ࡱ>           [ bjbj 42ΐΐ0  t z:z:GGGGGGGG8HYTG,R/bAcAcAcKo&p>rrX       $~ P1GBs&p&pBsBs1G G Ac KobbbBsGKoGKo bBs bb oKoМd1'G<0,pZ#ptopGobBsBsBs11bBsBsBs,BsBsBsBspBsBsBsBsBsBsBsBsBsz: F:  SUGICAL SAFETY CHECKLIST Rhiyoma Monique Ogadako, Jocelyne Tedajo. Aim: The aim of this research is to undertake a systematic mapping of systematic reviews which assess the impact of the World Health Organisation Surgical Safety Checklist on communication in the operating room. Methods: A thorough search of electronic databases, a few selected websites for grey literature, and hand searching of journals was undertaken for articles published in English language between 2010 and 2015. Applying the pre-determined inclusion and exclusion criteria to the abstracts of relevant articles, eligible reviews were identified. In addition, there was a citation and reference list search of each included review to identify any other eligible studies. An assessment of the reviews was undertaken using the Weight of Evidence framework developed by the EPPI-Centre (The Evidence for Policy and Practice Information and Co-ordinating Centre) which is part of the Social Science Research Unit at the Institute of Education, University College London. A systematic mapping of the included appraisal was done as the heterogeneity of the reviews prevented the undertaking of a meta-analysis or synthesis of the findings. Results: Four reviews were found to answer the research question and were included herein. They all reported an improvement in communication. However, two of the studies advised caution in the interpretation of their findings. As a result of the heterogeneity of the assessment, the findings of the included reviews could not be combined, instead they were systematically mapped in order to add to the knowledge base and identify areas for further research. Conclusion: The evidence supporting the claims of improvement in communication in the operating room with the use of the WHO SSC is weak. There is an indication for further research to evaluate the impact of the WHO SSC on communication in the operating room. LISTE DE CONTROLE DE LA SECURITE CHIRURGICALE Rhiyoma Monique Ogadako (UK), Jocelyne Tedajo (UK) Objectifs: Lobjectif de la prsente recherche est de procder une cartographie systmatique des revues systmatiques qui valuent limpact de la Liste de contrle de la scurit chirurgicale de lOrganisation mondiale de la Sant sur la communication au bloc opratoire. Mthodes: Nous avons recherch des articles publis en langue anglaise entre 2010 et 2015 travers une fouille minutieuse des bases de donnes lectroniques, sur quelques sites choisis de littrature grise, et par une lecture des revues en format papier. Lapplication de critres prdtermins dinclusion et dexclusion aux rsums darticles pertinents a permis didentifier les revues ligibles. En outre, il y avait une cl de recherche par une citation et par une liste de rfrence pour chaque nouvelle revue ajoute afin didentifier dautres revues recevables. Une valuation des revues a t effectue laide de lanalyse du poids de la preuve labor par lEPPI-Centre (Centre d'information et de coordination de la politique et de la pratique fondes sur des donnes probantes qui fait partie du Service de Recherche en Sciences sociales de lInstitute of Education, University College London). Une cartographie systmatique des revues inclues a t ralise car lhtrognit des revues a empch deffectuer une mta-analyse ou une synthse des rsultats. Rsultats: Nous avons trouv que quatre revues rpondaient la question de recherche et elles ont t inclues dans cette recherche. Toutes faisaient tat dune amlioration dans la communication. Toutefois, deux des tudes ont recommand la prudence dans linterprtation de leurs rsultats. En raison de l'htrognit des revues, les conclusions des revues ajoutes ne pouvaient pas tre mises ensemble; en revanche, elles ont t systmatiquement cartographies afin daccroitre la base de connaissances et didentifier les domaines de recherche ultrieurs. Conclusion: Il existe peu de preuves visant corroborer lide dune amlioration de la communication au bloc opratoire grce lutilisation de la liste de contrle de la scurit chirurgicale de lOMS. Il y a une indication de poursuivre les recherches afin dvaluer l'impact de la liste de contrle de la scurit chirurgicale de l'OMS sur la communication dans la salle dopration. OUTCOME OF FEEDING ENTEROSTOMY FOR NUTRITIONAL REHABILITATION IN DYSPHAGIA Anumenechi N, Edaigbini S.A, Aminu M.B, Delia I.Z Cardiothoracic unit, Surgery department, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria Background: feeding enterostomy is used to build up patients with dysphagia by definitive surgery. Objective: to evaluate the achievement of nutritional goals in dysphagia patients and to suggest management protocols. Methodology: A retrospective study of feeding enterostomies for dysphagia over 4 years. The preoperative, postoperative weights and progression to definitive esophageal replacement were analyzed. Results: There were 34 patients, records were available for 29 patients, ages ranged from 1.5 to 90 years, mean age was 29.7years, and male to female ratio was 3:7 The causes of dysphagia were corrosive esophageal stricture-12, esophageal cancer-13, pharyngeal tumor-3 and mediastinal mass 1. The duration of symptoms ranged from 3 weeks to 106 weeks (mean 26.4 weeks). Preoperative weight ranged from 6.2 68 kg (mean 24.1kg), postoperative weight was between 7 65 kg (mean 25.7kg); follow up period ranged from 0.5 to 12 months (mean 3.2 months), weight gain was negative for those who had their last weight check by 6 weeks post op (p value 0.057). 15 patients (52%) proceeded to have definitive esophageal replacement surgery. Conclusion: Feeding enterostomy was successful in nutritional rehabilitation of dysphagia patients and 6 weeks may be required to appreciate positive weight gain. There is a need for standard protocols for better management and follow-up of these patients. RESULTATS DE LA GASTRO-ENTEROSTOMIE POUR LA REHABILITATION NUTRITIONNELLE DES PATIENTS ATTEINTS DE DYSPHAGIE Anumenechi N, Edaigbini S.A, Aminu M.B, Delia I.Z Contexte: La gastro-entrostomie est utilise pour la rhabilitation nutritionnelle des patients atteints de dysphagie en attente de la chirurgie dfinitive. Objectif: Evaluer latteinte des objectifs nutritionnels chez les patients atteints de dysphagie et proposer des protocoles de prise en charge. Mthodologie: Etude rtrospective concernant tous les patients atteints de dysphagie ayant bnfici dune gastro-entrostomiesur une priode de 4 ans. Le poids pr et post-opratoire et lvolution jusquau remplacement de lsophage ont t analyss. Rsultats: Il y avait 34 patients avec des dossiers mdicaux disponibles pour 29 patients. Lgevariait de 1.5 90 ans avec un ge moyen de 29,7ans, et le ratio homme/femme tait 3:7. Les causes de la dysphagie taient; la stnose caustique de lsophage (n=12), le cancer de l'sophage (n=13), la tumeur du pharynx (n=3) et la masse mdiastinale (n=1). Le poids moyen en propratoire tait 24,1kg (6,2 - 68) et de 25,7kg (7 - 65) en post-opratoire. Avec un suivi moyen de 3,2 mois (0,5 -12) le gain pondral tait ngatif pour ceux qui ont eu leur dernirepese 6 semaines postopratoire (p=0,057). Le remplacement dfinitif de lsophage avait t ralis dans 52% (n=15) des cas. Conclusion: La gastro-entrostomie permet la rhabilitation nutritionnelle des patients atteints de dysphagie. Un dlai de six semaines est ncessaire pour apprcier le gain pondral. Llaboration de protocoles standards amliorerait la prise en charge et le suivi de ces patients. LAPAROSCOPIC REMOVAL OF A MIGRATED INTRAUTERINE DEVICE EMBEDDED IN THE ANTERIOR ABDOMINAL WALL: A CASE REPORT IN YAOUNDE, CAMEROON Nana Oumarou B, Bang Ga, Ekani Boukar Ym, Savom Ep, Ousmana O, Essomba A, Sosso M. Backround: Uterine perforation is a serious complication which can happen after intrauterine device (IUD) insertion. Following the uterine rupture, an IUD may migrate into gynecologic, urinary or gastro-intestinal system organs. There are many reports of migrated IUDs but fewer report of IUDs embedded in the abdominal wall. Laparoscopic removal of a migrated IUD wasnt yet described in our country. Case presentation: Herein we report a case of a 32-year-old Cameroonian woman who was presented to our gynecologic unit for a follow-up visit 3 months after uncomplicated IUD insertion. During vaginal examination, the IUD string wasnt found. Abdominal CT-scan showed the IUD embedded in the anterior abdominal wall. Through a laparoscopic approach, the device was removed and the post-operative course was uneventful. Conclusion: Surgical removal of a migrated IUD reduces the possible risks of abdominal complications. The laparoscopic approach for migrated IUD removal may be simple and safe even in developing countries, such as Cameroon. Surgeons should be aware of this approach. Key-words: Intrauterine device Migration Laparoscopy Cameroon. RETRAIT LAPAROSCOPIQUE DU DISPOSITIF INTRA-UTERIN APRES MIGRATION DANS LA PAROI ABDOMINALE ANTERIEURE: RAPPORT DE CAS A YAOUNDE (CAMEROUN) Bang Ga, Nana Oumarou, Ekani Boukar Ym, Savom Ep, Ousmana O, Essomba A, Sosso M. Contexte : La perforation de lutrus est une complication grave pouvant survenir aprs insertion dun dispositif intra-utrin (DIU). Aprs la rupture de lutrus, le DIU peut migrer vers les organes de lappareil gnital, urinaire ou digestif. Plusieurs cas de migration du DIIU ont t rapports mais peu de cas de DIU coincs dans la paroi abdominale. Le retrait par clioscopie dun DIU qui sest dplac navait pas encore t document dans notre pays. Prsentation de cas : Nous rapportons ici le cas dune Camerounaise de 32 ans qui sest prsente dans notre service de gyncologie pour une visite de contrle trois mois aprs insertion sans complications dun DIU. Lors de lexamen vaginal, le fil du strilet na pas t retrouv. Le scanner abdominal a rvl que le DIU stait coinc dans la paroi abdominale antrieure. Le dispositif a t retir par clioscopie et lintervention sest droule sans incidents. Conclusion : Le retrait par clioscopie dun DIU qui sest dplac rduit les risques ventuels de complications abdominales. Le retrait par clioscopie du DIU dplac peut tre simple et sre mme dans les pays en dveloppement comme le ntre. Les chirurgiens doivent intgrer cette technique. Mots-cls : Dispositif inra-utrin Migration coelioscopie Cameroun. EXTREMITY ULCERS SECONDARY TO PENTAZOCINE ABUSE Abikoye FO, Ayoade OA, Hassan AS, DrLawal MA, Egbeogu DC Department of Burns & Plastic Surgery, National Orthopaedic Hospital Igbobi, Lagos, Nigeria Email Address: tabikoye@yahoo.com Background: Pentazocine is a readily available opioid like analgesic. There has been an increase in the number of patients seen with pentazocine abuse with complications. A high index of suspicion is required. The skin is the tissue most evidently affected in drug addiction. When peripheral veins are sclerosed or inaccessible, the subcutaneous tissue and muscle are injected. Patient injects into thighs, forearms and buttocks under non sterile conditions.'Woody' cutaneous fibrosis with a background history of chronic pain is pathognomonic for pentazocine abuse. Objectives: To show our experience in the management of ulcers that develop following abuse and addiction of pentazocine, diagnostic clinical features, challenges in managing addicts and the way forward. Method: 4 patients who had easy access to pentazocine are presented. They persistently abused parenteral pentazocine by indiscriminately injecting both thighs in unsterile circumstances until they developed extensive necrotizing fasciitis and muscle necrosis. They were co-managed with the psychiatrist. They were admitted for inpatient wound care and investigations. Some challenges were encountered in their management. Results: They were females between 31-42 years, 3 patients had HbSS while 2 were health workers. Dose administered range between 360mg and 700mg/day. Duration of ulceration ranged from 10 months to 2 years. NPWT significantly improved their wounds. Conclusion: Pentazocine is a drug which is abused by patient with chronic pain. Obvious and extensive tissue loss is not a deterrent factor to further abuse. There is need for modification of the use of pentazocine and possibly should be a controlled prescription medication. ULCERES DES EXTREMITES LIES A LABUS DE LA PENTAZOCINE Abikoye FO, Ayoade OA, Hassan AS, Lawal MA, Egbeogu DC Department of Burns & Plastic Surgery, National Orthopaedic Hospital Igbobi, Lagos, Nigeria Email Address: HYPERLINK "mailto:tabikoye@yahoo.com"tabikoye@yahoo.com Contexte: La pentazocine est un opiode facilement accessible comme analgsique. On a observ une augmentation du nombre de patients ayant des antcdents dabus de pentazocine et des complications. Un indice lev de suspicion simpose. La peau est videmment le tissu le plus affect dans les cas de dpendance la drogue. Lorsque les veines priphriques sont sclroses ou inaccessibles, la drogue est administre par le tissu sous-cutan et les muscles. Le patient sinjecte dans les cuisses, lavant-bras et les fesses dans des conditions non striles. La fibrose cutane aux aspects ligneux avec des antcdents de douleur chronique est pathognomonique de labus de la pentazocine. Objectifs: Montrer notre exprience dans la prise en charge des ulcres lis labus et la dpendance la pentazocine, les caractristiques cliniques diagnostiques, les dfis de la prise en charge des toxicomanes et les perspectives davenir. Mthodologie: 4 patients qui avaient un accs facile la pentazocine se sont prsents. Ils ont administr sans interruption et par voie parentrale la pentazocine en sinjectant sans distinction les deux cuisses dans des conditions non striles jusqu' ce qu'ils dveloppent une fasciite ncrosante et une ncrose musculaire grave. Ils ont t pris en charge par un psychiatre ethospitaliss pour soins de blessures et enqutes. Certaines difficults ont t observes pendant la prise en charge. Rsultats: Il sagissait de femmes ges de 31 42 ans. 3 patientes prsentaient une HbSS tandis que 2 taient personnels de sant. La dose administre variait entre 360 mg et 700 mg/jour. La dure de l'ulcration allait de 10 mois 2 ans. La TPN a considrablement amlior leurs blessures. Conclusion: La pentazocine est une drogue utilise abusivement par les patients souffrant de douleur chronique. La perte vidente et grave de tissus nest pas un facteur dissuasif contre dautres abus. Il est ncessaire de revoir lutilisation de la pentazocine et de ne dlivrer ce mdicament que sur ordonnance. DRAINING PERICARDIAL EFFUSION IN PATIENTS WITH CONSTRICTIVE PERICARDITIS: A NEED FOR CAUTION Anumenechi, N; Edaigbini S.A; Aminu M, B; Delia I, Z Institution: Cardiothoracic unit, Surgery department, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria Background: Constrictive pericarditis is usually associated with ascites, hepatomegaly and pleural effusion. The usual practice is to relieve the respiratory distress caused by the pleural effusion, before surgical management of the pericardial constriction. Renal failure can complicate this protocol Objectives: To report the occurrence of perioperative renal failure in patients with constrictive pericarditis, who got tube thoracostomy before pericardiectomy. Methodology: This is a retrospective report of constrictive pericarditis patients who had post tube thoracostomy renal failure. Results: 3 patients had renal failure post tube thoracostomy S.D, a 28-year-old female who had a left tube thoracostomy that drained 3.7 liters of pus over 48 hours. She developed acute renal failure, and she died on the 6th day post tube thoracostomy. H.M, a 40-year-old female who had a right tube thoracostomy that drained 2.3 liters of effusion over 72 hrs. She went into acute renal failure, but she was successfully managed. U.M, a 37-year-old male, who had subxyphoid tube pericardiostomy and right tube thoracostomy simultaneously. Tube thoracostomy was slowly drained; he however went into acute renal failure, which was successfully managed. He eventually had a successful pericardiectomy. Conclusion Drainage of pleural effusion in patients with constrictive pericarditis can be complicated by acute renal failure. Caution should be exercised in the management of such patients. DRAINAGE DE LEPANCHEMENT PERICARDIQUE CHEZ LES PATIENTS ATTEINTS DE PERICARDITE CONSTRICTIVE: LA PRUDENCE EST DE MISE Anumenechi N, Edaigbini SA, Aminu MB, Delia IZ Cardiothoracic unit, Surgery department, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria Contexte: Le drainage de l'panchement pleural chez les patients atteints pricardite constrictive peut entraner une insuffisance rnale Objectifs: Attirer lattention des praticiens sur la possibilit de survenue d'une insuffisance rnale peropratoire chez les patients atteints de pricardite constrictive, ayant bnfici dun drainage pleural avant la pricardectomie. Mthodologie: Etude rtrospective portant sur tous les cas de patients prsentant une insuffisance rnale aprs la pose dun drain thoracique. Rsultats: nous avons retenus 3 patients; 1. SD, une femme de 28 ans qui avait eu un drainage pleural gauche ramenant 3,7 L de pus en 48 heures. Elle est dcde 6 jours plus tard dans un tableau dinsuffisance rnale aigue. 2. HM, patiente de 40 ans, chez qui avait t pos un drain pleural droit ramenant 2.3L en 72heures. Elle avait prsent une insuffisance rnale aigu, qui a t prise en charge avec succs. 3. UM, un homme de 37 ans, qui avait bnfici simultanment dune pericardiostomie et dun drainage pleural droite. Lpanchement pleural a t lentement vid; nanmoins il a prsent une insuffisance rnale aigu, qui a tgre avec succs. La pricardectomie avait t ralise avec des suites simples. Conclusion: le drainage de l'panchement pleural chez les patients prsentant une pricardite constrictive devrait tre fait avec prudence LAPAROSCOPY USING ROOM AIR INSUFFLATION IN A RURAL SETTING THE BONGOLO HOSPITAL EXPERIENCE Faniriko, MB, Niyukuri A , OConnor J, Thelander K., Thompson D, Park, A, OConnor Z. Presenter: Alliance Niyukuri, MD Email:  HYPERLINK "mailto:niallinace5@gmail.com"niallinace5@gmail.com Bongolo Hospital, Lebamba, Gabon. Backround/Objective: Laparoscopy offers several advantages over open surgery. Carbon dioxide (CO2) is the standard insufflation gas used for laparoscopy. The cost and availability of CO2 in Low and Middle Income Countries limits its widespread utilization. We evaluated the use of atmospheric room air insufflation during laparoscopy at our institution to evaluate the safety profile as well as associated intraoperative and postoperative complications. Methodology: All laparoscopic cases performed at our hospital between January 2006 and December 2013 were identified. Demographic and perioperative information was collected. Insufflation was achieved with a standard air compressor using filtered air and an insufflation regulator. All cases were evaluated for intraoperative events as well as post-operative complications. Results: A total of 368 laparoscopic procedures were performed in the studied period; of which the majority were gynecologic (43%), others were diagnostic laparoscopy 23%, cholecystectomy 23%, appendectomie 6%, ventral hernia 3%. There was a 2% complication rate with one perioperative death. The complications related to insufflation were episodes of hypotension. No intracorporeal thermal events were observed despite the use of diathermy. The other complications and the death were not clearly tied to insufflation with air. Conclusion: A wide array of laparoscopic procedures were safely performed using room air insufflation. The low cost and ready availability of room atmospheric air provides a viable and safe alternative for surgeons in low resource settings to perform laparoscopy. Prospective studies comparing this method to CO2 insufflation are warranted. Key words: laparoscopy, room air insufflation, rural surgery RETRAIT LAPAROSCOPIQUE DU DISPOSITIF INTRA-UTERIN APRES MIGRATION DANS LA PAROI ABDOMINALE ANTERIEURE: RAPPORT DE CAS A YAOUNDE (CAMEROUN) Nana Oumarou B, Bang Ga, Ekani Boukar Ym, Savom Ep, Ousmana O, Essomba A, Sosso M. Presenter : Dr BANG Guy Aristide Contexte: La perforation de lutrus est une complication grave pouvant survenir aprs insertion dun dispositif intra-utrin (DIU). Aprs la rupture de lutrus, le DIU peut migrer vers les organes de lappareil gnital, urinaire ou digestif. Plusieurs cas de migration du DIIU ont t rapports mais peu de cas de DIU coincs dans la paroi abdominale. Le retrait par clioscopie dun DIU qui sest dplac navait pas encore t document dans notre pays. Prsentation de cas: Nous rapportons ici le cas dune Camerounaise de 32 ans qui sest prsente dans notre service de gyncologie pour une visite de contrle trois mois aprs insertion sans complications dun DIU. Lors de lexamen vaginal, le fil du strilet na pas t retrouv. Le scanner abdominal a rvl que le DIU stait coinc dans la paroi abdominale antrieure. Le dispositif a t retir par clioscopie et lintervention sest droule sans incidents. Conclusion : Le retrait par clioscopie dun DIU qui sest dplac rduit les risques ventuels de complications abdominales. Le retrait par clioscopie du DIU dplac peut tre simple et sre mme dans les pays en dveloppement comme le ntre. Les chirurgiens doivent intgrer cette technique. Mots cls : Dispositif inra-utrin Migration coelioscopie Cameroun. SURGICAL WORKFORCE AND SURGICAL PROVIDER PRODUCTIVITY IN SIERRA LEONE: A NATIONAL INVENTORY Authors: Hkon A. Bolkan (1, 2), Lars Hagander (3), Johan v. Schreeb (4) Donald Bash-Taqi (5), Thaim B. Kamara (6), yvind Salvesen (1), Arne Wibe (1) Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, PO Box 8905, N-7491 Trondheim, Norway. Email: hakon.a.bolkan@ntnu.no institutions: 1. Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway 2. CapaCare, Norway 3. Pediatric Surgery and Global Pediatrics, Department of Pediatrics, Clinical Sciences Lund, Lund University, Sweden 4. Systems Research and Health Management Group, Karolinska Institutet, Stockholm, Sweden 5. Ministry of Health and Sanitation, Freetown, Sierra Leone 6. Department of Surgery, Connaught Hospital and College of Medicine Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone Background: Limited data is available on providers of surgical procedures and the impact of their interventions in low income countries. Goals: The objective of this study was to evaluate the distribution and productivity of all providers of surgical procedures in low-income countries, and to assess the correlation between the availability of the surgical practice, productivity ratesand the volume of surgical procedures in the districts and hospitals. Methodology: Using the available log books and interviews with key persons between January and May 2013, data was collected on surgical procedures and their providers in 56 (93.3%) of the 60 health facilities which practiced surgeryin Sierra Leone in 2012. Results: In Sierra Leone there were 164 full-time surgical posts, representing 2.7 providers of surgical procedures per 100,000 inhabitants.Non-specialists performed 52.8% of overall procedures.In rural areas, the density of specialists and medical doctors was respectively 26.8 and 6.3 times lower than in urban areas.Average individual productivity was 2.8 surgeries per week.A great variation was observed between the groups of surgical providers and locations.Excluding four centers where only ophthalmic surgery was proposed, there was a positive correlation between the surgical volume of a facility and the productivity of its providers (rs = 0.642, p <0.001). Conclusion: Less than half of surgical procedures in Sierra Leone are performed by specialists. Surgical providers are considerably more productive in health facilities with higher surgical volumes.If all suppliers had the productivity of specialists in the non-profit making private sector (5.1 procedures / week), the national surgical volume will increase by 85%. LA LAPAROSCOPIE DANS LES ZONES RURALES AVEC INSUFFLATION DE L'AIR-CAS DE LHPITAL DE BONGOLO Faniriko MB, Niyukuri A, OConnor J, Thelander K., Thompson D, Park A, OConnor Z. Presenter: Alliance Niyukuri, MD Email:niallinace5@gmail.com Bongolo Hospital, Lebamba, Gabon. Contexte/Objectif: La laparoscopie comporte un avantage par rapport la chirurgie ouverte. Le CO2 est le gaz standard dinsufflation en chirurgie laparoscopique. Le cot et la non-disponibilit du CO2 dans les pays ressources limit son utilisation. Nous avons valus linsufflation avec lair atmosphrique pendant la laparoscopie au sein de notre institution afin dvaluer la scurit et complications intra et post opratoires. Mthodologie: Tous les cas laparoscopiques raliss de Janvier 2006 Dcembre 2013 ont ts identifis. Les donnes dmographiques et peropratoires ont t collectes. Nous avons valus linsufflation avec lair ambiante en chirurgie laparoscopique au sein de notre institution afin danalyser sa scurit mais aussi les complications intra et postopratoires. Rsultats: Au total, 368 cas coelioscopiques ont t raliss dans la priode de notre tude, la majorit ayant t gyncologique (43%), mais aussi des cas de laparoscopie diagnostique (23%), cholcystectomie (23%), appendectomie (6%) et hernie icisionelle(3%). Le taux de complications tait de 2% avec un cas dcs en peropratoire. Les complications lies linsufflation taient des pisodes dhypotension. Pas daccidents thermiques intracorporels observs avec lutilisation de la cauterie. Dautres complications, incluant le dcs navaient pas de lien clair avec linsufflation avec lair. Conclusion: Un large spectre dinterventions laparoscopiques ont t ralises sans danger par linsufflation avec lair ambiante. Le cout rduit, et la disponibilit de lair atmosphrique fait de son usage une alternative viable, scurise pour les chirurgiens uvrant dans une zone ressources limites. Une tude prospective comparant cette mthode linsufflation avec le CO2 est recommande. Mots Cls: laparoscopie, insufflation avec lair, chirurgie ciel ouvert. SURGICAL SITE INFECTIONS IN THE SURGICAL DEPARTMENT OF SIKASSO HOSPITAL Maga A, Togo A, Kant L, Traor A, Diakit I, Dembl BT, Diallo G. Background: Surgical site infection is a major postoperative issue in surgery. We sought to determine the hospital incidence, risk factors, germs and their sensitivity, and the consequences of surgical site infections. Objective: Our prospective study lasted twelve months from 1 June 2010 to 31 July 2011, and involved all patients operated and admitted to hospital in the department. The criteria used were those laid down by CDC, Atlanta. Methodology: We registered 407 patients, including 241(59.2%) emergency cases. The mean age was 34.65 years (ranging from 1 to 99 years, AND: 18.46), with a 1.32 sex ratio. According to Altmeier, the infective risk included 45.2% type I, 11.5% type II, 19% type III, and 24.3% type IV. As for NNISS, 126 (31%) were NNISS 0, 172 (42.3%) NNISS 1, 105 (25.8%) NNISS 2, and 4 (1%) NNISS 3. According to Altmeiers class of infective risk, the ISO rate stood at 5.9% representing 7 out of 135 patients for type I; 10.6% representing 7 out of 66 patients for type II; 12.4% representing 12 out of 97 patients for type III; 31.2% representing 34 out of 109 patients for type IV. According to the NNISS score, the infective risk was evaluated with the following findings: 5.07% forscore 0; 21% for score 1; 25.8% for score 2; and 44.4% for score 3. Bacteriology was dominated by Escherichia coli (25%), Staphylococus aureus (10%), and Klebsiella pneumonia (10%). The most active antibiotics were cephalosporins, aminoglycosides, and quinolones with 80 to 100%; 75 to 100%; and 50 to 100% respectively. ISO extended hospital stay by 12.3 days on average, being 3.08 times longer than for non-infectious cases. Conclusion: ISO consequences are serious, and prevention should be emphasized. Key words: Infection, Surgery, Microbiology, Sikasso Hospital MAIN DUVRE CHIRURGICALE ET RENDEMENT DES PRESTATAIRES DE SOINS CHIRURGICAUX EN SIERRA LEONE: UN ETAT DES LIEUX NATIONAL Hkon A. Bolkan (1, 2), Lars Hagander (3), Johan v. Schreeb (4) Donald Bash-Taqi (5), Thaim B. Kamara (6), yvind Salvesen (1), Arne Wibe (1) Address of presenting author: Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, PO Box 8905, N-7491 Trondheim, Norway. Email: hakon.a.bolkan@ntnu.no institutions: 1. Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway 2. CapaCare, Norway 3. Pediatric Surgery and Global Pediatrics, Department of Pediatrics, Clinical Sciences Lund, Lund University, Sweden 4. Systems Research and Health Management Group, Karolinska Institutet, Stockholm, Sweden 5. Ministry of Health and Sanitation, Freetown, Sierra Leone 6. Department of Surgery, Connaught Hospital and College of Medicine Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone Contexte: On sait peu concernant les prestataires de soins chirurgicaux et la porte de leurs interventions dans des pays faible revenu. Objectifs: L'objectif de cette tude tait d'valuer la rpartition et le rendement de tous les prestataires de soins chirurgicaux dans un pays faible revenu, et d'valuer la corrlation entre la disponibilit de main duvre chirurgicale, le taux de rendement et le volume d'actes chirurgicaux au niveau des districts et des hpitaux. Mthodologie: A l'aide de cahiers de bord disponibles et d'entretiens avec des personnes ressources, entre janvier et mai 2013 des donnes ont t recueillies sur les actes chirurgicaux et leurs prestataires dans 56 (93.3%) des 60 structures sanitaires qui pratiquaient la chirurgie en Sierra Leone en 2012. Rsultats: En Sierra Leone il y avait 164 postes de chirurgien plein-temps, reprsentant 2,7 prestataires de soins chirurgicaux pour 100.000 habitants. 52.8% de toutes les interventions taient effectues par les non-spcialistes. En zones rurales, la densit de spcialistes et de mdecins tait respectivement 26,8 et 6,3 fois plus faible quen zones urbaines. La productivit moyenne individuelle tait de 2,8 interventions chirurgicales par semaine. Une grande variation a t observe entre les groupes de prestataires de soins chirurgicaux en fonction des lieux. En excluant quatre centres o uniquement la chirurgie ophtalmique tait propose, il y avait une corrlation positive entre le volume chirurgical d'un tablissement et le rendement de ses prestataires de soins chirurgicaux (rs = 0.642, p < 0.001). Conclusions: Moins de la moiti des interventions chirurgicales en Sierra Leone sont pratiques par des spcialistes. Les prestataires de soins chirurgicaux sont considrablement plus productifs dans les structures sanitaires avec des volumes de chirurgie plus levs. Si tous les prestataires avaient le rendement des spcialistes du secteur priv but non lucratif (5,1 actes/semaine), le volume national de chirurgie augmenterait de 85%. LAPAROSCOPIC DRAINAGE OF LIVER ABSCESSES IN YAOUNDE (CAMEROON): EARLY REPORT. Nana Oumarou B, Bang Ga, Savom Ep, Ekani Boukar Ym, Ousmana Oumarou, Essomba A, Sosso M. PRESENTER: Dr NANA OUMAROU Blondel Background: Percutaneous drainage with antibiotic therapy is considered as standard treatment of liver abscesses, but surgical drainage may be indicated in selected patients, laparoscopy being the best approach in such cases. However this approach still remain marginal in our country. Objectives: To evaluate safety and efficacy of laparoscopic drainage of liver abscesses in our service. Materials and Methods: We conducted a retrospective analysis of laparoscopic liver abscesses drainage in the visceral and laparoscopic surgery unit of the National Social Insurance Fund Health center of Yaound (CAMEROON) from January 2010 to August 2015. Results: Seven patients were recorded among whom were 4 men. Their mean age was 42.1 years-old. By using 3 ports, we were able to drain all abscesses and no conversion to open surgery was noticed. The mean operative time was 43.5 min. With a mean follow-up period of 28.8 months, no residual abscess was found. Conclusion: Laparoscopic drainage of liver abscesses in selected patients is safe and reproducible. It should be emphasized even in developing countries as our own. Key-Words: Liver abscess- Laparaoscopic drainage- Cameroon. INFECTION DU SITE OPERATOIRE DANS LE SERVICE DE CHIRURGIE DE LHOPITAL DE SIKASSO Maga A, Togo A, Kant L, Traor A, Diakit I, Dembl BT, Diallo G. Linfection du site opratoire constitue un problme majeur en postopratoire en chirurgie. Nos objectifs taient de dterminer la frquence hospitalire, les facteurs de risque, les germes responsables et tester leur sensibilit, les consquences engendres par les infections du site opratoire. Nous avons ralis une tude prospective de 12 mois du 1er Juin 2010 au 31 Juillet 2011, incluant tous les malades oprs et hospitaliss dans le service. Les critres ont t ceux dfinis par le CDC dAtlanta. Nous avons enregistr 407 malades dont 241(59,2%) cas durgences, et 166 (40,8%) froid; lge moyen tait de 34,65 ans (extrmes de 1 et 99 ans, ET: 18,46), le sex ratio de 1,32. Le risque infectieuxselon Altmeier a trouv 45,2% de type I, 11,5% de type II, 19% de type III, et 24,3% de type IV; selon NNISS, 126 (31%) taient NNISS 0; 172 (42,3%) NNISS 1; 105 (25,8%) NNISS 2; et 4 (1%) NNISS 3. Selon la classe de risque infectieux dAltmeier, le taux dISO a t de 5,9% soit 7 sur 135 malades pour le type I; 10,6% soit 7 sur 66 malades pour le type II; 12,4% soit 12 sur 97 malades pour le type III; 31,2% soit 34 sur 109 malades pour le type IV. Selon le score de NNISS, le risque infectieux a t valu et a trouv 5,07% pour le score 0; 21% pour le score 1; 25,8% pour le score 2; et 44,4% pour le score 3. La bactriologie a t domine par Escherichia coli (25%), Staphylococus aureus (10%), et Klebsiellapneumoniae (10%). Les antibiotiques les plus actifs ont t les cphalosporines, les aminosides, et les quinolones avec respectivement 80 100%; 75 100%; 50 100%. Le sjour hospitalier a t prolong de 12,3 jours en moyenne par lISO soit 3,08 fois suprieure ceux non infectieux. Conclusion: Les consquences de lISO restent graves, laccent doit tre mis sur sa prvention. Mots cls: Infection, Chirurgie, Microbiologie, Hpital de Sikasso LAPAROSCOPIC MANAGEMENT OF GENERALIZED PERITONITIS: OUR RESULTS AFTER 18 CASES IN YAOUNDE (CAMEROON). Nana Oumarou B, Bang Ga, Ekani Boukar Ym, Savom Ep, Ousmana O, Essomba A, Sosso M. Presenter: BANG Guy Aristide Background: Until now, laparoscopic management of generalized peritonitis is still controversial, some authors are considering peritonitis as contra-indication of laparoscopy. Objectives: To evaluate safety and efficacy of laparoscopic management of generalized peritonitis in our service. Materials and Methods: Prospectively, from January 2010 to August 2015, all patients with generalized peritonitis, hemodynamically stable, seen within the 48 hours following the first symptoms, aged between 15 to 50 years-old with no comorbidities were operated through a laparoscopic approach. Results: We included 18 patients among whom, 11 were men. Their mean age was 32.1 years-old. The etiology of peritonitis was complicated appendicitis (14 cases), perforated duodenal ulcer (3 cases) and jejunal perforation (1 case). Two cases (11.11%) were converted to open surgery. For the 16 procedures conducted totally by laparoscopy, the mean operative time was 155.4 min. Postoperatively one of such patients presented a residual abscess which required a laparotomy. The mean length of hospitalization was 6.3 days. Conclusion: Laparoscopic management of acute generalized peritonitis in carefully selected patients is feasible and effective. Key-Words: Generalized peritonitis Laparoscopy - Cameroon. DRAINAGE LAPAROSCOPIQUE DES ABCS DU FOIE A YAOUNDE (CAMEROUN): RAPPORT PRLIMINAIRE Nana Oumarou B, Bang Ga, Savom Ep, Ekani Boukar Ym, Ousmana Oumarou, Essomba A, Sosso M. Presenter : Dr NANA OUMAROU Blondel Contexte : Le drainage percutan associ une antibiothrapie est considr comme le traitement standard des abcs du foie. Mme si le drainage chirurgical peut tre indiqu chez certains patients, la laparoscopie est la meilleure approche dans de tels cas bien quelle demeure marginale dans notre pays. Objectifs: valuer linnocuit et lefficacit du drainage laparoscopique des abcs du foie dans notre service. Matriels et Mthodes: Nous avons effectu une analyse rtrospective du drainage laparoscopique des abcs du foie effectu au Service de chirurgie viscrale et laparoscopiquede lHpital de la Caisse national de prvoyance sociale de Yaound (CAMEROUN) de janvier 2010 aot 2015. Rsultats: Sept patients ont t enregistrs parmi lesquels 4 hommes. Leur ge moyen tait de 42,1 ans. A laide de 3 ports, nous avons pu drainer tous les abcs et aucune conversion la chirurgie ouverte na t observe. La dure opratoire moyenne tait de 43,5 minutes. Avec une priode moyenne de suivi de 28,8 mois, aucun abcs rsiduel na t trouv. Conclusion: Le drainage laparoscopique des abcs du foie chez des patients slectionns est une technique sre et reproductible, mme dans les pays en dveloppement comme le ntre. Mots cls: Abcs du foi- drainage laparoscopique - Cameroun. LAPAROSCOPIC TREATMENT OF PURULENT CHOLECYSTITIS: ILLUSION OR REALITY? ABOUT 5 CASES IN YAOUNDE (CAMEROON) NANA OUMAROU B, BANG GA, SAVOM EP, ESSOMBA R, EKANI BOUKAR YM, OUSMANA O, ESSOMBA A, SOSSO M. Prsentateur : Dr BANG Guy Aristide Background: Purulent Cholecystitis is often considered by most authors as contra-indication of laparoscopic cholecystectomy and its discovery following a laparoscopy implies a conversion. Objectives: Assess the feasibility and efficiency of laparoscopic cholecystectomy in case of purulent Cholecystitis. Materials and Methodology: Retrospectively, records of patient who underwent laparoscopic cholecystectomy for purulent Cholecystitis in our service from January 2010 to August 2015 were recorded. Results: Five records were collected including 4 women and 1 man. The average age was 45.8 years. Using 4 trocars we could perform laparoscopic cholecystectomy in all cases. In the 4 cases, the cystic duct underwent intra-corporeal suturing. A tubular drainage of the cystic duct was performed in all cases. No complications were recorded. Hospitalization lasted 4 days in all cases. Conclusion: Laparoscopic cholecystectomy in the case of purulent Cholecystitis is feasible and effective. Keywords: Purulent Cholecystitis - Cholecystectomy-Laparoscopy- Cameroon PRISE EN CHARGE LAPAROSCOPIQUE DE LA PRITONITE GNRALISE: NOS RSULTATS APRS 18 CAS YAOUND (CAMEROUN) Nana Oumarou B, Bang Ga, Ekani Boukar Ym, Savom Ep, Ousmana O, Essomba A, Sosso M. Presenter: BANG Guy Aristide Contexte: ce jour, le traitement de la pritonite gnralise par voie coelioscopique fait encore lobjet de controverses, certains auteurs considrant la pritonite comme une contre-indication pour la clioscopie. Objectifs: valuer la scurit et l'efficacit de la prise en charge de la pritonite gnralise par voie laparoscopique dans notre service. Matriels et mthodes: De faon prospective, de janvier 2010 aot 2015, tous les patients souffrant de pritonite gnralise, stables sur le plan hmodynamique, vu dans les 48 heures suivant lapparition des premiers symptmes, gs de 15 50 ans sans comorbidits ont t oprs par laparoscopie. Rsultats: Ltude a concern 18 patients dont 11 hommes. La moyenne dge tait de 32,1 ans. Ltiologie de la pritonite tait: appendicite complique (14 cas), ulcre duodnal perfor (03 cas) et perforation jjunale (01 cas). Deux cas (11,11%) ont t convertis la chirurgie ouverte. Pour les 16 procdures totalement excutes par clioscopie, le temps opratoire moyen tait 155,4 minutes. Aprs lopration, un de ces patients prsentait un abcs rsiduel qui a ncessit une laparotomie. La dure moyenne d'hospitalisation tait de 6,3 jours. Conclusion: La prise en charge laparoscopique de la pritonite gnralise aigu chez des patients soigneusement choisis est ralisable et efficace. Mots cls: Pritonite gnralise - laparoscopie - Cameroun. GS 012 PREVALENCE OF INGUINAL HERNIA IN ADULT MEN IN THE ASHANTI REGION OF GHANA Michael Ohene-Yeboah, Jessica H. Beard, Benjamin Frimpong- Twumasi, Adofo Koranteng, Samuel Mensah Presenter: Prof Michael Ohene-Yeboah Background: Inguinal hernia is thought to be common in rural Ghana, though no recent data exists on hernia prevalence in the country. This information is needed to guide policy and increase access to safe hernia repair in Ghana and other low-resource settings. Methods: Adult men randomly selected from the Barekese sub-district of Ashanti Region, Ghana were examined by surgeons for the presence of inguinal hernia. Men with hernia completed a survey on demographics, knowledge of the disease, and barriers to surgical treatment. Results: A total of 803 participants were examined, while 105 participants completed the survey. The prevalence of inguinal hernia was 10.8% (95% CI: 8.0, 13.6%), and 2.2% (95% CI: 0, 5.4%) of participants had scars indicative of previous repair, making the overall prevalence of treated and untreated inguinal hernia 13.0% (95% CI: 10.2, 15.7%). Prevalence of inguinal hernia increased with age; 35.4% (95 % CI: 23.6, 47.2%) of men aged 65 and older had inguinal hernia. Untreated inguinal hernia was associated with lower socioeconomic status. Of those with inguinal hernia, 52.4% did not know the cause of hernia. The most common reason cited for failing to seek medical care was cost (48.2%). Conclusion: Though inguinal hernia is common among adult men living in rural Ghana, surgical repair rates are low. We propose a multi-faceted public health campaign aimed at increasing access to safe hernia repair in Ghana. This approach includes a training program of non-surgeons in inguinal hernia repair headed by the Ghana Hernia Society, and could be adapted for use in other low-resource settings. TRAITEMENT LAPAROSCOPIQUE DES PYOCHOLECYSTITES: ILLUSION OU REALITE? APROPOS DE 5 CAS A YAOUNDE (CAMEROUN). NANA OUMAROU B, BANG GA, SAVOM EP, ESSOMBA R, EKANI BOUKAR YM, OUSMANA O, ESSOMBA A, SOSSO M. Prsentateur : Dr BANG Guy Aristide Contexte: La pyocholcystite est souvent considre par la plupart des auteurs comme une contre-indication de la cholecystectomie laparoscopique et sa dcouverte au dcours dune coelioscopie implique une conversion. Objectifs: Evaluer la faisabilit et lefficience de la cholcystectomie laparoscopique en cas de pyocholcystite. Matriels et mthodes: Rtrospectivement, les dossiers des patients ayant eu une cholecystectomie laparoscopique pour pyocholecystite dans notre service, de Janvier 2010 Aot 2015, ont t enregistrs. Resultats: Cinq dossiers ont t colligs dont 4 femmes et 1 homme. Lge moyen tait de 45,8 ans. En utilisant 4 trocarts nous avons pu raliser la cholecystectomie par voie coelioscopique dans tous les cas. Dans 4 cas, le canal cystique a t sutur en intra-corporel. Un drainage tubulaire en regard du canal cystique a t realis dans tous les cas. Aucune complication na t enregistre. La dure dhospitalisation tait de 4 jours dans tous les cas. Conclusion: La cholecystectomie laparoscopique en cas de pyocholcystite est ralisable et fficiente. Mots-cles: Pyocholecystite CholecystectomieLaparoscopie- Cameroun. NEGATIVE PRESSURE TREATMENT OF WOUNDS BY VACUUM ASSISTED CLOSED FORTUNE THERAPY AT THE OMAR BONGO ONDIMBA MILITARY HOSPITAL IN LIBREVILLE R.Tchoua, C.Igoho, G. Edjo Nkili, JM. Mandji Lawson , E.MbongoKama, A.Mikila Hospital dInstruction des Armes Omar Bongo Ondimba Romain Tchoua BP 20404 Libreville e-mail  HYPERLINK "mailto:rtrtchoua@yahoo.fr"rtrtchoua@yahoo.fr Introduction: serious infections on soft tissue wounds especially induce, apart from sepsis, problems of coverage and healing. They therefore require care and prolonged antibiotic therapy, as well as staff mobilization for bandage. That is why in this context, we proposed as alternative to conventional therapy to develop the technique of negative pressure treatment. Patients and method: It was an observational and retrospective study on vacuum assisted closed (VAC) treatment of patients with severe soft tissue infection admitted to the emergency department for outpatient. VAC equipment included a phlegm aspiration and a bandage kit. Results: Three cases were reported from 1 April to 30 June 2015: two women and one man. Their ages were respectively 28, 45 and 50 years old. They were hospitalized for myositis of the right thigh, lumbar region and right arm. They all had an initial antibiotic and local care followed by surgical drainage and installation of a VAC system at day 10, day 5 and day 6. The germs found were E. coli in two cases and Proteus mirabilis in one case. The outcome was favorable after two months of hospitalization in the first case and a month in the two other cases. Conclusion: VAC system saves procedures, personnel, bandage quantity and antibiotics. Its use has transformed the prognosis of some lesions and deserves wider dissemination. Using a Fortume system is an attractive alternative for economically weak settings. Keysword: VAC Wounds Infections PREVALENCE DE LA HERNIE INGUINALE CHEZ LES HOMMES ADULTES DANS LA REGION DASHANTI AU GHANA Michael Ohene-Yeboah, Jessica H. Beard, Benjamin Frimpong- Twumasi, Adofo Koranteng, Samuel Mensah Presenter: Prof Michael Ohene-YeboahMensah Contexte : La hernie inguinale est considre comme tant courante dans zones rurales du Ghana bien qu'il n'existe pas de donnes rcentes sur la prvalence de la hernie dans le pays. Ces informations sont ncessaires pour guider les dcisions politiques et accrotre l'accs la rparation sans danger des hernies au Ghana et dans dautres milieux faibles ressources. Mthodes : Les hommes adultes slectionns au hasard dans le sous-district de Barekese dans la rgion d'Ashanti au Ghana, ont t examins par des chirurgiens pour dceler la prsence de la hernie inguinale. Les hommes souffrant de hernie ont rpondu un sondage sur la dmographie, la connaissance de la maladie, et les barrires au traitement chirurgical. Rsultats: Au total, 803 participants ont t examins et 105 ont rpondu au sondage. La prvalence de la hernie inguinale tait de 10,8% (95% CI: 8,0, 13,6%), et 2,2% (95% CI: 0, 5,4%) des participants avaient des cicatrices rvlatrices d'une rparation antrieure, tablissant la prvalence globale de la hernie inguinale traite et non-traite 13,0% (95% CI: 10,2, 15,7%). La prvalence de la hernie inguinale augmentait avec l'ge ; 35,4% (95 % CI: 23,6, 47,2%) des hommes gs de 65 ans et plus souffraient de hernie inguinale. La hernie inguinale non-traite tait associe au faible statut socioconomique. Parmi ceux souffrant de hernie inguinale, 52,4% ne connaissaient pas la cause de la hernie. La raison la plus couramment voque pour la non prise en charge mdicale tait le cot (48.2%). Conclusion: Bien que la hernie inguinale soit courante chez les hommes adultes des zones rurales au Ghana, les taux de rparation chirurgicale sont faibles. Nous proposons une campagne de sant publique multiforme visant accrotre l'accs la rparation sans danger des hernies au Ghana. Cette approche inclut un programme de formation de non-chirurgiens la rparation des hernies inguinales sous la direction de la Ghana Hernia Society qui pourra tre adapt afin dtre utilis dans les milieux ressources faibles. ABDOMINAL EVISCERATIONS IN GENERAL SURGERY AT THE GABRIEL TOUR UTH Togo A, Kant L, Traor A, Diakit I, Samak A, Maiga A, Dembl BT, Diarra M, Diallo G. Our objectives consisted in determining the frequency of abdominal eviscerations in hospitals, identifying circumstances of the occurrence and main etiologies, analyzing treatment outcomes and assessing the cost of care. We performed a retrospective study on surgery at the Gabriel Tour University Teaching Hospital. This study lasted 8 years (1999-2006). All patients who were operated in the service for traumatic or post-operative abdominal eviscerations were included in the study. We did not take into account other types of eviscerations and patients operated in other services. We identified 74 cases including 42 traumatic abdominal eviscerations and 32 postoperative abdominal eviscerations with a mean age of 25 years and a sex ratio of 2 men at risk. Traumatic abdominal eviscerations in 29/42 patients were due to criminal assault whereas 15/32 eviscerations were recorded after bowel obstruction surgery. Postoperative abdominal eviscerations were operated using the bolster technique and traumatic abdominal eviscerations were closed with X points. Immediate postoperative complications included: parietal suppuration in 1 case and 2 cases of re-gutting. The average length of postoperative hospital stay was 11.2 days for postoperative abdominal eviscerations and 7.4 for traumatic abdominal eviscerations. Mortality was zero for traumatic abdominal eviscerations whereas 2 deaths were recorded for postoperative abdominal eviscerations. Conclusion: abdominal evisceration is a surgical emergency. Its treatment is purely surgical, closure using the bolster technique in case of postoperative abdominal eviscerations is necessary. Key-words: traumatic postoperative evisceration CHU Gabriel Toure. TRAITEMENT PAR PRESSION NEGATIVE DES PLAIES PAR VAC DE FORTUNE A LHIA OBO DE LIBREVILLE R.Tchoua, C.Igoho, G. Edjo Nkili, JM. Mandi Lawson, E.MbongoKama, A.Mikila Hospital dInstruction des Armes Omar Bongo Ondimba Romain Tchoua BP 20404 Libreville e-mail rtrtchoua@yahoo.fr Introduction: Les infections des parties molles sur les plaies en particuliers posent en dehors du sepsis, des problmes de couverture et de cicatrisation. Elles ncessitent pour cela des soins et une antibiothrapie prolonge, ainsi que la mobilisation dun personnel pour les pansements. Cest dans ce cadre quil a t propos comme alternative au traitement classique, dlaborer la technique de traitement de pression ngative. Patients et Mthodes: il sagissait dune tude observationnelle et rtrospective portant sur le traitement par VAC des patients admis au SAU pour infections graves des parties molles. Le matriel VAC comprenait en aspiration de mucosits et un kit de pansement. Rsultats: Trois cas ont t rpertoris du 1er avril au 30 juin 2015. Il sagissait de deux femmes et un homme, gs respectivement de 28, 45 et 50 ans. Ils taient hospitaliss pour myosite de la cuisse droite, de la rgion lombaire et du bras droit. Ils ont tous bnficis dune antibiothrapie initiale et des soins locaux, suivie dune vacuation chirurgicale et mise en place dun systme VAC J10, J5 et J6. Les germes retrouvs taient E. coli dans deux cas et Proteus mirabilis dans un cas. Lvolution a t favorable aprs deux mois dhospitalisation dans le premier cas et un mois dans les deux autres cas. Conclusion: Le VAC permet de raliser des conomies en gestes chirurgicaux, en personnel, en quantits de pansements et en antibiothrapie. Son utilisation a transform le pronostic de certaines lsions et mrite une plus large diffusion. Le recours a un systme de Fortume est une alternative sduisante pour les structures conomiquement faibles. Mots cls: VAC Plaies - Infection THE EFFECTS OF EBOLA ON THE NUMBER OF OPERATIONS IN SIERRA LEONE Alex van Duinen (1, 2), Bart Waalewijn (1, 3), Ibrahim Bundu (4), Hkon Bolkan (1, 2, 5) Address presenting author: St.Olavs Hospital, Surgical department, Postboks 3250 Sluppen, N-7006 Trondheim, Norway. Email: alexvanduinen@capacare.org Institutions: CapaCare, Norway St Olav University Hospital, Trondheim, Norway Masanga Hospital, Tonkolili, Sierra Leone Connaught Hospital, Freetown, Sierra Leone Norwegian University of Science and Technology, Trondheim, Norway Background: During the West-African Ebola Viral Disease (EVD) outbreak, over 25,000 people have been infected and over 10,000 people have died. Sierra Leone, with about 12,000 cases, is the most affected country. Health personal providing surgical care during the outbreak have an increased risk to attract EVD. Objectives: Aim of the study is to explore EVDs effect on number of operations before and during the outbreak. Methodology: Between September 2014 and January 2015, 21 Community Health Officers, collected weekly retrospective data from hospital records. Data was retrieved from all facilities that were known to provide major surgeries. Data was collected from before EVD outbreak (2014 week 2 to 21) and during (2014 week 22 to 2015 week 20). Results: From the 54 identified healthcare facilities, data from 42 was completely divided in three categories: governmental (21), private-non-profit (18) and private-for-profit (15). On average, 414 patients were operated weekly before the EVD onset and 241 after, an overall reduction of 42%. This decrease was higher after the peak (-46%) than before the peak (-39%). The reduction in admissions was more severe in the private-for-profit sector (-59%) compared to the private-non-profit (-56%) and governmental (-22%) sector. The province most affected was Southern (-49%). Conclusions: As a consequence of the current EVD epidemic, the number of weekly operations has decreased with 42%. The reduction is not equal among the different sectors and areas. Investment in human resources is essential to re-establish the Sierra Leonean healthcare system after the EVD epidemic. EVISCERATIONS ABDOMINALES EN CHIRURGIE GENERALE CHU GABRIEL TOURE. Togo A, Kant L, Traor A, Diakit I, Samak A, Maiga A, Dembl BT, Diarra M, Diallo G. Nos objectifs taient de dterminer la frquence hospitalire des viscrations abdominales, identifier les circonstances de survenue et les principales tiologies, analyser les rsultats du traitement et valuer le cot de la prise en charge. Nous avons ralis une tude rtrospective en chirurgie au CHU Gabriel Tour. Elle a dure 8 ans (1999 2006). Ont t inclus tous les oprs dans le service pour viscration abdominale traumatique ou post opratoire. Nous navons pas inclus les autres types dviscration et les malades oprs dans dautres services. Nous avons recens 74 cas dont 42 viscrations abdominales traumatiques (EAT) et 32 viscrations abdominales post-opratoires (EAPO) avec un ge moyen de 25 ans et un sexe ratio de 2 au risque des hommes. LEAT chez 29/42 malades taient due une agression criminelle tan disque 15/32 viscration ont t enregistrs aprs une intervention pour occlusion intestinale. Les EAPO ont t opres par la technique avec bourdonnet et Les EAT ont t fermes par des points en X. Les complications postopratoires immdiates ont t: la suppuration paritale dans 1 cas et 2 cas de r-viscration. La dure moyenne dhospitalisation postopratoire a t de 11,2 jours pour EAPO et 7,4 pour EAT. La mortalit a t nulle pour L EAT tandis quil y a eu 2 cas de dcs pour lEAPO. Conclusion: lviscration abdominale est une urgence chirurgicale. Son traitement est purement chirurgical, la fermeture sur bourdonnet en cas dEAPO est ncessaire. Mots-cls: Eviscration postopratoire traumatique CHU Gabriel, Tour. TUMOUR-STROMA RATIO AS A PROGNOSTIC FACTOR IN COLORECTAL CANCER IN YAOUND: A PRELIMINARY STUDY Ngo Nonga Bernadette, SavomEric Patrick; Tina Paul-Fernand; Mendimi Nkodo Joseph, Ngo Mayemi, Arthur Essomba Presenting author: SAVOM ERIC Correspondent: Pr B NGO NONGA, E-mail:  HYPERLINK "mailto:ngonongab@yahoo.com" ngonongab@yahoo.com, Mobile: +237 699866422 Background: Factors such as tumour-stroma ratio (TSR) have been found to be a reliable independent prognostic factor in some solid tumours. The aim of this preliminary study was to assess the relationship between the TSR in relation to the predicted prognosis based on the grade of the tumour in CRC. Methods: We reviewed retrospectively the pathological slides of patients with CRC at the Centre Pasteur of Yaound from January 2009 to May 2015. The stroma and the TSR were analysed by the 50 and 100 magnifications. This ratio was correlated to the grade and other standard clinicopathological factors of the colorectal cancer. The study has received approval of the national ethic committee. Results: There were 60 patients. The mean age was 53.715.5 with a sex ratio of 0.62. Right colon was the main location (55.5%). Moderately differentiated (grade II) adenocarcinoma, represented 73.3%. In 20 cases, the stroma recovered 20-30% of most invasive field. Thirty two cases were included in the stroma high group. TSR was not correlated with age, gender, tumour location, macroscopic aspect, resection margins, pathological type, histological grading, lymph node metastasis andpTNM staging. Only parietal invasion was significantly correlated with TSR (P=0.045). Conclusions: The role of the TSR still need to be determined in our environment. Key Words: Colorectal cancer, Stroma, Tumour-stroma ratio. IMPACT DE LEPIDEMIE D'EBOLA SUR LE NOMBRE DINTERVENTIONS CHIRURGICALES EN SIERRA LEONE Alex van Duinen (1, 2), Bart Waalewijn (1, 3), Ibrahim Bundu (4), Hkon Bolkan (1, 2, 5) Address presenting author: St.Olavs Hospital, Surgical department, Postboks 3250 Sluppen, N-7006 Trondheim, Norway. Email: alexvanduinen@capacare.org Institutions: 1. CapaCare, Norway 2. St Olav University Hospital, Trondheim, Norway 3. Masanga Hospital, Tonkolili, Sierra Leone 4. Connaught Hospital, Freetown, Sierra Leone 5. Norwegian University of Science and Technology, Trondheim, Norway Contexte: Pendant lpidmie dEbola, plus de 25.000 personnes ont t infectes et plus de 10,000 personnes ont perdu la vie. Avec prs 12.000 cas, la Sierra Leone est le pays le plus touch. Le personnel de sant assurant des soins chirurgicaux pendant cette pidmie courait un risque lev d'tre infect par le virus Ebola. Objectifs: L'objectif de notre tude est d'analyser limpact de la maladie virus Ebola sur le nombre d'interventions chirurgicales avant et aprs lpidmie. Mthodologie: De septembre 2014 janvier 2015, 21 Agents de Sant Communautaire ont collect les donnes hebdomadaires rtrospectives des fichiers hospitaliers de tous les tablissements identifis comme fournisseur d'interventions chirurgicales. Les donnes ont t collectes avant (semaines 2 21 de 2014) et pendant lpidmie (de la semaine 22 de 2014 la semaine 20 de 2015). Rsultats: Des donnes compltes ont t collectes dans 42 formations sanitaires sur 54 identifies, divises en trois catgories : publiques (21), prives but non lucratif (18) et prives but lucratif (15). En moyenne, avant lpidmie, 414 patients taient oprs chaque semaine comparativement 241 aprs, soit une rduction globale de 42%. Cette diminution tait plus importante aprs le pic de lpidmie (-46%) qu'avant ce pic (-39%). La diminution du nombre d'admissions tait plus accentue dans le secteur priv but lucratif (-59%) que dans le secteur priv but non lucratif (-56%) et le secteur public (-22%). La rgion la plus affecte tait la province du Sud (-49%). Conclusions: Du fait de l'pidmie dEbola, le nombre d'interventions chirurgicales pratiques chaque semaine a baiss de 42%. Cette baisse n'a pas la mme ampleur dans les diffrents secteurs et rgions. L'investissement dans les ressources humaines est indispensable pour le rtablissement du systme de sant en Sierra Leone aprs l'pidmie d'Ebola. LE RATIO TUMEUR-STROMAEST-IL UN FACTEUR DE PRONOSTIC DANS LE CANCER COLORECTAL A YAOUNDE Ngo Nonga Bernadette, Savom Eric Patrick; Tina Paul-Fernand; MendimiNkodo Joseph, Ngo Mayemi, Arthur Essomba Presenting author: SAVOM ERIC Correspondent: Pr B NGO NONGA, E-mail: HYPERLINK "mailto:ngonongab@yahoo.com"ngonongab@yahoo.com, Mobile: +237 699866422 Introduction: les facteurs comme le ratio tumeur/ stroma, ont t reconnus comme des facteurs pronostiques indpendants dans certains cancers pithliaux comme le cancer colorectal. Le but de cette tude prliminaire tait dvaluer le rle du ratio tumeur/stroma comme facteur pronostique dans le cancer colorectal. Mthode: Nous avons revu rtrospectivement toutes les lames de cancer du colon diagnostique de 2009 2015 au centre Pasteur de Yaound. Le stroma a t analys lagrandissement 50 fois et 100 fois. Nous avons revu ce ratio tenant compte du grade et dautres composantes clinico-pathologiques. Ltude a obtenu lapprobation du comit dthique. Rsultats: Nous avons recruts 60 patients. Lge moyen tait de 53,7+-15,5, avec un sex ratio de 0,62. Le cancer du clon droit tait la localisation la plus frquente (55,5%). Ladnocarcinome moyennement diffrenci tait le grade le plus frquent et reprsentait 73,3%. Dans 20 cas, le stroma recouvrait 20-30% de la surface la plus invasive, 32 cas taient considrs avec un stroma trs dense. Le ratio stroma/tumeur ntait pas corrl avec le sexe, lge, la localisation, laspect macroscopique, le type histologique, le grade, les mtastases ganglionnaires et le stade TNM. Seule linvasion paritale tait corrle avec le ratio (p=0,045). Conclusions: Le rle du ratio tumeur/stroma reste dterminer dans notre environnement. Mots cls: Cancer colorectal, Stroma, ratio tumeur/stroma TYMPANOMETRIC EVALUATION IN CEREBRAL PALSY PATIENTS IN BENIN CITY NIGERIA Akpalaba I.O, Ogisi F.O Department of Ear, Nose and Throat. University of Benin Teaching Hospital, (UBTH) Benin City, Edo State. CORRESPONDING AUTHOR Akpalaba I O, Email:  HYPERLINK "mailto:drogeakpalaba@gmail.com" drogeakpalaba@gmail.com, Phone number: +234-8035670178 Department of Ear, Nose and Throat. University of Benin Teaching Hospital, UBTH, Benin City, Edo State. Background: Cerebral palsy is a static neurologic condition from brain injury that occurred before cerebral development is complete.1 It is the most common childhood disability affecting 2.5 to 10.3 children per 1,000 live births in Nigeria. 1,2,3, 4, 5 They are more vulnerable to hearing loss. 23, 24 This hearing loss can be due to middle ear pathology, which is preventable and correctable; justifying the study. Objective: To determine the pattern of middle ear pathology and severity of Eustachian Tube Dysfunction (ETD) in children with Cerebral Palsy at UBTH, Nigeria. Methodology: A prospective descriptive study carried out for fourteen months (May 2014 to June 2015). Total population sampling technique was used. Sample size determined using Cochrans formula. 112 subjects participated, each ear, as a separate entity. Pretest was done on 60 subjects at Project Chari-love. Structured interviewer questionnaire was administered, otoscopy and Tympanometry were done. Data analyzed using Statistical Package for Scientific Solution version 16. Similar procedures were carried out on 112 control subjects comprising children in Russell International Group of Schools, Ugbowo. Benin city. Results: Otitis Media with Effusion predominated in 154 (68.8%) ears compared to 25.9% in the control. ETD, 129 (57.6%), mostly Type C1 tracing. Reduced middle ear compliance noted in 22 (9.9%) ears. (Statistically significant, p<0.001). Conclusion: Middle ear pathology is predominant in cerebral palsy patients. Otitis Media with Effusion is the commonest middle ear pathology in cerebral palsy patients. Eustachian tube dysfunction was mostly Type C1 tracing. Keywords: Middle ear pathology, Cerebral Palsy, Tympanometry VALUATION TYMPANOMTRIQUE CHEZ LES PATIENTS SOUFFRANT DE PARALYSIE CRBRALE A BENIN CITY, NIGRIA Akpalaba IO, Ogisi FO Department of Ear, Nose and Throat. University of Benin Teaching Hospital, (UBTH) Benin City, Edo State. Nigeria. Department of Ear, Nose and Throat. University of Benin Teaching Hospital, UBTH, Benin City, Edo State. Email: drogeakpalaba@gmail.com Phone number: +234-8035670178 Contexte: La paralysie crbrale est une affection neurologique permanente cause par une ls au cerveau, une blessure qui survient avant que le dveloppement du cerveau ne soit achev.1Il sagit de lincapacit pdiatrique le plus courante. Elle affecte 2,5 10,3 enfants pour 1000 naissances vivantes au Nigria. 1,2,3, 4, 5 Ces enfants sont plus susceptibles de souffrir dune perte de laudition. 