Factors influencing the choice of anesthesia as a career in a developing country

Career choice in medicine is influenced by several factors. Our aim was to look at reasons for choice of anesthesia as a career in a cohort of doctors applying for the residency training in a university hospital in a developing country. A semi-structured interview form is used in our department and includes a question related to career choice. Each applicant is interviewed by two faculty members independently. All interview forms between 1992 to 2004 were reviewed and the reason for choosing anesthesia was coded in different categories. The sample consisted of 167 applicants and 334 forms. There were 29 females and 138 males. The mean age of the applicants was 28 years. Sixty two percent chose anesthesia because of general interest and nature of the specialty, 24% of these mentioned had no specific reasons, 17% thought the specialty was intellectually challenging, 8% liked the technical aspect, 5% were interested in physiology and pharmacology, 2% liked the operating room environment, and 6% liked the immediate results. The second major group [36%] cited the reason as better economic opportunities. Sixteen percent were influenced by friends or relatives in their choice. Twenty six percent chose anesthesia primarily because of their interest in critical care, pain management or emergency management. Our data indicates that selection of career in anesthesia in our county is strongly related to the nature of specialty and future employment opportunities. A significant number were influenced by family and friends. This pattern is different from that reported from Australia and United States

[Ano-perianal suppurations during Crohn disease]

The authors present 26 cases of ano-perianal suppurations during Crohn disease, collected in theGastro-Enterology and Proctology unit of the CHU Ibn Rochd of Casablanca, during a period of 12 years [1977-1989]. In our series, the young adults represent 34% of the cases with a slight masculine predominance in 57.7% of the cases. The ano-peri-anal suppurations are inaugural in 38% of the cases. They are concomittant in 38% cases to an ileo-colic localization: in 50% of the cases to a colic localization, and 70% of the cases to a rectal localization. We note a predominance of the secondary lesions in 66,7% of the cases. A spontaneous cicatrization of the ano-peri-anal suppurations under a general medical treatment is obtained in 80% of the cases. The evolution of the patients under surgical proctologic treatments marked by a cicatrization of the lesion in 75% of the cases

situation of the laparoscopy in tuberculosous peritonitis. About 180 cases

Tuberculous peritonitis is still very frequent in our country. Through a retrospective serie of 180 cases, the authors relate their experience on laparoscopy in the diagnosis and compare their results to the data of literature. Laparoscopy with peritoneum and liver biopsies still have an important role in the diagnosis

Place de la laparoscopie dans le diagnostic du cancer de la vesicule billaire

8 cases of the gall-bladder's cancers had been diagnosed from 1976 to 1985 by the laparoscopy. It's about 6 women and 2 men. The average of age is 64 years, The confirmation had been obtained by biopsies directed by laparoscopy in 4 cases and by the exploratrice laparotomy in the other cases. The others emphasize that the laparoscopy may be useful in the diagnosis of the bladder's cancer, after the echography scannography. It avoids in certain number of cases some useless laparotomies

Colite a salmonelle a propos d'un cas

Salmonella colitis is relatively frequent. The authors make a brief recall of this affection about one observation at a young patient, from the data of the literature

L'abcen anal intra mural a propos de 20 cas

Our work is a retrospective study of 20 diseases of intra mural anal abscesses, made on a period extending for 6 years [January 1981 - January 1987], concerning 16 men and 4 women, with an average of age of 30,9 years. It is a disease which remains unknown by practitioner, though it is relatively frequent. We insist on the importance of the proctology examination to the diagnosis. The different aspects of this disease are posed in review, on the light of the data of the literature

laparoscopie indications incidents et accidents [a propos de 1850 cas]

The authors report their experience of the laparoscopy on a survey of 1850 cases made on a period extending for almost 12 years [1975 - October 1986]. The state that inspite of the events of the recent techniques of the imaging, the laparoscopy examination which is little expensive and a little aggressive, remains of great importance to the diagnosis of certain abdominal disease. mainly the peritoneal ones. These indications are discussed on the light of the data of the literature

Anal condyloma acuminatum. About 60 cases

In this study of 60 cases of anal condyloma acuminatum, most of the patients are from 20 to 45 years old [70%]. Most of them are males [80%]. Clinical diagnosis is generally easy; sometimes, treatment is disappointing and recurrences are frequent. It's the opinion of most of the specialists, that diathermy is the best treatment Eradication is the only garantee to avoid the exceptional cases of malignant transformation

Aspects actuels de l'ambiase hepatique - a propos de 3 observations

3 observations of the hepatic amibiasis were present in all masculine subjects, aged between 30 and 40 years old. The contingency of a hepatic amibiasis should be evoked in all painful hepatomegaly. The echotomography and amibic serology represent the most early and reliable means to confirm rapidly the diagnosis. The urgent treatment is dominated by the metronidazole, which is remarkable by its efficacy and its weak toxicity

Sacro coccygeal pilonidal sinus. About 32 cases

This is a retrospective study of 32 cases of pilonidal sinus. In all published series, the pilonidal sinus seems to be a young men's affection easy to diagnose, but usually unknown to the praticians. A tuft of hairs which is a the center of a fistulous orifice or a sacro coccygeal cavity is the most typical aspect. The best treatment, is the "open excision"; simple and effective; it gives the lowest ratio of recurrence [5.88% in our sery]. It's inconvenient is a longer recovery time

Study of the effect of encephabol infusion therapy on stroke

In a trial of 60 patients with stroke, the results of I.V. Encephabol were compared with complamin injection and symptomatic treatment. Cases treated with encephabol infusion showed 60% initial improvement and 70% at the conclusion of six months follow up period as against 255 with comlamin while those who had drugs only for symptomatic relief registered only marginal improvement and 2 of these deteriorated further

Alpha heavy chains disease: an intermediate stage

The authors report a case of alpha heavy chains disease associated with a lambliasis affecting a forty-year-old Moroccan women. Histologically, the stage of this case has not been described yet. It is intermediate between the stage A and B: there is a transparietal and plasmocytic infiltration of the small bowel as well as a ganglionic and periganglionic mesenteric infiltration and without any immunoblastic participation. This particularity warrents the tetracycline and cyclophosphamid association. This study is completed with a review of literature dealing with the alpha heavy chains disease