Surgical Treatment of the Upper Urinary Tract Lithiasis at the Urology Department of the Hopital General Idrissa Pouye

Upper urinary tract lithiasis is a condition characterized by the presence of stones which is a stony concretion of crystallized substances in the kidney and/or ureter. Objective: The objective of this work is to study the epidemiological, clinical and therapeutic aspects of upper urinary tract stones on the one hand, then to compare the different types of surgical treatments and their results. Materials and Methods: This is a retrospective and descriptive study focusing on the surgical management of upper urinary tract stones, between January 2017 and December 2020, at the Urology department of the Hopital General Idrissa Pouye. Results: During the study period, 7.59% of surgical interventions performed were related to the treatment of upper urinary tract stones. Average age was 45.20 ± 16.4 years, the age group [41 - 60] years was more affected with 42.68%. A history of urolithiasis was present in 25.52% of cases. Lower back pain was present in 97.48% of cases. On URO-CT scan, the stone was located more at the level of the ureter (49.57%). The size between 10 to 15 mm was more frequent (30.96%) and the density greater than 1000 HU was more frequent (33.47%). The most used therapeutic procedure was ureteroscopy (52.08%), followed by PCNL (40.83%) and open surgery (7.08%). The success rate (stone free) was 93.68% for the URS, 89.36% for the PCNL. The length of hospital stay for open surgery was 6.76 ± 4.25, for PCNL 2.62 ± 2 days and for URS 1.75 ± 1.62 days. Postoperative complications were present in 23.52% for open surgery, 11.22% for PCNL and 8% for URS. Conclusion: Urolithiasis is constantly growing in our regions. Effective endourological treatment is increasingly replacing open surgery. However, global access to these new techniques in our regions is slow to be effective.

Treatment of Kidney Stones by Percutaneous Nephrolithotomy: Evaluation of the Results of the First Series of Our Experience in the Urology Department of the Idrissa Pouye General Hospital in Dakar

The principle of PCNL is the extraction through a nephrostomy channel of kidney stones which are defined as the presence of crystalline concretions in the kidneys. Objectives: The objective of this work was to study the epidemiological, clinical and paraclinical aspects of patients with renal lithiasis treated by PCNL and on the other hand the different technical aspects of PCNL. Materials and Methods: This was a retrospective descriptive study, conducted in the urology department of HOGIP, covering the period from January 2015 to January 2019. We studied the demographic and clinical aspects of patients presenting renal lithiasis;we also studied the technical aspects and treatment outcomes. Statistical significance was set for α = 0.05. Results: Our series covered 82 PCNLs performed during the study period. The average age was 45.95 years, the age group [40 - 49 years] was more affected. Our study involved 44 men and 38 women, a sex ratio of 1.15. At the clinic, atypical lumbar pain was more frequent in 45.83% of cases. On URO-CT, the calculations were located more at the pyelic level (31.2%) and lower caliceal (27.2%). The size of stones measured between 15 and 20 mm in 30.52%. The stone density was between 500 and 1000 HU in 47.54% of cases. Intraoperatively, the patients were placed in lateral decubitus in 41.46% of cases. Only one access to the kidney was necessary in 87.8% of cases. The lithoclast was used in 65.85% of cases. The overall success rate (stone free) in our series was 96%. The majority of cases, 41.44%, drainage were done by natural means (totally tubeless). The average duration was 92 minutes. The complications encountered in our experience concerned 10 cases, a rate of 12.19%. Conclusion: Urinary lithiasis is more and more frequent in our regions. The development of Endo-urology offers several therapeutic options. Thus, PCNL occupies an important place in the management of kidney stones.

Collaborative Efforts and Strategies for Cholera Outbreak Control in Garissa County, Kenya: Implementation of Water Quality Monitoring Interventions

A multi-faceted Case Area Targeted Intervention (CATI) approach emphasizing the integration of Water, Sanitation and Hygiene (WASH) interventions and Oral Cholera Vaccine (OCV) campaign was employed to respond to the outbreak of cholera in Garissa County. Drinking water sources in areas heavily impacted by cholera were systematically mapped and tested for microbiological quality. The quality assessment was carried out in April 2023 during an ongoing cholera outbreak in the county. A total of 109 samples were collected and tested for thermotolerant coliforms and other in situ parameters. The finding revealed that more than 87% of the samples did not meet the World Health Organization (WHO) standard for thermotolerant coliforms;and 30% had turbidity values above the recommended threshold values. None of the 109 samples had any traceable residual chlorine. Following these findings, the county government implemented the targeted interventions which resulted in a positive impact in the fight against cholera. The WHO supported key interventions which included capacity building in water quality monitoring and prepositioning of critical WASH commodities to the cholera affected areas.