23, 24La perte de laudition, qui est vitable et peut tre corrige, pourrait tre cause par une pathologie de loreille moyenne; telle est la raison de la prsente tude. Objectif: Dterminer le type de pathologie de loreille moyenne et la gravit du dysfonctionnement de la Trompe dEustache (DTE) chez les enfants souffrant de paralysie crbrale UBTH, Nigria. Mthodologie: Une tude prospective descriptive a t mene pendant quatorze mois (mai 2014 juin 2015). La technique utilise tait celle de lchantillonnage total de la population. La taille de lchantillon a exig dutiliser le test de Cochran. 112 sujets ont particip, chaque oreille a t considre sparment. 60 sujets ont t pr-tests au niveau du Projet Charilove. Des questionnaires structurs ont t distribus, des otoscopies et tympanomtries ont t effectues. Les donnes ont t analyses laide de la version 16 du Statistical Package for Scientific Solution. Les mmes interventions ont t ralises sur 112 sujets tmoins constitus denfants du Russell International Group of Schools, Ugbowo. Benin City. Rsultats: Des otites moyennes avec effusion ont t trouves majoritairement dans 154 (68,8%) oreilles par rapport 25,9% chez les sujets tmoins; 129 (57,6%) prsentaient un DTE, surtout de Type C1. Une baisse de la conformit de loreille moyenne a t releve dans 22 (9,9%) oreilles. (Statistiquement significatif, p<0,001). Conclusion: Les pathologies de loreille moyennes prdominent chez les patients souffrant de paralysie crbrale. Les otites moyennes avec effusion sont les pathologies les plus frquentes de loreille interne chez les patients atteints de paralysie crbrale. Le dysfonctionnement de la trompe dEustache tait surtout de Type C1. Mots cls: Maladie de loreille moyenne, paralysie crbrale, tympanomtrie COMPLICATIONS AND RISK FACTORS OF THYROID GLAND SURGERY AT THE YAOUND UNIVERSITY TEACHING HOSPITAL (CHUY) BOLA SIAFA Antoine, DJOMOU Franois, NGOMBA Armelle Viviane, ANANGA Serge Pascal, NJOCK Richard, BENGONO TOURE Genevive Corresponding author: Dr BOLA SIAFA Antoine, ORL and Head and Neck surgeon. ORL Department of the Yaound University Teaching Hospital (CHUY). Yaounde, Cameroun. E-mail:  HYPERLINK "mailto:siafabola@yahoo.fr"siafabola@yahoo.fr Institution: Yaound University Teaching Hospital (CHUY) in Cameroon Background: Thyroidectomy is a common procedure performed in our department. It represents 19.1% of all our surgeries. Most patients operated for thyroidectomy present late with very large tumours leading to complications. Objectives: To assess the incidence of thyroidectomies complications in our department. To identify risk factors associated with these complications. Methods: We carried out a prospective and analytic study (June 2013 - July 2015), at the ORL and Head and Neck department of CHUY. All patients, operated for thyroidectomy by our team and who gave their consent were included. Socio-demographic, clinical and surgical data were collected and analysed. Patients who presented complications (cases) were compared to the others (controls); the Odds ratio were calculated. Results: 89 thyroidectomies were recruited; 8 (8.9%) developed complications. 4 had cervical hematoma (4.5%) with 2 compressive ones who were re-operated. 2 had severe dyspnoea (2.2%), they were re-intubated and one had a ten days tracheotomy but furthermore the evolution was good. One had dysphonia for a week and one case of severe hypocalcaemia was treated with intravenous calcium. Risk factors were intrathoracic goitres (Odds ratio=32, 95%CI=30-36), Total thyroidectomy (Odds ratio=16, 95%CI=12-18), past medical history of thyroidectomy (Odd ratio=11, 95%CI=9-13), enlarged multinodular goitres (Odds ratio=4.5, 95%CI= 3.5-6.4). Patients who developed complications also had more malignancies (30% versus 9%). Conclusion: The incidence of post thyroidectomy complications is 8.9% in our department. The most common risk factors are intrathoracic goitres and former thyroid surgery, these factors have to be addressed in order to reduce the complications. Keys words: Thyroidectomy, complications, risk factors, Yaound. Complications et facteurs de risque de la chirurgie de la glande thyrode au Centre hospitalier universitaire de Yaound (CHUY) BOLA SIAFA Antoine, DJOMOU Franois, NGOMBA Armelle Viviane, ANANGA Serge Pascal, NJOCK Richard, BENGONO TOURE Genevive Corresponding author: Dr BOLA SIAFA Antoine, ORL and Head and Neck surgeon. ORL Department of the Yaound University Teaching Hospital (CHUY), Yaounde, Cameroon. E-mail: siafabola@yahoo.fr Institution: Yaound University Teaching Hospital (CHUY) in Cameroon Contexte: La thyrodectomie est un acte chirurgical courant effectu dans notre service. Elle reprsente 19,1% de toutes nos chirurgies. La plupart des patients oprs pour une thyrodectomie prsentent plus tard de trs grosses tumeurs qui entrainent des complications. Objectifs: valuer lincidence des complications des thyrodectomies dans notre service. Identifier les facteurs de risque de ces complications. Mthodes: Nous avons ralis une tude prospective et analytique (de juin 2013 juillet 2015), au Service ORL et de chirurgie cervico-faciale du CHUY. Tous les patients, oprs pour une thyrodectomie par notre quipe et qui ont donn leur consentement ont t pris en compte. Les donnes sociodmographiques, cliniques et chirurgicales ont t recueillies et analyses. Les patients ayant prsent des complications (cas) ont t compares aux autres (contrles); lOdds ratio a t calcul. Rsultats: 89 thyrodectomies ont t enregistres; 8 (8,9%) ont dvelopp des complications. 4 avaient un hmatome cervical (4,5%) avec 2 units de compression qui ont t r-exploites. 2 avaient une dyspne svre (2,2%), ils ont t r-intubs et ont subi une trachotomie de dix jours, avec des suites favorables. Il y a eu un cas de dysphonie pendant une semaine et un cas dhypocalcmie svre a t trait avec du calcium par voie intraveineuse. Les facteurs de risque taient les goitres intra thoraciques (Odds ratio = 32, IC 95% = 30-36), la thyrodectomie totale (Odds ratio = 16, IC 95% = 12-18), les antcdents mdicaux de thyrodectomie (odd ratio = 11, 95% CI = 9-13), les goitres multi nodulaires volumineux (Odds ratio = 4,5, IC 95% = 3,5 6,4). Les patients ayant dvelopp des complications avaient galement plus de tumeurs malignes (30% contre 9%). Conclusion: Lincidence des complications post-thyrodectomie est de 8,9% dans notre service. Les facteurs de risque les plus courants sont les goitres intra thoraciques et lancienne chirurgie thyrodienne. Ces facteurs doivent tre abords afin de rduire les complications. Mots cls: thyrodectomie, complications, facteurs de risque, Yaound. ENDOSCOPIC ENDONASAL CLOSURE OF CEREBROSPINAL FLUID RHINORRHEA USING DIFFERENT TECHNIQUE G. M Mohammed, J.Yohanna, B.M Ahmad, U.S Grema, T.S Abubakar National Ear Care Centre Kaduna, Nigeria Centre du Soin de lOreille - Kaduna, Nigeria. Email mgmainas@gmail.com Introduction: Management of CSF rhinorrhea has been a challenging issue to ENT surgeons in Nigeria necessitating prolonged conservative management or intracranial approach by neurosurgeons with significant morbidity, including anosmia, intracerebral hemorrhage, frontal lobe deficits, need for extended hospital stay and higher recurrence rates. Objectives: To explore the less morbid approach of management of CSF rhinorrhea Method: A Prospective study of all patients managed with CSF leak in National Ear Care Centre and dialogue Hospital Kaduna, from January 2012 to June 2014. Aetiology, site of leak, surgical approach were reviewed. Results: During the period under study, 5 patients presented with CSF rhinorrhea. Three were as a result of head trauma while 2 were spontaneous CSF rhinorrhea. The site of CSF leak in three of the patients was from cribriform plate, one from the sphenoid while the site of leak cannot be located on computerized tomography in one patient that responded to conservative management. Four patients underwent endoscopic endonasal repair of CSF leak. Conclusion: Endoscopic endonasal approach for repair of CSF leaks is the mainstay of surgical therapy, with low morbidity, high success rates, and low complication and recurrence rates. FERMETURE ENDOSCOPIQUE ENDONASALE DE LA RHINORRHE DE LIQUIDE CPHALORACHIDIEN A LAIDE DUNE TECHNIQUE DIFFRENTE G. M Mohammed, J.Yohanna, B.M Ahmad, U.S Grema, T.S Abubakar National Ear Care Centre Kaduna, Nigeria Centre du Soin de lOreille - Kaduna, Nigeria. Email HYPERLINK "mailto:mgmainas@gmail.comIntroduction"mgmainas@gmail.comIntroduction Introduction: La prise en charge des rhinorrhe de LCR est un rel dfi pour les chirurgiens ORL du Nigeria car elle exige une prise en charge conservatrice prolonge ou une approche intracrnienne par des neurochirurgiens avec une morbidit significative, y compris lanosmie, lhmorragie intracrbrale, les dficits du lobe frontal, la ncessit dun sjour prolong l'hpital et des taux de rcidive plus levs. Objectifs: Explorer lapproche la moins morbide de la prise en charge de la rhinorrhe LCR Mthode: Une tude prospective de tous les patients pris en charge pour une fuite du LCR au National Ear Care Centre and dialogue Hospital de Kaduna, de janvier 2012 juin 2014. Ltiologie, le site de la fuite, et labord chirurgical ont t examins. Rsultats: Pendant la priode dtude, 5 patients ont prsent une rhinorrhe de LCR. Trois taient associs un traumatisme crnien tandis que 2 taient une rhinorrhe de LCR spontane. Le site de la fuite de LCR chez 3 patients tait la lame crible, lun venait des sp hnodes alors que le site de la fuite na pas pu tre localis sur tomodensitomtrie chez un patient qui a rpondu la prise en charge conservatrice. Quatre patients ont subi une rparation endoscopique endonasale de la fuite du LCR. Conclusion: Lapproche endoscopique endonasale pour la rparation des fuites du LCR est le pilier de la thrapie chirurgicale, avec une faible morbidit, un taux de russite lev, et un faible taux de complication et de rcurrence. AUDIOMETRIC PATTERNS OF PRESBYCUSIS IN ILE-IFE, NIGERIA Odefa Obasi Department of Otorhinolaryngology, Head and Neck Surgery, ObafemiAwolowoUniversityTeachingHospitalsComplex, Ile-Ife, Nigeria. Telephone: +234 8035851011, +234 8075526604 E-mail:  HYPERLINK "mailto:obasiodefa2@yahoo.com"obasiodefa2@yahoo.com Background: Presbycusis which occurs gradually over time is defined as the decline of hearing perception with advancing age. As the population of the elderly increases worldwide, the prevalence and incidence is expected to increase. There are various audiometric patterns of presbycusis as documented in literature. The patterns identifiable in a semi urban location like Ile-Ife, Osun State, Nigeria is important in correlating these findings with that published in literature in other parts of the world since there is a dearth of studies in Africa that determine the various audiometric patterns of presbycusis. Objectives: To determine the audiometric patterns of presbycusis in Ile Ife. Methodology: This is a community based study of elderly people with presbycusis in Ile Ife. A questionnaire was administered followed by a clinical examination of the ear and a pure tone audiometry. Analysis of the data was done using the Statistical Package for Social Sciences (SPSS version 20). Results: Among the patients diagnosed with presbycusis, the bilateral flat audiometric pattern was the most common audiometric pattern seen among presbycusis patients. Conclusion: The most common audiometric pattern of bilateral flat was consistent with the findings in literature. Public enlightenment and prevalence of presbycusis was found to be high and intermittent screening of the patients 30 years and above is recommended. Key words: Pure tone audiometry; Audiometric Patterns; Presbycusis; Ile-Ife; Nigeria Caractristiques audiomtriques de la presbyacousie Ile-Ife, Nigria OdefaObasi Research Department: Department of Otorhinolaryngology, Head and Neck Surgery, ObafemiAwolowoUniversityTeachingHospitalsComplex, Ile-Ife, Nigeria.. Telephone: +234 8035851011, +234 8075526604 E-mail: HYPERLINK "mailto:obasiodefa2@yahoo.com"obasiodefa2@yahoo.com Contexte: La presbyacousie qui survient progressivement au fil du temps est dfinie comme une altration de la perception auditive lie au vieillissement. Avec laugmentation de la population de personnes ges dans le monde, la prvalence et lincidence de la presbyacousie devrait saccroitre. Diffrentes formes audiomtriques ont fait lobjet dtudes. Les caractristiques identifies Ile-Ife, localit semi-urbaine de lEtat dOsun, Nigria, permettent dtablir des liens entre les rsultats obtenus et ceux publis travers le monde car, nous manquons cruellement dtudes visant dterminer les diffrentes caractristiques de la presbyacousie en Afrique. Objectifs : Dterminer les caractristiques audiomtriques de la presbyacousie Ile-Ife. Mthodologie : Il sagit dune tude communautaire portant sur des personnes ges souffrant de presbyacousie Ile-Ife. Un questionnaire a t distribu, suivi dun examen clinique de loreille et dune audiomtrie tonale. Les donnes ont t analyses laide du Logiciel de statistiques pour les sciences sociales (SPSS version 20). Rsultats : La surdit bilatrale est la pathologie la plus courante rencontre chez les patients souffrant de presbyacousie. Conclusion : La forme audiomtrique la plus frquente, la surdit bilatrale, tait compatible avec les rsultats des recherches. Il existe un lien troit entre le manque de sensibilisation gnrale et la prvalence de la presbyacousie, et nous recommandons le dpistage chez les patients gs de 30 ans et plus. Mots cls : Audiomtrie tonale; Caractristiques audiomtriques; Presbyacousie; Ile-Ife; Nigria. PREVALENCE OF PRESBYCUSIS IN ILE-IFE, NIGERIA Odefa Obasi Research Department: Department of Otorhinolaryngology, Head and Neck Surgery, ObafemiAwolowoUniversityTeaching Hospitals Complex, Ile-Ife, Nigeria.. Telephone: +234 8035851011, +234 8075526604 E-mail:  HYPERLINK "mailto:obasiodefa2@yahoo.com"obasiodefa2@yahoo.com Background: Presbycusis refers to age-related hearing loss which is known to be common among elderly persons. As the population of the elderly increases worldwide, the prevalence and incidence is expected to increase. The prevalence of presbycusisis of keen interest at this time because there is a paucity of studies to determine the exact prevalence of presbycusis in Ile-Ife, South-western Nigeria. Objective: To determine the prevalence of presbycusis in Ile Ife and its effect on quality of life. Methodology: This is a community based study of elderly people in Ile Ife. A structured proforma was administered followed by a clinical examination of the ear and a pure tone audiometry. Analysis of the data was done using the Statistical Package for Social Sciences (SPSS version 20) and the level of statistical significance was placed at p<0.05. Main Results: The prevalence of presbycusis in Ile-Ife was 34.8%. Conclusion: The prevalence of presbycusis was found to be high and periodic screening of the elderly is recommended to detect and rehabilitate those with presbycusis. Key words: Presbycusis; Prevalence; Pure tone audiometry; Ile-Ife; Nigeria Prvalence de la presbyacousie Ile-Ife au Nigeria OdefaObasi Research Department: Department of Otorhinolaryngology, Head and Neck Surgery, ObafemiAwolowoUniversityTeaching Hospitals Complex, Ile-Ife, Nigeria.. Telephone: +234 8035851011, +234 8075526604 E-mail: HYPERLINK "mailto:obasiodefa2@yahoo.com"obasiodefa2@yahoo.com Contexte: La presbyacousie est la perte de laudition lie l'ge et trs rpandue chez les personnes ges. Avec lexpansion de la population des personnes ges dans le monde entier, on devrait sattendre une augmentation de la prvalence et de lincidence de cette affection. La prvalence de la presbyacousie suscite un vif intrt en ce moment car trs peu dtudes ont t menes pour dterminer la prvalence exacte de la presbyacousie Ile-Ife, dans le sud-ouest du Nigeria. Objectif: Dterminer la prvalence de la presbyacousie Ile - Ife et son impact sur la qualit de vie. Mthodologie: Cette tude est base sur la communaut des personnes ges Ile - Ife. Un formulaire structur a t tabli, suivi dun examen clinique de loreille et dune audiomtrie tonale. Lanalyse des donnes a t ralise laide du Logiciel de statistiques pour les sciences sociales (SPSS version 20) et le niveau de significativit statistique a t tabli p<0.05. Rsultats: La prvalence de la presbyacousie Ile-Ife tait de 34.8%. Conclusion: La prvalence de la presbyacousie sest avre leve et un dpistage priodique des persones ges a t recommand afin de dtecter et de soigner ceux qui en souffrent. Key words: Presbyacousie; Prvalence; Audiomtrie tonale; Ile-Ife; Nigeria. EYE SOCKET SURGERY: AN EXAMPLE OF COLLABORATION BETWEEN ORL/OPHTHALMOLOGISTS AT THE YAOUNDE UNIVERSITY TEACHING HOSPITAL BOLA SIAFA Antoine, KAGMENI Gilles, DJOMOU Franois, OWONA NANGA Sandrine, NDJOLO Alexis Auteur correspondant: Dr BOLA SIAFA Antoine, mdecin ORL-CCF. Service ORL et de Chirurgie cervico-faciale. Centre Hospitalier et Universitaire de Yaound-Cameroun. E-mail:  HYPERLINK "mailto:siafabola@yahoo.fr"siafabola@yahoo.fr Introduction: Surgery of the eye sockets is a collection of various indications. These can involve several separate specialties (ORL, ophthalmology, maxillofacial surgery, ...). Since July 2015, an orbital surgical unit composed of ORL and Eye Surgeons was established at the Yaounde University Teaching Hospital. Objectives: To report preliminary results of the Orbital Surgical Unit of the Yaounde University Teaching Hospital. Methodology: Study on cases operated by surgeons at the Orbital Surgical Unit of the YUTH since the month of July 2015. Results: Seven patients (one male and six females) have already been operated by the Orbital Surgical Unit of the Yaounde University Teaching Hospital. The average age of patients was 40.1 years, ranging from 8 to 70 years. The most frequent indications consist of mucoceles (43%) and fractures of the orbital floor (43%). All patients were operated externally and by a double team. No complications were recorded and the postoperative course was eventful. Conclusion: The establishment of an orbital surgical unit is a new experience that we want to perpetuate. It is a collaboration that will benefit practitioners and patients with orbital surgery indications. Keywords: surgery, eye sockets, Ophthalmologists/ ORL collaboration. LA CHIRURGIE DES CAVITS ORBITAIRES: UN EXEMPLE DE COLLABORATION ORL-OPHTALMOLOGUES AU CHU DE YAOUND Auteurs : Dr BOLA SIAFA Antoine, Dr KAGMENI Gilles, Dr DJOMOU Franois, Dr OWONA NANGA Sandrine, Pr NDJOLO Alexis Auteur correspondant : Dr BOLA SIAFA Antoine, mdecin ORL-CCF. Service ORL et de Chirurgie cervico-faciale. Centre Hospitalier et Universitaire de Yaound-Cameroun. E-mail : HYPERLINK "mailto:siafabola@yahoo.fr"siafabola@yahoo.fr Introduction: La chirurgie des cavits orbitaires regroupe un ensemble dindications varies. Celles-ci peuvent faire intervenir plusieurs spcialits distinctes (ORL, Ophtalmologie, chirurgie maxillo-faciale,). Depuis le mois de Juillet 2015, une unit de chirurgie de lorbite compose de chirurgiens ORL et Ophtalmologistes a t mise sur pied au CHU de Yaound. Objectifs: Rapporter les rsultats prliminaires de lunit de chirurgie de lorbite du CHU de Yaound. Mthodologie: Etude de cas oprs par les chirurgiens de lunit de chirurgie de lorbite du CHUY depuis le mois de Juillet 2015. Rsultats: Sept patients ont dj t oprs par lunit de chirurgie de lorbite du CHU de Yaound. Un sujet masculin et six sujets de sexe fminin. Lge moyen des patients est de 40,1 ans avec des extrmes de 8 et 70 ans. Les indications les plus frquentes sont constitues de mucocles (43%) et de fractures du plancher orbitaire (43%). Tous les patients ont t oprs en double quipe et par voie externe. Aucune complication na t enregistre et les suites opratoires ont toutes t simples. Conclusion: La mise sur pied dune unit de chirurgie de lorbite est une exprience nouvelle que nous tenons prenniser. Cest une collaboration qui se veut bnfique pour les praticiens et les patients prsentant une indication de chirurgie orbitaire. Mots-cls: Chirurgie, cavits orbitaires, collaboration ORL-Ophtalmologues. ETIOLOGICAL PROFILE OF MATERNAL MORTALITY: A 5 YEAR SITUATIONAL COMPARISON OF A PERIPHERAL HOSPITAL AND A CENTRAL HOSPITAL IN CAMEROON. Nana NP, Dohbit JS, Takang WA, Medoua K.K.E.S., Eko E.F., Fouedjio JH. Background: Cameroon is one of the countries which did not reach MDG 5. Maternal mortality remains high. It is important to study and compare the situation at the peripheral centres and that at the reference centres. Objective: The aim was to investigate the medical causes of maternal deaths in two hospitals of different levels but with almost equal number of deliveries. Methods: A retrospective descriptive study in HCY and Bamenda Regional Hospital (HRB) covering the period from 1st January 2010 to 31 December 2014. Results: There were 173 maternal deaths for 17,943 live births at the Yaound Central Hospital giving a mortality rate of 964.16 / 100,000LB meanwhile 41 maternal deaths for 16,596 live births in Bamenda Regional Hospital giving a maternal mortality rate of 247.05 / 100.000 live births. The average age of deceased patients was 28.2 years and the most affected age group was 20-35 years and 64.8 % of them were jobless. At the central hospital, 70.7% of patients who died were from the peripheral health facilities against 32.4 % in the regional hospital. More than half of deaths (57.6%) occurred in the postpartum. Conclusions: The maternal mortality rate remains very high at the Yaounde Central Hospital. The Bamenda Regional Hospital should not be neglected. Keywords: Central Hospital Yaound, Bamenda Regional Hospital, maternal mortality, medical causes of maternal death. PROFIL ETIOLOGIQUE DE LA MORTALITE MATERNELLE: UNE ANALYSE COMPARATIVE SUR 5 ANS DUN HOPITAL PERIPHERIQUE ET UN HOPITAL CENTRAL AU CAMEROUN. Nana NP, Dohbit JS, Takang WA, Medoua K.K.E.S., Eko E.F., Fouedjio JH. Introduction : Le Cameroun est lun des pays nayant pas atteint lOMD 5. La mortalit maternelle reste leve. Il est important de comparer la situation au niveau priphrique celle du niveau de rfrence. Objectifs : Notre but tait dinvestiguer les causes de dcs maternel dans deux hpitaux de niveaux diffrents mais avec presque le mme nombre daccouchement. Mthode : Il sagissait dune tude rtrospective et descriptive lHCY et HRB (Hpital Rgional de Bamenda) allant du 1ier janvier 2010 au 31 dcembre 2014. Rsultats : Il y a eu 173 dcs maternels pour 17.943 naissances vivantes lHCY soit un taux de mortalit de 964,16/100.000 naissances vivantes ; et 41 dcs maternels pour 16.596 naissances vivantes lHRB soit un taux de mortalit de 247,05/100.000 naissances vivantes. Lge moyen des patientes dcdes tait de 28.2 ans et les tranches dges les plus atteintes taient les 20-35 ans et 64.8% des patientes taient sans emploi. A lHCY, 70,7% des patientes dcdes provenaient des formations sanitaires priphriques alors que seules 32,4% taient rfres lHRB. Plus de la moiti des dcs (57,6%) ont eu lieu dans le postpartum. Conclusion : La mortalit maternelle reste trs leve lHpital Central de Yaound. Le taux de lHRB nest pourtant pas ngliger. Mots cls : Hpital Central de Yaound, Hpital Rgional de Bamenda, taux de mortalit maternelle, causes mdicales de dcs maternel. THE OUTCOME OF SURGICALLY TREATED CASES OF PERSISTENT POSTPARTUM HAEMORRHAGE: A COMPARATIVE STUDY OF THE CONSERVATIVE AND THE RADICAL SURGICAL APPROACHES IN TWO MAJOR HOSPITALS IN YAOUNDE, CAMEROON. Dohbit JS, Foumane P, Nkwabong E, Kamouko OD, Meka NOE, Noa NCC., Mboudou ET. Corresponding author: Dr DOHBIT JULIUS SAMA Senior Lecturer of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, The University of Yaounde I., Cameroon Email: dohbit@yahoo.com Introduction: Post-partum hemorrhage is the leading cause of maternal mortality in Cameroon. Surgery is sometimes used as the last resort in its management. Objective: The aim of this study was to compare the fate of patients who had a conservative surgical treatment, to that of those who had a radical surgical treatment for post-partum hemorrhage. Methodology: The study covered the period from January 1st 2004 to December 31st 2014 and concerned women operated for post-partum hemorrhage in the Maternity services of The Yaounde University Teaching Hospital and of the Yaounde Gynaeco-Obstetric and Pediatric Hospital. The sampling was the consecutive and exhaustive type. The degree of association was measured using Odds ratio and relative risk with 95% confidence interval. Results: During the study period, a total of 42,944 deliveries were recorded of which 144 were complicated with postpartum haemorrhage requiring surgery, giving an overall frequency of 0.3%. Of the 60 files retained for our final analysis, 36(60%) underwent a radical surgical treatment and 24 (40%) underwent conservative surgical management. The conservative surgical management was more frequently done in women aged 30 to 35 years (P=0.03) and whose parities were between one and two (OR=13.5; P=0.00). The predisposing factors for conservative surgical management were: parity greater than or equal to 5 (OR=0.2; P=0.00) and a number of living children greater than or equal to 4 (OR=0.2; P= 0.00). Conservative surgical management was more associated with per-operative and post-operative complications (RR=8.2; P= 0.00). Conclusion: The conservative surgical management of postpartum haemorrhage exposes more to maternal death and to per-operative and postoperative complications when compared to the radical surgical approach. Keywords: conservative surgical treatment, radical surgical treatment, postpartum haemorrhage. LA PRISE EN CHARGE CHIRURGICALE DES HEMORRAGIES DU POST PARFUM: PRONOSTIC COMPARE DES APPROCHES RADICALES ET CONSERVATRICES DANS DEUX HOPITAUX UNIVERSITAIRES DE YAOUNDE, CAMEROON Dohbit JS, Foumane P, Nkwabong E., Kamouko OD, Meka NOE., Noa NCC., Mboudou ET. Corresponding author: Dr DOHBIT JULIUS SAMA Senior Lecturer of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, The University of Yaounde I., Cameroon Email: dohbit@yahoo.com Introduction : Lhmorragie du post-partum est la premire cause de mortalit maternelle au Cameroun. Sa prise en charge fait souvent appel la chirurgie en dernier recours. Objectif : Le but de ce travail tait de comparer le devenir des patientes traites par chirurgie conservatrice avec les patientes traites par chirurgie radicale. Mthodologie : Cette tude concernait la priode du 1er janvier 2004 au 31 dcembre 2014 et intressait les femmes opres pour hmorragie du post-partum dans les services de maternit du Centre Hospitalier Universitaire de Yaound et de lHpital Gynco-Obsttrique et Pdiatrique de Yaound. Lchantillonnage tait de type conscutif et exhaustif. Le degr dassociation a t mesur grce au calcul du rapport de ctes (Odds ratio=OR) et du risque relatif avec leurs intervalles de confiance 95%. Rsultats : Pendant la priode dtude, un total de 42.944 accouchements ont t enregistrs, avec 144 complications hmorragiques ncessitant la chirurgie, soit une frquence de 0,3%. Nous avons suivi 60 patientes rparties en 2 groupes : le groupe expos constitu des femmes ayant reu la prise en charge chirurgicale conservatrice qui tait au nombre de 24 (40%) ; le groupe non expos constitu des femmes ayant bnfici de la prise en charge chirurgicale radicale au nombre de 36 (60%). La prise en charge conservatrice tait pratique chez les femmes ge de 30 35 ans (P=0,03) et dont la parit tait comprise entre 1 et 2 (OR=13,5 ; P=0,00). Les facteurs protecteurs de la prise en charge chirurgicale conservatrice taient une parit suprieure ou gale 5 (OR=0,2 ; P=0,00) et un nombre denfant vivants suprieur ou gal 4 (OR=0,2 ; P=0,03). La prise en charge chirurgicale conservatrice multipliait par 5 le risque de dcs maternel (RR=5,4 ; P=0,00) et par 8 les complications per ou post-opratoires (RR=8,2 ; P=0,00). Conclusion : La prise en charge chirurgicale conservatrice expose aux dcs maternels et aux complications per ou post-opratoires lorsquelle est compare la prise en charge chirurgicale radicale. Mots cls: chirurgie conservatrice, chirurgie radicale, hmorragie du postpartum. PROLONGED OBSTRUCTED LABOUR AS A PRIMARY PRESENTATION OF A GIANT BLADDER CALCULUS: AN UNUSUAL OCCURRENCE Abubakar BM1, Atterwahmie AA2, Abdulkadir A3, Maina MS4, Panti AA5.Department of Surgery, Federal Medical Center, Nguru, Yobe ,Nigeria1. Department of Obstetrics and Gynaecology, Federal Medical Center, Nguru, Yobe, Nigeria2. Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria3. Department of Obstetrics and Gynaecology, Birniwa General Hospital, Birniwa Jigwa State, Nigeria4. Department of Obstetrics and Gynaecology, Usman Danfodio University Teaching Hospital, sokoto, Nigeria5. Correspondence to: Dr Abubakar Abdulkadir , Department of Surgery, Bayero University/Aminu 4Kano Teaching Hospital, Kano, PMB 3452, Kano State, Nigeria, E-mail: aabdulkadir21@gmail.com. Tel: +2348036781418 Background: Prolonged obstructed labour is a known complication of labour. It is however, unusual as a primary presentation of a giant calculus. Objective: We report a rare case of prolonged obstructed labour as a Primary Presentation of a giant bladder calculus. Case Report: The patient was a 25year old Para (6+1) 3 alive with lower urinary tract symptoms of 10 years ; suprapubic swelling and intermittent haematuria . She had a fresh still born delivered by Caesarean section (C/S) at her first presentation two weeks earlier following a prolonged obstructed labour that was secondary to a bladder mass. The pregnancy was booked but no antenatal ultrasound was done. All her previous deliveries were uneventful and the last child birth was 2 years to her presentation. She had low midline scar with bimanually palpable bladder mass that was hard, regular and mobile. Her Abdomino-pelvic ultrasound scan revealed giant bladder calculi with grade II-III obstructive uropathy. Pelvic X ray showed giant bladder calculus. Urine M/C/S yielded E. coli sensitive to Ciprofloxacin but other laboratory investigations were normal. She was treated for UTI then had opened Cystolithotomy with multiple bladder mucosal biopsies. The stone weigh 535g. Her Post-operative care was uneventful; no LUTS on removal of catheter. She was to be followed up in the appropriate clinics. Conclusion: Prolonged obstructed labour is an unusual presentation of a giant bladder calculus. Therefore, the diagnosis requires a high index of suspicion. Clinical assessment and Radiologic investigations establish the diagnosis. Emergency C/S with subsequent cystolithotomy is an appropriate treatment. Key words: prolong obstructed labour, giant calculus, primary presentation TRAVAIL AVEC OBSTRUCTION PROLONGE PAR UN CALCUL URINAIRE GANT EN PRSENTATION INITIALE: UN VNEMENT RARE Abubakar BM1, Atterwahmie AA2, Abdulkadir A3, Maina MS4, Panti AA5.Department of Surgery, Federal Medical Center, Nguru, Yobe ,Nigeria1. Department of Obstetrics and Gynaecology, Federal Medical Center, Nguru, Yobe, Nigeria2. Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria3.Department of Obstetrics and Gynaecology, Birniwa General Hospital, Birniwa Jigwa State, Nigeria4. Department of Obstetrics and Gynaecology, Usman Danfodio University Teaching Hospital, sokoto, Nigeria5. Correspondence to: Dr Abubakar Abdulkadir , Department of Surgery, Bayero University/Aminu 4Kano Teaching Hospital, Kano, PMB 3452, Kano State, Nigeria, E-mail: aabdulkadir21@gmail.com. Tel: +2348036781418 Contexte: Le travail avec obstruction prolong est une complication connue du travail daccouchement. Il est cependant inhabituel quil soit prolong par la prsentation primaire dun calcul urinaire gant. Objectif: Nous rapportons un cas rare de travail avec obstruction prolong par un calcul urinaire gant en prsentation primaire. Rapport de cas: La patiente tait ge de 25 ans, Para (6 + 1) 3 en vie souffrant des troubles urinaires du bas appareil depuis 10 ans et prsentant un gonflement sus-pubien et une hmaturie intermittente. Elle avait eu une morti-naissance par csarienne lors de sa premire prsentation deux semaines plus tt aprs un travail avec obstruction prolong caus par une masse dans la vessie. La grossesse tait enregistre, mais aucune chographie prnatale navait t faite. Toutes les accouchements prcdents staient drouls sans incident et le dernier accouchement avait eu lieu 02 ans avant sa prsentation. Elle avait une lgre cicatrice mdiane et une palpation deux mains a rvl une masse dure, rgulire et mobile dans la vessie. Son chographie abdomino-pelvienne a rvl des calculs urinaires gants avec une uropathie obstructive de grade II-III. La radiographie pelvienne a montr un calcul urinaire gant. Lanalyse durine a mis en vidence E. coli sensible la ciprofloxacine, mais les autres examens de laboratoire taient normaux. Elle a t traite pour une infection urinaire, puis a subi une cystolithotomie ciel ouvert avec plusieurs biopsies de la muqueuse vsicale. Le calcul pesait 535g. Ses soins post-opratoires se sont drouls sans problme ; aucun TUBA au retrait du cathter. Elle devait tre suivie dans des cliniques appropries. Conclusion : Un travail avec obstruction prolong par un calcul gant dans la vessie est inhabituel. Par consquent, le diagnostic requiert un fort indice de suspicion. Lvaluation clinique et les examens radiologiques permettent dtablir le diagnostic. Le traitement appropri est une csarienne en urgence suivie dune cystolithotomie. Mots cls : travail avec obstruction prolonge, calcul gant, prsentation primaire. PYONEPHROSIS DISCOVERED DURING PREGNANCY: A CASE REPORT Dohbit JS, Mbouch L, Tompeen I, Ngo UmEM, FoumaneP, Angwafo III FF. Background: Acute urinary tract infection is a common clinical problem in women of childbearing age especially during pregnancy where urinary stasis is constant. Infection of this urine stasis is pyonephrosis, whose occurrence during pregnancy has rarely been described in the literature Objectives: To report a case of pyonephrosis during pregnancy which was managed in Yaounde Gynaeco-Obstetric and Pediatric Hospital. Case report: It was a 23-year-old pregnant woman at 25 weeks of gestation, with 3 years history of non-investigated left flank pain, who complained for severe acute left flank pain, swelling of the left flank, pyuria with fever. Abdominal ultrasound was in favor of a pyonephrosis with extensive destruction of the left kidney. While waiting for a deferred nephrectomy, the emergency management was: fluid replacement, antibiotics and especially the achievement of a percutaneous nephrostomy drainage which will allow to continue the pregnancy to term. Conclusion: In the context of pregnancy, the pyonephrosis is a diagnostic and therapeutic emergency because renal functional prognosis is engaged. Its non- recognition can cause death from septic shock. A percutaneous nephrostomy drainage usually echo - guided is essential. Keywords: pyonephrosis, pregnancy, nephrostomy, nephrectomy. PYONPHROSE DCOUVERTE AU COURS DUNE GROSSESSE : PROPOS DUN CAS CLINIQUE Dohbit JS, Mbouch L, Tompeen I, Ngo UmEM, FoumaneP, Angwafo III FF. Contexte : Linfection urinaire aigue est un problme clinique frquent surtout chez la femme en priode dactivit gnitale et notamment pendant la grossesse o une stase urinaire est constante. La surinfection de cette stase urinaire ralise une pyonphrose dont la survenue au cours dune grossesse a t rarement dcrite dans la littrature. Objectif : Rapporter un cas de pyonphrose sur grossesse pris en charge lHpital Gynco-Obsttrique et Pdiatrique de Yaound Observation : Il sagit dune gestante de 23ans 25 semaines damnorrhe, venue consulter pour exacerbation dune douleur du flanc gauche non investigue depuis 3ans, tumfaction du flanc gauche et pyurie franche voluant en contexte fbrile chez qui une chographie abdominale faite en urgence tait en faveur dune pyonphrose avec destruction importante du rein gauche. En lattente dune nphrectomie diffre, la prise en charge en urgence a consist un remplissage vasculaire, une antibiothrapie et surtout la ralisation dun drainage par une nphrostomie percutane permettant de poursuivre la grossesse jusqu terme, Conclusion : En contexte gravidique, la pyonphrose est une urgence diagnostique et thrapeutique car le pronostic fonctionnel rnal est engag. Sa non reconnaissance peut entrainer le dcs par choc septique. Un drainage par nphrostomie percutane le plus souvent cho-guid est indispensable. Mots cls : Pyonphrose, grossesse, nphrostomie, nphrectomie A CASE OF A 26 WEEKS AMPULLAR PREGNANCY MIMICKING INTRA-UTERINE FETAL DEATH NKWABONG Elie1, FOGUEM TINCHO Eveline2 1MD, Department of Obstetrics and Gynecology, University Teaching Hospital & Faculty of Medicine and Biomedical Sciences, Yaound I, Cameroon 2MD, Faculty of Medicine and Biomedical Sciences, University of Yaound I, Cameroon Abstract: The ampulla is the commonest localization of ectopic pregnancy. Almost all ampullar pregnancies rupture during the first trimester. The diagnosis of ectopic pregnancy with ultrasound is usually easy during the first trimester. However, ultra-sonographic diagnosis becomes difficult in the second and third trimesters and the diagnosis is usually made during laparotomy. The authors report a case of a right ampullar missed abortion at 26 weeks gestation, which was diagnosed during laparotomy only, after repeated failed attempts at induction of labor. The initial ultra-sonographic diagnosis was that of an intrauterine late missed abortion. The authors recommend that in cases of repeated failed attempts at induction for late missed abortions, the probability of an ectopic pregnancy should be thought of, even if ultrasound scans diagnosed an intra-uterine pregnancy, and an exploratory laparotomy performed. Key words: Late missed abortion; Failed induction; Exploratory laparotomy; Advanced ampullar pregnancy; Total salpingectomy. CAS DE GROSSESSE AMPULLAIRE NON ROMPUE DE 26 SEMAINES MIMANT UNE GROSSESSE ARRETEE. NKWABONG Elie1, FOGUEM TINCHO Eveline2 1MD, Department of Obstetrics and Gynecology, University Teaching Hospital & Faculty of Medicine and Biomedical Sciences, Yaound I, Cameroon 2MD, Faculty of Medicine and Biomedical Sciences, University of Yaound I, Cameroon Rsum: Lampoule est la localisation la plus frquente de la grossesse extra-utrine. La grande majorit des grossesses ampullaires se rompent au 1er trimestre. Le diagnostic de la grossesse extra-utrine par chographie est assez facile au 1er trimestre. Cependant, le diagnostic par chographie devient difficile aux 2me et 3me trimestres. Les auteurs rapportent ici un cas de grossesse ampullaire arrte de 26 semaines dont le diagnostic a t pos en peropratoire aprs chec de nombreuses tentatives dinduction davortement tardif. Le diagnostic chographique initial tait celui dune grossesse intra-utrine arrte. Les auteurs recommandent quen cas dchec rpt dinduction, la probabilit dune grossesse extra-utrine doit tre voque mme si les chographies sries ont pos le diagnostic dune grossesse intra-utrine, et une laparotomie exploratrice doit tre effectue. Mots cls: Grossesse arrte; chec dinduction; Laparotomie exploratrice; Grossesse ampullaire de 26 semaines; Salpingectomie totale. COMBINE UTERINE AND BLADDER RUPTURE UNUSUAL COMPLICATION OF LABOUR IN A PRIMIGRAVIDA. I U Takai (MBBS, MHPM, FMCOG) 1, A Abdulkadir (MBBS, FWACS)2 1Department of Obstetrics and Gynaecology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria, 2Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria, Correspondence to: Dr Abubakar Abdulkadir, Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, PMB 3452, Kano State, Nigeria, E-mail: aabdulkadir21@gmail.com. Tel: +2348036781418 Background: Combined Uterine and Bladder rupture is a serious Uro-obsteteric emergency that results in stillbirth, maternal morbidity and occasional mortality. The bladder rupture is particularly very rare in absence of clinical factors that could predispose the bladder to be adherent to the lower uterine segment. Aims and objective: We report a rare case of bladder rupture combined with the uterine rupture in a primigravida during a prolonged obstructed Labour. Case Report: A 17 year old married Unbooked Primigravida, who presented with 3 days history of spontaneous labour at term initially managed at home. The labour was complicated by combined uterine and bladder rupture with sepsis. Following resuscitations, she had exploratory Laparotomy. Findings at the Laparatomy included thick foul smelling liquor, fresh still born male baby weighing 3.85Kg, ragged lower uterine rupture that extended down to the uterine cervix. There was associated urinary bladder rupture measuring 10cm7cm. She had uterine and urinary bladder repairs with an uneventful recovery before discharged to see family planning and gynae clinics. Conclusion: A high index of suspicion and appropriate prompt intervention will reduce the resulting morbidity and occasional mortality associated with the clinical condition. There should be increased community awareness on inherent risks associated unsupervised pregnancy, labour and delivery. DOUBLE RUPTURE UTERINE ET VESICALE UNE COMPLICATION DU TRAVAIL HABITUELLE CHEZ UNE PRIMIPARE. I U Takai1, A Abdulkadir2 1Department of Obstetrics and Gynaecology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria, 2Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria, Correspondence to: Dr Abubakar Abdulkadir, Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, PMB 3452, Kano State, Nigeria, E-mail: aabdulkadir21@gmail.com. Tel: +2348036781418 Contexte : la rupture utrine et vsicale est une urgence uro-obsttrique grave qui se traduit par la mortinatalit, la morbidit maternelle et la mortalit occasionnelle. La rupture de la vessie est particulirement rare en labsence de facteurs cliniques qui pourraient prdisposer la vessie adhrer au segment utrin infrieur. Objectif : Nous rapportons un cas rare de double rupture vsicale et utrine chez une primipare lors dun accouchement avec obstruction prolonge. Prsentation de cas : une primipare de 17 ans, marie, qui sest prsente aprs 3 jours de travail spontan terme initialement pris en charge domicile. Le travail sest compliqu par une double rupture de lutrus et de la vessie avec septicmie. Aprs ranimation, elle a subi une laparotomie exploratrice qui a mis en exergue une substance paisse dune odeur nausabonde, un bb mort-n de sexe masculin pesant 3,85 kg, une rupture du segment utrin infrieur qui sest tendue vers le col de lutrus. Elle a t associe la rupture de la vessie de 10cm7cm. La prise en charge a consist en la rparation de lutrus et de la vessie, avec des suites simples avant la sortie de lhpital pour se rendre dans un centre de planning familial et le service de gyncologie. Conclusion: Un indice lev de suspicion et une intervention rapide approprie permettront de rduire la morbidit et la mortalit occasionnelle lie ltat clinique qui en rsulte. Il faudrait intensifier la sensibilisation des communauts sur les risques lis la grossesse, au travail et laccouchement non suivis. POST-PARTUM ECLAMPSIACOMPLICATED BY HEMORRHAGIC STROKE: CASE REPORT Metogo Mbengono JA, Ndikontar R, Bengono Bengono R, Amengle AL., Metogo Ntsama J, Ze Minkande J. Facult de Mdecine et des Sciences Biomdicales Universit de Yaound, Cameroon. Email: HYPERLINK "mailto:junetmet@yahoo.fr"junetmet@yahoo.fr Abstract: Peripartal strokes are not rare. We reported a case of post-partum eclampsia complicated by hemorrhagic stroke on a primigravida parturient of 20 years old. She was referred for tonico-clonic seizures and right motor deficit. The treatment consisted of hydration in saline 0.9%, administration of antihypertensive: nicardipine to the electric syringe pump, prevention of vasospasm by nimodipine 90mg /24h, magnesium sulfate, acetaminophen 1 g / 6 h, ranitidine 50mg / 8h, the prevention of venous thromboembolic disease (stockings, enoxaparin 40mg / 24h). Recovery from the motor deficit started on the second day of hospitalisation. The patient was discharged after 24 days of hospitalisation. The aim of this report was to reveal that eclampsia is a major cause of peripartal stroke. Key words: Stroke, Eclampsia, Post-partum ECLAMPSIE DU POST-PARTUM COMPLIQUEE DUN ACCIDENT VASCULAIRE CEREBRAL HEMORRAGIQUE : CAS CLINIQUE MetogoMbengono JA., Ndikontar R, BengonoBengono R, Amengle AL, MetogoNtsama J, Ze Minkande J. Facult de Mdecine et des Sciences Biomdicales Universit de Yaound, Cameroon. Email :junetmet@yahoo.fr Rsum : Les accidents vasculaires crbraux du pripartum ne sont pas rares. Nous rapportons le cas dune patiente de 20 ans, G1P1001, rfre pour convulsions tonico-cloniques gnralises et dficit moteur de lhmicorps droit aprs un accouchement par voie basse. Le diagnostic daccident vasculaire crbral hmorragique compliquant une clampsie du post-partum immdiat a t pos aprs ralisation dun scanner crbral. Le traitement consistait lhydratation au srum sal 0,9%, ladministration dun antihypertenseur : nicardipine au pousse-seringue lectrique, la prvention du vasospasme par la nimodipine 90mg/24h, le sulfate de magnsium, paractamol 1g/6h, ranitidine 50mg/8h, la prvention de la maladie thrombo-embolique veineuse (bas de contention, enoxaparine 40mg/24h).La rcupration de la motricit sest faite progressivement ds le deuxime jour. Elle est sortie aprs 24 jours dhospitalisation.Lintrt tait de rvler que lclampsie est une forte pourvoyeuse daccidents vasculaires crbraux en priode pripartale. Mots-cls : Accident vasculaire crbral- Eclampsie- Post-partum G/O 008 IS INSULIN RESISTANCE INDEPENDENT OF OBESITY IN THE POLYCYSTIC OVARIAN SYNDROME IN SUB SAHARAN AFRICANS: A CLAMP STUDY Doh E, Mbanya A, Dohbit S, Kemfang-Ngowa JD, Tchana-Sinou M, Donfack OT, Foumane P, Doh AS, Sobngwi E, Mbanya JC. Background and objectives: Polycystic ovarian syndrome (PCOS) is one of the most common and heterogeneous ovulatory disorders among women of reproductive age. Although this condition has many unrelated presenting signs and symptoms, obesity and insulin resistance remain very common. Whether insulin resistance is independent of adiposity remains unclear. Methods: We evaluated insulin sensitivity in relation to obesity in PCOS in 24 sub-Saharan African women using the gold standard 80mU/m/min euglycaemic hyperinsulinaemic clamp (6 obese PCOS, 8 non-obese PCOS and 10 non-PCOS non-obese women) in a cross sectional, comparative study. Body composition was evaluated using electrical bio-impedance and resting energy expenditure measured by indirect calorimetry. Results: Participants age was similar across sub groups with (median [interquartile range]) 26[23-30] years for obese PCOS, 27[24-29] years for non-obese PCOS, and 23[23-24] years for non-obese non-PCOS women, with similar resting energy expenditure across groups (1411[1368-1613] vs 1274[1174-1355] vs 1239[1195-1454] respectively; p=0.306). Insulin sensitivity adjusted to lean mass in mg/kg varied significantly across groups from 11.2 [10.1-12.4] in obese PCOS, 12.9 [12.1-13.8] in non-obese PCOS, and 16.6 [13.8-17.9] in non-obese non-PCOS women; p=0.012). Conclusion: PCOS is associated with decreased insulin sensitivity in sub Saharan African women, and further worsened in the presence of associated obesity. Obesity does not seem to be explained by the resting energy expenditure suggesting an underestimated role of food intake. LA RESISTANCE A LINSULINE EST-ELLE INDEPENDANTE DE LOBESITE DANS LE CAS DU SYNDROME DES OVAIRES POLYKYSTIQUES EN AFRIQUE SUBSAHARIENNE: UNE ETUDE DE CLAMP Doh E, Mbanya A, Dohbit S, Kemfang-Ngowa JD, Tchana-Sinou M, Donfack OT, Foumane P, Doh AS, Sobngwi E, Mbanya JC. Contexte et objectifs : le syndrome des ovaires polykystiques (SOPK) est lun des troubles de lovulation les plus courants et htrognes chez les femmes en ge de procrer. Cette affection prsente de nombreux signes et symptmes indpendants, certes. Cependant, lobsit et la rsistance linsuline restent trs frquentes. Lindpendance de linsulinorsistance de ladiposit reste incertaine. Mthodes : Nous avons valu la sensibilit l'insuline par rapport lobsit dans le SOPK chez 24 femmes dAfrique subsaharienne laide de la norme dexcellence 80mU/m/min du clamp euglycmique hyperinsulinmique (6 SOPK obses, 8 SOPK non obses et 10 non-SOPK des femmes non obses), une tude comparative transversale. La composition corporelle a t value laide de la bio-impdance lectrique et la dpense nergtique au repos mesure par la calorimtrie indirecte. Rsultats : Lge des participants tait le mme dans tous les sous-groupes avec (mdiane [intervalle interquartile]) 26 ans [23-30] pour les cas dobsit avec SOPK, 27 ans [24-29] les non obses avec SOPK et 23 [23-24] ans pour les femmes non-obses sans SOPK, avec une dpense similaire nergtique au repos entre les groupes (1411[1368-1613] vs 1274[1174-1355] vs 1239[1195-1454] respectivement; p=0,306). La sensibilit linsuline ajuste la masse maigre en mg/kg variaient considrablement selon les groupes de 11,2 [10.1-12.4] chez les obses avec SOPK, 12,9 [12,1-13,8] chez les non-obses avec SOPK, and 16,6 [13.8-17.9] chez les femmes non-obses sans SOPK; p=0,012). Conclusion : le SOPK est associ une diminution de la sensibilit linsuline chez les femmes dAfrique subsaharienne, et saggrave davantage en cas dobsit associe. L'obsit ne semble pas sexpliquer par la dpense nergtique au repos suggrant un rle sous-estim de lalimentation. FTAL AND MATERNAL OUTCOME IN MECONIUM STAINED AMNIOTIC FLUID Nana NP, Dohbit JS, Mah EM, Mesumbe NE, Ngo Um ME, Foumane P. Background: Meconiun stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Its association to increased perinatal morbidity has been described. However, little has been done on this subject in our setting. Objective: The aim of this study was to determine the maternal and fetal outcome in meconiun stained amniotic fluid in two reference hospitals of Yaounde, Cameroon. Methodology: This was a prospective cohort study targeting pregnant women admitted in the labour wards of the maternity services of the Central Hospital of Yaound (HCY) and Gynaeco-Obstetric and Pediatric Hospital of Yaound (HGOPY). It was conducted during a 5 months period from December 2014 to April 2015. Women were classified according to the color of amniotic fluid exposed, for those with MSAF and non-exposed, and those with clear amniotic fluid (CAF). The two groups were followed up during labor and 72hours following delivery. Results: The incidence of MSAF was 11.15%, of which 52.1% was thick meconium stained and 47, 9% light meconium stained. Maternal morbidity was high in the group of MSAF, such as higher proportions of caesarian delivery (RR=2.35 p<10-4) and prolonged labor (RR=3 p<10-4). The incidence of chorioamnionitis and puerperal sepsis was low (0.94 and 0.70% respectively) but the risk was three times higher in the MSAF group. Fetuses and neonates born with MSAF had higher morbidity and mortality compared to those with CAF. Conclusion: MSAF is associated with increased perinatal morbidity and mortality. Key words: Amniotic fluid, meconiun stained amniotic fluid, perinatal morbidity, perinatal mortality. LE DEVENIR MATERNEL ET FTAL EN CAS DE LIQUIDE AMNIOTIQUE MECONIAL Nana NP, Dohbit JS, Mah EM, Mesumbe NE, Ngo Um ME, Foumane P. Introduction : Le liquide amniotique mconial (LAM) est frquemment rencontr dans la pratique obsttricale. Son association un risque lev de morbidit prinatale a t dmontre. Toutefois, la littrature sur le sujet reste trs pauvre dans notre contexte. Objectif : Le but de ce travail tait de dterminer les consquences maternelles et ftales du liquide amniotique mconial. Mthodologie : Il sagissait dune tude de cohorte prospective ciblant les femmes enceintes admises en salle de travail dans les maternits de lHCY et de lHGOPY. Elle sest droule sur une priode de 5 mois allant de dcembre 2014 avril 2015. Les femmes ont t classes selon la couleur du liquide amniotique en exposes pour celles ayant un liquide amniotique mconial et non-exposes pour celles ayant un liquide amniotique clair (LAC). Les deux groupes ont t suivis pendant toute la dure du travail et les soixante-douze(72) heures qui ont suivi laccouchement. Rsultats : Lincidence du LAM tait de 11,15%, dont 52,1% de LAM pais et 47,9% LAM lger. La morbidit maternelle avait augment par la prsence du LAM. En effet, des proportions plus leves de csarienne (RR=2,35 p<10-4) et de travail prolong (RR=3 p<10-4) ont t retrouves dans le groupe de LAM. Dans ce mme groupe, le risque de Chorioamniotite et dinfection puerprale tait trois fois plus lev. Les ftus et nouveau-ns issus daccouchements avec LAM prsentaient une morbi- mortalit plus leve que ceux avec LAC. Conclusion : le liquide amniotique mconial est associ une augmentation de la morbidit et de la mortalit prinatale. Mots cls : Liquide amniotique, liquide amniotique mconial, morbidit prinatale, mortalit prinatale. HOW SAFE IS TERM VAGINAL BREECH DELIVERY IN OUR SETTING, HGOPY, CAMEROON? A FIVE YEAR REVIEW Dohbit JS, Foumane P, Meka NU.E, Fadimatou M, Belinga E, Mboudou ET. Corresponding author: Dr DOHBIT JULIUS SAMA Senior Lecturer of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, The University of Yaounde I., Cameroon Telephone: (237) 677 786 059 Email: dohbit@yahoo.com Background: Breech delivery is known to be a stressful situation for the mother, her unborn baby and health care providers. Objective: The aim of this study was to evaluate the materno-fetal prognosis in vaginal breech delivery at term in singleton gestations. Methodology: An analytic and retrospective study was carried out, analyzing data from January 1st, 2010 to December 31st, 2014 in the Yaounde Gynaeco-Obstetric and Pediatric Hospital (HGOPY). Results: A total of 13,695 deliveries were recorded, among which 364 singleton breech deliveries, giving a frequency of 2.66 %. During labor, vaginal breech delivery exposed: to referral from other hospitals [RR=5.83; IC (3,55-9,58)], to uterine (dynamic) dystocia [RR=01.74; IC (1.07-2.83)], to meconium stained amniotic fluid [RR=21.05; CI (2.83-156.51)], to prolonged second stage of labour [RR=5.33; CI (1.23-23.11)], to fetal abnormalities in second stage of labour [RR=2.05; CI (1.15-3.67)], to Apgar scores less than 7 at the 5th minute [RR=7.20; CI(2.51-20.59)], to the need for neonatal resuscitation [RR=4.74; CI (3.09-7.26)], to transfer to the neonatology unit [RR=6.40; CI (2.18-18.77)], to fetal trauma [RR=12.00; CI (1.27-113.07)]. Vaginal breech deliveries were done by specialists [RR=9.85; CI (6.55-14.80)]. Conclusion: The fetal and neonatal outcome was jeopardized by several factors in the vaginal breech delivery group. The main maternal complication was dynamic dystocia. Keywords: breech, vaginal delivery, outcome, Cameroon. QUELLE EST LA SECURITE DE LACCOUCHEMENT VAGINAL DU SIEGE A TERME DANS NOTRE MILIEU, HGOPY, CAMEROUN? UNE REVUE DE 5 ANS DACTIVITES. Dohbit JS., Foumane P., Meka N. U. E., Fadimatou M.,. Belinga E., Mboudou E. T., Corresponding author: Dr DOHBIT JULIUS SAMA Senior Lecturer of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, The University of Yaounde I., Cameroon Telephone: (237) 677 786059 Email: dohbit@yahoo.com Introduction : laccouchement par le sige est une situation prouvante pour la mre, son ftus et les quipes obsttricale, nonatale et de ranimation qui lentourent. Objectif : Le but de notre travail tait dvaluer le pronostic materno-ftal de laccouchement du sige par voie basse terme. Mthodologie : une tude de cohorte historique a t mene, analysant les donnes allant du 1er janvier 2010 au 31 dcembre 2014 au sein de lHpital Gynco-Obsttrique et Pdiatrique de Yaound (HGOPY). Rsultats : sur les 13 695 accouchements enregistrs, il y a eu 364 accouchements sur grossesse monoftale en prsentation de sige soit une frquence de 2,66%. Au cours du travail, laccouchement par sige exposait : la rfrence partir dautres structures sanitaires [RR=5,83 ; IC (3,55-9,58)], la dystocie dynamique [RR=1,74 ; IC (1,07-2,83)], lmission du liquide amniotique mconial [RR=21,05 ; IC (2,83-156,51)], au prolongement de la phase expulsive [RR=5,33 ; IC(1,23-23,11)], la prsence danomalies ftales lors de lexpulsion [RR=2,05 ; IC (1,15-3,67)], au score dApgar <7 la 5me [RR=7,20 ; IC(2,51-20,59)], la ranimation nonatale [RR=4,74 ; IC(3,09-7,26)], au transfert en nonatalogie [RR=6,40 ; IC(2,18-18,77)], au traumatisme ftal [RR=12,00 ; IC(1,27-113,07)]. Les spcialistes pratiquaient plus les accouchements par sige que les accouchements du sommet [RR=9,85 ; IC (6,55-14,80)]. Conclusion : laccouchement par sige tait considrablement associ des complications ftales et nonatales et une complication maternelle. Mots cls : sige, accouchement, voie basse, pronostic, Cameroun. LIMIT OF SECURITY INVESTED TO THE NUMBER OF CESARIAN SECTION IN YAOUNDE GYNAECOLOGIC OBSTETRIC AND PEDIATRIC HOSPITAL OF YAOUNDE Dohbit JS, Ngo Um EM, Mamchew, Osogo E, NgoBatta, Foumane P. Abstract: The caesarean section is a surgical procedure that involves opening of the abdominal wall and the gravid uterus to extract a ftus and annexes. There is a rise in the number of caesarean sections, both in developed and developing countries. Complications of pregnancies on a scared uterus are related to the quality of the scar, the surgical technique and the number of caesarean section. In this study, we are evaluating the optimal number of caesarean section that can be practiced with insecurity limit. It is an analytical and retrospective study in the Yaounde Gynaeco-obstetric and Paediatric Hospital. We are going to draw our conclusion based on the results of this study. Key words: Cesarian, Limit, Security, Number, Scar. LIMITE DE SCURIT AU NOMBRE DE CSARIENNE LHPITAL GYNCO-OBSTTRIQUE ET PDIATRIE DE YAOUNDE Dohbit JS, Ngo Um EM, Mamchew, Osogo E, NgoBatta, Foumane P. Rsum: La csarienne est une intervention chirurgicale qui implique louverture de la paroi abdominale et de lutrus gravide pour extraire un ftus et les annexes. On note une augmentation du nombre de csariennes, la fois dans les pays dvelopps et les pays en dveloppement. Les complications de grossesses en cas dutrus cicatriciel sont lies la qualit de la cicatrice, la technique chirurgicale et le nombre de csarienne. Dans cette tude, nous valuons le nombre optimal de csariennes qui peuvent tre effectues dans la limite de scurit. Cest une tude analytique et rtrospective mene lHpital Gynco-obsttrique et Pdiatrique de Yaound. Notre conclusion sera tire sur la base des rsultats de cette tude. Mots cls : csarienne, limite, scurit, Nombre, cicatrice. THE EPIDEMIOLOGICAL PROFILE AND HISTOLOGICAL TYPES OF BREAST TUMORS MANAGED IN HGOPY. A FIVE YEAR RETROSPECTIVE REVIEW Dohbit JS, Foumane P, Kemfang JD, Meka NUE, Akame MG, Mboudou ET. Introduction: The histology of breast tumor is essential to confirm the diagnosis and predict the prognosis. Several studies on breast cancer have been conducted in Cameroon and almost nothing on benign tumors. Aim: The objective was to describe the epidemiology and histology of breast tumors. Methodology: This was a retrospective descriptive study over a period of five (05) years in the Yaounde Gyneco-Obstetric and Pediatric Hospital. Results: A total of 128 women with 138 breast specimens were examined. Malignant tumors accounted for 62% meanwhile 37% were benign. In the age group younger than 25 years, 96% of the tumors were benign. The mean age for benign tumors was 28.96 12.87 years. A mean age of 41.95 8.70 years was found for malignant tumors with a predominance of the 30-49 years age bracket (74.42 %). Menopause, multiparity, and breastfeeding were the risk factors found in patients with malignant tumors in our study with values of p <0.05 and OR contained in the confidence interval. However, after logistic regression, they were no longer significant. Breast nodule was found as the most common clinical presentation (83.3 %), breast self-examination was the most used screening method (93%). The average time to consultation was 11 months. The clinical stage T3N1Mx was most frequent (24.4 %), grade II of SBR (72.1 %). The histological types found for benign tumors were fibroadenoma (43.13 %) followed by fibrocystic breast disease (25.5 %) and papilloma (11.8 %); whereas invasive ductal carcinoma (65.1 %) and ductal carcinoma in situ (11.63 %) were the types of malignancies most found. Conclusion: Benign tumors are common in our environment with the younger patients being the most affected. The average age at diagnosis of malignant tumors is relatively young with a predominance of less than 50 years. The majority of patients discovered their tumors during breast-self-examination. Patients consult at an advanced stage of the disease. Key words: Breast tumor, Epidemiology, Histologic types. PROFIL EPIDEMIOLOGIQUE ET TYPES HISTOLOGIQUES DES TUMEURS DU SEIN PRISES EN CHARGE A HGOPY. UNE REVUE RETROSPECTIVE DE 5 ANS Dohbit JS, Foumane P, Kemfang JD, Meka N.U.E., Akame M.G., Mboudou E.T. Introduction : Lanalyse histologique est essentielle pour poser le diagnostic et faire un pronostic pour toute tumeur du sein. Beaucoup dtudes ont t menes au Cameroun sur le cancer du sein, mais nous navons retrouv aucune tude sur la tumeur bnigne du sein. Objectif : Le but de ce travail tait de dcrire l'pidmiologie et l'histologie des tumeurs du sein prise en charge HGOPY. Mthodologie : C'tait une tude rtrospective descriptive s'talant sur une priode de cinq (05) ans et ayant pour cadre l'Hpital gynco-obsttrique et pdiatrique de Yaound. Rsultats : Au total, 128 femmes avec un total de 138 pices de prlvements mammaires ont t examines. Les tumeurs malignes reprsentaient 62% et les tumeurs bnignes 37%. La tranche d'ge de < 25 ans avait 96% des tumeurs bnignes avec un ge moyen de 28.96 12.87 ans. Un ge moyen de 41.95 8.70 ans a t retrouv pour les tumeurs malignes avec une prdominance de la tranche de 30-49 ans (74.42%). La mnopause, la multiparit, l'allaitement maternel, taient les facteurs qui exposaient aux tumeurs malignes dans notre tude avec des valeurs de p < 0.05 et des OR contenus dans l'intervalle de confiance. Toutefois, aprs la rgression logistique, ils ne sont plus significatifs. Le nodule mammaire tait la prsentation clinique la plus retrouve (83.3%), l'autopalpation tait le moyen le plus utilis (93%). Le dlai de consultation moyen tait de 11 mois. Le Stade T3N1Mx tait le plus retrouv (24.4%), ainsi que le grade II de SBR. (72.1%). Les types histologiques retrouvs taient: l'adnofibrome (43.13%) suivi de la mastopathie fibrokystique (25.5%) et du papillome (11.8%) pour les tumeurs bnignes. Le carcinome canalaire infiltrant (65.1%), le carcinome canalaire in situ (11.63%) taient les types de tumeurs malignes les plus retrouvs. Conclusion : Nous avons trouv les tumeurs bnignes plus frquentes chez les patientes jeunes. Lge moyen au diagnostic du cancer du sein tait inferieur 50 ans. La majorit des patientes ont dcouvert leurs tumeurs pendant lautopalpation des seins. Les patientes consultaient un stade avanc de la maladie. Mots cls: Tumeur du sein, pidmiologie, types histologiques. BREAST CONSERVING SURGERY IN BREAST CANCER PATIENTS: UNTH EXPERIENCE EZEOME ER. ILOABACHIE I, ILO C, UNAKA KC, 1Enemuo VC. Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria. & Department of Surgery, FETHA , Abakaliki, Ebonyi State, Nigeria. Corresponding author: Prof EZEOME E.R Introduction; Breast conserving surgery (BCS) is a suitable treatment option for early and down staged breast cancer diseases. It compares favourably with modified radical mastectomy in outcome. Nevertheless, it is associated with higher local recurrence than mastectomy especially when clear resection margin is compromised. This treatment option is yet to take a firm footing in Nigeria and we are not aware of any report of its outcome in our local environment. In this communication, we report the results of breast conservation treatment as done in our centre Objective: To evaluate the outcome of breast conservation To determine the rate of local recurrence in breast conserving surgery Methods: This is a retrospective review of 16 cases of breast cancer done in our centre from 2002 to 2014. The case notes of the breast conservation surgeries were reviewed for patients demographic parameters, stage at diagnosis,pre-surgical treatments offered ,response to pre-surgical treatment, pre-op imaging investigations, type of breast conservation surgery done, care of the operating surgeon, early complications of the surgery, histo-pathological review of the resection margin, local recurrence, distant metastases, time to metastases. Cosmetic outcome as assessed by both surgeon and the patient and follow up events. Also included in the analysis was the reoperation and histological results of reoperation specimen was performed on. Results; Eighty one per cent of the patients had clear resection margins whereas 19% had positive margins. This degree of clear margins was achieved despite lack of intra-operative cytological assessment in our centre, and invasive breast diseases in most of the cases. At a median follow up of 34 months, one patient had loco-regional recurrence in the treated breast and axilla. There were also 2 cases of disease progression with pulmonary and hepatic metastases respectively and one mortality.     Conclusion: In view of low recurrence and satisfactory cosmetic outcome of BCS in our centre, it is a reliable option to mastectomy in patients with early and down staged breast cancer disease .Early presentation and prompt referral of breast cancer patients to our centre will guarantee more patient selection for BCS. Low threshold for BCS and provision of intra-operative cytological assessment facility are recommended. CHIRURGIE CONSERVATRICE DU SEIN CHEZ LES PATIENTS ATTEINTS DE CANCER DU SEIN: LEXPERIENCE DE LUNTH Ezeome ER, Iloabachie I, Ilo C, Unaka KC, 1Enemuo VC. Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria & Department of Surgery, FETHA, Abakaliki, Ebonyi State, Nigeria. Introduction: La chirurgie conservatrice du sein (CCS) est une option de traitement appropri pour le stade prcoce du cancer du sein. Cette technique est aussi avantageuse que la mastectomie radicale modifie en termes de rsultat. Toutefois, elle est associe une rcidive locale plus leve que la mastectomie en particulier lorsque la marge de rsection claire est compromise. Cette option de traitement na pas encore une base solide au Nigeria et nous ne disposons pas dinformations sur ses rsultats dans notre contexte. Dans cette tude, nous prsentons les rsultats de la chirurgie conservatrice du sein telle queffectue dans notre centre. Objectif : Analyser les rsultats de la conservation du sein et dterminer le taux de rcidive locale en chirurgie conservatrice su sein. Mthodologie : il sagit dune tude rtrospective de 16 cas de cancer du sein ralise dans notre centre de 2002 2014. Les registres de cas de chirurgies conservatrices du sein ont t examins en ce qui concerne les paramtres dmographiques du patient, le stade au moment du diagnostic, les traitements pr-chirurgicaux offerts, la raction au traitement pr-chirurgical, les examens pr-chirurgicaux d'imagerie, le type de chirurgie conservatrice du sein effectue, les soins prodigus par le chirurgien oprant, les complications prcoces de la chirurgie, lexamen histopathologique de la marge de rsection, la rcidive locale, les mtastases loignes, la dure pr-mtastatique, le rsultat esthtique valu la fois par le chirurgien et le patient ainsi que les manifestations de suivi. Etaient galement inclus dans l'analyse, les rsultats de la r-opration et de lhistologie de lchantillon. Rsultats : 81% des patients avaient des marges de rsection claires alors que 19% avaient des marges positives. Ce degr de marges claires a t ralis malgr l'absence d'valuation cytologique peropratoire dans notre centre, et les maladies invasives du sein dans la plupart des cas. Pour un suivi mdian de 34 mois, nous avons enregistr un cas de rcidive locorgionale dans le sein et laisselle traits chez un patient. Il y a aussi eu 2 cas de progression de la maladie avec des mtastases pulmonaires et hpatiques, respectivement et un cas de dcs. Conclusion: Compte tenu du faible taux de rcidive et du rsultat esthtique satisfaisant de la CCS dans notre centre, il sagit dune alternative fiable la mastectomie pour les patients au stade prcoce du cancer du sein. La prsentation prcoce et la rfrence rapide des patients atteints de cancer du sein dans notre centre garantiront davantage la slection des patients pour la CCS. Il est recommand de rendre plus accessible la CCS et de mettre en place des services d'valuation cytologique peropratoire. PREDICTIVE FACTORS FOR PERINATAL DEATH IN NUCHAL CORD CASES: A CASE CONTROL STUDY Pascal FOUMANE, Sraphin NGUEFACK, Jeanne Hortense FOUEDJIO, Aurlie BITNKEU ASSAM, Julius Sama DOHBIT, Emile Telesphore MBOUDOU. Objective: Our aim was to identify the predictive factors of perinatal death in the presence of nuchal cord. Methods: This was a case-control study involving 204 parturients whose babies presented with a nuchal cord at delivery, carried out during the period from October 1st 2014 to April 30th 2015 in three hospitals of Yaound, Cameroon. Results: After multivariate analysis, independent predictive factors for perinatal death in nuchal cord cases were: post-term (OR=209.70; CI= 3.09-14212.66), antepartum hemorrhage (OR=18.21; CI=1.47-224.78), fetal heart rate abnormalities during labor (OR=11.74; CI=1.33-103.37), augmentation of labor (OR=24.04; CI=1.85-311.52), second stage of labor lasting more than 30 minutes (OR=172.50; CI=20.60-1444.20) and tight nuchal cord at birth (OR=16.29; CI=2.07-127.87). Conclusion: We recommend the identification of predictive factors for perinatal death in case of known or suspected nuchal cord, so as to consider cesarean section to prevent adverse fetal outcome. Keywords: predictive factors, nuchal cord, perinatal death, Cameroon FACTEURS PREDICTIFS DES DECES PERINATAUX EN CAS DE CIRCULAIRE DU CORDON: ETUDE CAS-TEMOINS Pascal FOUMANE, Sraphin NGUEFACK, Jeanne Hortense FOUEDJIO, Aurlie BITNKEU ASSAM, Julius Sama DOHBIT, Emile Telesphore MBOUDOU. Objectifs : Notre but tait d'identifier les facteurs prdisant le dcs prinatal en prsence de circulaire du cordon. Mthodes : Il s'agissait d'une tude cas-tmoins concernant 204 parturients dont les nouveau-ns avaient prsent un circulaire du cordon la naissance pendant la priode du 1er Octobre 2014 au 30 Avril 2015 dans rois hpitaux de la ville de Yaound (Cameroun). Rsultats : Aprs analyse multivarie, les facteurs prdictifs indpendants de dcs prinatal dans les cas de circulaire du cordon taient: le post-terme (OR=209,70; CI= 3,09-14212,66), l'hmorragie antpartum (OR=18,21; CI=1,47-224,78), des anomalies du rythme cardiaque ftal au cours du travail (OR=11,74; CI=1,33-103,37), la stimulation du travail (OR=24,04; CI=1,85-311,52), un deuxime stade du travail durant plus de 30 minutes (OR=172,50; CI=20,60-1444,20) et un circulaire serr la naissance (OR=16,29; CI=2,07-127,87). Conclusion : Nous recommandons l'identification des facteurs prdictifs de dcs prinatal en cas de circulaire du cordon connu ou suspect, dans le but d'envisager une csarienne et d'amliorer le pronostic ftal. Mots-cls: facteurs prdictifs, circulaire du cordon, dcs prinatal, Cameroun KAOLIN CONSUMPTION AND OUTCOME OF SURGERY IN WOMEN: A COMPARATIVE STUDY OF 263 OPERATIONS AT THE YAOUND GYNAECO-OBSTETRIC AND PEDIATRIC HOSPITAL Pascal FOUMANE, Agns ESIENE, Julius Sama DOHBIT, Rassa Carine AMBATTA MBASSO, Christiane NSAHLAI, Jacqueline ZE MINKANDE. Obstetrics & Gynaecology & Pediatric Hospital, Yaounde, Cameroun. Objective: The objective of this study was to assess the effects of kaolin consumption on the outcome of surgery in women. Methods: It was a cohort study comparing the occurrence of complications among 263 consecutively recruited women who underwent gynecologic or obstetric surgery at the Yaound Gyneco-Obstetric and Pediatric Hospital, Cameroon. Results: Sixty of the recruited women (22.8%) declared kaolin consumption before surgery and 203 (77.2%) denied having consumed kaolin before surgery. Kaolin consumption was found to predispose to postsurgical infections (RR=3.03; IC=1.82-5.05). Conclusion: A systematic ban of kaolin consumption is thus recommended in order to prevent postsurgical infections. Keywords: Kaolin; Outcome; Surgery; Postsurgical infections; Cameroon. CONSOMMATION DU KAOLIN ET RESULTAT DE LA CHIRURGIE CHEZ LA FEMME: ANALYSE COMPARATIVE DE 263 OPERATIONS A L'HOPITAL GYNECO-OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE Pascal FOUMANE, Agns ESIENE, Julius Sama DOHBIT, Rassa Carine AMBATTA MBASSO, Christiane NSAHLAI, Jacqueline ZE MINKANDE. Objectif: Notre objectif tait d'valuer les effets de la consommation de kaolin sur le pronostic de la chirurgie chez la femme. Mthodes: Il s'agissait d'une tude de cohorte comparant la survenue de complications chez 263 femmes ayant subi une chirurgie gyncologique ou obsttricale conscutivement recrutes l'Hpital Gynco-Obsttrique et Pdiatrique de Yaound (Cameroun). Rsultats: Soixante des femmes recrutes (22,8%) ont dclar avoir consomm le kaolin avant la chirurgie et 203 (77,2%) n'ont pas reconnu en avoir consomm. La consommation de kaolin a t trouve associe la survenue d'infections post-opratoires (RR=3,03; IC=1,82-5,05). Conclusion: Il est recommand de bannir le kaolin des produits consomms pour prvenir les infections post-opratoires. Mots-cls: Kaolin; Pronostic; Chirurgie; Infections post-opratoires; Cameroun. OUTCOME OF INDUCED LABOR: A COHORT ANALYSIS OF 247 DELIVERIES AT THE YAOUND GYNAECO-OBSTETRIC AND PEDIATRIC HOSPITAL, CAMEROON Pascal FOUMANE, Julius Sama DOHBIT, Alice Elvire MAPINA MADOLA, Esther Juliette NGO UM MEKA, Christiane NSAHLAI, Emile Telesphore MBOUDOU Obstetrics & Gynaecology & Pediatric Hospital, Yaounde, Cameroun. Objective: The objective of this study was to assess the effects of induced labor on maternal and fetal outcomes. Methods: It was a cohort study comparing the occurrence of complications during labor and the early postpartum period among 247 pregnant women consecutively recruited at the Yaound Gynaeco-Obstetric and Pediatric Hospital, Cameroon , 122 of which (49.4%) underwent induction of labor and 125 (50.6%) who had spontaneous labor. Results: Women in whom labor was induced were at a greater risk of caesarean section (RR=2.56; CI=1.93-3.37) and uterine tear (RR=6.15; CI=4.77-7.92). They also had a decreased risk of episiotomy (OR=0.41; CI=0.21-0.82). Additionally, three cases of uterine rupture were recorded among them. Conclusion: Careful selection of patients to be induced and close follow-up of induced women are recommended to prevent these identified related hazards. Keywords: Induction of labor; Pregnancy; Outcome; Delivery; Uterine rupture; Cameroon. PRONOSTIC DU TRAVAIL INDUIT: ANALYSE D'UNE COHORTE DE 247 ACCOUCHEMENTS A L'HOPITAL GYNECO-OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE (CAMEROUN) Pascal FOUMANE, Julius Sama DOHBIT, Alice Elvire MAPINA MADOLA, Esther Juliette NGO UM MEKA, Christiane NSAHLAI, Emile Telesphore MBOUDOU Objectif: L'objectif de ce travail tait d'valuer les effets du travail induit sur le pronostic maternel et ftal. Mthodes: Il s'agissait d'une tude de cohorte comparant la survenue de complications au cours du travail et le post-partum prcoce chez 247 femmes enceintes conscutivement recrutes l'Hpital Gynco-Obsttrique et Pdiatrique de Yaound (Cameroun). Parmi celles-ci, 122 (49,4%) avaient subi une induction du travail et 125 (50,6%) taient entres spontanment en travail. Rsultats: Les femmes chez qui le travail avait t induit avaient un plus grand risque de csarienne (RR=2,56; CI=1,93-3,37) et de plaie utrine (RR=6,15; CI=4,77-7,92). Elles avaient un risque moindre d'pisiotomie (OR=0,41; CI=0,21-0,82). Par ailleurs, trois cas de rupture utrine ont t observes chez les femmes ayant eu un travail induit. Conclusion: Une slection rigoureuse des femmes devant tre induites et une surveillance troite du travail induit sont recommandes pour viter les complications identifies. Mots-cls: Induction du travail; Grossesse; Pronostic; Accouchement; Rupture utrine; Cameroun. OVARIAN CANCER: BEYOND EARLY DIAGNOSIS Ganiy Opeyemi Abdulrahman. Academic Clinical Fellow/Specialty Registrar in Obstetrics & Gynaecology, Womens Services, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom. Email: G.O.Abdulrahman1@newcastle.ac.uk Background: Ovarian cancer remains a major cause of mortality among women across the world. There is no previous study that has reported on the trends of ovarian cancer in Wales. The aim of this study was to provide an up-to-date analysis of time trends in incidence, survival and mortality from ovarian cancer in Wales. Methodology: Cases of ovarian cancer registered between 1985 and 2012 were identified from the Welsh Cancer Intelligence and Surveillance Unit (WCISU). Age-standardised incidence rates were determined. Trends in survival and mortality rates were also analysed. Results: A total of 10498 ovarian cancer cases were registered with the Welsh cancer registry from 1985 to 2012. The age-standardised incidence rate of ovarian cancer was 19.3 per 100000 populations over the study period. There has been no significant change in incidence of ovarian cancer in the last three decades (p= 0.851). The peak age of incidence is seen in the 60-69 age group (p<0.001). However, since the early 1990s, there has been a significant increase in incidence among the 70-79 age groups. There has been a significant improvement in one- and five-year survival from 53.7 and 31.5 respectively in 1985-1989 to 64.2 and 39.9 respectively in 2000-2004. There was no corresponding change in mortality during the study period (p = 0.894). Conclusion: The incidence of ovarian cancer has remained fairly stable in Wales in the past 30 years. There has been a significant improvement in survival but no change in mortality. This probably suggests a lead-time bias, with an increased survival rate due to early diagnosis but without a significant influence on the natural history of the disease. CANCER DE LOVAIRE: AU-DELA DU DIAGNOSTIC PRECOCE Ganiy Opeyemi Abdulrahman Academic Clinical Fellow/Specialty Registrar in Obstetrics & Gynaecology, Womens Services, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom. Email: HYPERLINK "mailto:G.O.Abdulrahman1@newcastle.ac.uk"G.O.Abdulrahman1@newcastle.ac.uk Contexte: le cancer de lovaire reste une cause majeure de mortalit chez les femmes dans le monde. Aucune tude na t mene sur les caractristiques du cancer de l'ovaire au Pays de Galles. Le but de cette tude tait de fournir une analyse plus rcente des tendances temporelles de lincidence, de la survie et de la mortalit lie au cancer de lovaire au Pays de Galles. Mthodologie: Les cas de cancer de l'ovaire enregistrs entre 1985 et 2012 ont t identifis partir de la Welsh Cancer Intelligence and Surveillance Unit (WCISU). Les taux d'incidence normaliss selon l'ge ont t dtermins. Les caractristiques en matire de survie et de mortalit ont galement t analyses. Rsultats: Un total de 10498 cas de cancer de l'ovaire ont t inscrits sur le registre de cancer du Pays de Galles de 1985 2012. Le taux dincidence normalis de cancer de lovaire selon lge tait de 19,3 pour 100000 habitants au cours de la priode d'tude. Il n'y a eu aucun changement significatif dans lincidence du cancer de lovaire au cours des trois dernires dcennies (p = 0,851). Le pic de lge d'incidence est observ dans le groupe g entre 60 et 69 ans (p <0,001). Cependant, depuis le dbut des annes 1990, nous avons observ une augmentation significative de l'incidence dans le groupe g entre 70 et 79 ans. Il y a eu une amlioration significative de la survie de un cinq ans de 53,7 et 31,5 respectivement entre 1985 et 1989 de 64,2 et 39,9 respectivement entre 2000-2004. Il n'y avait pas de changement correspondant en terme de mortalit au cours de la priode d'tude (p = 0.894). Conclusion: Lincidence du cancer de l'ovaire est reste relativement stable au Pays de Galles au cours des 30 dernires annes. Une amlioration significative de la survie a t observe, certes. Cependant, aucun changement sur la mortalit. Cette situation suggre probablement une tendance en matire de dlai, avec une augmentation du taux de survie grce au diagnostic prcoce, mais sans une influence significative sur lvolution naturelle de la maladie. TRENDS IN BREAST CANCER IN WALES Ganiy Opeyemi Abdulrahman Academic Clinical Fellow/Specialty Registrar in Obstetrics & Gynaecology, Womens Services, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom. Email: G.O.Abdulrahman1@newcastle.ac.uk Background: Breast cancer is the second commonest malignancy in the world. In 2012, approximately 522000 women died of breast cancer across the world. The aim of this study is to provide an up-to-date analysis of time trends in incidence, geographical distribution, survival and mortality from breast cancer in Wales. Methodology: Breast cancer cases registered between 1985 and 2012 were identified from the Welsh Cancer Intelligence and Surveillance Unit (WCISU). A Poisson regression model was fitted to assess temporal trends and rate ratios (RR) and 95% confidence intervals (CI) were determined and compared in relation to age, geographical distribution and mortality across time periods. Results: A total of 60227 women diagnosed with breast cancer were registered with the Welsh cancer registry between 1985 and 2012. The age-standardised incidence rate of breast cancer was 113.4 per 100000 populations over the study period. There has been a significant increase in the incidence of breast cancer over the study period, although a slight decline was recorded towards the end of the study. One and five-year relative survival improved from 83.3 and 64.2 respectively in 1985-1989 to 91.1 and 78.8 respectively in 2000-2004. There has also been a considerable improvement in relative survival across all age groups. Mortality has improved over the study period with the most dramatic decline in the age groups 45-54 years and 55-64 years (p<0.001). Conclusion: There has been a significant increase in the incidence of breast cancer in Wales over the last three decades, which is likely to be partly due to the introduction of the National Health Service Breast Screening Programme. There was a considerable decline in mortality rate across almost all age groups, especially in recent years. However, women over the age of 65 years had poorer outcome throughout the study period. EVOLUTION DE LINCIDENCE DU CANCER DU SEIN AU PAYS DE GALLES Ganiy Opeyemi Abdulrahman Academic Clinical Fellow/Specialty Registrar in Obstetrics & Gynaecology, Womens Services, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, United Kingdom. Email: G.O.Abdulrahman1@newcastle.ac.uk Contexte: Le cancer du sein est la deuxime tumeur maligne la plus frquente au monde. En 2012, environ 522 000 femmes sont mortes de cancer du sein lchelle plantaire. Lobjectif de la prsente tude est de fournir une analyse actualise des tendances actuelles de lincidence, la rpartition gographique, le taux de survie et de mortalit du cancer du sein au Pays de Galles. Mthodologie: Nous avons identifi les cas de cancer du sein enregistrs entre 1985 et 2012 partir du service Cancer Intelligence and Surveillance du Pays de Galles (Welsh Cancer Intelligence and Surveillance Unit (WCISU)). La Rgression de Poisson a t utilise dans loptique dvaluer les tendances temporelles et les ratios de taux (RR) et les intervalles de confiance (IC) 95% ont t dtermins et compars par rapport lge, la rpartition gographique et la mortalit sur des priodes de temps. Rsultats: Au total 60 227 femmes diagnostiques avec un cancer du sein ont t enregistres dans le registre doncologie du Pays de Galles entre 1985 et 2012. Le taux dincidence standardis du cancer du sein par rapport lge tait de 113,4 pour 100 000 personnes au cours de la priode dtude. Une augmentation significative de lincidence du cancer du sein a t note au cours de la priode dtude, malgr une lgre baisse vers la fin de ltude. Le taux relatif de survie de un et cinq ans sest amlior passant de 83,3 et 64,2 respectivement en 1985-1989 91,1 et 78,8 respectivement en 2000-2004. Une amlioration significative de la survie relative a t observe dans tous les groupes dge. La mortalit sest amliore au cours de la priode dtude avec une baisse plus spectaculaire dans les groupes des 45-54 ans et 55-64 ans (p<0,001). Conclusion: Lincidence du cancer du sein au Pays de Galles a connu une augmentation significative au cours des trois dernires dcennies. Ceci serait en partie d lintroduction du Programme de dpistage du cancer du sein du National Health Service Breast Screening. Presque tous les groupes dge ont expriment une baisse considrable du taux de mortalit, en particulier au cours des dernires annes. Cependant, lissue pour les femmes ges de plus de 65 a t ngative tout au long de la priode dtude. BREAST CANCER SURVIVAL IN CAMEROON: ANALYSIS OF A COHORT OF 404 PATIENTS AT THE YAOUND GENERAL HOSPITAL Jean Dupont Kemfang Ngowa, Jean Marie Kasia, Jean Yomi, Achille Nkigoum Nana, Anny Ngassam, Irene Domkam, Zacharie Sando, Paul Ndom, Anderson Doh Corresponding author: Dr JD Kemfang Ngowa, Yaound General Hospital, Yaound, Cameroon. E mail.  HYPERLINK "mailto:jdkemfang@yahoo.fr"jdkemfang@yahoo.fr ; tel. +237699943230 Objectives: This study aimed to estimate survival of breast cancer in a group of patients followed up at the Yaounde General Hospital in Cameroon. Methods. A retrospective review of breast cancer records of 404 patients managed for breast cancer between 1995 to 2007 at the Yaounde General Hospital was conducted. Survival analysis was carried out with survival defined as the time between the date of unequivocal diagnosis of cancer and the date of last follow-up or death. Survival curves were plotted under R.3.1.1software. Results: The mean age of patients was 47, 5 12,36 years. Most of the patients (67.9%) presented with advanced breast cancer disease(stage III and IV). Overall patient survival rate was 30% at 5 years and 13.2% at 10 years. The median survival time was 2 (1.9-3) years. There is a correlation between survival and stage of disease. The highest survival rates were recorded in stages I and II and the lowest in stage IV. There is no significant difference in survival between the age groups (p= 0.15). Conclusion: The overall survival rates of breast cancer at 5 years and 10 years among Cameroonian patients were lower compared to survival rates in some developed countries. Keywords: Survival; Breast Cancer; Developing Countries SURVIE DES PATIENTS DE CANCER DU SEIN AU CAMEROUN: ANALYSE D'UNE SRIE HOSPITALIRE DE 404 PATIENTES LHPITAL GNRAL DE YAOUND Jean Dupont Kemfang Ngowa, Jean Marie Kasia, Jean Yomi, Achille Nkigoum Nana, Anny Ngassam, Irene Domkam, Zacharie Sando, Paul Ndom, Anderson Doh Corresponding author: Dr JD Kemfang Ngowa, Yaound General Hospital, Yaound, Cameroon. E mail.jdkemfang@yahoo.fr ; tel. +237699943230 Objectifs : Dterminer la survie au cancer du sein dans un groupe de patients suivis lHpital Gnral de Yaound, Cameroun. Mthode : Nous avons rvis 404 dossiers de patients de cancer du sein pris en charge entre 1995 et 2007 l'Hpital Gnral de Yaound. L'analyse de la survie, dfinie comme tant le dlai entre la date du diagnostic sans quivoque du cancer du sein et la date de la dernire visite de suivi ou la date du dcs, a t faite. Les courbes de survie ont t traces sous le logiciel R.3.1.1. Rsultats: L'ge moyen des patients tait de 47,5 12,36 ans. La plupart des patients (67,9%) prsentaient un cancer avanc du sein (stade III et IV). Le taux global de survie des patients tait de 30% 5 ans et de 13,2% 10 ans. La dure mdiane de survie tait de 2 (1.9-3) ans. Il existait une corrlation entre la survie et le stade de la maladie. Les taux de survie les plus levs taient enregistrs dans les stades I et II et le plus faible au stade IV. Il n'y avait pas de diffrence significative de survie entre les groupes d'ge (p =0,15). Conclusion: Les taux de survie globale au cancer du sein 5 ans et 10 ans chez les patients camerounais taient bas par rapport aux taux de survie dans les pays dvelopps. Mots Cls: Survie; Cancer du sein; Pays en voie de dveloppement. PATTERN OF FEMALE GENITO-URINARY FISTULAE AND SURGICAL TREATMENT OPTIONS AT A TERTIARY HEALTHCARE CENTRE, NORTHERN NIGERIA Koledade AK, Abdullahi ZG., Umar AM., Zubair U, Abbas I, Mohammed U, Shittu SO. Obstetrics and Gynaecology Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Dr Afolabi Korede Koledade, akdade@yahoo.com Obstetrics and Gynaecology Department A.B.U. Teaching Hospital, Zaria Nigeria Background: Urinary incontinence especially from obstetrics cause constitute a foremost embarrassing morbidity in girls and women in the African continent. Most are preventable if attention is given to the girl child education; adequate antenatal care; skilled birth attendance as well as emergency obstetric and newborn care (EmONC). Unfortunately these are not optimal in most African countries. Objectives: To determine the socio-demographic variables, presentation and surgical treatment options of female patients presenting with genito-urinary fistulae at ABUTH, Zaria. Methodology: A retrospective descriptive study on female patients who presented with genito-urinary fistulae from 2005 to 2015. Results: Thirty folders out of 63 were recovered giving a retrieval rate of 48%. The age range of the patients was 14 to 56 years with a mean of 29.6 9.6 years. Up to 73.3% of the patients were married. Vesico-vaginal fistula constitute the majority 24 (80%) of all patients studied. Single fistula constituted majority 23 (76.6%) in the patients, two fistulae were found in 6 (20%) while 1 (3.3%) had three fistulae. Flap splitting was the commonest technique of repair 22 (73.3%) followed by saucerization 3 (10%). Restoration of continence was found in 22 (73.3%), stress incontinence in 2 (6.7%) while 6 (20%) had failure of repair. The size of fistulae did not determine the outcome repair in terms of restoration of continence, stress incontinence or failure of repair (P=0.483). Conclusion: Surgical repair of fistula is the main stay of treatment for genito-urinary fistulae. CARACTERISTIQUES DES FISTULES GENITO-URINAIRES FEMININES ET OPTIONS DE TRAITEMENTS CHIRURGICAUX DANS UN CENTRE DE SOINS TERTIAIRES, NORD DU NIGERIA Koledade A.K., Abdullahi Z.G., Umar A.M., Zubair U., Abbas I., Mohammed U., Shittu S.O. Obstetrics and Gynaecology Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Dr Afolabi Korede Koledade Obstetrics and Gynaecology Department A.B.U. Teaching Hospital, Zaria, Nigeria. HYPERLINK "mailto:akdade@yahoo.com"akdade@yahoo.com Contexte: Lincontinence urinaire, en particulier due des causes obsttricales, constitue la principale morbidit chez les filles et femmes en Afrique qui peut savrer embarrassante. En gnral, elle est vitable grce une bonne ducation de la jeune fille; des soins prnatals adquats; un accouchement assist par un personnel qualifi ainsi que par des soins obsttriques et nonataux durgence (SONU). Malheureusement, ces services ne sont pas optimaux dans la plupart des pays africains. Objectifs: Dterminer les variables socio-dmographiques, la prsentation et les possibilits de traitement chirurgicaux pour les patientes souffrant de fistule gnito-urinaire ABUTH, Zaria. Mthodologie: Il sagit dune tude descriptive et rtrospective sur des patientes souffrant de fistule gnito-urinaire de 2005 2015. Rsultats: Trente dossiers sur 63 ont t rcuprs, soit un taux de rcupration de 48%. Lge des patientes oscillait entre 14 et 56 ans, pour une moyenne de 29,6 9,6 ans. 73,3% des patientes taient maries. La majorit, 24 (80%) des patientes tudies prsentaient des fistules vsico-vaginales. La majorit des patientes, 23 (76,6%), souffraient de fistules simples, 06 patientes (20%) avaient deux fistules et 01 (3.3%) en avait trois. Les techniques les plus couramment utilises pour rparer les fistules taient la suture des parois vsicales et vaginales 22 (73.3%) suivie de la saucrisation 03 (10%). Il a fallu restaurer la continence chez 22 (73,3%) patientes, traiter lincontinence leffort chez 02 (6,7%) tandis que 06 (20%) nont pas pu tre rpares. La taille de la fistule ne dterminait pas lissue de la rparation en termes de restauration de la continence, dincontinence leffort ou dchec de la rparation (P=0,483). Conclusion: Le principal traitement des fistules gnito-urinaires est la rparation chirurgicale. HYSTERECTOMIES PATTERN AT A TERTIARY HEALTHCARE CENTRE, NORTHERN NIGERIA 1Koledade A.K., 1Oguntayo A.O., 1Zayyan M., 1Avidime S.,2Samaila M.O.A.,1Adesiyun A.G. 1Obstetrics and Gynaecology Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. 2Histopathology Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Dr Afolabi Korede Koledade Obstetrics and Gynaecology Department A.B.U. Teaching Hospital, Zaria, Nigeria. HYPERLINK "mailto:akdade@yahoo.com"akdade@yahoo.com Background: The uterus is an important female genital organ for menstrual and reproductive functions. However there are various gynaecologic and obstetric indications for carrying out hysterectomy. Objectives: To determine the indication and pattern of hysterectomies done at Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Methodology: A 5 year retrospective descriptive study on patients who had hysterectomy done from 2011 to 2015. Results: The age range of the patients was 26 to 70 years with a mean of 48.6 8.8 years. Hysterectomies constituted 19.3% of total gynaecology surgery done during the same period. Of these Total abdominal hysterectomy 144 (87.8%) was the most common, next was Vaginal hysterectomy with pelvic floor repair 13 (7.9%) and then Subtotal hysterectomy was 7 (4.3%). The commonest indication for Total abdominal hysterectomy was multiple uterine fibroids, a benign uterine tumour. Conclusion: Hysterectomyis a common gynaecological surgery which may be used to treat benign uterine pathologies especially when there is no more desire for conception. It could also be life saving in uncontrollable post-partum haemorrhage as well as malignant pelvic organ pathologies especially in early stages. TYPES DHYSTERECTOMIES PRATIQUEES DANS UN CENTRE DE SOINS DE SANTE TERTIAIRES AU NORD DU NIGERIA 1Koledade A.K., 1Oguntayo A.O., 1Zayyan M., 1Avidime S.,2 Samaila M.O.A.,1Adesiyun A.G. 1Obstetrics and Gynaecology Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. 2Histopathology Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Dr AfolabiKorede Koledade Obstetrics and Gynaecology Department A.B.U. Teaching Hospital, Zaria, Nigeria. HYPERLINK "mailto:akdade@yahoo.com"akdade@yahoo.com Contexte: Lutrus est un organe gnital fminin important pour les fonctions menstruelles et reproductives. Cependant, il existe diverses indications gyncologiques et obsttricales pour la ralisation de lhystrectomie. Objectifs: Dterminer lindication et le type d'hystrectomies effectues au CHU Ahmadu Bello Zaria au Nigeria. Mthodologie: Une tude descriptive rtrospective de 5 ans sur des patientes qui avaient subi une hystrectomie de 2011 2015. Rsultats: La tranche dge des patients variait de 26 70 ans avec une moyenne de 48,6 8,8 ans. Les hystrectomies constituaient 19,3% de toutes les interventions chirurgicales gyncologiques effectues pendant la mme priode. La plus frquente a t lhystrectomie abdominale totale, 144 (87,8%), suivie de lhystrectomie vaginale avec rparation du plancher pelvien, 13 (7,9%) et de lhystrectomie subtotale, 07 (4,3%). Lindication la plus frquente pour l'hystrectomie abdominale totale tait la prsence de multiples fibromes utrins, une tumeur utrine bnigne. Conclusion: Lhystrectomie est une intervention chirurgicale gyncologique courante qui peut tre utilise pour traiter des pathologies utrines bnignes surtout quand il ny a plus de dsir de conception. Elle peut galement tre salvatrice lors dune hmorragie du post-partum incontrlable ainsi que pour les pathologies malignes des organes pelviens en particulier un stade prcoce. USING OPEN DATA KIT TO IMPROVE DATA COLLECTION IN AN OBSTETRIC UNIT IN GHANA Authors: Larsen-Reindorf R E, Otupiri E, Aliyu M, Annan J J, Turpin C A, Larsen-Reindorf R. Introduction: Accurate data for obstetric units in Ghana are either not available or where available, it has required substantial financial outlay for equipment and human resource deployment. Good data are a prerequisite for effective planning and programming with the view to improving obstetric outcomes and maternal health. Methods: After an initial pilot phase, indicators to be measured were identified and defined. Open Data Kit (ODK) was used to create data entry screens on android smartphones. Three post-university interns were trained over a two-month period to use the data collection tool. They were also trained to extract de-identified data from the folders of patients. Training in interview techniques for information routinely not collected was also done. The KNUST/KATH Committee of Human Research, Publications and Ethics approved the study. Completing the data set for a patient required 10-15 minutes. Electronically completed questionnaires were forwarded to a pass-worded server in the cloud. Excel was used for data analysis Results: The study sample comprised about 5000 women who had delivered at the Komfo Anokye Teaching Hospital over an 8-month period. Three smartphones were used for the study at a total cost of US$350 (includes cost of server). The training was embedded in routine in-service training for health staff. The data set provided broad information: socio-demographic data, mode of delivery, birth outcomes, parameters to generate Robsons classification and quality of care information. Conclusion: With minimal training and inexpensive equipment, units in low-resource settings can collect good quality data for planning and programming purposes. UTILISATION DE KIT DE DONNEES OUVERTES EN VUE DAMELIORER LA COLLECTE DES DONNEES DANS UN SERVICE DOBSTETRIQUE AU GHANA Authors: Larsen-Reindorf R E, Otupiri E, Aliyu M, Annan J J, Turpin C A, Larsen-Reindorf R. Introduction: Lon note une absence dinformations prcises sur les services dobsttriques au Ghana, ou lorsquelles sont disponibles, elles ont ncessit dimportants moyens financiers en termes dquipement et de dploiement de ressources humaines. Lobtention de donnes fiables est un pralable une planification et une programmation efficace dans loptique damliorer les rsultats obsttricaux et la sant maternelle. Mthodes: Aprs une phase pilote initiale, les indicateurs mesurer ont t identifis et dfinis. Le Kit de donnes ouvertes (KDO) a t utilis pour crer des crans de saisie des donnes sur des Smartphones androdes. Trois stagiaires post-universitaires ont t forms pendant deux mois lutilisation de loutil de collecte des donnes. Ils ont galement t forms lextraction des donnes dpersonnalises partir des dossiers mdicaux des patients et ont galement suivi une formation en techniques dinterview pour la collecte dinformations qui ne sont pas recueillies systmatiquement. Ltude a t approuve par le comit KNUST/KATH de Human Research, Publications and Ethics. Il a fallu 10-15 minutes pour remplir toutes les informations sur un patient. Les questionnaires remplis par ordinateur ont t envoys dans le cloud un serveur protg par un mot de passe. Lanalyse des donnes a t faite sur Excel. Rsultats: Lchantillon de ltude tait constitu denviron 5 000 femmes qui avaient accouch au Centre Hospitalier Universitaire de Komfo Anokye sur une priode de 08 mois. Trois smartphones ont t utiliss pour ltude, pour un cot total de 350 USD (y compris le cot du serveur). La formation a t intgre dans la formation continue de routine du personnel de sant. La collecte des donnes a fourni de nombreuses informations sur les donnes sociodmographiques, le mode daccouchement, lissue de laccouchement, les paramtres en vue de gnrer la classification de Robson et la qualit des informations sanitaires. Conclusion: Avec un minimum de formation et un quipement peu couteux, les services se trouvant dans des zones ayant des ressources financires limites peuvent collecter des informations de qualit aux fins de la planification et de la programmation. OBSTACLES TO EARLY TREATMENT OF BREAST CANCERS IN CAMEROONS REFERRAL HOSPITALS MOUELLE SONE A, MBOUDOU E , NDOM NTOCK F Introduction and purpose: Breast cancer is the most common form of cancer in women worldwide. In Cameroon it is diagnosed late (70 to 80%). It has been shown that early diagnosis and treatment promote healing. Patients and method: Our prospective and descriptive study over a six-month period focused on women with breast cancer (stage III or IV) with evidence and having started treatment. Results: The average age was 45.710 years. 24% practiced self-examination before the illness. 64.4% lived in the Centre or Littoral Regions. The first symptom was a breast nodule in 85.7% of cases. 69.3% of patients first met a general practitioner or gynaecologist for consultation. 30% had poor initial management. One third of patients had been victims of misdiagnosis. 55.8% used traditional medicine. The average time between the appearance of the first symptom and the first consultation was 20 30 weeks. The average time between the first consultation and diagnosis was 12.3 16 months. The average time between diagnosis and treatment was 12 23 weeks. Conclusion: The obstacles were cultural beliefs, lack of information about breast cancer, the use of traditional medicine, and poor initial management. ENTRAVES A LINITIATION DU TRAITEMENT A UN STADE PRECOCE DES CANCERS DU SEIN DANS LES HOPITAUX GENERAUX DU CAMEROUN. MOUELLE SONE A, MBOUDOU E , NDOM NTOCK F Introduction et Objectifs: Le cancer du sein est la forme de cancer la plus frquente chez les femmes dans le monde. Au Cameroun, son diagnostic est pos tardivement(70 80%). Il a t dmontr que le diagnostic et traitement prcoce favorisent une gurison. Patients et mthode: Notre tude, prospective et descriptive sur une priode de 6 mois, intressait les femmes atteintes du cancer du sein (stade III ou IV) avec preuve et ayant dbut leur prise en charge thrapeutique. Rsultats: Lge moyen tait de 45,710ans. 24% pratiquaient lautopalpation des seins avant la maladie. 64,4% rsidaient dans la rgion du Centre ou Littoral. Le premier symptme apparu tait un nodule mammaire dans 85,7% des cas. La premire personne rencontre tait pour 69,3% des cas les mdecins gnralistes ou gyncologues. 30% ont eu une mauvaise prise en charge initiale. Le tiers de nos patientes ont t victime dune erreur diagnostique. 55,8% ont eu recours la mdecine traditionnelle. Le dlai moyen entre lapparition du premier symptme et la premire consultation est de 20 30semaines. Le dlai moyen entre la premire consultation et le diagnostic est de 12,3 16mois. Le dlai moyen entre le diagnostic et le traitement est de 12 23semaines. Conclusion : Les entraves taient les croyances culturelles, le manque dinformation sur le cancer du sein, le recours la mdecine traditionnelle, une mauvaise prise en charge initiale. COLPOSCOPY EXPERIENCE IN TERTIARY INSTITUTION IN NORTHERN NIGERIA Oguntayo O Adekunle1,Abdul A Mohammed1, Abdulazeez Bashir1,Kolawole O D Abimbola1 & Ahmed Saad2 1. Department of Obstetric & Gynaecology, ABU Teaching Hospital 2. Department Pathology ABU Teaching Hospital E mail: fayokunmi@yahoo.co.uk Background: Colposcopy has now become an important procedure in many developing nations like Nigeria, basically because of the increase incidence and prevalence of cervical cancers, which is now the leading cause of cancer death in women in the developing nations. This disease entity is ravaging our women, such that any woman that does not die from maternal mortality would die of cancers. Methods: It is a retrospective study of all the cases of colposcopy done in our centre in the last eight years. Information was extracted from the case notes, colposcopy register, histopathology laboratory and the information unit of the hospital, Results: A hundred and thirty one cases of colposcopy were carried out during the period under study. The mean age was 44.7 years. The mean parity was 5.High grade squamous intraepithelial lesion from Pap smear report before the colposcopy was the commonest indication, likewise the histology report of the tissue biopsy. Conclusion: the findings were all in conformity with risk factors for cervical cancers. EXPERIENCE LA COLPOSCOPIE DANS UN CENTRE HOSPITALIER UNIVERSITAIRE AU NORD NIGERIA Oguntayo O Adekunle1,Abdul A Mohammed1, Abdulazeez Bashir1,Kolawole O D Abimbola1 & Ahmed Saad2 1. Department of Obstetric & Gynaecology, ABU Teaching Hospital 2. Department Pathology ABU Teaching Hospital E mail: fayokunmi@yahoo.co.uk Contexte: La colposcopie est devenue aujourd'hui une intervention chirurgicale importante dans plusieurs pays en dveloppement comme le Nigeria, principalement en raison de la frquence et du taux lev des cancers du col de lutrus, qui est dsormais la principale cause de mortalit par cancer chez les femmes dans les pays en dveloppement. Cette pathologie dcime nos femmes, telle enseigne que toute femme qui ne meurt pas des suites de laccouchement mourra de cancer. Mthodes: Il sagit dune tude rtrospective de toutes les colposcopies ralises dans notre formation sanitaire au cours des huit dernires annes. Les donnes ont t extraites des registres de cas, du registre sur la colposcopie, du laboratoire dhistopathologie et de la cellule d'information de l'hpital. Rsultats: 131 colposcopies ont t ralises au cours de la priode dtude. Lge moyen tait de 44,7 ans. La parit moyenne tait 5. La lsion intra-pithliale pidermode au stade avancdiagnostique par le frottis cervical avant la colposcopie tait lindication la plus frquente, de mme que le rapport histologique de la biopsie des tissus. Conclusion: Les rsultats taient tous en conformit avec les facteurs de risque du cancer de col de lutrus. DILATATION AND CURETTAGE VERSUS MANUAL VACUUM ASPIRATION FOR FIRST TRIMESTER CLANDESTINE ABORTIONS Elie NKWABONG1, Joseph Nelson FOMULU1 1Department of Obstetrics & Gynecology, University Teaching Hospital, Yaound &Faculty of Medicine and Biomedical Sciences, University of Yaound I, Cameroon. Abstract: This retrospective descriptive study, aimed at comparing complications of clandestine abortions done with manual vacuum aspiration (MVA) to those of clandestine abortions done with dilatation and curettage (D&C), was carried out in the Yaound University Teaching Hospital (Cameroon) from March 1st to August 31st, 2012. Abortions carried out with MVA or D&C were recruited. Main variables studied were abortionist, method used, complications presented and hospital stay. Data was analysed using SPSS 18.0. Analyses included the t-test and the Fisher exact test. The level of significance was P<0.05.Main abortionists were nurses and general practitioners. Compared to MVA, women in the curettage group had more uterine perforations (P=0.004), prolonged hospital stay (P=0.018), maternal death (one case)and severe anemia (OR 1.5, 95%CI 0.5-4.3), though the difference was not statistically significant. D&C done by nurses had more risk of severe complications (OR 3.6, 95%CI 0.2-53.8),though the difference was not statistically significant. MVA constitutes a safer method than D&C. However, abortionists should receive adequate training before using MVA. Key words: Clandestine abortions- Manual vacuum aspiration- Dilatation and curettage- Complications. LA DILATATION ET CURETAGE VERSUS LASPIRATION MANUELLE INTRA-UTERINE DANS LA REALISATION DES AVORTEMENTS CLANDESTINS DU 1ER TRIMESTRE. Elie NKWABONG1, Joseph Nelson FOMULU1 1Department of Obstetrics & Gynecology, University Teaching Hospital, Yaound &Faculty of Medicine and Biomedical Sciences, University of Yaound I, Cameroon. Rsum: Cette tude rtrospective, dont le but tait de comparer les complications des avortements clandestins selon quils ont t raliss par dilatation et curettage (D&C) ou par aspiration manuelle intra-utrine (AMIU), a t ralise au Centre Hospitalier et Universitaire de Yaound (Cameroun) du 1er mars au 31 aout 2012. Tous les avortements du 1er trimestre faits par D&C ou parAMIU ont t recruts. Les principales variables tudies taient le prestataire de lavortement, la mthode utilise, les complications prsentes et la dure de lhospitalisation. Les donnes ont t analyses grce au logiciel SPSS 18.0. Les tests t de Student et le test exact de Fisher ont t utiliss pour la comparaison. Une valeur de P<0.05 a t considre statistiquement significative. Les prestataires de lavortement taient essentiellement les infirmiers et les mdecins gnralistes. Compares aux femmes dont les avortements avaient t faits par AMIU, les femmes du groupe D&C avaient eu plus de perforation utrine (P=0.004), une longue hospitalisation (P=0.018), plus danmie svre (OR 1.5, 95%CI 0.5-4.3) mme si la diffrence ntait pas statistiquement significative et un cas de mort maternelle (contre zro). La D&C faite par les infirmiers taient associe plus de complications svres (OR 3.6, 95%CI 0.2-53.8). LAMIU est plus approprie que la D&C dans lvacuation utrine au 1er trimestre. Nanmoins, avant de lutiliser, les prestataires doivent tre bien forms son utilisation. Mots cls: Avortements clandestins du 1er trimestre - Dilatation et curettage - Aspiration manuelle intra-utrine - Complications. DIAGNOSIS AND MANAGEMENT OF CERVICAL INTRAEPITHELIAL LESIONS BY DIATHERMY Sandjong TID(1), Tchuendem J(1);Ngoumene R(4);Sando Z(1,3); Tebeu PM(2,3), Doh AS(1,3) Yaounde Gynaeco-obstetric and Paediatric Hospital University Teaching Hospital of Yaounde Faculty of Medicine and Biomedical Sciences, University of Yaounde1 Universit des Montagnes de Bangangt. Objectives: The main objective of this work was to screen and treat precancerous lesions of the cervix. Specifically we evaluated respectively the sensitivity and specificity of acetic acid, Lugol-Iodine and colposcopy; then compared the results obtained with results of histology. Type of study and study period: This was a one year prospective study from 10th of February 2011 to 10th of February 2012 at Elad-OKU Materials and methods: Acetic acid, Lugol, colposcope, biopsy forceps and diathemy were used for the screening exercise; recruitment was done consecutively. Data analysis was performed on Excel and statistical tests were used to evaluate sensitivity. Results: Among the 1248 women screened 61 (%) tested positive for acetic acid and or Lugol. The sensitivity of acetic acid, Lugol, and colposcopy compared to histological examination, were respectively 39.34% (n = 24), 98.36% (n = 60) and 100% (n = 61). In the second phase 21 of 22 (0.95%) previously treated women did not present with any lesion, only one woman (5%) had a condyloma. Conclusion: Diathermy causes visible destruction of precancerous lesions. Keywords: screen and treat, VIA, VILI, colposcopy, biopsy, diathermy DIAGNOSTIC ET PRISE EN CHARGE DES LESIONS CERVICALES INTRAEPITHELIALES PAR ELECTRODIATHERMIE Sandjong TID(1), Tchuendem J(1);Ngoumene R(4);Sando Z(1,3); Tebeu PM(2,3), Doh AS(1,3) 1- Yaounde Gynaeco-obstetric and Paediatric Hospital 2- University Teaching Hospital of Yaounde 3- Faculty of Medicine and Biomedical Sciences, University of Yaounde1 4- Universit des Montagnes de Bangangt. Objectifs: lobjectif de ce travail tait de voir et traiter les lsons prcancreuses du col de lutrus. Spcifiquement nous avons recherch respectivement la sensibilit et la spcificit de lacide actique, du lugol et de la colposcopie; ensuite comparer aux rsultats anatomopathologiques Type dtude et priode: Il s'agit d'une tude prospective pendant un an du 10 fvrier 2011 au10 fvrier 2012 Elad OKU Matriel et mthode: Acide actique, lugol, colposcope, pince de biopsie et appareil delectrodiathemie, taient utiliss dpistes; le recrutement tait fait conscutivement. Lanalyse des donnes tait effectue sur des logiciels Excel et les tests sensibilits. Rsultats: parmi les 1248 femmes dpistes 61(%) femmes prsentaient des tests positif lacide actique et ou au lugol. Les sensibilits au test de lacide actique, du lugol, de la colposcopie par rapport lexamen anatomopathologique, taient respectivement 39,34%(n=24), 98,36%(n=60) et 100% (n=61). A la deuxime phase 21 sur 22 (0,95%) femmes antrieurement traites ne prsentaient plus de lsion, seule une femme (5%) prsentait un condylome. Conclusion: Lelectrodiathermie entraine une destruction visible des lsions prcancreuses. Mots cls: voir et traiter, VIA, VILI, Colposcopie, biopsie, electrodiathermie. ROLE OF COLPOSCOPY IN THE DIAGNOSIS OF PRECANCEROUS LESIONS AT THE YAOUNDE GYNECO - OBSTETRICS AND PEDIATRIC HOSPITAL I.SANDJONG1,5, Z.SANDO1,4, R.NGOUMENE5, R.TONYE3, PB. TIOMELA3, DOUMBA4, ENAMA1, PM.TEBEU2,4, TEBEU2,4, P. FOUMANE1,4, E. MBOUDOU4, A.SAMA Yaounde Gynaeco-Obstetric and Paediatric Hospital(YGOPH) Yaounde University Teaching Hospital(YUTH) YaoundeCentral Hospital (YCH) Faculty of Medicine and Biomedical Sciences of the University of Yaound 1 (FMBS/UYI) Universit des Montagnes (UdM) Objective: To establish the correlation between the colposcopy result and the results of histology in the diagnosis of precancerous cervical lesions. Specifically we looked for: the sensitivity and specificity of colposcopy Study type and study period: A descriptive cross-sectional study done at YGOPH over a period of 8 years from 2007-2015 Method and Materials: 97 women aged between 25-80 years underwent visual inspection of the cervix using a colposcope after application of 5% acetic acid(VIA) and / or Lugol's iodine (VILI) followed by biopsies for histology. Results: Precancerous lesions were confirmed in 73 women (75.26%). Compared to the pathological examination, the overall sensitivity and specificity of colposcopy was 84.75% and 39.50% respectively. For low-grade lesions (sensitivity = 72.72%, specificity = 70.30%). For high-grade lesions (sensitivity = 38.50%, specificity = 78.79%). For cancerous lesions :( sensitivity = 40%, specificity = 93.88%). Conclusion: As a means of screening, the combination of VIA and VILI has made colposcopy a useful method in our context, for the diagnosis of precancerous lesions of the cervix. APPORT DE LA COLPOSCOPIE DANS LE DIAGNOSTIC DES LESIONS PRECANCEREUSES A LHOPITAL GYNECO-OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE I.SANDJONG1,5, Z.SANDO1,4, R.NGOUMENE5, R.TONYE3, PB. TIOMELA3, DOUMBA4, ENAMA1, PM.TEBEU2, 4, TEBEU2, 4, P. FOUMANE1, 4, E. MBOUDOU4, A.SAMA 1-Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) 2-Yaounde University Teaching Hospital (YUTH) 3- YaoundeCentral Hospital (YCH) 4- Faculty of Medicine and Biomedical Sciences of the University of Yaound 1(FMBS/UYI) 5- Universit des Montagnes(UdM) Objectif: tablir la corrlation entre le rsultat colposcopique et le rsultat anatomopathologique dans le diagnostic des lsions prcancreuses du col utrin; spcifiquement nous avons recherch: la sensibilit et la spcificit de la colposcopie Type dtude et priode dtude: tude transversale descriptive ralise lHGOPY sur une priode de 8 ans de 2007 2015 Matriels et Mthode: 97 femmes ges de 25-80 ans avaient bnficies dune inspection du col utrin lexamen colposcopique, aprs application d'acide actique 5% (IVA) et/ou de solut de Lugol (IVL), suivis des biopsies pour les analyses anatomopathologiques. Rsultats: Les lsions prcancreuses ont t confirmes chez 73 femmes (75,26%).Par rapport lexamen anatomopathologique, la sensibilit et la spcificit globales de la colposcopie taient respectivement de 84,75% et 39,50%. Pour les lsions de bas grade (sensibilit = 72,72%, spcificit = 70,30%). Pour les lsions de haut grade(sensibilit = 38,50%, spcificit = 78,79%). Pour les lsions cancreuses: ( sensibilit= 40%, spcificit = 93,88%). Conclusion: comme moyen de dpistage lassociation IVA et IVL font de la colposcopie une mthode utilisable dans notre contexte et il est utile dans le diagnostic des lsions prcancreuses du col de lutrus. INSTRUMENTAL VAGINAL DELIVERIES-A REVIEW Shehu C E, Omembelede J Correspondence/Presenter : Shehu C E E-mail: consiego@yahoo.com Department of Obstetrics & Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria Background: Majority of women in Sub-Saharan Africa expect to achieve spontaneous vaginal delivery at the end of pregnancy. This is usually possible; however a few women receive one form of assistance or another to avert maternal or foetal morbidity or mortality. Training and research in instrumental vaginal delivery will improve the benefit for mothers and their babies and also maintain and improve the skills for these procedures. Objectives: To determine the incidence, indications, level of training and outcome of instrumental vaginal delivery in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Methodology: This was a 5-year retrospective study. Records of patients, who had vacuum or forceps delivery from 1st January 2008 to 31st December, 2012 were retrieved and relevant data extracted and analyzed using the SPSS for windows version 20.0 Results: The incidence of instrumental vaginal delivery was 0.96% of all deliveries (0.076% for forceps and 0.89% for vacuum deliveries). Vacuum extraction accounted for 92.2% of all instrumental deliveries. Use of forceps showed a decline over the years while vacuum use increased. 98.7% of the instrumental deliveries were emergency procedures. Delayed second stage (68.6%) and eclampsia (24.8%) were the common indications. Resident trainees mostly (93.4%) applied the instruments and the most common maternal complication was post partum haemorrhage (11.1%) followed by perineal tear (5.9%). Conclusion: The incidence of instrumental vaginal delivery is low. There is an obvious shift from use of forceps to vacuum extraction and this may explain the good maternal and perinatal outcomes. UNE ETUDE SUR LACCOUCHEMENT INSTRUMENTAL PAR VOIE BASSE Shehu C E, Omembelede J Correspondence/Presenter: Shehu C E E-mail: consiego@yahoo.com Department of Obstetrics & Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria Contexte: Bon nombre de femmes en Afrique sub-saharienne sattendent un accouchement normal par voie basse au terme de la grossesse. Cela est gnralement possible. Cependant, certaines femmes reoivent de laide sous une forme ou une autre pour viter la morbidit ou la mortalit maternelle ou ftale. La formation et la recherche sur laccouchement instrumental par voie basse permettront damliorer la prestation des soins en faveur des mres et de leurs bbs et aussi de maintenir et damliorer les rsultats de ces interventions. Objectifs: Dterminer lincidence, les indications, le niveau de formation et les suites de laccouchement par voie basse au Centre hospitalier universitaire dUsmanu Dan fodiyo, Sokoto, Nigeria. Mthodologie: Il sagit dune tude rtrospective sur 5 ans. Les dossiers des patients, qui avaient accouch par forceps ou par ventouse obsttricale du 1er janvier 2008 au 31 dcembre 2012 ont t colligs et les donnes pertinentes ont t extraites et analyses laide du logiciel SPSS sur la version Windows20.0 Rsultats: Lincidence de laccouchement instrumental par voie naturelle reprsentait 0,96% de tous les accouchements (0,076% au forceps et 0,89% par ventouse obsttricale). Lextraction par aspiration reprsentait 92,2% de tous les accouchements instrumentaux. Lutilisation du forceps a baiss au fil des ans tandis quon a observ une augmentation de lutilisation de la ventouse. 98.7% daccouchements instrumentaux taient des interventions en urgence. Le retard au cours du second stade de travail (68,6%) et lclampsie (24,8%) taient les indications courantes. La plupart des stagiaires rsidents (93,4%) ont utilis des instruments et la complication maternelle la plus frquente tait lhmorragie post-partum (11,1%), suivie de la dchirure prinale (5,9%). Conclusion: Lincidence de laccouchement instrumental par voie basse est faible. Il ya un passage vident de lutilisation de forceps lextraction par ventouse et cela peut expliquer les suites maternelles et prinatales satisfaisantes enregistres. SEXUAL DYSFUNCTION AMONG WOMEN ATTENDING INFERTILITY CLINIC IN A NIGERIAN TEACHING HOSPITAL Umar A M, Abdul M A Presenting Author: Umar A M, Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Shika, Nigeria. Email:  HYPERLINK "mailto:aminatulymhassan1@yahoo.com"aminatulymhassan1@yahoo.com. Intitution: Ahmadu Bello University Teaching Hospital, Shika, Nigeria. Background: There is paucity of data on female sexual dysfunction among infertile women in Africa and Nigeria. Objectives: To determine the prevalence of Female sexual dysfunction in all its subtypes among infertile women attending the gynaecology clinic, compare them with fertile women and get insight into the reasons why it is not discussed. Study Design: Analytical study. Setting: Gynaecology and Family planning clinics of ABUTH Zaria Methodology: Two hundred patients attending infertility clinic and 202 clients attending the family planning clinic for the first time were consecutively sampled. They were interviewed using a modified version of the Female Sexual Function Index. Additional open-ended questions were used to elucidate some of the reasons why it was not reported. General physical examination including height, weight and blood pressure as well as a pelvic examination was performed to rule out pelvic pathology. The data was analysed using SPSS version 20. p value was considered significant at less than 0.05. Results: The total prevalence rate for sexual dysfunction was 45.5%, with a significant difference between infertile and fertile women of (51.5% vs 39.6%; p=0.017, OR 1.619). Anorgasmia was the most prevalent subtype (27.9%) with significantly different rates (38.9% vs 13%; p <0.001, OR 2.877). Decreased libido was greater among fertile women (p 0.023, OR 0.432). Other domains were comparable in both groups. Younger women had greater prevalence of sexual dysfunction (25.7%). The prevalence of SD rose with Body Mass Index (BMI) reaching 100% in women with BMI e"35Kg/m2. Abnormal pelvic examination findings were more likely in infertile women with Dyspareunia (p 0.003). Other clinical examination findings did not correlate with SD. Most women with SD would prefer to be asked about SD by female medical personnel and would rather the doctor bring up the topic. Conclusion: Sexual dysfunction is prevalent among women in ABUTH Zaria, more so among infertile women. These women rarely seek help for SD even though they may believe it is causative to their problem. This study shows women would be responsive to being asked about sexual problems. Further study in the community is recommended before routine questioning on sexual function can be incorporated into the history of gynaecologic patients presenting with infertility. TROUBLES SEXUELS CHEZ LES FEMMES FREQUENTANT LA CLINIQUE DE FERTILITE DUN CENTRE HOSPITALIER UNIVERSITAIRE DU NIGERIA Umar A M, Abdul M A Presenting Author: Umar A M, Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Shika, Nigeria. Email: aminatulymhassan1@yahoo.com. Intitution: Ahmadu Bello University Teaching Hospital, Shika, Nigeria. Contexte: Il existe peu dinformations sur les troubles sexuels fminins chez les femmes striles en Afrique et au Nigria. Objectifs: Dterminer la prvalence de tous les types de troubles sexuels fminins chez les femmes striles frquentant le service de gyncologie, les comparer avec les femmes fertiles et comprendre les raisons pour lesquelles elles ne font pas lobjet dtude. Type dtude: Etude analytique. Cadre: Services de gyncologie et de planning familial dABUTH Zaria Mthodologie: Deux cent patientes de la Clinique de fertilit et 202 clientes reues au service de planning familial pour la premire fois ont t prleves de faon conscutive. Elles ont t interroges laide dune version modifie de lIndex de la fonction sexuelle fminine. Des questions ouvertes supplmentaires ont t utilises pour lucider quelques raisons pour lesquelles les troubles observs ne sont pas dclars. Un examen physique gnral notamment la taille, le poids, la pression artrielle et lexamen pelvien ont t effectu en vue dliminer toute anomalie pelvienne. Les donnes ont t analyses laide du SPSS version 20. La valeur p a t considre comme tant significative moins de 0,05. Rsultats: Le taux gnral de prvalence des troubles sexuels tait de 45,5%, avec une grande diffrence entre les femmes striles et les femmes fertiles de (51,5% vs 39,6%; p=0,017, OU 1,619). Lanorgasmie est le sous-type le plus rpandu (27,9%) avec des taux trs diffrents (38,9% vs 13%; p <0,001, OU 2,877). Les femmes fertiles prsentaient une baisse de la libido (p 0,023 OU 0,432). Dautres domaines ont pu faire lobjet de comparaison dans les deux groupes. Les femmes plus jeunes avaient une plus forte prvalence de troubles sexuels (25,7%). La prvalence des TS augmentaient avec l indice de masse corporelle (IMC) pour atteindre 100% chez les femmes avec un IMC e"35Kg/m2. Il tait plus probable de dcouvrir des anomalies pelviennes chez les femmes souffrant de dyspareunie (p 0,003). Dautres rsultats des examens cliniques navaient aucun rapport avec les TS. La plupart des femmes prsentant des TS prfreraient que les questions ce sujet leur soient poses par le personnel mdical fminin, et que ce soit le mdecin qui engage la conversation. Conclusion: Les troubles sexuels sont courants chez les femmes ABUTH Zaria, et davantage encore chez les femmes striles. Celles-ci recherchent rarement de laide pour les TS mme lorsquelles pensent quil peut sagir de la case de leur strilit. Ltude rvle que les femmes accepteraient dtre interroges au sujet de leurs problmes sexuels. Une tude approfondie au sein de la communaut est recommande avant lintgration des questions de routine sur les troubles sexuels dans les antcdents gyncologiques des patients striles. SURGERY AND UNIVERSAL HEALTH COVERAGE: IMPLEMENTING THE WHO SAFE CHILDBIRTH CHECKLIST FACILITATES COMPLIANCE WITH BEST PRACTICES Ogu Rosemary1,Charles Tobin-West2, Orazulike Ngozi1, Osita John1, Omosivie Maduka2, Inimgba Nestor1, Uzoigwe Samuel1. University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria; Department of Obstetrics & Gynaecology1; Department of Preventive and Social Medicineth2. Presenting Author: Dr Rosemary Ogu. Department of Obstetrics & Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. rosemary.ogu@uniport.edu.ng Background: Sub-Saharan Africa suffers some of the highest rates of maternal and perinatal mortality in the world. Poor quality of care and errors in clinical management are some of the key factors implicated. As part of efforts to reduce maternal morbidity and mortality, WHO piloted the Safe Childbirth Checklist Collaboration in selected centres in 2015.The University of Port Harcourt Teaching hospital was one of such centres in a low resource setting. The objectives were to determine the effectiveness of the Checklist in facilitating compliance with best practices among health care workers and to determine factors that enhance sustainability of the checklist. Methodology: A descriptive, cross-sectional design was used to generate information from doctors and nurses employing quantitative and qualitative methods. Quantitative data (questionnaires) was analysed using SPSS version 22 with level of statistical significance set at P = 0.05. Qualitative research was done by 4 Focus group discussions (FGDs) comprising 6 8 midwives and doctors.. Discussions covered the usefulness of the checklist in facilitating best practice. Interviews on themes and subthemes was coded and transcribed. Analysis was done using Atlas TI Software package. Results: 26 & 38 midwives/doctors participated in the FGDs and questionnaire survey respectively. Findings showed that patients were counseled more and professional standard of care improved when the checklist was used. The physical presence of the checklist in the labour ward enhanced sustainability. Conclusion: Using the checklist enhanced health workers compliance with best practices, while the mere presence of the checklist in the labour ward promoted its usage. Advocating for the use of Checklists in surgical units may enhance Universal Health Coverage. CHIRURGIE ET COUVERTURE SANITAIRE UNIVERSELLE: LA MISE EN OEUVRE DE LA LISTE DE CONTRLE OMS POUR LA SECURITE DE LACCOUCHEMENT SANS RISQUES FAVORISE LE RESPECT DES BONNES PRATIQUES Authors: Ogu Rosemary1, Charles Tobin-West2, Orazulike Ngozi1, Osita John1, Omosivie Maduka2, Inimgba Nestor1, Uzoigwe Samuel1. University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria; Department of Obstetrics & Gynaecology1; Department of Preventive and Social Medicineth2. Presenting Author: Dr Rosemary Ogu. Department of Obstetrics & Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. rosemary.ogu@uniport.edu.ng Contexte : LAfrique sub-saharienne prsente lun des taux les plus levs au monde de mortalit maternelle et prinatale. La mauvaise qualit des soins et les erreurs dans la prise en charge clinique sont quelques-uns des principaux facteurs responsables. Dans le cadre des efforts consentis en vue de rduire la morbidit et la mortalit maternelle, lOMS a lanc la collaboration pour la liste de contrle de scurit de laccouchement dans des formations sanitaires slectionnes en 2015. Le Centre hospitalier universitaire de Port Harcourt est lune de ces formations sanitaires situ dans une rgion o les ressources sont limites. Les objectifs consistaient dterminer lefficacit de la liste de contrle comme adjuvant au respect des bonnes pratiques par les personnels de sant et de dterminer les facteurs damlioration de la durabilit de la liste de contrle. Mthodologie: Un modle descriptif et transversal a t utilis en vue de gnrer des informations dtenues par les mdecins et les infirmiers laide de mthodes quantitative et qualitative. Les donnes quantitatives (questionnaires) ont t analyses laide du logiciel SPSS version 22 pour un niveau de significativit statistique fix P = 0,05. Une recherche qualitative a t effectue par 04 Groupes de discussions (FGD) constitues de 06 08 sages-femmes et mdecins. Les discussions concernaient lutilit de la liste de contrle comme facilitateur du respect des meilleures pratiques. Les entretiens sur les thmes et sous-thmes ont t cods et transcrits. Ils ont t analyss laide du logiciel Atlas.ti. Rsultats : 26 et 38 sages-femmes/mdecins respectivement ont particip aux FGD et lenqute partir de questionnaires. Les rsultats ont rvl que les patients recevaient davantage de conseils et les normes professionnelles taient meilleures lorsque la liste de contrle tait utilise. La prsence physique de la liste de contrle en salle de travail a amlior la durabilit. Conclusion : Lutilisation de la liste de contrle a amlior le respect des bonnes pratiques par les personnels de sant, et la simple prsence de la liste en salle de travail a favoris son utilisation. Le plaidoyer pour lutilisation de la liste de contrle dans les services de chirurgie pourrait amliorer la couverture sanitaire universelle. ANTROLITH OF THE MAXILLARY SINUS: A RARE DISEASE Bengondo M C1, Kenna E1, Vouffo F2, Tamgnoue G1, Mengong H1. 