ABSTRACT
This article deals with a very old subject that is also a challenge for the medical fraternity and masses. The masses and the medical fraternity go through the hypertensive related health issues in their daily lives. The issue is clubbed as Resistant Hypertension (RH) issues which are troubling the commonest human being to that of the scientific community. While the modern medicine through the existing treatment deals with the problem with chemical medications for the circulatory system, this article focuses on Homoeopathic system of medicine. Homoeopathy is clinically effective, cost effective and has no side effects. As all the homoeopathic medicines go through human clinical trial or are proved on human beings, all medicines have a mental calming aspect during the trials. This shows that there are N numbers of medicines in homoeopathy for the RH issues also. The current piece deals with some of the leading medicines based on the clinical experience of the lead author. Readers are requested to adhere to the protocol discussed here. The reader will get an idea of the problem at global & national level through the eyes of clinical health in the beginning sections before delving in to the Homoeopathic system of the AYUSH platform. Currently, the AYUSH platform has regained its value in the era of the current pandemic. The pandemic has escalated the RH issues further. In the absence of effective therapy in the modern medicine, the article peeps through what homoeopathy can offer to deal with RH issues that are effective clinically, safe and without side effects.

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Background: Occupations have psychological risk factors for musculoskeletal disorders and diseases. Many of them are preventable. Occupational strains are one of the preventive occupational risk factors. Objective: Introduction of musculoskeletal disorders and prevention, kinds, diagnosis and treatment. Materials and Methods: In a review study the author research in related scientific literature, websites and journals about the musculoskeletal disorders. Job musculoskeletal disorders and prevention, kinds, diagnosis and treatment. Results: Musculoskeletal disorders can be classified to neck, upper limbs, spine, lower limbs and rheumatologic disorders. But the prevention is important in the workplaces. Conclusion: Musculoskeletal disorders are important and recognizing the risk factors is important. Prevention is necessary.

ABSTRACT
Inguinal hernia is the spontaneous or progressive, temporary or permanent passage of viscera or part of viscera out of the cavity that normally contains it. This passage is made through an anatomically preformed area of weakness in the inguinal canal. The diagnosis of inguinal hernia is primarily clinical (inguinal swelling). Objectives: To study the epidemiological, diagnostic and therapeutic aspects of inguinal hernias in the general surgery unit of the Centre de Santé de Référence (CSRéf) in Fana. Results: 431 surgical interventions. 147 inguinal hernias including 12 cases of strangulation, The frequency of hernia was 34.11% in relation to surgical procedures, The 15-29 age group accounted for 32.7% of cases, The sex ratio was:35.75 in favour of men, In our study, farmers accounted for 53.06% of the total, Bilateral inguinal hernia which accounted for 57.14%, Patients who underwent para-rectal inguinotomy accounted for 88.4%, The Bassini technique was used in 70.75% of our patients, The operative follow-up was complicated in 19.73% of our patients, We recorded one case of death (0.7%). Conclusion: Inguinal hernia is a common surgical condition, preferentially affecting the male subjects and farmers, with a predominance of young people aged 15 to 25 years.

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Vaccination is one of the most efficient public health interventions in developing countries with epidemiological facies dominated by communicable diseases. Objective: To evaluate the efficiency of the logistical management of routine EPI vaccines and consumables in the Fana health district from 01 December 2018 to 30 November 2019. Results: The efficiency of the health areas in monitoring the storage temperature of vaccines (+2°c to +8°c) was 94.54%. The district obtained a rate of 100% in the management of stocks of vaccines and consumables. As for the quality of the cold chain equipment, the average rate obtained by the health district was 96.81%. The rate obtained by the district was 100% in relation to the maintenance of the cold chain equipment. In stock management, the average rate recorded in the district was 97.27%. The district obtained a rate of 100% in the efficiency of the vaccine management system. The average rate obtained by the district was 96.59% in the correct use of diluents. In the implementation of the Policy on opened vials (PFE), the rate obtained by the district was 90.81%. During the period, the management is 89.18% for the control of vaccine losses. Conclusion: All the cold chain equipment used for vaccine storage (Churchill solar fridges and vaccine carriers) comply with World Health Organization standards.

