Opinions of Students on the Contribution of the DIVA 3D Virtual Dissection Table to the Teaching of Anatomy at the Faculty of Medicine and Odontostomatology of Bamako

Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from November 1 to December 30, 2023 at the clinical and morphological anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako. Included in this study were students who participated in practical and tutorial sessions. The variables studied during this study were: the previous performance of dissection on a cadaver by the students, the opinion of the students on dissection on a cadaver, the replacement of dissection on a cadaver by virtual dissection in the absence of a body, the level student satisfaction. Results: We surveyed 130 participants. The average age was 22 ± 0.2 years with extremes of 17 and 29 years. 95.3% of participants were students. According to 66.7% of participants, virtual dissection is a good palliative in the absence of a corpse. 95.3% of participants found using the virtual dissection table easy with an average of 7.88 ± 1.4. The overall assessment was well rated by 99.3% of participants. Conclusion: According to the results of this study, the virtual dissection table should be improved by integrating commented videos. The use of the DIVA 3D virtual dissection table during practical and tutorial sessions is well appreciated by the students. We believe that the teaching of anatomy using 3D digital technology should be included in the study programs of the Faculty of Medicine and Odontostomatology.

Peritonitis: Perioperative Care in Surgical Emergencies CHU Ignace Deen

Objective: Describe the perioperative management of peritonitis in surgical emergencies. Methodology: This was a prospective observational study of the descriptive type over a period of 12 months from January 01 to December 31, 2020 in the surgical emergency room at the CHU Ignace Deen. Included in the study were all patients admitted for peritonitis aged greater than or equal to 18 years. The parameters were epidemiological, clinical and anesthetic. Results: Of the 653 admissions to surgical emergencies in 2020, 185 cases presented with peritonitis, i.e. 29.3%. The average age was 38.6 ± 16.64 years with extremes of 18 and 90 years. The sex ratio was 1.89. The comorbidities were dominated by gastritis and hypertension, i.e. 22%. The patients were classified as ASA 3U (52.4%), ASA2 U (39.5%) and ASA 4 U (8.1%). Preoperative resuscitation was provided only with 100% saline. 25.5% of patients had received a blood transfusion. The response time was less than 48 hours, i.e. 77.6%. General anesthesia was performed for all patients. Ketamine was the most used IV hypnotic (56.3%) combined with 100% halothane. The curares used were suxamethonium at (81.6%), Atracurium (81.6%) and rocuronium at (18.3%). Fentanyl was the only morphine used. Senior anesthesia technicians provided anesthesia in (63.2%). Intraoperative incidents were dominated by hypotension, difficult intubation, cardiac arrest, respectively 10.3%, 8% and 0.5%. The immediate postoperative incidents were arterial hypotension, nausea and desaturation, respectively 52.9%, 80% and 32.4%. Mortality was 3.4%. Conclusion: The perioperative management of peritonitis in the emergency room must be as early as possible in order to reduce morbidity and mortality.

The Reasons for Admission of Elderly Subjects in Intensive Care at the CHU Ignace Deen

Objective: To determine the reasons for admission of elderly subjects and the prognosis in general intensive care. Patients and Methods: Observational descriptive and analytical study with prospective collection of data over a period of one year from January 1 to December 31, 2021. Patients aged 65 or over were included. Abstract: During the study period, 223 cases were collected out of 587 patients admitted, giving a prevalence of 37.9%. The average age was 74.127.39 ± years with extremes of 65 and 96 years and a male predominance (58.7%). The comorbidities were dominated by arterial hypertension (71.3%). The patients were: transferred from medical and surgical emergencies (75.8%). The average admission time was 48.8 ± 29.8 hours. One hundred and eight patients had a Glasgow score between 3 and 7. The reasons for admission were dominated by vascular causes (51.6%). Strokes of any type accounted for 43.9% of these reasons for admission. The average time for carrying out the biological assessments and imaging was 41.8 ± 27.3 hours with the extremes of 3 and 89 hours, 37.2% had a complete assessment within 24 hours. The average duration of hospitalization was 7.10 ± 8.87 days with extremes of 1 and 72 days. The mortality rate was 71.7%. Conclusion: This study has made it possible to take stock of the reasons for the admission of elderly subjects to intensive care. It appears that vascular causes are the main reasons for admission with heavy comorbidities which results in high mortality.

Epidemiological Profile of Cyanotic Congenital Heart Disease in the “B” Surgery Department of Point G University Hospital, before the Advent of Extracorporeal Circulation

Aim: Evaluate the epidemiological profile of cyanotic congenital heart disease in Mali before the advent of extracorporeal circulation in the “B” Surgery Department at the Pont G University Hospital. Patients and Methods: This was a retrospective and descriptive study that took place from January 1, 2011 to December 31, 2017. The records of patients with cyanotic congenital heart disease in the “B” surgery department of Point G University Hospital were collected. Patients operated on for cyanotic congenital heart disease were included in this study. Non-operated patients were not included. Results: The records of 17 patients operated on for cyanotic congenital heart disease were retained. The average age of patients at the time of surgery was 5.18 years with extremes of 2 and 18 years. Boys were in the majority with 59%, i.e. a sex ratio of 1.42. Patients resided in Bamako in 82% of cases. Inbreeding was found in 35.3%. Eighty-eight percent of children were born at term and 94% had up-to-date vaccination status. The average duration of patient follow-up between diagnosis and surgical management was 5 years with extremes of 2 years and 12 years. Tetralogy of Fallot regular form was the most represented heart disease. Conclusion: Cyanogenic congenital heart disease remains the most frequent congenital pathologies in our country. They most often affect male children. Consanguinity is the most common etiological factor found. Tetralogy of Fallot regular form remains the most common.