1: Service de Chirurgie Maxillo-faciale et de Stomatologie, du C H U de Yaound 2: Service dAnatomie Pathologique du C H U de Yaound Abstract: Antrolith of the maxillary sinus is a rare disease. It can be primary or secondary, developing on an underlying disease such as aspergillosis of the maxillary sinus. We report the case of a 68 year-old male patient who presented with a swollen right upper lip evolving for nearly 20 years, in whom physical examination noted a hard swelling of the right upper vestibule of the mouth. Standard x-ray showed a well-defined opacity occupying the right maxillary sinus. Vestibular surgery enabled the extraction of the mass that had a stony consistency. Pathological examination revealed that it was an antrolith whereas mycological examination was negative. Antrolith should be considered as differential diagnosis in maxillary sinus opacities. Keywords: Antrolith, sinus, maxillary. ANTROLITHIASE DU SINUS MAXILLAIRE: UNE PATHOLOGIE RARE BENGONDO M C1, KENNA E1, VOUFFO F2, TAMGNOUE G1, MENGONG H1. 1: Service de Chirurgie Maxillo-faciale et de Stomatologie, du C H U de Yaound 2: Service dAnatomie Pathologique du C H U de Yaound Rsum: Lantrolithiase du sinus maxillaire est une pathologie rare. Elle peut tre primitive ou secondaire, se dveloppant sur une pathologie prexistante telle que laspergillose du sinus maxillaire. Nous rapportons le cas dun patient de 68 ans de sexe masculin venu en consultation pour tumfaction labiale suprieure droite voluant depuis prs de 20 ans, chez qui lexamen physique notait une tumfaction dure du vestibule buccale suprieur droit. La radiographie standard de face montrait une opacit bien dlimite occupant le sinus maxillaire droit. La chirurgie par voie vestibulaire a permit lextraction de la masse qui avait une consistance pierreuse. Lexamen anatomopathologique a conclu quil sagissait dune antrolithiase. Lexamen mycologique tait ngatif. Lantrolithiase doit tre retenue comme diagnostic diffrentiel dans les opacits du sinus maxillaire. Mots cls: antrolithiase, sinus, maxillaire. MAXILLOFACIAL TRAUMA AT THE YAOUNDE UNIVERSITY TEACHING HOSPITAL Abstract: Maxillofacial trauma is common at the Yaounde University Teaching Hospital. It mainly concerns young men. The main etiology is represented by road accidents. Amongst these accidents, those related to motor bikes are recurrent. The diagnosis is usually clinical and radiological. In cases of associated brain injury, a CT scan is often prescribed. Dentoalveolar and mandibular fractures are the most frequent, followed by those of LEFORT 1. The management of these fractures is orthopaedic, surgical or mixed. It depends on the available technical equipment. Maxillofacial trauma is common. All practitioners should be trained to manage their care, with a minimum technical platform. Keywords: Trauma, diagnosis, management MASSIVE PERIPHERAL ODONTOGENIC FIBROMA MIMICKING SOFT TISSUE SARCOMA Authors: Fomete B, Lawal S, Ajike SO Institution: Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Presenter:Dr Benjamin Fomete, Faculty of Dental Surgery Email:benfometey@hotmail.com Introduction: Odontogenic fibroma is described by the World Health Organization (WHO) as an uncommon benign tumor containing different quantities of inactive looking odontogenic epithelium in a well developed fibrous stroma. This neoplasm can be located inside the jaw bones or may be found in the oral mucosa. Case report: a 17 month old female child referred from a general hospital with a 5 months history of Lt lower jaw swelling initially slow growing but growth became rapid in the last 2/12. Swelling is said to be painless and no history of trauma nor any injury to the site. There were no other medical condition of note. Conclusion: peripheral odontogenic fibroma can occur outside the tooth bearing area. Key words: massive, peripheral, odontogenic, fibroma LE FIBROME ODONTOGENIQUE PERIPHERIQUE MASSIF IMITANT LE SARCOME Authors: Fomete B, Lawal S, Ajike SO, Institution: Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Presenter:Dr Benjamin Fomete, Faculty of Dental Surgery Email:benfometey@hotmail.com Introduction: L'OMS dcrit le fibrome odontognique comme une tumeur bnigne peu courante contenant une grande varit dpithlium odontognique apparemment inactif dans un stroma fibreux bien dvelopp. Cette tumeur peut tre localise l'intrieur des os de la joue ou alors dans la muqueuse orale. Observation: une fillette de 17 mois rfre d'un hpital priphrique prsentant une tumeur sur la joue gauche depuis 05 mois. Les autres antcdents taient ngatifs. La biopsie a rvl un fibrome odontognique priphrique. Conclusion: Le fibrome odontognique priphrique peut tre considr comme une tumeur mixte et apparaitre hors de la cavit orale. Mots cls: priphrique, odontognique, fibrome, massif ORAL AND MAXILLOFACIAL SURGERY: WHERE IS THE PLACE OF AFRICA IN ITS FUTURE? Fomete B, Ononiwu CN Department of Maxillofacial Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria Presenter: Fomete B, Faculty of Dental Surgery Email:  HYPERLINK "mailto:benfometey@hotmail.com"benfometey@hotmail.com Abstract: Oral and maxillofacial surgery (OMS) focuses on the prevention and treatment of diseases, injuries and deformities of the mouth, facial soft tissue, the maxillofacial bones, temporomandibular joint (TMJ), salivary glands, and for certain diseases, neck pathology. Oral and maxillofacial surgery (OMS) as it is known and practiced today did not exist slightly more than 120 years ago.' Dentistry was a young profession not highly regarded by the medical profession, and surgical procedures of the jaws and associated structures were traditionally performed by the physician. There are four basic systems of education and training in oral and maxillofacial surgery which has led into the division of the areas into four viz Europe, Asia, South and Central America and North America. Africa conspicuously absents. The issue of minimum scope of practice is necessary for all oral and maxillofacial surgeons and can be done by dividing the scope into three parts viz: area of expertise, area of competence and area of familiarity. There are many parts of the globe(especially Africa) where populations have little more than access to basic dentoalveolar surgery, where facial trauma is increasing day by day, where armed conflicts lack specialist treatment centres for the injured, and where congenital facial deformity or oral cancer remain largely undertreated. When the public needs are considered it is obvious that although it may be necessary to have some double degree oral and maxillofacial surgeons, the single degree oral and maxillofacial surgeon plays an even more essential role. Key words: Oral, maxillofacial, surgery, Africa LAVENIR DE LA CHIRURGIE ORALE ET MAXILLO-FACIALE: QUELLE EST LA PLACE DE LAFRIQUE? Authors: Fomete B, Ononiwu CN Institution: Maxillofacial Surgery, Ahmadu Bello University Teaching Hospital, Zaria Nigeria Presenter: Fomete B, Faculty of Dental Surgery Email: HYPERLINK "mailto:benfometey@hotmail.com"benfometey@hotmail.com Rsum: La chirurgie buccale et maxillo-faciale (CMF) porte sur la prvention et le traitement des maladies, des lsions et des malformations buccales, et des tissus mous du visage, des os maxillo-faciaux, de l'articulation temporo-mandibulaire (ATM), des glandes salivaires, et pour certaines maladies, des pathologies du cou. La chirurgie buccale et maxillo-faciale (OMS) telle que connue et pratique aujourdhui nexiste que depuis environ 120 ans. Il existe quatre systmes de base dducation et de formation en chirurgie orale et maxillo-faciale qui ont donn lieu a quatre groupes qui sont: Europe, Asie, Amrique centrale et du Sud, et lAmrique du Nord. LAfrique nen fait pas partie. La mise en place dun systme minimum de pratique est ncessaire et pourrait comprendre les trois domaines suivants: spcialisation, formation et initiation. Il existe de nombreuses parties dans le monde (notamment en Afrique) o les populations ont peu accs la chirurgie dento-alvolaire de base; les traumatismes faciaux augmentent jour aprs jour; il manque de centres spcialiss de prise en charge des victimes de conflits arms; et o les malformations faciales congnitales ou le cancer de la cavit buccale restent largement sous-traits. Lorsque les besoins des populations sont pris en compte, il est vident que, mme sil est ncessaire d'avoir des chirurgiens maxillo-faciaux nantis dune double qualification, le chirurgien buccal et maxillo-facial ayant une seule qualification joue un rle davantage important. Mots cls: orale, maxillo-faciale, chirurgie, Afrique RECURRENT MASSIVE PERIPHERAL ODONTOGENIC MYXOMA IN A12-YEAR-OLD FEMALE WITH HURLER SYNDROME Fomete B, Lawal S, Ajike SO, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Presenter:Dr Benjamin Fomete, Faculty of Dental Surgery Email:benfometey@hotmail.com Abstract: Odontogenicmyxoma also called odontogenicfibromyxoma is a rare tumour. It is the second most common odontogenic jaw tumour (after ameloblastoma) in sub-Saharan Africa, accounting for between 12% and 16% of odontogenic tumours. In the most recent classification of odontogenictumours, the World Health Organisation lists odontogenicmyxoma as composed of mesenchyme and/or odontogenicectomesenchyme with or without odontogenic epithelium. Cases arising from the gingival soft tissues with- out bony involvement are characterised as peripheral.Hurler syndrome is a rare, inherited disease of metabolism in which a person cannot break down long chains of sugar molecules called glycosaminoglycans (formerly called mucopolysaccharides).Historically, MPS I has been delineated into 3 separate diseases on the basis of clinical presentation, that is, Hurler syndrome (severe), Hurler-Scheie syndrome (intermediate), and Scheie syndrome (mild). This report presents a recurrent massive peripheral odontogenicmyxoma in a 12-year-old child with Hurler syndrome whose effect on the patient and the management highlights the challenges associated with oral surgical practice in a resource-poor environment. Key words: recurrent, massive, peripheral, odontogenic, myxoma, hurler syndrome. LE MYXOME ODONTOGENIQUE PERIPHERIQUE MASSIF CHEZ UN ENFANT DE 12 ANS ATTEINT DU SYNDROME DHURLER. Fomete B, Lawal S, Ajike SO, Institution: Ahmadu Bello University Teaching Hospital, Zaria Nigeria. Presenter:Dr Benjamin Fomete, Faculty of Dental Surgery Email:benfometey@hotmail.com Rsum: Le myxome odontognique, aussi appel myxome fibreux odontognique, est une tumeur rare. En Afrique Sub-saharienne, il vient en 2meposition derrire lamloblastome, constituant entre 12 et 16% des tumeurs odontogniques. Dans la plus rcente classification des tumeurs odontogniques, lOMS classe le myxome odontognique parmi les tumeurs constitues de msoderme et/ou dendoderme avec ou sans pithlium. Les cas dorigine gingivale sans composition osseuse sont classs comme priphriques. Le syndrome dHurler est une maladie mtabolique rare caractrise par un trouble de mtabolisme des mucopolysaccharides (MPS).Historiquement, MPS 1 a t associ trois diffrentes maladies sur la base de leur prsentation clinique. Ce sont le syndrome d` Hurler (forme svre), le syndrome d`Hurler-Scheie (intermdiaire) et le syndrome de Scheie (simple). Cet article prsente un cas de myxome fibreux odontogniquercurrent, massif chez un enfant de 12 ans avec un syndrome d`Hurler dont les effets chez le patient et dans la prise en charge mettent en relief les difficults inhrentes a la chirurgie orale dans un environnement caractris par des ressources limites. Mots cls: Myxome, odontognique, syndrome de Hurler, massif, priphrique, rcurrent NON-CLINICAL FACTORS AND PREDICTORS OF SELF-RATINGS OF ORAL HEALTH AMONG YOUNG ADOLESCENTS IN A RURAL NIGERIAN POPULATION *Lawal FB, Dauda MA Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria Correspondence Dr F.B. Lawal, Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria Presenter: Dr F.B. Lawal +2348023658988 folakemilawal@yahoo.com Objective: To assess the non-clinical determinants of self-ratings of oral health of young adolescents in a rural population. Methods: A cross sectional survey was conducted among 11-13 year olds in Igboora, Nigeria. Information on self-rating of oral health, self assessed satisfaction with oral health condition and tooth appearance, pain history, consultation with the dentists and oral hygiene measures were obtained using structured questionnaires translated to the local language. Data were analysed using SPSS; Chi Square and logistic regression were used to establish associations between variables and predictors with p value < 0.05 statistically significant. Results: Most 346 (86.5%) rated their oral health positively. The 12 year olds 31 (19.6%) were more likely to rate their oral health poorly compared to the other age groups (p = 0.015). Those who expressed dissatisfaction with their oral health condition, 25 (45.5%), with appearance of their teeth, 17 (44.7%), had pain, 35 (21.6%), or perceived a need for dental treatment, 43 (16.7%), were more likely to rate their oral health poorly (p < 0.001, p < 0.001, p = 0.001, p = 0.012 respectively). Twice daily cleaning of the teeth 206 (92.4%) was associated with positive self-ratings of oral health (p < 0.001). The significant predictors of self-ratings of oral health as revealed by the regression model were age, pain and self-assessed satisfaction with oral health condition (p < 0.05). Conclusion: Age, satisfaction with oral health condition and pain are factors that predict self rating of oral health in young adolescents in rural communities. FACTEURS ET INDICATEURS NON-CLINIQUES DE LAUTO-EVALUATION DE LA SANTE BUCCO-DENTAIRE CHEZ DES JEUNES ADOLESCENTS RECRUTES DANS UNE POPULATION RURALE DU NIGERIA *Lawal FB, Dauda MA Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria Correspondence : Dr F.B. Lawal, Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria Presenter: Dr F.B. Lawal +2348023658988 folakemilawal@yahoo.com Objectif: Evaluer les dterminants non-cliniques de lauto-valuation de la sant bucco-dentaire chez les jeunes adolescents dans une population rurale. Mthodes: Une enqute transversale a t mene chez des jeunes gs de 11 13 ans Igboora, Nigeria. Des donnes ont t recueillies sur lauto-valuation de la sant bucco-dentaire, lauto-satisfaction en ce qui concerne ltat de sant bucco-dentaire et lapparence des dents, les antcdents de douleurs dentaires, les consultations chez le dentiste et les rgles dhygine bucco-dentaire laide de questionnaires structurs traduits en langue locale. Les donnes ont t analyses laide du SPSS; Le test Chi Square et lanalyse de rgression logistique ont servi pour tablir des associations entre les variables et les indicateurs ayant une valeur statistiquement significative p < 0.05. Rsultats: La majorit des 346 personnes enqutes (86,5%) ont considr leur sant bucco-dentaire bonne. La population des 12 ans, 31 (19,6%) avaient plus tendance mal noter leur sant bucco-dentaire par rapport aux autres groupes (p=0,015). Ceux qui se sont dit peu satisfaits de leur sant bucco-dentaire, 25 jeunes (45,5%), de lapparence de leurs dents,17 (44,7%), qui avaient eu mal aux dents, 35 (21,6%), ou pensaient avoir besoin de se faire soigner les dents, 43 (16,7%), avaient davantage tendance mal noter leur sant bucco-dentaire. (p<0,001, p < 0,001, p=0,001, p = 0,012 respectivement). Ceux qui se lavaient les dents deux fois par jours, 206 jeunes, attribuaient une bonne note leur sant bucco-dentaire (92,4%) (p < 0,001). Les principaux indicateurs dauto-valuation de la sant bucco-dentaire mis en vidence par lanalyse de rgression logistique taient lge, la douleur et la satisfaction personnelle de ltat de sant bucco-dentaire (p < 0,05). Conclusion: Lge, la satisfaction concernant ltat de sant bucco-dentaire et la douleur sont des indicateurs de lauto-valuation de la sant bucco-dentaire chez les jeunes adolescents des communauts rurales. THE PROFILE OF EYE TRAUMA IN INSECURE AREAS IN THE FAR NORTH OF CAMEROON Aboubakar H, Koki G, Epe E, Noa G, Omgbwa Eball A, Bella AL, Ebana Mvogo C. Auteur correspondant: Dr ABOUBAKAR HASSAN,  HYPERLINK "mailto:abshassan2002@yahoo.fr"abshassan2002@yahoo.fr Institution: Hpital dInstruction et dApplication de Rfrence des Armes de Yaound (HIARAY) Introduction: For over one year, Cameroon has been at war against the sect Boko Haram in its northern region. Multiple and varied traumas, including those of the eye and its appendices, have been reported among civilian and military people. We deemed it appropriate to evaluate the ophthalmological emergency of these injuries based on a clinical epidemiological profile. Patients and Method: We conducted a prospective, descriptive study from January to October 2015 in the conflict area and HIARAY hospital, Yaounde. Our study focused on epidemiological and clinical data, injury mechanisms, functional visibility and its impact on professional activities. Results: For 10 months, 13 cases of eye trauma were observed for each 15 infected eyes. Seven (53.84%) of the cases were military and 6 (46.15%) civilian. The average age was 27.31 years and the sex ratio stood at M/F 5:5. There were eight right eyes with a mean uncorrected visual acuity of 3.8/10 and 7 left eyes with 3.5/10. The main injuries found were cataract in 4 (26.66%) cases, palpebral wounds and intra-ocular foreign bodies in every 3 (20%) cases followed by ball bursts in 2 (13.33%) cases. Explosions of home-made mines (10/15) and road accidents (5/15) were responsible for the traumas. Eleven cases involved unilateral eye injuries and 2 cases had bilateral traumas. Blindness was estimated at 40% and visual impairment at 66.66%. Conclusion: Eye injuries in conflict areas are serious and dramatic for affected people and difficult to repair for eye surgeons. Protective equipment, with helmet and visor, would help reduce the frequency. Key words: Eye injuries-conflict-Cameroon. LE PROFIL DES TRAUMATISMES OPHTALMOLOGIQUES EN ZONE DINSECURITEA LEXTREME NORD DU CAMEROUN. Aboubakar H, Koki G, Epe E, Noa G, Omgbwa Eball A, Bella AL, Ebana Mvogo C. Auteur correspondant: Dr ABOUBAKAR HASSAN, HYPERLINK "mailto:abshassan2002@yahoo.fr"abshassan2002@yahoo.fr Institution: Hpital dInstruction et dApplication de Rfrence des Armes de Yaound (HIARAY) Introduction: Depuis plus dun an, le Cameroun est en guerre contre la secte Boko haram dans sa rgion septentrionale. Des traumatismes multiples et varis parmi lesquels ceux de lil et de ses annexes ont t recenss chez les personnes civiles et militaires. Evaluer lurgence ophtalmologique partir dun profil pidmiologique et surtout clinique de ces traumatismes semblait opportun. Patients et Mthode: Nous avons men une tude prospective et descriptive de Janvier Octobre 2015 sur les lieux du conflit et lHpital dInstruction et dApplication de Rfrence des Armes de Yaound (HIARAY). Les paramtres tudis taient les donnes pidmiologiques et cliniques, les mcanismes lsionnels, le retentissement fonctionnel et son impact professionnel. Rsultats: Pendant 10 mois, 13 cas de traumatisme oculaires taient observs pour 15 yeux atteints. Sept (53,84%) cas taient des militaires et 6 (46,15%) des civils. La moyenne dge tait de 27,31 ans et le sex ratio de 5,5 H/F. Huit yeux taient droits avec une acuit visuelle moyenne sans correction de 3,8/10 et 7 gauches avec 3,5/10. Les principales lsions retrouves taient la cataracte avec 4 (26,66%) cas, les plaies palpbrales et les corps tranger intra oculaires avec chacune 3 (20%) cas suivis des clatements du globe avec 2 (13,33%) cas. Les explosions de mines artisanales (10/15) et les accidents de circulation (5/15) taient les mcanismes responsables. Onze avaient une atteinte unilatrale et 2 une bilatrale. Le taux de ccit tait valu 40% et celui de malvoyance 66,66% Conclusion: Les traumatismes oculaires en zone de conflit sont graves et dramatiques pour les personnes atteintes et difficiles rparer pour le chirurgien ophtalmologue. Des matriels de protection type de casque avec visire permettraient den rduire la frquence. Mots cls: Lsions oculaires-conflit-Cameroun. PRIMARY EYE CARE: OBSTACLES TO OPHTHALMIA NEONATORUM PREVENTION IN A GAROU-BOULA DISTRICT HOSPITAL IN CAMEROON. Auteurs: Bella AL, Epe E, Sewou C, Kenne M, Mbende A Orateur: Bella Assumpta Lucienne - Coordonnateur du Programme National de lutte contre la ccit/Ministre de la Sant Publique- Cameroun. Email:  HYPERLINK "mailto:ngonbidjoe@yahoo.fr"ngonbidjoe@yahoo.fr Introduction: The prevalence of childhood blindness which is estimated at one per one thousand children represents a heavy burden for the family and the society in our setting. However haf of this blindness is avoidable. This is the case of the optalmia noenatorum. Purpose: To determine the obstacles to the implementation of the Cred method in Garoua-Boula district hospital. Methodology: We conducted in April 2015 a survey targeting txo groups. The first group was the maternity staff who answered a semi-structured interview. On the other hand, a questionnaire was administered to the mothers of new-borns who received no prevention of ophtalmia neonatorum in post-partum. Results: The Four health workers of our survey used the antibiotic eye drops at birth. However in the absence of protocol, they did not use the correct antibiotic, and its administration was not systematic due to its unavailability through the health system. Fifteen mothers were questioned, only one declared having been sensitized on the interest of the prevention during the prenatal follow-up. Conclusion: Structural causes prevailed as obstacles to the prevention of the ophtalmia neonatorum in our setting (absence of protocol unavailability of medicine, absence of information during pregnancy). It is necessary to strengthen primary eye care, in the context of shortage of specialized human resources, if the expect to reach the Sustainable Development Goals. Keywords: ohtalmia nenatorum Crede method Sustainable Development Goals. OPH002 SOINS OCULAIRES PRIMAIRES- OBSTACLES A LA PREVENTION DE LOPHTALMIE NEONATALE DANS UN DISTRICT DE SANTE AU CAMEROUN Bella AL, Epe E, Sewou C, Kenne M, Mbende A Bella Assumpta Lucienne - Coordonnateur du Programme National de lutte contre la ccit/Ministre de la Sant Publique- Cameroun. Email: HYPERLINK "mailto:ngonbidjoe@yahoo.fr"ngonbidjoe@yahoo.fr Introduction: La ccit infantile dont la prvalence est estime un pour mille enfants reprsente un lourd fardeau pour les familles et la socit dans notre environnement. Cependant la moiti des ccits infantiles est vitable. Cest le cas de lophtalmie nonatale. But: Dterminer les obstacles lapplication de la mthode de Cred lhpital de district de Garoua-Boula. Mthodologie: Il sagissait dune enqute CAP ralise au mois davril 2015, ciblant deux groupes. Dune part le personnel de la maternit de lHD de Garoua Boula qui a rpondu un guide dentretien semi-structur. Dautre part les mamans des nouveau-ns nayant reu aucune prophylaxie en post partum qui on a administr un questionnaire. Rsultats: Les quatre personnels de sant administrent la chimioprophylaxie en salle daccouchement. Cependant en labsence de protocole clair, ils utilisent un antibiotique non adapt, et lapplication nest pas systmatique en raison lindisponibilit frquente du collyre dans la formation sanitaire. Des quinze mamans interroges, une seule dclare avoir t informe lors des consultations prnatales, de lintrt de la chimioprophylaxie oculaire. Conclusion: Les causes structurelles prdominent comme obstacles la prvention de lophtalmie nonatale dans notre milieu (absence de protocole, indisponibilit des mdicaments, absence dinformation des parturientes). Le renforcement des soins de sant oculaire primaires, dans un contexte de dficit en ressources humaines spcialises est un dfit relever pour prtendre atteindre les Objectifs de Dveloppement Durable. Mots cls: ophtalmie nonatale- Mthode de Cred- ODD DEPRESSION IN VISUALLY IMPAIRED ADULTS ATTENDING A TERTIARY EYE CLINIC S. BITTO-IKYAA, C.O. BEKIBELE, O. GUREJE, T.T. BITTO Department of Ophthalmology Garki Hospital Abuja,Nigeria. Correspondence e-mail Address: HYPERLINK "mailto:swissbitto@yahoo.com"swissbitto@yahoo.com Abstract Background: Visual impairment has been found to be associated with depression globally; however, there is paucity of such information in an African setting. Depression in the visually impaired is associated with increasing difficulty in carrying out activities of daily living, mobility, and socializing, by reducing motivation, initiative and resiliency thus affecting negatively quality of life. Objectives: To determine the hospital prevalence of depression and the relationship between visual impairment and depression among adult patients attending the Eye Clinic of the University College Hospital, Ibadan, Oyo State, Nigeria. Methodology: A prospective, monocenter, cross-sectional study was conducted recruiting 450 adult participants visiting the Eye Clinic for the first time. All participants had visual acuity assessment and ocular examination done. They were all screened for depression using the Becks Depression Inventory 2nd edition (BDI-II). Results: The mean age of participants was 51.1618.48 years with a male to female ratio of 0.8:1. The hospital prevalence of depression among visually impaired adults was 27.1%. There was a significant association between increasing severity and prolonged duration of visual impairment and depression. After adjusting for confounders, the grade and duration of visual impairment, unemployment and a history of hypertension were significant predictors of depression; with duration of visual impairment being the strongest predictor (AOR, 10.05; 95% CI, 3.4-29.7) of depression. Conclusion: Depression is common and under diagnosed among visually impaired patients attending the Eye Clinic, University College Hospital, Ibadan. A significant direct relationship between severity and duration of visual impairment and rate of depression was observed. DEPRESSION CHEZ LES ADULTES MALVOYANTS SUIVIS DANS UN SERVICE DOPHTALMOLOGIE S. BITTO-IKYAA, C.O. BEKIBELE, O. GUREJE, T.T. BITTO Presenter: Sewuese BITTO-IKYAA Department of Ophthalmology, Garki Hospital Abuja, Nigeria. Correspondence e-mail Address:HYPERLINK "mailto:swissbitto@yahoo.com"swissbitto@yahoo.com Name of Institution: Garki Hospital Abuja, Nigeria Contexte: Il a t prouv lchelle mondiale que la dficience visuelle est associe la dpression. Cependant, il y a manque de ces informations dans le contexte africain. La dpression chez les malvoyants est associe la difficult croissante mener les activits de la vie quotidienne, se mouvoir, et entretenir des relations sociales, rduisant ainsi la motivation, lesprit dinitiative et la dtermination du patient et affectant ngativement sa qualit de vie. Objectifs: dterminer la prvalence hospitalire de la dpression et la relation entre la dficience visuelle et la dpression chez les patients adultes suivis au service dophtalmologie du CHU dIbadan, dans ltat dOyo au Nigeria. Mthodologie: Une tude transversale prospective mono-centrique a t mene sur 450 participants adultes vus au service dophtalmologie pour la premire fois. Tous les participants avaient subi une valuation de lacuit visuelle et un examen oculaire. Ils ont tous subi le test de dpistage de la dpression laide delinventairede dpression deBeckII (IDB-II). Rsultats: Lge moyen des participants tait de 51,16 18,48 ans avec un ratio homme-femme de 0,8: 1. La prvalence de la dpression chez les adultes ayant une dficience visuelle tait de 27,1%. Il y avait un lien significatif entre la gravit croissante et la dure prolonge de la dficience visuelle ainsi que la dpression. Aprs lajustementdesvariables confusionnelles, le degr et la dure de la dficience visuelle, le chmage et lantcdent dhypertension taient des indicateurs importants de la dpression; la dure de la dficience visuelle tant le principal indicateur (AOR, 10,05; IC 95%, de 3,4 29,7) de la dpression. Conclusion: La dpression est frquente et sous-diagnostique chez les patients atteints de dficience visuelle suivis au service dophtalmologie du CHU dIbadan. Un lien significatif troit a t observ entre la gravit et la dure de la dficience visuelle et le taux de dpression. OCCUPATIONAL EYES INJURIES: A CASE SERIES OF 2 CASES Epee E1,.Mvilongo C1, Nguena B1. Eyoup G1, Helles G 1, Chilla F1, Ebana Mc 1. 1ophthalmology unit of the Yaounde Central Hospital , Yaounde, Cameroun. Presenter : Epe Emilienne. Email :  HYPERLINK "mailto:epeeemilienne@gmail.com"epeeemilienne@gmail.com Introduction: The workplace is generally the seat of personal injuries. The ocular involvement during these accidents is frequent in our setting and in general relates to the young males. We report the case of 2 patients who presented with eyeball injuries and intraocular metallic foreign bodies, occupational eye injuries, followed up in the ophthalmology unit of the Yaounde Central Hospital. Observation: Case1: Mr. X, 35 years old carpenter, consulted for post traumatic ocular pain of the right eye which has occurred one year ago. On examination visual acuity was decreased to perception of light, a scleral scar, a stained cornea with fundus inaccessible. Ocular ultrasound highlighted a complete retinal detachment while an intraocular foreign body could be seen on Xray, a complete picture of siderosis. Case2: Mr. Y 37 years mechanic, consulted for decreased visual acuity of the L left eye following trauma induced with a hammer while at work. On clinical examination the left eye had perception of light a penetrating corneoscleral injury with iris incarceration, and intravitreal hemorrhage. X ray imaging allow to visualize an opaque intraocular FB. The management was conservative for the first one and the second case had surgical repair. Conclusion: Occupational injury frequently affects the eye and intraocular metallic foreign bodies are often reported. Their outcome depends on the severity of the trauma, the location, the causative agent the time of management. Key words: occupational accident, metal foreign body, corneoscleral injury. TRAUMATISMES OCULAIRES PROFESSIONNELS: UNE SERIE DE 2 CAS Epee E1,.Mvilongo C1, Nguena B1. Eyoup G1, Helles G 1, Chilla F1, Ebana Mc 1. 1ophthalmology unit of the Yaounde Central Hospital Orateur : Epe Emilienne. Email : HYPERLINK "mailto:epeeemilienne@gmail.com"epeeemilienne@gmail.com Introduction: le milieu professionnel est gnralement le sige des traumatismes corporels. L'atteinte oculaire pendant ces accidents est frquente dans notre contexte et concerne en gnral les jeunes hommes. Nous rapportons le cas de 2 patients qui se sont prsents avec des lsions au globe oculaire, des corps trangers mtalliques intraoculaires, des traumatismes oculaires professionnels et qui ont t suivis au Service dophtalmologie de l'Hpital Central de Yaound. Observation: Cas 1:M. x, menuisier de 35 ans, consult pour cause de douleur oculaire post-traumatique l'il droit survenue il y a un an. Lexamen de l'acuit visuelle a rvl, la perception de la lumire, une cicatrice sclrotique, une corne tachete avec un fond inaccessible. L'chographie oculaire a mis en vidence un dcollement complet de la rtine tandis que la radiologie a permis de visualiser un corps tranger intraoculaire, une image complte de la sidrose. Cas 2: M.y mcanicien de 37 ans, consult pour motif de diminution de l'acuit visuelle de l'il droit des suites d'un traumatisme par marteau au travail. Daprs l'examen clinique, l'il gauche avait, la perception de la lumire, un traumatisme cornosclral pntrant avec incarcration de liris et une hmorragie intraveineuse. L'imagerie par rayons-X a permis de visualiser un FB intra- oculaire opaque. La prise en charge tait conservatrice pour le premier cas et le second a subi une rparation chirurgicale. Conclusion: Le traumatisme en milieu professionnel affecte frquemment l'il et les anticorps mtalliques intraoculaires sont souvent rapports. Leur pronostic dpend de la gravit du traumatisme, de la localisation, de l'agent pathogne et du moment de la prise en charge. Mots cls: Accident de travail, Corps tranger mtallique, lsion corno-sclrale. INDICATIONS OF ORBITAL EXENTERATION: ABOUT 3 CONSECUTIVE CASES AT THE YAOUNDE UNIVERSITY TEACHING HOSPITAL Nomo AF1, Kagmeni G1-2, Nanfack Ngoune C3, Moukouri E1-2, Bella AL1-3 1Faculty of medicine and biomedical sciences of Yaounde 2 Yaounde University Teaching Hospital 3 Yaounde Gynaeco-Obstetric and Pediatric Hospital Presenter: Nomo Arlette Email:arlynm2012@gmail.com Purpose: To determine the clinical indications for orbital exenteration in a tertiary Yaounde Teaching Hospital. Design: Retrospective consecutive case series Methods: Review of medical records of 3 patients who underwent orbital exenteration in ophthalmology unit of Yaound University Teaching Hospital between February to May 2015 Results: There were 2 women and 1 man, mean age 41 years (range 27 and 64 ). All patients were blind on affected eye at presentation. Clinical examination as well as CT-Scan of orbits revealed an intra-orbital tumor with proptosis grade IV. Two patients underwent total or extended orbital exenteration and 1 underwent subtotal exenteration. Histologic findings included: one squamous cell carcinoma, one achromic melanoma and one adenoic cystic carcinoma. Post operatively; all patients were referred to the oncology unit of the Yaounde General Hospital for an adjuvant treatment. Conclusion: Our study highlights the radical management of oculo-orbital tumor in our setting. Late diagnosis was the major risk factor. Population should be educated for early presentation in case of any eye tumor. Key words: exenteration, malignant tumor, orbit LES INDICATIONS DE LEXENTERATION ORBITAIRE: A PROPOS DUNE SERIE DE 3 CAS CONSECUTIFS AU CENTRE HOSPITALIER UNIVERSITAIRE DE YAOUNDE Nomo AF1, Kagmeni G1-2, Nanfack Ngoune C3, Moukouri E1-2, Bella AL1-3 1Faculty of medicine and biomedical sciences of Yaounde 2 Yaounde University Teaching Hospital 3 Yaounde Gynaeco-Obstetric and Pediatric Hospital Corresponding author mail: Nomo Arlette arlynm2012@gmail.com Introduction : Lexentration est lexrse de tout le contenu orbitaire avec le prioste laissant ainsi nu les parois osseuses de lorbite. Cest une technique chirurgicale dfigurante. Il sagit dans la plupart des cas dune chirurgie carcinologique dune tumeur maligne ayant envahi lorbite. Ce travail nous a permis dobserver les difficults diagnostiques et thrapeutiques des tumeurs orbitaires et de dterminer les indications chirurgicales au Centre Hospitalier Universitaire de Yaound (CHUY). Mthode : Analyse rtrospective de 3 cas conscutifs de tumeurs orbitaires malignes exentres au CHUY de Janvier mai 2015. Rsultats : Trois patients ont t exentrs dont 2 femmes et un homme. Leurs ges respectifs taient de 27 ans, 34 ans et 64 ans avec une moyenne dge de 41 ans. Lacuit visuelle propratoire de lil atteint tait une absence de perception lumineuse chez les 3 patients. Lexamen ophtalmologique de ces patients ainsi que le scanner orbitocrbral ralis rvlaient une protrusion du contenu orbitaire (exophtalmie) de lil atteint avec une tumeur envahissant toute lorbite. Un traitement chirurgical par exentration du contenu orbitaire a t ralis avec analyse anatomopathologique de chaque pice chirurgicale. Cette exentration tait partielle chez une patiente et totale chez 2 patients de notre srie. Sur le plan histologique toutes les tumeurs taient malignes : 1 cas de mlanome malin achromique, un cas de carcinome pidermode moyennement diffrenti et ulcr et un cas de carcinome adnode kystique. Tous les patients ont t rfrs chez un oncologue lhpital Gnral de Yaound pour un traitement adjuvant. Conclusion : Ces cas posent ainsi un problme de prise en charge tardive des tumeurs malignes dans notre contexte, de mauvais pronostic visuel et un prjudice esthtique. Le diagnostic tardif tait le principal facteur de risque de cette chirurgie mutilante. Mots cls : exentration, tumeur maligne, orbite A RARE CASE OF CHILDHOOD OPTIC NERVE GLIOMA: RETINAL VASCULAR OCCLUSION 1Nanfack C, 2Nomo AF; 2Emche C, 1-2Bella AL 1Hpital Gynco-obsttrique et Pdiatrique de Yaound 2Facult de Mdecine et des Sciences Biomdicales de Yaound Email auteur:  HYPERLINK "mailto:arlynm2012@gmail.com"arlynm2012@gmail.com Introduction: Gliomas are tumors developed from glial cells (astrocytes, oligodendrocytes, ependymal cells or choroid plexus).The visual loss, proptosis and strabismus are often the main signs of the disease. Case report: We report a case of left optic nerve glioma in an 11 year old girl with no particular history who came to consult with severe visual loss. Ophthalmologic examination revealed: non perception of light, esotropia, a non-reactive pupil semi mydriasis. Fundoscopy revealed papilledema and mixed arterial and venous retinal vascular occlusion. The CT scan of orbits confirmed the left optic nerve glioma, retinography also confirmed mixed vascular occlusion. Conclusion: Gliomas of the optic nerve are rare tumors particularly in children. These may be aggressive due to the extension to neighboring structures. Keywords: glioma, optic nerve, retinal vascular occlusion. UNE PRESENTATION RARE DU GLIOME DU NERF OPTIQUE DE LENFANT : LOCCLUSION VASCULAIRE RETINIENNE. 1Nanfack C, 2Nomo AF; 2Emche C, 1-2Bella AL 1Hpital Gynco-obsttrique et Pdiatrique de Yaound 2Facult de Mdecine et des Sciences Biomdicales de Yaound Email auteur: HYPERLINK "mailto:arlynm2012@gmail.com"arlynm2012@gmail.com Introduction: Les gliomes sont des tumeurs dveloppes partir des cellules gliales (astrocytes, oligodendrocytes, cellules de lpendyme ou plexus chorodes), et qui se manifestent habituellement par une baisse dacuit visuelle, l'exophtalmie et le strabisme. Observation mdicale: Nous rapportons ainsi un cas de gliome du nerf optique gauche chez une jeune fille ge de 11 ans sans antcdent particulier qui est venue consulter pour une BAV svre chez qui lexamen ophtalmologique a rvl : une absence de perception lumineuse, une sotropie, une pupille en semi mydriase aractive . Un tableau ddme papillaire et une occlusion vasculaire rtinienne mixte artrielle et veineuse taient retrouvs au fond doeil. Le scanner orbito crbral a confirm le gliome du nerf optique gauche, la rtinographie a montr locclusion vasculaire mixte. Conclusion: Les gliomes du nerf optique sont des tumeurs rares de lenfant. Elles peuvent tre agressives du fait de lextension aux structures avoisinantes. Mots cls : gliome, nerf optique, occlusion vasculaire rtinienne MODIFIED SMALL INCISION CATARACT SURGERY AND INTRAOCULAR LENS IMPLANTATION IN HIV PATIENTS Kagmeni Giles1,2,*, Domngang Christelle3, Nguefack-Tsague Georges2, Ebana Mvogo Come2 and Peter Wiedemann4 1University Teaching Hospital Yaounde (UTHY), Cameroon. 2University of Yaound I, Faculty of Medicine and Biomedical Sciences, Yaound, Cameroon. 3Mountains University Bangangt, Cameroon. 4Eye Hospital of Leipzig University, Germany. *Corresponding author email:  HYPERLINK "mailto:dr.kagmeni@gmx.net"dr.kagmeni@gmx.net Aim: To describe a surgical technique suitable for cataract surgery in regions with a high prevalence of HIV infection. Methods: We reviewed the medical records of 20 consecutive AIDS patients with cataract who underwent modified small incision cataract surgery (mSICS) with posterior chamber lens implantation. Classic extra capsular cataract extraction (ECCE) was compared to mSICS. The number of potentially risky steps for contamination during surgery and duration of surgery were analyzed. A risky step was defined as any time when the surgeon had to use a sharp instrument. A students paired t-test was carried out to compare continuous variables and P values less than 0.05 were considered statistically significant. Results: Twenty patients were included in the study; thirteen males (65%) and seven females (35%). The mean age was 46.3 13.6 years (range 22 to 70 years).The number of potentially risky steps for contamination was significantly higher in the classical ECCE than in mSICS (P < 0.001). The mean duration of cataract surgery with mSICS was significantly shorter as well (P < 0.001). Conclusion: Conversion to mSICS is essential in order to reduce accidental injuries during cataract surgery in sub-Saharan countries. Sharp instruments should be passed through a neutral zone to ensure that the surgeon and nurse do not touch the same instrument at the same time. Key words: Small incision cataract surgery (SICS), AIDS CHIRURGIE MODIFIEE DE LA CATARACTE PAR MICRO-INCISION ET IMPLANTATION DE LENTILLES INTRAOCULAIRES CHEZ LES PATIENTS SEROPOSITIFS Kagmeni Giles1,2,*, Domngang Christelle3, Nguefack-Tsague Georges2, Ebana Mvogo Come2 and Peter Wiedemann4 1University Teaching Hospital Yaounde (UTHY), Cameroon. 2University of Yaound I, Faculty of Medicine and Biomedical Sciences, Yaound, Cameroon. 3Mountains University Bangangt, Cameroon. 4Eye Hospital of Leipzig University, Germany. *Corresponding author email: HYPERLINK "mailto:dr.kagmeni@gmx.net"dr.kagmeni@gmx.net Objectif: dcrire une technique chirurgicale approprie la chirurgie de la cataracte dans les rgions forte prvalence de linfection VIH. Mthodes: Nous avons examin les dossiers mdicaux de 20 patients atteints de SIDA et souffrant de cataracte qui ont subi une chirurgie modifie de la cataracte par micro-incision (CMCMI) avec implantation de la lentille en chambre postrieure. Lextraction extra capsulaire classique de la cataracte (EECC) a t compare la CMCMI. Le nombre de dmarches potentiellement risque de contamination pendant la chirurgie et la dure de la chirurgie ont t analyss. Une dmarche risque a t dfinie comme chaque fois que le chirurgien a d utiliser un instrument tranchant. Un test t appari a t effectu sur un tudiant afin de comparer les variables continues, etles valeurs P<0,05 ont t considres comme statistiquement significatives. Rsultats: l'tude a t mene avec vingt patients, treize hommes (65%) et sept femmes (35%). Lge moyen tait de 46,3 13,6 ans (intervalle 22 70 ans). Le nombre de dmarches potentiellement risque de contamination tait plus lev dans lEECC classique que dans la CMCMI (P <0,001). La dure moyenne de la chirurgie de la cataracte avec la CMCMI tait galement plus courte (P < 0.001). Conclusion: Le passage la CMCMI est capital afin de rduire les lsions accidentelles lors de chirurgie de la cataracte dans les pays sub-sahariens. Les outils tranchants doivent passer par une zone neutre pour s'assurer que le chirurgien et linfirmier ne touchent pas le mme instrument au mme moment. Mots cls: Chirurgie de la cataracte par micro-incision (CCMI), SIDA COST FOR THE TREATMENT IN YAOUNDE OF DIABETIC RETINOPATHY WITH ARGON LASER Koki G1-2, Helles G1, Epe E1-3, Bilong Y1, Bimba S1, Bella AL1-4, Ebana Mvogo C1-3. 1: Facult de Mdecine et des Sciences Biomdicales Universit de Yaound I 2: Hpital dInstruction et dApplication de Rfrence des Armes de Yaound 3: Hpital Central de Yaound 4: Hpital Gynco-obsttrique et Pdiatrique de Yaound Orateur: Koki Godefroy email:  HYPERLINK "mailto:kok2002g@yahoo.fr"kok2002g@yahoo.fr Purpose: Assess expenditure on treatment by Argon laser of a patient who has diabetic retinopathy with an indication. Patients and Methods: This was a prospective, transversal and descriptive study conducted at the angiography centre of the Yaounde Central Hospital between October 2014 and October 2015. All diabetic patients with retinopathy and having an indication to this treatment were considered. Costs comprised initial and final AGF, appointment, transport between the place of residence and the laser treatment centre. Results: In all, 43 out of 330 patients (13%) were selected. The average age was 55.67 8.40 years. There were many more housewives 15 (34.9%), followed by 13 (30.2%) retirees. Twenty-seven (62.8%) patients funded their treatment themselves. The average overall expenditure was 86002 67197 f CFA per eye, being 132 102 euros. Discussion: Treating diabetic retinopathy by Argon laser is expensive in our environment due to transport costs. Conclusion: Creating more treatment centres in all 10 regions of Cameroon would reduce cost. Keywords: Diabetic retinopathy, treatment cost, Argon laser. QUEL COUT POUR LE TRAITEMENT DE LA RETINOPATHIE DIABETIQUE PAR LASER ARGON A YAOUNDE? Koki G1-2, Helles G1, Epe E1-3, Bilong Y1, Bimba S1, Bella AL1-4, Ebana Mvogo C1-3. 1: Facult de Mdecine et des Sciences Biomdicales Universit de Yaound I 2: Hpital dInstruction et dApplication de Rfrence des Armes de Yaound 3: Hpital Central de Yaound 4: Hpital Gynco-obsttrique et Pdiatrique de Yaound Orateur: Koki Godefroy email: HYPERLINK "mailto:kok2002g@yahoo.fr"kok2002g@yahoo.fr But: valuer les dpenses effectues pour traiter avec du laser Argon un patient atteint de rtinopathie diabtique prsentant une indication. Patients et Mthodes: tude prospective, transversale et descriptive ralise au centre dangiographie de lHpital Central de Yaound dOctobre 2014 Octobre 2015. taient inclus tous les patients diabtiques atteints de rtinopathie ayant une indication ce traitement. Les cots portaient sur lAGF initiale et finale, la prise de rendez-vous, le transport aller-retour du lieu dhabitation et du traitement laser. Rsultats: Au total, 43 patients sur 330 (13%) taient retenus. Lge moyen tait de 55,67 8,40 ans. Les mnagres taient plus nombreuses avec 15 (34,9%) cas suivies de 13 (30,2%) retraits. Vingt-sept (62,8%) patients finanaient eux mme leur traitement. La dpense globale moyenne tait de 86002 67197 f CFA par il soit 132 102 euros. Discussion: Le cot du traitement de la rtinopathie diabtique par laser argon est lev dans notre milieu cause des dpenses lies au transport. Conclusion: La cration dautres centres de traitement de cette affection dans les 10 rgions du Cameroun rduirait ces cots. Mots cls: Rtinopathiediabtique, Cot de traitement, Laser argon. SHORT TERM OUTCOME AFTER LASER PHOTOCOAGULATION FOR DIABETIC RETINOPATHY IN YAOUNDE Aim: Determine the functional outcome following laser photocoagulation in Yaound Methodology: Prospective study spanned 16 months. Patients with preproliferative DR, proliferative DR, and /or macula oedema received laser treatment and a follow up of 3 months consisting of fundoscopy, retinal fluorescence angiography and visual acuity. The evaluation criteria were: visual acuity, regression of new vessels and maculopathy Results: Sixty-five eyes had laser photocoagulation. High blood pressure was present in 36 patients (87.8%). Seven eyes (10.1%) presented with preproliferative DR, 53 (76.6%) presented proliferative diabetic retinopathy. Complicated diabetic retinopathy was present in 9 eyes (13%). Twenty eyes (27.8%) presented with diabetic maculopathy. Fifty eyes (76.9) had panretinal photocoagulation, 3 eyes (4.6%) had respectively macular grid and focal photocoagulation, 9 eyes (13.8%) received joint panretinal photocoagulation and macular grid. The anatomic evolution following laser treatment was marked by the complete regression of preproliferative and mild proliferative DR. Moderate and severe DR regressed in 35 eyes (68.6%); stabilized in 10 eyes (19.6%) and worsened in 6 eyes (11.7%). The evolution of complicated proliferative DR was mediocre in the 2 eyes. Macular oedema regressed in 12 eyes (85.7%) and persisted in 2 eyes (14.3%). Following laser treatment, 16 eyes (24.6%) had a VA of 0.1; 15 eyes (23%) had VA between 0.1 and 0.3 meanwhile 17 eyes (26.1%) had VA between 0.3-0.7 ; 17 eyes (26.1%) had VA e"0.7. visual outcome improved or remained stable in 50 eyes (76.9%) and deteriorated in 15 eyes (23.1%) Conclusion: Photocoagulation permits the preservation of visual function in patients especially when the indications are respected and when it is done on time, especially in cases with macular oedema Key words: diabetic retinopathy: photocoagulation, diabetic maculopathy. PRONOSTIC A COURT TERME DE LA PHOTOCOAGULATION RETINIENNE POUR RETINOPATHIE DIABETIQUE A YAOUNDE Nanfack C.1, Koki G.2, Bella AL1-2 1: Hpital Gynco-Obsttrique et Pdiatrique de Yaound 2: Facult de Mdecine et des Sciences Biomdicales- Universit de Yaound I Orateur: Nanfack Chantal, Email:cngoune@yahoo.fr Introduction/But: Dterminer le rsultat fonctionnel aprs photocoagulation au laser Yaound Mthodologie: Etude prospective, par chantillonnage conscutif de tout patient diabtique prsentant une rtinopathie diabtique prprolifrante, prolifrante et /ou un dme maculaire pour laquelle: Un traitement au laser diode a t administr, et un suivi comportant, un examen du fond dil, une angiographie rtinienne, et une mesure de lacuit visuelle. Les critres dvaluation taient lacuit visuelle, la rgression de la maculopathie, et des novaisseaux Rsultats: Soixante-cinq (65) yeux ont reu une photocoagulation. Sept (10,1%) yeux prsentaient une RD prprolifrante, 53(76,6 %) yeux une RD prolifrante. Les formes compliques de RD taient prsentes dans 9(13%) yeux. Vingt (27,8%) yeux prsentaient une maculopathie diabtique. La photocoagulation panrtinienne tait le traitement dans 50(76,9%) yeux, 3(4,6%) yeux avaient reu respectivement un grid maculaire et photocoagulation focale. 9(13,8) yeux avaient reu une photocoagulation panrtinienne associe un grid maculaire. Lvolution anatomique tait marque par la rgression complte des rtinopathies diabtiques prprolifrante et prolifrante minime. Les RDP modre et svre ont rgress dans 35(68,6%) yeux, stabilises dans 10 (19,6%) yeux, et aggraves dans 6 (11,7%). Lvolution de la RDP complique tait mdiocre dans les 2 yeux. L Sdme maculaire a rgress dans12 (85,7%) yeux et persist dans 2(14,3%) yeux. Concernant l AV, 16 (24,6%) yeux avaient une AV 1/10, 15 (23%) yeux avaient une AV comprise entre 1/10- 3/10, 17(26,1%) yeux avaient une AV comprise entre 3/10-7/10, et 17 (26,1%) yeux avaient une AV  7/10. La fonction visuelle s est amliore ou stabilise dans 50 (76,9%) yeux et dtriore dans 15 (23,1%) yeux. Conclusion: La PPR a permis d obtenir un pronostic fonctionnel favorable. Ce rsultat tait dautant plus favorable que la RD tait prise en charge prcocement Mots cls: rtinopathie diabtique, photocoagulation, maculopathie diabtique PREVALENCE OF CHILDHOOD VISUAL IMPAIRMENT IN LA BRIQUETERIE YAOUNDE Auteurs : Ntyame- Bourdon E1., Bella AL1,2., DjoumaNembot F4., Ngomba A1,3., pe 1,3. 1: Ministre de la Sant Publique; 2: Facult de Mdecine et des Sciences Biomdicales de Yaound; 3: Facult de Mdecine et des Sciences Pharmaceutiques de Douala; 4: Facult des Sciences Universit Yaound I Orateur: Ntyame-Bourdon Eliette email:  HYPERLINK "mailto:eliette_m2000@yahoo.fr"eliette_m2000@yahoo.fr Abstract: Despite a worldwide prevalence of 1 child per one thousand which may appear low, childhood blindness represents a heavy social and economic burden for families and countries. It is also recognized that half of the causes of blindness is avoidable or curable. In order to set up effective control strategies in Cameroon, it is necessary to have reliable data on the prevalence and causes of childhood blindness. Thus, we have conducted a preliminary survey in Yaounde, the capital of Cameroon with the overall objective to estimate the prevalence of visual impairment in the community amongst children aged from 3 months to 15 years, and to describe its epidemiology and clinical figures. We conducted a cross-sectional descriptive survey with a stratified cluster sampling method. The recruitment of 696 children in our sample was done door to door in 220 households distributed in 20 clusters in the health areas of the Briqueterie and Ekoudou, after parental consent. The statistical analysis was done by the software Epi Info 7. We found the prevalence of visual impairment up to 5,7 and the prevalence of blindness was 1,4. Refractive errors were the main causes. Key-words: Childhood blindness Childhood visual impairment Refractive errors PREVALENCE DE LA MALVOYANCE INFANTILE AU QUARTIER BRIQUETERIE DANS LA VILLE DE YAOUNDE Ntyame- Bourdon E1., Bella AL1,2., DjoumaNembot F4., Ngomba A1,3., pe 1,3. 1: Ministre de la Sant Publique; 2: Facult de Mdecine et des Sciences Biomdicales de Yaound; 3: Facult de Mdecine et des Sciences Pharmaceutiques de Douala; 4: Facult des Sciences Universit Yaound I Orateur: Ntyame-Bourdon Eliette email: HYPERLINK "mailto:eliette_m2000@yahoo.fr"eliette_m2000@yahoo.fr Rsum: Malgr une prvalence mondiale de 1 pour mille enfants qui peut priori apparaitre faible, la ccit infantile reprsente un lourd fardeau social et conomique pour les familles et les pays. Il est par ailleurs reconnu que la moiti des causes de ccit est vitable ou curable. Afin de pouvoir mettre en place au Cameroun des stratgies de lutte efficaces, il est ncessaire de disposer de donnes fiables de prvalence et des causes de ccit infantile. Aussi, avons-nous men une enqute prliminaire dans un quartier de la ville de Yaound, la capitale du Cameroun dont lobjectif gnral tait destimer la prvalence communautaire de la malvoyance chez les enfants gs de 3 mois 15 ans et den dcrire le profil pidmiologique et clinique. Nous avons men une enqute transversale et descriptive selon la mthode dchantillonnage stratifi en grappes. Le recrutement de696enfants de notre chantillona t fait en porte porte dans deux-cent-vingt mnages repartis dans vingt grappes dans les aires de sant de la Briqueterie et dEkoudou, aprs obtention du consentement parental. Lanalyse statistique, a t faite par le logiciel Epi info 7. Nous avons obtenu une prvalence de la malvoyance de 5,7 et une prvalence de la ccit de 1,4. Les vices de rfraction reprsentaient la principale cause de la malvoyance. Mots-cls: Ccit infante- Malvoyance infantile- Vices de rfraction. HAZARD AT THE WAR FRONT -FRIEND OR FOE? Oyediji F.J, Odugbo O.P, Obikili G.A Presenter: Oyediji Funmilayo J, Department of Ophthalmology, Jos University Teaching Hospital, Jos, Nigeria. Email:  HYPERLINK "mailto:funmiola5@yahoo.com"funmiola5@yahoo.com Background: Over this decade, activities of insurgents have steadily gained momentum. This has led to the more engagement of young people into the Nigerian Security Agents-Joint Tax Force (JTF). The JTF include army, navy and air force. Improper mastery of newly acquired weapons could lead to advertent injury of fellow security agents by their colleagues. Objective: To draw attention to the devastating effects of guns on friends at the battle front. Methodology: Illustrative case report and a review of literature Results: A young air force officer who suffered facial injury from the mechanical impact of the back blast from a Rocket Propelled Grenade (RPG). This resulted in severe ocular injuries and visual impairment. This is the first report of back blast from a RPG in Nigeria. The write up is aimed at raising awareness of our security personnel to vulnerability of the face and eyes at the war front. Conclusion: As these great men and women are on the battle field, they should be properly educated on risks their weapons of warfare pose to them and their colleagues. RISQUES AU FRONT AMI OU ENNEMI? Oyediji F.J, Odugbo O.P, Obikili G.A Presenter: Oyediji Funmilayo J, HYPERLINK "mailto:funmiola5@yahoo.com"funmiola5@yahoo.com Department of Ophthalmology, Jos University Teaching Hospital, Jos, Nigeria. Contexte : Au cours de la prsente dcennie, les insurrections ont progressivement pris de lampleur ce qui a conduit un enrlement accru des jeunes gens dans la Nigerian Security Agents-Joint Task Force (JTF) (la Force conjointe des Agents de scurit nigrians). La JTF comprend les forces terrestres, navales et ariennes. A cause du manque de matrise des armes nouvellement acquises, les agents de scurit peuvent blesser accidentellement leurs collgues. Objectif : Attirer lattention sur les effets dvastateurs des armes sur les amis au front. Mthodologie : Prsentation dun cas illustratif et revue de la littrature Rsultats : Un jeune officier de larme de lair a t bless au visage par limpact mcanique de lexplosion dune grenade propulse par fuse (RPG) avec pour consquences des blessures oculaires graves et une dficience visuelle. Il sagit ici du premier cas rapport dune blessure cause par lexplosion dune RPG au Nigria. Le but du prsent article est de sensibiliser notre personnel de scurit sur la vulnrabilit du visage et des yeux sur le champ de bataille. Conclusion: Quand nos braves hommes et femmes sont sur le champ de bataille, ils doivent tre bien informs du danger que reprsentent leurs armes pour eux-mmes et pour leurs collgues. SHORT-TERM PROGNOSIS OF PATIENTS TREATED FOR RETINOBLASTOMA AT THE YAOUNDE GYNAECO-OBSTETRIC AND PAEDIATRIC HOSPITAL Talla C1.Jibia G1.Ngoulou V1.Nanfack C2. Abdouramani O2.Aboutou R2.Eballe Omgbwa A2. Bella AL1.2 1: Facult de Mdecine et des Sciences Biomdicales Yaound I 2: Hpital Gynco-Obsttrique et Pdiatrique de Yaound Presenter: Talla Corine Email:  HYPERLINK "mailto:corinetalla@yahoo.fr"corinetalla@yahoo.fr Introduction: Retinoblastoma is the most common ocular malignancy in children. The survival rate is 98% in developed countries, attributed to early diagnosis and quick and easy access to quality care. Purpose: We sought to evaluate the fate of patients treated for retinoblastoma in one of the teaching hospitals in Yaounde. Methodology: It was a retrospective study of cases including those of patients who were treated for retinoblastoma during the period running from August 2004 to August 2015. Families were contacted by telephone and an appointment was obtained as soon as possible for monitoring the health of children. The following variables were analyzed: age, sex, clinical signs, operated eye, time between diagnosis and treatment, histological findings, treatment type, condition of second eye, psychosocial trend and survival rate among monitored patients. Results: A total of 13 cases of children (14 eyes), 8 male and 5 female was examined. Clinically, the leading cases were leucocoria (62%), strabismus (23%), proptosis (8%). The left eye was the most affected (61.54%) and the endophytic shape the most common (38%). The management time-limit was 1 month one week; therapeutic modalities were 100% of cases for enucleation including 38% associated with chemotherapy; visual acuity of the second eye was most often normal (63.70%), hyperopia was most common (36.40%) and normal eye background (100%); enrolment was 100%. The overall survival rate at 5 years was 77.77%. Two cases of death were recorded, with one occurring after metastasis. There was no local recurrence. Conclusion: Late management of retinoblastoma was a bad prognostic factor in our context. However, we noted a high survival rate. Key words: Retinoblastoma, enucleation. PRONOSTIC A COURT TERME DES PATIENTS SUIVIS POUR RETINOBLASTOME A LHOPITAL GYNECO-OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE Talla C1.Jibia G1.Ngoulou V1.Nanfack C2. Abdouramani O2.Aboutou R2.Eballe Omgbwa A2. Bella AL1.2 1: Facult de Mdecine et des Sciences Biomdicales Yaound I 2: Hpital Gynco-Obsttrique et Pdiatrique de Yaound Orateur: Talla Corine, E-mail: HYPERLINK "mailto:corinetalla@yahoo.fr"corinetalla@yahoo.fr Introduction: Le rtinoblastome est la tumeur maligne oculaire la plus frquente chez lenfant. Le taux de survie est 98% dans les pays dvelopps grce un diagnostic prcoce et un accs facile et rapide des soins de qualit. But : Notre travail consistait valuer le devenir des patients ayant prsent un rtinoblastome dans lun des centres hospitaliers et universitaires de Yaound. Mthodologie: Il sagissait dune tude rtrospective dans laquelle taient inclus les dossiers des malades suivis pour rtinoblastome durant la priode dAot 2004 Aot 2015. Les familles taient contactes par tlphone et un rendez-vous ds que possible tait obtenu pour le suivi des enfants. Les variables analyses taient: lge, le sexe, les signes cliniques prsents, lil opr, le dlai entre le diagnostic et la prise en charge, les rsultats histologiques, le type de traitement, ltat du second il, lvolution psycho-sociale et le taux de survie chez les patients suivis. Rsultats: Un total de13 dossiers denfants (14 yeux), 8 de sexe masculin et 5 de sexe fminin a t inclus. La clinique tait domine par la leucocorie (62%), le strabisme (23%), lexophtalmie (8%).Lil gauche tait le plus atteint (61.54%), la forme endophytique la plus frquente (38%). Le dlai de prise en charge tait de 1 mois une semaine; les modalits thrapeutiques taient de 100% de cas pour lnuclation dont 38% taient associs la chimiothrapie; lacuit visuelle du second il tait normale pour la plupart (63.70%), lhypermtropie la plus frquente (36.40%) et le fond dil normal (100%); la scolarisation tait de 100%. Le taux de survie global 5 ans tait de 77,77%; 2 cas de dcs taient enregistrs dont lun aprs la survenue des mtastases. Il ny avait pas de rcidives locales. Conclusion: La prise en charge tardive du rtinoblastome tait un facteur de mauvais pronostic dans notre milieu; toutefois nous avions not un taux de survie lev. Mots-cls: Rtinoblastome, nuclation. TRABECULECTOMY AT THE YAOUNDE GYNAECO-OBSTETRIC AND PEDIATRIC HOSPITAL: INTRAOCULAR PRESSURE AND ANATOMICAL RESULTS Tock O1, Ghemmogne C1, Takou V1, Nanfack C2, Abdouramani O2, Omgbwa Eballe A3, Bella AL1-2 1 Facult de Mdecine et des Sciences Biomdicales Universit de Yaound I 2 Hpital Gynco-Obsttrique et Pdiatrique de Yaound 3 Facult de Mdecine et des Sciences Pharmaceutique de Douala Auteur correspondant: Tocke Messina Sylvianne  HYPERLINK "mailto:messinasylviane@gmail.com"messinasylviane@gmail.com Introduction: The primary open-angle glaucoma is a fairly common condition in Africa. Medical treatment, expensive in developing countries, is a real handicap for the majority of glaucoma patients and trabeculectomy appears to be the treatment that should be offered early enough. We report the results of our work on the trabeculectomy in Cameroonians at a teaching hospital. Goal: To evaluate the functional outcome of patients who underwent trabeculectomy at the Yaounde Gynaeco-Obstetrics and Pediatric Hospital. Materials and Methods: This is a retrospective study of patient records that underwent trabeculectomy at the YHGOP from 2005 to 2015. All the records of patients operated during this period regardless of the surgeon were included in the study. The following variables were analysed: age, sex, type of glaucoma, eye surgery, the use/no use of antimytotic, the time between the diagnosis of glaucoma and trabeculectomy, intraocular pressure before and after surgery (6th month), postoperative complications. Results: A total of 71 eyes of 52 patients were included, 31 men and 21 women aged between 09 months to 75 years. The mean age was 59.2 years and the time between the discovery of glaucoma and trabeculectomy was 14.18 months. Indications of trabeculectomy were mostly failure of medical treatment (60% of cases). 