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Objectives: To evaluate the surgical activities of the surgical unit of the Fana Health Centre. This was a prospective and descriptive study carried out in the surgical unit of the Fana Health Centre over a period of 12 months (01 July 2020 to 30 June 2021). Results: 331 surgical consultations with 242 surgical pathologies operated on, i.e. 73.11%. Men were more affected than women with a sex ratio of 2.9 and a predominance of young adults aged 16-30 years with 28.51%. The main disease groups encountered were the digestive disease class with a rate of 82.23% in first place, followed by diseases of the urinary system with 19.83%. The average length of hospital stay was 5 days. We observed that of the 242 patients operated on, 10 died (6 from septic shock and 4 from pulmonary embolism). Conclusion: This work has enabled us to highlight the surgical activities of the surgical unit at the Fana Health Centre, to evaluate its performance and shortcomings.

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Introduction: Surgical abdominal emergencies are abdominal pain evolving for a few hours or a few days (less than 3 days) which can be traumatic or non-traumatic which are related to a surgical pathology. Purpose: Studying surgical abdominal emergencies at the Fana reference health center (Csref). Methodology: This was a prospective study carried out at the csref of Fana from January 1, 2022 to December 31, 2022. Results: During the study we identified 121 cases of surgical abdominal emergencies including 76 men and 45 women with a sex ratio of 1.68, the average age was 29.95 years ± 18.71. These were 6 surgical emergencies which are: Acute appendicitis (45 cases), Intestinal obstruction (32 cases), Acute peritonitis (30 cases), Traumatic hemoperitoneum (06 cases), GEU (05), Evisceration (3). Abdominal pain was the main reason for consultation. The physical examination made it possible in the majority of cases to make the diagnosis. Faced with certain doubtful cases, we requested paraclinical examinations (ultrasound in 26 cases, ASP in 56 cases and grouping/rhesus in all cases). The morbidity rate was 12.4% and mortality 6.66%. Conclusion: The frequency of surgical abdominal emergencies is high at the Csref of Fana with 20.20%. The clinical picture is polymorphous. The causes are many and varied; dominated by acute appendicitis, intestinal obstruction and peritonitis.

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Introduction: Acute hyperglycemia following traumatic injury is common. Studies have shown that 20– 30% of trauma patients present following injury with blood glucose values ≥ 200 mg/dL, and that a majority of patients demonstrate values ≥ 150 mg/dL. The relationship between hyperglycemia and adverse outcomes, such as infectious complications, has been well described in the surgical literature. Post-traumatic hyperglycemia is less well-documented in orthopaedic trauma patients. Aim of the Study: The aim of this study was to evaluate the role of admission hyperglycaemia as a risk factor for surgical site infection in orthopaedic trauma patients. Methods: This was a retrospective observational study and was conducted in the Department of Orthopaedics Surgery of Brahmanbaria medical college Hospital, Brahmanbaria, Bangladesh during the period from October, 2020 to October, 2022. We included 130 patients who were admitted to orthopaedics surgery department. Result: Majority of our patients (41.54%) were aged 41-50 years and 65% patients were male compared to female (35%). The mean age was 45.69 ± 22.83 years. Majority (41.54%) of our patients had a preoperative American Society of Anesthesiologists (ASA) classification of II. Majority of patients 36.15% had type 1 open fracture. We found 45 patients with surgical site infection. Admission glucose more than 200 mg/dL was found higher (26.67%) in infected group. Among the hyperglycemic patients 36.36% were classified as ASA III & the surgical site infection for 30 days was found 54.55%. Conclusion: We found that orthopaedic trauma patients without a history of diabetes showed a significant independent correlation between an admission BG value of ≥200 mg/dL and 30-day surgical site infection (SSI). Because of this, admission glucose readings in orthopaedic trauma patients may be a key indicator of the risk of infection.

