[Regional anesthesia for ambulatory surgery in ophthalmology]

We report a survey of 1075 patients who underwent surgery in the operating room of Ophthalmology, which is to assess the quality of ambulatory anesthesia practice in our structure, and its evidenced by the anesthesia safety and satisfaction of the patient. Prospective study spread over six months to August 2009 to January 2010, surgery activity is distributed mainly on the five business days of the week. The duration of the interventions is less than an hour for most acts. One form of exploitation has been established to collect these data. The results are expressed as number, average, extreme and percentage. The average age was 57 years, including 180% cases pediatriques. 70% were classified as high risk. The regional anesthesia performed on an outpatient basis has involved 846 patients, or 3/4 of the activity of the block. Surgery for cataract accounted for 96% of ambulatory anesthesia, followed by the schedules and the anterior segment. Intraoperative complications were represented by bradycardia: 70%, bronchospasm: 90%, intraorbital hematoma: 9% postoperative nausea and vomiting: 1%, two cases of enophthalmos, and one case of delayed awakening. It is an attractive alternative to general anesthesia. Much of the ophthalmic surgery is performed on an outpatient basis, with obvious benefits in terms of economics and patient satisfaction. However, the constraints associated with this practice should not be forgotten, the need for coordination and organization seems even more necessary than elsewhere. The organization of staff training and patient information is a prerequisite for its realization

[Pseudotumoral form of abdominal tuberculosis in child, about 4 cases]

The primary infection is the major form of infantile tuberculosis. The pseudo-tumoral form of tuberculosis is very rare in the child. It often poses a problem of positive diagnosis. Four cases were diagnosed over a four years period, in the paediatric service of surgery of the CHU Hassan II of Fez. All children were admitted initially for abdominal tumours and whose diagnosis was made in per operational

[Acute transverse myelitis - about a case report]

The acute transverse myelitis is characterized by motor, sensor and autonomic dysfunction. The causes are multiple requiring a rigorous diagnostic investigation. The idiopathic forms are rare. The imagery by magnetic resonance easily makes it possible to make the diagnosis of myelitis but also to follow the evolution under treatment. We report a clinical case of an acute transverse myelitis whose assessment etiologic was negative with a fatal resulting

Prevalence of the nosocomial infection and risk factors

The prevalence of the nosocomial infection was 6, 7%, in the first study done at the University hospital center. The results were considered as underestimated. This study was done to determine the prevalence and risk factors associated with to create a new strategy against NI in this UHC. A cross sectional study was conducted. All the patients hospitalized the day of the study in this establishment were included and were examined to look for NI. The following risk factors were also looked for: the presence of a catheter, a urinary sound and surgical intervention. The statistical analysis was carried out using the software Epi info version 6. Chi-square test was used for comparing categorical data, and the Student's t-test for comparing the means. Significance was taken as P < 0.05. 276 patients were hospitalized the day of the study. Sex Ratio [Men/Women] was 0.92. The average age was 35.25 +/- 21 years with [0 - 84]. More than a third of the investigated patients [40.9%] had surgery and 36.2% of them had a vascular catheter, 13.8% had a urinary sound and 4.3% benefited from artificial ventilation. The prevalence of NI was 11.2% in all departments. 79, 3% of patients got NI on the same day of study and in the same hospitalised department The two main factors associated with the occurance of NI were surgicl operations [p = 0.04] and duration of hospitalisation [15 days or more] [p = 0, 002]. The results between the present and previous study [2004 and 2006 respectively] shows a significant increase of the NI prevalence [p = 0, 036]. The results of this study 2006 allowed estimating the NI prevalence evolution with a more relevant collection of data, consequently, a rational and adequate decision-taking

Acute oedema of the lung and pre-eclampsia about 15 cases

Our aim is to point out the relation between acute oedema of lung and pre-eclampsia and guidelines of care. All the patients were hospitalized in the intensive care unit of the university hospital center of Hassan II of Fez, for pre-eclampsia and eclampsia from January 2003 to March 2006. The authors report 15 cases of acute oedema of the lung [AOL] associated with pre-eclampsia. The average age was of 24 +/- 9 years. We noted 9 primipars, 6 cases of AOL occurred in delivery period. 10 cases of preeclampsia were detected, whereas it was associated to a cardiomyopathy of the peripartum and three rheumatic valvulopathies. The childbirth took place by Caesarean at 8 patients and 7 were confined by low way. 9 patientes required artificial ventilation and the haemodialysis was carried out in 3 patientes. The evolution was favourable in 12 patientes. We deplored three maternal deaths and 4 newborn deaths. The acute oedema of the lung during the preeclampsia is a serious pathology; its mechanism of appearance is complex. The materno-foetal forecast depends on how the treatment was prompt, of the severity of the EP and the age of the pregnancy. The prevention is based on the antenatal consultation and the monitoring of any EP in order to propose in time a possible ending of pregnancy

Analgesie post-operatoive en chirgie thoracique

Could provide good post-operative pain and the respiratory impairment; principally cause of morbidity and mortality. The authors present a review of different methods of analgesia in thoracic surgery and the results of two prospective studies: thoracic extradural analgesia with bupivacaine 0,25% and lumbar extradural analgesia with morphine

Les accidents vasculaires ce're'braux ische'miques post-ope'ratoires [a'propos de 15 cas]

The study of 15 cases of post-operative ischemic cerebro vascular strokes taken care of in central unit of intensive care of CHU Ibn-Sina during 8 years, and the review of literature lead to the following results. The ischemic stroke is scarce in general surgery and is often related to thrombosis on pathologic arteries. The prevention of such accidents is based on the detection of a cephalic artery stenosis. In case the detection of this stenosis doesn't need a surgical intervention, it at least necessitates an adequate management of anesthesia and intensive care

Analysis de la mortalite dans les pe'ritonites post-ope'ratoives [a'propos de 78 cas]

The mortality of post-operative peritonitis [POP] remains high. It is essentially related to age, location of state, but the most important prognosis factor is the latency of reintervention. all these factors contribute to the development of A.P.O.A. at the en emergency of multivisceral deficiency syndrome, is the direct cause of death The study of 78 cases of POP taking care of at central unit of intensive care in CHU Ibn-Sina during 6 years, allowed us to evaluate these different factors, the most important of which stay a precocious diagnosis