Objective: This study aims to analyze clinical, paraclinical and therapeutic aspects of sinusitis complications in the Otorhinolaryngology department at the teaching hospital of Gabriel Toure in Bamako. Materials and ...Objective: This study aims to analyze clinical, paraclinical and therapeutic aspects of sinusitis complications in the Otorhinolaryngology department at the teaching hospital of Gabriel Toure in Bamako. Materials and methods: This descriptive and longitudinal study was conducted on 12 months from March 2012 to February 2013 in 9 cases of sinusitis complications in the department of Otorhinolaryngology at the University Hospital Gabriel Toure in Bamako. Results: The average age of patients was 22.7 years;a median of 19 years within 6 men and 3 women with almost 12.9 days of care seeking duration. The factors of risky were the use of nonsteroid anti-inflammatory drugs NSAID (4 cases), maxillofacial trauma (1 case) and HIV (1 case). Facial pain was the major symptom, such as frontal oedema, rhinorrhea with pus shedding and nasal obstruction. Computer tomography was used for complications specification. Frontal sinusitis was the most encountered with subperiosteal abscess (44.4%). Streptococcus pneumoniae was identified in 3 cases. Medical treatment associated to surgery was conducted on 7 patients. Two cases of death have been registered. Conclusion: The complicated sinusitis is an emergency and dangerous disease requiring specific care by a multidisciplinary staff. Much of complications are commonly encountered despite the antibiotic era.展开更多
Retinoblastoma (RB) treatment aims at saving the life and preserving useful vision. In most low-income countries, because of delays in diagnosis, advanced disease presentation is quite common. This prospective study a...Retinoblastoma (RB) treatment aims at saving the life and preserving useful vision. In most low-income countries, because of delays in diagnosis, advanced disease presentation is quite common. This prospective study aimed at evaluating the treatment results of orbital RB with regards to overall survival rate of the patients treated with chemotherapy and radiotherapy. The study was performed from 01 November 2011 to 31 December 2015 in the paediatric oncology unit of Gabriel Touré Teaching Hospital, Bamako, Mali and The Institute of Tropical Ophthalmology of Africa (IOTA), Bamako, Mali. All intra-orbital non-metastatic RB cases not previously treated by chemotherapy or radiotherapy were included in this study. Fourteen patients were included into the study. Median age was 2 years, and sex ratio 2.5 (M = 10;F = 4). Right eye (n = 12, 85.7%) was more often affected than left eye (n = 2;14.3%). Chemotherapy toxicities were mainly haematological including grade 3 anemia (n = 2;7%) and grade 4 neutropenia (n = 3;11%). Twelve patients (86%) were enucleated after neoadjuvant chemotherapy. Two patients (14%) abandoned treatment before enucleation. The IRSS pathology staging was: stage IIIa in 6 patients (50%), and stage II in six patients (50%). Six children (43%) received orbital radiotherapy at total dose of 45 Gy;Six children (43%) achieved complete remission;Overall survival rate was 48% at 4 years (95% CI: 22.5% - 74.4%). In conclusion, the therapeutic strategy based on neoadjuvant chemotherapy followed by enucleation, adjuvant chemotherapy and external beam radiotherapy, was beneficial in patients with stage III disease, achieving an event-free survival rate of 48%.展开更多
文摘Objective: This study aims to analyze clinical, paraclinical and therapeutic aspects of sinusitis complications in the Otorhinolaryngology department at the teaching hospital of Gabriel Toure in Bamako. Materials and methods: This descriptive and longitudinal study was conducted on 12 months from March 2012 to February 2013 in 9 cases of sinusitis complications in the department of Otorhinolaryngology at the University Hospital Gabriel Toure in Bamako. Results: The average age of patients was 22.7 years;a median of 19 years within 6 men and 3 women with almost 12.9 days of care seeking duration. The factors of risky were the use of nonsteroid anti-inflammatory drugs NSAID (4 cases), maxillofacial trauma (1 case) and HIV (1 case). Facial pain was the major symptom, such as frontal oedema, rhinorrhea with pus shedding and nasal obstruction. Computer tomography was used for complications specification. Frontal sinusitis was the most encountered with subperiosteal abscess (44.4%). Streptococcus pneumoniae was identified in 3 cases. Medical treatment associated to surgery was conducted on 7 patients. Two cases of death have been registered. Conclusion: The complicated sinusitis is an emergency and dangerous disease requiring specific care by a multidisciplinary staff. Much of complications are commonly encountered despite the antibiotic era.
文摘Retinoblastoma (RB) treatment aims at saving the life and preserving useful vision. In most low-income countries, because of delays in diagnosis, advanced disease presentation is quite common. This prospective study aimed at evaluating the treatment results of orbital RB with regards to overall survival rate of the patients treated with chemotherapy and radiotherapy. The study was performed from 01 November 2011 to 31 December 2015 in the paediatric oncology unit of Gabriel Touré Teaching Hospital, Bamako, Mali and The Institute of Tropical Ophthalmology of Africa (IOTA), Bamako, Mali. All intra-orbital non-metastatic RB cases not previously treated by chemotherapy or radiotherapy were included in this study. Fourteen patients were included into the study. Median age was 2 years, and sex ratio 2.5 (M = 10;F = 4). Right eye (n = 12, 85.7%) was more often affected than left eye (n = 2;14.3%). Chemotherapy toxicities were mainly haematological including grade 3 anemia (n = 2;7%) and grade 4 neutropenia (n = 3;11%). Twelve patients (86%) were enucleated after neoadjuvant chemotherapy. Two patients (14%) abandoned treatment before enucleation. The IRSS pathology staging was: stage IIIa in 6 patients (50%), and stage II in six patients (50%). Six children (43%) received orbital radiotherapy at total dose of 45 Gy;Six children (43%) achieved complete remission;Overall survival rate was 48% at 4 years (95% CI: 22.5% - 74.4%). In conclusion, the therapeutic strategy based on neoadjuvant chemotherapy followed by enucleation, adjuvant chemotherapy and external beam radiotherapy, was beneficial in patients with stage III disease, achieving an event-free survival rate of 48%.
