ABSTRACT
Objective: Analyze the epidemiological, anatomo -clinical, therapeutic and evolutionary aspects of iatrogenic obstetric fistulas linked to a gynecological/obstetric procedure (caesarean section, hysterectomy, myomectomy, use of forceps, treatment of uterine prolapse, or vaginal surgery). Patients and Methods: This was a descriptive prospective study, concerning 62 patients hospitalized in the Urology department of the Point-G University Hospital from January 5, 2010 to June 30, 2014 for iatrogenic obstetric fistulas. The epidemiological, anatomo -clinical, therapeutic and evolutionary aspects were analyzed. Results: Iatrogenic obstetric fistulas were found in 19% of patients out of 321 cases of urogenital fistulas hospitalized in urology. The average age was 32 years with extremes of 15 and 52 years. The revealing clinical signs were: permanent loss of urine (87.10%), loss of urine while standing (9.70%), loss of urine while lying down (3.20%). Gynecological/obstetric procedures: caesarean section n= 39, hysterectomy n= 15, myomectomy n= 1, use of forceps n= 5, cure of uterine prolapse, vaginal surgery n= 1) were the most common causes. Type V fistulas were the most encountered with 74.20% and among these V fistulas, retro-trigonal fistulas were the most represented with 37.80% of cases followed by uretero-vaginal fistulas (31.10%) and vesico-uterine fistulas (15.60%). The upper route was used in 41 cases; followed by the low way in 18 cases and the mixed way in 3 cases. Trigono -cervico-uterine duplication was performed in 23 cases followed by uretero -vesical reimplantation in 19 cases. The treatment was satisfactory in 55 cases, i.e. 88.70% (no leakage) and poor in 7 cases.

ABSTRACT
In Mali, particularly in CHU Gabriel TOURE, organization of block activities is always problematic due to operative programming ignorance by staff of sector and other proximity, thus causing a blow to the good functioning of block. Objectives: Determine the knowledge level of staff intervening in block; to describe the existence of block operative charter functioning, know the existence of block operative components, Analyze the unrolling operative program. Methodology: We carried out a prospect, descriptive and transversal study to CHU Gabriel TOURE close to staff practicing to the operative blocks and other relation services; the sampling was probabilistic, based on systematic random technic. Result: Decisional proceedings and coordination in the block are ignored by the all respondent staff (100%). 50, 57% of respondent staff have witnessed the inobservance of hygiene rules concerning the patient, professionals, staffs in training, visitors, equipments, locals and environment. 75, 87% of respondents have testified a specify date and hour existence of programming meetings, but which are not surely respected according to 58, 63% of those same respondents. As far as 72, 44% have testified a fix hour existence to the bloc opening while.77, 01% have found regular hour inexistence to the startup of program. It also exists that a room is defined for each specialty working in the block say 65, 52% of respondent staff. 63, 22% of respondents affirmed that there is no own channel pour patient and material. Moreover it states that none of investigated staff does not know the responsible of block team coordination (100%). There are no established punishments at the block also supporting modalities of dysfunction and conflicts, respectively say 57, 48% and 70, 12% of respondent staff. 100% of respondents testified collegiality’s absence in operative; programming meeting and that 51,72% of respondent staff judged that topics reading are not done during programming meeting ....

ABSTRACT
We report a case of bowel evisceration following uterine perforation after an abortive manoeuvre by unqualified personnel. After the procedure, there was abundant vaginal bleeding and a complication was encountered: small bowel evisceration approximately 1 metre long via the vagina, certainly following the seizure of these small bowels and their successive traction which led first to the uterine cavity, then the vagina and finally to the vulva. Given the author's fear, the patient was referred urgently for treatment. After a transfusion of two units of blood and a triple laparotomy, a 1 m resection of the small intestine with end-to-end anastomosis was performed; suture of the uterine perforation and curettage of the cavity. The patient was discharged from the centre 10 days after surgery. Conclusion: This case shows the clandestine nature of induced abortions, which are responsible for multiple complications, including visceral lesions and uterine perforations.

ABSTRACT
Objective: To find out the relationship between hematological parameters and disease severity among COVID-19 patients. Methods: This cross-sectional analytical study was conducted in the COVID unit of Dhaka Medical College and Hospital (DMCH). The study was conducted from October 2020 to September 2021. Patients diagnosed with COVID-19 infection detected by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) admitting in the Corona unit of DMCH, Dhaka, Bangladesh. Purposive sampling technique was applied to collect the samples. 96 patients were included for the study. Result: In case of severity of patients, 17 (17.7%) patients had mild illness, 29 (30.2%) had moderate illness and 50 (52.1%) patients had severe illness due to COVID-19 infection. Furthermore, according to gender, the proportion of male patients (70.0%) were significantly more in severe group compared to mild/moderate group (47.8%). Moreover, the mean age of the patients in severe group (56.2± 14.3) were significantly higher than the mean age of the patients in mild/moderate group (48.7±12.5) as p=0.007. Patients in severe group had significantly higher neutrophil count than mild/moderate group (p<0.001). On the other hand, patients in severe group had significantly lower lymphocyte, eosinophil and platelet count than mild/moderate group (p<0.05). The neutrophil-to-lymphocyte ratio (NLR) was significantly higher in severe group compared to mild/moderate group (p<0.001).

ABSTRACT
The ileosigmoid node is a rare surgical emergency. We report a case of intestinal obstruction by ileosigmoid node that occurred in a young adult patient himself accompanying another patient. Management was early and confirmation was intraoperative.

ABSTRACT
Intraluminal textiloma is caused by the retention of surgical textile material in the digestive tract (compress, drape). Textiloma is found intraluminally due to an inflammatory process that causes necrosis and progressive passage of the material through the digestive tract wall. It can be found anywhere along the digestive tract, from the stomach to the colon. The symptoms are not very specific and vary from transit disorders to intestinal obstruction. Morphological examination is frequently used to make a diagnosis. The treatment depends on the locasation and consists of textiloma extraction. We present two (2) clinical aspects of postoperative digestive intraluminal migration of an abdominal field following digestive surgery in this study. The extremely rare nature of these two cases, as well as the diagnostic errors and management methods of this postoperative complication, prompt us to discuss them.

ABSTRACT
Littré's hernia is the presence of Mekel's diverticulum in the hernial sac. Meckel's diverticulum is the most common birth defect of the digestive tract. It results from the involution of the omphalomesenteric or vitelline duct which normally becomes obliterated around the sixth week of intrauterine life. Although this condition is common, its presence in the hernial sac during the cure of a hernial strangulation is an extremely rare case in our practice. We report a case concerning a 42-year-old sportsman, admitted to the general and visceral surgery department of the Ignace Deen National Hospital for painful, irreducible, non-impulsive and non-expansive right inguino-scrotal swelling on coughing in whom, at the end of the clinical examination the diagnosis of a strangulated right inguino-scrotal hernia was made, he benefited from a surgical management during which the exploration revealed a hernial sac containing hail with a formation oblong on the antemesenteric surface without necrosis with peritoneal fluid. We proceeded to a resection carrying the diverticulum followed by the end-to-end ileal-ileal anastomosis plus the cure of the hernia according to Desarda. The medium-term follow-up with a follow-up of six months did not note any particularity. The diagnosis of this condition is difficult and often arises intraoperatively and the treatment is surgical.