Background: Prematurity is the leading cause of neonatal mortality and morbidity in the world. Several etiological factors contribute to its occurrence requiring identification for effective prevention. The objective of this work was to study the epidemiological and etiological factors of prematurity in the maternity ward of the Grand YOFF General Hospital (GYGH) in Dakar. Methods: This was a prospective study including all live and viable newborns conducted during January 1 st to August 31 st. They were divided into 2 groups: premature infants (22 WA-36 WA+6 days) and term infants (over 37 WA). Statistical comparisons were based on percentages for the chi-square test or Fisher's exact small sample test. Results: During the study, 501 newborns were collected including 360 term neonates (71.9%) and 141 premature babies (28.1%). The sex ratio was 1.07. Of the premature babies, 48.2% were hypotrophic. There were 13 cases of premature death (9.22%). The occurrence of prematurity was significantly related to educational level, geographic origin and body mass index (BMI). The number of prenatal consultations (PNC) less than 3 was related to a risk of prematurity (p=0.001). Genitourinary infections (p=0.059), high blood pressure (p=0.047), pre-eclampsia (p=0.009), isolated anaemia (p=0.0001) and isolated bleeding (p=0.015) were found as significant etiological factors. Conclusion: In our study, several etiological factors associated with prematurity were identified. Combating these factors is an effective way to prevent prematurity in our low-income countries.
Takayasu's arteritis (TA) is an infl ammatory disease of large vessels that predominantly affects the aorta and its main branches such as supra-aortic trunks, renal and digestive arteries. The diagnosis is based on criteria proposed by the American College of Rheumatology and modifi ed by Sharma. These vascular lesions present a problem of surgical indications because of their pathogenic particularity. In this work, we report our experience on the diagnosis and management of two cases of TA. The case 1 was a 62-year-old female patient diagnosed with stenosis of the common carotid artery and the right subclavian artery. A bypass between the carotid artery and the subclavian artery was indicated but not performed. The second patient was a 23-year-old female patient diagnosed with renovascular hypertension. Investigations showed a signifi cant stenosis of the left renal artery. She underwent angioplasty-stenting of the left renal artery and the result was good. Her echocardiography showed left ventricular and atrial hypertrophy and both. The two patients had no indirect signs of myocardial ischemia and arterial pulmonary injuries.
INTRODUCTION : Un épanchement pleural néoplasique survient chez 50% des patients atteints de cancer métastatique. Il entraine une réduction significative de la qualité de vie par la dyspnée, la toux et par les ponctions itératives qu’il engendre. Le but de la symphyse pleurale est d’améliorer la qualité de vie. Nous rapportons les résultats de la prise en charge des pleurésies néoplasiques dans le service de chirurgie thoracique et cardiovasculaire (CTCV) de l’Hôpital de Fann. MATERIELS ET METHODES : Il s’agit d’une étude rétrospective sur trois ans incluant tous les patients admis dans le service de CTCV pour la prise en charge d’une suspicion de pleurésie néoplasique. Les paramètres étudiés ont été : l’âge, le sexe, la symptomatologie, le terrain, le type de néoplasie, les traitements antérieurs reçus, le délai entre l’épanchement et la chirurgie, les résultats et le geste de la thoracoscopie. RESULTATS : Durant la période d’étude, 28 patients ont été colligés dont 20 femmes et huit hommes. L’âge variait entre 26 et 64 ans. La majorité des patients avaient un antécédent de cancer. La principale symptomatologie était la dyspnée. La vidéothoracoscopie a permis d’objectiver des lésions nodulaires sur la plèvre dont l’examen extemporané a permis de confirmer la néoplasie chez 26 patients et une lésion de tuberculose évolutive chez un. La symphyse pleurale par talcage a été réalisée chez 22 patients. Le talcage n’a pas été réalisé pour défaut de ré-expansion pulmonaire chez quatre patients et du fait de l’origine infectieuse chez un. Le geste a permis de d’améliorer la qualité de vie chez tous les patients. Quatre d’entre eux ont eu un drain définitif et une récidive de la pleurésie est survenue chez un patient sur le côté controlatéral. CONCLUSION : La vidéothoracoscopie est la première indication devant tout patient cancéreux présentant une pleurésie. Elle permet de poser le diagnostic de la pleurésie et de réaliser la symphyse pleurale, ce qui permet une amélioration de la qualité de vie des patients.
The evaluation of the extension of the atheromatous lesion is essential for the planning of the endovascular technique at the level of the femoral arterial bifurcation. Therefore, we changed the classification of Azema and applied it to a series of patients who had undergone open surgery of the femoral arterial bifurcation. This evaluation made it possible to have an idea of the distribution of atheromatous lesions in this region and to compare the efficiency of this modified classification of Azéma with others used in the literature. This modified classification of Azema is relevant and constitutes a decision-making tool for the endovascular therapeutic indications of femoral arterial bifurcation.
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