Dakar médical
-
The ordering of tests is often done in a systematical way. In spite of the studies which have proved that these tests are not useful, and despite the advice of the SFAR (1992) the ordering remains excessive, and is a source of expenses for the population. In that study we have done an evaluation for the ordering of preoperative tests in our structure and we have tried to see if the advice of the SFAR were followed, if they were sufficient to modify the habits of ordering the tests.
-
In 15 years period, 137 children with foreign bodies of inferior respiratory tracts were admitted in the otorhinolaryngology and head and neck department of the University of Dakar. For 48 of them, generally late admitted, a tracheostomy was performed. Male children were most affected. ⋯ One case of death was to be deplored. This critical place of tracheostomy increases the morbidity and the mortality in relation with the inhalation of foreign body. This unusual practice of tracheostomy illustrates the arduousness of our working conditions.
-
Twenty one (21) strains of Klebsiella pneumoniae are isolated from patients hospitalized since 48 hours for neurological affections, and from medical staff hands. Eighteen (18) other strains isolated from other clinics were studied for comparison. The identification used API20 E system (BioMérieux), and the susceptibility to antibiotics was tested by disc diffusion test (antibiogram). ⋯ Nosocomial strains are more resistant than the other: 57.14% vs 16.67% (p = 0.02) and 28.57% among them are extended-spectrum beta-lactamase positive. Amikacin (87.5%) and Ciprofloxacin (100%) are the most efficient antibiotics, when Cotrimoxazole inhibits 31.25% of the strains. The electrophoretic profiles show an important diversity of strains and suggest an external contamination.
-
During the period between the end of 1993 and the beginning of 1994 there was a large epidemic rush from severe nosocomial infection essentially in the form of septicemia. Authors implemented a classification of these epidemics and some strains were sent to the Institute Pasteur Paris for a further examination. ⋯ These studies have shown that its about real epidemic, because the same strains were transmitted from one patient to another. This show the precarious condition of our hospital hygiene, involving the necessity of an efficient training of our health staff.
-
Caudal loco regional anesthesia is a quite simple and secure procedure. That is a prospective study made on seventy children operated in orthopaedics, urology and general surgery below the ombilicus. The caudal epidural anesthesia followed a general anesthesia in all seventy cases and brought relief in terms of analgesia, even for those painful surgical procedures. The good post operative status with only some minor complications leads us to use widespreadly caudal epidural.