[Prophylactic caesarean deliveries]

The rate of caesarean deliveries has increased in recent years. Among the major problems of the practitioners in this regard we find the choice of indications. The overall objective of this study is to profile information and compare with the practices of some teams described in the literature, while assessing the value of the programming of these cesarean vis- a- vis the maternal and fetal prognosis. This study aims to profile the indications of prophylactic caesarean deliveries and to assess the value of their programming in terms of maternal-foetal morbidity. 290 prophylactic cesareans were performed at the teaching maternity between January, 1[st] and December 31[st] 2007, divided into programmed prophylactic caesarean and prophylactic caesareans carried out urgently. The rate of caesarean sections was 17%. 26% of these caesarean sections were prophylactic, and were spread in 55% of programmed ones and 45% of urgent ones. The scarreduterus and the foetal-pelvic disproportion were two thirds of the indications in our series. The average gestational age of achievement of the prophylactic caesareans was 39 weeks. When the type of anaesthesia used, 2/3 o the programmed ones were done under spinal anaesthesia, while 86% of the urgent ones were under general anaesthesia. Wound infection was the prophylactic caesareans in two thirds of cases. The best conditions for programmed prophylactic caesareans compared to the prophylactic caesareans carried out urgently show the interest of programming, and justify the need for proper monitoring of all pregnanciesintensive care unit

[Paravaginal desmoid tumor]

Desmoid tumors are benign but are characterized by a local real malignancy because of their propensity to relapse. This is a woman 27 years old who presents a pelvic pain with a paravaginal mass. The MRI showed a pelvi perineal tumor. A vaginal resection was performed and histology was in favor of a sedmoid tumor. A year later, recurrence was noted. The desmoid tumors are rare tumors that occur in young adults. Surgical treatment is curative treatment of choice, even if it does not prevent relapse. Other therapies have been proposed, including hormonal therapy with good results. The invasive potential and high recurrence rate of these tumors are tumors feared

[Prevalence of celiac disease in patients with type 1 diabetes mellitus]

The aim of our study was to determine the prevalence of celiac disease in patients with type 1 diabetes mellitus. Between january 2004 and december 2005, 72 patients with type I diabetes mellitus and having pseudo ulcerous dyspepsia were included in this prospective study. Upper gastrointestinal endoscopy with proximal intestinal biopsies was performed in all patients. Patients with villous atrophy were tested for anti-gliadine antibodies, anti-endomysium antibodies and for anti-human tissue transglutaminase antibodies. Villous atrophy was observed in three patients [4, 1%]. It was subtotal in two cases and total in one case. Anti-gliadine antibodies, anti-endomysium antibodies and anti-human tissue transglutaminase antibodies were positive to three patients. The prevalence of celiac disease in patients with type 1 diabetes mellitus is high [4, 1%]. Early screening of celiac disease must be recommended to this diabetic population