Publications et Ouvrages des Enseignants

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Background: Cholecystectomy is one of the most practiced surgeries; the learned societies published guidelines to improve surgical practices. Guidelines are sometimes not followed, either by negligence, by lack of means, or an adequate professional environment. So, to know the real practices of surgeons, a survey was conducted. Methods: An anonymous national survey involving all practicing Algerian surgeons was conducted. At the end of the survey, all data were captured and processed using the SPSS v20 software; χ2 tests were used to compare different groups of surgeons. Results: Only 122 responses were retained, twenty-two percent of surgeons perform open cholecystectomy. No surgeon performed routinely cholangiography, 43% extracted the gallbladder using extraction disposal, 18% performed systematic abdominal cavity drainage, all surgeons send the gallbladder to histology for examination and postoperative antibiotic prophylaxis was routinely prescribed by 69% of surgeons. The average postoperative hospitalization recommended by surgeons was 1.65 days (0-5) days. The experience of the surgeon or his position was associated with lower rates of systematic prescription of antibiotic prophylaxis, and with a lower duration of postoperative hospitalization. Conclusions: We recommend the publication of guidelines of good practices adapted to the socio-professional and economic context of countries. 

 
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Peritoneal cavity drainage is not riskless and several publications reported drain-induced complications. However, till this day, abdominal drainage is still a subject of divergence between necessity and usual operative practice. We describe in this publication an exceptional complication of drainage, which is the drain site evisceration of the appendix.

 

 
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Transomental hernia is the rarest form of internal hernias. Clinical expression of this pathology is ambiguous and diagnosis is often made at the complication phase, after irreversible strangulation of the herniated loop. Radiological diagnosis is still difficult and intraoperative exploration usually allows discovering this pathology when the patient is operated for acute intestinal obstruction. Treatment is surgical and aims to treat intestinal obstruction and prevent a recurrence. We describe the case of a 65 years old male operated on for a preoperatively suspected internal hernia; surgical exploration found a transomental hernia through the greater omentum.

 
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Le syndrome de la pince aorto-mésentérique «SPAM » ou syndrome de Wilkie, est une obstruction duodénale secondaire à une pince anatomiquement acquise qui résulte de la compression du troisième duodénum par l'artère mésentérique supérieure « AMS » en avant, et l'aorte en arrière suite à la disparition du tissu graisseux périvasculaire. Les états de dénutrition avancés en sont souvent la cause, et le SPAM se manifeste cliniquement par des vomissements, des plénitudes et des douleurs post prandiales. Le traitement est médical, mais en cas d’échec la chirurgie s'impose. Nous rapportons un cas de SPAM survenu chez un patient âgé de 78 ans présentant une broncho-pneumopathie chronique obstructive, une démence sénile et une anorexie, consultant pour vomissements répétés remontant à plus d'une semaine.

 
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Today we have enough scientific publications showing that the majority of children infected with SARS-CoV-2 have a very favor­able outcome. At present, morbidity in children remainslow and deathis an extremely rare event. The purpose of this article is to describe the pediatrics pecificities of covid 19 viral infection in children admitted to EHU Oran. Materials-methods:Were corded over a 10-month period (March 1 to December 30, 2020) the data using a pre-established survey sheet. We are included all children under the age of 17. For each patient, we are studied the socio-demographic parameters, the clinical signs at the consultation, the results of the PCR and the child’s fate. Result: 302 children admitted with a mean age of 8.04 ± 0.2 years were the subject of the study The children were most often asymptomatic and very few children had presented a mildform (digestive pain, fever, cough, rhinorrhea), all were hospitalized with their parents, in different hospital service welcoming covid pathology at EHUO. The PCR was positive in 40% of the children. A multisystemic inflammatory syndrome in post covid 19 was noted in three patient. Conclusion:Children represent only a small percentage of cases of acute SARS-CoV-2 infection and are generally asymptomatic, or have mild to moderate symptoms

 
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Résumé :

Introduction : La thrombose veineuse cérébrale (TVC) est rare avec une présentation clinique variable. L'héparine est utilisée pour le traitement de première intention en association avec une prise en charge symptomatique et étiologique.

Méthodes: Un examen rétrospectif des dossiers médicaux et radiologiques des patients atteints de TVC pris en charge au niveau de la réanimation pédiatrique CHU Oran, Algérie, sur une période de 10 ans a été réalisé dans le but est de déterminer les caractéristiques cliniques, radiologiques, étiologiques et pronostiques des TVC dans cette tranche d'âge.

Résultats : De 2008 à 2018, 10 enfants ont eu une thrombose veineuse cérébrale. Leur âge variait de 29 jours à 10 ans. Les crises épileptiques (n=2), l'état de mal épileptique convulsif (n=5) et les signes neurologiques focaux (n=5) ont été les premiers symptômes cliniques. La présence d'une thrombose du sinusale longitudinale (n=3) et latérale (n=10) a été mis en évidence par une tomodensitométrie non injectée, confirmée par angiographie par résonance magnétique, et l’IRMC. La thrombose était associée à des facteurs prédisposants dans tous les cas. Le traitement a consisté en une anti coagulation avec de HBPM, suivie d'une anti coagulation orale. L’évolution générale a été bonne; on déplore deux décès.

