<strong>Introduction</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> During childbirth by Caesarean, several types...<strong>Introduction</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> During childbirth by Caesarean, several types of anesthesia can be used. The Caesarean, the most practiced surgical delivery technique in obstetrics, has a risk for complications for both </span><span style="font-family:Verdana;">the pregnant</span><span style="font-family:Verdana;"> women and newborns. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To evaluate the importance of the complications due to Caesarean in the Teaching hospital Gabriel Toure. </span><b><span style="font-family:Verdana;">Patient and Methods: </span></b><span style="font-family:Verdana;">We conducted a </span><span style="font-family:Verdana;">cross sectional</span><span style="font-family:Verdana;"> survey in the departments of </span><span style="font-family:Verdana;">intensive</span><span style="font-family:Verdana;"> care unit and gyneco-obstetric from January to August 2017 in the University hospital Gabriel Touré of Bamako. Our study population was pregnant women who gave birth to children by Caesarean. We included all cases of preventive and emergent Caesarean under loco-regional or general anesthesia. Data were compiled from the obstetrical files of the patients, the anesthetic consultation registry </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the </span><span style="font-family:Verdana;">databasis</span><span style="font-family:Verdana;"> of the department of gyneco-obstetric. The test of khi</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of Pearson was used for the comparison of our results with a value of p < 0.05 considered as statistically significant. </span><span style="font-family:Verdana;">The consent of the patients or parents was gotten. The survey didn’t include a potentially dangerous act. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">During the study period, 1875 childbirths have been recorded of which 633 were by Caesarean (33.7%). We collected and analyzed 524 files of Caesarean. The mortality rate was 1.5% in pregnant women and 15% in newborns. The average age was 26.6 ± 6.9 </span><span style="font-family:Verdana;">ans</span><span style="font-family:Verdana;">. Pregnant women were referrals in 59.4% of the cases. The most frequent motive of referrals was high blood pressure and pregnancy in 66.6%. The Caesarean was indicated in most of the cases on </span><span style="font-family:Verdana;">previously</span><span style="font-family:Verdana;"> operated uterus in 22% and eclampsia was present in 14%. The maternal mortality had occurred in </span><span style="font-family:Verdana;">a context</span><span style="font-family:Verdana;"> of hemorrhage in 50% of the cases. The factors of maternal </span><span style="font-family:Verdana;">morbi-mortality</span><span style="font-family:Verdana;"> were the mode of admission, iterative Caesarean, t surgeon, context of the Caesarean, realization of the anesthetic consultation </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the technic of anesthesia (p = 0.05). The factors of fetal mortality were the realization of </span><span style="font-family:Verdana;">endo-tracheal</span><span style="font-family:Verdana;"> intubation, technic of anesthesia, </span><span style="font-family:Verdana;">realization</span><span style="font-family:Verdana;"> of the anesthesia consultation, </span><span style="font-family:Verdana;">context</span><span style="font-family:Verdana;"> of the Caesarean, iterative Caesarean </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the mode of admission (p</span></span><span style="font-family:""><span style="font-family:Verdana;"> ≤ </span><span><span style="font-family:Verdana;">0.05). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The </span><span style="font-family:Verdana;">caesarean</span><span style="font-family:Verdana;"> is associated with a high risk of maternal complications and a very important fetal mortality. The anesthesia consultation in the follow-up of pregnancy would reduce this high mortality.</span></span></span>展开更多
