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Preliminary Results of Rib Osteosynthesis at the Teaching Hospital Sylvanus Olympio in Lomé
No full textIntroduction: Flaps and rib fractures can be life-threatening due to disruption of hematosis. In certain “many” situations, it is important to quickly restore parietal rigidity by costal osteosynthesis. The objective of our work is to report the surgical results of a first Togolese series of rib osteosynthesis performed in the context of chest trauma.Patients and methods: We proceed by a retrospective study on a series of patients treated for severe blunt chest trauma and who underwent osteosynthesis from 2020 to 2022. Epidemiological and clinical data, in particular the radiological lesion assessment clinic, the therapeutic measures as well as the immediate operative follow-up were collected.Results: six patients with blunt chest trauma. They were four men and two women whose mean age was 44.4 years. Five patients were admitted for polytrauma and one patient for a serious thoracic trauma. All were admitted to intensive care unit on day 0 of the trauma. The radioclinical assessment had noted staged fractures of ribs and/or thoracic flap with an average of six affected ribs. All the patients presented pleural effusions and benefited from pleural drainage on their admission to intensive care, often after a chest X-ray or after carrying out a chest CT scan or a whole-body CT scan. The indication for rib osteosynthesis was retained on the clinical criteria, in particular the existence of a pleural effusion, the instability of the wall and the impact on hematosis, by the drop in peripheral oxygen saturation (Sp02). Despite oxygen therapy above 6 l/min for more than 4 days, and according to the results of the chest CT scan and the evolution of the patient after the implementation of the means of resuscitation. The osteosynthesis material used was “third tube” orthopedic plates molded intraoperatively in three patients, pelvic plates in one patient. The average number of plates used was 4.5 and that of Vis was 18. Two patients underwent osteosynthesis by Judet staple.Conclusion: rib osteosynthesis contributes to a regression of symptoms, in particular chest pain, to reduce the duration of hospitalization, morbidity and mortality, and then improves the functional respiratory prognosis in the short and long term. Despite our reduced technical platform, the results are generally good, reducing the hospital stay in intensive care. This encourages the practice of surgical management of multiple rib fractures associated or not with a rib flap
Musculoskeletal Disorders and Stress among Moroccan Dentists: A Cross Sectional Study
Get PDFBackground and aim: Dentists' treatment tasks require repetitive actions, uncomfortable postures, and intense effort, all of which can lead to health disorders. The aim of the study was to describe the prevalence of musculoskeletal disorders among Moroccan dentists and the factors associated with these diseases. Material and methods: To conduct a descriptive cross-sectional survey, an anonymous questionnaire on occupational health problems was distributed to a representative sample of 310 Moroccan dentists. Sample size calculation and sampling were performed using Epi info software. Data were analyzed using the SPSS (Statistical Package for the Social Sciences) software. The associations among the frequency of variables were evaluated by the chi-square test (P < 0.05).Results: Out of 310 questionnaires distributed, we received 286 responses, for a response rate of 95.33%. A total of 286 dentists were included in our survey. The mean age of the participants was 41.19 (±7.63) years. The results showed that 62.9% of the surveyed dentists complained of musculoskeletal disorders. Moreover, 79.4% of practitioners had high stress levels. Concerning sports activity, 55.9% of the practitioners practiced a sport activity.Conclusions: For Moroccan dentists, the occurrence of musculoskeletal pain is a critical problem. Considering the scale of the problem, it is necessary to implement education in ergonomics among dentists and dental students, and to promote the holistic health of dental professionals. As musculoskeletal pain is a critical issue for Moroccan dentists, it's judicious to consider ergonomics courses at the beginning of dental education programs, then every year until graduation, and to provide professional dentists with continuous training all along their careers
A Case Report on Congenital Biliary Atresia with Ventricular Septal Defect
Get PDFBiliary atresia, an obstructive cholangiopathy with an idiopathic etiology, is a congenital disorder that eventually destroys liver parenchyma. In some circumstances, it is associated with other abnormalities such as congenital heart diseases, intestinal, and spleen anomalies. Diagnosis of biliary atresia is based on clinical manifestations and specific diagnostic tests. Prolonged pathological jaundice is a critically important sign in newborns that needs to be recognized early in order to reduce the chances of further complications. The mainstay of treatment is the Kasai procedure (portoenterostomy), and it is eighty percent successful if performed before or within the first two months of life.Here, we report a case of a two-month-old baby who had biliary atresia with a ventricular septal defect (VSD). The baby had a prolonged history of jaundice, pruritus, yellow-colored urine, and pale stools. He was initially brought to a local clinic for his jaundice, where pharmacological treatment was commenced. However, the symptoms persisted, and he was referred to a hospital where he was placed under blue light phototherapy with no marked improvement in his symptoms. For a definite diagnosis and treatment, he was then referred to a multispecialty hospital where diagnostic tests were ordered. The HIDA scan showed no uptake of contrast in the bile ducts and gallbladder, which is suggestive of congenital biliary atresia. An intraoperative cholangiogram showed a definite diagnosis of biliary atresia, which was performed, and the Kasai procedure was done successfully. All his family members were healthy with no history of congenital disease.The essential outcome in this case is to consider biliary atresia as a cause of prolonged jaundice in infants, and occasionally it is associated with other congenital anomalies. The diagnosis and treatment should be urgent in order to prevent complications