Progression of Minimally Invasive Urological Surgery at Hôpital Général Idrissa Pouye in Dakar in 20 Years of Practice

Introduction: Open surgery is gradually being supplanted by minimally invasive surgical techniques worldwide. Our study aimed to describe the place of minimally invasive surgery at the Hôpital Général Idrissa Pouye (HOGIP) in Dakar. Materials and Methods: This is a descriptive cross-sectional study over a 20-years period from 1st June 2000 to 31st December 2021 in the urology department of HOGIP in Dakar. The list of all surgical procedures performed was computed. We evaluated the distribution of minimally invasive procedures (endoscopy, PCNL, laparoscopy) overall and over the years. We made calculations of proportions and statistical significance was considered for alpha = 0.05. Results: In 20 years, 14,855 surgical procedures were performed, of which 5344 (36%) were minimally invasive surgeries. The average age of men was 53.19 years (standard deviation: 21.77) vs 47.32 years (standard deviation: 18.43) for women. Minimally invasive procedures in the lower urinary tract accounted for 71.93% and involved 1033 cystoscopies (26.87%), 1020 Trans Urethral Resection of Prostate (TURP) (26.53%), 931 Direct Vision Internal Urethrotomy (DVIU) (24.21%, and 612 Trans Urethral Resection of the Bladder (TURB) (15.92%). In the upper urinary tract, 1461 (28.07%) minimally invasive procedures were performed, including PCNL in 193 cases (3.61%), laser endopyelotomy in 104 cases (1.95%), ureteroscopy in 486 cases (1.7%) and laparoscopy in 39 cases (0.46%). The proportion of minimally invasive surgery has gradually increased. Among the 5344 minimally invasive procedures, 333 (5.23%) were performed in 2000-2004 and 2332 (43.63%) in 2015-2019. Conclusion: Minimally invasive surgery represents an important part of the activity of the HOGIP urology department. Its development has improved over the years offering its advantages to the patients.

Variational Calculation of the Doubly-Excited States Nsnp of He-Like Ions via the Modified Atomic Orbitals Theory

In this paper, we have declined the formalism of the method of the Modified Atomic Orbital Theory (MAOT) applied to the calculations of energies of doubly excited states 2snp, 3snp, and 4snp Helium-like systems. Then we also applied the variational procedure of the Modified Atomic Orbital Theory to the computations of total energies, excitation energies of doubly-excited states 2snp, 3snp, 4snp types of Helium-like systems. The results obtained in this work are in good agreement with the experimental and theoretical values available.

Modified Atomic Orbital Calculations of Energy of the(2s^(2)^(1)S)Ground-State,the(2p^(2)^(1)D);(3d^(2)^(1)G)and(4f^(2)^(1)I)Doubly Excited States of Helium Isoelectronic Sequence from H-to Ca^(18+)

We report in this paper the ground-state energy 2s^(2)^(1)S and total energies of doubly excited states 2p^(2)^(1)D,3d^(2)^(1)D,4f^(2)^(1)I of the Helium isoelectronic sequence from H-to Ca^(18+).Calculations are performed using the Modified Atomic Orbital Theory(MAOT)in the framework of a variational procedure.The purpose of this study required a mathematical development of the Hamiltonian applied to Slater-type wave function[1]combining with Hylleraas-type wave function[2].The study leads to analytical expressions which are carried out under special MAXIMA computational program.This first proposed MAOT variational procedure,leads to accurate results in good agreement as well as with available other theoretical results than experimental data.In the present work,a new correlated wave function is presented to express analytically the total energies for the 2s21S ground state and each doubly 2p^(2)^(1)D,3d^(2)^(1)D,4f^(2)^(1)I excited states in the He-like systems.The present accurate data may be a useful guideline for future experimental and theoretical studies in the(nI^(2))systems.

