Morbi Infectious Mortality of Diabetics Hospitalized at the Medical Clinic of Abass Ndao Health Center

Introduction: Diabetes is a public health problem and is exposed to some complications, particularly infectious. The work on this entity remains segmentary in Africa. The objective was to describe the morbi infectious mortality of the diabetics at the Medical Clinic II of Abass Ndao Health Center of Dakar. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted from 01 January 2016 to 31 December 2016. It covered patients with diabetes hospitalized during the study period. Epidemiological data and infectious diseases were evaluated. Results: During the study period, 346 diabetics have respected the inclusion criteria. These were 165 men (47.68%), a sex ratio of 0.91. The mean age was 56.17 years. The age group of [60 - 69 years] accounted for 31.5% and 95.6% of the patients came from the Dakar region. The average age of diabetes was 10.31. Diabetes had been evolving for less than 5 years in 25.15% of patients and inaugural in 11.46%. About 82.36% of our patients had type 2 diabetes. The acute complications of diabetes were ketoacidosis (51.89%), hyperosmolar hyperglycemia (0.58%), and hypoglycemia (1.45%). The mean infections were the skin and soft tissues (54.91%), urogenital infections (16.18%), respiratory infections (14.45%), malaria (3.46), infections of the skin and soft tissues were dominated by the diabetic foot (41.90%). The 125 non-diabetic patients developed 38 infectious pathologies, the main ones being respiratory infections (24.32%), infections of the skin and soft parts (24.32%). HIV infection was observed in 0.28% of diabetics and 8.10% of non-diabetic patients. 93 patients died (15.70%). Fifty-one of them died of infectious diseases (54.8%), 42 non-infectious diseases (45.16%), and subjects aged over 60 years, representing 72.54%. The means of consultation was 30 days. The highest rates of lethality were diabetes (37.41%), acute gastroenteritis (17.64%), and acute pyelonephritis (12.5%). The lethality rates of indeterminate infections and malaria were 10% and 8.33%, respectively. Conclusion: Infection is a significant complication in diabetics not neglectable to diabetes. These discovery patterns call for more early diagnosis and appropriate management to reduce the mortality of diabetics.

SARS-CoV-2 outbreak impact on a trauma unit

BACKGROUND From February 2020 onwards,our country has been hit by the coronavirus severe acute respiratory syndrome-2(SARS-CoV-2)infection.At a glance,hospitals became overrun and had to reformulate all the assistance guidelines,focusing on the coronavirus disease 2019.One year after the start of the pandemic,we present the results of a morbimortality study.AIM To analyze how our department was affected by the outbreak in terms of morbimortality,and to analyze demographic data,admission to hospital-related data,and subgroups analyses for patients with hip fractures and polytrauma.METHODS We designed a study comparing data from patients who were admitted to our unit due to a lower limb fracture or a high energy trauma during the pandemic(from March to April 2020)to those admitted during the same period in 2019 before the pandemic.during the pandemic situation.Both cohorts completed a minimum of 6 mo of follow-up.RESULTS The number of patients admitted to hospital in 2020 was nearly half of those in 2019.Hip fractures in the elderly represented 52 out of 73 of the admitted patients.Twenty patients had a positive test result for SARS-CoV-2 infection.Patients with SARS-CoV-2 infection were admitted to the hospital for a longer time than the non-infected(P<0.001),and had a higher mortality rate during hospitalization and follow-up(P=0.02).Patients with a hip fracture associated with a severe respiratory syndrome were mostly selected for conservative treatment(P=0.03).CONCLUSION Mortality and readmission rates were higher in the 2020 cohort and during follow-up,in comparison with the cohort in 2019.

Can Necrosis and Ovarian Vein Thrombus Be a Serious Complication in Morbidly Adherent Placenta?

We report a case of a 40-year-old woman, second pregnancy, previous cesarean section due to intrauterine growth restriction and placenta accreta spectrum disorders. She was 25 weeks gestational age, admitted to the hospital 25 weeks gestational age, diagnosed with fetal death. Initial conservative management attempt with uterine preservation progresses to complications requiring total hysterectomy followed by a rare outcome: pelvic thrombi with uterine necrosis, with its associated clinical complications.

Prognosis of the Patients in Resuscitation Field in Mali

Introduction: The patients whose vital prognosis is immediately threatened by one or several serious organs failures and consecutive to various pathologies are admitted in resuscitations (IUC). The rates of morbi-mortality are raised in Africa. Objective: To study the prognostic factors. Patient and Methods: It was about a transverse survey from January 2015 to April 2016 in the unit of polyvalent resuscitation of the service of anesthesia resuscitation of the academic hospital center of Gabriel Toure. It included all patient admitted for medico-surgical pathologies of more than three hours of hospitalization. It was about a consecutive recruitment of case. The Chi2 and Fisher tests were used for the comparison of our results with a p value = 0.05 considered as meaningful. The consent of the patients or parents was gotten. The survey didn’t include a potentially dangerous act. Results: During the period, 624 patients have been collected of which: 50.4% were medical pathologies, 19.4% surgical pathologies and 30.2% of gynéco-obstetric pathologies. At least a complication had occurred in 11.2%. Mortality was of 27%. The sex-ratio was of 0.51. The middle age was of 31.88 ± 17, 2 years with extremes of 2 years and 80 years. The met complications were: the scab, the syndrome of acute respiratory distress (ARD), the urinary infection, the pneumopathie, the shock, thrust hypertensive, stops cardio circulatory with respectively 35.1%, 26.6%, 22.3%, 6.4% and 3.2%. The middle length of stays was of 4.83 ± 5.32 days with extremes of 1 day to 29 days. Conclusion: The complications under hospitalization in unit (IUC) of resuscitation in Mali are a major challenge in term of prevention and management. The potentially non serious pathologies complicate themselves and compromise the vital prognosis.