Renal Solitary Fibrous Tumor - A Case Report
Get PDFA renal solitary fibrous tumor (SFT) is an unusual and especially rare entity. Preoperative diagnosis is usually difficult, but it remains of favorable prognosis. In this study, the authors report a case of a 33-year-old Moroccan man with a history of left pyelolithotomy who presented with a 19 cm left renal mass associated with two kidney stones in the lower calyx. He underwent an open radical nephrectomy, and pathology revealed a renal SFT. To the best of our knowledge, our patient is the first case of renal SFT with a history of urolithiasis and presenting with concomitant ipsilateral calculi. Radical nephrectomy is still the cornerstone gold standard therapy for patients with large renal tumors, especially for rare tumors with no proper protocol
The Implementation and Testing of a Reliable and Valid Oral Fat Tolerance Test (OFTT) for Research and Clinical Purposes
Get PDFBackground: Increased fat intake leads to a greater risk of atherosclerosis due to the increase in circulating triglycerides (TG), which damages the endothelial lining. An oral fat tolerance test (OFTT) is usually employed to evaluate postprandial lipid metabolism. However, there has yet to be a standardized procedure for doing an OFTT. This investigation assists in the determination of a standardized, reliable, and valid OFTT. Methods: All participants (n=20) were free of any known cardiovascular or metabolic disease. Participants were allotted 20 minutes to complete the OFTT. Baseline and subsequent blood analyses postfeeding were collected at 1, 2, 3, and 4 hours. One of the three OFTT loads of varying fat concentrations was administered to each participant in a randomized crossover design, containing fat loads of 150 g, 100 g, and 50 g of fat. A single-measure consistency intraclass correlation coefficient was used to determine significance (r>0.75). Results: The test-retest reliability of the OFTT loads (150 g, 100 g, and 50 g) were all significant (p<0.001), with ICC at 0.745, 0.923, and 0.715, respectively. Face Validity was confirmed upon repeat analysis. Conclusions: The 100 g OFTT load was the most reliable and valid measure for observing TG elevation. It is proposed that the 100 g load would be a reliable tool for further research investigation and eventual use for clinical purposes
Complications During Root Canal Shaping: A Survey Among Dentists in Morocco
Get PDFIntroduction: Endodontic therapy is a complex procedure that requires a high level of precision due to the intricacies of the root canal system. Despite advancements in endodontic tools and techniques, incidents such as instrument fractures, dentinal plugs, false routes, and root perforations can occur when best practice recommendations are not adhered to. These complications pose a significant public health concern as they can lead to potentially severe infectious complications and ultimately result in endodontic treatment failure. The aim of this study is to elucidate the causes of endodontic complications, particularly during the root canal shaping stage, and to identify strategies for their prevention.Materials and Methods: A cross-sectional, analytical, descriptive, and unidirectional study was conducted on a randomly selected sample of 300 private dentists in Casablanca. The questionnaires were completed anonymously, and statistical analyses were performed using SPSS software. The discussion will be enriched through a comprehensive literature search of major databases, complemented by a series of clinical cases illustrating these complications and the means by which they can be mitigated.Results: The study reveals that 91% of dentists encountered complications during endodontic therapy, with 284 dentists (94.98%) experiencing complications during root canal shaping. The most prevalent complication was instrument fracture, reported by 235 dentists (82.75%). Key contributing factors to these complications included forced file passage, non-adherence to the instrumental sequence, and absence or inadequacy of irrigation. However, these incidents can be averted by adhering to a meticulous treatment protocol and respecting the various steps critical to the success of root canal shaping.Conclusion: In conclusion, there exists a disparity between recommended best practices and the current practices in the field of endodontics, which can lead to multiple complications and subsequent endodontic treatment failures
The Orthodontic Management of Obstructive Sleep Apnea: A Systematic Review
No full textBackground: Obstructive Sleep Apnea (OSA) is considered a real public health problem, often unrecognized or underdiagnosed, requiring multidisciplinary care, including orthodontics that plays an essential role in the screening and managing ventilation. Objective: Our study aims to explain the vital role of orthodontic therapies, whether orthopedic or surgical, in the multidisciplinary management of OSA and improving nasal breathing through a systematic review. Materials and Methods: The literature search was performed in the following databases: PubMed, ScienceDirect, and Cochrane Library. The investigation was limited to publications written in English and French from 2010 to January 2022. Results: Based on the keywords used, eighty-three references were initially identified. After eliminating duplicates, the number of articles was reduced to 79. Studying the titles and abstracts made it possible to select 50 articles. After reading the complete text, 16 publications were included in this systematic review. Eight studies have investigated rapid maxillary expansion (RME), five have evaluated mandibular advancement (MA), and three have investigated the effect of genioplasty in children with OSA. Conclusion: The orthodontic arsenal is well suited and highly beneficial for OSA treatment, whether orthopedic, orthodontic, or surgical correction of jaws
Sinopharm BBIBP-CorVi and Myocarditis: A Causal Link?
