Cervical trauma: Epidemiological, Diagnostic and Therapeutic aspects at the Adolphe SICE General Hospital in Pointe-Noire

Introduction: Cervical spine injuries are relatively rare, and caused by external sharp and vulnating agents. They can be potentially serious and life-threatening. The aim of this work was to describe the epidemiological, clinical and therapeutic aspects. Patients and Method: This was a descriptive, retrospective, cross-sectional study of the records of patients with neck trauma from January 1, 2005 to December 31, 2018, conducted in the ENT and Cervico-Facial Surgery Department of the Adolphe SICE Hospital in Pointe-Noire (Congo-Brazzaville). Results: The study included 30 patients from a total of 107 cases of cervicofacial trauma. The average annual incidence of cervical trauma was 2 cases per year, with a predominance of males, including 25 males (83.3%) and 5 females (16.6%), i.e. a sex ratio of 5:1. The average age was 34.4 years with extremes of 17 to 70 years. 50% of our patients were single. The circumstances of occurrence were represented by knives (83% of cases), followed by road traffic injuries (13%) and firearms (3%). Sharp objects were the most common cause of injury (83%). The mechanism of injury was a section in 87% and a contusion in 13%. Neck pain was the main symptom in 100% of cases. The wound represented 87% of the physical examination, followed by edema and hemorrhage in 33% and 20% respectively. The trauma was isolated in 80% of cases and in a context of polytrauma in 4%. Exploratory and reparative cervicotomy was the most common surgical procedure, 87%, followed by tracheotomy, 27%. The evolution was simple, in spite of the parietal suppuration noted in 10% of the cases. Conclusion: Despite their rarity, cervical trauma remains a worrying surgical emergency in our work context. These traumas are the prerogative of young adult males in connection with external vulnating agents with high traumatic risk. Keywords: Trauma ; penetrating wound; Neck; Cervicotomy

Management of Laryngo-Tracheo-Bronchial foreign bodies in children at the Adolphe SICE General Hospital in Pointe-Noire, Congo

Background: The objectives of our study were to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of laryngotracheobronchial foreign bodies. Patients and methods: This was a descriptive and retrospective study carried out over a period of 12 years (2007-2019), in the ENT and cervico-facial surgery department of the General Hospital Adolphe SICE of Pointe-Noire (Congo). Results: During this period, we collected 20 files of patients whose age varied from 1 to 10 years with an average age of 5 years who were received for foreign body inhalation. The average age of our patients was 5 years with extremes ranging from 1 to 10 years. A male predominance was noted with a sex ratio of 1.62. The average consultation time was 3 days (2 hours and 30 days), 12 patients (60%) were seen within the first 24 hours. The penetration syndrome was the most common functional sign in 10 cases (50%). The standard cervico-thoracic radiograph was normal in 7 cases (35%). The foreign body was opaque in 10 cases (50%), and in 1 case atelectasis was noted. CT scan was performed in 2 cases (10%). The larynx was the most common location. Indeed, the glottis was affected in 8 cases (61.5%), followed by the supraglottis in 3 cases (23.07%) and the subglottis in 2 cases (15.3%). The plastic toys were found more in the glottis in 6 cases (30%). The evolution after endoscopy was favourable in 17 cases (85%), 2 cases required thoracic surgery, and one death was recorded. Conclusion: Laryngo-tracheo-bronchial foreign bodies are frequent, they pose a public health problem. Their management depends on the strength of the relationship between the ENT surgeon and the anaesthetist. Keywords: Child; Laryngo-Tracheo-Bronchial Foreign Bodies; Endoscopy

Hypertension in the Workplace: Study among Workers in an Oil Production Company in Pointe-Noire (Congo)

Hypertension is a real public health problem in the world. The almost rare data on hypertension in the Congolese oil sector led us to carry out this study. Objective: Describe the epidemiological profile of the hypertensive worker in a Congolese oil production company in the city of Pointe-Noire. Methodology: This is an observational study, descriptive cross in collection of retrospective data, which involved 815 workers. After informed consent, a questionnaire was administered to workers whose variables such as weight, height, and blood pressure were taken. Statistical analysis was carried out using the EPI-INFO 7 software. Results: The prevalence of hypertension in workers was 16.3%, i.e. 18.0% in men and 8.0% in women with a significant difference (p <0.05). 25.8% of hypertensive workers were obese and 19.0% overweight. Obese workers were approximately 5 times more vulnerable than others to hypertension, and this was significantly (p <0.001). Risk factors such as age, gender and BMI and diabetes have been significantly associated with hypertension. The older the worker, the more there was an increased risk of developing hypertension (p <0.001). However, other factors such as sports activity and smoking were not significantly related to hypertension (p ˃ 0.05). Conclusion: Hypertension is a worrying pathology among workers in an oil company in Congo. It would be imperative to strengthen communication with employees with the aim of raising awareness and changing behavior.