eSciPub Journals

Our Journals

TIBIAL PLATEAU FRACTURES IN A LIMITED-RESOURCE SETTING: A PROSPECTIVE STUDY OF SURGICAL TECHNIQUES AND OUTCOME OVER THREE YEARS

Research Article of American Journal of Orthopedic Research and Reviews Tibial plateau fractures in a limited-resource setting: A prospective study of surgical techniques and outcome over three years Daniel Handy Eone1*, Itambi Maxwell Asoh1, Ernest Kikah Ndifor1, Mbaga Ntjam Andre Claude1, Fonkoue Loic2, Muluem Olivier Kennedy1, Guifo Marc Leroy3, Kaldadak Martin4, Ibrahima Farikou5 1Orthopaedic and Trauma Surgery Unit, Yaounde Central Hospital. 2Orthopaedic and Trauma Surgery Unit, Yaounde Emergency Centre. 3Orthopaedic and Trauma Surgery Unit, Yaounde University Teaching Hospital. 4Orthopaedic and Trauma Surgery Unit, Yaounde Military Hospital. 5Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, The University of Yaounde I. Introduction: Tibial plateau fractures form a wide spectrum of injuries accounting for 1.2% of all fractures and a prevalence of 10 cases per 100,000 inhabitants. Methodology: A prospective consecutive multicentre study from May 2018 to May 2021 was carried out in Yaounde. All consenting cases of tibial plateau fracture underwent surgical treatment while patients with pathologic fractures, previous knee osteoarthritis, medically unfit for surgery, and discharging against medical advice were excluded. Data was analysed with SPSS 26.0 and the level of significance set at p<0.05. Results:Eighty-four (84) cases of tibial plateau fractures were sampled and 68 consented to surgery. The mean age was 42 ±13.6 years and sex ratio 2.4. Estimated prevalence was 2.2 cases per 100,000 inhabitants. Schatzker type II fractures were most represented (33.3%). The left leg was affected in 57.1%. Motorbike accidents were the main cause of injury (66.7%). Of the 68 operated, 63.3% by plating osteosynthesis, 32.4% by external fixation, and 4.4% by screws fixation. Tricortical iliac bone graft was realised in 4 cases. The minimum follow-up was 6 months, with a median of 18 months (5 to 37 months). Plating osteosynthesis (p<0.001), operative time between 60 to 120 minutes (p<0.02) and a good ...

INDICATIONS AND OUTCOMES OF THE KOCHER-LANGENBECK SURGICAL APPROACH IN THE MANAGEMENT OF ACETABULAR FRACTURES IN A RESOURCE LIMITED SETTING

Research Article of American Journal of Orthopedic Research and Reviews Indications and Outcomes of the Kocher-Langenbeck Surgical Approach in the Management of Acetabular Fractures in a Resource Limited Setting Handy ED1*, EK Ndifor¹, AM Itambi¹, Mbaga AC¹, Ndikum BN², Fonkoue L³, Muluem K⁴, Guifo ML⁵, MA Sosso⁶ 1Orthopeadics and Trauma Unit, Yaounde Central Hospital. 1Orthopeadics and Trauma Unit, Yaounde Central Hospital. 1Orthopeadics and Trauma Unit, Yaounde Central Hospital. 1Orthopeadics and Trauma Unit, Yaounde Central Hospital. 2Public Health Expert, Elig-Essono Sub-Divisional Medical Centre. 3Orthopeadics and trauma unit, Yaounde Emergency Centre. 4Orthopeadics and Trauma Unit, Yaounde General Hospital. 5Orthopeadics and Trauma Unit, Yaounde University Teaching Hospital. 6Head of Department, Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I. The Kocher-Langenbeck (K-L) approach is the ‘workhorse’ of surgery for acetabular fractures needing posterior fixation. It is indicated for most of these fractures for proper surgical technique and optimal outcome. We therefore evaluated the outcome of surgically treated acetabular fractures through the K-L approach in our setting with limited resources. 57 patients were operated by the K-L approach during the 3-year study period. The most common indications of this approach were: posterior wall (38.6%) and transverse + posterior wall fractures (36.8%). Based on Matta’s criteria of fracture reduction, 81 % were judged anatomic, 16% imperfect and 3 % poor. A surgery waiting time of 8 to 14 days after injury, significantly favoured anatomic fracture reduction. The MAP score was excellent in 72 % and unacceptable in 10.6 %. Factors associated with poor outcomes were poor fracture reduction and the development of early post-operative complications. Iatrogenic sciatic nerve palsy (ISNP) was the most significant post-operative complication (19.3%). The levering of Hohmann retractors in the sciatic notches was the major risk factor for developing ISNP, compared to the use of sciatic nerve ...

