[Arterial injury as a complication of lumbar disc surgery]. / Le cas clinique du mois. Plaie artérielle compliquant une chirurgie discale lombaire.

Vascular complications are unusual after lumbar disc surgery. Iliac artery injury is the most common. The vascular injury may cause severe bleeding and hypotension. If the injury is missed, an arteriovenous fistula may develop. This complication is fortunately the most common. We describe the case of a 41 year-old man who was operated on for lumbar disc herniation. A few hours after surgery, he had developed prolonged hypotension leading to the diagnosis of iatrogenic vascular injury. The CT scan confirmed the diagnosis of right common iliac tear with voluminous retroperitoneal haematoma. Emergent surgery was carried on with success.

[Cardiac multifocal hydatid cyst]. / Localisation cardiaque d'une hydaditose multifocale. A propos d'un cas.

Hydatid cysts in the heart are rare, with an unpredictable outcome and numerous complications, requiring rapid surgical management. We report the case of a 19 year old female patient, who underwent surgery with extra corporeal circulation for a hydatid cyst of the interventricular septum of the heart, complicated by secondary pulmonary echinococcus infection, confirmed on CT and MRI. Resection of the cyst was performed via a right auriculotomy. The post operative period was favourable; the other pulmonary sites were treated medically. We emphasise the methods of diagnosis and management.

Seroepidemiology of hepatitis B virus markers among hospital health care workers. Analysis of certain potential risk factors.

OBJECTIVES: To determine, the prevalence of hepatitis B virus markers among hospital health care workers, to determine the influence of some risk factors on such prevalence and to outline the specific policies to tackle such problems among hospital health care workers. METHODS: Hepatitis B virus markers including hepatitis B surface antigen, anti-hepatitis B surface antigen and anti-hepatitis B core antigen were determined from sera samples collected from 459 hospital health care workers at different hospital departments. The prevalence of hepatitis B virus among these employees was correlated by a variety of risk factors such as gender, age, blood transfusion, and needle-stick and sharps injuries, and previous history of jaundice using logistic regression analyses. RESULTS: Of the hospital health care workers studied 143 (31%) of employees showed evidence of previous hepatitis B virus infection, including 17 (4%) carriers. The highest incidence was among those who were working at infectious diseases departments where 22 (43%) employees were found to be seropositive, followed by 26 (41%) employees from surgical departments. The risk factors, which were found to influence seropositivity, include age over 40 years old, needle-stick and sharps injuries and previous blood transfusion. Other factors such as gender, and previous history of jaundice were statistically insignificant. CONCLUSION: The hepatitis B virus infection was high among the hospital health care workers studied. This was influenced by certain potential occupational risk factors. As there is emerging evidence that vaccination among health care workers was infective. Specific measures should be implemented to reduce such risk. These may include strict policies on sharps and considering any blood or other body fluids being a potential risk. Education, clinical advice and health insurance should be available for health care workers who are at a higher risk of contracting hepatitis B virus infection.