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Background: Wrist denervation is a palliative intervention aimed at alleviating painful symptoms while preserving joint mobility. However, the outcomes of this procedure remain controversial. Objectives: The purpose of our study is to assess the long-term results of wrist denervation. Design & Methods: Our experience involved 25 denervations performed between 2009 and 2019. Retrospective evaluation of results focused on pain (visual analog scale), function (Quick Dash), joint ranges of motion, and radiological control. Results: Our patients were middle-aged men (average age: 44 years) and one woman (age: 47 years); 16 of them were manual laborers. The dominant side was affected in 20 cases. The conditions treated included sequelae of scaphoid nonunion in 16 cases, severe scapholunate ligament injury in 5 cases, distal radius fracture in 3 cases, and Kienböck's disease in 1 case. Our surgical technique involved three approaches: dorsal, dorso-radial, and dorso-ulnar, with excision of the posterior interosseous nerve, anterior interosseous nerve, and articular branches of the radial sensory nerve and dorsal cutaneous branch of the ulnar nerve. Two patients were lost to follow-up. The average follow-up period was 43 months. Pain, assessed using a visual analog scale, averaged 3 at rest and 5 during activity. There was no change in wrist joint ranges of motion. The average postoperative Quick Dash score was 22.24/100. Only 5 patients showed no improvement. Radiological findings remained stable in the majority of cases. Complications included transient paresthesias (2 cases), algodystrophy (2 cases), and cold intolerance (2 cases). Only 5 patients required reclassification. Conclusions: The typical indication is a chronically painful wrist in a patient retaining useful strength and ranges of motion. This experience confirms the expected outcomes of this surgery: pain relief and preservation of mobility, following a technically precise yet simple procedure with few notabl

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The incarceration of the vermicular appendage through the hernia sac is commonly referred to as Claudius Amyand's hernia. It is a rare and exceptional pathology in children providing an acute scrutum. We report the case of a 7-month-old boy with an acute scrotum due to a strangulated inguno scrotal hernia who admitted to pediatric emergencies. The management consisted in a conditioning and a preoperative assessment. An exploration having revealed in the hernia sac an appendix of normal appearance. An appendectomy and a closure of the hernia sac was done. Evolution was uneventful.

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Background: Neonatal sepsis is among the leading causes of neonatal mortality. Due to limited laboratory services, the diagnosis is mainly based on clinical presentation. Signs and symptoms of neonatal sepsis are multiple and nonspecific. Blood culture is the gold standard for the diagnosis of neonatal sepsis. The demographic and obstetric factors associated with neonatal sepsis vary in facilities and locations. Therefore, we conceptualized the study to determine the factors that can independently predict the occurrence of neonatal sepsis. Methodology: A prospective cross-sectional study was conducted by recruiting neonates admitted to the neonatal ward with signs and symptoms of sepsis. The blood sample was collected for culture, and isolates were identified using conventional methods. Descriptive analysis was presented as frequencies and proportions. Univariate logistic regression analysis was used to analyze the factors associated with laboratory-confirmed neonatal sepsis. Multivariable logistic regression was performed to determine the independent predictors of neonatal sepsis. A p-value of less than 0.05 was considered statistically significant. Results. Two hundred seventy-nine neonates were recruited; 161(57.7%) were aged less than four days. Fever was the most common complaint in 72.4% of neonates among the 13 clinical features used to determine the clinical diagnosis of neonatal sepsis. Of 279 blood cultures performed, 198(71.0%) were culture-positive. In bivariate analysis, birth asphyxia, vaginal delivery, and foul-smelling liquor had increased odds of neonatal sepsis. However, neonatal sepsis was independently associated vaginal delivery. Neonates born through vaginal delivery had 2.57 times the adjusted odds of getting neonatal sepsis than those born by cesarean section (aOR = 2.57, 95% CI = 1.3–28.2, p= 0.021) Conclusion: Vaginal delivery was the only factor independently associated with laboratory-confirmed neonatal sepsis. There is a need for evalua

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Introduction: Abdominal trauma is a shock of any kind exerted on the abdomen. It is quite frequent in childhood and is of type: abdominal bruises, and abdominal wounds. This study aimed to assess the epidemio-clinical and evolutionary aspects of abdominal trauma in childhood. Materials and Methods: The results, from a retrospective study covering children aged 0 to 15 years, treated in the Pediatric Surgery Service of Fousseyni Daou Hospital in Kayes from January 2021 to December 2023 for abdominal trauma. Results: Over a period of 2 years we collected 20, 16 boys and 4 girls cases, being a hospitalization frequency of 5.71%. The age bracket of 11 to 15 years was majority being 60% with a male predominance of 80%. Pupils were the majority with 60%. The predominant functional sign was abdominal pain in 100% of cases and one case of terminal hematuria, associated with a minimal pelvic fracture secondary to a seizure. Ultrasound imaging was performed in 80% of our patients. A laparotomy was performed in 35% (7). In our operated patients we recorded 1 case of parietal suppuration. Evolution was favorable in all our patients and one was reoperated for occlusion on flange. After a median retraction of 6 months, the mortality rate was 0%.