Introduction: Hospitalization in intensive care is a source of stress and anxiety for close to the patients. Anxio-depressive symptoms appear to be common in intensive care and their prevalence is poorly evaluated. Th...Introduction: Hospitalization in intensive care is a source of stress and anxiety for close to the patients. Anxio-depressive symptoms appear to be common in intensive care and their prevalence is poorly evaluated. The objective of this study was to evaluate the prevalence of anxio-depressive symptoms in families. Materials and method: Observational prospective study in families of patients hospitalized in the intensive care unit for a period of 5 months. Symptoms of anxiety and depression were measured using Hospital Anxiety and Depression Scale (HADS) during hospitalization. Anxiety and depression were defined by a score greater than 10. Factors associated with the onset of anxious-depressive symptoms were sought. The prevalence of post-traumatic stress disorder in close relatives was measured by the Impact Event Scale-Revised scale (IES-R). Results: A total of 107 patients were admitted to the intensive care unit, of which 49 families agreed to participate in our study. Overall mortality was 32.2% during this period. Fifty-eight (58) patients were not included for the following reasons: death or hospitalization of less than 48 hours, refusal of families, institution, and lack of parents speaking French. Forty-nine (49) relatives completed the HADS questionnaire. Forty-three families completed the IES-R questionnaire, a return rate of 87.7%. The prevalence of anxiety was 61.2% among parents in early hospitalization. The level of anxiety was significantly associated with male parents (p = 0.035) and those with lower education (p = 0.046). The prevalence of depressive symptoms in parents was evaluated 53% at D3. Education level (p = 0.048) and male parents (p = 0.048) appeared to be a significant depression factor. The prevalence of post-traumatic stress disorder was 55.1% among the relatives of the patients. The lack of co-morbidity in admission patients was significantly associated with the occurrence of post-traumatic stress disorder in the family. Conclusion: The prevalence of anxiety and depression symptoms was high in our study. Men were at greater risk of developing these symptoms. The parents of the patients carburized appear as a population with higher risk manifestation of psychological disorders;further research is needed in this group.展开更多
Summary: Polytrauma is the leading cause of death in the under-40 population. They are accompanied by major morbidity with severe sequelae. The polytraumatized is defined as a serious trauma with several bodily injuri...Summary: Polytrauma is the leading cause of death in the under-40 population. They are accompanied by major morbidity with severe sequelae. The polytraumatized is defined as a serious trauma with several bodily injuries, at least one of which is life-threatening in the very short term. The initial hospital care must not barely delay and directly affect the prognosis. In developing countries, the absence of pre-hospital medicine means that mortality is still very high, which leads us to initiate this work, which aims to study the epidemiological and clinical aspects of polytrauma in emergency and in resuscitation of Gabriel Toure University Hospital. Material and Methods: This was a retrospective study that took place over a period of ten (10) months from February to November 2016. We included all patients received for polytrauma emergency hosting service. The data were collected using a surveycard. Results: During our study period, we collected a total of 200 polytraumatized cases out of a total of 16,141 patients admitted to the emergency hosting service, a prevalence of 1.3%. The age group of 20 - 29 years was the most represented with average age of 32.39 years. The male sex was predominant with 65% with a sex ratio of 1.9. The students were the most represented with 24%. The trauma occurred at 22.5% between 8:00 and 12:00 am, the public road was the main place of the trauma with 57.5% of the cases. Two-wheeled vehicles were involved in the accident in 68.9% of cases. The delay between trauma and admission was minus 6 hours in 70.5% of cases, 15.5% had a Glasgow lessthan 8% and 44.5% PAS Conclusion: The polytrauma is clinical situation putting the patients vital prognosis at stake. The haemorrhage is the origin of the student mortality. The installation of rigorous diagnostic system and a pre-hospital medicine will reduce the morbi-mortality.展开更多
Intra-uterine manual aspiration is the recommended maneuver for abortive endo-uterine evacuation. It must be performed in a medical setting for therapeutic purposes, while respecting its contraindications and asepsis ...Intra-uterine manual aspiration is the recommended maneuver for abortive endo-uterine evacuation. It must be performed in a medical setting for therapeutic purposes, while respecting its contraindications and asepsis rules essential for its implementation. The ignorance of anatomical structures by the authors of clandestine abortions is marked by the presence of utero-adnexal lesions, digestive lesions and vesical lesions or evisceration by the vagina. Vaginal evisceration of the small bowel is a rare and serious complication of manual intrauterine aspirations and induced abortions. Their late diagnosis and clandestine practice are responsible for unpredictable severe secondary complications and remain an important cause of morbidity and mortality. The development of a policy of continuous training of agents on the technique of manual intrauterine aspiration, broad information on contraceptive methods and a multidisciplinary, rapid and adequate management of complications will provide minimum morbidity and mortality. Conclusion: Abortion is a serious source of life-threatening complications.展开更多
