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La survenue d'une occlusion intestinale au cours de la grossesse est rare. Il s’agit d’une association qui engage le pronostic vital maternel et foetalcar souvent source de retard diagnostique. Nous rapportons un cas de volvulus du colon sigmoïde sur grossesse évolutive. Il s'agit d'une patiente âgée de 32 ans que nous avons reçu aux urgences pour syndrome occlusif depuis deux jours. Cette patiente était par ailleurs suivie pour une grossesse mono- foetale évolutive estimée à 32 semaines et 02 jours confirmée à l'échographie. L'examen abdominal objectivait un météorisme important asymétrique. La radiographie de l'abdomen sans préparation était en faveur d'un volvulus du colon pelvien. Une laparotomie exploratrice a confirmée le diagnostic. Une césarienne associée à une sigmoïdectomie avec anastomose terminoterminale immédiate avaient été réalisées. Les suites opératoires étaient simples chez la patiente et la sortie était faite au 6ème jour post-opératoire. Le nouveau-né était décédé au 5ème jour de vie d'une détresse respiratoire. Le volvulus du colon sigmoïde compliquant la grossesse est une urgence qui doit souffrir d'aucun retard diagnostique ni thérapeutique. La prise en charge doit être pluridisciplinaire entre chirurgiens, obstétriciens, anesthésistes-réanimateurs et néonatologues.L’accès à l’endoscopie en urgence pourrait améliorer le pronostic en permettant la chirurgie à froid après une bonne maturation foetale.Mots-clés : volvulus, colon sigmoïde, grossesse.The occurrence of bowel obstruction during pregnancy is rare. It is an association that has a poor prognosis for the mother and the fetus because it is often diagnosed late. We report a case of sigmoid volvulus in pregnancy. It was a 32-year-old woman who consulted in the emergency department for bowel obstruction for two days. This patient was also followed by obstetrician for an active mono-fetal pregnancy estimatedat 32 weeks and 02 days confirmed by ultrasonography. The abdominal examination showed an asymmetrical meteorism. The plain abdominalradiography radiograph found a coffee bean sign suggestive of sigmoid volvulus. An exploratory laparotomy confirmed the diagnosis. Caesarean section associated with a sigmoidectomy and immediate anastomosis were performed. Postoperative period was uneventful and the patient was discharged on the 6th day. The newborn died on the 5th day of respiratory distress. Sigmoid volvulus complicating pregnancy is an emergency. It must not suffer from any diagnostic or therapeutic delays. The management is multidisciplinary between surgeons, obstetricians, anesthetists and neonatologists. Access to emergency endoscopy may improve the prognosis by allowing surgery after good fetal maturation.Key words: volvulus, sigmoid colon, pregnancy.

The diagnosis of ovarian tumor in pediatrics is often difficult and delayed due to unspecific call signs and polymorphic imaging presentations. These tumors are rare, estimated in children at around 2.6 / 100,000 girls per year, functional lesions being excluded. Ten to 20% of them are malignant [1-2] and represent 3% of cancers in girls under the age of 15 [3]. The World Health Organization classifies these tumors into three main groups based on whether they are derived from the surface epithelium, germline cells or ovarian stroma or sex cords. Primary or secondary locations are possible in leukemias and lymphomas [4-5]. Giant ovarian cystadenocarcinomas are rarely described. The huge ovarian masses are mostly benign, but the malignancy should be ruled out by pathology exams. Giant cysts require resection by laparotomy because of compression symptoms or the risk of malignancy, but also to prevent perforation and spillage of cystic fluid into the peritoneal cavity [6]. Here we report an observation made in a 14-year-old girl who was diagnosed with a large ovarian tumor and who was found to be a malignant tumor on pathology with papillary-type mucinous cystadenocarcinoma.

To determine the duration of single-fetal pregnancy in black Senegalese women and the factors that contribute to it.

