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The aim of this study was to report a clinical case of ileocaecal node in the visceral surgery department of Donka. The ileosigmoid node or the ileosigmoid knot (ISK), is an exceptional clinical entity, it is a surgical emergency characterized by strangulation of the small intestine forming a knot around the base of the sigmoid colon with risk of rapid necrosis of the small intestine. And the colon. The preoperative diagnosis of this condition is difficult because of its rarity and atypical radiographic results. We report a case of an ileosigmoid node discovered in a 62-year-old subject who consulted in our department for an occlusive syndrome.

Pyothoraxes, also called thoracic empyemas, are defined by the presence between the two layers of the pleura, of a frankly purulent liquid, or of a shady or clear liquid but containing a majority of altered polynuclear cells with germs direct examination. They are said to be traumatic when they follow a thoracic trauma whatever the mechanism; usually a pre-existing post-traumatic pleural effusion. The general objective of this study was to help identify the epidemiological and prognostic factors in the management of post-traumatic pyothorax in the Thoracic Surgery Department of the Donka National Hospital. Methodology: This was a descriptive retrospective study covering a period of 2.5 years from 01/06/2016 to 31/12/2018 carried out in the Thoracic Surgery Department of the Donka National Hospital. Results: During the study period, 17 cases of post-traumatic pyothorax were observed among the 288 files of admitted and hospitalized patients. In the course of this study, a rate was 5.90%. The most affected age group was 1 to 5 years old. The male sex was in the majority (76.5%). The most common occurrence was the fall, i.e. 41.2%. 47% of patients consult after 60 days. Chest pain and dyspnea were the main symptoms during our study (82.3%). Antibiotics and analgesics dominated the medical treatment used in 100% of the cases and pleural drainage was the first line surgical treatment practiced in 88.2% of the cases. The prognosis is favorable without sequelae in 52.9% of cases with an average hospital stay of 9 days. Post-traumatic pyothorax is a serious pathology involving the vital and functional respiratory prognosis, hence the need to diagnose and treat it early.

complex (MTBC) Lineage 3 (L3) strains are abundant in world regions with the highest tuberculosis burden. To investigate the population structure and the global diversity of this major lineage, we analyzed a dataset comprising 2682 L3 strains from 38 countries over 5 continents, by employing 24-loci mycobacterial interspersed repetitive unit-variable number of tandem repeats genotyping (MIRU-VNTR) and drug susceptibility testing. We further combined whole-genome sequencing (WGS) and phylogeographic analysis for 373 strains representing the global L3 genetic diversity. Ancestral state reconstruction confirmed that the origin of L3 strains is located in Southern Asia and further revealed multiple independent introduction events into North-East and East Africa. This study provides a systematic understanding of the global diversity of L3 strains and reports phylogenetic variations that could inform clinical trials which evaluate the effectivity of new drugs/regimens or vaccine candidates.

Introduction: Tramadol* is a synthetic opioid agonist used as an analgesic. Despite its minor potential of addiction, it created recently a lot of concern. Its misuse may be motivated by a need to control the pain or by looking for her euphoric character. The aim of our study was to proceed a psychopathological reading of a case of addiction to Tramadol in a sickle cell patient with histrionic personality traits. Methods: We report the case’s management of a patient with addiction to Tramadol in a sickle cell patient with histrionic personality traits. The diagnosis was based on the DSM IV criteria. The review was done in the model of semi-structured interviews. Observation: Miss DP is 23 years old, sickle cell patient (AS profile). It is addressed to us for the management of an excessive consumption of Tramadol* started 4 years ago. Because of the difficulties of care in outpatient, we conducted hospitalization. The interviews highlight the histrionic personality traits and disruption of family dynamics. Discussion: Painful chronic diseases require a long analgesic treatment. It is a factor of dependence specially when the patient has a personality disorder. Multidisciplinary treatment between psychiatrist and addiction specialist and medical doctor is a guarantee of success.

Introduction: The ileosigmoid node is a double volvulus involving the sigmoid and the small intestine. The preoperative diagnosis is difficult in our practice setting. We report a case of ileosigmoid node that we discuss with data from the literature. Observation: This was a 40-year-old man admitted for diffuse abdominal pain of progressive onset, paroxysmal, accompanied by cessation of materials and gas, profuse vomiting of food and hiccups, progressing for 24 hours. With a history of persistent constipation and episodes of sub-occlusion, clinical examination noted pain, abdominal distension and dullness of the flanks and inaudible peristalsis. The digital rectal examination noted an emptiness of the rectal bulb and a bulging of the Douglas. The biological assessment was unremarkable. The ASP showed an arched image. Confirmation was intraoperative with a small bowel volvulus around the sigmoid in the form of a node producing double ileal and sigmoid necrosis. We performed an ileo-ileal anastomosis resection and a left iliac colostomy using the Hartman technique. The postoperative follow-up was simple, the patient was discharged on D10 postoperative. Six weeks later the patient was readmitted for restoration of colonic continuity. Five months later, no complaints were reported. Conclusion: The ileo-sigmoid node is a rare cause of intestinal obstruction, difficult to diagnose preoperatively in our exercise setting, the progression is rapid towards digestive necrosis. The availability of emergency CT examinations and early management of this condition would improve the prognosis.

Introduction: The aim of this study was to evaluate the results of one-stage colectomy versus two-stage colectomy at Conakry University Hospital. Methods: This was a retrospective study conducted at the University Hospital of Conakry from January 1, 2015 to December 31, 2019. All patients hospitalized and operated on in the Ignace Deen General Surgery and Donka Visceral Surgery departments for pelvic colon volvulus (PCV) who underwent colectomy during the study period were included. Results: We collected 87 cases of pelvic colon volvulus (PCV). The average age was 45.71 years with extremes of 5 years and 80 years with a male predominance of 82.83% and a sex ratio of 5.18. The morbidity was marked by 2 cases of anastomotic fistulas, 7 cases of parietal suppuration and 1 case of peristomal hemorrhage. 4 cases of death were noted in two-stage colectomy and 2 cases in one-stage colectomy. Conclusion: The occurrence of morbidity and mortality was not related to the type of colectomy. As our study does not allow us to affirm the superiority of one technique over the other, we recommend considering a future dynamic study that would take into account a larger sample.

Ordinal embedding is the task of computing a meaningful multidimensional representation of objects, for which only qualitative constraints on their distance functions are known. In particular, we consider comparisons of the form “Which object from the pair (j,k) is more similar to object i?”. In this paper, we generalize this framework to the case where the ordinal constraints are not given at the level of individual points, but at the level of sets, and propose a distributional triplet embedding approach in a scalable learning framework. We show that the query complexity of our approach is on par with the single-item approach. Without having access to features of the items to be embedded, we show the applicability of our model on toy datasets for the task of reconstruction and demonstrate the validity of the obtained embeddings in experiments on synthetic and real-world datasets. Deutsche Forschungsgemeinschaft GRK 1994/1 Version of record