The Pan African medical journal
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Review Case Reports
[Fracture-separation of the medial clavicular epiphysis: about 6 cases and review of the literature].
This study aims to describe the epidemiological characteristics and the different anatomo-clinical entities of the fracture-separation of the medial clavicular epiphysis but also to relate the morphological and functional results of bloody reduction followed by osteosuture using non absorbable thread. Five boys and one girl (mean age 14 years) showed a closed and isolated shoulder girdle trauma. Clinical examination and medical imaging, especially CT scan, allowed the diagnosis of epiphyseal separation and to classify the degree of medial clavicular epiphysiseal ossification indicating the direction of displacement as well as the nature of displacement according to the Salter-Harris classification. ⋯ It can be serious because of the risk of visceral and vascular compression in its posterior form. Tomdensitometry is irreplaceable for an accurate diagnosis. Our preference is for bloody reduction followed by osteosuture using non metallic thread.
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Despite significant progress made in the field of safety in anesthesia, morbidity (serious or not, completely or partially related to anesthesia) remains common and no health practitioner is immune from accidents. In the current context where priority is given to training programmes, to quality and safety improvement in health care, the occurrence of an anesthesia-related accident in the surgery department is an extremely traumatic event. The fear of prosecution, the emotional context make it difficult to manage. For this reason, it must be codified according to Department protocols, based on three main axes of management: patient victim, medical and paramedical staff involved and accident analysis to prevent its recurrence. ⋯ This observation highlights the different adverse events which have been recorded since the establishment of the data registry 6 months before. We offer a critical reading of this data registry for the sole purpose of improving our practices with a view to strengthening safety during anaesthesia.
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Randomized Controlled Trial Comparative Study
The analgesic effect of clonidine as an adjuvant in dorsal penile nerve block.
Dorsal penile nerve block (DPNB) is a commonly performed regional anesthetic technique for male circumcision. The aim of this study was to assess the analgesic effect of the adjunction of clonidine to bupivacaine 0.5% in this block. ⋯ Clonidine can be used in dorsal penile nerve block to improve and to prolong its analgesic effects after male circumcision.
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Adults and children are required to fast before anaesthesia to reduce the risk of regurgitation and aspiration of gastric contents. However, prolonged periods of fasting are unnecessary and may cause complications. This study was conducted to evaluate preoperative fasting period in our centre and compare it with the ASA recommendations and factors that influence fasting periods. ⋯ The mean fasting periods were 7.65 times longer for clear liquid and 2.5 times for solids than the ASA guidelines. It is imperative that the Hospital should establish Preoperative fasting policies and teach the staff who should ensure compliance with guidelines.
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Cardiac myxoma are the most common benign primary cardiac tumors that can lead to many complications as described in literature. Here we report the case of a boy aged 11 that was referred for etiological diagnosis of ischemic stroke. ⋯ Patient was referred to surgery. The diagnosis was confirmed and the mass was completely resected.