The Problematics of Transferred Parturient Women in Guinean Urban Areas: The Case of the Donka Maternity Ward at the University Hospital Centre (Chu) Conakry

Objectives: To describe the socio-demographic aspects of transferred parturient women;To identify the means of transport used by the evacuated parturient women to the Donka maternity ward at the University Hospital of Conakry;To describe the difficulties met;And to assess maternal and fetal prognosis. Methodology: It consisted of a prospective study over a period of 6 months from 01/02 to 31/07/2018. All patients transferred to the maternity ward of the Donka National Hospital of Conakry University Hospital. Results: The frequency of obstetric transfers was 13.79%. The epidemiological profile was that of a parturient woman of an average age of 25.7 years, married, and housewife, unschooled, who was on her first pregnancy and from the city of Conakry. The average distance covered was 16 km with extremes of 3 and 50 km. The transfer to the referral maternity clinic was not medicalized in 94% of cases. The venous route was not taken in 96% of cases. The parturient was not escorted by a health worker in 98% of cases. Bleeding was the most frequent reason for evacuation, followed by acute fetal sufferings. The average number of prenatal consultation was 2 with extremes of 0 and 9. The average length of stay was 3.6 days with extremes of 1 and 28 days. The majority of transferred women had a full-term pregnancy. The Cesarean section was 79.4%. The Retro placental hematoma was the most common complication found and was 29.4%. The counter-reference was not made in 97.79%. We recorded 8 maternal deaths, for a lethality rate of 1.77%. Possible interventions to reduce the dramatic situation of obstetric evacuations require first of all the decentralization of health care structures capable of performing a cesarean section. This approach should aim to create medical centers with a surgical antenna in all municipalities. These decentralized units would reduce the delay in case management and thus, limit the number of complications.

Care Taking of Obstetric Emergencies in the Department of Gynaecology and Obstetrics at Donka National Hospital, University Teaching Hospital (CHU) of Conakry, Guinea

Objectives: The objectives of this work were to calculate the frequency of obstetrical emergencies, to describe the socio-demographic profile of women admitted for obstetric emergencies, to identify the main emergencies, to describe the care taking of emergencies and to establish the maternal foetal prognosis of obstetric emergencies. Methodology: It was a 6-month descriptive prospective study conducted in the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU Conakry, Guinea. The study took place from July 1st to December 31st, 2005. The data collected were entered and corrected using the Word and Excel 2010 software and then transferred to the Epi Info software version 7 for analysis. The results are presented in the form of tables, figures and texts using Word and Excel software, commented on, discussed and compared to current literature data. The limitations of the study: The poor filling of the partograph has been the main problem of our study. Results: The frequency of obstetric emergencies was 19% in the Department. The socio-demographic profile was that of a woman aged 15 to 24 (46.4%), married (92%), housewives (38.1%), out of school (49.5%), nulliparous (34.3%), without prenatal follow-up (47.37%), coming from home (56%), evacuated (44%). The main emergencies are dominated by haemorrhage (34.5%) followed by HTA Arterial hypertension and eclampsia (25.7%). The therapeutic attitude was based on clinical data and was dominated by caesarean section (70%). General anaesthesia was performed in 75% of cases and 1.6% benefited from local anaesthesia. The demand for blood was honoured in 19% of the cases. The maternal morbidity was dominated by anaemia (66.7%) and a lethality of 4%. After the 5th minute, 47% of the newborns had APGAR greater than 7. The neonatal mortality rate was 21%. Conclusion: To avoid and/or reduce obstetric emergencies, it is necessary to detect and treat risk factors during referrals, properly monitor child labor, refurbish providers of basic facilities, promptness in the management of the admission of emergencies and the availability of blood products.