Place of therapeutic patient education in chronic hepatitis C treated with direct-acting antivirals

Research Article of Open Journal of Gastroenterology and Hepatology Place of therapeutic patient education in chronic hepatitis C treated with direct-acting antivirals Michel Doffoel1*, Simona Tripon1, Florence Ernwein1, Frédéric Chaffraix1, Lucile Haumesser2, Robert Bader3, Jean-Philippe Lang1, Anais Lang1, Dominique Paya4, Maude Royant1, Aurélie Velay-Rusch5, Martine Tebacher6, Nicolas Meyer2, François Habersetzer7, Thomas Baumert8 1Service expert de lutte contre les hépatites virales d’alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires, Strasbourg, France. 2Groupe méthode en recherche clinique, Pôle de santé publique au travail, Hôpitaux universitaires, Strasbourg, France. 3Service d’hépato gastroentérologie, Groupement hospitalier régional mulhouse sud alsace, Mulhouse, France. 4Pharmacie, Hôpitaux universitaires, Strasbourg, France. 5Laboratoire de Virologie, Hôpitaux universitaires, Strasbourg, France. 6Centre régional de pharmacovigilance, Hôpitaux universitaires, Strasbourg, France. 7Service d’hépato gastroentérologie, Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires, Strasbourg, France. 8Institut de recherche sur maladies virales et hépatiques, Inserm U1110, Université de Strasbourg, Strasbourg, France. Objective: Today, with the availability of direct-acting antivirals (DAAs), the value of therapeutic patient education (TPE) in chronic hepatitis C needs to be redefined, as these drugs have made treatment simple. The study presented here in sought to define what role TPE plays today in hepatitis C management along with what factors are associated with such programs being used. Methods: We included 786 patients mono-infected with hepatitis C virus (HCV) who underwent treatment with DAAs. 284 of whom benefited from a TPE program (36.1%). The characteristics of HCV and how it was treated were compared retrospectively between TPE+ and TPE- patients. The TPE program was overseen by a nurse. Results: The following factors were associated with TPE on multivariate analysis: migrant status (OR=3.63, 95%CI: 2.24-5.96, p <0.001), advanced fibrosis (OR=1.73, 95%CI: 1.08-2.76, p=0.022), tobacco use (OR=1.84, 95%CI: 1.10-3.08, p=0.020) and pangenotypic DAA treatment (OR=0.42, 95%CI: 0.26-0.68, p <0.001). Sustained virological response at 12 weeks (SVR 12) was 96% ...

Digestive manifestations of SARS-COV2 infection in Togo

Research Article of Open Journal of Gastroenterology and Hepatology Digestive manifestations of SARS-COV2 infection in Togo BAGNY Aklesso1,2, KOGOE Lidawu Roland-Moïse1*, LAWSON-ANANISSOH Laté Mawuli1,2, GBOLOU Mawunyo Henoc1, REDAH Debehoma Venceslas1, KANAKE Yendoukoa Yves1 1Gastroenterology and hepatology department of Campus teaching hospital, Lome, Togo; 2Gastroenterology and hepatology department; University of Lome, Togo. Objective: to identify the main digestive manifestations related to SARS-CoV-2 in Togo and to determine their impact on the prognosis of the disease. Patients and method: This was a cross-sectional study with retrospective and prospective collection, with descriptive and analytical aims, conducted from May 1, 2020 to April 30, 2021 at the national center for the management of infectious diseases of Lome. Patients of both sexes and of any age, tested positive for SARS-CoV-2 by PCR on nasopharyngeal and oropharyngeal samples and hospitalized at the national center for infectious disease management of Lome were included in this study. Digestive manifestations were divided into gastrointestinal manifestations and hepatobiliary manifestations. The threshold of significance of the tests was retained for a p value less than or equal to 0.05. Results: out of 876 patients hospitalized during the study period, 215 presented with digestive manifestations, corresponding to a prevalence of 24.54%. the predominance was male, with a male/female sex ratio of 1.74. the mean age was 46.07+/-16.14 [02 months - 82 years]. gastrointestinal manifestations were found in 11.98% of cases. abdominal pain was the most frequent digestive symptom (15.35%). hepatobiliary manifestations were represented by cytolysis syndrome (44.19%) and cholestasis syndrome (36.28%). digestive manifestations were associated with renal failure (p=0.03) and thrombocytosis (p<0.01). The occurrence of death was associated with a decrease in HDL-cholesterol (p<0.001) and the presence of renal failure (p=0.027). The cure rate in our study was 83.72% with a lethality of 16.27%. Conclusion: the digestive manifestations constitute a not negligible ...

