La Tunisie médicale
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La Tunisie médicale · Nov 2006
Case Reports[Tracheobronchopathia osteochondrodysplasias. About one case revealed by haemoptysis].
Tracheobronchopathia osteochondrodysplasias is a benign and rare chronic disease, whose etiology remains obscure. It is characterized by the presence of subepithelial osteocartilaginous focal lesions without any relation to tracheal rings, essentially localized in the lower two thirds of the trachea and the major bronchi. ⋯ The lesion was suspected by bronchoscopy and the diagnosis was made histologically, showing heterotopic bone formation. The evolution of this affection was marked by a good clinical tolerance with only a symptomatic treatment.
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Gallbladder agenesis is a rare malformation, that can lead to an unnecessary and dangerous surgery. We report a case of gallbladder agenesis in a 27-year-old woman who had a right upper abdominal pain described as intermittent without fever neither jaundice during 1 year and half. ⋯ The MRI-cholangiography confirmed the agenesis of gallbladder. Using this case report, we will try to remember outcome particularities of this bile duct malformation.
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La Tunisie médicale · Jul 2006
Randomized Controlled Trial Comparative Study Clinical TrialCo-analgesic effect of ketorolac after thoracic surgery.
Thoracotomies are painful surgical procedures and adequate pain relief is associated with improved respiratory function and fewer respiratory complications. After thoracotomy for lung resection, patients received morphine-based patient-controlled analgesia (PCA). Three groups were prospectively and randomised investigated: patients receiving preemptive ketorolac, those given postoperative ketorolac and controls. ⋯ At 48 h after surgery, compared to controls, morphine consumption was 36% lower for the preemptive ketorolac group and 17% lower for postoperative ketorolac group (p < 0.05). No statistically significant differences were observed for pulmonary function tests. These results suggest that non-steroidal anti-inflammatory drugs can reduce the opioid requirements after thoracic surgery but do not improve lung function.
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The delivery haemorrhage is actually a problem of public health. It is responsible of 31.5 % of the maternal death in Tunisia. The goal of this work is to study the frequency of this complication, its gravity, its risk factors, its etiologists and its methods of treatment. ⋯ Factors of risk taking out again our set are: gestational toxemia (35.4%), primiparity (33.8%), advanced maternal age (30.7%), pre-existent anaemia (24.6%). the uterine surdistension (21.3%), an abnormal middle length of labour (69.6%). use of oxytocin during labour (34%), induction (21.5%). Etiologists in our set are: atone in 63% of cases, retained placenta in 31.2% des cases, coagulopathie (9.2%), placenta previa (1.5%), uterine inversion (1.5%). The hold must be in charge multidisciplinary, systematized, precocious and dynamic.