Objectives:To determine the duration of single-fetal pregnancy in black Senegalese women and the factors that contribute to it. Patients and methods:This is a retrospective and prospective cross-sectional study that evaluated parturients admitted to the Philippe Maguilen Senghor health center for the management of their delivery of a monofoetal pregnancy from January 1, 2012 to December 31, 2018. All parturients with the following characteristics were included: monofoetal pregnancy, date of last menstrual period known or reconstituted on the basis of an early ultrasound (≤13SA + 6 days), a term of pregnancy greater than or equal to 37 weeks, spontaneous induction from work and a child living at birth. The data was entered into our e-Perinatal computer database and analyzed first on Microsoft Excel 2016 and then using SPSS 24 Mac version software. The continuous quantitative variables were described by their position and dispersion parameters: mean, median, mode and standard deviation. They were compared using the ANOVA test. The relationship between the quantitative variables was assessed using a bivariate linear correlation. The level of significance used was 0.05. Results:Over 7 years, 13,292 parturients met the inclusion criteria, representing a frequency of 35.6% of all admissions. The average age was 27.36 years with extremes of 13 and 49 years. Almost 9 in 10 parturients were under the age of 35. The average duration of gestation was 278.69 days, the median was 278 days while the mode was 279 days; which corresponded respectively to 39SA + 6 days, 39SA + 5 days and 39SA + 6 days. Parity, maternal age and type of fetal presentation did not influence the duration of pregnancy. However, male fetuses were born on average one day earlier (39SA + 5) compared to female fetuses. Conclusion:The Senegalese black woman gives birth on average 6 to 10 days earlier than the Caucasian woman. Boys are born a day earlier than girls. It is necessary to encourage women to remember the date of their last period and to consult early enough for an early ultrasound. Finally, it is necessary to consider a larger study to clarify the duration of pregnancy in black women on an African scale in order to provide recommendations for clinical practice. Keywords:Duration of pregnancy; Expected date of delivery; Dakar

Objectives:To assess the frequency and predictive factors of uterine rupture on no-scar uterus and on scarred uterus in an intermediate level health hospital in Dakar. Method of study:This retrospective was carried out by the Philippe Maguilen Senghor Health Center in Yoff (Dakar) during the period from January 1, 2011 to December 31, 2017. It included all the women who gave birth there'' a single pregnancy after 22 weeks of amenorrhea with a longitudinal fetal presentation or admitted after childbirth. We had studied socio-demographic characteristics and risk factors for uterine rupture. The extracted data was analyzed first on Microsoft Excel 2016 and then on EPI info. Results:Over 7 years, 29,332 deliveries of single pregnancies were recorded in our structure with 54 uterine ruptures, and a frequency of 0.18%. Induction of labor was spontaneous in 47 of the patients who presented with uterine rupture; labor was artificially induced in only 7 patients, with frequencies of 0.17% and 0.36% of all uterine ruptures, respectively. Considering the risk factors of uterine rupture, 5 parameters were discriminating: multiparity (p Conclusion:The rate of uterine rupture in our structure is certainly low but should call for more vigilance during labor with a focus on evacuated patients who have started their work in another structure, patients with a uterine scar and multiparous. Childbirth on a scar uterus is a reasonable option after eliminating a potential cause of obstructed labor. Keywords:Ruptured uterus; Scar uterus; Risk factors

Background:Ovarian dermoid cyst is a benign congenital tumor. It is often incidentally diagnosed and can be revealed in very rare cases by spontaneous rupture. We report the case of a ruptured ovarian dermal cyst complicated by generalized peritonitis. Case report:This was a 20-year-old female patient, who consulted for abdominal pain associated with fever and vomiting. Physical examination found generalized abdominal contracture. Plain abdominal radiography found pneumoperitoneum. Biology showed leukocytosis at 18000 / mm3. Median laparotomy revealed a collection 2000 cc of pus with a ruptured right ovarian mass. An adnexectomy with lavage of abdominal cavity were performed. Anatomopathological examination concluded to an ovarian dermoid cyst with no sign of malignancy. The postoperative course was uneventful. Conclusion:Rupture of a dermoid cyst of the ovary is a rare acute complication. Examination of the operative specimen is mandatory to eliminate malignancy. Keywords:Ovary; Dermoid cyst; Rupture; Acute complication; Peritonitis; Ovary

Background: The torsion of pedunculated uterine leiomyoma is a rare complication of uterine leiomyoma.