Get PDFSince the introduction of the SARS-CoV-2 vaccine, several side effects have been reported, including acute myocarditis, which is primarily associated with mRNA vaccines. However, the cardiac side effects of other forms of vaccination against COVID-19 are still unknown.Here, we present a case of a possible connection between myocarditis and attenuated vaccine Sinopharm BBIBP-CorV. An 18-year-old female patient was admitted to the intensive care unit (ICU) for the management of respiratory distress associated with hemodynamic instability one week after receiving an attenuated vaccineMyocarditis has been reported as a complication of SARS-CoV-2 mRNA vaccines. Our case report suggests a possible link between myocarditis and attenuated vaccines. Therefore, more research is warranted to determine this causal link
Nephrotic Syndrome Revealing of a Squamous Cell Bronchial Carcinoma
No full textMalignant broncho-pulmonary tumors are the principal cause of the paraneoplastic nephrotic syndrome. These tumors are most often small cell or squamous bronchial carcinomas. In 75% of cases, the nephrotic syndrome is due to membranous glomerulonephritis. We report the case of a 67 years old patient, a chronic tobacco user, followed since June 2019 for a nephrotic syndrome caused by extra-membranous glomerulonephritis. A chest computed tomography revealed a mass of the left lower lobe. Trans-parietal biopsy of this process revealed a squamous bronchial carcinoma. PET scan detected no other fixations. The proteinemia was at 39g/l with albuminemia at 14 g/l. Surgical resection was then indicated and the patient underwent a left lower lobectomy with radical lymph adenectomy. Outcomes were simple with complete resolution of paraneoplastic nephrotic syndrome
Predisposition to Tartar following Fixed Retainers in a Population with a Healthy Periodontium: A Prospective Study
Get PDFIntroduction: Fixed retainers are systematically used after the orthodontic treatment to avoid recurrence. The continued presence of retainers creates difficult areas to clean, which can lead to plaque build-up and the formation of tartar, which can lead to gum inflammation and even periodontal disease. The objective of our study is to follow the evolution of periodontal indices after wearing the fixed retainer in patients with healthy periodontium treated in a dental office in Rabat. Materials and Methods: This was a prospective descriptive-analytical study that targeted 38 patients with a wire-type retainer device bonded in the city of Rabat. During our survey, we used a questionnaire divided into two parts. The first part was reserved for the patient, who answered questions about oral hygiene habits and information about the retainer. The second part concerned the methods and materials used by the orthodontist. Moreover, a clinical card included periodontal data collected on anterior teeth with a fixed retainer and was filled out during a physical examination. Results: An accumulation of dental plaque is observed mainly in the mandible in a moderate way visible to the naked eye in 69% of patients; this accumulation of plaque increases with the age of the retainer, especially in the mandible. Gingival inflammation manifested by spontaneous or induced bleeding is seen moderately in the mandible in 62% of patients. Mild-to-moderate bleeding in the maxilla in 54% of patients, a deposit of supragingival tartar covering a maximum of one-third of the tooth surface, mainly at the mandibular incisors in 66% of patients, and no bone loss related to fixed retainers in the anterior area of the mandible and maxilla have been reported despite the age of the retainer. The comparison of periodontal indices over three different wearing times showed statistically significant deterioration of periodontal health over time, especially at the mandibular incisors. Conclusion: Given the significant impact on periodontal health, this study made us aware of the importance of regularly monitoring oral hygiene during the contention phase