5 trabeculectomies were performed with the use of 5FU. The mean IOP before surgery was 32,53mmHg and 16,88mmHg six months after trabeculectomy. The mid-term post-operative complications were dominated by abnormalities of the filtration bleb, and most serious complications were endophthalmitis (1 case) and retinal detachment (1 case). Postoperative follow-up was between 1 month and 8 years with an IOP success rate in 45% of cases at mid-term (9 months). Conclusion: Trabeculectomy is less practiced. The difficult long-term post-operative monitoring makes it delicate to assess trabeculectomy results. Keywords: Primary open angle glaucoma, trabeculectomy. TRABECULECTOMIE A LHOPITAL GYNECO-OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE: RESULTATS PRESSIONNELS ET ANATOMIQUES Auteurs: Tock O1, Ghemmogne C1, Takou V1, Nanfack C2, Abdouramani O2, Omgbwa Eballe A3, Bella AL1-2 1 Facult de Mdecineet des Sciences Biomdicales Universit de Yaound I 2 Hpital Gynco-Obsttrique et Pdiatrique de Yaound 3 Facult de Mdecine et des Sciences Pharmaceutique de Douala Auteur correspondant: Tocke Messina Sylvianne HYPERLINK "mailto:messinasylviane@gmail.com"messinasylviane@gmail.com Introduction: Le glaucome primitif angle ouvert est une affection assez frquente en Afrique. Le traitement mdical, onreux dans les pays en dveloppement constitue un handicap pour la majorit des glaucomateux et la trabculectomie apparat comme le traitement proposer suffisamment tt. Nous rapportons nos rsultats sur la trabculectomie chez le Camerounais dans un centre hospitalier universitaire. But: Evaluer les rsultats fonctionnels des malades ayant subi une trabculectomie lhpital Gynco-obsttrique et Pdiatrique de Yaound. Matriels et mthodes : Cest une tude rtrospective sur les dossiers des malades ayant bnfici dune trabculectomie HGOPY de 2005 2015. Ont t inclus dans ltude, tous les dossiers des malades oprs au cours de cette priode quelque soit le chirurgien. Les variables analyses taient: lge, le sexe, le type de glaucome, lil opr, lusage ou non dantimytotique, la dure entre le diagnostic de glaucome et la trabculectomie, la pression intraoculaire avant et aprs la chirurgie (6me mois), les complications postopratoires. Rsultats: Un total de 71 yeux de 52 patients, 31 hommes et 21 femmes gs de 09 mois 75 ans a t inclus. Lge moyen tait de 59,2 ans et le dlai entre la dcouverte du glaucome et la trabculectomie de 14,18mois, les indications de la trabculectomie tait surtout lchec du traitement mdical (60% des cas). Seulement 5 trabculectomies ont t ralises avec usage de 5FU, la PIO moyenne avant la chirurgie tait de 32,53mmHg et de 16,88mmHg 6 mois aprs la trabculectomie. Les complications post opratoires moyen terme taient domines par les anomalies de la bulle de filtration, les complications les plus graves taient lendophtalmie (1 cas) et le dcollement de rtine (1 cas). Le suivi post opratoire tait de 10,6mois en moyenne avec un taux de succs pressionnel moyen terme (9 mois) de 45%. Conclusion: La trabculectomie est peu pratique. Le suivi post opratoire difficile long terme rend dlicat une apprciation des rsultats fonctionnels. Mots cls: Glaucome primitif angle ouvert, trabculectomie. MALARIA AND PAEDIATRIC ANAEMIA IN YAOUNDE MBEDE J, OBAMA M T, SAME EKOBO, NGONGANG J, KONA NGONDO F S. Auteur correspondant: KONA NGONDO FRANCOIS. Email: stephkona@yahoo.fr Introduction: Every year 1,500,000 to 2,700,000 children die from malaria. 50% of these deaths are the consequence of malarial complications in children aged between 1 and 5 years. Anaemia is a serious malarial complication. Nutritional deficiencies are also a major cause of anaemia especially in tropical Africa. Purpose: To find out whether there is a relationship between P. falciparum paracitaemia and severe anaemia and evaluate the impact of iron deficiency in the occurrence of severe malarial anaemia in children. Methodology: 150 children residing in Yaounde and admitted for confirmed malaria were examined between July 2004 and January 2005. The blood tests conducted were a GE and a blood smear to confirm the diagnosis and determine parasitaemia, NFS and serum assessment were also conducted to evaluate the level of anaemia and identify any related iron deficiency. Results: The lowest average parasitaemia was found in the 6 months to 12 months age bracket. Severe anaemia with Hb less than 5 grams per decilitre was found in 20.7% of our patients. We found a negative correlation between parasite load and Hb level (r= -0.9) i.e.the higher the parasitaemia the lower the Hb level. Iron deficiency was found in 36.7% of patients. For the same parasitaemia, the average Hb was lower in children with hyposideremia. Conclusion: There is a negative correlation between falciparum parasite load and Hb level suggesting that the higher the parasitaemia the lower the Hb. Iron deficiency is common in our study and potentiates the occurrence of severe anaemia especially for parasitaemia below 2%. Keywords: Malaria, severe anaemia, iron deficiency, parasitaemia. GEN001 PALUDISME ET ANEMIE DE LENFANT A YAOUNDE MBEDE J, OBAMA M T, SAME EKOBO, NGONGANG J, KONA NGONDO F S. Auteur correspondant : KONA NGONDO FRANCOIS. Email : HYPERLINK "mailto:stephkona@yahoo.fr"stephkona@yahoo.fr Introduction: Chaque anne 1,5 2,7 millions denfants dcdent cause du paludisme. 50% de ces dcs sont lis aux complications du paludisme et concernent les enfants de 1 5 ans. Lanmie est une complication importante de la malaria. Les carences nutritionnelles sont galement une cause majeure danmie surtout en Afrique tropicale. Objectifs: Rechercher une relation ventuelle entre la parasitmie P. falciparum et la gravite de lanmie et valuer limpact de la carence martiale dans la survenue de lanmie svre chez lenfant impalud. Mthodologie: 150 enfants rsidant Yaound admis pour accs palustre confirm ont t examins de Juillet 2004 Janvier 2005. Les tests sanguins ralisstaient une GE et un frottis sanguin permettant de confirmer le diagnostic et de dterminer la parasitmie, une NFS et un bilan srique ont galement t ralis pour valuer le degr danmie et rechercher une carence martiale associe. Rsultats: Le taux moyen de parasitmie le plus bas tait retrouv dans la tranche dge 6 mois 12 mois. Les anmies svres soit un taux dHb infrieur 5 grammes par dcilitre taient rencontres chez 20.7% de nos patients. Nous avons retrouv une corrlation ngative entre la charge parasitaire et le taux dHb (r= -0,9) autrement dit plus les parasitmies taient enleves, plus les taux dHb taient bas. On retrouvait la carence martiale chez 36,7% des patients. Pour une mme parasitmie le taux moyen dHb tait plus bas chez les enfants ayant une hyposidrmie. Conclusion: Il existe une corrlation ngative entre la charge parasitaire P. falciparum et le taux dhmoglobine suggrant que plus la parasitmie est leve plus le taux dhmoglobine est bas. La carence martiale est frquente dans notre tude et potentialise la survenue de lanmie svre surtout pour les parasitmie inferieures 2%. Mots cls: Paludisme, anmie svre, carence martiale, parasitmie. ASSESSMENT OF THE EXTENT OF TOBACCO USE AMONG ADOLESCENTS IN URBAN AREAS: A CASE REPORT OF THE CITY OF BANGUI BOBOSSI SERENGBE G , NDOYO J , DJOUDA SAH FOPA S Auteur correspondant: DJOUDA SAH FOPA SERGE, Email: sergedjo@yahoo.fr Abstract: From December 2008 to January 200, during 6 weeks, we conducted a school-based survey on students in 4th 6th grade in the town of Bangui. It included data on the prevalence of cigarette and other tobacco use as well as information on some determinants of tobacco use: access/availability and price, environmental tobacco smoke exposure (ETS), cessation, media and advertising and school curriculum. This work permitted to evaluate the national program against tobacco use by the youth in Central African Republic. A two stages cluster sample design was used to produce representative data for all Bangui. At the first stage, schools were selected with a probability proportional to enrolment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. The school response rate was 100%. The comprehensive response rate was 96% from 1000 participants. 29% of students currently use any form of tobacco. 11% currently smoke cigarettes. 38% currently use other forms of tobacco. ETS exposure is high; almost 22% of students live in homes where other people smoke in their presence; 9, 8% are exposed to smoke at school. 35,5% of male students and 41% of female students think that smoking permits to have many friends. Almost 83,6% of students think smoking in public place should be banned. Almost 65,4% want to quit. Over 49% saw pro cigarette ads in the past 30 days. These results show on one hand the extent of smoking among young people in the Central African Republic and secondly the inadequate application of regulations on tobacco. Key words: tobacco use, students, school, tobacco exposure, advertising, Bangui. EVALUATION DE LAMPLEUR DU TABAGISME CHEZ LES ADOLESCENTS EN MILIEU URBAIN: CAS DE LA VILLE DE BANGUI BOBOSSI SERENGBE G, NDOYO J, DJOUDA SAH FOPA S Auteur correspondant: DJOUDA SAH FOPA SERGE, Email: sergedjo@yahoo.fr Rsum: Nous avons organis du mois de dcembre 2008 au mois de janvier 2009 pendant 6 semaines, une enqute sur le tabagisme chez les jeunes adolescents de 13 18 ans en milieu scolaire Bangui. Cette enqute fournit des renseignements sur certains dterminants de la consommation du tabac qui sont: Les connaissances et attitudes des jeunes vis--vis du tabac ; laccessibilit et la disponibilit aux produits du tabac ; lexposition la fume du tabac ; le sevrage ; la publicit et le parrainage du tabac et lenseignement sur le tabac en milieu scolaire. Ce qui permet de suivre et dvaluer les efforts raliss En Rpublique centrafricaine dans le cadre de la lutte anti-tabac. La population de ltude est reprsente par les lves inscrits en classe de 6me, 5me, 4me et 3me pendant la priode de lenqute. Un chantillonnage deux degrs a t ralis partir de la base des donnes exhaustives sur les tablissements denseignement secondaires de Bangui. Le premier degr a consist la slection de 12 tablissements scolaires et le 2me degr a consist la slection randomise des classes proportionnellement leurs tailles. Les rsultats sont ci-aprs: En ce qui concerne la participation, tous les 12 tablissements retenus ont particip lenqute, soit un taux de participation de 100% ; 996 lves sur 1000 ont rpondu toutes les questions soit un taux de rponses compltes de 99.6% et 1000 lves sur 1000 sont gs de 13 15 ans, soit un taux de prcision de 100%; Le taux de prvalence du tabagisme est de 11% et 38% des lves consomment les autres produits du tabac; Par rapport aux connaissances et attitudes, 35,5% des garons et 41% des filles pensent que fumer permet davoir beaucoup damis; En ce qui concerne laccessibilit et la disponibilit aux produits du tabac, 19% des lves fument rgulirement dans les salles de cinma; Le niveau dexposition la fume du tabac est lev, 22% la maison et 9,8% lcole; 65,4% de ces fumeurs dsirent arrter de fumer; Sur le plan publicitaire, 49% ont vu des panneaux publicitaires, et les journaux et 26% ont des objets portant les logos de cigarettes; Peu dlves ont t enseigns lcole sur les effets du tabac (49%) et seulement 40% ont discut avec les jeunes de leurs ges des raisons qui les poussent fumer. Ces rsultats montrent dune part lampleur du tabagisme en milieu des jeunes en Centrafrique et dautre part linsuffisance dapplications des textes rglementaires sur le tabac. Mots cls: tabagisme, jeunes adolescents, milieu scolaire, sevrage, publicit, Bangui. PHENOTYPIC CHARACTERIZATION OF KLEBSIELLA SPP. PRODUCING BETA LACTAMASE AND CARBAPENEMASE IN THREE REFERRAL HOSPITALS OF CAMEROON Anicette Chafa Betbui3, Hortense Gonsu Kamga1,2**, Michel Toukam1, Calixte Didier Mbakop1, Francois-Xavier Mbopi-Kou1, Sinata Shiro Koulla1. 1. Department of microbiology & Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaound I. 2. Bacteriology laboratory, Yaounde University Teaching Hospital.3. Department of Microbiology, School of Health Sciences, Catholic University. *Presenting author: Hortense Gonsu Kamga Email:  HYPERLINK "mailto:hgonsu@gmail.com"hgonsu@gmail.com Objective: Antimicrobial resistance constitutes a major public health issue in the world. This study aims at ameliorating the epidemiological and bacteriological knowledge of Klebsiella spp. in Cameroon. Methodology: A descriptive, cross sectional study was carried for a period of 6 months from May to November 2013. Klebsiella strains were collected from three referral hospitals and analysis was carried out in the bacteriology laboratory of the Yaounde University Teaching Hospital. The susceptibility testing was done using the diffusion disk method on Mueller Hinton. The antibiotics which were tested were the -lactamine, and the inhibitors like clavulanic acid, tazobactam, EDTA, cloxacillin and 3-aminophenyl boronic acid hydrochloride. The determination of MIC was also carried out to identify the different resistance phenotypes. Results: Strains were isolated from urine (52.5%), blood (21.2%), pus (15.2%) and other specimen (11.1%). Out of 99 strains, Klebsiella pneumoniae pneumoniae was the most prevalent (78.7%), followed by Klebsiella oxytoca (12.12%), Klebsiella pneumoniae ozaenae (5.05%), and Klebsiella pneumoniae rhinoscleromatis (4.04%). The antimicrobial susceptibility testing confirmed the natural resistance of Klebsiella spp. to amoxicillin (100%), and revealed a global predominance of resistant to ticarcilline (100%), piperacilline (76%), and to Cefalotine (85%). The most active antibiotics were imipenem (99%) and ertapenem (77%). The main phenotypes observed were: extended spectrum -lactamase (30.30%), wild phenotype (27.27%), penicillinase resistant to inhibitors (16.16%), carbapenemase (11.11%). Out of the 11 Klebsiella producing carbapenemases, 5 were of class C and 6 of class D. Conclusion: The emergence of Klebsiella producing carbapenemase in our health facilities is a reality. CARACTERISATION PHENOTYPIQUE DE LA KLEBSIELLA SPP. PRODUISANT DES BETA-LACTAMASES ET DES CARBAPENEMASES DANS TROIS HOPITAUX DE REFERENCE DU CAMEROUN Anicette Chafa Betbui3, Hortense Gonsu Kamga1,2**, Michel Toukam1, Calixte Didier Mbakop1, Francois-Xavier Mbopi-Kou1, Sinata Shiro Koulla1. 1. Department of microbiology & Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaound I. 2. Bacteriology laboratory, Yaounde University Teaching Hospital.3.Department of Microbiology, School of Health Sciences, Catholic University. *Presenting author: Hortense Gonsu Kamga Email: hgonsu@gmail.com Objectif: La rsistance aux antimicrobiens est lun des principaux problmes de sant publique au monde. La prsente tude vise amliorer les connaissances pidmiologiques et bactriologiques sur la Klebsiella spp. au Cameroun. Mthodologie: Une tude descriptive et transversale a t mene pendant 06 mois, de mai novembre 2013. Des souches de Klebsiella spp. ont t collectes dans trois hpitaux de rfrence et analyses dans le laboratoire de bactriologie du Centre hospitalier universitaire de Yaound. Lantibiogramme a t ralis par diffusion de Mueller Hinton. Les antibiotiques qui ont t tests taient le -lactamine, et les inhibiteurs tels que l acide clavulanique, tazobactam, EDTA, cloxacilline et le chlorhydrate de l acide borique 3-aminophnyl. Afin d identifier les diffrents phnotypes rsistants, les CMI ont galement t dtermines. Rsultats: Les souches ont t isoles partir des urines (52,5%), du sang (21,2%), du pus (15,2%) et dautres chantillons (11,1%). Des 99 souches, Klebsiella pneumoniae pneumoniae tait la plus frquente (78,7%), suivie de Klebsiella oxytoca (12,12%), Klebsiella pneumoniae ozaenae (5,05%), et Klebsiella pneumoniae rhinoscleromatis (4,04%). Lantibiogramme a confirm la rsistance naturelle de Klebsiella spp. lamoxicilline (100%), et une prdominance gnrale dans la rsistance la ticarcilline (100%), pipracilline (76%), et la cfalotine (85%). Les antibiotiques les plus actifs taient l imipnme (99%) et l ertapnme (77%). Les principaux phnotypes observs taient: le -lactamase large spectre (30,30%), phnotype sauvage (27,27%), pnicillinase rsistant aux inhibiteurs (16,16%), carbapnmase (11,11%). Des 11 Klebsiella produisant des carbapnmases, 05 taient de classe C et 06 de classe D. Conclusion: Lapparition de carbapnmase produisant le Klebsiella dans nos formations sanitaires est une ralit. NASAL CARRIAGE OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS AND ITS SUCCEPTIBILITY PATTERN TO ANTIBIOTICS IN ADULT PATIENTS AND MEDICAL STAFF IN SOME HOSPITAL INSTITUTIONS IN YAOUNDE. Hortense Kamga Gonsu , Sinda L Kouemo, Valentine Ngum Ndze, Francois-Xavier Mbopi-Keou, Sinata Koulla Shiro. Faculty of Medicine and Biomedical Sciences, University of Yaound1, Cameroon *Presenting author: Hortense Gonsu Kamga Email:  HYPERLINK "mailto:hgonsu@gmail.com"hgonsu@gmail.com Objective: The aim of this study was to evaluate the nasal carriage of methicillin-resistant staphylococcus aureus and its succeptibility pattern to antibiotics in adult patients and medical staff in some hospital institutions in Yaounde. Methodology: A prospective analytic study was performed from January to April 2011. Anterior nasal swabs were taken from 295 adults, of whom 75 were medical staff and 220 hospitalized patients in surgical, medical an intensive care units in some hospital in Yaounde. Staphylococcus aureus stains were isolated from mannitol salt agar and identified by Gram stains and catalase and coagulase tests. Methicillin and other antibiotics susceptibility testing were performed with sixteen antibiotics using disc diffusion methods. Results: Of the 295 samples analysed, 120 (40.6%) were Staphylococcus aureus positive, with 85% MRSA among the Staphylococcus aureus carriers. The prevalence of MRSA in medical staff was 31(41.3%) and 71(32%) for hospitalized patients. The highest rate of MRSA colonization was recorded at the ICU 18(42%). Most MRSA strains were highly sensitive to vancomycin (84.5%) and teicoplamin (70.4%) in patients. In medical staff, the highest rate of resistance was recorded with penicillin G (84%), trimethoprim/sulfamethoxazole (77.4%), while in hospitalized patients, highest rates of resistance were observed with gentamicin (53.5%) and erythromycin (55%). Conclusions: MRSA colonization is significantly associated with units and hospital settings of the study population. Isolated strains of MRSA were highly resistant to most classes of antibiotics used in treating Staphylococcus aureus infections. PORTAGE NASAL DE STAPHYLOCOCCUS AUREUS RESISTANT A LA METICILLINE ET PROFIL DE SA SENSIBILITE AUX ANTIBIOTIQUES CHEZ LES PATIENTS ADULTES ET LE PERSONNEL MEDICAL DANS CERTAINES FORMATIONS HOSPITALIERES DE YAOUNDE. Hortense Kamga Gonsu , Sinda L Kouemo, Valentine Ngum Ndze, Francois-Xavier Mbopi-Keou, Sinata Koulla Shiro. Faculty of Medicine and Biomedical Sciences, University of Yaound1, Cameroon *Presenting author: Hortense Gonsu Kamga Email: HYPERLINK "mailto:hgonsu@gmail.com"hgonsu@gmail.com Objectif: La prsente tude vise valuer le portage nasal de staphylococcus aureus rsistant la mticilline et la structure de sa sensibilit aux antibiotiques chez les patients adultes et le personnel mdical dans certaines formations hospitalires de Yaound. Mthodologie: Une tude analytique prospective a t conduite de janvier avril 2011. Des prlvements des fosses nasales antrieures ont t effectus chez 295 adultes, dont 75 personnels mdicaux et 220 patients hospitaliss dans les services de chirurgie, de mdecine et de soins intensifs dans certains hpitaux de Yaound. Des souches de Staphylococcus aureus ont t isoles laide de la glose de Chapman et identifies grce la coloration de Gram et les tests de catalase et de coagulase.Des tests de sensibilit la mticilline et autresantibiotiques ont t raliss par diffusion avec seize antibiotiques. Rsultats: Des 295 chantillons analyss, 120 (40,6%) taient positifs aux Staphylococcus aureus, dont 85% de SARM parmi les porteurs de Staphylococcus aureus. La prvalence du SARM chez le personnel mdical tait 31(41,3%) et 71 (32%) chez les patients hospitaliss. Le taux le plus lev de colonisation, 18 (42%), par les SARM a t enregistr lICU. La plupart des souches de SARM taient trs sensibles la vancomycine (84,5%) et la ticoplamine (70,4%) chez les patients. Chez le personnel mdical, le taux de rsistance le plus lev a t observ avec la pnicilline G (84%), la trimthoprime/sulfamthoxazole (77,4%), tandis que chez les patients hospitaliss, les taux de rsistance les plus levs ont t nots avec la gentamicine (53,5%) et lerythromycine (55%). Conclusions: La colonisation par le SARM est associe de manire significative aux services et milieux hospitaliers dans la population tudie. Des souches isoles de SARM ont t trs rsistantes la plupart des classes dantibiotiques utilises dans le traitement des infections Staphylococcus aureus. PHENOTYPIC CHARACTERIZATION OF ACINETOBACTER STRAINS RESISTANT TO CARBAPENEMASES : THE CASE OF TWO UNIVERSITY HOSPITALS OF YAOUND-CAMEROON. A D. Tiokeng1, H. Gonsu Kamga*1,2 ML Guiffo 1,3, M. Toukam1, C D. Mbakop1, E. Guenou 3, S. Takongmo1,3 F.-X. Mbopi-Keou1. 1. Department of Microbiology & Infectious Diseases, Faculty of Medicine and Biomedical Science, University of Yaound I; 2. Bacteriological laboratory, Yaound University teaching hospital; 3. Department of Surgery. Faculty of Medicine and Biomedical Science, University of Yaound I; 4. School of Health Science- Catholic University of Central Africa *Presenting author: Hortense Gonsu Kamga Email:  HYPERLINK "mailto:hgonsu@gmail.com"hgonsu@gmail.com Objective: This study focused on phenotypic characterization of Acinetobacter strains resistant to carbapenemases in two University Hospitals of Yaounde-Cameroon. Methodology: A descriptive and prospective study was carried out from July to December 2013 at the University Teaching Hospital and Central Hospital of Yaounde on hospital environment and biological samples. Acinetobacter sp. was identified using API 20NE (Biomrieux). Susceptibility testing was carried out using diffusion method. Phenotypic characterization of the strains was done; carbapenemases classification was performed using the modified Hogde and synergy tests. Data analysis was performed using Epi Info statistical software version 3.4.3. Significant level was set at p < 0.05 with a 95% confidence interval. Results: Twenty four strains were isolated, including 16 strains from the hospital environment and 8 patients. Acinetobacter baumanii was the most frequent isolate species (75%).Most of the isolates (87%) were obtained from admitted patients on antibiotherapy. Acinetobacter sp. was usually isolated from urinary catheter (50%). From the environment, work benches (25 %) and tables (18.3%) were usually contaminated. Most of the strains were multidrug resistant, with high rates to beta-lactams: piperacillin (100%), piperacillin + tazobactam and ceftazidim (95,8%) cefepim (91,7%), chloramphenicol (87,5%), ticarcillin and ticarcillin + clavulanic acid (83,3%). Various phenotypes were observed among betalactams: natural type (13%), high-level cephalosporinases (41%), ESBL (23%), oxacillinases (10%), cAMP (8%) and metallo-  lactamases (5%). Conclusion: Resistance rate of isolates is high. Various resistance phenotypes are observed. We urge policy makers to update guidelines and recommendations for microbiological monitoring of the environment in health care facilities. CARACTERISATION PHENOTYPIQUE DES SOUCHES DACINETOBACTER RESISTANTES AUX CARBAPENEMASES: LE CAS DE 2 HOPITAUX UNIVERSITAIRES DE YAOUNDE-CAMEROUN  A D. Tiokeng1, H. Gonsu Kamga*1,2ML Guiffo 1,3, M. Toukam1, C D. Mbakop1, E. Guenou 3, S. Takongmo1,3 F.-X. Mbopi-Keou1. 1. Department of Microbiology & Infectious Diseases, Faculty of Medicine and Biomedical Science, University of Yaound I; 2. Bacteriological laboratory, Yaound University teaching hospital; 3. Department of Surgery. Faculty of Medicine and Biomedical Science, University of Yaound I; 4. School of Health Science- Catholic University of Central Africa *Presenting author: Hortense Gonsu Kamga Email: HYPERLINK "mailto:hgonsu@gmail.com"hgonsu@gmail.com Objectif: La prsente tude porte sur la caractrisation phnotypique des souches dAcinetobacter rsistantes aux carbapnmases dans deux hpitaux universitaires de Yaound, Cameroun. Mthodologie: Une tude descriptive et prospective a t mene de juillet dcembre 2013 au Centre hospitalier universitaire et lHpital central de Yaound en milieu hospitalier et sur les chantillons biologiques. LAPI 20NE (Biomrieux)a permis didentifier lAcinetobacter sp. Lantibiogramme a t ralis par diffusion et la caractrisation phnotypique des souches a t faite. La classification des carbapnmases a t faite laide des tests de Hogde modifis et des tests de synergies. Lanalyse des donnes a t effectue laide du logiciel Epi Info statistical version 3.4.3. Le taux significatif a t fix p < 0,05 avec un intervalle de confiance 95%. Rsultats: Vingt-quatre souches ont t isoles, dont 16 en milieu hospitalier et 08 chez des patients. La souche isole la plus frquemment rencontre tait lAcinetobacter baumanii (75%). La plupart des isolats (87%) ont t obtenus sur des patients hospitaliss sous antibiothrapie. Acinetobacter sp. a gnralement t isole partir des cathters urinaires (50%). De faon gnrale, en milieu hospitalier, les paillasses (25 %) et les tables (18,3%) taient contamines. La plupart des souches taient multirsistantes, avec des taux levs de rsistance aux bta-lactamines:pipracilline (100%), pipracilline + tazobactam et ceftazidime (95,8%) cfpime (91,7%), chloramphnicol (87,5%), ticarcilline et ticarcilline + acide clavulanique (83,3%). Divers phnotypes ont t nots parmi les bta-lactamines: type naturel (13%), haut niveau de cphalosporinases (41%), ESBL (23%), oxacillinases (10%), cAMP (8%) et mtallo-  lactamases (5%). Conclusion: Le taux de rsistance des isolats est lev. Divers types de rsistances des phnotypes ont t nots. Nous invitons les dcideurs mettre jour leurs directives et recommandations en matire de suivi microbiologique du milieu dans les formations sanitaires. Management of neurological emergencies in the intensive care unit of the Yaounde Gynaeco- Obstetric and Paediatric Hospital Bengono Bengono R, Owono P, Amengle AL, Tchokam L, Metogo Mbengono JA, Esiene A, Ndikontar R, Ze Minkande J Faculty of Medicine and Biomedical sciences, University of Yaound I, Yaounde, Cameroun. Corresponding author : Email:  HYPERLINK "mailto:rodbeng@yahoo.fr"rodbeng@yahoo.fr Background: The management of neurological emergencies represents a challenge in African hospitals. The aim of our study was to describe their management in an intensive care unit. Material and methods: We carried out a descriptive and prospective study over 6 months. We included all patients admitted for neurological emergencies into the intensive care unit of the Yaounde Gynaeco-Obstetric and Paediatric Hospital. We studied the frequency of neurological emergencies, the different emergencies encountered, treatment administered, and factors associated with poor prognosis. Results: The frequency of neurological emergencies was 7.4%. Eclampsia was recorded in 48.6% of patients. The management of eclampsia was based on the use of magnesium sulphate and antihypertensive bitherapy with nicardipine and alpha methyl-DOPA. All cases of neurological infection received empirical triple antibiotic therapy with short duration corticosteroid therapy. Management of non traumatic coma was mainly symptomatic. Management of strokes was guided by the findings on the head CT scan. Non traumatic coma and neurological infections were the most deadly, responsible for 46.2% and 30.7% of deaths respectively. Factors associated with poor prognosis were age above 55 years, HIV immune deficiency, a Glasgow score below 8, admission interval greater than 6 hours, poor adherence to treatment, and the development of complications. Conclusion: The management of neurological emergencies is not optimal. We can improve the management by efficient health policies. Key words: Management, Neurological emergencies, Intensive care unit. PRISE EN CHARGE DES URGENCES NEUROLOGIQUES DANS LUNITE DE REANIMATION DE LHOPITAL GYNECO-OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE Bengono Bengono. R; Owono. P; Amengle. A.L; Tchokam. L; Metogo Mbengono.. J.A; Esiene A; Ndikontar. R; ZeMinkande. J. Dpartement de Chirurgie et Spcialits, FMSB Email: HYPERLINK "mailto:rodbeng@yahoo.fr"rodbeng@yahoo.fr Introduction: La prise en charge des urgences neurologiques reprsente un vrai challenge dans les hpitaux dAfrique. Le but de notre tude tait de dcrire leur prise en charge dans une unit de ranimation. Mthodologie: Il sagissait dune tude prospective et descriptive de 6 mois. Etaient incluses, toutes les patientes admises pour une urgence neurologique dans lunit de ranimation de lHpital Gynco-Obsttrique et Pdiatrique de Yaound. Les informations collectes concernaient la frquence, les tiologies, le traitement institu et les lments de mauvais pronostic.Les donnes taient analyses partir des logiciels Epi-info et Microsoft Office Excel 2010. Rsultats: La frquence des urgences neurologiques tait de 7,4%. Lclampsie reprsentait la cause la plus frquente (48,6%). Le traitement de lclampsie reposait sur le sulfate de magnsium associ la nicardipine et lalpha mthyl-dopa. Les infections neurologiques taient traites par une triple antibiothrapie probabiliste associe une courte corticothrapie. Le traitement des comas non traumatiques tait symptomatique. Le traitement des accidents vasculaires crbraux tait orient par la tomodensitomtrie crbrale. Les principales causes de dcs taient les comas non traumatiques (46,2%) et les infections neurologiques (30,7%). Les lments de mauvais pronostic taient un ge > 55 ans, immunodpression au VIH, score de Glasgow < 8, dlai dadmission > 6 heures, mauvaise observance du traitement et la survenue de complication. Conclusion: La prise en charge des urgences neurologiques nest pas optimale. Une meilleure politique de sant pourrait tre un axe damlioration. Mots cls: Prise en charge, Urgence neurologique, Ranimation ANTIBIOTICS SENSITIVITY AND RESISTANCE IN ACUTE GENERALIZED PERITONITIS IN YAOUND Ngo Nonga Bernadette, Kouam Cyrille, Ngo Mbi Michelle, Gonsu Hortense, , Tochi, Essomba Arthur Faculty of Medicine and Biomedical sciences, University of Yaound I Corresponding author: Bernadette Ngo Nonga,  HYPERLINK "mailto:ngonongab@yahoo.com"ngonongab@yahoo.com Presenting author Dr Kouam Cyrille Background: The objectives of this study were to determine the most common germs found in acute peritonitis and their sensitivity to commonly prescribed antibiotics. Methods: we conducted a prospective and analytic study at the University Hospital Centre and the Central hospital of Yaound from October 2013 to March 2014. We included all consenting patients admitted with a clinical diagnosis of acute generalized peritonitis. Gram stain, Culture of the infected peritoneal fluid and antibiogram sensitivity were done using a well standardized method. The study was approved by the National ethic committee of Cameroon and the Ethic committee of the faculty of medicine and biomedical sciences. Results: 43 patients met the criteria: there were 28 men and 15 women. The mean age was 30.8 years. The most common cause of acute generalized peritonitis were perforated gastro-duodenal ulcer and acute appendicitis which represent 36,6% each. We had found 67,4% of positive culture and E coli was the most identified pathogen (41,1%) followed by Klebsiella pneumonia (23,5%). These enterobacteriaces were resistant to the most commonly prescribed antibiotics (ceftriaxone, gentamicine,) they were most sensitive to Imipenem and amikacin. The mortality rate was 25,6% and the morbidity was 21% and the most common complications was deep surgical sites infection. Conclusions: E Coli and K Pneumonia are the most common germ involved in acute generalized peritonitis and they are resistant to the empirically prescribed antibiotics, and it may therefore be useful to culture peritoneal fluid systematically to use antibiotic appropriately. Keywords: peritonitis- bacteriology- sensitivity- antibiogram- antibiotics SENSIBILITE ET RESISTANCE AUX ANTIBIOTIQUES DANS LES PERITONITES GENERALISEES AIGUES A YAOUNDE Ngo Nonga Bernadette, Kouam Cyrille, Ngo Mbi Michelle, Gonsu Hortense, , Tochi, Essomba Arthur Faculty of Medicine and Biomedical sciences, University of Yaound I Corresponding author: Bernadette Ngo Nonga, HYPERLINK "mailto:ngonongab@yahoo.com"ngonongab@yahoo.com Presenting author Dr Kouam Cyrille Introduction: Les objectifs de cette tude taient de dterminer le profil bactriologique dans les pritonites aigues gnralises et leur sensitivit aux antibiotiques. Nous avons men une tude prospective au CHU de Yaound et lhpital Central de Yaound dOctobre 2013 Mars 2014. Etaient inclus tous les patients consentant prsentant une pritonite aigue gnralise chez qui une culture avec antibiogramme taient ralise. Ltude a reu lapprobation du comit dthique de la facult. Rsultats: Les causes les plus frquentes de pritonites taient la perforation dulcre gastroduodnal et lappendicite aigue. Les cultures taient positives dans 67% des cas avec E coli (41%) et le K pneumonia (23,5%) comme germes les plus isols. Ces bactries taient rsistantes aux antibiotiques les plus prescrits tels que la ceftriaxone et la gentamicine et taient sensibles limipenem et a lamikacine. La mortalit tait de 25,6% et la morbidit de 21% et la complication la plus frquente tait linfection du site opratoire. Conclusions: Les entrobactries sont les germes les plus retrouvs dans la pritonite aigue et sont souvent rsistants aux antibiotiques usuels. Il serait ds lors utile de faire la culture du pus pritonal pour prescrire lantibiothrapie de faon approprie. ANTIBIOTIC SUSCEPTIBILITY PROFILE OF ENTEROCOCCUS SPP. ISOLATED FROM PATIENTS WITH URINARY TRACT INFECTION AND HEALTH CARE ENVIRONMENT IN TWO REFERENCE HOSPITALS IN CAMEROON. Hortense Gonsu Kamga1,2** , Myriam Sango Gueye3, Michel Toukam2, Michel Kengne3, Francois-Xavier Mbopi-Keou1,2** . 1. Department of microbiology & Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaound I. 2. Bacteriology laboratory, Yaound University Teaching Hospital; 3. Department of Microbiology, School of Health Sciences, Catholic University. *Presenting author: Hortense Gonsu Kamga Email:  HYPERLINK "mailto:hgonsu@gmail.com"hgonsu@gmail.com Objective: The aim of this study was to evaluate the Antibiotic susceptibility profile of Enterococcus spp. isolated from patients with urinary tract infection and health care environment in two Reference Hospitals in Cameroon. Methodology: Clinical and environmental specimens were collected and cultured in the appropriate culture media: CPS chromogenic medium for urine, bile esculin agar supplemented with vancomycin for stools and bile esculin agar for environmental specimens. The antibiotic susceptibility testing was done using the disk diffusion method as recommended by Antibiotic Committee of French Microbiology Society (CASFM 2013) and the resistance to vancomycin was determined by the agar screen method. Results: Out of 250 clinical and environmental specimens collected, 50 strains of enterococci were isolated with the most prevalent in the following order: 26 E. faecium, 17 E. faecalis, 4 E. durans, 3 E. avium. Resistance observed in E. faecalis and E. faecium to erythromycin (84)% , ampicillin (60%), cotrimoxazol (42.4)%, tetracycline (41.6)%, vancomycin 28% and teicoplanin (19.2%). Out of the 50 isolates, 7 were resistant to vancomycin (with CMI greater or equal to 4g/ml) from which 04 were isolated from urine, 02 from environment and one from faeces. Genes Van A, Van B and the phenotypes S and SKG were frequently observed with E. faecium. Conclusions: Vancomycin enterococci resistance and high level of aminoglycoside resistance (HLAR) lead us to recommend that health policy planners need to reinforce the bacterial resistance committee activities in order to monitor enterococci infections. PROFIL DE LA SENSIBILITE AUX ANTIBIOTIQUES DES ENTEROCOCCUS SPP ISOLES CHEZ DES PATIENTS ATTEINTS DINFECTION DES VOIES URINAIRES ET ENVIRONNEMENT DES SOINS DE SANTE DANS DEUX HOPITAUX DE REFERENCE AUCAMEROUN. Hortense Gonsu Kamga1,2** , Myriam Sango Gueye3, Michel Toukam2, Michel Kengne3, Francois-Xavier Mbopi-Keou1,2** . 1. Department of microbiology & Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaound I. 2. Bacteriology laboratory, Yaound University Teaching Hospital; 3.Department of Microbiology, School of Health Sciences, Catholic University. *Presenting author: Hortense Gonsu Kamga Email: HYPERLINK "mailto:hgonsu@gmail.com"hgonsu@gmail.com Objectif: Lobjectif de cette tude tait dvaluer le profil de la sensibilit aux antibiotiques des Enterococcus spp isol chez des patients atteints dinfection des voies urinaires et l'environnement de soins de sant dans deux hpitaux de rfrence au Cameroun. Mthodologie: Les chantillons cliniques et environnementaux ont t prlevs et cultivs dans les milieux appropris: milieu chromogne CPS pour lurine, la glose bile esculine complte par la vancomycine pour les selles et la glose bile esculine pour les chantillons environnementaux. Lpreuve de sensibilit aux antibiotiques a t ralise par la mthode de diffusion de disques telle que recommande par le Comit de lantibiogramme de la socit franaise de microbiologie (CASFM 2013) et la rsistance la vancomycine a t dtermine par la mthode de dpistage sur glose. Rsultats: Sur 250 chantillons cliniques et environnementaux recueillis, 50 souches dentrocoques ont t isoles et surtout dans lordre suivant: 26 E. faecium, 17 E. faecalis, 4 E. durans, 3 E. avium. La rsistance observe dans E. faecalis et E. faecium lrythromycine (84)%, l'ampicilline (60%), le cotrimoxazole (42,4)%, la ttracycline (41,6)%, la vancomycine et la teicoplanine 28% (19,2%). Sur les 50 isolats, 7 taient rsistants la vancomycine (avec le CMI suprieure ou gale 4g/ml) dont 04 ont t isols partir de l'urine, 02 de l'environnement et un des selles. Les gnes Van A, Van B et les phnotypes S et SKG ont t frquemment observs avec E. faecium. Conclusions: la rsistance la vancomycine entrocoque et le degr lev de rsistance aux aminosides nous amnent recommander aux planificateurs de la politique de sant le renforcement des activits du comit sur la rsistance bactrienne afin de surveiller les infections aux entrocoques. CHIRURGIE ET COUVERTURE SANITAIRE UNIVERSELLE: LA MISE EN OEUVRE DE LA LISTE DE CONTRLE OMS POUR LA SECURITE DE LACCOUCHEMENT SANS RISQUES FAVORISE LE RESPECT DES BONNES PRATIQUES Ogu Rosemary, Charles Tobin-West, Orazulike Ngozi, Osita John, Omosivie Maduka, Inimgba Nestor, Uzoigwe Samuel. Contexte: LAfrique sub-saharienne prsente lun des taux les plus levs au monde de mortalit maternelle et prinatale. La mauvaise qualit des soins et les erreurs dans la prise en charge clinique sont quelques-uns des principaux facteurs responsables. Dans le cadre des efforts consentis en vue de rduire la morbidit et la mortalit maternelle, lOMS a lanc la collaboration pour la liste de contrle de scurit de laccouchement dans des formations sanitaires slectionnes en 2015. Le Centre hospitalier universitaire de Port Harcourt est lune de ces formations sanitaires situ dans une rgion o les ressources sont limites. Les objectifs consistaient dterminer lefficacit de la liste de contrle comme adjuvant au respect des bonnes pratiques par les personnels de sant et de dterminer les facteurs damlioration de la durabilit de la liste de contrle. Mthodologie: Un modle descriptif et transversal a t utilis en vue de gnrer des informations dtenues par les mdecins et les infirmiers laide de mthodes quantitative et qualitative. Les donnes quantitatives (questionnaires) ont t analyses laide du logiciel SPSS version 22 pour un niveau de significativit statistique fix P = 0,05. Une recherche qualitative a t effectue par 04 Groupes de discussions (FGD) constitues de 06 08 sages-femmes et mdecins. Les discussions concernaient lutilit de la liste de contrle comme facilitateur du respect des meilleures pratiques. Les entretiens sur les thmes et sous-thmes ont t cods et transcrits. Ils ont t analyss laide du logiciel Atlas.ti. Rsultats: 26 et 38 sages-femmes/mdecins respectivement ont particip aux FGD et lenqute partir de questionnaires. Les rsultats ont rvl que les patients recevaient davantage de conseils et les normes professionnelles taient meilleures lorsque la liste de contrle tait utilise. La prsence physique de la liste de contrle en salle de travail a amlior la durabilit. Conclusion: Lutilisation de la liste de contrle a amlior le respect des bonnes pratiques par les personnels de sant, et la simple prsence de la liste en salle de travail a favoris son utilisation. Le plaidoyer pour lutilisation de la liste de contrle dans les services de chirurgie pourrait amliorer la couverture sanitaire universelle. CHIRURGIE ET COUVERTURE SANITAIRE UNIVERSELLE: LA MISE EN OEUVRE DE LA LISTE DE CONTRLE OMS POUR LA SECURITE DE LACCOUCHEMENT SANS RISQUES FAVORISE LE RESPECT DES BONNES PRATIQUES Ogu Rosemary, Charles Tobin-West, Orazulike Ngozi, Osita John, Omosivie Maduka, Inimgba Nestor, Uzoigwe Samuel. Contexte: LAfrique sub-saharienne prsente lun des taux les plus levs au monde de mortalit maternelle et prinatale. La mauvaise qualit des soins et les erreurs dans la prise en charge clinique sont quelques-uns des principaux facteurs responsables. Dans le cadre des efforts consentis en vue de rduire la morbidit et la mortalit maternelle, lOMS a lanc la collaboration pour la liste de contrle de scurit de laccouchement dans des formations sanitaires slectionnes en 2015. Le Centre hospitalier universitaire de Port Harcourt est lune de ces formations sanitaires situ dans une rgion o les ressources sont limites. Les objectifs consistaient dterminer lefficacit de la liste de contrle comme adjuvant au respect des bonnes pratiques par les personnels de sant et de dterminer les facteurs damlioration de la durabilit de la liste de contrle. Mthodologie: Un modle descriptif et transversal a t utilis en vue de gnrer des informations dtenues par les mdecins et les infirmiers laide de mthodes quantitative et qualitative. Les donnes quantitatives (questionnaires) ont t analyses laide du logiciel SPSS version 22 pour un niveau de significativit statistique fix P = 0,05. Une recherche qualitative a t effectue par 04 Groupes de discussions (FGD) constitues de 06 08 sages-femmes et mdecins. Les discussions concernaient lutilit de la liste de contrle comme facilitateur du respect des meilleures pratiques. Les entretiens sur les thmes et sous-thmes ont t cods et transcrits. Ils ont t analyss laide du logiciel Atlas.ti. Rsultats: 26 et 38 sages-femmes/mdecins respectivement ont particip aux FGD et lenqute partir de questionnaires. Les rsultats ont rvl que les patients recevaient davantage de conseils et les normes professionnelles taient meilleures lorsque la liste de contrle tait utilise. La prsence physique de la liste de contrle en salle de travail a amlior la durabilit. Conclusion: Lutilisation de la liste de contrle a amlior le respect des bonnes pratiques par les personnels de sant, et la simple prsence de la liste en salle de travail a favoris son utilisation. Le plaidoyer pour lutilisation de la liste de contrle dans les services de chirurgie pourrait amliorer la couverture sanitaire universelle. Management of Burns and its challenges in a tertiary hospital in Northwestern Nigeria: A 10 year review Opara AC1, Nazish PA*1, Francis Mark1, Isa Abdullahi1, Umar M Ahmed1, Gidadawa AY1, Ibrahim AU1, Legbo JN1 1Department of Surgery, UDUTH, Sokoto, Nigeria. *Presenter: +2348023775382, naz_per@yahoo.com. Abstract Background: Burns are ranked in the top 15 leading causes of the burden of disease globally, with an estimated 265,000 deaths annually, and a significant morbidity from non-fatal burns, the majority located in low and middle income countries, of which Nigeria is a part. Objectives: To study the pattern of presentation, treatment offered and the outcome of management. Methodology: This is a retrospective study of our burn patients seen between January 2005 to December 2014. Sources of information were the case notes. Data extracted included demographics as well as treatment modalities and outcome. Results: A total of 154 patients with burn injuries were studied. Males were 92(59.7%), while females were 62(40.3%). Majority of burn injuries occurred at home during the month of January. Conclusion: Burns are preventable. Public enlightenment on measures to ensure safe home environment is necessary. PRISE EN CHARGE DES BRULURES ET SES DEFIS DANS UN HOPITAL DE SOINS TERTIAIRES AU NORD-OUEST DU NIGERIA: UNE ETUDE SUR UNE PERIODE DE 10 ANS Opara AC1, Nazish PA*1, Francis Mark1, Isa Abdullahi1, Umar M Ahmed1, Gidadawa AY1, Ibrahim AU1, Legbo JN1 1Department of Surgery, UDUTH, Sokoto, Nigeria, West Africa *Presenter: +2348023775382, naz_per@yahoo.com. Mode of Presentation: Power-point Contexte: Les brlures sont classes parmi les 15 principales causes du fardeau de la maladie l'chelle mondiale, avec prs de 265.000 dcs par an, et une morbidit significative lie aux brlures non mortelles, la majorit des cas survenant dans les pays revenu faible et moyen, dont le Nigria fait partie. Objectifs: tudier les types de prsentation, du traitement offert et des rsultats de la prise en charge. Mthodologie: Il sagit dune tude rtrospective sur nos patients brls reus entre janvier 2005 et dcembre 2014. Les sources dinformation sont les notes de cas. Les informations extraites comportaient les donnes dmographiques ainsi que les modalits de traitement et les rsultats. Rsultats: Un total de 154 patients souffrant de brlures a t tudi. 92 hommes (59,7%) et 62 femmes (40,3%). La majorit des brlures sont survenues la maison au cours du mois de janvier. Conclusion: Les brlures sont vitables. Toutefois, la sensibilisation du public sur les mesures visant assurer un environnement scuritaire domicile est ncessaire. POST-TRAUMATIC FAT EMBOLISM SYNDROME: CLINICAL CASE OF THE UTH OF BRAZZAVILLE Elombila M.1, Moyikoua R.2, Otiobanda G.F.1, Mawandza P.D.1, Niengo G.1, Monka M.3 1. Service de ranimation polyvalente, centre hospitalier universitaire de Brazzaville; 2. Service de radiologie, centre hospitalier universitaire de Brazzaville; 3. Service de traumatologie et orthopdie, centre hospitalier universitaire de Brazzaville. Auteur correspondant: Elombila Marie,  HYPERLINK "mailto:elombila@gmail.com"elombila@gmail.com, +242 05 579 09 20 Introduction: Fat embolism syndrome is a rare syndrome, found in cases of long bone fractures with a non-negligible morbidity/mortality. Gurd criteria remain the most used for positive diagnosis. Treatment is primarily preventive. Observation: We report the case of a young man aged 29 years who, two days after an accident on the public highway that caused a fracture of the right femur, presents a consciousness disorder associated with acute respiratory failure and a petechial syndrome. A brain MRI in T2 mode, Flair and diffusion was performed revealing multiple visible punctate hyperintensities of the supra and infra tentorials. The diagnosis of fat embolism syndrome was considered. Care was administered during resuscitation. The outcome was favorable after eight days. Conclusion: Search for fat embolism syndrome in the context of a trauma with the presence of respiratory and neurological disorders. Its management is symptomatic. Prevention of this syndrome is based on the early fixation of fractured long bones. Keywords: fat embolism syndrome, trauma, fracture of long bones, MRI. SYNDROME DEMBOLIE GRAISSEUSE POST-TRAUMATIQUE: CAS CLINIQUE AU CHU DE BRAZZAVILLE Elombila M.1, Moyikoua R.2, Otiobanda G.F.1, Mawandza P.D.1, Niengo G.1, Monka M.3 1. Service de ranimation polyvalente, centre hospitalier universitaire de Brazzaville; 2. Service de radiologie, centre hospitalier universitaire de Brazzaville; 3. Service de traumatologie et orthopdie, centre hospitalier universitaire de Brazzaville. Auteur correspondant: Elombila Marie, HYPERLINK "mailto:elombila@gmail.com"elombila@gmail.com, +242 05 579 09 20 Introduction: Le syndrome d'embolie graisseuse (SEG) est un syndrome rare, retrouv en cas de fractures des os longs avec une morbi-mortalit non ngligeable. Les critres de Gurd restent les plus utiliss pour le diagnostic positif. Le traitement est avant tout prventif. Observation: Nous rapportons le cas dun jeune homme de 29 ans prsentant deux jours aprs un accident de la voie publique occasionnant une fracture du fmur droit, un trouble de conscience associe une insuffisance respiratoire aigue et un syndrome ptchial. Une IRM crbrale en mode T2, Flair et en diffusion a t ralise rvlant de multiples hypersignaux punctiformes visibles des tages sus- et sous-tentoriels. Le diagnostic dun syndrome dembolie graisseuse a t retenu. La prise en charge tait faite en ranimation. Lvolution a t favorable aprs huit jours. Conclusion: Devant les troubles respiratoires et neurologiques dans un contexte traumatique le syndrome dembolie graisseuse doit tre recherch. La prise en charge est symptomatique. La prvention de ce syndrome se base sur la fixation prcoce des fractures des os longs. Mots cls: syndrome dembolie graisseuse, traumatisme, fracture des os longs, IRM. Retrospective analysis of the current injury registration system at a level III hospital in Cameroon: the experience of over 5,000 patients in five years Alain Chichom Mefire [1], alainchichom@yahoo.com Isabelle Feldhaus [2],  HYPERLINK "mailto:isabelle.feldhaus@ucsf.edu"isabelle.feldhaus@ucsf.edu; Rochelle A. Dicker, [2],  HYPERLINK "mailto:rochelle.dicker@ucsf.edu"rochelle.dicker@ucsf.edu; Obieze. C. Nwanna-Nzewunwa, [2],  HYPERLINK "mailto:obieze.nwanna-nzewunwa@ucsf.edu"obieze.nwanna-nzewunwa@ucsf.edu; Catherine Juillard,[2], catherine.juillard@ucsf.edu [1] Department of Surgery, Faculty of Health Sciences, University of Buea, Cameroon [2] Center for Global Surgical Studies, Department of Surgery, University of California, San Francisco, CA, United States Corresponding author: Isabelle Feldhaus 1001 Potrero Ave. Room 400 San Francisco, CA 94110 Email:  HYPERLINK "mailto:isabelle.feldhaus@ucsf.edu"isabelle.feldhaus@ucsf.edu Phone: +141 52 06 33 50 Background: The burden of injury in sub-Saharan Africa is quickly rising alongside rapid urbanization and increasing road traffic, becoming a leading cause of death and disability. In Cameroon, the burden of road injury alone increased by 75% between 1990 and 2010. Current epidemiological data can inform strategies for the prevention and treatment of injuries in this context. Our objective was to describe patterns and trends in trauma presenting to a tertiary hospital in Cameroon and characterize the reliability of data in its existing trauma registration system. Methods: Retrospective review was conducted on the Emergency Ward log of Limbe Regional Hospital for entries between January 2008 and October 2013. The log regularly records data on patient sex, age, occupation, municipality of residence, type of injury, type of road traffic collision, prehospital delay, respiratory rate, systolic blood pressure, and outcome. Descriptive analysis was performed to profile the patient population arriving to the Emergency Ward for trauma. All records were included in analysis. Results: Data was collected for 5,617 patients in the nearly five-year study period. Two-thirds of the patient sample was male and 62% were between the ages of 19 and 39 years. The median age of injury was 26 years. Occupations most common among the patient sample included students (27%), transportation (16%), and business (14%). Over half of patients presented with injuries sustained as a result of road traffic incidents with 74% of these incidents involving a motorcycle. Though the majority of patients experienced prehospital delays of less than one hour, 22% experienced delays between one and six hours. Most patients were formally discharged with 6% admitted to the ward. Across variables, missing data comprised 0.7% to 8% of the sample. Discussion: Study findings demonstrate the significant burden of injury, particularly that attributable to road traffic incidents, at Limbe Regional Hospital. Men and those ages considered most economically productive are primarily those experiencing traumatic injury, suggesting opportunities for targeted intervention and prevention policy. Incidents resulting in injury involving motorcycles were also notably high, urging research into improving conditions surrounding this particular mode of transport. Future research should also examine the reasons for preventable delays in care, which directly impacts patient outcomes in the time-sensitive context of trauma. ANALYSE RETROSPECTIVE DU REGISTRE DES TRAUMATISMES DUN HOPITAL DE NIVEAU 3 AU CAMEROUN: LEXPERIENCE AVEC PLUS DE 5.000 PATIENTS EN 5 ANS Alain Chichom Mefire [1], alainchichom@yahoo.com Isabelle Feldhaus, MSPH [2], HYPERLINK "mailto:isabelle.feldhaus@ucsf.edu"isabelle.feldhaus@ucsf.edu; Rochelle A. Dicker, MD [2], HYPERLINK "mailto:rochelle.dicker@ucsf.edu"rochelle.dicker@ucsf.edu; Obieze. C. Nwanna-Nzewunwa, MS [2], HYPERLINK "mailto:obieze.nwanna-nzewunwa@ucsf.edu"obieze.nwanna-nzewunwa@ucsf.edu; Catherine Juillard,[2], catherine.juillard@ucsf.edu [1] Department of Surgery, Faculty of Health Sciences, University of Buea, Cameroon [2] Center for Global Surgical Studies, Department of Surgery, University of California, San Francisco, CA, United States Corresponding author: Isabelle Feldhaus 1001 Potrero Ave. Room 400 San Francisco, CA 94110 Email: HYPERLINK "mailto:isabelle.feldhaus@ucsf.edu"isabelle.feldhaus@ucsf.edu Phone: +141 52 06 33 50 Contexte: Le fardeau des traumatismes en Afrique subsaharienne augmente rapidement, en raison de lacclration de l'urbanisation et de l'augmentation du trafic routier. les traumatismes deviennent une cause majeure de dcs et d'invalidit. Au Cameroun, le fardeau des blessures de la route seul a augment de 75% entre 1990 et 2010. Les donnes pidmiologiques actuelles peuvent clairer les stratgies de prvention et de prise en charge des traumatismes dans ce contexte. Notre objectif est de dcrire les tendances des traumatismes prsents dans un hpital de soins tertiaires au Cameroun et de dterminer la fiabilit des donnes de son systme d'enregistrement des traumatismes. Mthodes: Une tude rtrospective a t mene sur la base des donnes du journal des urgences de l'Hpital Rgional de Limbe enregistres entre janvier 2008 et octobre 2013. Le journal enregistre rgulirement des donnes sur le sexe du patient, son ge, sa profession, son lieu de rsidence, le type de traumatisme, le type de collision routire, le retard pr-hospitalier, la frquence respiratoire, la tension artrielle systolique, et lissue de lhospitalisation. L'analyse descriptive dtermine la population de patients arrivant au service des urgences suite un traumatisme. Toutes les donnes ont t incluses dans l'analyse. Rsultats: Les donnes ont t recueillies pour 5617 patients durant les cinq annes de la priode d'tude. Deux tiers de l'chantillon de patients taient de sexe masculin; 62% taient gs de 19 et 39 ans. L'ge mdian des patients traumatiss tait de 26 ans. Les professions les plus courantes parmi l'chantillon de patients comprenaient les tudiants (27%), transporteurs (16%), et commerants (14%). Plus de la moiti des patients prsentaient des traumatismes subis la suite daccidents de la route avec 74% de ces accidents impliquant une moto. Bien que la majorit des patients aient connu des retards pr-hospitaliers de moins d'une heure, 22% ont connu des retards entre une et six heures. Seulement 6% des patients ont t hospitaliss dans le service. Pour l'ensemble des variables, 0,7% 8% des donnes de l'chantillon sont absentes. Discussion: Les rsultats de ltude dmontrent le fardeau significatif des traumatismes l'Hpital rgional de Limbe, en particulier celui attribuable aux accidents de la route. Les hommes ainsi que la tranche dge considre la plus productive au plan conomique sont les principales victimes de traumatismes, suggrant la possibilit d'une intervention cible et dune politique de prvention. La proportion leve daccidents traumatiques impliquant des motos appelle la recherche sur l'amlioration les conditions entourant ce mode de transport. Il serait souhaitable dtudier plus en dtail les raisons des retards vitables de prise en charge qui influent directement sur le pronostic des patients traumatiss. Understanding the national impact of trauma to prevent injury and improve care in Cameroon: Preliminary findings of a pilot multicenter trauma registry Fanny Nadia Dissak-Delon [1] Marquise Kouo Ngamby [1] Isabelle Feldhaus [2] Catherine Juillard [2] [1] Ministry of Public Health, Cameroon [2] Center for Global Surgical Studies, Department of Surgery, University of California, San Francisco Corresponding author: Fanny Nadia Dissak-Delon Email: fannynadia@gmail.com Background: Rates of injury in sub-Saharan Africa are among the highest in the world. Our understanding of the burden in Cameroon is limited by the lack of strategic, prospective data collection for trauma. Our objective was to develop a national trauma registry to inform targeted injury prevention interventions and appropriate resource allocation in Cameroon. Methods: In June 2015, a multicenter trauma registry was launched in three hospitals across Cameroon. Data was collected prospectively until early November 2015 on patient demographics, injury context, prehospital care, diagnostics, interventions, treatments, disposition, and cost of care. Descriptive statistics profiled the population arriving to emergency wards for injury and the hospital experience of trauma patients in Cameroon. Results: A total of 1,032 patients presented to emergency wards during the study period. The mean age of patients was 32(15.7) years. The majority of patients were male (67.3%),while 27.7% were female. Most patients were self-employed (30.6%) or salaried workers (21.7%). Road traffic incidents were the most common mechanism of injury (59.2%). More than half (54.7%) of patients were discharged home from the hospital, while 16% were admitted to the inpatient ward. The mean and median cost of care was US$45.83(99.72) and US$29.17 [IQR: 16.66, 49.99], respectively. Conclusions: Study findings demonstrate the utility of prospective data collection for injury in a resource-limited context. Understanding the profile of patients arriving to Cameroonian hospitals for trauma provides opportunities for targeted interventions and policy. Findings also reveal the burden of injury and utilization of services for appropriate resource allocation. COMPRENDRE LIMPACT DES TRAUMATISMES A LECHELLE NATIONALE AFIN DE LES PREVENIR ET AMELIORER LA PRISE EN CHARGE DES TRAUMATISES AU CAMEROUN: RESULTATS PRELIMINAIRES DUN REPERTOIRE DE TRAUMATISMES PILOTE MULTICENTRIQUE: Fanny Nadia Dissak-Delon [1], Marquise KouoNgamby [1], Isabelle Feldhaus [2], Catherine Juillard [2] [1] Ministry of Public Health, Cameroon [2] Center for Global Surgical Studies, Department of Surgery, University of California, San Francisco Corresponding author: Fanny Nadia Dissak-Delon Email: fannynadia@gmail.com Contexte: Les traumatismes sont ingalement rpartis dans le monde, les chiffres relevs en Afrique Subsaharienne faisant partie des plus levs. Lapprhension du fardeau rel des traumatismes sur la population et le systme de sant est limite, du fait de linsuffisance dune collecte prospective et stratgique des indicateurs cls. Notre objectif tait de dvelopper un rpertoire national des traumatismes afin dadresser des interventions prventives cibles et une allocation approprie des ressources au Cameroun. Mthodes: En juin 2015, un rpertoire des traumatismes a t mis en place dans trois hpitaux travers le Cameroun. Des donnes ont t collectes de manire prospective jusquen dbut novembre 2015, portant sur les caractristiques socio dmographiques des patients, le contexte des traumas, la prise en charge pr hospitalire, le diagnostic, les interventions, les traitements, le devenir et le cot des soins. De ces donnes ont t gnres des statistiques descriptives du profil des sujets arrivant dans les services des Urgences des suites de trauma, et des caractristiques de lexprience des patients traumatiss au Cameroun. Rsultats : Un total de 1032 patients reus dans les diffrents services des urgences. Lge moyen tait de 32 (15,7) ans. La majorit des patients tait de sexe masculin (67,3%). La plupart des patients taient auto-employs (30,6%) ou salaris (21,7%). Les accidents de la voie publique taient de loin le mcanisme le plus frquent des traumas (59,2%). Plus de la moiti (54,7%) taient renvoys domicile aprs la prise en charge hospitalire, tandis que 16% taient admis en hospitalisation. La moyenne et mdiane du cot des soins taient respectivement 45,83(99,72) USD et 29,17 USD [IQR : 16.66, 49.99]. Les donnes manquantes constituaient entre 1 et 5% des informations rapportes. Conclusions: Les trouvailles de ltude dmontrent lutilit dune collecte prospective des donnes sur les traumas dans un contexte de ressources limites. La connaissance du profil des patients admis dans les services des urgences au Cameroun est une opportunit pour ces communauts de mettre en place des interventions et politiques de prvention cibles. Nos observations relvent galement le fardeau des traumas et lutilisation des services par ces patients, pour une allocation adquate des ressources. EPIDEMIOLOGY OF INJURIES, OUTCOMES AT A RURAL HOSPITAL IN CAMEROON: RESULTS AND LESSONS LEARNED. Authorship: Moses Kasumba1 Chao Long3, Jim Brown2, Sherry M Wren2 Corresponding Author: Kasumba Moses Pan African Academy of Christian Surgeons (PAACS) Mbingo Baptist Hospital.NW , Email: kasumbakaggya@yahoo.com Backround: 90% of the worlds injury-related deaths occur in low- and middle-income countries, yet epidemiologic data are scarce. Country specific information is necessary to improve prevention and treatment of these injuries. We aimed to define the epidemiology of trauma and assess patterns of outcomes using the previously validated Kampala Trauma Score II (KTSII) at Mbingo Baptist Hospital (MBH). Methods: Trauma patients (12/5/13-6/7/15) were prospectively enrolled. Data variables included injury mechanism and type, transport mode/time, KTSII variables, procedures and outcomes in ER and at two weeks. Findings: 1423 patients (75.8% male, 24.2% female); 64.8% referrals. Median of pre-hospital delay was 1 day (IQR <1-3 days). Mechanisms included road traffic accidents (RTAs) (68.3%), falls (22.0%), penetrating trauma (3.0%), blunt assaults (2.8%), burns (2.7%), other (1.2%). Motorcycle-related crashes71.7% of all RTAs with 11.0% helmet use, and car-related crashes accounted for 24.7% with 4.4% seatbelt use. Lower extremity (785, 55.2%), upper extremity (213, 15.0%), and head (119, 8.4%), 87.1% operated. At two weeks, 88.6% had been discharged and 1.7% had died. The KTSII distribution was 37.2% mild, 53.5% moderate and 9.3% severe; among the 24 patients that died, 29.2% were mild, 33.3% moderate, and 37.5% severe. Learned: Registry captured important epidemiologic data on patients at MBH. Mortality review of patients with moderate and low KTSII scores suggests need for improvement in triage at MBH and referring facilities. PIDEMIOLOGIE DES TRAUMATISMES, PRONOSTIC DANS UN HPITAL RURAL DU CAMEROUN: RSULTATS ET LEONS APPRISES Moses Kasumba1 Chao Long3, Jim Brown2, Sherry M Wren2 Corresponding Author: Kasumba Moses Pan African Academy of Christian Surgeons (PAACS) Mbingo Baptist Hospital.NW Email: kasumbakaggya@yahoo.com Contexte: 90% des dcs lis aux traumatismes travers le monde surviennent dans les pays revenus faibles et moyens. Cependant, les donnes pidmiologiques restent rares. Des informations spcifiques aux pays sont donc ncessaires afin damliorer la prvention et la prise en charge de ces traumatismes. Notre tude a pour objectif de dfinir lpidmiologie des traumatismes et dvaluer les profils de rsultats observs laide du Calcul de lchelle de Kampala II (KTSII) pralablement valid lHpital Baptiste deMbingo (HBM). Mthode: Des patients traumatiss (12/5/13-6/7/15) ont t colligs de manire prospective. Les variables de donnes comprenaient le mcanisme et le type de traumatisme, le mode et lheure darrive, les variables KTSII, les interventions chirurgicales et rsultats ladmission lhpital et aprs deux semaines. Conclusion: 1423 patients (75,8% dhommeset 24,2% de femmes); 64,8% de patients rfrs. Le retard pr-hospitalier moyen tait de 1 jour (EI "1 3 jours). Les traumatismes taient dus aux accidents de la circulation routire (ACR) (68,3%),aux chutes(22%), aux incidents par pntration (3%), aux agressions (2,8%), aux brlures (2,7%) et autres formes de traumatisme (1,2%). De tous les ACR, les accidents de moto taient de 71,1% avec un taux de port de casque de 11%. Les accidents de voiture quant eux taient de 24,7% avec un taux de port de ceinture de scurit de 4,4%. La plupart des traumatismes taient localiss au niveau des membres infrieurs (785 cas, 55,2%), des membres suprieurs (213 cas, 15%) et de la tte (119 cas, 8,4%). Pendant leur hospitalisation, 87,1% ont subi une opration. Aprs deux semaines, 88.6% sont sortis de lhpital et 1,7% sont dcds. Le KTS II a rvl un score de 37,2% faible, 53,5% moyen et 9,3% grave. Des 24 patients dcds, 29,2% avaient un score faible; 33,3% un score moyen et 37,5% un score grave. Leons apprises: Notre registre de traumatismes contenait dimportantes donnes pidmiologiques sur les patients de lHBM. Lexamen du taux de mortalit des patients ayant des scores KTS II moyens et faibles montre la ncessit damliorer le tri des patients lHBM et dans les formations sanitairesnon spcialises. Spine Injury in Developing Countries: A Review of Clinical Research Liu M1, Wu HH2, Patel KR2, Turner W2, Caldwell AM2, Coughlin R2, Shearer D2, Larouche J2 1Stanford University School of Medicine, Stanford, CA, USA, 2University of California, San Francisco, San Francisco, California, USA Presenter: Max Liu, 1220 Earnest Street, Hercules, California, 94547, USA Correspondence to: Max Liu, +1(510)691-8034, maxliu@stanford.edu Background: Although surgical treatment of spine injuries continues to be a challenge in low-and-middle income countries (LMICs), few studies have been done to address this challenge. Objectives: The purpose of this scoping review was to identify the global burden of spine injury, the providers who treat spine patients, and the deficiencies in existing LMIC clinical research. Methods: Spine related clinical studies conducted in LMICs from 2004-2014 were identified and organized by diagnosis, disease etiology, type of healthcare providers conducting the research, region, and level of evidence. Results: 125 studies published in 72 different journals were included in this study. 