Objectives: The main objective of this work was to evaluate emergency obstetric care at the reference maternity hospital Saint-Louis. The specific objectives were to analyze evolving trends and propose solutions to improve the quality of obstetric care. Methodology: This was a descriptive cross-sectional study of all obstetric obstetric attendants in the period from January 2011 to December 2015.Results: We recorded 25,363 inmates in the delivery room with an annual average of 5017. The deliveries accounted for 22,975 entrants, or 90.58%. Caesareans were 4083 cases, or 17.7% of deliveries. Obstetric evacuation accounted for 3845 cases, or 16.3% of obstetric admissions. Stillbirth was 6.5 per 100 live births. We recorded a maternal mortality rate of 547.08 per 100,000 live births. The causes were direct in 70% of cases and indirect in 30%.Conclusion: The results of this work confirm a fact: the regional hospital center of Saint Louis because of its geographical position is a center of reference in the system in northern Senegal. The availability of SONUC has improved maternal and neonatal health indicators in the area. Then, it is necessary to insist on the necessity of the decentralization of the obstetric and surgical activities on the periphery.

Objectives: To describe the epidemiological and clinical profile of the evacuated patients, to analyze the means of evacuation as well as the cost of the evacuation, and finally, to evaluate the maternal-fetal prognosis of the evacuated patients.Material and methods: We carried out a prospective study going from January to December 2015 covering all obstetric emergencies evacuated at the Ourossogui maternity ward. Study variables: epidemiological; evacuation conditions, diagnostic and therapeutic aspects and prognostic aspects.Results: The frequency of obstetric evacuation was 66.2%. Our patients were primiparous (39.2%), out of school (85.6%), married (97.7%) and low income (94.7%) with an average age of 24.8 years. The average number of CPNs was 2.6. More than one in three women had 4 CPNs or more (33.6%). The distance traveled averaged 45.6 km with extremes of 1 km to 160 km. The ambulance was used in 90% of cases. The reasons for evacuation were dominated by obstructed labor in 29.4%; hemorrhages in 26.5%. Eight home deliveries and four en route were noted. The maternal prognosis was favorable in 98.6%. Seventeen cases of death were recorded, ie 1.4%. The child was alive and well in 83.2% and deaths accounted for 16%. Maternal deaths most often occurred among illiterate, low-income, multi-gesting women with fewer than 4CPNs under 35 years of age who traveled long distances and were evacuated by unskilled staff.Conclusion: Emergency obstetric evacuation represents a major challenge for the health system in the Matam region. Improvements include literacy training for the population, continuous training of health personnel and recruitment of practitioners.

