ABSTRACT
Pancreatic surgery remains associated with significant mortality and morbidity. Efforts are generally focused on reducing postoperative complications, but early detection of patients at risk could be another effective strategy. Cephalic duodenopancreatectomy (DPC) is the treatment of choice for pancreatic head adenocarcinomas and Vater ampullomes. In the multicenter series of the French Association of Surgery published in 2010, DPC had a hospital mortality of 4% and a morbidity of 54%, about half of which corresponded to severe complications. In Algeria, in recent years, there has been a reduction in post-DPC mortality, especially in high-volume operating centres. We report the case of a patient operated for an adenocarcinoma of the head of the pancreas, in whom a DPC was performed with a favorable initial evolution. Three weeks after his discharge, he returned for abdominal pain accompanied by an infectious syndrome. The scan showed a tubular formation of 5 cm intra-abdominal. The surgical revision confirmed the presence of an intra-abdominal drain fragment responsible for a digestive wound in the small intestine. The purpose of this article is to draw attention to this exceptional, but possible complication in order to make surgeons aware of the need for particular vigilance when managing postoperative drains.

ABSTRACT
Liver tumors account for 1 to 4% of solid tumors in children and are mainly represented by hepatoblastoma, hepatocellular carcinoma, and hemangioendothelioma. Cystic mesenchymal hamartoma is a rare benign tumor of the liver in children, accounting for 5 to 8% of primary hepatic tumors. Very few cases have been reported in the literature. We report the case of a 3-year-old girl who presented with abdominal pain. MRI suggested the diagnosis by revealing a large solid-cystic mass in the right lobe of the liver, and histological examination following a CT-guided biopsy confirmed the diagnosis of mesenchymal hamartoma of the right liver. An extended right hepatectomy including segment IVb was performed. The aim of our article is to describe the diagnostic and therapeutic approach to this very rare liver tumor.

ABSTRACT
Adenocarcinoma of the pancreas (AP) accounts for 90% of pancreatic tumours and is expected to become the second leading cause of cancer deaths in Europe and the United States by 2030. Its incidence has been increasing significantly for several years. The curative treatment of adenocarcinoma of the pancreas until recently relied mainly on surgery, which is only feasible in a limited number of cases due to the high frequency of loco-regional (lymph node and vascular) and metastatic extension, particularly hepatic. Chemotherapy has both curative and palliative indications. In recent years, systemic induction treatment has become the reference for borderline classified tumors. The results of the first prospective randomized phase II studies confirm the interest of a systematic induction treatment. We report the case of a 57-year-old woman, diagnosed with an adenocarcinoma of the head of the pancreas classified as borderline. Induction chemotherapy was performed, followed by reassessment and cephalic duodenal-pancreatectomy surgery. The aim of this work is to present the diagnostic and therapeutic approach adopted for a borderline tumor of the pancreas head.

ABSTRACT
Biliary lesions remain a serious complication of laparoscopic cholecystectomy. Although their reported incidence is less than 0.7%, the actual incidence likely remains underestimated. Some lesions go unnoticed for many years and are only revealed during late complications, such as secondary biliary cirrhosis. In addition, these lesions may incur the surgeon’s medico-legal responsibility. We report the case of a 69-year-old man consulting for cholestatic icterus occurring three months after a cholecystectomy. The MRI confirmed the diagnosis of an E3 type lesion according to the Strasberg classification. After failure of endoscopic treatment, hepatic-jejunal anastomosis was performed. The objective of this observation is to illustrate the different stages and difficulties of managing a complex traumatic lesion of the main biliary tract.

