[Hospital Management of Work-related injuries in informal sector: case of artisanal fishing in Saint-Louis (Senegal)]

OBJECTIVES

to determine the mechanisms, lesions and hospital management of work-related accidentduringtraditional fishing,an activity subject to vital occupational risks.

MATERIALS AND METHODS

Descriptive retrospective study on occupational injury files in artisanal fishing professions, registered at the Saint-Louis Regional Hospital (Senegal), from January 2014 to December 2019. All complete records of trauma during any activity related to artisanal fishingwereincluded. Data on accident mechanisms, injuries observed, and hospital management were collected.

RESULTS

47 male workers were on average 28.4 years old. Direct shock from a pirogue was most frequent (68.10%), followed by sharp or blunt objects (16.27%). The lesions were characterized by bone fractures in 63.83% of cases (n=30); chest-abdominal-pelvic and limb contusions and wounds represented 12.67% and 21.27% of cases, respectively. Medical management was done in 21 cases (44.7%). Surgery was dominated by intramedullary nailing in 15 cases (31.9%). Two laparotomies were performed with intestinal sutures. A chest contusion death was reported.

CONCLUSION

Traumatic occupational risks in traditional fishing are life threatening. A better understanding of these risks and their consequencesmakes it possible to ensure good prevention.

[Scrotal traumas: clinical and therapeutic aspects in the service of urology of the Gabriel Touré University hospital]

OBJECTIVE

To describe epidemiological, clinical, paraclinical and therapeutic aspects of scrotal trauma in the service of urology-andrology of the Gabriel Touré University hospital from Bamako in Mali.

MATERIAL AND METHOD

This was a retrospective study concerning 13 patients' files which were taken care from the service of Urology-andrology at the Gabriel Touré hospital of Mali for scrotal trauma from February, 2006 until January, 2013. The following parameters were studied: frequency, age, etiology, motive and the time limit of consultation, results of clinical examination, protocol of adopted treatment and outcome.

RESULTS

The mean age was 28 years with extremes of 1 year and 46 years old. The circumstances of occurrence were dominated by road traffic accidents (12 cases), an aggression by firearms. The timeout of consultation varied between 1 hour in 1 day. Enlarged and painful scrotum was the most frequent motive for consultation (n=12). In the physical examination the trauma was closed in 10 cases, and opened in 3 cases.

On the therapeutic plan, 7 of our patients underwent a surgical procedure and 5 a conservative management (surveillance (monitoring) + AIN). Surgical procedures consisted of: plastic surgery of the scrotal and penile envelopes (n=2), an orchidopexy, an uretroplastia (n=1), a wound care and drainage of the bladder, and orchidectomy. The average hospital stay was of 5 days with extremes at one day and 1 month. Immediate postoperative recoveries were simple in all patients except two.

CONCLUSION

A surgical exploration must be realized in the case of hematocele or of the rupture of the testicular albuginea via ultrasound. Early intervention allows for the preservation of the gonadal function.

Burn injuries and soft tissue traumas complicated by mucormycosis infection: a report of six cases and review of the literature

Mucor fungus infection is a rare opportunistic infection, rapidly progressive and often fatal in immunocompromised patients, or in patients with chronic debilitating diseases. We report six cases of trauma patients with mucormycosis. Three had severe thermal burns, one of them with a medical history of diabetes mellitus. The other three patients suffered from severe soft tissue injuries caused by traffic accidents. In all cases there had been spontaneous exposure and contact of the wounds with soil. During hospitalization, fungi cultures and/or biopsies of all wounds were performed and all resulted positive. The patients were treated with Amphotericin B (AmB) and surgical debridement. Two of them died and the other four were fully healed and discharged. Mucormycosis should be considered in any case of aggressive skin tissue necrosis with a history of soiled wounds. We suggest that mucormycosis is treated by intravenous and local administration of AmB, extensive and repeated debridement and cautious coverage of the wound. The plastic surgeon must wait for negative swab cultures and biopsies before covering the defects with skin grafts or flaps. Reconstruction may be challenging, depending on the extent, depth, location and special indications of the affected site and the donor site availability.

[Not Available]

Les accidents dus aux pétards sont des accidents graves. Leur recrudescence ces dernières années en Algérie, essentiellement durant les fêtes du Mawlid Ennabaoui (fête de la naissance du prophète), mérite à notre sens d'entreprendre des bilans exhaustifs dont celui-ci dans le but d'une sensibilisation de toutes les compétences concernées. Nous avons réuni sur trois années consécutives (2002, 2003, 2004) 60 dossiers de malades ayant subi des accidents oculaires par pétards. Nos patients sont répartis en 42 consultations pour blessures légères et 18 hospitalisations pour blessures graves. Parmi ces derniers, neuf ont présenté des complications et séquelles graves (cinq cas de cécité par atrophie du globe oculaire, trois cas de cécité cornéenne et un cas de cécité par trou maculaire). Dans tous ces cas l'incapacité permanente partielle est au minimum de 30%. Au vu de ces données nous proposons des mesures d'éducation sanitaire et une sensibilisation du grand public aux traumatismes oculaires, par le biais de mé dias appropriés: radio, télévision, affiches.