Difficult intubation in a parturient with syringomyelia and Arnold-Chiari malformation: use of airtraq[TM] laryngoscope

Anesthetic technique in parturient with syringomyelia and Arnold-Chiari malformation is variable depending on the teams. Difficult intubation is one of the risks when general anesthesia is opted. Different devices have been used to manage the difficult intubation in pregnant women. We report the use of Airtraq[TM] laryngoscope after failed standard laryngoscopy in a parturient with syringomyelia and Arnold-Chiari type I malformation

Diabetic neuropathy and peri operative period in general surgery: about 164 cases

The objective of our study is to evaluate the morbidity of diabetic neuropathy, during peri operative time in a general surgery unit. This retrospective study was conducted between January 2002 and December 2004 in the Military Hospital Mohamed V in Rabat. All diabetic patients with a diabetic neuropathy and who had surgery were included [164 upon 516 diabetic patients]; mean age is 54.6 +/- 10.2 years and type 1 diabetes was present in 56% of the cases. The diagnosis of diabetic neuropathy was based on a careful clinical examination. A distal and symmetrical neuropathy was found in 91% of the cases; a proximal and symmetrical neuropathy in 10% and a diabetic foot in 68%. In these patients, neuropathy was associated to hypertension [29%], to renal insufficiency [9%] and to cardiac disease 4%. Diabetic neuropathy was significantly associated to a higher hospitalization duration [p<0.05] and to a higher postoperative incidence of infection

Occlusive arteriopathy of lower limbs and diabetes mellitus

Trophic disorders of the diabetic foot represent a major problem in public health since they are responsible of a high morbi-mortality rate. After a pathophysiological review of the question, we discuss the recent classification of diabetic arteriopathy, the interest of the different methods of exploration and we discuss their management

Problemes de la reamination en chirurgie de guerre

The various elements that have been studied throughout this day - time [which has been wholly devoted to war surgery and to catastrophies] enable us to draw out quite an appreciable of lessons. The problem of war surgery was tackled at the outset bearing in mind the experience of the health service for the last ten years whether :- In the middle east, - In Zaire, - Or in the Sahara. The emphasis has been put on the specification of this "polymorphic trauma " which requires a "polyvalent" training. A parallel to the medical branch-which deals with catastrophes has been outlined. Then, owing to the up - to - date provided items of ballistics, the anatomo - pathological lesions " caused by war shrapnels, the blast and the " therapeutical - anatomo - clinical " results that derive from all these, we have been reminded of all of these aspects The importance lying in the " medicalized " evacuating operations at the front battle line towards the rear where the injured patient is to be found at the " H.G.A ", has been previously mentioned. To this second level, the " hinge - role " makes medical surgery the nucleus point where about the most important decisions - that are the heaviest as far as consequences are concerned - such a " role chaniere " has been depicted stressing the point that the " sorting-out requires a swift and sure diagnosis. The "facial sores" which are usually the natural accompaniments to war shocks with all their "after-effects" the "broken - muzzies" have been the topic of a talk built on the experience of the Hematology Department in MOHAMED V [H. M. 1.]. The neurological traumas, as them, have been split up into two sections: The first category is devoted to the "medullar - vertebra wounds" which have to be dealt with at the back. The second section is devoted to the "skull and brain injuries" and requires an early surgery. As for the "shattered limbs ", which are also of paramount importance, appertaining to this kind of surgery, the call for a "parage" is seen as necessary and as such must be perfect using the "outer-expanders ", the simplification of the medical care that usually follows surgical operations and the movements likely to be performed when mascular wounds are there. For the "uro-genital" lesions, if the emergency diagnosis of wounds-connected with the outer side of genital organs - is evident, the check - up concerning these lesions, therefore, needs a "U.I.V", with a "twice-timed" surgery. The prognosis is worse when faced with a " poly - trauma ". The shocks concerning the chest and the abdomen are common as well, the partnership " chest - abdomen " is always derogatory especially for the colic sore. The experience of the department of surgery in MOHAMED V H.M.I, has been brought in. The reanimation staff has participated in the debate so as to bring to mind the "reanimation" of the "scorched" patients of the first forty eight hours. As a matter of fact, the "burn" seeks to become one of the most recurring lesions when in time of conflict. The "burn" needs specific means that should be brought into practice at the start. The position that "reanimation procedures" take up in war surgery is there at all levels whether at the back or the front [and this has been mentioned previously]. The "reanimation procedure" is absolutely essential, both at the front-through the use of sensible rescue actions and for the H.C.A. level thanks to the bringing in of modern techniques for the sake of a deep and thorough medical care. The various discussions have been followed up by a warm debate mainly focusing on the contribution of the experience of war surgery through civilian practice. In the field of "medicine of catastrophes ", the devising of a "medicalied" transport service - the SAMU kind - fitting the realities of the country seems to be quite necessary. The F. A. R, health service collaboration whose experience has been brought to light during this day-time, seems to be basic seen under such an angle