7% were performed collaboratively between a LMIC and a HIC. 46% were conducted by orthopedic surgeons, 30% by neurosurgeons, 8% by radiologists, and 3% by orthopedic surgeons and neurosurgeons working collaboratively. Most studies were conducted in South Asia (67%) or Sub-Saharan Africa (16.8%) and focused on traumatic (42%) and infectious (15%) disease etiologies. 94% of studies were classified as level III evidence or below.14% used a control group. 3 studies utilized randomization. Interpretation: Future investigation into the burden of spine injury in the regions found to be underrepresented in this study should be performed. TRAUMATISMES DE LA COLONNE VERTEBRALE DANS LES PAYS EN DEVELOPPEMENT: REVUE DE LA RECHERCHE CLINIQUE Liu M1, Wu HH2, Patel KR2, Turner W2, Caldwell AM2, Coughlin R2, Shearer D2, Larouche J2 1Stanford University School of Medicine, Stanford, CA, USA, 2University of California, San Francisco, San Francisco, California, USA Presenter: Max Liu, 1220 Earnest Street, Hercules, California, 94547, USA Correspondence to: Max Liu, +1(510)691-8034, maxliu@stanford.edu Contexte: Bien que le traitement chirurgical des lsions de la colonne continue d'tre un dfi dans les pays revenu faible et moyen (PFR-PRI), peu d'tudes ont t ralises pour relever ce dfi. Objectifs: L'objectif de cette tude de porte tait d'identifier le fardeau mondial des traumatismes de la colonne vertbrale, les prestataires de soins en faveur des patients atteints de traumatismes de la colonne vertbrale, et les lacunes dans la recherche clinique existante dans les PFR-PRI. Mthodes: les tudes cliniques de la colonne vertbrale menes dans les PFR-PRI entre 2004-2014 ont t identifies et organises par le diagnostic, l'tiologie de la maladie, le type de fournisseurs de soins de sant qui effectuent la recherche, la rgion, le niveau de preuve. Rsultats: 125 tudes publies dans 72 revues diffrentes ont t inclues dans cette tude. 7% ont t ralises en collaboration entre un PFR-PRI et un HIC. 46% ont t effectues par les chirurgiens orthopdistes, 30% par les neurochirurgiens, 8% par les radiologues, et 3% par des chirurgiens orthopdistes et les neurochirurgiens qui travaillent en collaboration. La plupart des tudes ont t menes en Asie du Sud (67%) ou en Afrique subsaharienne (16,8%) et axes sur les traumatismes (42%) et les tiologies des maladies infectieuses (15%). 94% des tudes ont t classes comme preuves de niveau III ou au-dessous. 14% ont utilis un groupe de contrle. 3 tudes ont utilis la randomisation. Interprtation: Des tudes devraient tre menes dans lavenir sur le fardeau des traumatismes de la colonne vertbrale dans les zones sous-reprsentes dans cette tude. Patterns of Injury at a Public Referral Hospital in Ethiopia: Opportunities for Injury Prevention and Improved Care Adam Laytin, NebyouSeyoum, SeyoumKassa, Catherine Juillard, Rochelle Dicker Background : Injury accounts for 10% of deaths worldwide, and 90% of injury deaths occur in resource-poor settings. Institutional trauma registries are essential to describe and address this large burden.This study describes patterns of injury in Addis Ababa, Ethiopia to identify opportunities for injury prevention and quality improvement. Methods: This is an analysis of prospectively collected data from an institutional trauma registry atMenelik II Specialized Hospital in Addis Ababa, Ethiopia. All patients presenting to the hospital with serious injuries requiring intervention over a 7-month period were included. Univariate and bivariate analyses were performed for patient demographics and injury characteristics. Results: A total of 576injured patients were treated. Median age was 35 years and 72% were male. The most common mechanisms of injury were traffic injuries (35%), falls (32%) and blunt assault (17%).Over half of traffic injury victims were pedestrians. Common injury settings included streets (61%), homes (16%) and workplaces (14%). Median delay in presentation was 4 hours.64% of patients were transferred from another facility. Only 3% of patients were hypotensive on arrival and 10% had moderate or severe traumatic brain injury. Conclusion: This study highlights the utility of institutional trauma registries in collecting crucial injury surveillance data. In Addis Ababa, road safety and workplace safety are important targets for injury prevention. Our findings suggest that the most severely injured patients may not be making it to the referral centers with the capacity to treat their injuries, so efforts to improveprehospital care and triage are needed. TYPES DE TRAUMATISMES DANS UN HOPITAL PUBLIC DE REFERENCE EN ETHIOPIE: OPPORTUNITES DE PREVENTION DES TRAUMATISMES ET DAMELIORATION DES SOINS Adam Laytin, NebyouSeyoum, SeyoumKassa, Catherine Juillard, Rochelle Dicker Contexte: Les traumatismes reprsentent 10% des dcs dans le monde, et 90% des dcs par traumatisme surviennent dans les rgions ressources limites. Le registre institutionnel des traumatismes est un outil essentiel dans la description et la recherche de solutions ce grand fardeau. La prsente tude dcrit les caractristiques des traumatismes rencontrs chez les patients Addis-Abeba, en thiopie, dans loptique didentifier les possibilits de prvention des traumatismes et l'amlioration de la qualit des soins. Mthodes: Il sagit dune analyse des donnes recueillies de faon prospective partir dun registre hospitalier des traumatismes, celui du Menelik II Specialized Hospital Addis-Abeba, Ethiopie. Y ont t enregistrs tous les patients qui se sont prsents l'hpital avec des blessures graves ncessitant une intervention durant une priode de 07 mois. Des analyses univaries et bivaries ont t ralises pour dterminer la rpartition dmographique des patients et les caractristiques des blessures. Rsultats: Un total de 576 patients atteints de blessures graves ont t traits. L'ge mdian tait de 35ans; 72% taient de sexe masculin. Les causes les plus courantes de traumatismes taient les accidents de la voie publique (35%), les chutes (32%) et les agressions brutales (17%). Plus de la moiti des victimes de la route taient des pitons. Les endroits les plus courants o avaient eu lieu les traumatismes taient: la rue (61%), la maison (16%) et le lieu de travail (14%). Le dlai moyen de prsentation lhpital tait de 04 heures. 64% des patients ont t transfrs dans un autre hpital. Seul, 3% des patients souffraient dhypotension l'arrive et 10% prsentaient un traumatisme crnien modr ou svre. Conclusion: La prsente tude dmontre l'utilit des registres hospitaliers des traumatismes dans la collecte des donnes essentielles la surveillance des traumatismes. Addis-Abeba, la scurit routire et au travail sont des cibles importantes dans la prvention des traumatismes. Nos rsultats suggrent que les patients les plus gravement blesss peuvent ne pas se rendre dans les hpitaux de rfrence capables de soigner leurs blessures.Par consquent, des efforts doivent tre faits en vue damliorer les soins pr-hospitaliers et le triage. Spectrum of Hand Injuries at a tertiary hospital in Northwestern Nigeria: A 10 year review Opara AC1, Nazish PA*1, Francis Mark1, Oyeleke A1, Lawal SG1, Fawa AS1, Legbo JN1 1Department of Surgery, UDUTH, Sokoto, Nigeria, West Africa +2348023775382, naz_per@yahoo.com. Background: Optimal hand function is a crucial component of a high quality survival following hand injury. Epidemiological study of hand injuries from our environment are few, thus need for this study. Objectives: To study the pattern of hand injuries in view of suggesting some preventive measures. Methodology: This is a retrospective study of the various hand injuries seen between January 2005 to December 2014. Sources of information were the case notes. Data extracted included demographics and treatment modalities and outcome. Results: A total of 32 patients with hand injuries were studied. Males were 29(90.6%), while females were 3(9.3%). Majority of the hand injuries were seen in the adults 21(65.6%) and they were due to assaults in majority of cases 11(34.4%) followed by road traffic accidents 10(31.2%). Conclusion: Some forms of hand injuries are preventable. Public enlightenment on prevention is advocated. SPECTRE DES BLESSURES DE LA MAIN DANS UN HOPITAL TERTIAIRE AU NORD-OUEST DU NIGERIA: UNE ETUDE SUR UNE PERIODE DE 10 ANS Opara AC1, Nazish PA*1, Francis Mark1, Oyeleke A1, Lawal SG1, Fawa AS1, Legbo JN1 1Department of Surgery, UDUTH, Sokoto, Nigeria, West Africa : +2348023775382, naz_per@yahoo.com. Contexte: La fonction optimale de la main est un lment essentiel d'une survie de haute qualit suite une blessure la main. Les tudes pidmiologiques des blessures de la main menes dans notre contexte sont peu nombreuses; do la ncessit de la prsente tude. Objectifs: tudier les types de blessures de la main en vue de proposer des mesures prventives. Mthodologie: Il sagit dune tude rtrospective de plusieurs blessures de la main observes entre janvier 2005 et dcembre 2014. Les sources dinformation taient les notes de cas. Les donnes extraites comprenaient les donnes dmographiques, les protocoles de soins et les rsultats. Rsultats: Ltude a t mene sur un total de 32 patients victimes de blessures la main; soit 29 (90,6%) hommes et 3 (9,3%) femmes. La majorit des blessures la main ont t observes chez les adultes 21 (65,6%) et elles taient causes par des agressions dans la plupart des cas, 11 (34,4%) suivies des accidents de la circulation routire 10 (31,2%). Conclusion: Certaines formes de blessures de la main sont vitables. Il est ncessaire de sensibiliser le public sur les mesures prventives. Determinants of outcome in traumatic head injuries: An Abakaliki Experience D.E Ogolo Correspondence to: Dr Donald E. Ogolo, Department of Surgery, Federal Teaching Hospital, P.M.B 102, Abakaliki, Nigeria (E-mail:  HYPERLINK "mailto:donekom@yahoo.com"donekom@yahoo.com; phone number: (234)08068668284) Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: Traumatic head injury is an important global health problem and is relatively common. It constitutes a major cause of traumatic death, disability and increased socioeconomic burden worldwide. Objectives: To ascertain factors significantly responsible for mortality from traumatic head injuries and prescribe measures necessary to circumvent such outcome. Methodology: A retrospective study of all traumatic head injuries seen at the Federal Teaching Hospital, Abakaliki from October 2013 to September 2015 was done utilizing data from patients case notes, ward registers and casualty. Extracted data was analyzed using descriptive statistics. Results: A total of 221 patient records were analyzed with 161 males and 60 females. It was observed that though the younger age group (19-30 years) was the most frequently affected by traumatic head injuries (36.2%), the elderly (>60 years) are 4.6 times more likely to die from traumatic head injuries than any other age group. Also, those with severe head injuries are 58 times more likely to die than any other category of head injury, even though the commonest category affected was mild head injuries (68.7%). Traumatic head injured patients from RTAs are 5.8 times more likely to die than any other cause. The sex of the patient and the length of hospital stay had no significant influence on mortality from traumatic head injuries. Conclusion: The GCS at presentation, age of the patient and cause of head injuries are important determining factors of outcome in traumatic head injuries, with the GCS (severity) being the single most important determining factor. Efforts should be made at preventing such causes, with prompt and aggressive care instituted for cases at risk of unfavourable outcome. Keywords: traumatic, head, injuries, severity, mortality, age FACTEURS DE PRONOSTIC DANS LES TRAUMATISMES CRANIENS: UNE EXPERIENCE DABAKALIKI D.E Ogolo Correspondence to: Dr Donald E. Ogolo, Department of Surgery, Federal Teaching Hospital, P.M.B 102, Abakaliki, Nigeria (E-mail: HYPERLINK "mailto:donekom@yahoo.com"donekom@yahoo.com; phone number: (234)08068668284) Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Contexte: le traumatisme crnien est un problme important de sant relativement courant lchelle mondiale. Il constitue lune des principales causes de dcs par traumatisme, dinvalidit et daccroissement du fardeau socio-conomique dans le monde entier. Objectifs: dterminer les principaux facteurs de la mortalit lie aux traumatismes crniens et prescrire les mesures ncessaires visant viter un tel rsultat. Mthodologie: Une tude rtrospective de tous les traumatismes crniens enregistrs au Federal Teaching Hospital dAbakaliki doctobre 2013 septembre 2015 a t mene laide des donnes extraites des dossiers des patients, des registres de services et des accidents. Les donnes extraites ont t analyses laide de la statistique descriptive. Rsultats: Un total de 221 dossiers de patients ont t analyss, soit 161 homme et 60 femmes. Il a t observ que, bien que le groupe dge plus jeune (entre 19 et 30 ans) tait le plus souvent affect par les traumatismes crniens (36,2%), les personnes ges (> 60 ans) sont 4,6 fois plus susceptibles de mourir de traumatismes crniens que toute personne issue dune autre tranche dge. Aussi, les personnes victimes de traumatismes crniens graves sont 58 fois plus susceptibles de mourir que celles victimes de toute autre catgorie de traumatismes crniens, mme si la catgoriela plus courante tait les traumatismes crniens lgers (68,7%). Les patients souffrant de traumatismes crniens dus lACR sont 5,8 fois plus susceptibles de mourir que toute autre cause. Le sexe du patient et la dure du sjour lhpital na pas dinfluence significative sur la mortalit par traumatismes crniens. Conclusion: Lchelle de coma de Glasgow(ECG) lors de la consultation, lge du patient et la cause des traumatismes crniens constituent des facteurs de pronostic importants des traumatismes crniens, avec lECG (gravit) comme seul facteur dterminant le plus important. Des efforts devraient tre fournis pour la prvention de ces causes, avec des soins urgents et intensifs mis en place pour les cas risque de rsultats dfavorables. Mots-cls: traumatique, tte, lsions, gravit, mortalit, ge. The role of external fixator in emergency traumatology at the Omar Bongo Ondimba Military Hospital in Libreville R.Tchoua, ,G.Edjo Nkili, E.Sougou,L.Nguiabanda,E.Mbongo Kama,Y.Oliveira Military Hospital Omar Bongo Ondimba Romain Tchoua BP 20404 Libreville e-mail rtrtchoua@yahoo.fr Introduction: The majority of trauma patients arriving alive at the emergency department have limb lesions. The treatment required during the first hours is a surgical debridement, a possible vascular repair and bone stabilization. The goal of emergency treatment is to save the victim, save the limb and preserve the function. Achieving the limb stabilization is the safest way. Patients and methods: It was a retrospective and descriptive study on a two year period (January 2013 - December 2014). It focused on stabilizing limbs by external fixation. The parameters studied were: age, gender, injury location, fixation delay and duration, and the evolution. Results: During this period, we recorded 44 cases of external limb fixation. Sex ratio was 4.5 for men. The average age was 30 years (extremes 18-62 years). Were admitted mostly lower extremity traumas in 91% of cases, and primarily at the level of the leg in 70% of cases. Five patients had injuries in more than 3 locations. The implementation period of the external fixator was 58 hours and the duration of the fixation 5 months. Evolution was favorable in all cases with walking recovery, except few cases of delayed consolidation and vicious union. Conclusion: External fixator is the modern way of osteosynthesis. It stabilizes in all locations, all types of fractures. Mechanically, it provides the best stabilization. For this purpose, you need an experienced surgical team and this can be done by any non-orthopedic surgeon. Keys words: Trauma Limbs External Fixator. PLACE DU FIXATEUR EXTERNE EN TRAUMATOLOGIE DURGENCE A LHOPITAL DINSTRUCTION DES ARMEES OMAR BONGO ONDIMBA DE LIBREVILLE R.Tchoua, G.Edjo Nkili, E.Sougou,L.Nguiabanda,E.Mbongo Kama,Y.Oliveira HpitaldInstruction des Armes Omar Bongo Ondimba Romain Tchoua BP 20404 Libreville e-mail rtrtchoua@yahoo.fr Introduction: La majorit des traumatiss qui arrivent vivants au service des urgences prsentent une lsion des membres. Le traitement impose au cours des premires heures un parage chirurgical, une rparation vasculaire ventuelle et une stabilisation osseuse. Le but du traitement en urgence est de sauver la victime, sauver le membre et prserver la fonction. Pour y parvenir, la stabilisation du membre est le moyen le plus sr. Patients et Mthodes: Il sagissait dune tude rtrospective et descriptive dune dure de deux ans (Janvier 2013 Dcembre 2014). Elle portait sur la stabilisation des membres par fixateur externe. Les paramtres tudis taient: lge, le sexe, le sige des lsions, le dlai de fixation, la dure de fixation et lvolution. Rsultats: Durant cette priode, nous avons enregistr 44 cas de fixation externe des membres. le sexe ratio est de 4.5 en faveur des hommes, la moyenne dge de 30 ans (extrmes 18 - 62 ans). Ont t admis en majorit des traumatismes des membres infrieurs dans 91% des cas et essentiellement au niveau de la jambe dans 70% des cas. Cinq patients avaient plus de 3 localisations. Le dlai de mise en place du fixateur externe tait de 58 heures et la dure de la fixation de 5 mois. Lvolution a t favorable dans tous les cas avec une reprise de la marche, en dehors de quelques cas de retard de consolidation et cal vicieux. Conclusion: Le fixateur externe est le moyen moderne dostosynthse. Il permet de stabiliser dans toutes les localisations, tous les types de fractures. Mcaniquement, il apporte la stabilisation la meilleure. Pour cela, il faut une quipe chirurgicale ayant une exprience et reste la porte de tout chirurgien non orthopdique. Mots cls: Traumatisme Membres Fixateur Externe Initial External Fixation or Intramedullary Nailing for Gustilo 3A Tibial Shaft Fractures: a Preliminary Randomized Controlled Trial in Dar es Salaam, Tanzania Zahra1, Liu M2, Morshed S3, Yusi K3, Shearer D3, Haonga B1 1Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania 2Stanford University School of Medicine, Stanford, California, United States of America 3University of California, San Francisco, San Francisco, California, United States of America Presenter: Max Liu, 1220 Earnest Street, Hercules, California, 94547, USA Correspondence to: Max Liu, +1(510)691-8034, maxliu@stanford.edu Background: Despite thirty years of research comparing external fixation to intramedullary nailing, controversy on the optimal method of surgical fixation persists. Objectives: To compare external versus internal fixation for treatment of open tibia fractures Methods: A preliminary randomized clinical trial was conducted from March 2013 to February 2014 at one study center in Tanzania. Fifty-four patients with Gustilo 3A tibia fractures were enrolled and randomized to two treatment groups. Twenty six were treated with definitive external fixation, and 28 were managed with intramedullary nailing. Results: The most common mechanisms of injury included motorcycle collisions (75.8%) and motor vehicle collisions (20.4%). We found no statistically significant difference in the rates of wound healing or incidence of deep infection (7.7% for IMN vs 12.5% for ex-fix). Twelve patients (46.2%) treated with external fixators developed superficial infection, none of which required implant removal. The intramedullary nail group exhibited a faster time to callus formation (92% at 10 weeks) than the external fixation group (25% at 10 weeks). Two ex-fix patients (8.3%) were found to have significant post-operative limb length discrepancies and three (12.5%) were revised for angular or rotational malalignment. Conclusion: Early results from this pilot study predict a clinical advantage for intramedullary nailing. Further investigation is warranted. FIXATION EXTERNE INITIALE OU ENCLOUAGE DU TIBIA POUR LES FRACTURES DIAPHYSAIRES TIBIALES GUSTILO 3A: UN ESSAI CONTROLE RANDOMISE PRELIMINAIRE A DAR ES SALAAM, EN TANZANIE Zahra1, Liu M2, Morshed S3, Yusi K3, Shearer D3, Haonga B1 1Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania 2Stanford University School of Medicine, Stanford, California, United States of America 3University of California, San Francisco, San Francisco, California, United States of America Presenter: Max Liu, 1220 Earnest Street, Hercules, California, 94547, USA Correspondence to: Max Liu, +1(510)691-8034, maxliu@stanford.edu Contexte: Malgr trente annes de recherche comparant la fixation externe un enclouage mdullaire, la controverse sur la mthode optimale de fixation chirurgicale persiste. Objectifs: comparer la fixation externe la fixation interne pour le traitement des fractures ouvertes du tibia Mthodes: Un essai clinique randomis prliminaire a t men de mars 2013 fvrier 2014, dans un centre d'tude en Tanzanie. Cinquante-quatre patients atteints de fractures du tibia Gustilo 3A ont t inclus et randomiss dans deux groupes de traitement. Vingt-six ont t traits par fixation externe dfinitive, et 28 par enclouage. Rsultats: Les mcanismes de traumatismes les plus courants inclus sont les collisions de moto (75,8%) et les collisions de vhicules automobiles (20,4%). Nous navons trouv aucune diffrence statistiquement significative dans les taux de gurison ou l'incidence de l'infection profonde (7,7% pour les cas denclouage contre 12,5% pour les fixations externes). Douze patients (46,2%) traits par fixateurs externes ont dvelopp une infection superficielle, aucun n'a ncessit une ablation de l'implant. Le groupe de lenclouage mdullaire a prsent une formation plus rapide du cal (92% 10 semaines) que dans le groupe de fixation externe (25% 10 semaines). Deux patients traits par fixation externe (8,3%) ont prsent d'importants carts post-opratoires de la longueur du membre et trois (12,5%) ont subi une rvision pour dfaut d'alignement angulaire ou de rotation. Conclusion: Les premiers rsultats de cette tude pilote prdisent un avantage clinique pour lenclouage. Une enqute plus approfondie est justifie. TYPES ET PRONOSTIC DES TRAUMATISMES ABDOMINAUX PENETRANTS DANS DEUX HOPITAUX DE REFERENCE A YAOUNDE Tim F. Tientcheu1,2, Ngo Nonga B3, Essomba A2,3. Yaounde Central hospital, surgical emergency unit Military hospital Yaounde Yaounde university Teaching hospital Une tude rtrospective sur 79 patients victimes de traumatismes abdominaux pntrants a t conduite dans deux hpitaux de rfrence de Yaound en vue dvaluer le type de traumatismes et les rsultats de la prise en charge prcoce. Lge des patients (74 hommes, 05 femmes) variait entre 07 et 56 ans (moyenne de 28,91 ans). Les blessures larme blanche, 65 (82,05%), taient les principales causes de TAP. Dans 56,96%, il sagissait dagressions/crimes avec violence mais lon a not une augmentation de traumatismes causs par les forces de lordre (policiers/militaires) chez 08 (10,13%) patients. Larrive tardive au centre de soins reste frquente car, 39,24% des sujets sont arrivs plus de 12 heures aprs avoir t blesss et seuls 02 (2,54%) ont t reus lheure critique (0-1 heure). Dix patients souffraient de choc hmorragique, 16 de pritonite et 11 prsentaient des viscrations. Lorgane le plus gnralement atteint tait le gros intestin qui dans la plupart des cas avait t perfor. Trente-trois (42%) patients ont reu une prise en charge conservatrice et 08 (10%) patients ont subi une intervention chirurgicale salvatrice (DCS). La prise en charge non-chirurgicale sest rvle un chec pour 21% des patients prsentant une pritonite, car celle-ci est un indicateur pour une laparotomie. Le taux de laparotomie non thrapeutique tait lev dans notre srie (22%). Lon a enregistr 06 dcs (7,59%) pour une priode moyenne de mortalit de 30 heures (entre 03-72 heures). La relance de lconomie chancelante et de lemploi rmunr pour les jeunes sont les principaux domaines ncessitant une intervention prompte, cible et soutenue en vue de rduire les crimes violents Yaound. Il est ncessaire dquiper les services des urgences en comptences et matriels en vue damliorer la prise en charge et faire baisser la morbidit et la mortalit. Mots cls: Traumatisme abdominal pntrant, chirurgie conservatrice, prise en charge non-chirurgicale, laparotomie non thrapeutique. TRAITEMENT DES FRACTURES FEMORALES DE LENFANT. NOTRE EXPERIENCE AU CENTRE HOSPITALIER UNIVERSITAIRE DE YAOUNDE. Tochie Joel, Guifo Marc Leroy, Ibrahim Farikou, Mouafo Tambo, Nana Theohile, Takongmo Samuel. Presenting and Corresponding Author: Dr Tochie Joel, Hospitals Intern at Faculty of Medicine and Biomedical sciences, University of Yaounde I, Cameroon; Tel: (237) 676 55 88 25; joeltochie@gmail.com Contexte: Les modalits de traitement des fractures fmorales pdiatriques (FFP) ont largement volues, incluant des mesures conservatrices et chirurgicales. Namoins, il nexiste pas de consensus universel sur leur prise en charge. Objectifs: Dterminer le profil pidmiologique des FFP, valuer leurs traitements, analyser les difficults thrapeutiques et les rsultats du traitement dans notre milieu. Mthodes: Ctait une tude de cohorte prospective portant sur tous les cas de FFP (0 15 ans) traites entre 2010 et 2014 au service de chirurgie du CHU de Yaound, Cameroun. Les variables tudies taient le profil dermographique, le mcanisme des fractures, le mode de traitement, les difficults et lvolution 12 mois de suivi. Rsultats: 25 patients ont t inclus, soit 17 garons et 8 filles (ratio M/F 2.1:1, moyenne dge 3 ans, tranche de 4 jours 12 ans). Tous avaient des fractures fermes, donc 76% diaphysaires. Les principaux mcanismes taient des chutes accidentelles (36%) et les jeux (32%). Les mesures de traitement: traction suivie dun pltre (40%), immobilisation pltre seule (32%), rduction orthopdique suivie dun pltre (16%) et la chirurgie (12%). Les difficults thrapeutiques: le manque de techniques danesthsie appropries pour les rductions orthopdiques, linsatisfaction des parents du fait de limmobilisation prolonge de leurs enfants et labsence dun amplificateur de brillance en peropratoire pour la chirurgie. Hormis un cas de raccourcissement acceptable du membre de 1.5cm aprs la chirurgie, aucune autre complication na t rencontre. Conclusion : Le traitement des FFP est prdomin par les mesures orthopdiques, avec des rsultats satisfaisants. Cependant, les enfants doivent tre sensibiliss sur les jeux dangereux responsables de fractures et la chirurgie est ncessaire pour une rhabilitation prcoce et une meilleure satisfaction du couple parent-enfant. Mots Cls: fractures fmorales, enfants, traitement, difficults, devenir, Cameroun OUTCOME OF MITRAL VALVE REPAIR IN BACTERIALENDOCARDITIS AS COMPARED TO DEGENERATIVE MITRAL VALVE DISEASE Christian Emeka AMADI, MD; Yasmin MAOR, MD; Ehud RAANANI, MD Presenter: DrAmadi Christian Emeka; Address: Department of Cardiac Surgery, Sheba Medical Center, Israel; E-mail: ace251276@yahoo.com Department of Cardiac Surgery, TheLeviev Heart Center, Sheba Medical Center, Israel Objective: To compare the Outcome of the Repair of Mitral Valve in severe Mitral Regurgitation (MR) following Bacterial Endocarditis (BE) and that in the setting of Degenerative Mitral Disease (DMD). Methods: From 2004 to 2015, 632 Patients underwent Mitral Valve Repair, of which 64 (10%) were for BE and 568 (90%) for DMD. Of the 64 Patients, 36 were acute, 9 sub-acute and 19 were for healed Infective Endocarditis. Patients were followed up clinically and by Echocardiography for a period of 44+32 and 34+31 months for the BE and DMD groups respectively. Results: In the early phase; in-hospital mortality was 0(0%) for the BE group while 1(0.2%) for DMD group. Other postoperative complications were also comparable in both groups. In the late phase, 55 Patients (93%) & 487 Patients (89%) remained in early NYHA Functional Class (FC I & II) while 52 (88%) & 487 (89%) were without significant MR for the BE & DMD groups respectively. However, reoperations were 5(8%) & 27 (5%) and Late deaths were 5 (8%) and 20 (4%) for the BE & DMD groups respectively. There were no cases of recurrent BE. CONCLUSION: Mitral Valve Repair in the setting of Infective Endocarditis is safe and provides early excellent results. Late Clinical and Echocardiographic results were comparable with Patients that underwent repair for Severe Regurgitation for DMD and freedom from Bacterial Endocarditis was excellent even if the repair was done within the acute phase of the disease. RSULTAT DE LA RPARATION DE LA VALVE MITRALE DANS UN CAS DENDOCARDITE BACTRIENNE PAR RAPPORT A LA MALADIE VALVULAIRE MITRALE DGNRATIVE Christian Emeka AMADI, MD; Yasmin MAOR, MD; Ehud RAANANI, MD (Presenter: DrAmadi Christian Emeka; Address: Department of Cardiac Surgery, Sheba Medical Center, Israel; E-mail: HYPERLINK "mailto:ace251276@yahoo.com"ace251276@yahoo.com) Department of Cardiac Surgery, TheLeviev Heart Center, Sheba Medical Center, Israel Objectif: Comparer les rsultats de la rparation de la valve mitrale dans la rgurgitation mitrale (MR) aprs une endocardite bactrienne (BE) dans un contexte de maladie valvulaire mitrale dgnrative (DMD). Mthodes: De 2004 2015, 632 patients ont subi une rparation de la valve mitrale, dont 64 (10%) pour endocardite bactrienne (EB) et 568 (90%) pour DMD. Des 64 patients, 36 cas dEB taient aigus, 9 subaiges et 19 ltaient pour endocardite infectieuse cicatrise. Les patients ont t suivi cliniquement et par chocardiographie pour une priode de 44+32 et 34+31 mois pour les groupes dEB et DMD respectivement. Rsultats: Dans la premire phase; la mortalit en milieu hospitalier tait de 0 (0%) pour le groupe EB et 1 (0,2%) pour le groupe DMD. Dautres complications postopratoires ont galement t compares entre ces deux groupes. Dans la dernire phase, 55 patients (93%) et 487 patients (89%) sont rests dans la classe initiale de la NYHA (FC I & II) tandis que 52 (88%) et 487 (89%) nont pas prsent de RM grave pour les groupes EB et DMD respectivement. Cependant, 05 (8%) et 27 (5%) patients ont t oprs de nouveau et il y a eu des dcs tardifs, 05 (8%) et 20 (4%) pour les groupes EB et DMD respectivement. Aucun cas dEB rcurrente na t enregistr. Conclusion: La rparation de la valve mitrale dans un contexte dendocardite infectieuse est une intervention sre qui produit dexcellents rsultats initiaux. Les rsultats cliniques et chocardiographiques ultrieurs taient semblables ceux des patients ayant subi une rparation pour la rgurgitation grave dans un contexte de DMD et labsence dendocardite bactrienne tait excellente bien que la rparation ait t effectue au cours de la phase aige de la maladie. What to learn after 1000 Arteriovenous fistula for hemodialysis in Sub-Saharan Africa? Marcus Fokou, Gloria Ashuntantang, Abel Teyang, Francois Kaze, Alain Chichom Mefire, Marie Patrice Halle, Fru Angwafo III, Samuel Takongmo Correspondence to: Marcus Fokou, MD, General, Vascular and transplantation surgeon The Yaounde General Hospital, BP 5408 Yaounde, Cameroun; E-mail: mfokou@yahoo.com Background: Hemodialysis is not yet extended in sub-Saharan Africa. But like everywhere in the world, the issue of vascular accesses is a major challenge in the existing centers. objectivs :To present the particular aspects of arteriovenous fistula (AVF) for hemodialysis Yaound. Methods: From November 2 002 to September 2015,1000 AVF were constructed on 872 adults. Demographic data, patency, and complications were analyzed in association to age, sex, and comorbidities (HIV, hypertension, diabetes). Results: Males represented 73.7% , the mean age was 45.3 years. As etiologies of end-stage renal disease (ESRD) and comorbidities, chronic glomerulonephritis was leading (25.9%), followed by hypertension (22.3%), and diabetes (20.1%). No cause for the ESRD could be identified in 17.2%. Only 20.64% enter dialysis with AVF. The main types of AVF were radiocephalic (68%) and brachiocephalic (24.9%) with a mean follow-up of 279 days. The cumulative patency rate was 76% at 1 year and 51% at 2 years. Altogether, 362 complications occurred in 16% of the AVF with Aneurysms (27.65%), failure to mature (14.89%), and thrombosis (10.63%) being the commonest. Their management included the creation of a new access for 121 complications (33.51%) and non operative for 44.14%. Their rate was not influenced by diabetes mellitus (x2 =3.58, P >0.05) and HIV-positive status (x2 = 0.64 , P > 0.05). Conclusion: According to our patients characteristics, there is a possibility of constructing AVF on nearly every hemodialysis patient with a good outcome. QUE RETENIR APRES 1000 FISTULES ARTERIOVEINEUSES POUR HEMODIALYSE EN AFRIQUE SUBSAHARIENNE? Marcus Fokou, Gloria Ashuntantang, Abel Teyang, Francois Kaze, Alain Chichom Mefire, Marie Patrice Halle, Fru Angwafo III, Samuel Takongmo Correspondence to: Marcus Fokou, MD, General, Vascular and transplantation surgeon The Yaounde General Hospital, BP 5408 Yaounde, Cameroun; E-mail: mfokou@yahoo.com Contexte: Lhmodialyse est peu rpandue en Afrique subsaharienne. Dans les centres existants comme ailleurs dans le monde, les abords vasculaires restent un challenge. Objectifs: Prsenter les particularits des fistules arterioveineuses (FAV) pour hmodialyse Yaound. Mthodes: De novembre 2002 septembre 2015, 1000 FAV ont t construites chez 872 adultes. Les donnes dmographiques, la permabilit, les complications ont t analyses en relation avec l'ge, le sexe, les co-morbidits (HIV, Hypertension , diabte). Rsultats: Les hommes constituaient 73,7% des patients. Lge moyen tait de 45,3 ans. Comme tiologies de la maladie rnale chronique ( MRC) et co-morbidit, les glomrulonphrites chroniques prdominaient (25,9%), l'hypertension artrielle 22.3%, le diabte 20,1%. Aucune cause n'a t identifie chez 17,2%. Seuls 20,64% dbutent la dialyse avec une FAV. Les FAV taient surtout radiocephaliques (68%) brachiocephalique (24,9%). Le suivi moyen tait de 279 jours. Le taux de permabilit cumul tait de 76% un an et 17.2% 2 ans. Au total 362 complications ont t observes dans 16 % des FAV. Les pseudo-anvrismes (27,65% ), le dveloppement insuffisant (14,89%), les thromboses (10,63%) taient les plus frquentes. Leur traitement tait la cration d'une nouvelle FAV (33,51 %) et non opratoire dans (44,14%). Le taux de complication n'est pas influenc par le diabte (x2 =3.58, P >0.05 ) et le statut HIV positif (x2 = 0.64, P > 0.05) . Conclusion: Presque tous nos hmodialyss peuvent bnficier d'une FAV avec un rsultat satisfaisant. PERIPHEREAL VASCULAR INJURIES AND THEIR COMPLICATIONS IN YAOUNDE Ngo Nonga Bernadette, Savom Eric, Bang Aristide, Biongolo Frank, Bisay, Dpartement de chirurgie et spcialits, Facult de Mdecine et des sciences biomdicales, Universit de Yaound I, Cameroun Presenting author: Dr Savom Corresponding author: Pr B NGO NONGA Background and objective: The incidence of vascular trauma in Cameroon and Central Africa is unknown because very few studies on vascular injuries in this region have been published. The objective of this study is to contribute to the body knowledge of vascular injuries in Cameroon Materials and Methods: We have retrospectively reviewed all vascular trauma managed at the University Teaching Hospital of Yaounde from July 2007 to December 2010. We have excluded all the patients with traumatic amputations or severe crush syndrome of the extremities. The charts were reviewed for demographic data, the cause of the injury and the surgical treatment. Results: During that period we founded 12 patients with a vascular injury in a total of 2436 trauma cases with an incidence of 0,5%. There were 11 men for one woman. The mean age was 28, 5(18-55) years. All the patients sustained a penetrating injury. Nine patients were referred 6 weeks to 2 years after the trauma with a complication, while only three patients were seen at the time of the trauma to the popliteal and brachial arteries. The three patients were amputated because of a long delay before revascularization and lack of appropriate equipment. Five patients presented an arteriovenous fistula and 4 a pseudoaneurysm, they were repaired without complications. Conclusion: Vascular injuries are usually overlooked in our environment, and we would recommend a vascular exam in patients with penetrating injuries to the limb to avoid missing them. Keywords: Penetrating injury- peripheral - vascular- pseudoaneurysm- arteriovenous fistula- LES TRAUMATISMES VASCULAIRES PRIPHRIQUES ET LEURS COMPLICATIONS YAOUND Ngo Nonga Bernadette, Savom Eric, Bang Aristide, Biongolo Frank, Bisay, Dpartement de chirurgie et spcialits, Facult de Mdecine et des sciences biomdicales, Universit de Yaound I, Cameroun Presenting author: Dr Savom Corresponding author: Pr B NGO NONGA Introduction et objectifs: Lincidence des lsions vasculaires priphriques au Cameroun et trs probablement en Afrique Centrale reste indtermine car peu dtudes ont t consacres au traumatisme des vaisseaux dans notre environnement. Cette tude a pour but de contribuer une meilleure connaissance de ces traumatismes au Cameroun. Matriels et mthodes: nous avons recens rtrospectivement tous les cas de traumatisme vasculaire traits au Centre hospitalier universitaire de Yaound de 2007 2010. Ont t exclus tous les patients avec des crasements de jambes et des amputations traumatiques. Les dossiers ont t analyss pour les facteurs dmographiques, la nature du traumatisme, la lsion vasculaire observe ainsi que le traitement appliqu. Rsultats: nous avons retrouvs 12 patients sur 2436 traumatismes donnant une incidence de 0,5%, parmi lesquels 11 hommes et une femme, lge moyen tait de 28,5(18-55) ans. Tous les patients ont t victimes dune plaie pntrante. Neuf patients ont t rfrs au stade de complication aprs une latence de 6 semaines 2 ans aprs le traumatisme. Les trois patients vus en urgence prsentaient des lsions des vaisseaux poplits et des artres brachiale et radiale, ils ont du tre amputs cause du retard de la prise en charge et du manque dquipement adquat. Cinq patients prsentaient une fistule arterio-veineuse, 4 patients des pseudos anvrysmes tous oprs avec succs. Conclusion: Les traumatismes vasculaires sont souvent mconnus et nous attirons lattention de tous les mdecins dans notre contexte sur limportance de lexamen vasculaire en urgence en cas de plaie pntrante au niveau des membres. Mots cls: traumatisme- pntrants - vasculaire- pseudo-anevrysme- fistule artrio-veineuse-priphrique Diaphragmatic injuries associated with thoraco-abdominal trauma Ngo Nonga Bernadette, Bang Aristide, Savom Eric, Zoa Theophan, Tochie, Essomba Arthur Department of surgery, faculty of medicine and biomedical sciences, University of Yaounde I, Cameroon Presenting author: Bang Aristide Corresponding author: Bernadette Ngo Nonga, ngonongab@yahoo.com Background and objectives: diaphragmatic injuries are usually associated with severe chest, abdomen, pelvis and head trauma. They have been associated more with blunt trauma than penetrating trauma and the mortality associated with them have been to be very high. The incidence of these lesions is unknown in Cameroon. We are reporting our experience in the management of diaphragmatic injuries in our environment. Patients and method: From July 2002 July 2012, we have reviewed the reported cases of post traumatic diaphragmatic injuries in 2 hospitals in Cameroon. Results: During that period, we found 10 patients operated upon for diaphragmatic injuries. All of them were male with a mean age of 34, 5 years, and all of them presented associated lesions to others organs. Penetrating injuries were found in 70% of them. The mean injury severity score was 37.5. Diaphragmatic injuries represent 0.05% of all the trauma patients admitted during that period in both hospitals. There is no specific sign or symptom pathognomonic of diaphragmatic rupture, but there are some criteria that can be useful in our environment with its limited resources, . Conclusion: Diaphragmatic injuries can be difficult to diagnose and they are associated with a high mortality and they are found in major thoraco-abdominal trauma, Keywords; diaphragm, injury, trauma, Cameroon, lesions LESIONS DIAPHRAGMATIQUES ET TRAUMATISME THORACO-ABDOMINAL Ngo Nonga Bernadette, Bang Aristide, Savom Eric, Zoa Theophan, Tochie, Essomba Arthur Department of surgery, faculty of medicine and biomedical sciences, University of Yaounde I, Cameroon Presenting author: Bang Aristide Corresponding author: Bernadette Ngo Nonga, ngonongab@yahoo.com Contexte et objectif: Les lsions traumatiques du diaphragme sont souvent associes des lsions svres du thorax, de labdomen, du bassin et du cerveau. Elles sont souvent retrouves avec les traumatismes ferms et saccompagnent dune mortalit leve. Lincidence de ces lsions est inconnue au Cameroun. Nous rapportons ici notre exprience dans la prise en charge des lsions diaphragmatiques dans notre milieu. Mthode: De juillet 2002 juillet 2012, nous avons revu les dossiers de tous les patients oprs pour une lsion du diaphragme dans deux grand hpitaux du Cameroun. Rsultats: Au cours de cette priode, nous avons opr 10 patients avec des lsions traumatiques du diaphragme. Tous les patients taient de sexe masculin, 7 dentre eux prsentaient des lsions pntrantes alors que dans 3 cas il sagissait de traumatisme ferm. Lge moyen tait de 34,5 ans. La lsion se trouvait droite dans 7 cas. Le score ISS (injury severity score) moyen tait de 37,5 et tous les patients prsentaient des lsions associes dautres organes. Les lsions pntrantes taient responsables du traumatisme dans 70% des cas. Les lsions traumatiques du diaphragme reprsentaient seulement 0,05% de tous les cas de traumatismes reus au cours de cette priode. Il nexiste pas de symptmes ou de signes spcifiques permettant de diagnostiquer les plaies du diaphragme, malgr cela nous pensons que quelques critres permettent de les suspecter dans notre milieu o les moyens diagnostiques sont limits. Conclusion: Le diagnostic des traumatismes du diaphragme est difficile et nous pensons que ceux-ci contribueraient la forte mortalit lie aux traumatismes majeurs au Cameroun Mots cls: diaphragme- lsion- traumatisme- diagnostic- plaie- Cameroun MALIGNANTHISTIOCYTOSIS OF THE LUNGS AND CHEST WALL: A CASE REPORT OF DIAGNOSTIC CONUNDRUM AND TREATMENT CHALLENGES IN RESOURCE POOR SETTING Jameel Ismail Ahmad1, Ismail Mohammed Inuwa1, Dalha Gwarzo Haliru2, Imam Mohammed Ibrahim3 Division of Cardiothoracic Surgery, Surgery Department, Bayero University Kano/ Aminu Kano Teaching hospital, Kano, Nigeria Department of Haematology, Bayero University Kano/ Aminu Kano Teaching hospital, Kano, Nigeria Department of Histopathology, Bayero University Kano/ Aminu Kano Teaching hospital, Kano, Nigeria Corresponding and presenting author: Jameel Ismail Ahmad, Division of Cardiothoracic Surgery, Surgery Department, Bayero University Kano/ Aminu Kano Teaching hospital, PMB 3452, Kano, Nigeria. E-mail:  HYPERLINK "mailto:iajameel@yahoo.com"iajameel@yahoo.com Institution where study was done: Aminu Kano Teaching Hospital, Kano, Nigeria Backround: Malignant histiocytosis is a rare condition with variable clinical presentation and prognosis. Its diagnosis requires high index of suspicion and further evaluation. Thus it poses a diagnostic as well as management challenges especially in resource poor setting. OBJECTIVE: To highlight the diagnosis and treatment challenges in the management of malignant histiocytosis so that physicians can diagnose it early and initiate appropriate treatment. Case report: Our patient is a 35 year old man who presented with chest wall mass, dyspnoea and right cervical lymphadenopathy and was initially being evaluated for lymphoma. Biopsy of the lymph nodes was done twice in different hospitals and that of the chest wall mass done once. Histological diagnosis was arrived at with the aid of immunohistochemistry three months after his first presentation to the hospital. The patient was then commenced on chemotherapy and showed remarkable improvement on the short term basis. He is currently on the maintenance regimen. Conclusion: Malignant histiocytosis is a rare disease laden with management challenges. Despite that, its diagnosis and treatment can be achieved even in resource poor setting with increased index of suspicion, team work and good laboratory support. Key words: Malignant histiocytosis, diagnosis, treatment, challenges, immunohistochemistry. HISTIOCYTOSE MALIGNE DES POUMONS ET DE LA CAGE THORACIQUE: ETUDE DE CAS DES DIFFICULTES EN MATIERE DE DIAGNOSTIC ET DE TRAITEMENT DANS UNE REGION A RESSOURCES LIMITEES Jameel Ismail Ahmad1, Ismail Mohammed Inuwa1, Dalha Gwarzo Haliru2, Imam Mohammed Ibrahim3 Division of Cardiothoracic Surgery, Surgery Department, Bayero University Kano/ Aminu Kano Teaching hospital, Kano, Nigeria Department of Haematology, Bayero University Kano/ Aminu Kano Teaching hospital, Kano, Nigeria Department of Histopathology, Bayero University Kano/ Aminu Kano Teaching hospital, Kano, Nigeria Corresponding and presenting author: Jameel Ismail Ahmad, Division of Cardiothoracic Surgery, Surgery Department, Bayero University Kano/ Aminu Kano Teaching hospital, PMB 3452, Kano, Nigeria. E-mail: HYPERLINK "mailto:iajameel@yahoo.com"iajameel@yahoo.com Institution where study was done: Aminu Kano Teaching Hospital, Kano, Nigeria Contexte: Lhistiocytose maligne est une maladie rare ayant des prsentations cliniques diverses et un pronostic mdical vari. Son diagnostic ncessite un indice lev de suspicion et une valuation approfondie. Pour cette raison, elle pose un problme de diagnostic et reprsente un dfi dans la prise en charge, en particulier dans un contexte faibles ressources. Objectif: Mettre en vidence les difficults de diagnostic et de traitement dans la prise en charge de lhistiocystose maligne en vue dun diagnostic prcoce et dune prise en charge approprie. Etude de cas : Notre patient est un homme de 35 ans prsentant une masse dans la cage thoracique, des dyspnes et des adnopathies cervicales latrales droite. Lvaluation initiale avait conclu un lymphome. Une biopsie des ganglions lymphatiques a t ralise deux reprises dans deux hpitaux diffrents et celle de la masse dans la cage thoracique a t faite une fois. Le diagnostic histologique a t pos grce limmunohistochimie trois mois aprs la consultation initiale. Le patient a ainsi pu commencer la chimiothrapie et son tat sest remarquablement amlior en peu de temps. Il est actuellement sous un protocole dentretien. Conclusion: Lhistiocytose maligne est une maladie rare qui pose de grands problmes dans la prise en charge. Cependant, il est possible de la diagnostiquer, mme dans un contexte ressources limites grce un indice lev de suspicion, un travail dquipe et une bonne quipe de laboratoire. Mots cls: Histiocytose maligne, diagnostic, traitement, problmes, immunohistochimie. Lung resection for complex aspergilloma in a poor setting Bernadette Ngo Nonga, Aristide Bang, Perfura Yone, Mbatchou , Zoa Theophan, Maurice Sosso Faculty of Medicine and biomedical science, University of Yaounde I Corresponding author: Bernadette Ngo Nonga,  HYPERLINK "mailto:ngonongab@yahoo.com"ngonongab@yahoo.com Presenting author: Dr Bang Aristide Background: Complex aspergilloma is the most common type found in our environment. Surgery remains the standard of care and it may be difficult due to the fact that aspergilloma is found in a sequellae of a healed TB infection and as such, is associated with fibrosis, making the surgery difficult, mostly in our environment with little appropriate material. Methods: We have reviewed all cases of aspergilloma operated in the past 5 years in our service from January 2011 to May 2015. . The cases were reviewed for demographic, clinical, surgical and pathological and outcome informations. The study was approved by the ethic committee of the faculty of medicine. Results: We have found 18 patients. The mean age was 40 years with a sex ratio of 3,75. All the patients had a history a healed TB and 21% were HIV positive. They all presented a complex aspergilloma. The main presenting symptoms were hemoptysis. The CT scan was realized in all the cases and showed a complex aspergilloma in all of them. All the patients underwent resection using a regular, endotracheal intubation, and a simple drainage system. There was one mortality and one unplanned return to the OR. Average length of hospital stay was 7 days. Conclusions: complex form of pulmonary aspergilloma can be managed surgically in our poor environment with very good results Keywords: Aspergilloma- tuberculosis- lung resection- sequellae- drainage RESECTION PULMONAIRE POUR LASPERGILLOME COMPLEXE DANS LES MILIEUX A RESSOURCES LIMITEES Bernadette Ngo Nonga, Aristide Bang, Perfura Yone, Mbatchou , Zoa Theophan, Maurice Sosso Faculty of Medicine and biomedical science, University of Yaounde I Bernadette Ngo Nonga, HYPERLINK "mailto:ngonongab@yahoo.com"ngonongab@yahoo.com Dr Bang Aristide Introduction: Laspergillome complexe est la forme la plus frquente dans notre environnement.:la chirurgie est le traitement de rfrence et est rendue difficile par la fibrose intense qui peut accompagner les squelles de tuberculoses et par le matriel pas toujours adquat. Matriel et mthodes: Nous avons men une tude rtrospective de Janvier 2011 Mai 2015 dans le service de chirurgie du Centre Hospitalier et Universitaire de Yaound, incluant les patients des deux sexes, gs de plus de 15 ans et chez qui le diagnostic daspergillome pulmonaire avait t pos. Ltude a t soumise au comit dthique de la facult. Rsultats: Dix-huit patients ont t colligs. Lge moyen tait de 40 ans et un sexe ratio de 3,75/1 en faveur du sexe masculin. Tous les patients avaient un antcdent de tuberculose pulmonaire et 21,05% taient immunodprims au VIH. Le maitre-symptme tait lhmoptysie. Tous les patients ont eu une rsection pulmonaire sous anesthsie gnrale avec intubation endotracheale simple et lusage dun systme de drainage simplifi. Nous avons eu un dcs et une intervention pour fistule bronchique. Le sjour moyen lhpital tait de 7 jours. Conclusion: La rsection pulmonaire dans laspergillome complexe peut tre ralise dans notre contexte avec de bons rsultats. Mots-cls: Aspergillome pulmonaire Tuberculose VIH - Yaound. MORBIDITY AND MORTALITY ASSOCIATED WITH APPENDICECTOMY IN CHILDREN AT THE YAOUNDE CENTRAL HOSPITAL. Ndongo R*, Fossi G*, Lyhmi NS*, Nyanit BD*, Ditope JJ*, Ngomsi W*, Kouna TIN, Bukam RM*, BobOyono JM* * Service de chirurgie pdiatrique, Hpital Central de Yaound Dr Ndongo Rn Service de chirurgie pdiatrique, Hpital Central de Yaound Backround: The outcome of appendicectomy in developing countries is associated with a significantly higher mortality and morbidity compared to the developed world. Objective: We aimed to determine the factors affecting the outcome of appendicitis children in a tertiary hospital in Yaound. Methodology: A retrospective analysis of all children treated for appendicitis at the Yaounde Central Hospital, between July 2009 and November 2015. Data collected from patients medical records was analyzed for operative delay, type of incision, findings and post operative morbidities and mortality. Results: A total of 69 children aged between 2 and 16 (mean 9.7 2.8) years, comprising 47 males and 22 females with male/female ratio of 2.1:1 had appendicectomy. Only 60.9% (n=42) had surgery within 24 hours of admission. The incision used was: McBurney oblique (58%), Rocky-Davis (4%) and lower midline (37.7%). Different complications ranged from appendix abscess 18 (24.2 %), perforated appendix 10 (14.5%), gangrenous appendix 10 (14.5%) and peritonitis 38 (60.6%). These influenced post operative outcome with wound infection recorded in 64.3%. Five patients were reoperated for intra-abdominal abscess (n=1) and adhesions (n=4). The case fatality rate in our series was 1.5%. Conclusion: Late diagnosis due to low index of suspicion was rampant which significantly increased associated morbidities and mortality among children managed with appendicitis. Keywords: Appendicitis, Children, Yaound. MORBIDITE ET MORTALITE DES APPENDICECTOMIES CHEZ LENFANT A LHOPITAL CENTRAL DE YAOUNDE. Ndongo R*, Fossi G*, Lyhmi NS*, Nyanit BD*, Ditope JJ*, Ngomsi W*, Kouna TIN, Bukam RM*, BobOyono JM* * Service de chirurgie pdiatrique, Hpital Central de Yaound Dr Ndongo Rn Service de chirurgie pdiatrique, Hpital Central de Yaound Contexte: La morbidit et la mortalit des appendicectomies dans les pays en dveloppement, ne sont pas superposables celles observes dans les pays dvelopps. Objectif: Le but de ce travail tait danalyser la morbidit de lappendicectomie dans un service de chirurgie pdiatrique et les ventuels moyens de labaisser. Mthodologie: Il sest agi dune tude rtrospective et descriptive sur 5 ans (juillet 2009-novembre 2015), portant sur 69 dossiers de patients des 2 sexes, de 9ans 9mois dge moyen (extrmes 2 -15ans), colligs dans le Service de Chirurgie Pdiatrique de lHpital Central de Yaound pour appendicite. Les paramtres suivants ont t tudis: dlai opratoire, voies dabord, les dcouvertes opratoires et suites opratoires. Rsultats: Lintervention tait ralise dans les 24 heures suivant le diagnostic dans 60,4% des cas. La voie dabord tait: oblique au point de McBurney (58%), transversale sous ombilicale droite (4%) ou mdiane (37,7%). Lappendice tait catarrhal dans 33,3% des cas, abcd (24,2%), gangren (14,5%), perfor (14,5%) ou sain (2,9%). Il existait une pritonite associe dans 38 cas. Une appendicectomie a t ralise chez tous nos patients associe un drainage dans 50,7% des cas. La morbidit de 60,9% tait domine par les suppurations paritales (64,3%). Une r-interventions a t ncessaire dans 5 cas pour occlusion sur bride (n=4) et suppuration profonde (n=1). La mortalit de notre srie tait de 1,5% (n=1). Conclusion: La morbidit et la mortalit lies a lappendicectomie restent leves dans notremilieu du fait du diagnostic tardif. Mots cls: appendicectomie, enfant, Yaound. OUR EXPERIENCE WITH CHEILOPLASTY ACCORDING TO THE MODIFIED MILLARD TECHNIQUE IN REPARATORY SURGERY OFCONGENITAL CLEFT LIP IN CHILDREN AT THE GYNECO-OBSTETRIC AND PEDIATRIC HOSPITAL- YAOUNDE: A STUDY OF 100 CASES. F.T. MOUAFO, S.N. LYHMI, J.G.EDOUMA, G. FOSSI, FADI, J. DITOPE, D. NYANIT, R. NDONGO, J.M. BOBOYONO, G. ANDZE. Context: Cheiloplasty for congenital cleft lip is currently undergoing revolutionary changes in our setting with net increase in local expertise. Objectives: The objective of this work was to present the results of cheiloplasty by the modified MILLARD technique for congenital cleft lip in the Pediatric Surgery Unit at the Gyneco-Obstetric and Pediatric Hospital-Yaounde. Methods: This was a retrospective and descriptive study over 5 years period in the pediatric surgery unit. Included in our study were patient aged 0-18 years, operated for congenital cleft lip. The cheiloplasty technique used was the modified MILLARD technique comprising a rhinoplasty. Results: The mean delay before consultation was 1.75 years with 45.9% of consultation done before 1 year of age and 1.6% done at birth. No antenatal diagnosis was made during our study. The sex ratio was 3:2 in favour of females and 62.3% were aged between 1 to 9 years. Isolated labial lesions were in 11.5% of cases. Associated malformations were essentially; an interventricular communication, syndactyly, divergent strabismus and microcephaly. The evolution was satisfactory in 70.5% of cases. No deaths were observed and mean follow-up time was 3 months. Conclusion: The results of cheiloplasty for congenital cleft lip by the modified MILLARD technique were satisfactory both at the esthetic and functional levels. Keys -words: Congenital Cleft lips child modified MILLARD technique Gyneco-Obstetric and Pediatric Hospital-Yaounde. NOTRE EXPERIENCE DE LA CHEILOPLASTIE SELON MILLARD MODIFIEE DANS LA CHIRURGIE REPARATRICE DES FENTES LABIALES CONGENITALES CHEZ LENFANT A LHOPITAL GYNECO-OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE: A propos de 100 cas. F.T.MOUAFO, S.N.LYHMI, J.G.EDOUMA, G.FOSSI, FADI, J.DITOPE, D.NYANIT, R.NDONGO, J.M.BOBOYONO, G.ANDZE. Contexte: La chiloplastie pour fentes labiales congnitales est en plein essor dans notre milieu avec une nette augmentation de lexpertise locale. Objectif: Lobjectif de ce travail tait de prsenter les rsultats de la chiloplastie par une technique de MILLARD modifie pour Fentes Congnitales dans le service de Chirurgie Pdiatrique de lHpital Gynco-Obsttrique et Pdiatrique de Yaound. Mthodologie: Ltude tait rtrospective et descriptive sur 5 ans, dans le service de Chirurgie Pdiatrique de lHpital Gynco-Obsttrique et Pdiatrique de Yaound. Elle portait sur les patients gs de 0 18 ans, souffrant de Fentes Labiales Congnitales opres, soit un total de 100 cas. La technique de chiloplastie utilise tait une technique de MILLARD modifie, comportant une rhinoplastie. Rsultats: Le dlai moyen de consultation tait de 1.75 ans avec 45.9% de consultation avant 1an et 1.6% la naissance. Aucun diagnostic antnatal navait t pos dans notre srie. Le sex-ratio tait de 3/2 en faveur des filles et 62.3% des patients taient gs entre 1 et 9 ans. Les atteintes labiales isoles reprsentaient 11.5% de cas. Les malformations associes taient essentiellement: une communication inter-ventriculaire, une syndactylie, un strabisme divergent, une microcphalie. Lvolution tait satisfaisante dans 70.5% de cas. Aucun dcs navait t enregistr et le recul moyen tait de 3 mois. Conclusion: Les rsultats de la chiloplasties pour fentes labiales congnitales par une technique de MILLARD modifie taient satisfaisants tant sur le plan esthtique que fonctionnel. Mots-cls: Fentes Labiales Congnitales Enfant - MILLARD modifie - Hpital Gynco-Obsttrique et Pdiatrique de Yaound EPIDEMIOLOGIC, DIAGNOSTIC AND THERAPEUTIC ASPECTS OF INTUSSUSCEPTION IN INFANTS BELOW 3 YEARS IN YAOUNDE Mouafo Tambo FF(1), Ndongo R(2), Ditope JJ(1), Nyanit BD(1), Fossi G(1), Lyhmi NS(1), Salihou AS(1), Fadi S(1), Andze OG(1), BobOyono JM (2), Sosso MA(1), Hpital Gynco-Obsttrique et Pdiatrique de Yaound, ( HGOPY) Hpital Central de Yaound, (HCY) Correspondance: Pr Mouafo Tambo FaustinFlicien HGOPY Email: HYPERLINK "mailto:faustintambo@yahoo.fr"faustintambo@yahoo.fr Background: Intussusception is a common medico-surgical emergency in infants less than 3 years. The incidence of the disease seems to be on the rise due to the global introduction of rotavirus vaccine. Objective: The aim of this study was to describe the epidemiology, diagnosis, and clinical manifestations of intussusceptions 4 years before the introduction of the rotavirus vaccine. Methodology: We carried out a retrospective descriptive and analytic study concerning all cases of intussusceptions aged below 3 years and managed by either operative or non-operative methods in the pediatric surgery services of 2 referral hospitals in Yaounde over a period of 4 years (January 2010 December 2013). Results: Fifty three cases were recorded, with an incidence of 13 patients per year. Infants aged 3-9 months were the most commonly affected. The male preponderance was remarkable with a sex ratio of 2:1. Hydrostatic reduction was carried out in 14.3% of cases. According to the Brighton classification, 96% of our patients corresponded to the level 1 diagnostic criteria .The case fatality rate was 7.5% in our series. Conclusion: There is a marked difference in the intussusceptions case-fatality rate between the developed world and our setting. Key words: intussusception, aspects, Yaounde. PROFIL EPIDEMIOLOGIQUE, DIAQGNOSTIQUE ET THERAPEUTIQUE DES INVAGINATIONS INTESTINALES AIGUES CHEZ LES ENFANTS DE MOINS DE 3 ANS A YAOUNDE. Mouafo Tambo FF(1), Ndongo R(2), Ditope JJ(1), Nyanit BD(1), Fossi G(1), Lyhmi NS(1), SalihouAS(1), Fadi S(1), Andze OG(1), BobOyono JM (2), Sosso MA(1), Hpital Gynco-Obsttrique et Pdiatrique de Yaound, ( HGOPY) Hpital Central de Yaound, (HCY) Pr Mouafo Tambo FaustinFlicien HGOPY , Email:faustintambo@yahoo.fr Contexte: Les invaginations intestinales aigues (IIA) ralisent une grande urgence mdico-chirurgicale notamment chez les nourrissons entre 3 et 12mois. Elles connaissent un regain dintrt depuis lintroduction de la vaccination contre le rotavirus qui aurait augment leur frquence. Objectif: Le but de ce travail tait de dgager un profil des IIA Yaound 4 ans avant lintroduction du vaccin contre le rotavirus. Matriel et mthode: Notre tude a t rtrospective, descriptive et analytique, sur 4 ans, dans les services de chirurgie pdiatrique de 2 hpitaux de rfrence de la ville de Yaound. Ont t inclus dans cette tude tous les enfants de moins de 3 ans prsentant une IIA leur date dentre dans le service. Rsultats: Cinquante-trois patients ont t retenus, soit une frquence annuelle de 13 patients. La tranche dge la plus touche se situait entre 3 et 9 mois. La prdominance tait masculine avec un sex-ratio de 2/1..Le niveau de certitude diagnostique de linvagination intestinale aigue dans 96% des cas tait le niveau 1 (cas certain) selon la classification de Brighton. Le lavement opaque thrapeutique na t de mise que chez 14,3% de nos cas. Le taux de mortalit tait de 7,5% dans notre srie. Conclusion: Les invaginations intestinales aigues ont une rputation de bnignit en Occident mais celle-ci nest pas transposable dans notre contexte. Mots cls: Invaginations intestinales aigues, profil, Yaound. Risk factors for obstetric trauma at the Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH) Mouafo Tambo FF, Ngo Um Meka E., Mah E., Ngwanou DH., Foumane P. Background: The birth injury of newborns represents all pediatric incidents inherent in difficult birth. The lesions can go up to 30 per 1000 live births. Childbirth is a happy event, and can be a family drama if surrounded by pain. Purpose: The aim of our study was to identify risk factors for obstetric trauma at the Yaounde Gynaeco Obstetrics and pediatric Hospital (YGOPH). Methodology: It was a retrospective and descriptive study including files of newborns from D0 to D21 of life, with a birth injury, over a period of 11 years. The files were selected in the Neonatology and Pediatric Surgery services of YGOPH. Were excluded, birth trauma of cephalic pole and the records of more than 28 days of life. The parameters studied were: obstetrical factors (quality of the practitioner, place and conduct of delivery), maternal (age, comorbidities) and fetal (position, weight, term). Results: Of the 14,284 newborns recorded at the HGOPY, we identified 140 cases; that is an incidence of 0.98%. Maternal factors were as follows: the mean maternal age was 28.14%, primiparous women accounted for 59.9 % of cases. We obtained 97.3% of vaginal deliveries, 5.3% of instrumental deliveries and 41.7 % of macrosomic babies. According to obstetric factors, 42.8 % of deliveries were made in a health center, 44.3% were performed by nurses. The identified lesions were dominated by the paralysis of the brachial plexus 70.6%, fractures of the clavicle 22.5 % and those of the humerus 4.8%. Conclusion: Neonatal obstetric trauma is a real problem and can lead to a family tragedy. It can be prevented by the training of practitioners in the detection of risk factors, and good obstetrical practices. Facteurs de risques du traumatisme obsttrical lHGOPY propos de 140 cas Mouafo Tambo FF, Ngo Um Meka E., Mah E., Ngwanou DH., Foumane P. Contexte: Le traumatisme obsttrical du nouveau-n est lensemble des incidents inhrents un accouchement dystocique. Les lsions rencontres peuvent atteindre jusqu 30 pour 1000 naissances vivantes. Objectif: Le but de ce travail tait de dcrire les facteurs de risques du traumatisme obsttrical lHpital Gynco obsttrique et pdiatrique de Yaound (HGOPY). Mthodologie: Il sest agi dune tude rtrospective et descriptive sur une priode de 11 ans, portant sur les dossiers de nouveau-ns de J0 J21 de vie, prsentant un traumatisme obsttrical dans lunit de nonatologie et le service de chirurgie pdiatrique de lHGOPY. Ont t exclus, les traumatismes obsttricaux du ple cphalique. Les facteurs obsttricaux (qualit du praticien, lieu et droulement de laccouchement), maternels (ge, morbidit associe) et ftaux (poids, position, terme) nous ont intresss. Rsultats: Pendant la priode d'tude, 14284 nouveau-ns ont t reus HGOPY, dont 140 cas de traumatisme obsttrical ce qui reprsente 0.98% des admissions. 