Biomedical subjects

P A Fall

Publications and source records attributed to P A Fall.

31 records · Page 2Linked to original sources

PubMed1999

[Simultaneous treatment of benign prostatic hypertrophy and inguinal hernia: an old procedure revisited].

The association of benign prostatic hyperplasia (BPH) and inguinal hernia still pose the problem of the chronology of their repair. Indeed, first hernial repair without removing the cervicoprostatic obstruction exposes to a high rate of recurrence due to the dysuria. The objective of this work was to report our experience about the simultaneous cure of the BPH and inguinal hernia. We have performed a retrospective study including a non consecutive series of 92 patients presenting both BPH and inguinal hernia. Studied parameters was age, occupation, clinical symptoms, the procedure and operative continuations. Mean age was 70.22 years old, range from 57 to 90 years old. Past history of inguinal hernia repair was found in 18.5%. 19.13% had hernial recurrence while 6.5% had contralateral hernia. Main clinical features were inguinal mass (43.5%) and acute urinary retention (11.9%). The average weight of prostatic tumor was 87.1 g. Surgery was performed under spinal anaesthesia in 96.8%. All patients underwent suprapubic transvesical prostatectomy. Hernial repair was done according to Bassini procedure in 82.6%, Mac Way procedure in 14.2% and Forgues procedure in 3.2%. The overall morbidity rate was 15.2%. The hernial recurrence rate was 7.6%. There was no postoperative mortality. The simultaneous repair of BPH and inguinal hernia offers some advantages. First of all, it reduces considerably the anaesthetic risk owing to the importance of cardiovascular diseases in aging patients. On and other hand, the low recurrence rate of the hernia and the substantial savings are adjunct advantages. We conclude that simultaneous repair of BPH and inguinal hernia is simple, safe and economic.

Aged↗

PubMed1998

Visual-induced postural sway in children with and without otitis media.

Children with otitis media with effusion (OME) have been shown to have a significantly higher velocity of sway than normal children. To further evaluate the effect of OME on balance, we studied visual dependency for balance by investigating the influence of optic flow on postural sway. The results of this preliminary study suggest that children with OME may be more visually dependent for balance than healthy age-matched controls. This was particularly evident for higher-frequency stimulus conditions (0.25 Hz) as opposed to lower-frequency stimulus conditions (0.10 Hz). These findings indicate that OME may affect vestibular function in children, thereby causing excessive reliance on other, nonvestibular sensory cues to maintain balance. Further studies are needed to define the role of vestibular function in the management of children with OME.

Child↗

PubMed1998

[Malignant kidney tumors in adults in Senegal: diagnostic and therapeutic problems].

The aim of this study was to analyze problems posed by adult renal malignant tumors both in the diagnostical and therapeutical viewpoints. We have performed a retrospective study including 48 cases of confirmed renal cancer. Have been included adult patients who presented a cancer of the kidney operated or not. Studied parameters were age, sex, clinical signs, complementary explorations i.e. biology, renal ultrasonography, IVU, Computerized tomography, the operative indication and the prognosis. We have used Robson's staging to classify our patients. The average age was 51 years with extremes of 18 and 83 years. However 60% of them were less than 50 years. Adenocarcinoma was the main histological form encountered. It has been found in 93% of cases. The flank mass has been the mode of discovery in 70.8% of cases. The classic symptomatic triad associating hematuria, pain and the renal mass has been found in 20.8% of cases. Ultrasonography and Intravenous urography (IVU) have allowed to pose the diagnosis in 93.75% of cases. Patients were often referred very late with an average delay of consultation of 14 month. So, 25% of them presented with metastasis at the moment of the diagnosis. Radical nephrectomy was performed in 60% of cases. 40% of patients have not been operated due to the advanced evolution of the tumor. The global mortality to 1 year was estimated at 38%. We conclude that renal malignant tumors in the adulthood, in our practice, presents some particularities. Indeed, patients are referred late when clinical symptoms are sufficiently evocative to suspect the diagnosis. At these advanced stages, there is no curative therapeutic. So, a precocious diagnosis is necessary in order to propose to patients radical nephrectomy which remains the only efficient therapeutical procedure of the localized renal cancer in the adulthood.

Adolescent↗

PubMed1998

[Epididymal manifestations of urogenital tuberculosis].

