[Apropos of 6 fractures of the acetabulum with dislocation in polytraumatized patients].
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Biomedical subjects
Publications and source records attributed to L J Courbil.
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The authors report their own experience from 200 cases and they consider the matter from the point of a surgeon operating in a small medical unit in Africa. The clinical and biological aspects are described; the importance and the difficulties of appreciating the real spreading of infection are emphasized. Conventional radiology is of major value. The biological diagnosis may give way to a medical treatment with DDS and sulfamethoxypyridazine in cases due to actinomycetes with red or yellow granules; but in fungic cases fungicid drugs proved to be inefficient. Surgery is still an important component of the treatment. Its tactics are discussed according to the germ, the localization, the extension and also to the social and psychological status, but it is hoped that more sanitary education will reduce its preponderence in making possible earlier diagnosis and treatment.
Two varieties of conditions of shock may be isolated during necrotic amoebic colitis (13 cases). Eight patients present a simple hypovolemic shock secondary to wastage by diarrhea and perilesional oedema with globular, protein, alcaline and potassic deficiency. Its prognosis is relatively good, after vascular infilling and corrections of metabolic disorders. Five other patients present real toxi-infectious shock resulting from widespread tissue necrosis with auto-intoxication associated with septicemic complications. Its prognosis is frankly bad. The treatment is far more difficult. The use of cardiovascular analeptics, such as dopamine, after an infilling failure, is not always sufficient to re-establish the situation. The exeresis of necrotic tissues is an indispensable condition to remove the cause of the shock before septicaemic generalisation.
Genital tuberculosis in 76 Senegalese women and 82 Nigerian women, have been compiled from statistical tables covering a period of 10 years. The authors present the features of genital tuberculosis in african females. In most cases, diagnosis is made through peroperative findings or anatomo-pathological control of exeresis specimens; still, biopsy of endometrium, systematically performed on each patient consulting for sterility, gave opportunity to detect an important number of cases of genital tuberculosis in Nigeria. The frequency of this disease is low among other unspecific genital infections. Its medical treatment is effective on tuberculous infection but not on sterility which is an unavoidable sequella.