44,3% des accouchements taient effectus par des paramdicaux et dans un centre de sant dans 42,8% des cas. Laccouchement par voie basse reprsentait 97,3% dont 5,3% par manuvres instrumentales Lge maternel moyen tait de 28 ans (extrmes?) et la pauciparit retrouve dans 59,9% des cas. La macrosomie ftale reprsentait 41,7% de nos cas. Les aspects lsionnels taient domins par les paralysies du plexus brachial (70,6%) et les fractures (clavicule 22,5% et humrus 4,8%). Conclusion: La connaissance des facteurs de risques du traumatisme obsttrical est une condition pour sa prvention. Mots cls: traumatisme obsttrical, facteurs de risque, HGOPY. EPIDEMIOLOGICAL, DIAGNOSTIC AND THERAPEUTIC ASPECTS OF ANORECTAL DEFECTS IN CHILDREN AT THE YAOUNDE GYNAECO- OBSTETRIC AND PAEDIATRIC HOSPITAL MouafoTambo FF., Fadi S., Nyanit BD., Ditop J., Malagal R., Andz OG. Background: Anorectal malformations had a prevalence of 5.4 cases per year at the Yaounde Gynaeco-Obstetric and Paediatric Hospital and these could be life-threatening in the forms without belatedly identified fistulas. Purpose: This work sought to highlight the epidemiological, diagnostic and therapeutic features of anorectal malformations at the Yaounde Gynaeco-Obstetric and Paediatric Hospital following 10 years of practice. Methodology: The study was retrospective and descriptive. It focused on records of patients in their 0 day to 15 years of life, and suffering from anorectic defects. It lasted 10 years. We paid particular attention to age, gender, birth-place, variety diagnosis, associated malformations, treatment duration and surgical techniques. Results: Fifty-four patient records were selected. The mean age at the time of consultation was 7 months (D1-14years) and 85% were born in hospitals. The patients were mostly males (56%) with a sex ratio of 1.25. Variety diagnosis noted 41% of lower forms, 33% of higher forms and 26% of intermediate forms. Rectovaginal fistula was top with 57.1% of cases. Associated malformations comprised kidney (48%), heart (40%) and spinal (32%). Mean treatment time was 5 days (D1-D30). The following procedures were used: immediate proctoplasty (69.4%), colostomy (69.4%) followed by colo-anal reduction (79.6%) according to Pena; fistulectomy (55%). Morbidity was represented by anal stenosis (15.4%) and fecal incontinence (23.1%). The overall mortality rate was 14.8%. Conclusion: It is suggested that there should be systematic inspection of the perineum of all newborn babies in the delivery room. Keywords: anorectal malformation, epidemiology, diagnosis, treatment, child, Cameroon. ASPECTS EPIDEMIOLOGIQUES, DIAGNOSTIQUES ET THERAPEUTIQUES DES MALFORMATIONS ANORECTALES CHEZ LENFANT A LHOPITAL GYNECO OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE MouafoTambo FF., Fadi S., Nyanit BD., Ditop J., Malagal R., Andz OG. Contexte: Les malformations anorectales (MAR)ont une prvalence de 5,4cas par an HGOPY etmettent en jeu le pronostic vital dans les formes sans fistules vues tardivement. Objectif: Lobjectif de ce travail tait de souligner les particularits pidmiologiques, diagnostiques et thrapeutiques des MAR lHGOPY aprs 10annes de pratique. Mthodologie: Notre tude tait rtrospective de type descriptif, sur dossiers de patients de J0 15 ans de vie, porteurs de MAR traites, sur une priode de 10ans.Age, sexe, lieu de naissance, diagnostic de varit, malformations associes, dlai thrapeutique ettechniques chirurgicales nous ont intresss. Rsultats: 54 dossiers de patients ont ts retenus. Lge moyen au moment de la consultation tait de 7mois (J1-14ans) et 85% des patients taient ns en milieu hospitalier. La prdominance masculine tait note (56%) avec un sex ratio de 1,25. Le diagnostic de varit notait 41% des formes basses, 33% des formes hautes et 26% des formes intermdiaires. La fistule rectovaginale tait au 1er plan avec 57,1% des cas. Les malformations associes taient dabord rnales (48%) puis cardiaques (40%) et rachidiennes (32%). Le dlai thrapeutique moyen tait de 5jours (J1-J30). Les gestes raliss taient: proctoplastie demble (69,4%), colostomie (69,4%) suivie dabaissement colo-anal (79,6%) selon Pena; fistulectomie (55%). La morbidit tait reprsente par la stnose anale (15,4%) et lincontinence anale (23,1%). Le taux global de mortalit tait de 14,8%. Conclusion: Les auteurs insistent sur linspection systmatique du prine de tout nouveau n en salle daccouchement. Mots cls : MAR, pidmiologie, diagnostic, traitement, enfant, Cameroun. Hypertrophic pyloric stenosis in the paediatric surgery department of Gabriel Tour Teaching Hospital Maiga. A, Samak.A, Diakit.I, Traor.A, Togo.A, Kant.L, Traor.M, Kon.O, Diallo.G Purpose: We set out to study hypertrophic pyloric stenosis at Gabriel Tour hospital with a view to making recommendations. Materials and Mthod: Our study was retrospective from December 1999 to December 2005 and prospective from January 2006 to February 2007. It covered an overall period of six years two months, and was conducted in the paediatric surgery department of Gabriel Toure Teaching Hospital. Results: During the study period, 27,951 consultations were carried out in paediatric surgery, and 4,487 patients were effectively operated, including 43 cases of hypertrophic pyloric stenosis, representing 0.95% of patients operated in the department. The mean age was 30 +/- 15 days. The standard deviation was 0.70 and the extremes were 10 days to 60 days. All patients underwent extramucosal pyloromyotomy following the Fredet-Ramsted procedure. The postoperative course was uneventful in 90.7% of cases with a mortality of 2.32% and morbidity of 6.97 %. The treatment cost stood at CFAF136, 750 on average with extremes of CFAF 48,500 to CFAF 225,000. Conclusion: Hypertrophic pyloric stenosis in infants is rare in our practice. Epidemiological and clinical data are not different from those observed in other series. We observed four boys for every girl. Self-medication, inadequate health coverage and ignorance of the disease, among others, are believed to be responsible for delayed diagnosis. The availability and accessibility of diagnostic sources, including ultrasound, should allow early diagnosis. Health insurance could provide adequate care for poor patients. Key words: Hypertrophic pyloric stenosis, pyloromyotomy, ultrasound. Area: visceral surgery, gastroenterology, oncology. La stnose hypertrophique du pylore dans le service de chirurgie pdiatrique du C.H.U Gabriel Tour. Maiga. A, Samak.A, Diakit.I, Traor.A, Togo.A, Kant.L, Traor.M, Kon.O, Diallo.G But: Notre objectif tait dtudier la stnose hypertrophique du pylore lhpital Gabriel Tour afin de dgager des recommandations. Matriels et Mthode: Il sagit dune tude rtrospective allant de dcembre 1999 dcembre 2005 et prospective allant de janvier 2006 fvrier 2007 soit une priode totale de 6ans et 2 mois ralises dans le service de chirurgie pdiatrique du C.H.U de Gabriel TOURE. Rsultats: Pendant la priode dtude 27951 consultations ont t effectues en chirurgie pdiatrique dont 4487 oprs et parmi ces malades nous avons trouv 43 cas de stnose hypertrophique du pylore soit 0,95% des patients oprs dans le service Lage moyen a t de 30 +/- 15 jours avec un cart type de 0.70 et des extrmes de 10 jours et 60 jours. La pyloromyotomie extra muqueuse de Fredet et Ramsted a t faite chez tous nos malades. Les suites ont t simples dans 90,7 % avec une mortalit de 2,32 % et une morbidit de 6,97 %. Le cot de la prise en charge sest lev 136750fcfa en moyenne avec des extrmes de 48500 fcfa 225000 FCFA. Conclusion: La stnose hypertrophique du pylore du nourrisson est rare dans notre pratique. Les donnes pidmiologiques et cliniques ne sont pas diffrentes de celles observes dans les autres sries. Nous avons observ 4 garons pour une fille. Lautomdication, linsuffisance de couverture sanitaire et la mconnaissance de la pathologie seraient entre autre lorigine des retards de diagnostic. La disponibilit et laccessibilit des moyens diagnostiques notamment lchographie devrait permettre un diagnostic prcoce. Lassurance maladie pourrait permettre une prise en charge adquate des patients aux conditions socio conomiques dfavorises. Mots cls: Stnose hypertrophique du pylore, pyloromyotomie, chographie. Secteur dintrt: chirurgie viscrale, gastro-entrologie, cancrologie. Analysis of Caustic Esophageal Injuries in Rural Cameroon: A Retrospective Single Hospital-Based Study Authorship:KasumbaMosesa, Jim Browna, Jason Axtb, KayleJanec, Chaoc Affiliations: a), b) Pan-African Academy of Christian Surgeons, Mbingo Baptist Hospital, Cameroon c) Stanford University, Department of Surgery Stanford University School of Medicine Corresponding Author: Kasumba Moses Pan African Academy of Christian Surgeons (PAACS) Mbingo Baptist Hospital North-West Cameroon Phone: 67225238 Email: kasumbakaggya@yahoo.com Significance: In Cameroon, caustic esophageal injuries are a major contributor to the injury-related disease burden, permanent disability, and deaths. Comprehensive data are needed for prevention and treatment. Objective: To understand the epidemiology, diagnosis, treatment and outcomes of caustic esophageal injuries at Mbingo Baptist Hospital (MBH). Methods: All records for patients with caustic ingestion who underwent endoscopyor surgery at MBH between 2012 to2015 were reviewed. Results: We reviewed 20 admissions.13 males and 7 females, with a median age of 1.83years. Average time to presentation was 5.6 weeks, (SD 4.3 weeks), with 75% (n=15) of ingestions occurring within thehome. Alkali was the ingested agent in 12 cases (60%) with 50.5% (n=11) from unlabeled containers. Caregivers generally were uneducated as to childhood prevention measures in the home. Eighty five percent (n=17) had caustic strictures and required on average 1.81 dilations monthly. Fifteen percent required operative procedures with 10% (n=2) sustaining esophageal perforation andone sudden death. Of those dilated, 45% were able to feed with an average luminal diameter of 1.1cm. Conclusions: This review outlines the need for public awareness about storage and labeling of caustic agents and parental education to prevent esophageal injuries in children. Long term follow up is mandatory for improved outcome. Analyse des lsions caustiques sophagiennes en zone rurale au Cameroun: Une tude rtrospective monocentrique Authorship:KasumbaMosesa, Jim Browna, Jason Axtb, KayleJanec, Chaoc Intrt : Au Cameroun, les lsions caustiques de lsophage sont une cause majeure des maladies causes par les lsions, dinvalidit permanente et de dcs. Il est ncessaire de recueillir des informations compltes en vue de les prvenir et de les traiter. Objectif : Comprendre lpidmiologie, le diagnostic, le traitement et les suites des lsions caustiques de lsophage lHpital Baptiste de Mbingo (MBH). Mthodes: Tous les dossiers des patients prsentant une ingestion caustique et ayant subi une endoscopie ou une opration chirurgicale MBH entre 2012 et 2015 ont t examins. Rsultats : Nous avons examins 20 dossiers dhospitalisation de 13 hommes et 07 femmes, pour un ge moyen de 1,83 an. La dure moyenne jusqu la prsentation tait de 5,6 semaines, (SD 4,3 semaines), et 75% (n=15) des ingestions taient survenues la maison. Dans 12 cas (60%), lagent ingr tait un produit alcalin et 50,5% (n=11) des patients lavaient bu dans des rcipients non tiquets. En gnral, les proches ignoraient les mthodes de prvention des accidents domestiques chez les enfants. 85% (n=17) des patients souffraient de stnose caustique sophagienne et ont ncessit en moyenne 1,81 dilation par mois. 15% ont subi une opration chirurgicale parmi lesquels 10% (n=2) prsentant une perforation de lsophage et une mort subite. 45% des patients ayant subi la dilatation taient capables de salimenter avec un diamtre luminal moyen de 1,1cm. Conclusions: La prsente tude souligne la ncessit de sensibiliser le public sur le stockage et ltiquetage des produits caustiques et dduquer les parents afin de prvenir les lsions sophagiennes chez les enfants. Un suivi long terme est obligatoire en vue damliorer les rsultats. HIRSCHSPRUNGS DISEASE MANAGED IN AN ADULT S P Agbo, B Bashir,A Khalid Department of surgery UsmanuDanfodiyo university teaching hospital, Sokoto, Nigeria, E-mail  HYPERLINK "mailto:agbostephen@yahoo.com"agbostephen@yahoo.com Introduction: Hirschsprungs disease otherwise called aganglionic mega colon or intestinal aganglionosis is a type of mega colon that presents commonly in childhood and rarely in adulthood. Itis a condition characterized by absence of parasympathetic ganglion cells in the Auerbachs and Meissners plexuses of the colonic wall. The exact worldwide incidence remains unknown. Case presentation: In this case a 35 year old male farmer presented with history of chronic constipation and abdominal distention that dated back to early childhood. He had visited several hospitals but corrective surgery could not be done. Over the years patient was able to achieve some partial relief of chronic constipation and abdominal distention with soap and water enema until he presented to our centre with features of acute intestinal obstruction following a referral from a peripheral hospital. He was resuscitated and managed conservatively to relieve the obstruction. Barium enema and full thickness rectal biopsy confirmed short segment aganglionic mega colon. He was prepared for and offered Soaves endo-rectal pull through with a covering colostomy which was closed 3 months post operatively. His firstand second year follow up visits were uneventful as patient is completely free of symptoms. Conclusion: Hirschsprungs disease even though rare may occasionally present to the general surgeon in adulthood. Key words: Hirschsrungs disease, Aganglionic mega colon. PRISE EN CHARGE DE LA MALADIE DE HIRSCHSPRUNG CHEZ UN ADULTE S P Agbo, B Bashir,A Khalid Department of surgery UsmanuDanfodiyo university teaching hospital, Sokoto, Nigeria, E-mail HYPERLINK "mailto:agbostephen@yahoo.com"agbostephen@yahoo.com Introduction: la maladie de Hirschsprung encore appele mgaclon aganglionnaire ou aganglionose intestinale est un type de mgaclon qui se manifeste souvent durant lenfance et rarement lge adulte. Elle est caractrise par une absence de cellules ganglionnaires parasympathiques dans les plexus dAuerbach et de Meissner de la paroi colique. Lincidence globale exacte reste inconnue. Observation: Dans ce cas, un agriculteur de 35 ans de sexe masculin sest prsent avec un antcdent de constipation chronique et une distension abdominale qui remontaient la petite enfance. Il avait consult dans plusieurs hpitaux mais la chirurgie corrective ne pouvait tre faite. Au fil des ans, le patient a eu un soulagement partiel de la constipation chronique et de la distension abdominale grce au lavement leau et au savon jusqu' ce qu'il se prsente notre centre avec des caractristiques docclusion intestinale aigu suite une rfrence par un hpital priphrique. Il a t ranim et pris en charge de manire prudente pour soulager lobstruction. Le lavement baryt et la biopsie rectale de pleine paisseur a confirm un court segment de mgaclon aganglionnaire. Il a t prpar et a subi une traction endo-rectale de Soave avec une colostomie de couverture qui a t ferme 3 mois aprs l'opration. Sa premire et deuxime anne de visites de contrle taient sans incident car le patient avait t compltement soulag des symptmes. Conclusion: mme si elle est rare, la maladie de Hirschsprung peut parfois tre prsente au chirurgien gnraliste lge adulte. Mots-cls: maladie de Hirschsrung, mgaclon aganglionnaire. Determinants of mortality in neonatal intestinal obstruction at the Gyneco-obstetric and Pediatric Hospital of Yaound (YGOPH) Mouafo Tambo FF(1), Ditope JJ(1), Tamtchap MV(1), Fossi G(1), Nyanit BD(1), Chiabi A(2), Ze Minkande J(3), Andze OG(1) (1) Pediatric Surgery Unit, YGOPH (2) Paediatrics and neonatology Unit, YGOPH (3) Anesthesia and intensive care unit, YGOPH Background: Recent advances in neonatal surgery especially in developed countries has greatly improved the outcome of neonates with intestinal obstruction, where as in most developing countries the mortality remains high, 20-70% as reported. Objective: This study was designed to determine the causes of mortality in patients with neonatal intestinal obstruction at the YGOPH. Methodology: Records of all cases of neonates aged 0-28 days presenting with an intestinal obstruction confirmed radiologically and managed at the peadiatric surgery unit of the YGOPY between 1st January 2007 to 31st December 2014, were retrospectically reviewed. Results: Sixty-four cases of neonatal intestinal obstruction were managed representing 0.86% of the neonatal admissions during the study period. Overall mortality was 37.3%. Average duration of symptoms defore consultation was 7.9 days. The most common cause of intestinal obstruction in our series was Hirschsprungs disease (43.3%). Less than 25% of our study population survived till the operation. Conclusion: Late presentation, absence of antenatal diagnosis and lack of adequate transport, the non-availability of neonatal intensive care units, resource deficiency and ignorance et lack of fundamental organization all appear to be contributive factors to poor outcome in our setting. Key words: determinants, mortality, neonatal obstruction, Yaounde, Cameroon Facteurs de mortalit des occlusions nonatales LHpital Gynco-obsttrique et Pdiatrique de Yaound(HGOPY) Authors: Mouafo Tambo FF(1), Ditope JJ(1), Tamtchap MV(1), Fossi G(1), Nyanit BD(1), Chiabi A(2), Ze Minkande J(3), Andze OG(1) (1) Pediatric Surgery Unit, YGOPH (2) Paediatrics and neonatology Unit, YGOPH (3) Anesthesia and intensive care unit, YGOPH Introduction: Dans les pays en voie de dveloppement, le pronostic des occlusions nonatales reste rserv, avec une mortalit comprise entre 20 et 70% alors que le chiffre est infrieur 15% dans les pays dvelopps. Le but de ce travail tait de dterminer les facteurs de mortalit des occlusions nonatales dans le contexte dun pays sous-mdicalis. Matriel et mthodes: Notre tude a t rtrospective, descriptive et analytique sur une priode de 7 ans, allant du 1er Janvier 2007 au 31 Dcembre 2014, dans le service de chirurgie pdiatrique de lHGOPY. Ont t inclus tous les dossiers de nouveau-ns gs de J0 J28 prsentant un tableau clinique docclusion nonatale confirm radiologiquement et pris en charge lHGOPY. Rsultats: Soixante-quatre dossiers de nouveau-ns occlus ont t retenus. Quarante-sept nouveau-ns sont dcds, soit un taux de mortalit de 73,4%. Le dlai moyen de consultation tait de 6,4 jours avec des extrmes de J0 et J21. La priode nonatale prcoce (J0-J8) tait la plus concerne par la mortalit. Aucun patient navait t lobjet de transport mdicalis et le diagnostic antnatal tait quasi inexistant. Le dlai moyen du diagnostic tait de 1,46 jour avec des extrmes de J0 et J7 de vie et la maladie de Hirschsprung tait la cause la plus frquente des occlusions nonatales (43,3%). Le dlai moyen de prise en charge chirurgicale tait de 3,3 jours avec des extrmes de J1 et J7 de vie. Moins de 20% des nouveau-ns avaient bnfici dun traitement chirurgical. Conclusion: Le retard la consultation, labsence de transport mdicalis et de diagnostic antnatal, linsuffisance du plateau technique en units de soins intensifs nonatals, la faiblesse du pouvoir dachat des populations et le dficit organisationnel semblent tre au premier plan des facteurs de mortalit des occlusions nonatales dans notre milieu. Mots cls: facteurs de mortalit, occlusions nonatales, Yaound-Cameroun Stooling pattern and Timing of First Meconium Passage in Neonatesa pilot study Ezomike UO ,Ugwu EOV ,Ekenze SO 1.Sub-Department of Pediatric Surgery University of Nigeria Teaching Hospital Ituku/Ozalla Enugu 2.Department of Obstetrics and Gynaecology University of Nigeria Teaching Hospital Ituku/Ozalla Enugu Background: Timing of first meconium passage is a good pointer to colonic function.Delayed meconium passage beyond 48hours of age usually signal distal bowel dysfunction.Timing may vary depending on race,GA,birth weight,method of delivery. Subsequent stooling habit may be abnormal in those with delayed meconium passage and may be affected by feeding practice Objectives: To determine the timing of meconium passage in neonates and subsequent stooling pattern in children and to assess, if any,the effects of birth weight,gestational age,mode of delivery,feeding practice on them. Materials and Methods: A cross-sectional study using interviewer-administered questionnaires to obtain data from the mothers of apparently normal infants attending postnatal clinic Results: There were 409 neonates (199 males and 210 females). Birth weight ranged from 1.5 kg to 6kg (mean 3.410.53). Gestational age at birth ranged from 31-42weeks (median 39). Median age at presentation 42 days. 7.2% were preterm and 2.5% weighed less than 2.5 kg. Deliveries were by spontaneous vertex in 62% and via caesarean section in 37%.Passsage of first meconium was within 24hours in 54% and in 48hours 91% had passed. Meconium passage was spontaneous in 96.5% and assisted in the rest.52% commenced breastfeeding within 24 hours. 52% commenced breastfeeding within 24hours and 62% were exclusively breastfed .Frequency of stool passage ranged from once in 7 days to 6times per day (Mean 2.011.03) Conclusion: Majority of infants (95.5%) pass stool at least once daily . 53% of neonates pass meconium spontaneously within 24 hours but 91% in 48 hours. Types de selles et dlai de la premire mission du mconium chez les nouveau-ns: une tude pilote Ezomike UO ,Ugwu EOV ,Ekenze SO 1.Sub-Department of Pediatric Surgery University of Nigeria Teaching Hospital Ituku/Ozalla Enugu 2.Department of Obstetrics and Gynaecology University of Nigeria Teaching Hospital Ituku/Ozalla Enugu Contexte: Le dlai dmission du mconium pour la premire fois est un indicateur du bon fonctionnement du clon. Un retard dmission du mconium excdant 48 heures aprs la naissance est gnralement un indicateur de dysfonctionnement de lintestin distal. Le dlai peut varier en fonction de la race, de lge gestationnel, du poids la naissance et du mode daccouchement. Les habitudes subsquentes de dfcation peuvent tre anormales chez les nouveau-ns ayant excrt le mconium tardivement et pourraient tre affectes par lalimentation. Objectifs: Dterminer le dlai dmission du mconium chez les nouveau-ns et les caractristiques des selles ultrieures chez les enfants. Evaluer, le cas chant, limpact que le poids la naissance, lge gestationnel, le mode daccouchement et le type dalimentation a sur eux. Matriels et Mthodes: Il sagit dune tude transversale laide de questionnaires distribus par les enquteurs en vue dobtenir des informations des mres denfants apparemment normaux venant pour les soins postnatals Rsultats: Lchantillon tait constitu de 409 nouveau-ns (199 de sexe masculin et 210 de sexe fminin). Le poids la naissance variait entre 1,5kg et 6kg (moyenne de 3,410,53). Lge gestationnel la naissance variait entre 31-42 semaines (moyenne de 39). Lge moyen la prsentation tait de 42 jours.7,2% taient des prmaturs et 2,5% pesaient moins de 2,5kg. Les accouchements spontans par vertex constituaient 62% des cas et par csarienne 37%. La premire mission du mconium a eu lieu dans les 24 heures chez 54% des cas et dans les 48 heures, 91% des nouveau-ns avaient vacu le premier mconium. Lmission du mconium a t spontane dans 96,5% des cas et assist pour le reste. 52% ont commenc lallaitement maternel dans les 24 heures et 62% taient allaits exclusivement au sein. La frquence de lmission du mconium variait dune fois en 07 jours 06 fois par jour (moyenne 2,011.03) Conclusion: La majorit des nourrissons (95.5%) ont fait leurs selles au moins une fois par jour. 53% des nouveau-ns ont excrt du mconium spontanment dans les 24 heures; 91% dans les 48 heures. COMMONLY DIAGNOSED SOLID AND NON SOLID CANCERS IN CHILDREN AT THE BUTARE UNIVERSITY TEACHING HOSPITAL (BUTH) ETERE Winnie ( HYPERLINK "mailto:eterewinnie@gmail.com"eterewinnie@gmail.com) Background: Over the past two decades, great strides have been made in Africa in general and Rwanda in particular in the reduction of child mortality. Nowadays, apart from neonatal related cases, pediatric cancer is among the first causes of hospitalization and is also one of the three leading causes of mortality in children. Objective: The study focused on identifying the commonly diagnosed solid and non solid cancers in children in BUTH laboratory. Methods: this was a retrospective cross sectional descriptive study conducted from January 2010 to December 2012. All admitted children were aged from 0 to 18 years. Results: Among 54 children admitted in BUTH during the period of the study, the most common cancers are solid lymphoma cancers (40.74%) followed by bone cancer (22,22%) then leukemia (22.22%) which is a non solid cancer. Male (55.50%) are more affected than female (44.40%) and the most affected age group was 10-15 years (33.33%) Conclusion: We should be more interested in the diagnosis and the management of pediatric cancers to reduce their mortality and morbidity in our hospitals. Key words: Pediatric, solid cancer, non solid cancer, Butare University Teaching Hospital LES CANCERS SOLIDES ET NON SOLIDES LES PLUS DIAGNOSTIQUES CHEZ LES ENFANTS AU LABORATOIRE DE LHOPITAL UNIVERSITAIRE DE BUTARE ETERE Winnie (HYPERLINK "mailto:eterewinnie@gmail.com"eterewinnie@gmail.com) Introduction: Ces deux dernires dcennies, de grandes batailles ont t menes en Afrique en gnral et au Rwanda en particulier dans le but de rduire la mortalit infantile. De nos jours, en dehors des causes nonatales, le cancer pdiatrique est parmi les premires causes dhospitalisation ainsi que lune des trois premires causes de mortalit infantile. Objectif: le but de ltude tait didentifier les cancers solides et non solides les plus diagnostiqus chez les enfants au Laboratoire de lHpital Universitaire de Butare. Mthodologie: Il sagissait dune tude rtrospective, compartimente en sections croises descriptives pendant une priode allant de Janvier 2010 Dcembre 2012. Tous ceux qui avaient entre 0 et 18 ans taient inclus, ainsi que ceux qui avaient t admis lHpital Universitaire de Butare. Rsultats: Parmi les 54 patients inclus dans cette tude, les cancers les plus diagnostiqus taient les cancers solides savoir le lymphome (40,74%) et lostosarcome (22,22%) suivis du cancer non solide quest la leucmie (22,22%). Les garons (55,50%) taient plus affects que les filles (44,40%) et la tranche dge la plus en vue tait 10-15ans (33.33%). Conclusion: Nous devrions davantage porter notre intrt sur le diagnostic et la prise en change des cancers pdiatriques afin de diminuer leur mortalit et leur morbidit dans nos hpitaux. Mots-cls: Pdiatrique, cancer solide, cancer non solide, Hpital Universitaire. Medullary sponge kidney: A severe case at the Yaounde Central Hospital Mbassi A.A1,3, Mekeme M.J1, Mbouch L.1, Mobi H. 3 , Fouda PJ1,2 , Angwafo III F.F2 , Sow M.1,2 Service dUrologie, Hpital Central de Yaound - Cameroun Dpartement de Chirurgie et Spcialits, FMSB, UYI. Dpartement de Chirurgie et Spcialits, ISTM Correspondance: Mbassi Achille Aurle , Mobile: +237 67758 09 52, E-mail:  HYPERLINK "mailto:drmbassi@yahoo.com"drmbassi@yahoo.com Abstract: Medullary Kidney Sponge or Cacchi-Ricci disease is the pre-caliceal ectasia of the renal ducts. Authors present history of a patient aged 56 years old, known diabetic who complained about multiple macroscopic hematuria since 31 years with transient left renal colic. Physical examination was not remarkable. A scout abdomen and CT scan showed multiple stones in left kidney region. We performed a left nephrectomy; 61 stones were extracted from the kidney and excretory duct was dilated. As Cacchi-Ricci disease generally presents with both kidneys affected, dietary and nephro-urological follow-up is necessary. LA MALADIE DE CACCHI-RICCI: A PROPOS DUN CAS SEVERE A LHOPITAL CENTRAL DE YAOUNDE Mbassi A.A1,3, Mekeme M.J1, Mbouch L.1, Mobi H. 3 , Fouda PJ1,2 , Angwafo III F.F2 , Sow M.1,2 Service dUrologie, Hpital Central de Yaound - Cameroun Dpartement de Chirurgie et Spcialits, FMSB, UYI. Dpartement de Chirurgie et Spcialits, ISTM Correspondance: Mbassi Achille Aurle, Mobile: +237 67758 09 52, E-mail: HYPERLINK "mailto:drmbassi@yahoo.com"drmbassi@yahoo.com Rsum : Nous prsentons un cas de nphrocalcinose droite compliquant une ectasie des tubes collecteurs dans la mdullaire encore appele la Maladie de Cacchi-Ricci. Il sagit en effet dun patient connu diabtique, g de 56 ans et qui prsentait depuis 31 ans de multiples pisodes dhmaturie associe des coliques frustres du flanc gauche. Lexamen physique na pas rvl danomalies. Une radiographie de larbre urinaire sans prparation a rvl de nombreuses lithiases en projection du rein gauche, luroscanner a montr une nphrocalcinose mdullaire gauche obstructive. Nous avons ralis une nphrectomie totale gauche qui nous a permis de mettre en vidence 61 concrtions dans des cavits excrtrices dilates. Lvolution post-opratoire est sans particularits. Compte tenu du caractre bilatral souvent retrouv dans la maladie de Cacchi-Ricci, des mesures hygino-dittiques ainsi quun suivi nphro-urologique sont ncessaires. Mots cls: Cacchi-Ricci, nphrocalcinose, nphrectomie Adrenal adenoma with Cushing syndrome: two cases report Mbouch L1, Kamga J2, Essomba A2, Fotso C2, Makon A3, Poyi M2, Mba 2, Kamgang2,Choukem S4, Binam F2,5, Angwafo III FF 1,5 1 Service de Chirurgie Pdiatrique Hpital Gynco-Obsttrique et Pdiatrique de Yaound 2 Service de Chirurgie Hpital Gnral de Yaound 3 Service dUrologie Hpital Central de Yaound 4 Service dEndocrinologie Hpital Gnral de Douala 5 Facult de Mdecine et des Sciences Biomdicales de lUniversit de Yaound I Correspondance: Pr Angwafo III, Fru Fobuzshi Hpital Gynco-obsttrique et Pdiatrique de Yaound Tlphone: (237) 22212431, (237)677705749 Email:  HYPERLINK "mailto:fobuzshi@yahoo.com"fobuzshi@yahoo.com Background: Adrenal tumors are often found incidentally during abdominal imaging. We report two cases of unilateral adenoma with Cushing syndrome. Objective: The goal is to present the management of two hyper functionning adrenal gland adenoma Observation: Concerning the first case, a 46 year old man known hypertensive and type 2 diabetic mellitus was addressed by endocrinologist for the management of left adrenal tumor diagnosed following a CT Scan done for abdominal swelling. He was complaining of insomnia. A 24 hour free cortisol was elevated 195 g/24h, ACTH level was < 1ng/ml. the patient underwent a left adrenalectomy. Steroid therapy was given. He developed symptoms of adrenal insufficiency and was admitted to intensive unit care. A 37 year old woman with hypertension and type 2 diabetic mellitus was addressed by endocrinology unit for left adrenal tumor. She observed weight gain, increasing abdominal girth since one year. A 24 hour free cortisol was 250g/24h, ACTH level was < 1ng/ml. a left adrenalectomy was performed. She presented symptoms of adrenal insufficiency quickly corrected by corticoid therapy. Both cases were diagnosed adenoma on the histology. Conclusion: Patient with cushing syndrome due to cortisol secreting adrenal adenoma may benefit from adrenalectomy combined with steroid therapy. A multidisciplinary approach is necessary Key words: adrenal adenoma, Cushing, adrenalectomy, steroid therapy ADENOME SURRENALIEN ASSOCIEE A UN SYNDROME DE CUSHING: A PROPOS DE 2 CAS Mbouch L1, Kamga J2, Essomba A2, Fotso C2, Makon A3, Poyi M2, Mba 2, Kamgang2,Choukem S4, Binam F2,5, Angwafo III FF 1,5 1 Service de Chirurgie Pdiatrique Hpital Gynco-Obsttrique et Pdiatrique de Yaound 2 Service de Chirurgie Hpital Gnral de Yaound 3 Service dUrologie Hpital Central de Yaound 4 Service dEndocrinologie Hpital Gnral de Douala 5 Facult de Mdecine et des Sciences Biomdicales de lUniversit de Yaound I Correspondance: Pr Angwafo III, Fru Fobuzshi Hpital Gynco-obsttrique et Pdiatrique de Yaound Tlphone: (237) 22212431, (237)677705749 Email: HYPERLINK "mailto:fobuzshi@yahoo.com"fobuzshi@yahoo.com Contexte: Les tumeurs surrnaliennes sont le plus souvent dcouvertes fortuitement au cours dune imagerie abdominale. Nous rapportons deux observations dadnome surrnalien associ un hypercorticisme. Objectif: Le but de ce travail est de rendre compte de la prise en charge de deux cas de tumeur surrnalienne cortico-scrtante opre Observation: Le premier cas est celui dun patient g de 46 ans, hypertendu et diabtique. Il a t rfr par un endocrinologue pour masse surrnalienne gauche corticoscrtante. Il se plaignait de distension abdominale, dinsomnie et avait des vergetures. Le cortisol libre urinaire tait de 195 g/24h, l ACTH<1ng/ml. Une surrnalectomie gauche a t pratique et le patient a t supplment en corticodes. La non compliance l opothrapie a conduit une insuffisance surrnalienne aigue qui a ncessit un sjour lunit de soins intensifs. Dans le deuxime cas, il sagissait dune patiente de 37 ans rfre par le service dendocrinologie pour masse surrnalienne gauche. Elle remarquait depuis 1 an une prise de poids excessive, un syndrome oedmato-ascitique. Elle tait suivie pour un diabte depuis 10 ans. Le cortisol libre urinaire tait de 250g/24h, l ACTH<1ng/ml. Une surrnalectomie gauche associe une opothrapie a t ralise. Elle a dvelopp une insuffisance surrnalienne aigue rapidement corrige par l administration de corticodes. L analyse histopathologique a rvl un adnome. Conclusion: La surrnalectomie associe une opothrapie continue doit tre de mise dans la prise en charge dadnomesurrnalien cortico-scrtant; do la ncessit dune collaboration multidisciplinaire. Mots-cls: adnome surrnalien, Cushing, surrnalectomie, corticoide Cancer of the penis: report of 2 cases treated at the Yaounde Central Hospital Auteurs: Mekeme M. J.1,Mbassi A.A. 1,Nwaha Makon A.S.2,Fouda J.C.2,Fouda P.J.1,Sow M1 1-Sevice dUrologie Hpital Central de Yaound 2-Universit Yaound I, Facult de Mdecine et des Sciences Biomdicales Correspondence: Dr MekemeMekeme Junior, Hospital Central de Yaound, Service dUrologie E-mail:  HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr, Tel: (237) 677 67 62 40 Background: Cancers of the penis are uncommon tumors. Penile carcinoma account for 0.4% to 0.6% of all malignant neoplasms among men in the United States and Europe; it may represent up to 10% of malignant neoplasms in men in some Asian, African, and South American countries. Penile cancer is a disease of older men but the incidence of this carcinoma in Cameroon is unknown. Objectives: We present two cases of squamous cell carcinoma of the penis and literature review. Observations: The first case is a 77-year-old patient presenting also a cancer of the body and gland penis and an enlarged prostate who received emasculation with bilateral lymphadenectomy and perineal urethrostomy. The second is a 40-year-old patient with cancer of the penis gland who had received a partial penectomy Conclusion: penile cancer is an aggressive tumor with a poor prognosis. Multidisciplinary consultation meetings found their interest in the case of rare cancers where treatment decisions, poorly codified, deserve to be taken collegially. Key words: squamous cell carcinoma, penectomy, emasculation URO003 TUMEURS DE LA VERGE: A PROPOS DE DEUX CAS PRIS EN CHARGE A LHOPITAL CENTRAL DE YAOUNDE. Auteurs: Mekeme M. J.1,Mbassi A.A. 1,Nwaha Makon A.S.2,Fouda J.C.2,Fouda P.J.1,Sow M1 1-Sevice dUrologie Hpital Central de Yaound 2-Universit Yaound I, Facult de Mdecine et des Sciences Biomdicales Correspondence: Dr MekemeMekeme Junior, Hospital Central de Yaound, Service dUrologie E-mail: HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr, Tel: (237) 677 67 62 40 Contexte: Le cancer du pnis est une lsion peu frquente. Il reprsente 10 20% de tous les cancers de l'homme dans certaines rgions d'Afrique et d'Asie En Europe, la prvalence est de 0,4 0,6% des cancers de l'homme. Cest une pathologie du sujet g dont lincidence est inconnue au Cameroun. Objectif: Nous rapportons deux cas de carcinome pidermode du pnis, avec revue de la littrature. Observations: Le premier un patient 77 ans prsentant en mme temps un cancer des corps et gland de la vergeet une hypertrophie de la prostate qui a bnfici dune masculation avec lymphadenectomie bilatrale et uretrostomie prinale. Le second un patient de 40 ans prsentant un cancer du gland du pnis qui a bnfici dune pnectomie partielle. Conclusion: le cancer du pnis est une tumeur agressive et de mauvais pronostic. Les runions de concertation multidisciplinaires trouvent leur intrt dans ces cas de cancers rares o la dcision thrapeutique, mal codifie, mrite dtre prise de faon collgiale. Mots cls: carcinome pidermoide, pnectomie, masculation PRIMARY URETHRAL CANCERS: A CASE OF EPIDERMOID CARCINOMA IN MEN AND ADENOCARCINOMA IN WOMEN. Correspondance: Dr Mekeme Mekeme Junior- Service dUrologie- Hpital Central de Yaound Email:  HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr Tel: 00237 677676240 Background: Urethral cancer is a rare disease in both men and women. The most frequent histological type is squamous cell carcinoma. It is often diagnosed at late stage. Objective: To report two cases of urethral cancer followed-up at the Yaounde Central Hospital. Case 1: A 77-year-old man presented with acute urinary retention. Clinical exam was unremarkable. A suprapubic catheter was inserted. Cystourethography revealed urethra stricture. A stage urethral repair was realized. Analysis revealed a squamous cell carcinoma. Bladder and prostate were invaded in subsequent check-up. Patient died after radiation therapy. Case 2: A 75-year-old woman was admitted for acute urinary retention associated with vaginal bleeding. On clinical exam, we noticed a bleeding urethral tumor. A biopsy showed an adenocarcinoma. The patient was referred for radiation therapy but since then, she is lost to follow-up. CANCERS PRIMITIFS DE L'URETRE: CAS DE CARCINOME EPIDERMOIDE CHEZ L'HOMME ET D'ADENOCARCINOME CHEZ LA FEMME. Dr Mekeme Mekeme Junior- Service dUrologie- Hpital Central de Yaound Email: HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr Tel: 00237 677676240 Contexte: Les cancers primitifs de l'urtre sont rares aussi bien chez l'homme que chez la femme. La forme histologique la plus frquente est le carcinome pidermode. Le diagnostic est souvent tardif Objectif: Rendre compte de la prise en charge de deux cas de cancer de lurtre dans le service dUrologie de LHpital Central de Yaound. Observations: Le premier patient tait un homme de 77 ans qui sest prsent avec une rtention aigue durine. Le reste de lexamen tait normal. Une cystostomie a t faite. Lurtrocystographie a montr une image de rtrcissement de l'urtre bulbo-membraneux. Un premier temps d'urthroplastie a t pratiqu. Lanalyse anatomopathologique a conclu un carcinome pidermode bien diffrenci, invasif et kratinisant d'origine papillomateuse. Le bilan dextension a rvl une atteinte prostatique et vsicale. Aprs quelques sances de radiothrapie, le patient est dcd. Le second cas est celui dune patiente de 75 ans qui a t consulte pour rtention aigue d'urine associe une mtrorragie. A l'examen, on notait une masse bourgeonnante du mat urtral avec un saignement et la prsence d'un globe vsical. Une sonde de cystostomie sus pubienne a t pose; une biopsique de l'urtre a mis en vidence un adnocarcinome de l'urtre. La patiente a t envoye en radiothrapie mais elle est perdue de vue. Conclusion: Les troubles mictionnels de types obstructifs associs une induration de lurtre chez l'homme et une image en lacune la cysto-urthrographie sont des moyens de suspicion d'une tumeur urtrale. Mots cls: urtre, carcinome pidermode, adnocarcinome. POST TRADITIONAL CIRCUMCISION PENILE SKIN DEGLOVING IN A FIVE YEAR OLD BOY: CASE REPORT DR. Muhammad Ujudud Musa, DR. Isah Muhammad Jamiu, DR. AbdulkadirAbubakar, DR. Bashir Yunusa Dr Muhammad Ujudud Musa, Urology Unit Department of Surgery Federal Medical Centre Katsina, P.M.B 2121, JibiaBypass, Katsina, Katsina State Nigeria, ujudud@gmail.com Backround: Circumcision is a surgical method in which portion of the foreskin is removed. Circumcision is one of the oldest surgical procedures performed. We did not come across complete degloving of the entire penile skin, as in this 5-year-old boy. He had application of concoction on the penis leading to sloughing of the penile skin. Objectives: Objectives is to present this rare complication of traditional circumcision following the application of a traditional concoction Case description: He presented with a history a penile swelling and pain with discharge of purulent material 5 days following a traditional circumcision and application of a concoction on the penis. Two days prior to presentation the mother noticed a discharge from the swollen penis. He was acutely ill-looking boy warm to touch (temperature 37.8C). He had a degloved penis with sloughs and purulent discharge. Patient had split thickness skin grafting on 9th day of admission. Immediate post-operative was uneventful Discussion: Circumcision is one of the common surgeries in urology, a safe and simple procedure. Serious complications can occur because of unprofessional or traditional practices. Complications range from infections to partial to total amputation of the penis. Our patient presented with a unique presentation which is complete degloving of the penile skin. 3 cases of partial penile skin deglobing reported by Sotolongo et al. Gearhart et al reported the rate of 0.2-0.6%, which ranges from bleeding to complete amputation of the glans. Gee et al reported a child with denudation of the penile skin, treated initially by burying the penis in a scrotal skin tunnel. Denudation in adult male was managed by split thickness skin grafting Conclusion: Although circumcision is regarded as a minor surgical procedure, it is not free of complications. Urologists have to pay more attention to reducing the complications. Penile injury from circumcision can have lifetime functional, psychological, and cosmetic sequel. ARRACHEMENT DE LA PEAU DU PNIS APRS UNE CIRCONCISION TRADITIONNELLE CHEZ UN PETIT GARCON DE 5 ANS: CAS CLINIQUE DR. Muhammad Ujudud Musa, DR. Isah Muhammad Jamiu, DR. AbdulkadirAbubakar, DR. Bashir Yunusa Corresponding Author; Dr Muhammad Ujudud Musa, Urology Unit Department of Surgery Federal Medical Centre Katsina, P.M.B 2121, JibiaBypass, Katsina, Katsina State Nigeria, ujudud@gmail.com Contexte: La circoncision est une procdure chirurgicale au cours de laquelle une partie du prpuce est enleve. Elle est lune des plus vieux actes chirurgicaux. Nous navions jamais rencontr un cas darrachement complet de la peau du pnis comme ctait le cas chez ce petit garon de 05 ans. Une concoction lui avait t applique sur le pnis ayant entrain larrachement de la peau de celui-ci. Objectives: Notre objectif est de prsenter cette complication rare de la circoncision traditionnelle suite lapplication dune concoction traditionnelle Description de cas: Lenfant prsentait des antcdents de gonflement du pnis accompagns de douleurs et dun coulement purulent 05 jours aprs une circoncision traditionnelle et lapplication dune concoction sur le pnis. Deux jours avant son admission lhpital, la mre a remarqu un coulement purulent du pnis enfl. Il sagissait dun garon visiblement trs malade et dont le corps tait chaud au toucher (temprature 37,8C). La peau du pnis tait arrache, desquame et un coulement purulent sen chappait. Le patient a reu une greffe dpaisseur de peau au 9me jour de son admission. Les suites opratoires immdiates taient sans incident Discussion: La circoncision est lun des actes chirurgicaux les plus courants en urologie; il sagit dune intervention sure et simple. De graves complications peuvent survenir en raison de pratiques non professionnelles ou traditionnelles. Les complications vont des infections lablation partielle ou totale du pnis. Le cas de notre patient, larrachement total de la peau du pnis, tait unique 3 cas darrachement partiel de la peau du pnis ont t rapport par Sotolongo et al. Gearhart et al. Ont rapport un taux de 0,2 0,6%, qui varie des saignements lablation complte du gland. Gee et al. ont dcrit le cas dun enfant dont la peau du pnis a t compltement dnude, son traitement initial a consist cacher le pnis dans un tunnel scrotal. Un adulte mle prsentant un pnis dnud a t traite par une greffe dpaisseur de peau Conclusion: Bien que la circoncision soit considre comme un acte chirurgical simple, elle nest pas exempte de complications. Les urologues doivent davantage veiller rduire ces complications. Les blessures pniennes lies la circoncision peuvent laisser des squelles fonctionnelles, psychologiques et cosmtiques vie. Uroflowmetry in the Management of Lower Urinary Tract Symptoms in Ibadan, Nigeria Toluyemi Malomo, Ambrose Anegbe, S. Adekola Adebayo, Augustine Takure, Linus O Okeke, Olayiwola B, Shittu and E.Oluwabunmi Olapade-Olaopa PIUTA Ibadan Centre, Department of Surgery, University of Ibadan and University College Hospital, Nigeria Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: piutaibadan@yahoo.com Introduction: Lower urinary tract symptoms (LUTS) account for 75% of presentations to the Urology Division of the University College Hospital, Ibadan. These patients are now routinely evaluated with the International Prostate Severity Score (IPSS) questionnaire and uroflowmetry. This study reports on our experience with these established and validated tools in the management of LUTS in our center. Patients and Methods: Records of all patients presenting our center with LUTS between 2010- and 2015 and who had no prior intervention were scrutinized. Subjective and objective severity of LUTS was evaluated with the IPSS questionnaire and uroflowmetry (using MMS uroflowmeter FCC-ID: POOWML-C40XX). The data were analyzed with SPSS (version 22). Parameters evaluated were IPSS, Quality of life (QoL), and average flow rate (AFR) and Post voidal residual (PVR). Results: Five hundred and sixteen patients were evaluated for LUTS in the study period. Using IPSS, 45%, 44% and 11% patients had mild, moderate and severe LUTS respectively. Further analysis showed that 62% of patients with mild LUTS had AFR suggestive of lower urinary tract obstruction, while 88.2% and 78.9% in the group with moderate and severe LUTS respectively had AFR suggestive of LUO (p=0.001). Conclusion: This study confirms that uroflowmetry correlates significantly with IPSS in patients with moderately-severe LUTS. It is also useful in identifying patients whose LUTS are not due to bladder outlet obstruction. LA DEBITMETRIE URINAIRE DANS LA PRISE EN CHARGE DES SYMPTOMES DES VOIES URINAIRES INFERIEURES A IBADAN, NIGERIA Toluyemi Malomo, Ambrose Anegbe, S. Adekola Adebayo, Augustine Takure, Linus O Okeke, Olayiwola B, Shittu and E.Oluwabunmi Olapade-Olaopa PIUTA Ibadan Centre, Department of Surgery, University of Ibadan and University College Hospital, Nigeria Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: piutaibadan@yahoo.com Introduction: les Maladies des voies urinaires infrieures (MVUI) reprsentent 75% des visites la Division durologie de lUniversity College Hospital dIbadan. Ces patients sont maintenant valus rgulirement laide du questionnaire de lInternational Prostate Severity Score (IPSS) et de la dbitmtrie urinaire. Cette tude rend compte de notre exprience avec ces outils tablis et valids dans la prise en charge des MVUI dans notre centre. Patients et Mthodes: Les dossiers de tous les patients ayant visit notre centre pour motif de MVUI entre 2010 et 2015 et qui navaient subi aucune intervention au pralable ont t examins attentivement. La gravit objective et subjective des MVUI ont t values laide du questionnaire IPSS et de la dbitmtrie urinaire (par la dbitmtrie urinaire MMS FCC-ID: POOWML-C40XX). Les donnes ont t analyses avec SPSS (version 22). Les paramtres valus taient IPSS, la qualit de vie (QV), le dbit moyen (DM) et le rsidu post mictionnel (RPM). Rsultats: Cinq cent seize patients ont t valus pour les MVUI pendant la priode dtude. Lutilisation de lIPSS a montr que 45%, 44% et 11% des patients avaient respectivement des MVUI bnignes, modres et svres. Une analyse plus pousse a montr que 62% des patients prsentant des MVUI bnignes avaient une AFR indiquant une obstruction des voies urinaires infrieures, tandis que 88,2% et 78,9% dans le groupe ayant des MVUI modres et svres avaient respectivement une AFR indiquant une LUO (p=0.001). Conclusion: Cette tude confirme que la dbitmtrie urinaire correspond de faon significative lIPSS chez les patients prsentant des MVUI modrment svres. Elle est galement utile pour lidentification des patients dont les MVUI ne sont pas dues lobstruction vsicale. Circumcaval Ureter: A case report at the Norwegian Hospital of NGaoundr Danki Sillong F2, Nwaha Makon AS1, Mbouche L3, Essomba A1, Sow NM1, Fouda JC1, Angwafo III1, 3. 1 Facult de Mdecine et des Sciences Biomdicales. 2 Hpital Norvgien de NGaoundr. 3 Hpital Gynco-Obsttrique et Pdiatrique. Correspondance: Dr DANKI SILLONG Franklin, Hpital Norvgien de NGaoundr, danki_franklin@yahoo.fr Background: Circumcaval ureter is a congenital obstruction of the ureter in association with an anomalous course to the inferior vena cava (IVC).The reported incidence of circumcaval ureter is approximately 1 in 1100. There is a 2.8-fold male predominance. Objectives: to report a new observation of right circumcaval ureter and literature review. Observation: A 29-year-old female patient with no particular medical history. The presenting symptom was right flank pain. Imaging studies made the diagnosis of type I right retrocaval ureter. A satisfactory result was obtained by rotating the urethra and JJ stent fixation. Conclusion: a rare congenital malformation solely diagnosed by imaging. Keywords: Retrocaval ureter; Renal colic; Pelvicaliceal dilatation URETERE RETROCAVE: A PROPOS DUN CAS A LHOPITAL NORVEGIEN DE NGAOUNDERE. DankiSillong F2, Nwaha Makon AS1, Mbouche L3, Essomba A1, Sow NM1, Fouda JC1, Angwafo III1, 3. 1 Facult de Mdecine et des Sciences Biomdicales. 2 Hpital Norvgien de NGaoundr. 3 Hpital Gynco-Obsttrique et Pdiatrique. Dr DANKI SILLONG Franklin, Hpital Norvgien de NGaoundr, danki_franklin@yahoo.fr Contexte: Lurtre rtrocave (circumcave ou postcave) est une anomalie congnitale rare du rapport de la veine cave infrieureet luretre. Par rapport au nombre dautopsies, la frquence de cette anomalie est de lordre de 1/1100avec une prdominance pour les hommes (2,8). Objectif: Rapporter 01 nouveau cas duretre rtro caveobserv dans notre structure hospitalire et faire la revue de la littrature. Observation: il sagit dune patiente ge de 29 ans, sans antcdents particuliers. La symptomatologie dappel a t une douleur lombaire droite. Les examens dimagerie ont permis de poser le diagnostic duretre rtro cave droitde type I selon Kenawi et Williams. Une lombotomie droite avec dcroisement de luretre et monte de sonde JJ, ont permis davoir un rsultat satisfaisant. Conclusion: Malformation congnitale rare dont le diagnostic est lapanage des moyens dimagerie. UNUSUAL VESICAL CALCULUS: A RARE CONSEQUENCE OF SELF-INSERTED FOREIGN BODY PER-URETHRA FOR SEXUAL GRATIFICATION 1TELA UM, 2ABUBAKAR A,3ADAMU SA, 4AHMED M, 5ABUBAKAR BM 1Division of Urology, Department of Surgery, University of Maiduguri Teaching Hospital, Borno State, Nigeria. 2Urology unit, Department of Surgery, Aminu Kano Teaching Hospital, Kano state, Nigeria. 3Department of Anaesthesiology, University of Maiduguri Teaching Hospital, Borno State, Nigeria. 4Division of urology, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. 5Department of Surgery, Federal Medical Centre, Nguru, Yobe state, Nigeria Correspondence :Dr.Usman M. Tela, Division of Urology, Department of Surgery, University of Maiduguri Teaching Hospital, Borno State, Nigeria. Email:  HYPERLINK "mailto:umtela@yahoo.com"umtela@yahoo.com Telephone: +2347033733312 Aim: To draw attention to this rare presentation resulting from prolonged retention of self -inserted foreign body for sexual gratification. Method: Case report The Case: We report the case of 21 year old male student who presented with Progressive lower urinary tract symptoms, mainly irritative with strangury and occasional terminal haematuria. He was evaluated for vesical calculus. He had cystolithotomy with findings of donut-like calculus encasing a coiled cable. Post-operative outcome was satisfactory. Conclusion:A retained self-inserted foreign body per-urethra are usually bothersome and intervened within limited time. When clinical information are hidden by the patient, intervention will be delayed and can result as a nidus for calculus. CALCUL VSICAL INHABITUEL: UNE CONSEQUENCE RARE DE LAUTO INSERTION DUN CORPS TRANGER PAR LURTRE A DES FINS DE GRATIFICATION SEXUELLE 1TELA UM, 2ABUBAKAR A,3ADAMU SA, 4AHMED M, 5ABUBAKAR BM 1Division of Urology, Department of Surgery, University of Maiduguri Teaching Hospital, Borno State, Nigeria. 2Urology unit, Department of Surgery, Aminu Kano Teaching Hospital, Kano state, Nigeria. 3Department of Anaesthesiology, University of Maiduguri Teaching Hospital, Borno State, Nigeria. 4Division of urology, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. 5Department of Surgery, Federal Medical Centre, Nguru, Yobe state, Nigeria Correspondence : Dr.Usman M. Tela, Division of Urology, Department of Surgery, University of Maiduguri Teaching Hospital, Borno State, Nigeria. Email: HYPERLINK "mailto:umtela@yahoo.com"umtela@yahoo.com Telephone: +2347033733312 Objectif: attirer lattention sur cette prsentation rare associe la rtention prolonge de corps tranger auto-insr en vue dune gratification sexuelle. Mthode: Etude de cas Cas: Nous prsentons le cas dun tudiant de 21 ans de sexe masculin qui sest prsent avec des symptmes progressifs affectant les voies urinaires infrieures, particulirement irritants avec strangurie et hmaturie terminale occasionnelle. Il a subi une valuation du calcul vsical. La cystolithotomie a rvl un calcul en forme de beignet recouvrant un cble en spiral. Le rsultat post-opratoire a t satisfaisant. Conclusion: Un corps tranger auto-insr retenu par lurtre est habituellement gnant et intervient dans un dlai limit. Lorsque le patient cache les informations cliniques, lintervention sera retarde et peut devenir un foyer de calcul. ANATOMO-PATHOLOGICAL AND PRONOSTIC ASPECTS OF KIDNEY TUMORS IN ADULTS: A REPORT OF 35 CASES IN YAOUNDE Auteurs: Essomba A, Mekeme J, Mbassi A, Kamga J, Mbouche L, Fouda PJ, Sow M, Angwafo F Correspondant: Pr ANGWAFO III Fru Facult de Mdecine et des Sciences Biomdicales Hpital Gnral de Yaound Pr SOW Mamadou Hpital Central de Yaound From January 2010 to June 2015 we carried out a retrospective, prospective and analytic study of 35 cases of renal tumors at the urology and surgical services of the Yaounde Central Hospital and Yaounde General Hospital respectively. The mean age was 54, 69 years (21-80 years) with a female predominance 76% (n=26). Flank pain was the most common symptom (91%), hematuria (49%), lumbar mass (29%) and 3 cases (9%) were discovered incidentally. All the patients had renal ultrasound and 31 patients (89%) had renal scan. 20 patients (57%) had right renal tumors with a superior right pole predominance (60%), visceral metastasis (11%) and vena cava thrombosis (11%). Stage I (40%), II (29%) according to ROBSON and T2 (37%) tumors were the most frequent. 24 patients (69%) had radical nephrectomy while 3 patients (9%) had partial nephrectomy; and 2 patients (6%) had surgery for metastasis. Renal cell carcinoma was seen in 23 patients (66%), 3 cases of angiomyolipoma (8%) and 4 cases of complex cysts (11%) were recorded. 