Conclusion : Le diagnostic de thrombose veineuse cérébrale peut être posé de manière plus précise et non invasive par angio-IRM.

 
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Abstract:

Introduction: Acute disseminated encephalomyelitis (ADEM) is a demyelinating central nervous system disorder. The experience of children in our area is limited.

Purpose: We describe a cohort of consecutive children with ADEM.

Methods: Clinical and MRI of brain characteristics, treatment, and outcome of a series of ADEM hospitalized in PICU, Oran University Hospital center (Algeria) from January 2011 to May 2016 were reviewed.

Results: There were 07 males and 03 females. The mean age (median) at onset was 48 months [range, 6 –132 months]. All children had a prodromal event (infectious 08 cases or vaccination 02 cases). The mean interval between the febrile prodrome and the beginning of neurologic disturbance was 14 days (range, 3 to 30 days). Limb weakness (02 cases), ataxia (02 cases), ophthalmoplegia (02 cases), and acute hemiparesis (02 cases) were the most prominent initial findings. Aphasia was noticed in one patient. the Seizure was observed in 07 patients. Consciousness disturbance (n=5) evolved into a coma with cardiomyopathy of stress in one patient. CSF lymphocyte pleocytosis was found in 3 patients (9 – 208 cells/mm3). Initial MRI showed a deep gray matter involvement in 6 cases. Electroencephalogram (EEG) showed slowing of background activity in 04 patients. 05 patients were treated with IV immunoglobulin alone and 03 with high-dose IV methylprednisolone pulse. Among 10 patients, five had long-term neurological squeals.

Conclusion: We conclude that early diagnosis and prompt treatment of ADEM will probably reduce morbidity and the seizures are not uncommon in ADEM.

Keywords: Encephalopathy, ADEM, Brain Magnetic Resonance Imaging, Children, Outcome.

[ Modifié: samedi 8 janvier 2022, 11:44 ]
 
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ABSTRACT:

Introduction: Refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) are serious and frequent neurological emergencies in children associated with high morbidity and mortality. Despite this, we note the absence of published Algerian data. The aim of this work is to determine the demographic data, the etiologies, and the factors of progression in RCSE and SuperRCSE as well as the short-term prognosis.

Design: Prospective observational study with retrospective analysis of all the episodes of RCSE and Super-RCSE treated between January 1, 2008, and April 30, 2016. Setting: Pediatric Intensive Care Unit, University Hospital of Oran, Algeria. Patients: RCSE is defined as seizure activity that persists after administration of a first-line benzodiazepine (BZD) and a second-line antiepileptic drug (AED). Super-RCSE is defined as «SE that has continued or recurred despite 24 hours of general anesthesia. » Factors independently associated with Refractory and Super-RCSE were established through univariate and multivariable analyses. The outcome was evaluated using the Glasgow Outcome Score.

 Results: Among 443 patients with status epilepticus, 140 patients (31.6%) were afflicted with refractory status epilepticus and 25 (5.6%) with SRSE. The mean age of the entire cohort was 40.65 ± 2.16 months [1 – 180 months].135 patients (33.8%) had suffered previous seizures; RCSE was related to younger age (< 3 years) (OR 1.76; 95% CI 1,018 – 3,058) p=0.043, duration of status epilepticus >2 h (OR 3.096; 95% CI 1, 77 – 5, 39) p= 10⎺⁴, acute symptomatic etiologies (OR 3.609; 95% CI 2,112 – 6.166), Severe consciousness impairment (GCS < 13/15) before treatment (OR 18.55; 95% CI 8,202 – 41.972) p= 10⎺⁴ and Non respect of the therapeutic protocol upstream of PICU (OR 3.659; 95% CI 1,926 – 6.949) p= 10⎺⁴. Super-RCSE was independently associated with age greater than 3 years (OR 3.28; p=0.018), indeterminate etiology (OR 6.628; p=0.009), encephalitis (OR 4. 782; p=0.003) and use of Vasopressor medications (OR 4.239; p=0.007). Overall mortality was 83 (20.75%).

Conclusion The etiologies of CSE are heterogeneous, with a significant incidence of RCSE in the acute symptomatic group. Encephalitis was the determinant of the progression of CSE to Super-RCSE. The therapeutic success of which depends on whether or not the cause of CSE can be treated.

Keywords: Refractory status epilepticus; Super-Refractory status epilepticus; Etiology; PICU; Outcome; Children. Abbreviations: SE: Status Epilepticus, RCSE: Refractory Convulsive Status Epilepticus, NRCSE: Non-Refractory Convulsive Status Epilepticus, Super-RCSE: Super-Refractory Convulsive Status Epilepticus, BZD: Benzodiazepine, AED: Antiepileptic Drogue, CNS: Central Nervous System

[ Modifié: samedi 8 janvier 2022, 11:44 ]
 
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مقياس نظرية الأدب

المحاضرة الثالثة : نظرية التلقي

 
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بعد ماتناولنا في المحاضرة السابقة مختلف التحديات الثقافية الإستعماريه على الجزائر، نتطرق في هذه المحاضرة كيف رد الجزائريين على هذه التحديات سواء بشكل سلي او إيجابي، فالسيوم نرى الرد السلبي عليها وف يالمحاضرة القادمة سنرى الرد شبه الإيجابي