RESUMEN
Low income countries are disproportionately affected by injuries. Most injury related death and disabilities occur as the result of road traffic accidents. This study aims at analysing the epidemiology and pattern of road traffic related injuries in a semi-urban area in the northern part of Cameroon where no such data existed before.This hospital based retrospective analysis was conducted over a period of five years in a level III institution in the Adamaoua region of Cameroon. The records of all patients received in the emergency department of Ngaoundere hospital after a road traffic related injury were reviewed for epidemiological variables; type of vehicle involved; nature and severity of injuries; modalities of management and outcome. A total of 1257 victims of road traffic injuries could be analyzed. Their ages ranged from 2 to 84 years and males were more affected than females. Almost 60 of victims were motorcycle users. Each patient sustained a mean of 1.3 lesions. The head and lower limbs were the most affected body parts. The most frequent lesions were soft tissue injuries and bone fractures; involving mostly the lower limb. Most injuries were of minor or moderate severity and the admission rate was 28. A total of 79 patients (6.3) were reported dead. Most of them sustained a head injury. The massive presence of motorcycles in the Adamaoua region seems to influence the pattern of road traffic injuries. A more comprehensive system of capturing injury cases needs to be developed in Ngaoundere
Asunto(s)
Accidentes , Estudios Retrospectivos , Heridas y Lesiones/diagnóstico , Heridas y Lesiones/epidemiologíaRESUMEN
INTRODUCTION: Pott's disease is a common entity in our hospital. The authors report their experience in the surgical treatment of Pott disease. PATIENTS AND METHODS: This is a retrospective study including all patients who underwent surgery for Pott's disease in our institution between November 1999 and November 2004. RESULTS: Forty-three patients were included, including 23 men and 20 women (ratio 1.15). Location of the disease was cervical (2 cases), dorsal (19 cases), dorsolumbar (2 cases) lumbar (16 cases) and sacrolumbar (4 cases). Ten patients were HIV positive (24%). The surgical indication was sometimes diagnostic, but predominantly therapeutic (medullary compression, instability or deformity). Spinal decompression alone was performed in 23 cases, associated with internal fixation of the spine (17 cases) or external immobilization (Halo Vest) in two cases. The anterior approach was used in four cases and a posterior approach in 38 cases. Decompression by posterior approach included 1 or 2 level laminectomy alone or associated with internal plate fixation (4 pedicle screws and 2 plates). There was no functional recovery in patients with a complete neurological deficit (Frankel A); those with a severe deficit (Frankel B) partially recovered, while those with more moderate deficits (Frankel C and D) recovered completely. Fusion was obtained (graft integration) regardless of the surgical approach used, progression of the deformity was stopped and early mobilization was possible. CONCLUSION: Surgery definitely plays a role in the diagnosis and treatment of Pott's disease, especially in countries where patients are seen at a late stage of the disease when complications have developed. Surgical decompression should not be delayed until lesions become ischemic and irreversible (Frankel A). LEVEL OF EVIDENCE: Level IV. Retrospective study.
Asunto(s)
Placas Óseas , Tornillos Óseos , Vértebras Cervicales , Vértebras Lumbares , Fusión Vertebral/métodos , Vértebras Torácicas , Tuberculosis de la Columna Vertebral/cirugía , Adolescente , Adulto , Anciano , Camerún , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Estudios Retrospectivos , Resultado del Tratamiento , Tuberculosis de la Columna Vertebral/diagnóstico por imagen , Adulto JovenRESUMEN
Neurosurgery remains a very marginal activity in sub-Saharan Africa. In this part of the world which counts nearly 40 countries, some do not have a single neurosurgeon, some have one to five, the number of ten neurosurgeons per country remaining an exception! In its concern of popularizing and of developing neurosurgery worldwide, the WFNS organized an international course in Africa, October 2007 2nd-3rd in Yaoundé (Cameroon). The Cameroon Neurosurgery Society (CNS) took this opportunity to organize its very first congress in the presence of the WFNS delegation from October 1st to 4th, 2007. The joint meeting with the WFNS was baptized the "African Week of Neurosurgery". This special event was a first in sub-Saharan Africa. The delegation of the WFNS, led by Professor J. Brotchi (Belgium) President of the WFNS, was made up of Professors A. Sousa (Brazil), Mr. Choux (France), N. Tribolet (Swiss), M. Arraez (Spain), A. Bricolo (Italy), A. Kamlichi (Morocco), G. Dechambenoit (France), K. Kalangu (Zimbabwe). Twenty three neurosurgeons coming from nine African countries (Cameroon, Nigeria, Gabon, Congo, Niger, Burkina Faso, Ivory Coast, Senegal, and Guinea) took an active part in work. The scientific success of this event led to the creation of the "Association of Neurological Surgeons of Africa (ANSA)" which will be the WFNS-Africa interface in order to insure the development of neurosurgery in Africa.