Background: Obstetric Fistula (OF) is a breach of the birth canal due to obstructed labor. It is a major public health problem in developing countries. Objective: Study the epidemiology and treatment of obstetric fist...Background: Obstetric Fistula (OF) is a breach of the birth canal due to obstructed labor. It is a major public health problem in developing countries. Objective: Study the epidemiology and treatment of obstetric fistulas at the Departmental University Hospital Centre of Borgou and Alibori (CHUD-B/A) in Parakou, Benin. Study Method: This was a descriptive and analytical cross-sectional study with prospective data collection on women treated during OF care missions from February 2020 to April 2021 in CHUD-B/A in Parakou, Benin. The data concerned their socio-demographic characteristics, obstetric history, the clinic and therapeutic characteristics of their obstetric fistulas. Results: In total 97 patients with OF were treated during the 14-month period. The average age of the patients was 36.42 ± 11.75 years old. The patients were married (51.54%), without professional occupation (54.64%) and had no formal education (73.20%). The vesico-vaginal variety was predominating (54.64%). The fistulas were of Type I (46.39%), Type II (20.62%) and Type III (32.99%) according to the classification of Waaldjik Kees. The patients were operated on under spinal anesthesia (94.79%), and vaginally (55.67%) according to the principle of Chassar Moir (68, 60%). The associated procedures were lengthening urethroplasty (17.53%), and interposition of the Martius flap (1.03%). The overall success rate without Stress Urinary Incontinence was 71.13%. The factors associated with the failure of the fistula repair were: the nutritional status of the patients (p = 0.004), the previous repair failure (p = 0.001), the high size of the fistula (p = 0.007), the fistula severity (p and a urethral reconstruction (p Conclusion: OF is a relatively frequent pathology in Benin. Vesico-vaginal fistula is the most common form. The success rate of the surgical treatment is satisfactory, but depends on some factors.展开更多
Introduction: The primary localization of non-Hodgkin lymphoma of the muscle is rare. Only the biopsy allows the certainty diagnosis. The aim was to report a first case of small cell lymphoma of the gastrocnemius in M...Introduction: The primary localization of non-Hodgkin lymphoma of the muscle is rare. Only the biopsy allows the certainty diagnosis. The aim was to report a first case of small cell lymphoma of the gastrocnemius in Mali and to do a review of the literature. Clinical Observation: It was about a 34-year-old woman who consulted 3 months after the onset of symptoms for swelling and pain in the left calf. On clinical examination there was a hard, painful and warm mass in the left calf, with paresthesias in the tibial nerve territory associated with partial functional impotence of the leg. The ultrasound revealed a hyper echogenic and heterogeneous non-vascularized mass of the left gastrocnemius muscle measuring 65 × 45 × 40 mm non-vascularized on color Doppler and pulsed in favor of myositis. Magnetic resonance imaging (MRI) concluded in a well-limited heterogeneous cystic mass in the left gastrocnemius muscle respecting the bone of benign appearance: remodeled Baker’s cyst? Considering the radioclinical unconformity, thoraco-abdominal CT was performed and revealed pulmonary metastasis. The biopsy carried out concluded with a small cell lymphoma of the gastrocnemial muscle. Marginal resection was performed associated with adjuvant chemotherapy. The advancement at 9 months was satisfactory.展开更多
文摘Background: Obstetric Fistula (OF) is a breach of the birth canal due to obstructed labor. It is a major public health problem in developing countries. Objective: Study the epidemiology and treatment of obstetric fistulas at the Departmental University Hospital Centre of Borgou and Alibori (CHUD-B/A) in Parakou, Benin. Study Method: This was a descriptive and analytical cross-sectional study with prospective data collection on women treated during OF care missions from February 2020 to April 2021 in CHUD-B/A in Parakou, Benin. The data concerned their socio-demographic characteristics, obstetric history, the clinic and therapeutic characteristics of their obstetric fistulas. Results: In total 97 patients with OF were treated during the 14-month period. The average age of the patients was 36.42 ± 11.75 years old. The patients were married (51.54%), without professional occupation (54.64%) and had no formal education (73.20%). The vesico-vaginal variety was predominating (54.64%). The fistulas were of Type I (46.39%), Type II (20.62%) and Type III (32.99%) according to the classification of Waaldjik Kees. The patients were operated on under spinal anesthesia (94.79%), and vaginally (55.67%) according to the principle of Chassar Moir (68, 60%). The associated procedures were lengthening urethroplasty (17.53%), and interposition of the Martius flap (1.03%). The overall success rate without Stress Urinary Incontinence was 71.13%. The factors associated with the failure of the fistula repair were: the nutritional status of the patients (p = 0.004), the previous repair failure (p = 0.001), the high size of the fistula (p = 0.007), the fistula severity (p and a urethral reconstruction (p Conclusion: OF is a relatively frequent pathology in Benin. Vesico-vaginal fistula is the most common form. The success rate of the surgical treatment is satisfactory, but depends on some factors.
文摘Introduction: The primary localization of non-Hodgkin lymphoma of the muscle is rare. Only the biopsy allows the certainty diagnosis. The aim was to report a first case of small cell lymphoma of the gastrocnemius in Mali and to do a review of the literature. Clinical Observation: It was about a 34-year-old woman who consulted 3 months after the onset of symptoms for swelling and pain in the left calf. On clinical examination there was a hard, painful and warm mass in the left calf, with paresthesias in the tibial nerve territory associated with partial functional impotence of the leg. The ultrasound revealed a hyper echogenic and heterogeneous non-vascularized mass of the left gastrocnemius muscle measuring 65 × 45 × 40 mm non-vascularized on color Doppler and pulsed in favor of myositis. Magnetic resonance imaging (MRI) concluded in a well-limited heterogeneous cystic mass in the left gastrocnemius muscle respecting the bone of benign appearance: remodeled Baker’s cyst? Considering the radioclinical unconformity, thoraco-abdominal CT was performed and revealed pulmonary metastasis. The biopsy carried out concluded with a small cell lymphoma of the gastrocnemial muscle. Marginal resection was performed associated with adjuvant chemotherapy. The advancement at 9 months was satisfactory.