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Abstract: Since 2012, Mali has been experiencing a security crisis, characterized by armed attacks against civilians and soldiers; in the form of terrorist attacks or ambushes using various vulnerable agents. The injuries observed are often multiple and serious and can affect all organs to varying degrees. The penis is rarely hit by firearms due to its position, its volume relative to the rest of the body, and its mobility. We report a case of penile urethral section by firearm, initially treated in a primary structure, then referred to our structure for better management. The patient was a 13-year-old boy with no known medical or surgical history. He was traveling to their field with his older brother in a cart. Along the way, they were attacked by unidentified armed individuals. They were immediately rescued and taken back to their health facility, where the older brother succumbed to his injuries. There, he underwent an open cystostomy and a penile bandage, as he had no other associated injuries. A week later, he was referred to our facility for better care. On admission, he was hemodynamically stable and had a well-draining cystostomy catheter. Lateroventral penile degeneration was present, along with a section of the penile urethra over an infected wound. There were no lesions of the corpora cavernosa. Otherwise, there were no other unusual features. We initially initiated treatment with antibiotics, anti-inflammatories, and a daily dressing. He also received antitetanus serum. Three months later, we scheduled and performed an end-to-end urethroplasty of the penile urethra under a CH14 catheter. The postoperative course was uneventful.

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Abstract: Background: Stillbirths, particularly macerated stillbirths linked to delayed antenatal care (ANC) and chronic placental insufficiency, remain a critical public health challenge in low-resource settings. In Tanzania, 34% of women initiate ANC after 16 weeks, exacerbating risks of undetected maternalfetal complications. This study investigated the association between delayed ANC attendance and macerated stillbirths at Mwananyamala Regional Referral Hospital in Dar es Salaam, Tanzania. Methods: A retrospective cross-sectional study analyzed medical records of women with stillbirths (≥28 weeks) from January- December 2024. Data on ANC timing, maternal demographics, comorbidities, and pregnancy outcomes were collected. Logistic regression and ANOVA were used to assess associations, adjusting for confounders (e.g., age, parity, HIV). Results: Among 199 participants (57.6% response rate), 73.9% initiated ANC after 12 weeks and 94.5% attended fewer than the recommended 8 visits. Macerated stillbirths accounted for 74.9% of cases, with 42.2% of women reporting prior stillbirths. Late ANC initiation independently increased macerated stillbirth risk (AOR=3.46, 95% CI:0.182-0.742). Grand multiparity (≥5 births) was strongly associated with fresh stillbirths (OR=164.5, 95% CI:13.1-206.7), while multiparity (2-4 births) predicted macerated stillbirths (AOR=2.69, P=0.008). Hypertensive disorders (41.2% prevalence), particularly preeclampsia (OR=2.78, P=0.017), and HIV (43.2% prevalence) were linked to adverse outcomes. Higher education showed a protective trend (OR=0.39, P=0.089). Conclusion: Delayed ANC initiation, multiparity, and hypertensive disorders are critical, modifiable risk factors for macerated stillbirths in urban Tanzania. Community-driven ANC promotion and targeted prenatal monitoring for high-parity women are urgently needed to reduce preventable stillbirths.

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Objectives: This retrospective study seeks to delineate the epidemiological, clinical, and radiological profiles of patients admitted to the intensive care unit (ICU) for stroke at the Essos Hospital Center, a tertiary care facility in Cameroon. Methods: We conducted a comprehensive analysis of the clinical records of all patients diagnosed with stroke and admitted to the ICU between January 2019 and December 2024. Data on demographics (age, sex, risk factors), clinical characteristics (stroke subtype, Glasgow Coma Scale score at admission, clinical manifestations), and radiological findings (stroke type based on neuroimaging, lesion localisation) were systematically collected and subjected to descriptive statistical analysis. Results: Of the 100 patients included, the mean age was 63 years, with a predominance of male patients (70%). Ischaemic strokes represented 65% of cases, while haemorrhagic strokes accounted for 35%. Hypertension (75%), diabetes mellitus (30%), and smoking (25%) were the predominant risk factors. Neuroimaging, particularly computed tomography (CT), identified cerebral infarctions in 60% of cases and intracerebral haemorrhages in 30%. The overall ICU mortality rate was 40%, with key prognostic factors including advanced age, low Glasgow Coma Scale score at admission, and the specific localisation of cerebral lesions. Conclusions: This study underscores the high prevalence of ischaemic strokes and the significant role of modifiable risk factors in the aetiology of stroke. Strokes remain a leading cause of mortality in the ICU in Cameroon. Early intervention and optimised management of modifiable risk factors hold potential for improving clinical outcomes in this patient population.