No Abstract

Le but de notre étude était de rapporter notre expérience dans la prise en charge des fistules entéro-cutanées post-opératoires (FECPO). Il s’agissait d’une étude rétrospective qui s’est déroulée au CHU A Le Dantec sur 10 ans (2000- 2010). Les critères d’inclusion étaient les patients qui présentaient une FEC PO durant la période d’étude. Les paramètres étudiés étaient les suivants : le terrain, l’intervention initiale, les circonstances de découverte, le délai d’apparition et les caractéristiques de la FEC PO, l’évolution sous traitement médical, les indications et les résultats du traitement chirurgical. Ont été inclus dans l’étude 25 patients d’âge moyen de 30 ans. Il s’agissait de 17 hommes et de 8 femmes avec un sex-ratio de 2,1. Six patients (24%) avaient au minimum un antécédent de laparotomie. Sept cas de dénutrition (28%) ont été notés. L’intervention initiale concernait le grêle dans 40% des cas et le côlon dans 32% des cas ; elle avait été réalisée dans un contexte d’urgence chez 17 patients (68%). Des incidents et difficultés opératoires avaient été rapportés chez 7 patients (28%). Les circonstances de découverte de la fistule étaient à type d’écoulement anormal de liquide digestif à travers l’incision dans 72% des cas. Les fistules étaient semi-précoces dans 56% des cas ; elles étaient iléales dans 13 cas (52%), et de bas débit dans 19 cas (76%). Sous traitement médical, 15 patients (60%) avaient évolué vers une guérison spontanée. Un traitement chirurgical était indiqué chez 9 patients (36%) avec évolution favorable dans 66 % des cas. La mortalité globale était de 12% (n=3), par défaillance multi viscérale. Dans notre service, les FEC PO sont surtout des complications du sujet jeune, de type semiprécoce, de siège invariablement iléal et colique, à bas débit et à trajet latéral qui guérissent majoritairement sous traitement médical dans un délai moyen de 3 semaines. Le traitement chirurgical est surtout indiqué devant le sepsis intra abdominal qui explique la mortalité rapportée.Mots clés : Fistule entéro-cutanée, traitement, chirurgie.

A study was carried out to identify and evaluate factors affecting variation in conception rate (CR) in Cameroonian Zebu cattle following oestrus synchronisation and artificial insemination (AI). Two hundred and six local female Zebu cattle were evaluated to determine relationship between factors such as lactation number, age, body condition score (BCS), days postpartum and conception rate. Animals received an intravaginal progesterone release device (PRID®) containing 1.55mg of progesterone and a capsule with 10mg estradiol benzonate for 10 days and were treated with luteolytic dose of PGF2α and 1000mg IU PMSG at the time of PRIDt withdrawal. Animals were inseminated 48 hours after PGF2α and PMSG injection. Pregnancy status was assessed by observed non-return to oestrus and confirmed by rectal palpation 55-60 days after insemination. The overall CR was 47.6%. CR was influenced (p< 0.05) by lactation number, age and days postpartum of cows. The multivariate logistic regression model used revealed that CR was optimum in primiparous cows, those between 4.5 -7 years old and 151-300 days postpartum.

Introduction: One Health is a concept that establishes the link between humans, animals and the environment in a collaborative approach. Since One Health's inception, several interventions have been developed in many regions and countries worldwide to tackle complex health problems, including epidemics and pandemics. In the developed world, many collaborative platforms have been created with an international strategy to address issues specific or not to their environment. Unfortunately, there is a lack of synthesis on the challenges and opportunities Low and Middle-Income Countries (LMICs) face., Methods: Following The Preferred Reporting Elements for PRISMA Systematic Reviews and Meta-Analyses (PRISMA), we conducted a systematic review. We applied a search strategy to electronic bibliographic databases (PubMed, Embase, Global Health, Web of Science and CINAHL). We assessed the included articles' quality using the Mixed Methods Appraisal tool (MMAT)., Results and Discussion: A total of 424 articles were initially identified through the electronic database search. After removing duplicates (n = 68), 356 articles were screened for title and abstract, and 16 were retained for full-text screening. The identified barriers were the lack of political will, weak governance and lack of human, financial and logistics resources. Concerning the enablers, we listed the existence of a reference framework document for One Health activities, good coordination between the different sectors at the various levels, the importance of joint and multisectoral meetings that advocated the One Health approach and the Availability of funds and adequate resources coupled with the support of Technical and Financial partners., Conclusion: One Health strategy and interventions must be implemented widely to address the rising burden of emerging infectious diseases, zoonotic diseases, and antimicrobial resistance. Addressing those challenges and reinforcing the enablers to promote managing global health challenges is necessary., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/record&#95;email.php, Unique Identifier: CRD42023393693., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yopa, Massom, Kiki, Sophie, Fasine, Thiam, Zinaba and Ngangue.)