文摘<strong>Introduction</strong><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> During childbirth by Caesarean, several types of anesthesia can be used. The Caesarean, the most practiced surgical delivery technique in obstetrics, has a risk for complications for both </span><span style="font-family:Verdana;">the pregnant</span><span style="font-family:Verdana;"> women and newborns. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To evaluate the importance of the complications due to Caesarean in the Teaching hospital Gabriel Toure. </span><b><span style="font-family:Verdana;">Patient and Methods: </span></b><span style="font-family:Verdana;">We conducted a </span><span style="font-family:Verdana;">cross sectional</span><span style="font-family:Verdana;"> survey in the departments of </span><span style="font-family:Verdana;">intensive</span><span style="font-family:Verdana;"> care unit and gyneco-obstetric from January to August 2017 in the University hospital Gabriel Touré of Bamako. Our study population was pregnant women who gave birth to children by Caesarean. We included all cases of preventive and emergent Caesarean under loco-regional or general anesthesia. Data were compiled from the obstetrical files of the patients, the anesthetic consultation registry </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the </span><span style="font-family:Verdana;">databasis</span><span style="font-family:Verdana;"> of the department of gyneco-obstetric. The test of khi</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of Pearson was used for the comparison of our results with a value of p < 0.05 considered as statistically significant. </span><span style="font-family:Verdana;">The consent of the patients or parents was gotten. The survey didn’t include a potentially dangerous act. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">During the study period, 1875 childbirths have been recorded of which 633 were by Caesarean (33.7%). We collected and analyzed 524 files of Caesarean. The mortality rate was 1.5% in pregnant women and 15% in newborns. The average age was 26.6 ± 6.9 </span><span style="font-family:Verdana;">ans</span><span style="font-family:Verdana;">. Pregnant women were referrals in 59.4% of the cases. The most frequent motive of referrals was high blood pressure and pregnancy in 66.6%. The Caesarean was indicated in most of the cases on </span><span style="font-family:Verdana;">previously</span><span style="font-family:Verdana;"> operated uterus in 22% and eclampsia was present in 14%. The maternal mortality had occurred in </span><span style="font-family:Verdana;">a context</span><span style="font-family:Verdana;"> of hemorrhage in 50% of the cases. The factors of maternal </span><span style="font-family:Verdana;">morbi-mortality</span><span style="font-family:Verdana;"> were the mode of admission, iterative Caesarean, t surgeon, context of the Caesarean, realization of the anesthetic consultation </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the technic of anesthesia (p = 0.05). The factors of fetal mortality were the realization of </span><span style="font-family:Verdana;">endo-tracheal</span><span style="font-family:Verdana;"> intubation, technic of anesthesia, </span><span style="font-family:Verdana;">realization</span><span style="font-family:Verdana;"> of the anesthesia consultation, </span><span style="font-family:Verdana;">context</span><span style="font-family:Verdana;"> of the Caesarean, iterative Caesarean </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> the mode of admission (p</span></span><span style="font-family:""><span style="font-family:Verdana;"> ≤ </span><span><span style="font-family:Verdana;">0.05). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The </span><span style="font-family:Verdana;">caesarean</span><span style="font-family:Verdana;"> is associated with a high risk of maternal complications and a very important fetal mortality. The anesthesia consultation in the follow-up of pregnancy would reduce this high mortality.</span></span></span>