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Background: The basic need for investigating the damaged remains is to create a biological profile that matches, resembles, and identifies the individual by estimating the age, gender, and stature of the remains. This profile serves to increase the chances of identification and investigation of the cause of death. The study aimed at estimating the stature of Ikwerre students at Rivers State University using middle finger length. Materials and Methods: Standing height and middle finger length of 267 subjects were measured using a digital stadiometer and digital vernier calliper, respectively. Statistical analysis, employing the t-test, Pearson correlation, and regression analysis, was carried out with the aid of SPSS version 23.0. Results and Discussions: Results showed that all parameters investigated were higher in males (P <0.05) and that the correlations between middle finger lengths and stature were significant in both genders; no significant difference was found between the left and right middle finger lengths in the study population. Conclusion: The study concludes that it is possible to estimate the stature of an unknown Ikwerre student from the length of the right and left middle fingers. This study has demonstrated its application in identification, especially in cases of accidents with dismembered body parts. This study is recommended to forensic experts, anatomists, physicians, medical practitioners, and the government of Rivers State for use as a reference for other studies.

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A cross-sectional study with two collection techniques, a retrospective collection involving 347 files and a cross-sectional collection by face-to-face mode interview of the mothers of the 9 children who died during the collection period and part of the nursing staff. It aimed to assess mortality among malnourished children aged 6-59 months and to contribute to the improvement of their health status. The mortality rate among the malnourished is relatively low 3.69%. Malaria was frequently associated with malnutrition: 53.65%. Hypovolaemic and septic shock were the most common causes of death with 46.15 and 38.46%. In view of these results, emphasis should be placed on early referral of children with complications and also on vaccination campaigns, awareness-raising on exclusive breastfeeding and dietary diversification. In Mali in general and in Fana in particular, malnutrition remains a huge health problem in children aged 6-59 months.

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The odontostomatology consultation is a medical visit which, according to Hippocrates, involves the following four stages: observation, palpation, percussion and auscultation. The aim was to study the reasons for consultation in Odontostomatology. Methodology: Retrospective and descriptive over three months from 1er January to 31 March 2022. Results: The age group 15 to 44 years was the most represented, i.e. 72% of cases. The female sex constituted 59%; the household profession was the most represented, i.e. 43% of cases, and the marital status was married (70%) of cases. Dental pain was the most frequent cause of consultation (98%), followed by dental mobility (2%), and self-medication was used by 37% of our patients. Dental caries was the most common diagnosis, accounting for 77.87% of cases. Conclusion: Early consultation and appropriate management can prevent the most serious complications of oral diseases.

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Summary: In Mali, the increase in the number of road accidents is proportional to the increase in the number of cars in circulation. A study of public transport drivers revealed that 23.1% of the drivers surveyed were unfit to drive out of a sample of 385 drivers. The objective of this study was to assess the visual aptitude for driving of inter-urban public transport drivers on the RN 6 and RN 30 in Fana. Results: The study involved 150 collective transport drivers, the majority of whom were in the 30-39 age group, representing 46.7% (n=70) with extremes of 20 and 68 years, the average age being 35.81±9.66 years. A total of 14.7% (n=22) of the drivers surveyed were unfit to drive and the causes of reduced visual acuity among unfit drivers were cataracts with 36.36% (n=8), followed by optic neuropathies with 22.73% (n=5) and ametropias with 18.19% (n=4). With regard to the relationship between the age of the drivers and visual aptitude for driving, the study revealed that 46.15% (n=6) of the drivers aged over 50 years were unfit. Conclusion: The results of this study show the need to make the ophthalmological examination compulsory when issuing and renewing a driving licence throughout Mali.

