Objective: To analyze the practices of general practitioners (GPs) in terms of recommendations on individual screening for prostate cancer (PCa). Methods: An anonymous cross-sectional survey using a pre-established questionnaire was conducted among 193 GPs in the city of Lubumbashi from May 1st to July 31st, 2020. The questionnaire included three parts: identity criteria of GPs, screening practice and the opinion of GPs on the recommendations. Results: The participation rate was 79%. Eighty-two-point nine percent of respondents said they offered screening for PCa; 42.5% of them said they offered this screening to all men within a certain age limit, ranging between 50 to 75 years in 38.8% of the cases. Only 12.5% of GPs provided complete prior information to their patients. Thirty-six-point three percent of GPs reported combining digital rectal examination with total PSA testing, but in the presence of an abnormality, 60.6% reported that they referred their patients directly to the urologist without ordering other additional investigations (first or second line). Finally, 32.7% of GPs found that the recommendations disseminated were appropriate for their practice. Conclusion: Individual screening for PCa is widely proposed; but there are differences between the practices reported by GPs and official recommendations of learned societies. Our study highlights the need to popularize the recommendations of learned societies to GPs.
We report the case of a 30-year-old patient with goiter who increased in volume more and more in an infectious context with neck pain and signs of compression. This had motivated surgical management. The pathological result of the operating room revealed sub-acute thyroiditis of Quervain-Crile.
Astragalo-scapho-calcaneal dislocation is very rare. The medial variety is the most common. We report a case of a young patient who presented as a result of a road traffic accident with an internal astragalo-scapho-calcaneal dislocation. He received orthopaedic treatment with good clinical and radiological results.
Introduction: The study of mortality in a community permits to define the axes of disease prevention and readjust health policies. In a hospital department, such a study allows monitoring and revision of therapeutic measures; these are likely to deteriorate in their implementation over the years, which requires periodic criticism. The aim of our work was to record the frequency of deaths in the surgical department of the university clinic of Lubumbashi, to specify the characteristics of the deceased population as well as the main causes of death. Patients and method: This is a descriptive cross-sectional study with retrospective data collection, examining mortality in the surgical department of the university clinic of Lubumbashi over a six-month period, from January 15, 2020 to July 15, 2020. The data were collected from the hospitalization registers and files of patients in intensive care and from the operating protocol registers, grouped together on a three-fold sheet: epidemiological-clinical, therapeutic and progressive and processed in Word and Excel. We excluded from the study patients whose death was noted on admission to the emergency room. Results: The mortality rate was 18.8%, the mean age was 49.21 ± 21.87 (Extremes: 2-93 years) and the sex ratio M / F 5.14. Emergency was the most common mode of admission in 65.12% of cases (n = 28). 51.16% of death cases (n = 22) occurred postoperatively, while in 41.86% of cases (n = 18) patients had died without being operated. There were no reported comorbidities in 74.42% of the deaths (n = 32), and diabetes mellitus was the most common comorbidity in 16.28% of the cases (n = 7). 80% of the deaths were classified ASA III (n = 20). The initial cause of death was more abdominal and digestive pathologies (emergencies) in 39.53% (n = 17) of the whole series. In our study, patients who had had surgery before death accounted for 58.14% of cases, and 40% of them had been operated on at least once. The abdominal and digestive operations were more reoperated than the others with 9/10 cases, or 90% of re-intervention. The mean operating time was 6.54 ± 3.41 (Extreme: 0 and 9 days), and the mean hospital stay was 8.4 ± 14.5 (Extreme: 0 and 61 days). Conclusion: Our work has shown that the mortality rate found at 18.8% remains high given the university status of our establishment where the patients treated are often carriers of serious pathologies and where the interveners are varied. This forces us to question ourselves, not to make ourselves feel guilty but to draw the attention of general surgery nursing staff to our shortcomings, and to correct them.
Rupture of the small intestine by blunt abdominal trauma is a rare phenomenon and is most often secondary to violent contusions. The diagnosis is not easy but should be suspected in the face of intense abdominal pain and peritoneal signs (defense evolving towards contracture), after a high-energy trauma. The authors report two cases of jejunal rupture consecutive to road traffic accidents diagnosed late and followed up at university clinics in Lubumbashi.
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