文摘Introduction: Hospitalization in intensive care is a source of stress and anxiety for close to the patients. Anxio-depressive symptoms appear to be common in intensive care and their prevalence is poorly evaluated. The objective of this study was to evaluate the prevalence of anxio-depressive symptoms in families. Materials and method: Observational prospective study in families of patients hospitalized in the intensive care unit for a period of 5 months. Symptoms of anxiety and depression were measured using Hospital Anxiety and Depression Scale (HADS) during hospitalization. Anxiety and depression were defined by a score greater than 10. Factors associated with the onset of anxious-depressive symptoms were sought. The prevalence of post-traumatic stress disorder in close relatives was measured by the Impact Event Scale-Revised scale (IES-R). Results: A total of 107 patients were admitted to the intensive care unit, of which 49 families agreed to participate in our study. Overall mortality was 32.2% during this period. Fifty-eight (58) patients were not included for the following reasons: death or hospitalization of less than 48 hours, refusal of families, institution, and lack of parents speaking French. Forty-nine (49) relatives completed the HADS questionnaire. Forty-three families completed the IES-R questionnaire, a return rate of 87.7%. The prevalence of anxiety was 61.2% among parents in early hospitalization. The level of anxiety was significantly associated with male parents (p = 0.035) and those with lower education (p = 0.046). The prevalence of depressive symptoms in parents was evaluated 53% at D3. Education level (p = 0.048) and male parents (p = 0.048) appeared to be a significant depression factor. The prevalence of post-traumatic stress disorder was 55.1% among the relatives of the patients. The lack of co-morbidity in admission patients was significantly associated with the occurrence of post-traumatic stress disorder in the family. Conclusion: The prevalence of anxiety and depression symptoms was high in our study. Men were at greater risk of developing these symptoms. The parents of the patients carburized appear as a population with higher risk manifestation of psychological disorders;further research is needed in this group.
文摘Summary: Polytrauma is the leading cause of death in the under-40 population. They are accompanied by major morbidity with severe sequelae. The polytraumatized is defined as a serious trauma with several bodily injuries, at least one of which is life-threatening in the very short term. The initial hospital care must not barely delay and directly affect the prognosis. In developing countries, the absence of pre-hospital medicine means that mortality is still very high, which leads us to initiate this work, which aims to study the epidemiological and clinical aspects of polytrauma in emergency and in resuscitation of Gabriel Toure University Hospital. Material and Methods: This was a retrospective study that took place over a period of ten (10) months from February to November 2016. We included all patients received for polytrauma emergency hosting service. The data were collected using a surveycard. Results: During our study period, we collected a total of 200 polytraumatized cases out of a total of 16,141 patients admitted to the emergency hosting service, a prevalence of 1.3%. The age group of 20 - 29 years was the most represented with average age of 32.39 years. The male sex was predominant with 65% with a sex ratio of 1.9. The students were the most represented with 24%. The trauma occurred at 22.5% between 8:00 and 12:00 am, the public road was the main place of the trauma with 57.5% of the cases. Two-wheeled vehicles were involved in the accident in 68.9% of cases. The delay between trauma and admission was minus 6 hours in 70.5% of cases, 15.5% had a Glasgow lessthan 8% and 44.5% PAS Conclusion: The polytrauma is clinical situation putting the patients vital prognosis at stake. The haemorrhage is the origin of the student mortality. The installation of rigorous diagnostic system and a pre-hospital medicine will reduce the morbi-mortality.
文摘Intra-uterine manual aspiration is the recommended maneuver for abortive endo-uterine evacuation. It must be performed in a medical setting for therapeutic purposes, while respecting its contraindications and asepsis rules essential for its implementation. The ignorance of anatomical structures by the authors of clandestine abortions is marked by the presence of utero-adnexal lesions, digestive lesions and vesical lesions or evisceration by the vagina. Vaginal evisceration of the small bowel is a rare and serious complication of manual intrauterine aspirations and induced abortions. Their late diagnosis and clandestine practice are responsible for unpredictable severe secondary complications and remain an important cause of morbidity and mortality. The development of a policy of continuous training of agents on the technique of manual intrauterine aspiration, broad information on contraceptive methods and a multidisciplinary, rapid and adequate management of complications will provide minimum morbidity and mortality. Conclusion: Abortion is a serious source of life-threatening complications.