ABSTRACT
Speedboat drivers are known to operate daily under challenging conditions, including prolonged engine vibration, exposure to fuel fumes, amongst others; thus, making it necessary to assess the likely adjustments in the cardiopulmonary profile possibly exerted by these occupational exposures. This cross-sectional observational study was conducted amongst speed boat drivers operating in Port Harcourt, Rivers State, Nigeria. The study used the purposive/snowball sample size techniques to recruit the participants. Precisely 60 consenting subjects were engaged in the study, making up 30 speedboat drivers and 30 non- speedboat drivers. Quantitative data obtained from the study participants were statistically analysed using version 25.0 of the IBM Statistical Product and Service Solutions (SPSS) software. The study found that, the boat drivers were within their productive age (44.60 years) with healthy mean BMI (26.00 ± 9.28 Kg.m2). On changes in cardiovascular indices, the study found significantly (p<0.05) raised systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure levels in the speed boat drivers with higher risks of hypertension. Considering the outcome on electrocardiographic (ECG) changes in the speedboat drivers, it was found that there was a comparatively lower incidences of sinus rhythm with normal ECG features but raised abnormal ECG features. The speed boat drivers also manifested sinus arrhythmia, septal infarct, sinus bradycardia, and many cases of sinus rhythm with abnormal findings. It is thus suggested that, the subjects should be educated or motivated to have good health-seeking attitude in order to avert possible risks of cardiovascular accidents.

ABSTRACT
Hearing is one of the greatest form of communication among living being. Other different form of communications are signs and writing. In the developed world hearing loss has been on the rise due to modernization of the communities all over the planet. This involves heavy industries, airplanes and occupations that produces a lot of noise. This study has shown the magnitude of hearing problems in adult and also associated factors in a particular group. The study has been conducted at referral consultant hospital serving about 8regions of the country. This is analytical cross-sectional study; conducted from Sept 2024 to December 2024. The total number of the study participants was 118 whereby the leading age group to be affected with hearing loss among adults is the age between 50yrs to 59yrs by 23.7% followed by age 30yrs to 39yrs and above 60years by 21.2%.Widowed were leading by 29.7% among the marital status that had highest problem with hearing loss followed by singles 27.1% .Also employees and fishing participants were found to have marked hearing loss compared to other cadres by 22%.The prevalence of hearing loss in adult is found to be 26.3%.Among those diagnosed, mixed hearing loss was the most common type, affecting 14.4% of participants, followed by sensorineural hearing loss at 6.8% and conductive hearing loss at 5.1%. In terms of severity, 10.2% of participants were found to have profound hearing loss, representing the most severe cases. Mild hearing loss was reported in 5.1%, while moderate and severe cases were 4.2% and 6.8%, respectively. These findings indicate delayed detection of the adult hearing loss and highlight the need for early screening, occupational noise control and ototoxic medication monitoring.

ABSTRACT
Background: Sleep is a complex phenomenon that plays a pivotal role in ensuring the optimal functioning of the body, especially in adolescence. Poor-quality sleep among adolescents is a major public health problem and the subject of numerous studies in other parts of the world; however, it remains relatively underexplored in our context. This study aimed to assess sleep quality among adolescents attending schools in urban and semi-urban areas. Methods: This descriptive and analytical cross-sectional study was conducted over seven months. We included all voluntary adolescents aged 10–19 years who had given their written informed consent or that of their legal guardian(s). Our sampling was convenient and consecutive. Data on socio-demographic features and lifestyle were collected, and we used the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale to assess each participant. Univariate and multivariate analyses were performed to identify factors associated with sleep quality. P < 0.05 was considered statistically significant. Results: A total of 952 were selected, including 309 in semi-urban areas and 643 in urban areas. The mean age of the population was 16.33 ± 1.70 years, with 52.0% female participation. Drug consumption was found in 25.3% of participants, and psychoactive substance consumption in 49.9% of participants, with the rates of consumption of these substances being significantly higher in urban areas than in semi-urban areas. Sleep quality was poor in 41.0% of students, 46.3% in urban areas, and 29.3% in semi-urban areas, the prevalence of sleep quality being significantly higher in urban areas (p < 0.001). Insomnia, which was identified in 19.4% of study participants, was the most common sleep disorder in our study population. Independent risk factors for poor sleep quality among students included living in urban areas, age between 17 and 19 years, the female sex, being in the first or last year of school,