Dakar médical
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The objective of this study is to assess both intra and post operative analgesia in infants undergoing umbilical hernia repair under general anaesthesia with neither opioid nor muscle relaxant, associated with a para umbilical block. It's a prospective study covering a 15 months period. The study included 75 infants (age = 5 months - 13 years; body weith = 6 kg - 35 kg). ⋯ Surgical conditions were considered as being godd or satisfactory in 90.6% and 9.4% of cases, respectively. Post operative analgesia, assessed 1 and 6 hours after completion of surgery was convenient in 93.3% of infants. The block appears as simple, most after efficient and safe in umbilical surgery.
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Maternal mortality and lethality in childhood constitute a major problem in Senegal. These two rates are often hight in areas off hight birth rate. In the medical district of Kolda (Senegal) no reliable data on reproductive health exists. ⋯ The maternal death rate was estimated at 1285 per 100.000 alive births [998-1576]. The infant mortality rate was 83 per 1000. These results justify impremantation of a "vigorous" reproductive health policy in this area.
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Case Reports
[Role of transesophageal echocardiography in the diagnosis of aortic dissection. Report of 5 cases].
Aortic dissection is medical and surgical emergency. About 5 cases, the authors emphasized the role of transesophageal echocardiography in the diagnosis of aortic dissection. ⋯ Echocardiography were performed by an apparatus Hewlett Packard sonos 1000 with colour doppler and multiplanar transesophageal. Transesophageal echocardiography made the diagnosis by showing dilatation of aorta, intimal flap, false channel; this exam also allow to classify the aortic dissection.
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The goal of this prospective work is to study the per- and post-operative complications of spinal anaesthesia for cesarean and to evaluate their management. We included in the study all parturients undergoing cesarean section to the maternity of hospital Aristide Le Dantec since December 1998 to March 1999. Patients presented contra-indications of spinal anaesthesia, arterial hypertension and/or acute fetal distress were excluded. ⋯ Maternal hypotension was the only per-operative complication in our study: 52% with 2 cases of cardiac arrest who needed tracheal intubation and injection of epinephrine. Post operative complications were represented by post-dural headaches about 5.4% and no epidural blood-patch were necessary for their management. We have noted any neurological or infectious complication during supervision of our patients.
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The diagnosis and the management of the foreign bodies of the oesophagus in the children have benefited from the digestive endoscopy and the anaesthesia progresses the last ten years. A 120 files review concerning children who suffered from foreign bodies of the oesophagus is reported. The average age was 4 years. ⋯ The foreign body of the oesophagus is not always harmless. It can determine complications often revealing ones. It seems necessary to us to stress the prevention of that accident by a vast sensitising compaign of the parents.