Epidemiological-Clinical and Therapeutic Aspects of Acute Appendicitis at the Reference Health Center of Commune III (C.S.Ref CIII) of the District of Bamako

Objectives: It was to determine the epidemiological-clinical and therapeutic aspects of acute appendicitis at the Reference Health Center of Commune III of the district of Bamako. Methodology: This was a prospective study from January 1 to December 31, 2020 including patients operated for acute appendicitis and confirmed at histology and cases of abscess and appendicular plastron. Results: We collected 60 cases of acute appendicitis. They accounted for 17.29% of surgical indications. The average age of our patients was 25.5 years. The male sex was the most represented at 63% with a sex ratio of 1.72. The Pain in the right iliac fossa was the most represented reason for consultation with 76.7%. It was at the type of bite 70% of the cases. On physical examination the defense of the right iliac fossa was present in 96.7%. Digestive signs were marked by nausea 28.4% (17 patients) and vomiting 25% (15 patients). The digital rectal exam was painful to the right of the Douglas fir in 76.7% of our patients. In biology a complete blood count (CBC) performed in all our patients has objectified hyper leukocytosis in 80% of cases. The reactive protein (CRP) performed in 36 patients was elevated with values between 18 and 46 mg/ml. The imaging performed was an abdominal ultrasound that found a roundel image of the appendix with increased size in 65%. Surgical treatment consisted of classical Mac Burney appendectomy in 54 patients (90%). The gesture performed was an appendectomy in all our patients. All our appendectomy parts were sent for pathological examination. This examination classified the parts as non-specific appendicitis in 60%, phlegmonous appendicitis in 22% and catarrhal appendicitis in 18% of cases. Surgical follow-up was simple in 98.4% (59 patients) and morbidity was marked by digestive fistula in one patient. We recorded one case of death (1.6%). Conclusion: Acute appendicitis remains the most common surgical emergency in commune III of the district of Bamako. It is a pathology that can be found at all ages of life. Its morbidity and mortality are low subject to early diagnosis and management.

Clinical Stage Evaluation at Diagnosis of Prostate Cancer at Urology-Andrology Clinic Cnhu-Hkm Cotonou

Aims: To evaluate the clinical stage at diagnosis of prostate cancer. Materials and Methods: This study was retrospective and?descriptive from January 2008 to June 2013. Patients who were diagnosed with prostate cancer wereinvolved and confirmed by clinical examination anatomopathological screening. They also realized a total serum PSA, a bladder-prostatic and abdominal ultrasound. Results: Average age was seventy years, ranging from fifty years to seventy years. The general status of our patients was satisfactory in 78% of cases. Main symptoms were dysuria and frequencyin 96% and 86%, respectively. Family past history of prostate cancer were found in 24% of cases. Twenty-three patients (43%) had a total serum PSA ≥ 100 ng/ml. Adenocarcinoma was the main histological type. Grades 1 and 4 were the most frequent. Thirty-three patients (66%) had a Gleasonscore betwen [2]-[6]. Forty-four patients (88%) had locally advanced and metastatic desease. The D’Amico score was identified in six patients but 3 and 2 patients were low risk and intermediate riskrespectively. Finally, 1 patient was high risk. Conclusion: Prostate cancer remains elderly man cancer. It was discovered in locally advanced and metastatic desease in this series. This diagnosis was late in the majority of cases.

Quality management in anatomic pathology:The past,present,and future

One of the challenges in anatomic pathology laboratories is to meet the increasing need for pathological diagnosis,using quality management(QM)activities and systems to ensure that patients receive their accurate and timely pathology report.The aim of this paper is to review anatomic pa-thology QM from both management and technical perspectives,including the past,present,and future opportunities.First,the evolution of the QM concept and scope will be discussed.Next,current QM system imple-mentation and laboratory accreditations will be discussed from the man-agement perspective,and common medical errors in anatomic pathology in different testing cycles will be analyzed.Finally,selected future management systems to improve the level of total QM worldwide for patient safety and the potential of informatics to be used as an auxiliary tool in anatomic pathology will be discussed.