ABSENCE OF OXIDATIVE STRESS AND SIRTUINS RECRUITMENT ON CARDIAC TISSUE POST STRESS

Research Article of American Journal of Cardiology Research and Reviews ABSENCE OF OXIDATIVE STRESS AND SIRTUINS RECRUITMENT ON CARDIAC TISSUE POST STRESS Ana Elisa T.S. de Carvalho*, Marco A. Cordeiro, Luana S. Rodrigues, Daniela Ortolani, Regina C. Spadari* Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos, SP, Brazil Stress has emerged as a factor associated with cardiovascular disease. Catecholamines released during the stress reaction by the sympathetic nerves and the adrenal medulla couple to β1-and β2-adrenoceptors in the cardiomyocytes membrane enhancing heart function in order to attend the organism demand. This might produce excessive reactive oxygen species what may culminate with oxidative stress and progression of several cardiac diseases. Sirtuins have been described as cardioprotective factors and important regulators of the cellular stress response in the heart. The aim of this work is to investigate the putative participation of oxidative stress and sirtuins in the heart of rats submitted to foot shock stress, an experimental model where there is up regulation of β2-adrenoceptors and downregulation of β1-adrenoceptors. The data have shown that in the myocardium of rats submitted to foot shock stress the H2O2 concentration, catalase and superoxide dismutase activity, NAD+/NADH ratio, as well as the protein expression of sirtuins 1 and 3 were not altered. Pharmacological blockade of the β2-adrenoceptors by ICI118,551, did not modify this scenario. It is concluded that foot shock stress does not cause disruptions in oxidative stress or redox state processes in the myocardium, and consequently, sirtuins are not recruited to stress response. Keywords: oxidative stress, sirtuins, foot shock stress, β2-adrenoceptor ...

PD-1/PD-L1-negative tracheal mucoepidermoid carcinoma: A case report and systematic review of the literature

Case Report of International Journal of Case Reports PD-1/PD-L1-negative tracheal mucoepidermoid carcinoma: A case report and systematic review of the literature Jian Guo2, Yingying Liu2,3, Ji Chen1, Hai Xia Li1, Zeng Tao Wang1, Jie Liu3, Yi Gong1,2* Baoshan district hospital, Huashan Hospital Affiliated to Fudan University, Shanghai, China; Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Discipline of Pathology, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales Background: Tracheal mucoepidermoid carcinoma is a rare form of non-small cell lung carcinoma and is defined as a tumor characterized by a combination of squamous, mucus-secreting, and intermediate cell types. This carcinoma is usually located in the lobar or segmental bronchus. Currently, surgery is the preferred treatment for this disease, which includes pneumonectomy, lobectomy, and sleeve lobectomy. Case presentation: A 50-year-old Chinese male presented with cough, shortness of breath and hemoptysis, and the effect of antibiotic therapy was not good. Subsequently, the airway occupied lesion was found by chest CT, and he was transferred to our hospital for surgical resection. Histologically, the tumor contained squamous epidermal cells, mucoepidermoid cells and intermediate cells. Immunohistochemistrically, the tumor cells were positive for p63, CK5/6, CK7 and Ki67. However, the tumor is generally negative for TTF-1 and neuroendocrine markers. The patient had no recurrence 15 months after the surgery. Conclusions: We report a rare case of mucoepidermoid carcinoma in the distal trachea in which the surgery was difficult and could not be performed like a traditional pulmonary resection. We first provide a comprehensive description of airway management and anesthesia intubation. After surgery, we reviewed the literature and found that PD-1/PD-L1 detection had never been reported in tracheal mucoepidermoid carcinoma. Therefore, we studied the PD-1/PD-L1 pathway in this patient, and the results were negative, which may indicate that ...