Uterine Rupture: Epidemiological Aspects, Etiologies and Maternal-Fetal Prognosis in the Obstetric Gynecology Department of the Donka CHU Conakry National Hospital, Guinea

Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. Methodology: It was about a descriptive survey with compilation of the data in two phases: a retrospective spreading on one period of 6 years and the other forecasting of 1 one year achieved to the service of Obstetric Gynecology of the hospital National Donka, Fallen from Conakry, Guinea. Results: We recorded 24.030 childbirths of which 188 cases of uterine rupture either a frequency of 0.78, which represents an uterine rupture for 128 childbirths. The epidemiological profile was the one of a woman of 24 to 28 years (31.91%), housewives (69.14%), without prenatal follow-up (47.87%), big multipare (37.76%) and évacuées (78.78%). The motives of consultation have been dominated by the hémorragie (95.74%). The rupture was of transverse type in the majority of the case (63.82%). The hysterorraphy was the most performed surgical procedure which is 85.10% followed by the total sub hysterectomy in 10.63%. The newborns of birth weight superior or equal to 4000 g represent 25.53%. The maternal morbidity has been dominated by the anemia of the postpartum (60%). We recorded a rate of maternal létalité of 12.76%. The maternal deaths were due to the hemorrhage in 78.57%. The living newborns endured a respiratory distress in 9.57% and those stillborn represent 87.23%. The etiologies of uterine rupture were dominated by fetal-pelvic disproportions 48.93% followed by an iatrogenic uterine rupture 22.33%. Conclusion: The reduction of this uterine rupture rate would pass by the recentered prenatal consultation offered, the one of obstetric cares and complete néonataux of emergency, the discount to level of the beneficiaries of the basic structures so that they can discover the cases in time susceptible to drag a rupture to evacuate better in time and the promptness in the hold in charge since the admission of the emergencies in the structures of superior level.

Dead Fœtale in Utéro: Hospitable Frequency, Etiologies and Maternal Prognosis to the Service of Obstetric Gynecology of the Hospital National Donka, CHU of Conakry, Guinea

Objectives: The objectives of this work were to calculate the frequency of MFIU, to describe the epidemiological profile, to identify the étiologies and to establish the maternal prognosis. Methodology: It was about a prospective survey of analytic type spreading on one period of twelve (12) month achieved to the service of Obstetric Gynecology of the hospital National Donka, FALLEN from Conakry. Results: On 5226 childbirths, we recorded 208 cases of MFIU, either a frequency of 3.98%. The epidemiological profile was the one of a teenager or aged woman (more of 35 ans) with respectively (8.17%) and (7.20%), sans follow-up prénatal (10.41%), nullipare (6.02%), célibataire (7.80%), ménagère (5.02%) and non scolarisée (5.16%). The MFIU occurred in the age group of 32 - 36 SA. L’absence of the MAF was the main motive of consultation 94.23%. All cases of MFIU benefitted from a confirmation scan. The vasculo-renal syndromes and their complications were the main étiologie 43.75%;follow-up of the malaria is 13.94%. The majority of the gestantes were delivered by low way 98.08%. The induction of work has been made mainly to the misoprostol (Cytotec 200 μg) either 81.86% against 10.78% of Syntocinon in drip. The maternal morbidity has especially been dominated especially by the hemorrhages in the case of long length retention and the infections when the membranes are broken either 1.44% against 98.56% of case of good maternal prognosis. No maternal death has been recorded. Conclusion: The prenatal consultation offer recentered and the one of medical correct cares of the vasculo-renal syndromes and the malaria could reduce the cases of death fœtale efficiently in utero.

The Maternal Deaths at the Obstetrics and Gynaecology Department of the Ignace Deen National Hospital, University Teaching Hospital (CHU) Conakry, Guinea

Objectives: 1) To calculate the ratio of maternal mortality. 2) To describe the socio-demographic characteristics of deceased patients. 3) To identify the main causes of maternal deaths. Methodology: This was a retrospective study of the 12-month period from January 1st to December 31st, 2015 performed at the Gynaecology Obstetrics Department of the Ignace Deen National Hospital, Conakry, Guinea. The study included women who died during pregnancy, childbirth, and in its peripheries according to WHO’s maternal death report. Results: We collected 38 cases of maternal deaths out of 4404 live births, accounting a ratio of 863 per 100,000 live births. The socio-demographic characteristics of these 38 patients were: 20 - 24 years of age (26%), married (78%), housewives (37%), students (44%), and nulliparous (29%), no prenatal follow-up (47%), and home-birth (49%). The 1st and 3rd type of delay amounted for 40% and 53%, respectively. Patients consulted after 12 hours after symptom-onsets accounted 47%, whereas those before 6 hours accounted for 19%, suggesting the delay of first medication. The final diagnosis and diagnosis at admission coincided in 69% of cases. The emergency kit was available for all. The opinion of a specialist was available in 16 patients. Blood was available in 40% of the patients who required it. Death caused by conditions directly related to pregnancy/delivery accounted for 71%. Haemorrhage was the most frequent cause of death. Death occurred within the first 24 hours of admission in 73% of cases. Conclusion: We here shed light on the maternal death in this area. Although we did not demonstrate the method/procedure to reduce this high rate of maternal mortality, the present study may provide a fundamental data to reduce maternal death in this area.