OBJECTIVE: To define the epidemiological, anatomical, clinical and therapeutic aspects of tuberculous epididymitis in adults in the tropics. MATERIAL AND METHODS: This was a retrospective study of 11 cases of confirmed and treated tuberculous epididymitis. RESULTS: The most frequently affected age-group was 40-49 years. The commonest expression was that of a chronic epididymal nodule. The diagnosis was confirmed by histological examination of the epididymectomy specimen (10 cases) and bacteriology in one case. Combination antituberculous chemotherapy was systematically administered and epididymectomy was performed in all patients. CONCLUSION: The diagnosis of tuberculous epididymitis is often very difficult in the absence of a history of recent or active tuberculosis. However, this diagnosis must be considered in any case of chronic epididymal nodule, particularly in a context of infertility. The very mutilating treatment consists of epididymectomy in chronic forms, which also constitutes a diagnostic confirmation procedure, hence the value of prevention based on eradication of tuberculosis.

Adult↗

PubMed1998

[Erectile dysfunction in diabetics. Epidemiological profile in Senegal].

OBJECTIVE: The objective of this study was to report the epidemiological profile of erectile dysfunction in a population of diabetic men. MATERIAL AND METHODS: This was a prospective study including 431 diabetic patients seen in the outpatients department. 69 of these patients suffered from erectile dysfunction. A control group of 138 patients was randomly selected according to age from among the remaining 362 patients. Each patient was submitted to complete clinical examination. The medical and surgical history, particularly vascular, neurological, endocrine and urological, was recorded. The patient's smoking and drinking habits and treatment with any antidiabetic or other drugs were also recorded. Statistical analysis was performed according to the case-control method. The limit of significance was p < 0.05. RESULTS: The overall prevalence of erectile dysfunction was 16%. This rate is lower than those reported in the literature. Among the various risk factors, only complications of diabetes, especially neurological complications, were clearly correlated with the risk of erectile dysfunction (p = 0.0004). Similarly, the prevalence of erectile dysfunction increased with the duration of diabetes (p = 0.049). CONCLUSION: The prevalence of erectile dysfunction in diabetic patients often appears to be overestimated in the literature. Methodological biases would explain the marked variation of reported prevalence rates. In contrast, our study confirms previous reports that neurological factors play a predominant role.

Adolescent↗

PubMed1996

Age-standardized incidence and prevalence of Parkinson's disease in a Swedish community.

Parkinson's disease (PD) shows a geographical variation. All prescriptions for anti-parkinsonian drugs were recorded for a half-year in a region with low L-dopa consumption. Hospital and outpatient records were studied and physicians were asked to supply details of PD patients in the region, with 147,777 inhabitants. The crude prevalence was 115 PD per 100,000 inhabitants, based on 170 cases. In contrast to other studies we report an age-standardized prevalence, which was 76 per 100,000, using the European Standard Population as reference. The corresponding approximate incidences were 11.0 (crude) and 7.9 (age-standardized) per 100,000 person-years. Male preponderance appeared in all age groups. Mean age at onset was 65.6 years, the highest figure reported. Variation between studies for age at onset, differences in prevalence, and male preponderance suggest environmental risk factors to be of importance for PD.

Adult↗

PubMed1996

[Cesarean section in a developing country. Profile and perspectives apropos of 21,743 deliveries between 1992 and 1995].

In three years and six month 21,743 delivered at the Maternity of Dakar University Hospital. Among them there were 2650 cesarean section. The cesarean rate is 16.93% of living birth. The principal indication was foeto-pelvic disproportion (32.5%) especially pelvic problem (27%). There was post operative mortality (1%) (especially hypertension) and morbidity (6%) (especially infection). Neonatal prognosis was also poor with a 10% early neonatal mortality. These findings show the important insufficiency and reflect major problems facing obstetric in Black Africa.

Apgar Score↗

PubMed1995

ECT in Parkinson's disease. Changes in motor symptoms, monoamine metabolites and neuropeptides.

Electroconvulsive therapy (ECT) was given to 16 non-depressed, non-demented patients with advanced Parkinson's disease (PD). In all the patients an antiparkinsonian effect was seen, lasting for 18 months in one patient, 3-5 months in seven patients, and a few days to four weeks in eight patients. After ECT the levels of homovanillic acid and neuropeptide Y in cerebrospinal fluid (CSF) were significantly increased. The eight patients with long lasting motor improvement after ECT had significantly lower CSF-3-methoxy-4-hydroxyphenylglycol compared to the group with short lasting improvement. Five patients developed transitory mental confusion after ECT. In these patients, and in no others, a high albumin-ratio was found already before ECT was given - an indication of blood CSF barrier damage. Our results suggest that ECT is valuable in patients with drug refractory PD or PD with intolerance to antiparkinsonian drugs.

Aged↗

PubMed1993

Comparative study of sultamicillin and amoxicillin-clavulanate: treatment of acute otitis media.

