[Splenectomy among thalassemia major patients: a study of 44 cases]

The present study was designed to explore the principle indications of splenectomy in transfusion dependant thalassemie patients and to evaluate incidence, risk factors and degree of severity of splenectomy among these patients. In a retrospective analysis, we identified patients with thalassemia major who underwent splenectomy within an 9 years period. Transfusion needs were calculated by the volume of annual blood units devided by the patients' weight at the middle of the same period. Occurrence of hypersplenism is defined by transfusion's requirement over 250ml/kg/year with or without periphericcytopenia. Statistical analysis was carried out using software [SPSS version 11.5]. 44 thalassemie patients took part in the study [mean age, 13 years; range: 42 months-18years]. The mean age of splenectomy was 6 years and 9months [2years-1 Syears and Gmonths]. The mean indication of splenectomy was the increase of transfusion requirement. Pneumococcal, haemophilus influenzae and meningococcal A+C vaccinations were administered respectively to 97.7 per cent, 88.6 per cent and 90.9 per cent of patients. We assisted clinically to a reduction of transfusion requirement and biologically to the increase of haemoglobin's mean level. Ferritinemia and iron overload were notably decreased. Of the 44 patients who underwent splenectomy 10 developed complications [22.7 per cent]. Splenectomy is also beneficial in treating thalassemia major. It reduces patients' transfusion requirement and iron overload and increases the mean level of haemoglobin. Overwhelming post splenectomy infection remains a serious complication in these patients

[Necessity of physical activities restriction after lumbar discectomy]

Necessity of physical activities restriction after lumbar discectomy have been described in the literature. The aim of this study was to determine if early rehabilitation could favorably influence the prognosis of military patients who had undergone lumbar disk surgery. We performed a retrospective study involving patients who have had lumbar disk surgery, and had undergone physical rehabilitation program. A clinical evaluation, an assessment of pain and a functional assessment by the Arabic version amended self-questionnaire Oswestry have been made for these patients before and after a rehabilitation program started since the 40[th] postoperative day. We have collected 50 cases: 40 men and 10 women of average age 30 years. All these patients have been improved after surgery with no radiculalgies, but with persistence lumbar pain syndrome. After rehabilitation program, we noted a reduction of 42.85% of pain and functional improvement with a reduction in the average score of Oswestry index of 61.18%. The average work incapacity was 4 months. A workstation adaptation was indicated for all patients. Intensive rehabilitation program started early after lumbar disk surgery can improve the functionality of patients operated, and allows early return to professional activities with reduction of the healthcare cost