Photoionization Study of Cl II, Ar II and Kr II Ions Using the Modified Atomic Orbital Theory

Resonance energies of the Cl II-[3s23p3(2D5/2)]nd and [3s23p3(2P3/2)]nd, Ar II-3s23p4(1D2)ns, nd and of the Kr II [4s24p4(1D2)]ns, nd and 4s24p4(3P2,3P1)]ns, 4s24p4(3D2)]ns, nd and 4s24p4(3D2, 1S0)]ns, nd Rydberg series are reported. Natural widths of the Ar II-[3s23p4(1D2)]ns, nd series are also reported. Calculations are done in the framework of the Modified Atomic Orbital Theory (MAOT). Excellent agreements are obtained with available theoretical and experimental data. High lying accurate resonance energies up to n = 40 are tabulated. The possibility to use the MAOT formalism report rapidly with an excellent accuracy the position of the excitation resonances as well as their width within simple analytical formulae is demonstrated.

Delivery Complications of the Single Fat Large Foetus (Macrosomia) with Teenagers at the Obstetrics and Gynaecology Department of the Donka National Hospital, University Teaching Hospital (CHU) of Conakry, Guinea

Objectives: The objectives of this work were to: 1) Calculate the delivery frequency of the large foetus with complications to teenagers;2) Describe the epidemiological profile of these teenagers;3) Identify the risk factors of the large foetus and to establish the maternal prognosis and foetus. Methodology: This was a prospective descriptive 6-month study performed at the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU of Conakry, Guinea. We chose a regular amplitude of one year and we got the following slices: 16 years, 17 years, 18 years. Results: We recorded 14.23% (801/5629) teenage deliveries of which 9.4% (75/801) deliveries are single fat fetus and 93.3% (70/75) of them developed complications. The epidemiological profile was that of an 18 years old teenager (61.4%), single (58.6%), professional (44.3%), out of school (57.1%), primiparous (68.6%), having performed 3 - 4 CPN (47.1%), coming from home (65.7%) and carrying a full term pregnancy (100%) and having delivered by high way medical assistance (52.9%). Risk factors were dominated by the male foetus (75.7%). Maternal morbidity was dominated by cervico-perineal tears 28.6%. The recorded maternal mortality was 4.3%. The 3 cases of maternal deaths were caused by the hemorrhage. The APGAR score at the first minute was in 51.4% between 4 and 6;at the 5th minute in 80% between 7 and 10. The most common foetal complication was acute foetal distress 44.3%. Foetal lethality was 12.8%. Conclusion: Here, we demonstrated the teenage pregnancy and macrosomia in this area. We did not show how we can improve this situation based on the data;however, describing this situation may be of use as a fundamental data to make a better antenatal checkup and teenager-education.

Variational Calculations of Energies of the (2<i>snl</i>) ^1,3<i>L^π</i>and (2<i>pnl</i>) ^1,3<i>L^π</i>Doubly Excited States in Two-Electron Systems Applying the Screening Constant per Unit Nuclear Charge

In this paper, resonance energies and excitation energies of doubly 2sns 1,3Se, 2snp 1,3P0, 2pnp 1,3De, 2pnd 1,3F0 and 2pnf 1,3Ge excited states of the helium isoelectronic sequence with Z ≤ 10 are calculated. Calculations are carried out in the framework of the variational procedure of the formalism of the Screening Constant per Unit Nuclear Charge (SCUNC). New correlated wave function of Hylleraas type is used. Precise resonance and excitation energies are tabulated and good agreement is obtained when a comparison is made with available literature values.