Sultamicillin is a mutual prodrug of ampicillin and sulbactam that is chemically linked by a diester bond. This investigational agent has beta-lactamase-inhibiting activity by virtue of sulbactam, a novel beta-lactamase inhibitor. A double blind randomized study was conducted to evaluate the safety, efficacy and tolerance of sultamicillin for treatment of acute otitis media compared with amoxicillin-clavulanate. A total of 144 subjects were included (96 randomly assigned to the sultamicillin and 48 to the amoxicillin-clavulanate groups). No safety concerns for sultamicillin were identified during the study. The clinical efficacy in effusion clearance between the two groups was found not to be statistically different at 10 days (P = 0.23) and 30 days (P = 0.72). Similar rates of side effects, primarily gastrointestinal, were reported in both study groups. Sultamicillin may be an alternative for the treatment of acute otitis media when persistence and recurrence of disease become an issue.

Acute Disease↗

PubMed1989

Care of pressure sores: a controlled study of the use of a hydrocolloid dressing compared with wet saline gauze compresses.

An occlusive hydrocolloid dressing (Comfeel Ulcus) was compared with a conventional wet saline gauze dressing regarding the effect on ulcer cleansing and healing processes, experience of pain and the consumption of nursing time, in a controlled, randomized and partially single-blind study with parallel groups of long-stay patients with pressure sores. After a few weeks' treatment the relative decrease in ulcer areas with time was larger in the group treated with the hydrocolloid dressing. The difference was almost statistically significant at week 5 (p = 0.054) and definite at week 6 (p = 0.006). At week 6 the median remaining ulcer area in per cent of the initial area was 0% in the hydrocolloid dressing group and 31% in the group treated with saline gauze (p = 0.016). Analysis of the healing distribution function showed the hydrocolloid dressing to be more effective, although the overall difference was non-significant (p = 0.15). Care of the pressure sore took significantly less time with hydrocolloid dressings.

Aged↗

PubMed1982

Oral vitamin D and ultraviolet radiation for the prevention of vitamin D deficiency in the elderly.

Different methods for the prevention and treatment of vitamin D deficiency were studied in 42 institutionalized elderly people. One group received ultraviolet radiation (UVR) on a large area of the body surface once a week for three months. The results were compared with those in groups receiving either 450 IU vitamin D2 together with 420 mg calcium daily, 420 mg calcium alone, or no treatment. A significant increase in serum 25-hydroxyvitamin D was obtained with UVR. A similar increase was obtained with oral vitamin D2. A small but significant decrease in serum alkaline phosphatase was observed in subjects receiving vitamin D and calcium or calcium alone. No effects on serum phosphate, urinary cyclic adenosine monophosphate and urinary calcium were seen. Though brief UVR at one-week intervals is an efficient and safe method for prevention of vitamin D deficiency in the elderly, it is in our experience time-consuming for the ward staff and thus less convenient than oral vitamin D supplementation.

Administration, Oral↗

PubMedDate not supplied

Otitis media: an update.

Otitis media in children continues to be a major challenge for health care providers. With the emergence of resistant organisms and the increase in the incidence of otitis media, the management of this disease has become increasingly complex. The pathogenesis of otitis media is discussed, standardized terminology is presented, and current strategies are described. In addition, suggestions for managing this common illness incorporating the Agency for Health Care Policy and Research Guidelines on Otitis Media with Effusion in Young Children are made.

Adolescent↗

PubMedDate not supplied

Sultamicillin (ampicillin-sulbactam) in the treatment of acute otitis media in children.

Sultamicillin, a dimer of ampicillin and a beta-lactamase-inhibiting agent, sulbactam, was given in oral form to 50 infants and children with acute otitis media. Tympanocentesis was performed on entry into the trial. Beta-lactamase-positive Haemophilus influenzae or Branhamella catarrhalis was isolated from 14 of 73 (19.2%) middle ear effusions in 9 children. Relief of symptoms (fever/otalgia) occurred in all children who completed therapy. However, in 8 children (16%), the antimicrobial agent was discontinued due to presumed adverse side effects (primarily gastrointestinal); vomiting which began prior to entry was noted in another subject who was withdrawn. An additional 14 children completed the course of treatment despite having diarrhea. Of the 41 children who completed drug therapy, 11 (26.8%) were effusion-free after 10 days, and 22 of 33 (66.7%) evaluable children were effusion-free after 6 weeks. Sultamicillin is a novel therapeutic approach to beta-lactamase-producing bacteria. In its oral form, however, diarrhea is a troublesome side effect.

Ampicillin↗