13 patients had BLT, 11 males and 2 females. The average age of the patients was 32.5 years. The lesions were cauliflower-like and located on the vulva (n = 2), the penis, the perineum, the anorectal region in men (n = 11). Serology was positive for: HIV (n = 3), chlamydia (n = 4). The management was surgical by cauterization and excision. Cystoscopy and rectoscope were normal. The cure was obtained in all patients. Two patients had a recurrence at 5 months requiring a second successful cure. <strong>Conclusion:</strong> BLT is a frequent pathology in the urology department of the University Hospital of National Reference of N’Djamena in Chad. The surgical treatment by “cauterization exeresis” gives a better treatment.
文摘<strong>Introduction:</strong> Penile cancer is a rare primary malignancy that occurs in patients in their 60s and 70s. The aim of the study was to describe the anatomical aspects of penile cancer and to report the difficulties of its management. <strong>Materials and Methods:</strong> This was a retrospective descriptive study of patients with penile tumors from January 2007 to December 2019. Patients of sexual age with an ulcerated lesion of the penis, who came to our department and whose clinical and paraclinical workup led to the diagnosis of penile cancer, were included. The variables studied were clinical, paraclinical and therapeutic. <strong>Results:</strong> In 12 years, we diagnosed and managed 8 patients with penile cancer, an incidence of 0.7 per year. The reason for consultation was the chronic ulcerating wound of the penis with a “cauliflower” aspect. The first medical consultation was late (n = 8) after a long latency period lost to traditional healers. The lesion was located in the glans penis (n = 6) and/or in the corpus cavernosum (n = 2). Histological analysis of the cores concluded to a squamous cell carcinoma. Patients were classified as T2N+M+ (n = 3) and T2N0M0 (n = 5). One patient had accepted partial amputation of the penis. <strong>Conclusion:</strong> Penile cancer is a rare tumor. Partial amputation of the penis is the only alternative in our practice context, an alternative often refuted.