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The level of use of MCMs remains low in our country. The objective of this study was to analyze the factors associated with the low use of modern contraceptive methods in the Diamarabougou health area. It was a cross-sectional study with an analytical focus conducted among 150 PAFs selected through random sampling. The study established the following: -Modern contraceptive prevalence was 35%. -The majority of women knew about family planning (99%). -The main source of information was health personnel (34.7%). -The reasons for the low use of MCM were The low level of education of the woman and/or her spouse, the desire to have many children and the unfavorable opinion of the spouse. -Both men and women believe that lack of control over the menstrual cycle, jealousy, and lack of distraction are the reasons for many unplanned pregnancies; - The main disadvantage of contraception is infertility. -The main disadvantage of contraception is sterility. For the ATRs, contraception is an effective way to fight against maternal and infant mortality. They also believe that the use of contraception and the choice of a smaller family are also accompanied by significant economic and material advantages, as expenses related to health, education and family maintenance are reduced. Conclusion : The use of modern contraceptive methods remains low in the Diamarabougou health area. The correct information to women and the identification of associated factors: the low level of education of the woman and her spouse, the desire to have many children, insufficient discussion with the spouse and the lack of involvement of traditional birth attendants in family planning programs.

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Intentional assaults and injuries are defined as the result of intentional physical attacks on the body of another person. The objective was to determine the clinical, etiological and socio-demographic aspects of Voluntary beatings and injuries in the Health District of Markala. This was a prospective study of cases of Intentional assaults and injuries in the Markala Health District from 1 January 2022 to 31 December 2022. Results: Out of 738 cases of traumatic pathologies, we recorded 274 cases of Intentional assaults and injuries, i.e. a frequency of 37.12%, with a male predominance of 79.80%. The injured were aged between 21 and 30 years, i.e. 41.24%. Peasants were the most affected with 35.76% of armed attacks occurring in 44.16%. Bladed weapons were the most used (53.28%), causing wounds in 39.05% of cases, with 34.30% of cases involving the head. Conclusion: Violence, a real problem in society, has reached worrying proportions in the Markala health district because of the resurgence of juvenile delinquency but also because of the security crisis that Mali is currently experiencing. This is a phenomenon of great magnitude which has led us to reflect on possible solutions to reduce this problem.

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Apheresis platelet concentrates (APC) are platelet suspensions obtained by apheresis from a cell separator. These techniques, which appeared a little more than 20 years ago, are currently the best way to obtain platelets in large quantities from a single donor. These separators, whether discontinuous or continuous flow, perform extracorporeal circulation from anticoagulated blood, which allows the collection of platelets, returning to the donor his red blood cells and a more or less important part of his plasma. The procedures used are all automated and often adaptable to the donor's parameters. Apheresis platelet concentrates are single-donor products and therefore limit the transfusion risks compared to standard platelet concentrate mixtures, which are derived from five to six donors on average. The objective of our work is to study platelet donations by apheresis technique, their advantage, indication, and description of the equipment used, during a period of 3 years, from July 2017 until July 2020. And during this period, 29 apheresis procedures were performed by HAEMONETICS' MCS+. The clinical hematology department is the first applicant of APC where acute leukemia and non-Hodgkin's lymphoma are the most treated pathologies by this substitution.

ABSTRACT
B-cell prolymphocytic leukemia is a very rare mature B-cell leukemia occurring in elderly people diagnosed when prolymphocytes comprise more than 55% of the lymphoid cells in peripheral blood. Its evolution is most often aggressive. We report here the cases of two patients with clinical signs dominated by splenomegaly associated with significant hyperlymphocytosis. Their blood smears revealed extensive prolymphocyte invasion suggesting Prolymphocyte leukemia confirmed by immunophenotyping. Both purine analogues and monoclonal antibodies have shown promoting results, however, allogeneic hematopoietic stem cell transplantation remains the only therapeutic means allowing a lasting response. However, it is reserved for young patients with compatible donors. A good understanding of the pathogenesis and a better integration of the molecular data of this hemopathy open the way to the use of new targeted therapies. Prolymphocyte leukemia is a very rare, complex, and often aggressive, mature lymphoid hemopathy. The mean age of onset is 65 years with a predominance of males. We report here the case of a patient with splenomegaly and severe lymphocytosis in whom the smear showed an invasion of 90% of prolymphocytes suggesting Prolymphocyte leukemia confirmed by immunophenotyping.