18 patients had simple evolution (51%), 3 patients developed surgical site suppurations (9%), 5 patients had hemorrhages (14%) and 3 cases of pulmonary embolism (9%). The median survival of the patients was estimated at 30 months. Key-words: kidney tumors, nephrectomy, renal cell carcinoma ASPECTS ANATOMO-PATHOLOGIQUES ET PRONOSTIQUES DES TUMEURS RENALES DE LADULTE: A PROPOS DE 35 CAS A YAOUNDE Essomba A, Mekeme J, Mbassi A, Kamga J, Mbouche L, Fouda PJ, Sow M, Angwafo F Pr ANGWAFO III Fru Facult de Mdecine et des Sciences Biomdicales Hpital Gnral de Yaound Pr SOW Mamadou Hpital Central de Yaound Rsum: A partir dune tude rtrospective, prospective et analytique, nous rapportons 35 cas de tumeurs rnales de ladulte dans les services durologie de lHpital Central et de Chirurgie de lHpital Gnralde Yaound, de la priode allant de Janvier 2010 Juin 2015. Lge moyen tait de 54,69 ans (21-80 ans). Le sexe fminin prdominait 76% (n=26). Les douleurs lombaires reprsentaient le signe urologique le plus frquent 91%, lhmaturie 49%, les masses lombaires 29%, 3 cas de dcouvertes fortuites ont t observs (n=9%). Lchographie rnale a t ralise chez tous les patients (n=35), le scanner chez 31 patients (89%). La localisation de la tumeur rnale droite tait 57% (n=20) avec une prdominance au ple suprieur droit (60%), des mtastases viscrales (11%) et des thrombus cave (11%) ont t retrouvs. Les stades tumoraux I (40%), II (29%) selon ROBSON et T2 (37%) taient les plus frquents. La nphrectomie largie a t ralise chez 24 patients (69%), tandis que la nphrectomie partielle chez 3 patients (9%), et la chirurgie pour mtastases 6% (n=2). Le carcinome cellules rnales a t retrouv 66% (n=23), 3 cas dangiomyolipomes (8%) et 4 cas de kystes complexes (11%) ont t enregistrs. 18 patients ont eu une volution simple (51%), 3 patients des suppurations (9%), 5 cas dhmorragies (14%) et 3 cas dembolies pulmonaires (9%) ont t enregistrs. La mdiane de survie des patients a t estime 30 mois. Mots cls: tumeurs rnales, nphrectomie, carcinome cellules rnales Prostate Cancer: Experience with 100 patients in a single center in Douala Cameroon. KAMADJOU C. (1); KAMGA J. (2); EYONGETA D. (3); TENKE C.(1); KAMENI A. (1) ; NJINOU B. (1) 1. Centre Mdico Chirurgical dUrologie, Douala Cameroun 2. Hpital Gnral, Yaound Cameroun 3. Hpital Gnral, Douala Cameroun Correspondance: Dr Kamadjou Cyril : Centre Mdico Chirurgical dUrologie. Valle Manga Bell Bali Douala Cameroun. HYPERLINK "mailto:cyrkamadjou@yahoo.fr"cyrkamadjou@yahoo.fr Purpose: Describe and evaluate how to manage patients with prostate cancer in a single center in Cameroon. Materials and methods: Between January and April 2015, 100 patients were diagnosed with a prostate cancer after prostate biopsy. A CT scan was performed in many cases to initiate the treatment. Results: The mean age was 65 and the digital examination was pathologic in 65% of cases. Prostate cancer history was found in 7% of patients. 64% of the patients had low urinary tract symptoms and the mean PSA was 432,35 ng/ml. Prostate biopsy was performed in all patients by trans rectal ultrasonography and in 93% the histology was an adenocarcinoma. The Gleason score was superior to 7 in 53% of patients. Bone mets were discribed in 20 patients. Radical prostatectomy was performed in 24% of patients, 16 patients underwent orchiectomy, 27 a deprivation hormone therapy and we proposed an active surveillance in only one patient. A first line Chemotherapy was initiated in 5 patients. At least, 32 patients did not start a treatment and 2 deaths were observed before starting the treatment. Conclusion: In our experience, prostate cancer is often diagnosed late in life when curative treatment is not an option. Patients do not accept radical prostatectomy due to urinary incontinence and impotence. CANCER DE LA PROSTATE: EXPERIENCE MONOCENTRIQUE AVEC 100 PATIENTS A DOUALA AU CAMEROUN KAMADJOU C. (1); KAMGA J. (2); EYONGETA D. (3); TENKE C.(1); KAMENI A. (1) ; NJINOU B. (1) 1. Centre Mdico Chirurgical dUrologie, Douala Cameroun 2. Hpital Gnral, Yaound Cameroun 3. Hpital Gnral, Douala Cameroun Correspondance: Dr Kamadjou Cyril : Centre Mdico Chirurgical dUrologie. Valle Manga Bell Bali Douala Cameroun.HYPERLINK "mailto:cyrkamadjou@yahoo.fr"cyrkamadjou@yahoo.fr Objectif: Dcrire et valuer la prise en charge les patients atteints du cancer de la prostate dans un seul centre au Cameroun. Matriels et mthodes: Entre janvier et avril 2015, 100 patients ont t diagnostiqus atteints de cancer de la prostate aprs une biopsie de la prostate. Un scanner a t ralis dans de nombreux cas pour initier le traitement. Rsultats: Lge moyen tait de 65 ans et l'examen numrique tait pathologique dans 65% des cas. Un antcdent de cancer de la prostate a t rvl chez 7% des patients. 64% des patients avaient des symptmes au niveau des voies urinaires basses et le PSA moyen tait de 432,35 ng / ml. Une biopsie de la prostate a t ralise chez tous les patients par chographie transrectale et 93% l'histologie tait un adnocarcinome. Le score de Gleason tait suprieur 7 chez 53% des patients. Les mtastases osseuses ont t dcrites chez 20 patients. La prostatectomie radicale a t ralise chez 24% des patients, 16 patients ont subi une orchidectomie, 27 un traitement par privation dhormone et nous avons propos une surveillance active chez un seul patient. La chimiothrapie de premire intention a t initie chez 5 patients. Au moins, 32 patients nont pas commenc un traitement et 2 dcs ont t enregistrs avant le dbut du traitement. Conclusion: Daprs notre exprience, le cancer de la prostate est souvent diagnostiqu tardivement lorsque le traitement curatif nest plus possible. Les patients nacceptent pas la prostatectomie radicale en raison de l'incontinence urinaire et de limpuissance. Epidemiological, clinical and therapeutic aspects of male circumcision complications at the Yaounde Central Hospital Mbassi AA1,3, MekemeMJ1, MbouchL1, Mobi H3, Tchinda P, Fouda PJ1,2,Angwafo III FF2 , SowM.1,2 Service dUrologie, Hpital Central de Yaound - Cameroun Dpartement de Chirurgie et Spcialits, FMSB, UYI. Dpartement de Chirurgie et Spcialits, ISTM Mbassi Achille Aurle, Mobile: +237 77 58 09 52 , E-mail: drmbassi@yahoo.com Objective: To determine the epidemiological, clinical and therapeutic aspects of circumcision at the Yaounde Central Hospital. Materials and methods: it is a retrospective study carried out on the medical records of 54 patients admitted at the Urology clinic of the Yaounde Central Hospital from 2000 to 2014. Outcome variables for analysis were described through their mean, maximum, minimum, number and percentage. p<0, 05. Results: mean age at operation was 3.05 years. Circumcision was performed in a hospital setting in 48.10 cases and realized by paramedical personnel in 22 cases (40.70%). Mean period for consultation was 5.58 months. Dysuria was the main complaint (63%). Urethrocutaneous fistula was the major complication in 26 cases (48.10%). Meatotomy was the most practiced surgery (36.70%). Fistula closure was realized in 10 cases (20.40%). Conclusion: circumcision is a surgery which can result in complications particularly on micturition and the sexual outcomes of the individual. ASPECTS EPIDEMIOLOGIQUES, CLINIQUES ET THERAPEUTIQUES DES COMPLICATIONS DE LA CIRCONCISION A LHOPITAL CENTRAL DE YAOUNDE. Mbassi AA1,3, MekemeMJ1, MbouchL1, Mobi H3, Tchinda P, Fouda PJ1,2,Angwafo III FF2 , SowM.1,2 Service dUrologie, Hpital Central de Yaound - Cameroun Dpartement de Chirurgie et Spcialits, FMSB, UYI. Dpartement de Chirurgie et Spcialits, ISTM Correspondance: Mbassi Achille Aurle, Mobile: +237 77 58 09 52, E-mail: drmbassi@yahoo.com Objectif: dterminer les aspects pidmiologiques, cliniques et thrapeutiques des complications de la circoncision lHpital Central de Yaound. Mthodologie: il sagit dune tude rtrospective portant sur les dossiers mdicaux des 54 patients reus et pris en charge dans le Service dUrologie de lHpital Central de Yaound sur une priode de 14 ans, pour la priode de 2000 2014. Les variables ont t analyses par leur moyenne, maximum, minimum, effectif et pourcentage en considrant un seuil de signification p<0,05. Rsultats: la moyenne dge au moment de la circoncision tait de 3,05 ans. Les circoncisions taient ralises dans 48,10% des cas lhpital. Loprateur tait paramdical chez 22 patients (40,70%). Le dlai moyen de consultation en milieu spcialis tait de 5,58 mois. 34 (63%) patients se prsentait la consultation avec pour motif la dysurie. La complication majeure tait la fistule urthro-cutane dans 48,10% des cas. La matotomie a t ralis chez 18 patients (36,70%), la cure de fistule urthro-cutane chez 10 patients (20,4%). Conclusion: la circoncision nest pas un acte banal car les complications qui en dcoulent ont un retentissement sur la qualit de la miction et le devenir sexuel de lindividu. PENILE FRACTURE: EPIDEMIOLOGIC, CLINICAL, THERAPEUTIC AND PROGNOSTIC FEATURES. REPORT OF 15 CASES AT THE YAOUNDE CENTRAL HOSPITAL ESSOMBA A2, SOW N2, FOUDA P J1,2, ANGWAFO III F2, SOW M1,2 (1)Hpital Central de Yaound (2)Dpartement de Chirurgie et Spcialits, FMSB (3)Dpartement de Chirurgie et Spcialits, ISTM (4)Facult de Mdecine et de Sciences Pharmaceutique, Universit de Douala Correspondant: Dr MBASSI Achille Aurle, Hpital Central de Yaound, Email:  HYPERLINK "mailto:drmbassi@yahoo.com"drmbassi@yahoo.com, Tel+237677580952 Introduction: Penile fracture is a rare traumatic emergency generally occurring in a context of deviant sexual behaviors and requiring immediate management. The goal of this work is to outline the profile of these patients received at the emergency unit and to assess the prognosis after management in the urology service of the Yaounde Central Hospital. Patients and methods: This is a descriptive and retrospective study, from 2008 to 2014, concerning 15cases of penile fractures received in our setting. Results: Extremes of age were 22 and 48 years, with a median of 35. The delay of consultation was few hours in all cases. Coitus injury was the main mechanism of trauma, following deviant sexual behaviors in almost all cases. Four cases had acute urinary retention associating a penile fracture and urethral rupture. The remaining eleven were sole fractures with 3 ruptures of both corpus cavernosum and 8 having one corpus cavernosum ruptured. The mean delay of surgery was an hour. The functional prognosis still remains to be assessed with all patients lost to follow-up. Conclusion: The immediate management of penile fractures guarantees functional recovery. Key words: fracture, penile, epidemiologic, clinical, therapeutic, prognosis. FRACTURE DE VERGE: ASPECTS EPIDEMIOLOGIQUES, CLINIQUES, THERAPEUTIQUES ET PRONOSTIC. A PROPOS DE 15 CAS A LHOPITAL CENTRAL DE YAOUNDE MBASSI A A1,3, MEKEME M J1, MOBY H4, MBOUCHE L2, DOUANLA D E2, MAKON A S2, ESSOMBA A2, SOW N2, FOUDA P J1,2, ANGWAFO III F2, SOW M1,2 (1)Hpital Central de Yaound (2)Dpartement de Chirurgie et Spcialits, FMSB (3)Dpartement de Chirurgie et Spcialits, ISTM (4)Facult de Mdecine et de Sciences Pharmaceutique, Universit de Douala Correspondant: Dr MBASSI Achille Aurle, Hpital Central de Yaound, Email: HYPERLINK "mailto:drmbassi@yahoo.com"drmbassi@yahoo.com, Tel+237677580952 Introduction: La fracture de verge est une urgence traumatique rare survenant gnralement dans un contexte de comportement sexuel dviant et ncessitant une prise en charge immdiate. Le but de ce travail est de ressortir le profil de ces patients reus aux urgences et dvaluer le pronostic aprs prise en charge au service durologie de lHCY. Patients et mthode: Il sagit dune tude rtrospective, descriptive allant de 2008 2014, et portant sur15cas de fracture de verge reus dans notre service. Rsultats: Les extrmes dge taient de 22ans 48ans pour un ge moyen de 35ans. Le dlai de consultation tait de quelques heures dans tous les cas. Le faux pas cotal tait le mcanisme lsionnel frquent, suite des comportements sexuels dviants dans la quasi-totalit des cas. Quatre cas avaient une rtention aigue durine, associant une fracture de verge et une rupture de lurtre. Les onze autres cas taient de fractures de verge dont 3 avec rupture des deux corps caverneux et 8 ayant rompu un seul corps caverneux. Le dlai moyen de prise en charge chirurgicale tait dune heure. Le pronostic fonctionnel reste encore valuer chez ces patients perdus de vue. Conclusion: La prise en charge immdiate de la fracture de verge garantie la rcupration fonctionnelle. Mot cls: fracture, verge, pidmiologique, clinique, thrapeutique, pronostic Obstetric fistula control campaigns in Cameroon: experiences and lessons Mekeme M. J1; Mbassi A. A.1; Moby H2, Mbouche L3F, Fouda C4 , Nwaha M4, Fouda P.J.1, Sow M.1; Angwafo III F4.; Sosso M.A.4 1Hopital Central de Yaound, Service dUrologie 2Hopital Bonassama Douala 3Hopital Gynco-obsttrique et Pdiatrique de Yaound 4 Universit de Yaound I, FMSBM Correspondence: Dr Mekeme Mekeme Junior Service dUrologie Hopital Central de Yaound Email:  HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr, Tel: 00237 677676240 Obstetrical fistula is an abnormal communication between bladder and vagina or between rectum and vagina following an obstructed labour. It is a public health problem particularly in poor regions. Objective: To give back the outcomes of obstetrical fistula treatment using a flap to improve pelvic continence Material and method: We conducted a prospective and retrospective study in several health facilities in Cameroon during 12 months. All patients with cervico-urethral fistula and who underwent surgery by using a flap were included. Results: We performed surgery on 28 patients aged from 15 to 45 years old. Partial breakdown was observed in 5 patients. 18 % of patients presented with stress incontinence. 3 cases of total incontinence were registered. Success rate was 82.1% Conclusion: The flap use to repair fistula respects the external urethra sphincter. This technique is easy to apply singularly for young surgeons. Key words: Obstetrical fistula, flap, Cameroon CAMPAGNES DE LUTTES CONTRE LES FISTULES OBSTETRICALES AU CAMEROUN: EXPERIENCES ET LEONS Mekeme M. J1; Mbassi A. A.1; Moby H2, Mbouche L3F, Fouda C4 , Nwaha M4, Fouda P.J.1, Sow M.1; Angwafo III F4.; Sosso M.A.4 1Hopital Central de Yaound, Service dUrologie 2Hopital Bonassama Douala 3Hopital Gynco-obsttrique et Pdiatrique de Yaound 4 Universit de Yaound I, FMSBM Correspondance: Dr Mekeme Mekeme Junior Service dUrologie, Hopital Central de Yaound, Email: HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr, Tel: 00237 677676240 Contexte: La fistule obsttricale est une communication anormale entre la vessie et le vagin ou le rectum et le vagin aprs un accouchement dystocique. Cest un problme de sant publique surtout dans les rgions o la disponibilit des soins nonataux et obsttricaux est insuffisante. Objectifs: Le but de notre travail tait de rendre compte de notre exprience dans la prise en charge des fistules obsttricales au Cameroun en utilisant un lambeau de voisinage en vue damliorer la continence dans les fistules cervicale, cervico-vaginale et urthro-vaginale. Mthodologie: Il sagissait dune tude prospective avec un volet rtrospectif conduit dans plusieurs formations sanitaires du Cameroun pendant une priode de 12 mois. Ont t inclus toutes les patientes prsentant une fistule obsttricale associe des lsions cervico-urthrales et chez qui la technique du lambeau de voisinage a t applique. Rsultats : La technique a t applique chez 28 patientes ges de 15 44 ans. Le lchage des sutures a t observ chez 5 patientes. 18 % des patientes (n=5) ont eu une incontinence leffort. Trois cas dincontinence totale ont t enregistrs et ont persist au-del de 12 mois. Le taux de russite a t de 82,1%. CONCLUSION : Lutilisation du lambeau de voisinage permet de respecter le sphincter stri de lurtre, elle remet la vessie dans son enceinte manomtrique. En outre, cest une technique facile et accessible pour les jeunes chirurgiens dans les situations disolement. Mots cls: fistules obsttricales, lambeau, Cameroun FOURNIERS GANGRENE: EPIDEMIOLOGICAL AND CLINICAL ASPECTS AT THE YAOUNDE CENTRAL HOSPITAL MEKEME M J1, MBASSI A. A.1, MBOUCHE L2, KENMOE M1, NWAHA M1 FOUDA PJ3, SOW M3. 1 Service de chirurgie urologique Hpital Central de Yaound 2 Hpital gynco-obsttrique et Pdiatrique de Yaound 3 Universit de Yaound I, Facult de Mdecine et des Sciences Biomdicales Correspondance: Dr Mekeme Mekeme Junior Service dUrologie, Hopital Central de Yaound, Email:  HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr, Tel: 00237 677676240 Background: Fourniers gangrene is a necrosis of soft tissues of the perineum and external genitalia. Treatment combines resuscitation, antibiotic and necrosectomy Objective: The purpose of this study was to highlight the epidemiological and clinical aspects of the Fourniers gangrene at the Yaounde Central Hospital Material and method: We carried out a retrospective and descriptive study over a period of six years at the Yaounde Central Hospital. We enrolled all files of patients treated and followed-up for Fourniers gangrene. Variables included were sociodemographic parameters, clinical findings, risk factors, prognosis, mortality. Results: 52 cases were enrolled. The median age of patients was 47. 42 18.25 years. The most common risk factors were alcohol (25%), diabetes mellitus (19. 44%), HIV-AIDS (13.89%). The major complaint was scrotal swelling (71.20%) with an average period of 9.25 6.84 days for consultation. Fever (100%), local pain and edema (96.20%) were almost present. 69.20% of patients were seen at the stage of necrosis. The most common clinical form was localized on external genitalia (40%). The mortality rate was 15.40%. Conclusion: Fourniers gangrene is no longer rare in our milieu. This medico-surgical emergency needs to be known by the majority of practitioners. Key words: Fourniers gangrene, Yaounde Central Hospital GANGRENE DE FOURNIER : ASPECTS EPIDEMIOLOGIQUES ET CLINIQUES A LHOPITAL CENTRAL DE YAOUNDE MEKEME M J1, MBASSI A. A.1, MBOUCHE L2, KENMOE M1, NWAHA M1 FOUDA PJ3, SOW M3. 1 Service de chirurgie urologique Hpital Central de Yaound 2 Hpital gynco-obsttrique et Pdiatrique de Yaound 3 Universit de Yaound I, Facult de Mdecine et des Sciences Biomdicales Correspondance: Dr Mekeme Mekeme Junior Service dUrologie, Hopital Central de Yaound, Email: HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr, Tel: 00237 677676240 Contexte: La gangrne de Fournier est une ncrose fulminante des tissus mous du prine et des organes gnitaux externes. La prise en charge repose sur la ranimation, lantibiothrapie et la ncrosectomie. Cest une affection insidieuse dont le retard diagnostique peut tre fatal pour le patient. Objectif: Le but de notre tude tait de ressortir les aspects pidmiologiques et cliniques de la gangrne de Fournier Mthodologie : Il sest agi dune tude rtrospective de type descriptif, portant sur les dossiers des patients traits et suivis pendant une priode de six ans lHpital Central de Yaound. Les variables tudies portaient sur les paramtres sociodmographiques, le tableau clinique, les facteurs de mauvais pronostic, la mortalit. Rsultats: 52 cas ont t colligs. Lge moyen tait de 47,42 18,25 ans. Les facteurs de risque prdominants ont t les suivants : lalcoolisme (25%), le diabte (19 ,44%), le VIH-Sida (13,89%). Le principal motif de consultation tait la tumfaction scrotale (71 ,20%) avec un dlai moyen de 9,25 6,84 jours. la fivre (100%), la douleur locale et ldme local (96,20%) taient quasi constants et 69,20% des patients venaient consulter au stade de ncrose. La forme clinique la plus rencontre tait la forme scrotale (40%). Le taux de mortalit tait de 15,40%. Conclusion: La gangrne de Fournier nest plus une maladie rare dans notre milieu. Les auteurs plaident pour une meilleure connaissance de cette pathologie par les praticiens car cest une urgence mdico-chirurgicale. Mots cls: gangrne de fournier, Hpital Central de Yaound CLINICAL, THERAPEUTIC AND EVOLUTIVE ASPECTS OF PROSTATE CANCER AT THE YAOUNDE CENTRAL HOSPITAL AND THE YAOUNDE GENERAL HOSPITAL Mekeme J.1, Moby H2 ,Mbassi A. A.1,Mbouche L3, Ndgishe F.L.4,Fouda P.J.1, Angwafo Fru III 5, Sow M.1,Yomi J.5, Sosso M. A.5. 1-Service dUrologie Hpital Central de Yaound 2- Hpital Bonassama Douala 3-Service de Chirurgie Pdiatrique Hpital Gynco-Obsttrique et Pdiatrique de Yaound 4-Universit des Montagnes 5-Universit Yaound I, Facult de Mdecine et des Sciences Biomdicales Background: Prostate cancer is the most common cancer in men. The majority of patients in our environment are diagnosed late. Currently, treatment benefit from the progress in molecular diagnosis, technology and new target therapy. Objective: To report the clinical, therapeutic and evolutive aspects of prostate cancer in two referral hospitals. Materials and methods: We carried out a retrospective and prospective study at the Yaounde Central Hospital and the Yaounde General Hospital during a period of 9 years (January 2005 to December 2014). We included 174 patients. The variables of interest included: age of patient, clinical and paraclinical parameters, treatment protocol. Results: The median age of patients was 67.9 8 years. Urinary symptoms were predominant (81.60%). Hypertension was associated in 45.9%. Digital rectal examination combined with transrectal ultrasound suspected a prostate cancer in 96.6%. The mean value of PSA was 1345,3 3116,34 ng/ml. 54.5% of patients (n=95) were diagnosed at stage T4. Adenocarcinoma (97.70%) was the predominant histological pattern. Hormonal therapy was used in all patients. The median overall survival was 27 months. Conclusion: Treatment of prostate cancer in our region demands standardization of diagnostic and therapeutic protocol so that all patients would benefit from various management options. Key words: prostate cancer, treatment, survival, Yaound ASPECTS CLINIQUES, THERAPEUTIQUES ET EVOLUTIFS DU CANCER DE LA PROSTATE A LHOPITAL CENTRAL ET LHOPITAL GENERAL DE YAOUNDE Mekeme J.1, Moby H2, Mbassi A. A.1, Mbouche L3, Ndgishe F.L.4, Fouda P.J.1, Angwafo Fru III 5, Sow M.1,Yomi J.5, Sosso M. A.5. 1-Service dUrologie Hpital Central de Yaound 2- Hpital Bonassama Douala 3-Service de Chirurgie Pdiatrique Hpital Gynco-Obsttrique et Pdiatrique de Yaound 4-Universit des Montagnes 5-Universit Yaound I, Facult de Mdecine et des Sciences Biomdicales Contexte: Le cancer de la prostate est la tumeur maligne la plus frquente chez lhomme. La prise en charge a bnfici des progrs du diagnostic cyto-gntique, de la technologie et des nouvelles molcules. Le diagnostic est tardif dans notre contexte Objectif: Le but de notre tude tait de faire ressortir les aspects cliniques, thrapeutiques et volutifs du cancer de la prostate dans deux hpitaux de rfrence. Mthodologie: Il sagissait dune tude descriptive et rtrospective, incluant 174 dossiers des patients traits et suivis lHpital Central et lHpital Gnral de Yaound pendant une priode de 9 ans allant de Janvier 2005 Dcembre 2014. Lge, les signes cliniques et paracliniques, les protocoles thrapeutiques ont t tudis Rsultats: La moyenne d'ge des patients tait de 67,9 8 ans. Les manifestations cliniques taient domines par les troubles urinaires (81,60%). L'hypertension artrielle (45,9%) tait la principale comorbidit. Le toucher rectal coupl lchographie endo-rectale a permis de poser le diagnostic dune prostate suspecte dans 96,6% des cas. Le taux moyen du PSA total tait de 1345,3 3116,34 ng/ml. 54,5% des patients (n=95) ont t diagnostiqus au stade T4. Le type histologique majoritairement retrouv tait ladnocarcinome (97,70%). Lhormonothrapie a t la principale modalit thrapeutique. La mdiane de survie globale tait de 27 mois. Conclusion: La prise en charge du cancer de la prostate dans notre milieu passe par la standardisation des procdures diagnostiques et des protocoles thrapeutiques pour offrir nos patients les diffrentes options thrapeutiques. Mots-cls : Cancer prostate, traitement, survie, Yaound RISK FACTORS FOR OBSTETRIC FISTULA IN EASTERN CAMEROON MEKEME J.1, MBASSI A. A.1MOBY H2 , MBOUCHEL3, ESSOMBA A. G. 4 NWAHA M A4 ,FOUDA P.J.1, SOW M1, ANGWAFO Fru III 4, SOSSO M. A.4. 1-Service dUrologie Hpital Central de Yaound 2- Hpital Bonassama Douala 3-Service de Chirurgie Pdiatrique Hpital Gynco-Obsttrique et pdiatrique de Yaound 4-Universit Yaound I, Facult de Mdecine et des Sciences Biomdicales Correspondence : Dr Mekeme Mekeme Junior Service dUrologie, Hopital Central de Yaound, Email:  HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr, Tel: 00237 677676240 Background: Obstetric fistula usually occurs in women with a disadvantaged socio-economic status. Objective:To identify and highlight the risk factors for obstetric fistula in Eastern Cameroon. Methods: This was a convenient sample of 59 patients aged 15-65 years recruited consecutively from the Eastern region after sensitization via the local health and administrative authorities. The study was carried out at the Bertoua Regional Hospital from 02 to 30 June 2009. Results: The average height of patients was 151.94 cm. The duration of fistula ranged between 2 months and 35 years with a median of 6 years. The fistula size varied from 0.5 cm to 6 cm with a median of 2 cm. The median age at 1stdelivery was 16.5 years. The labor lasted about 48 hours for 22 % of patients with a median of 36 hours. Only 3.4 % of patients were salaried workers, 39% were housewives. 23.7 % had secondary education and none had university education. 10.17% delivered at home. 83.1 % attended at least one antenatal visit. Conclusion: The risk factors for obstetric fistula in Eastern Cameroon are multiple; early (teenage) pregnancies as well as prolonged labor are by far the most common causes while low socioeconomic status and illiteracy are the key factors. Keys word: Obstetric fistula, Risk factors, Eastern Cameroon. FACTEURS DE RISQUES DES FISTULES OBSTETRICALES A LEST DU CAMEROUN MEKEME J.1, MBASSI A. A.1MOBY H2, MBOUCHEL3, ESSOMBA A. G. 4 NWAHA M A4, FOUDA P.J.1, SOW M1, ANGWAFO Fru III 4, SOSSO M. A.4. 1-Service dUrologie Hpital Central de Yaound 2- Hpital Bonassama Douala 3-Service de Chirurgie Pdiatrique Hpital Gynco-Obsttrique et pdiatrique de Yaound 4-Universit Yaound I, Facult de Mdecine et des Sciences Biomdicales Correspondance: Dr Mekeme Mekeme Junior Service dUrologie, Hopital Central de Yaound, Email: HYPERLINK "mailto:juniormekeme@yahoo.fr"juniormekeme@yahoo.fr, Tel: 00237 677676240 Contexte: Les fistules obsttricales surviennent gnralement chez les femmes au statut socio-conomique dfavoris Objectif: Le but de notre travail tait didentifier et de faire ressortir les facteurs de risque des fistules obsttricales (FO) lEst du Cameroun. Mthodologie: Il sagissait dune tude transversale mene pendant une priode de 28 jours dans la rgion de lEst Cameroun. taient inclus, les seules patientes prsentant une fistule obsttricale. La sensibilisation tait faite travers les mdias, les autorits administratives et sanitaires de la rgion. Les patientes remplissaient des fiches denqute prtablies.Les paramtres socio-dmographiques et anthropomtriques ont t tudis. Rsultats: 59 patientes dont lge est compris entre 15 et 65 ans ont t colliges. La taille moyenne des patientes tait de 151,94 cm. Lge moyen des patientes lors du premier accouchement tait de 16,5 ans. 22% des patientes avaient une dure moyenne du travail de 36 heures. 39% des femmes taient des femmes au foyer. 23,7% des patientes avaient un niveau dducation du secondaire et aucune navait fait des tudes suprieures. Laccouchement a t fait domicile dans 10,17% des cas et la maternit chez 67,8% des patientes. 83,1% des patientes ont eu au moins une consultation prnatale. Conclusion: Les facteurs de risque de la FO lEst du Cameroun sont multiples. Les grossesses prcoces et le travail prolong sont les causes les plus frquentes. Lanalphabtisme et un bas niveau de vie socio-conomique sont des facteurs dterminants. Mots cls: fistules obsttricales, facteurs de risque, Est du Cameroun CLINICAL AND THERAPEUTIC EPIDEMIOLOGICAL PROFILE OF ERECTILE DYSFUNCTION IN DOUALA Moby EH 1, Sala BT 1, Mbassi A 2, Mekeme J 2, Youaga S 3, Angwafo III F 4 1: FMSP Douala, 2: Hpital Central de Yaound, 3: UDM Bangangt, 4: FMSB Yaound Prsentateur : MOBY EH. Mail: demobs@yahoo.com Background: Erectile dysfunction is a disease that can have devastating effects on masculinity and the future of the family. Purpose: The purpose of this study is to provide the clinical and therapeutic epidemiological profile of erectile dysfunction in three hospitals in Douala. Methodology: The descriptive and prospective study was conducted over a period of six months in the urology departments of selected hospitals. A questionnaire containing socio-demographic, clinical, International Index of Erectile Function 5 score and therapeutic data was used to collect data. Data analysis was performed with the aid of the SPSS 20.0 software. Results: 205 patients were enrolled in the study. Erectile dysfunction prevalence was 27.2%, with a mean age of 50 years. 40% of patients were earlier treated by a general practitioner, and 31.2% by a specialist. Erectile dysfunction was present in 38% of patients aged below 40 and 72% aged above 40. 43.4% of patients had moderate erectile dysfunction while 36.6% did have severe erectile dysfunction. Advanced age was significantly associated with a severe form of erectile dysfunction (P<0.001). Glycemia was requested for 82% of cases and 98% of patients were treated. Conclusion: Erectile dysfunction is present in Douala, with a prevalence of 27%. Management of such patients is important for marital and family stability. Key words: Erectile dysfunction, profile, Douala. PROFIL EPIDEMIOLOGIQUE CLINIQUE ET THERAPEUTIQUE DE LA DYSFONCTION ERECTILE A DOUALA Moby EH 1, Sala BT 1, Mbassi A 2, Mekeme J 2, Youaga S 3, Angwafo III F 4 1: FMSP Douala, 2: Hpital Central de Yaound, 3: UDM Bangangt, 4: FMSB Yaound PRESENTATEUR: MOBY EH. Mail: demobs@yahoo.com Contexte: La dysfonction rectile une affection capable davoir des effets dvastateurs sur la masculinit et lavenir de la famille. Objectif: Cette tude a pour but de prsenter le profil pidmiologique clinique et thrapeutique de la dysfonction rectile dans trois hpitaux de Douala. Mthodologie: Il sagissait dune tude descriptive prospective qui sest droule pendant 6 mois, en consultation durologie des hpitaux retenus. Un questionnaire comportant des donnes sociodmographiques, cliniques, le score International Index of Erectile Function 5 et des donnes thrapeutiques a permis de collecter les donnes. Lanalyse statistique sest faite laide du logiciel SPSS 20.0 Rsultats: 205 patients ont ts enrls dans ltude. La prvalence de la dysfonction rectile tait de 27,2%, avec une moyenne dge de 50 ans. 40% des patients taient prcdemment suivis par des mdecins gnralistes, et 31,2% par un spcialiste. La dysfonction rectile tait prsente 38% avant 40 ans, et 72% aprs 40 ans. 43,4% des patients prsentaient une dysfonction rectile modre et 36,6%, une dysfonction rectile svre. Lge avanc tait associ de faon significative une forme svre de dysfonction rectile (P<0,001).La glycmie, avec 82%, tait lexamen le plus demand. 98% des patients ont t traits. Conclusion: La dysfonction rectile est prsente Douala, avec une prvalence de 27%. La prise en charge de ces patients est importante pour lquilibre du couple et de la famille. Mots cls: Dysfonctionnement Erectile, profil, Douala. EPIDEMIOLOGIC, CLINICAL AND THERAPEUTIC PROFILE OF MALE URETHRAL STRICTURES IN DOUALA Moby EH 1, Sala BT 1, Mbassi A 2, Mekeme J 2, Deffo S 3, Angwafo III F 4 1: FMSP Douala, 2: Hpital Central de Yaound, 3: UDM Bangangt 4: FMSB Yaound Prsentateur: MOBY EH. Mail: demobs@yahoo.com Background: Urethral stricture has diverse etiology: infectious, iatrogenic, post-traumatic and congenital. In developed countries, the infectious forms are declining while the post-traumatic and iatrogenic forms are rising. What is the situation in Cameroonian urban areas? Purpose: To determine the clinical and therapeutic epidemiologic profile of male urethral strictures in Douala. Methodology: We conducted a retrospective study over a period of 5 years in two hospitals in Douala. The study focused on male patients who fulfilled the selection criteria and were managed within the study period. Statistical analysis was performed using the SPSS 20.0. Software. Pearsons correlation coefficient was used for comparing the associations between variables. Result: 144 patients were enrolled in the study and were of an average age of 38.38 years, with extremes of 1 year and 97 years. Urethral stricture prevalence stands at 7%. Dysuria is the main reason for consultation (44.4%). Strictures are infectious (48.6%), iatrogenic (26.4%), or traumatic (24.3%). They have spongy (40.3%), medullary (29.2%), and membranous (20.1%) seats. End to end urethroplasty (37.5%) and instrumental dilatation (32.6%) are the most used surgical techniques. Recurrences (44.4%) are the most postoperative course and appear on average 2.75 months after surgery. Conclusion: Urethral stenosis or stricture is common among young adults in Douala and infectious etiologies are dominant. Choosing treatment for better long term results is a problem. Keywords: Urethral stricture, epidemiology, diagnosis, treatment, Douala. PROFIL EPIDEMIOLOGIQUE CLINIQUE ET THERAPEUTIQUE DES STENOSE URETRALES MASCULINES A DOUALA Moby EH 1, Sala BT 1, Mbassi A 2, Mekeme J 2, Deffo S 3, Angwafo III F 4 1: FMSP Douala, 2: Hpital Central de Yaound, 3: UDM Bangangt 4: FMSB Yaound PRESENTATEUR: MOBY EH. Mail: demobs@yahoo.com Contexte: La stnose urtrale est dtiologie diverse: infectieuse, iatrogne, post-traumatique et congnitale. Les formes infectieuses sont en dcroissance dans les pays dvelopps au profit des formes post-traumatiques et iatrognes. Quel est ltat des lieux en milieu urbain Camerounais? Objectif: Dterminer le profil pidmiologique, clinique et thrapeutique des stnoses urtrales masculines Douala Mthodologie: Nous avons men une tude rtrospective sur 5 ans, dans deux hpitaux de Douala. Etaient concerns, les patients masculins remplissant les critres dinclusion et pris en charge pendant la priode dtude. Lanalyse statistique a t faite grce au logiciel SPSS 20.0. Le coefficient de corrlation de Pearson a t utilis pour la comparaison des associations entre les variables. Rsultats: 144 patients ont t enrls dans ltude, de moyenne d'ge 38,38 ans, avec des extrmes de 1 an et 97 ans. La prvalence des stnoses urtrales est de 7%. Les dysuries constituent le principal motif de consultation (44,4%). Lorigine des stnoses est infectieuse (48,6%), iatrogne (26,4%) et traumatique (24,3%). Les siges sont spongieux (40,3%), bulbaire (29,2%) et membraneux (20,1%). Lurtroplastie termino-terminale (37,5%), et la dilatation instrumentale (32,6%) sont les techniques chirurgicales les plus utilises. Les rcidives (44,4%) constituent la principale volution post-opratoire et apparaissent en moyenne 2,75 mois aprs lintervention. Conclusion: La stnose urtrale Douala est une pathologie de ladulte jeune o les tiologies infectieuses sont prdominantes. Elle pose le problme du choix du traitement permettant dobtenir de meilleurs rsultats long terme. Mots cls: Stnose de l'urtre, pidmiologie, diagnostic, traitement, Douala. Transrectal prostate biopsy: indications, results and complications at the Brazzaville Teaching Hospital (CHU Brazzaville) Bouya PA, Odzb AWS, OndzelOpara AS Ngalouo M, OndongoAtipo AM, Banga Mouss R B. Service dUrologie- Urologie, CHU de Brazzaville Correspondence: Dr ODZEBE AWS Chirurgien Urologue, CHU de Brazzaville, Email: odzebe_s@yahoo.fr Purpose: Contribute to improving care for patients with prostate tumour. Patients and methods: This was a descriptive evaluative study which involved collecting restrospective data in the Andrology/Urology Department of CHU Brazzaville from 2009 to 2014. It concerned patients treated for prostate tumours and having undergone prostate biopsy using digital technology (2009-2012) and ultrasound (2012-2014). Result: The average age of patients was 64.98 years. The largest age group was that of those over 55 years. The biopsy revealed adenocarcinoma in36.1% of cases. The percentage of biopsies revealing a cancer was 13.88% (5/36) when the PSA was between 4 and 10ng/ml, this rate was 42.17% (70/166) when the PSA was > 10ng/ml. Out of 75 Gleason scores, 9.33% had a score between 2 and 4, 34.67% a score between 5 and 7 and 56% a score between 8 and 10. The overall complications rate was 19.71% with predominantly bleeding complications. Conclusion: One out of three biopsies reveals a prostate cancer. Significant associations were found between age and cancer, biopsy results and DRE, and PSA levels and prostate cancer. Key words: prostate biopsy, prostate cancer, DRE, PSA, complications. BIOPSIE PROSTATIQUES TRANSRECTALES: INDICATIONS, RESULTATS ET COMPLICATIONS AU CHU DE BRAZZAVILLE Bouya PA, Odzb AWS, OndzelOpara AS Ngalouo M, OndongoAtipo AM, Banga Mouss R B. Service dUrologie- Urologie CHU de Brazzaville Correspondance: Dr ODZEBE AWS Chirurgien Urologue CHU de Brazzaville Email: odzebe_s@yahoo.fr Objectif : Contribuer lamlioration de la prise en charge des patients porteurs dune tumeur prostatique. Patients et Mthodes: Il sest agi dune tude valuative descriptive recueil de donnes rtrospectives allant de 2009 2014, ralise dans le service dUrologie Andrologie du CHU de Brazzaville. Celle-ci a concern les patients suivis pour tumeurs prostatique et ayant subi la biopsie prostatique selon les techniques digitoguide (2009-2012) et choguide (2012-2014). Rsultats: Lge moyen des patients taient 64,98ans. La tranche dge la plus importante tait celle des sujets de plus de 55ans. La biopsie a rvl36,1% dadnocarcinome. Le pourcentage des biopsies rvlant un cancer est de 13,88% (5/36) lorsque le PSA tait entre 4 et10ng/ml, ce taux est 42,17% (70/166) lorsque le PSA tait (10ng/ml. Sur 75 scores de Gleason 9,33%avait un score entre 2 et 4, 34,67% un score compris entre 5 et 7 et 56% un score 8 et 10.Le taux global des complications tait 19,71% avec une prdominance des complications hmorragiques. Conclusion:Une biopsie sur trois est en faveur dun cancer de la prostate.Des associations significatives ont t retrouves entre lge et le cancer, les rsultats du toucher rectal et la biopsie ainsi que le taux de PSA et le cancer de la prostate. Mots-cls: biopsie prostatique, cancer de la prostate, toucher rectal, PSA, complications. Priapism: epidemiological, diagnostic and therapeutic aspects Odzb AWS Bouya PA, Banga Mouss R B, Ngapoula, Ondzel Opara AS Ngalouo M, Ondongo Atipo AM Service dUrologie- Urologie, CHU de Brazzaville Correspondance: Dr ODZEBE AWS, Chirurgien Urologue, CHU de Brazzaville, Email: odzebe_s@yahoo.fr Purpose: This study sought to: determine the frequency of priapism, determine the consultation period, and list the factors predisposing to priapism. Patients and method: 83 (eighty-three) patients were treated for priapism in the urology-andrology department of CHU Brazzaville, between 1 June 2005 and 1 June 2015. The study variables were: epidemiological (frequency, age, marital status, employment status, origin, place of living, history; diagnostic (circumstances occurred, consultation period, type of erection, haemoglobin electrophoresis, CBC results, aetiology); therapeutic(medical and surgical treatment); evolution (detumescence time, recurrence, complications). Results: Priapism is the fourth urological emergency after acute urinary retention, renal colic, and hematuria, with a frequency of 1.37%. The average age of patients was 25.69 13.5 years. Sickle cell disease was noted in 57.8% of cases. Twelve patients who consulted within 12 hours were successfully treated with oral and injectable etilefrine (IIC). 36 (thirty-six) consulted between 12 and 36 hours and were successfully treated with spongiocarvernous fistula using the WINTER technique. Of the 35 patients who consulted after 36 hours and were treated using the WINTER technique first line, there were 10 cases of failure which were then treated secondarily using the ALGHORAB method. Conclusion: Priapism is not only a rare disease in urology but also a urological emergency. The Sickle cell aetiology is predominant, followed by idiopathic causes. Nearly half the patients are still admitted in urology after the 36th hour. Surgical treatment yields good results especially when patients are seen early. Keywords: priapism, urological emergency, Sickle Cell PRIAPISME: ASPECTS EPIDEMIOLOGIQUES, DIAGNOSTIQUES ET THERAPEUTIQUES Odzb AWS Bouya PA, Banga Mouss R B, Ngapoula, Ondzel Opara AS Ngalouo M, Ondongo Atipo AM Service dUrologie- Urologie, CHU de Brazzaville Correspondance: Dr ODZEBE AWS Chirurgien Urologue, CHU de Brazzaville, Email: odzebe_s@yahoo.fr Objectif: les objectifs de cette tude taient: de dterminer la frquence du priapisme, dterminer le dlai de consultation et rpertorier les diffrents facteurs prdisposant au priapisme Malades et mthodes: quatre-vingt-trois (83) malades ont t traits pour priapisme dans le service durologie-andrologie du C.H.U de Brazzaville, du 1er juin 2005 au 1er juin 2015. Les variables dtude taient: pidmiologiques (La Frquence, LAge, Le Statut matrimonial, le statut professionnel, la provenance, le milieu de vie, les Antcdents; Diagnostique (les circonstances de survenu, le dlai de consultation, le type drection, lelectrophorse de lhmoglobine, Les rsultats de lhmogramme, Les tiologie ) thrapeutique(traitement mdical et chirurgical ); lvolution (le Temps de dtumescence, la rcidive, les complications). Rsultats: Le priapisme reprsente la 4me urgence urologique aprs la rtention aigudurine, la colique nphrtique, et lhmaturie, sa frquence est de 1,37%. Lge moyen des patients tait de 25,69 13,5 ans. La drpanocytose tait note dans 57,8% des cas. Douze patients qui ont consults avant 12heure ont t traits avec succs par tilefrine orale et injectable (IIC). Trente-six (36) ont consults entre 12 et 36 heure et traits avec succs par fistule spongiocaverneuse selon WINTER. Sur les 35 patients consults aprs 36 heure et traits selon la technique de WINTER en premire intention, IL Ya eu 10 cas dchec quon a secondairement trait selon la mthode dALGHORAB. Conclusion: Le priapisme est une pathologie rare en urologie, cest une urgence urologique. Ltiologie drpanocytaire prdomine suivi des causes idiopathiques. Prs de de la moiti des patients sont encore admis en urologie aprs la 36me heure. Le traitement chirurgical permet dobtenir des bons rsultats et surtout quand les malades sont vus prcocement. Mots cls: priapisme, urgence urologique, Drpanocytose The effect of diet on urinary nerve growth factor on unobstructed and obstructed murine bladders Temitope Adedeji, Ayodeji A Fasanmade and E.OluwabunmiOlapade-Olaopa Institutions: Department of Physiology and PIUTA Ibadan Centre, Department of Surgery, University of Ibadan, Nigeria Corresponding author:Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email:  HYPERLINK "mailto:piutaibadan@yahoo.com"piutaibadan@yahoo.com Introduction: Abnormal growth of afferent and efferent neurons stimulated by nerve growth factor (NGF) may contribute to detrusor dysfunction and also to lower urinary tract symptoms (LUTS). Different diets have been shown to have variable effects on LUTS. We therefore investigated the effects of diet on the expression of NGF, as a mechanism for dietary influence on bladder function in the obstructed and un-obstructed bladder. Methods: We induced experimental BOO surgically in male wistar rats. Animals were prefed on various diets which were continued for 4 weeks after surgery. Rats were divided into sham-operated and BOO groups each with the following: control (normal rats feeds), high-carbohydrate (HCD), high-fat (HFD) and high-protein (HPD) dietary groups. ELISA for NGF was adapted from the methods of Westcamp and Otten (1987) and Hellweg (1989). Results: In the unobstructed groups, NGF was significantly increased in animals fed on HFD and HPD (P<0.05) but was unchanged in HCD. In the BOO groups, NGF decreased only in the HCD-BOO group in comparison with the BOO control while the HFD and HPD remained unchanged. In individual comparisons of all dietary groups with their corresponding dietary-BOO groups, only the HFD exhibited a significant difference. Conclusion: The results of this study show that diet has a variable effect on NGF expression in un-obstructed and obstructed murine bladders and that changes in NGF expression may contribute to the influence of diet on LUTS. LEFFET DE LALIMENTATION SUR LE FACTEUR DE CROISSANCE DES NERFS URINAIRES SUR LES VESSIES MURINES NON OBSTRUEES ET OBSTRUEES TemitopeAdedeji, Ayodeji A Fasanmade and E.OluwabunmiOlapade-Olaopa Institutions: Department of Physiology and PIUTA Ibadan Centre, Department of Surgery, University of Ibadan, Nigeria Corresponding author: Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: HYPERLINK "mailto:piutaibadan@yahoo.com"piutaibadan@yahoo.com Introduction: La croissance anormale des neurones affrents et effrents stimule par le facteur de croissance des nerfs (NGF) peut contribuer au dysfonctionnement dudtrusoret lapparition des troubles urinaires du bas appareil (TUBA) Il a t prouv que les rgimes alimentaires ont divers effets sur les TUBA en fonction de leur nature.Nous avons donc tudi les effets de lalimentation sur lexpression du FCN, en tant que mcanisme par lequel lalimentation influence la fonction vsicale dans les vessies obstrues et non obstrues. Mthodes: Du BOO exprimental a t chirurgicalement induit des rats wistar mles. Les animaux ont t pralablement soumis diffrents rgimes alimentaires qui ont t poursuivis 04 semaines aprs lopration. Les rats ont t diviss en groupe de pseudo-oprs et en groupe de BOO comprenant chacun les catgories alimentaires suivantes: tmoins (rats nourris normalement), alimentation riche en glucides (HCD), alimentation riche en graisses (HFD) et alimentation riche en protines (HPD). Le test ELISA pour FCN a t adapt partir des mthodes de Westcampet Otten (1987) et Hellweg (1989). Rsultats: Dans le groupe non obstru, le FCN a considrablement augment chez les animaux suivant un rgime alimentaire riche en graisses (HFD) et en protines (HPD) (P<0,05) mais na pas chang chez ceux ayant une alimentation riche en glucides(HCD). Chez les groupes BOO, le FCN a diminu uniquement chez le groupe HCD-BOO par rapport au groupe-tmoin BOO, tandis que les HFD et HPD sont rests sans changement. Lors des comparaisons individuelles de tous les groupes sous rgime alimentaire avec leurs groupes-tmoins BOO sous rgime alimentaire, seuls les HFD ont prsent une diffrence significative. Conclusion: Les rsultats de la prsente tude rvlent que lalimentation a diffrents effetssur lexpression du FCN dans les vessies murines non obstrues et obstrues, et les changements dans lexpression peuvent contribuer linfluence que lalimentation a sur les TUBA. Epidemiology of bladder cancers in Ibadan, Nigeria 1,2Takure AO*, 3Odubanjo MO*, 1,2Adebayo SA, 3Oluwasola O, 1,2Shittu OB, 1,2Okeke LI, 1,4Fadimu OA, 1,2Olapade-Olaopa EO Affiliations: 1Urology Division, Department of Surgery, University of Ibadan, Nigeria, 2PIUTA Ibadan Centre, Department of Surgery, University of Ibadan, Nigeria 3Department of Pathology, University College Hospital, Ibadan, Nigeria 4Department of Surgery, Federal Medical Centre, Abeokuta, Nigeria Corresponding author: Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: piutaibadan@yahoo.com Introduction: A previous study from the University College Hospital, Ibadan southwest, Nigeria on bladder cancers had described an increase in the frequency of urothelial carcinoma (UC) compared to the earlier reported preponderance of squamous-cell carcinoma (SCC). In this current study, we provide an update on the histopathologic pattern of this disease in our community. Methods: We reviewed the records of the Ibadan Cancer Registry from January 1997 to December 2014 and analyzed the data available on the histologic subtypes of bladder carcinoma diagnosed in the hospital. Results: Two hundred and sixteen bladder tumours were recorded during this period with a male to female ratio of 3.2:1. There were 181 bladder carcinomas. Of these, 68.5%, 19.9% and 11.6% were urothelial carcinomas (UC), squamous cell carcinomas (SCC), and adenocarcinomas (AC) respectively. UC was more common in all age groups and its peak age of occurrence was in the 51-60 year age group. The peak age for SCC was in the 41-50 year age group. Mean and median age of occurrence was significantly lower in females in all histotypes, and lowest in SCC [P = < 0.0001]. Conclusion: This population study has confirmed UC as the predominant histotype of bladder cancer in Ibadan, Southwest Nigeria currently and that both UC and SCC occur earlier in women. These findings have significant implications for health policies in the country. EPIDEMIOLOGIE DES CANCERS DE LA VESSIE A IBADAN AU NIGERIA 1,2Takure AO*, 3Odubanjo MO*, 1,2Adebayo SA, 3Oluwasola O, 1,2Shittu OB, 1,2Okeke LI, 1,4Fadimu OA, 1,2Olapade-Olaopa EO Affiliations:1Urology Division, Department of Surgery, University of Ibadan, Nigeria, 2PIUTA Ibadan Centre, Department of Surgery, University of Ibadan, Nigeria 3Department of Pathology, University College Hospital, Ibadan, Nigeria 4Department of Surgery, Federal Medical Centre, Abeokuta, Nigeria Introduction: Une tude antrieure ralise au Centre Hospitalier Universitaire dIbadan, au sud-ouest du Nigeria, sur les cancers de la vessie, avait rvl une augmentation de la frquence du carcinome urothlial (CU) par rapport la prpondrance du carcinome spinocellulaire (CSC) rapporte avant. Nous prsentons dans notre tude une mise jour du profil histopathologique de cette maladie dans notre communaut. Mthodologie: Nous avons pass en revu le registre des cancers dIbadan de janvier 1997 dcembre 2014 et analys les donnes disponibles sur les sous-types histologiques du cancer de la vessie diagnostiqu lhpital. Rsultats: 216 tumeurs de la vessie ont t enregistres au cours de cette priode avec un ratio homme-femme de 3,2: 1. 181 carcinomes de la vessie ont t recenss. Parmi ceux-ci, 68,5% taient des carcinomes urothliaux (CU), 19,9% des carcinomes spinocellulaires (CSC) et 11,6% des adnocarcinomes (AC). Le CU tait plus frquent dans tous les groupes d'ge et apparaissait plus dans la tranche d'ge allant de 51 60 ans. Le pic de lapparition du CSC a t observ dans la tranche d'ge allant de 41 50 ans. Lge moyen et mdian de lapparition tait significativement plus faible chez les femmes dans tous les histotypes, et plus faible encore en ce qui concerne le CSC [P = <0,0001]. Conclusion: Cette tude de la population a confirm que le CU est lhistotype prdominant du cancer de la vessie Ibadan au sud-ouest du Nigeria et que lapparition du CU et du CSC est prcoce chez les femmes. Ces rsultats ont des implications importantes pour les politiques de sant dans le pays. Influence of diet on CXCL12 activity in un-obstructed and obstructed murine bladders Temitope Adedeji, Ayodeji A Fasanmade and E.Oluwabunmi Olapade-Olaopa Institutions: Department of Physiology and PIUTA Ibadan Centre, Department of Surgery, University of Ibadan, Nigeria Corresponding author: Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: piutaibadan@yahoo.com Introduction: CXCL12 is an inflammatory chemokine which is found in the normal urothelium but its expression is increased in interstitial cystitis/painful bladder syndrome (IC/PBS). Diet has been shown to influence inflammation and worsen lower urinary tract symptoms (LUTS). We investigated dietary influence on CXCL12 expression to determine possible mechanisms by which diet might affect LUTS in un-obstructed and obstructed murine bladders. Methods: We induced experimental BOO surgically in male wistar rats. Animals were prefed on various diets which were continued for 4 weeks after surgery. Rats were divided into sham-operated and BOO groups each with the following: control (normal rats feeds), high-carbohydrate (HCD), high-fat (HFD) and high-protein (HPD) dietary groups. CXCL12 was assayed by ELISA using appropriate rat CXCL12 kits. Results: In the unobstructed bladders, CXCL12 was significantly increased in animals fed on HFD and HPD (P<0.05) and significantly decreased in HCD. In the BOO groups, the HCD-BOO group exhibited a decrease in CXCL12 when compared to the BOO control, while CXCL12 increased in the HFD-BOO group. The HPD-BOO however remained unchanged. In individual comparisons of dietary groups with their corresponding dietary-BOO group, all dietary groups exhibited a significant difference. Conclusion: The results of this study show that HFD and HCD elicit different reactions in CXCL12 activity in un-obstructed and obstructed murine bladders. These findings suggest that changes in CXCL12 activity may mediate the influence of diet on LUTS in humans. INFLUENCE DE LALIMENTATION SUR LACTIVITE DU CXCL12 DANS DES VESSIES MURINES NON-OBSTRUEES ET OBSTRUEES Temitope Adedeji, Ayodeji A Fasanmade and E.Oluwabunmi Olapade-Olaopa Institutions: Department of Physiology and PIUTA Ibadan Centre, Department of Surgery, University of Ibadan, Nigeria Corresponding author: Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: piutaibadan@yahoo.com Introduction: CXCL12 est une chimiokineinflammatoire que lon retrouve dans lurothlium normal mais son expression augmente en prsence dunecystite interstitielle /dun syndrome douloureux de la vessie (IC/PBS). Il a t dmontr que lalimentation a un impact sur linflammation et aggrave les symptmes de troubles urinaires du bas appareil (TUBA). Nous avons tudi linfluence de lalimentation sur lexpression du CXCL12 en vue de dterminer les ventuels mcanismes par lesquels lalimentation influencerait lesTUBA dans des vessies murines non-obstrues et obstrues. Mthodes: Des rats mlesWistaront reu du BOO exprimental par intervention chirurgicale. Les animaux avaient t pralablement bnficis de diffrents rgimes alimentaires qui ont t poursuivis pendant 04 semaines aprs lintervention chirurgicale. Les rats ont t rpartis en groupes de pseudo-oprs et en groupes de BOO dont chacun comportait les groupes dittiques suivants: un groupe tmoin (alimentation normale pour rats), alimentation riche en glucides (HCD), alimentation riche en graisses (HFD) et alimentation en protines (HPD). Le CXCL12 a t analys laide des kits CXCL12 ELISA pour rats. Rsultats: Dans les vessies non obstrues, le CXCL12 a augment de faon significative chez les animaux ayant reu une alimentation riche en graisses (HFD) et chez ceux ayant reu une alimentation riche en protines (HPD) (P<0,05); il a baiss sensiblementchez ceux ayant reu une alimentation riche en glucides (HCD). Dans les groupes BOO, le groupe HCD-BOO a montr une baisse de CXCL12 par rapport au groupe tmoin BOO, et le CXCL12 a augment dans le groupe HFD-BOO. Cependant, le groupe HPD-BOO est rest inchang. Lors des comparaisons individuelles entre les groupes sous rgimedittique et leur groupe tmoin BOO-sous rgime dittique, tous les groupes dittiques ont montr une grande diffrence. Conclusion: Les rsultats de la prsente tude ont rvl que le HFD et le HCD entrainent diffrentes ractions dans lactivit du CXCL12 dans les vessies murines non obstrues et obstrues. Ces conclusions suggrent que linfluence de lalimentation sur les TUBAchez les humains peut tre mdie par les changements dans lactivit du CXCL12. Usefulness of Indigenous Language Patient Information Leaflets to Sample Affected and Non-affected Population of Ibadan, South West Nigeria Funmilola Iranade, Duro Adeleke and E.Oluwabunmi Olapade-Olaopa Institutions: PIUTA Ibadan Centre, Department of Surgery and Department of Linguistics and African Languages, University of Ibadan, Nigeria Corresponding author: Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: piutaibadan@yahoo.com Introduction: Patient Information Leaflets (PILs) provide information to patients (affecteds) and non-patients (non-afffecteds) alike to improve understanding of the disease and increase participation in the decision- making processes of their treatment. The aim of this study was to determine the usefulness of indigenous language PILs on urological diseases to both affecteds and non-affecteds. Methods: Patient information leaflets developed for specific urological diseases and their treatment in English were translated into Yoruba the indigenous language of our locality. The leaflets were then translated to 50 randomly selected affecteds and 50 non-affected respondents. Questionnaires, in both languages, were then administered to assess their understanding of the leaflets and their usefulness. The responses were collated and analyzed. Results: When the responses from affecteds and non-affecteds were combined, majority (78%) stated that they understood the leaflets and most (83%) described them as very helpful. All respondents (100%) found the translations useful, with most (84%) strongly agreeing that they broadened their knowledge of urological diseases and treatments, and majority (66%) stated they useful in choosing the appropriate treatments. Also, majority (64%) of the respondents believed they could advise others based on the knowledge they obtained from the indigenous language PILs. Most respondents (80%) agreed strongly that the PILs should be shared with other people as a source of information. Conclusion: Majority of affected and non-affected population found indigenous language PILs useful in broadening their understanding of urological diseases and their treatments and would recommend them to others as veritable sources of information. UTILITE DES DEPLIANTS DINFORMATION DES PATIENTS EN LANGUE LOCALE POUR LA POPULATION AFFECTEE ET NON AFFECTEE ECHANTILLONNEE A IBADAN DANS LE SUD-OUEST DU NIGERIA Funmilola Iranade, Duro Adeleke and E.Oluwabunmi Olapade-Olaopa Institutions: PIUTA Ibadan Centre, Department of Surgery and Department of Linguistics and African Languages, University of Ibadan, Nigeria Corresponding author: Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: piutaibadan@yahoo.com Introduction: les dpliants dinformation des patients (DIP) fournissent des informations aux malades (personnes affectes) et aux non-malades (personnes non-affectes) pour amliorer la comprhension de la maladie et accroitre la participation au processus de prise de dcisions de leur traitement. Le but de cette tude tait de dterminer lutilit de tels DIP en langues locales sur les maladies urologiques chez les personnes affectes et non-affectes. Mthodes: les dpliants dinformation des patients labors en anglais pour des maladies urologiques spcifiques et leur traitement ont t traduits en Yoruba, la langue parle dans notre localit. Ces dpliants ont ensuite t traduits pour 50 personnes affectes choisies au hasard et 50 rpondants non-affects. Les questionnaires bilingues ont t administrs pour valuer leur comprhension des dpliants et leur utilit. Les rponses ont t compiles et analyses. Rsultats: Lorsque les rponses issues des personnes affectes et non-affectes ont t mises ensemble, la majorit des rpondants (78%) ont dclar quils comprenaient le contenu du dpliant et la plupart (83%) lont dcrit comme tant trs utile. Tous les rpondants (100%) ont jug les traductions utiles, avec plus de 84% affirmant qu'elles ont largi leur connaissance sur les maladies et les traitements urologiques, et la majorit (66%) a dclar que le dpliant tait utile dans le choix des traitements appropris. En outre, la majorit des rpondants (64%) estiment qu'ils pourraient conseiller les autres sur la base des connaissances acquises des DIP en langue locale. La plupart des rpondants (80%) taient entirement daccord que les DIP doivent tre partags avec dautres personnes comme source d'information. Conclusion: La majorit de la population affecte et non affecte a trouv les DIP en langues locales utiles car elles largissent leur comprhension des maladies urologiques et de leurs traitements et les recommanderaient dautres comme de vritables sources d'information. CLOSED BLADDER EXSTROPHY: A RARE CASE AT THE YAOUNDE GYNAECO-OBSTETRIC AND PEDIATRIC HOSPITAL MouafoTambo FF, KounaTsala IN, Mantho F, Mbouche L, Bob D, Ditope J, Fadi, Malagal, Andze OG. Correspondance: Pr MouafoTambo Faustin Flicien Service de Chirurgie Pdiatrique Hpital Gynco-Obsttrique et Pdiatrique de Yaound  HYPERLINK "mailto:faustintambo@yahoo.fr" faustintambo@yahoo.fr Background: Bladder exstrophy is a rare complex congenital malformation. Worldwide, the frequency reported is 10,000 to 50,000 births. Closed bladder exstrophy is even more exceptional and to the best of our knowledge, no case has been reported in Africa so far. Objective: The aim of this report was to add this case to those currently existing in the medical literature worldwide and present the therapeutic difficulties in an African setting. Case presentation: The authors report a case of a 5-year-old girl seen at the paediatric surgery service of the Yaounde Gynaeco-Obstetric and Pediatric Hospital. The patient presented with a low set umbilicus, wide pubic diastasis and a hypoplasic urethra that could not admit a size 10 foley catheter. However, the bladder neck was functional, as the patient was continent. The clitoris was bifid but of normal size. Endoscopic evaluation showed a dilated bladder probably resulting from chronic bladder outlet obstruction. The vagina was horizontalised but normal in size (6 cm) and the cervix appeared normal. The kidneys were well differentiated and no dilatation of the calices was seen at the adbominal ulstrasound. The use of intermittent catheterisation as decribed by Mitrofanoff deserves to be discussed in our setting. Conclusion: The management of closed bladder exstrophy specifically in the African milieu is paved with difficulties and the outcome is uncertain. Key words: closed bladder exstrophy, Yaounde, Cameroon. EXTROPHIE VESICALE FERMEE A PROPOS DUN CAS RARE A LHOPITAL GYNECO-OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE MouafoTambo FF, KounaTsala IN, Mantho F, Mbouche L, Bob D, Ditope J, Fadi, Malagal, Andze OG. Correspondance: Pr MouafoTambo Faustin Flicien Service de Chirurgie Pdiatrique Hpital Gynco-Obsttrique et Pdiatrique de Yaound HYPERLINK "mailto:faustintambo@yahoo.fr"faustintambo@yahoo.fr Contexte: Lextrophie vsicale est une malformation congnitale complexe qui a une rputation de raret dans la littrature mondiale avec une frquence estime un cas sur 10000 50000 naissances. Lorsquelle est ferme cest dire continente, il sagit dune situation exceptionnelle dont aucun cas document na t rapport en Afrique notre connaissance. Objectif: Le but de ce travail tait dajouter cette forme rare au registre de la littrature mondiale tout en soulignant les difficults thrapeutiques en milieu Africain. Observation: Les auteurs rapportent chez une fillette de 5 ans lHpital Gynco-Obsttrique et Pdiatrique de Yaound un cas exceptionnel dextrophie vsicale ferme avec diastasis pubien majeur, implantation basse de lombilic et prsence dun urtre hypoplasique laissant peine passer une sonde urinaire CH10. Lon notait la prsence dun col vsical fonctionnel, puisque la fillette tait continente. Le clitoris tait bifide et de taille normale. A la cystoscopie, la vessie tait de grande capacit et trabcule, tmoignant dune gne lvacuation des urines. Le vagin tait horizontalis mais de taille normale (6cm) avec prsence dun col utrin daspect normal. A lchographie urinaire, les 2 reins taient bien diffrencis sans dilatation des voies excrtrices. La ncessit dune vacuation de cette vessie par cathtrisme intermittent type Mitrofanoff est une option discuter dans notre contexte. Conclusion: Le traitement de lextrophie vsicale, notamment en milieu africain est une entreprise hrisse de difficults et dont le rsultat est plus ou moins hasardeux. Mot cls: extrophie vsicale ferme, Yaound, Cameroun. FOLLOW UP OF CHIDREN WITH POSTERIOR URETHRAL VALVES OPERATED AT THE YGOPH Guemkam G*, Mouafo Tambo FF**,Mbouche L**, Kamadoju C**,Mure PY***, Angwafo FFF**, Ondobo AG** Centre Mre et Enfant/ Fondation Chantal Biya Yaound Hpital Gynco-Obsttrique et Pdiatrique de Yaound (HGOPY) Hospices Civils de Lyon/Universit Claude Bernard Lyon1 Correspondance: Pr Mouafo Tambo FaustinFlicien Service de chirurgie pdiatrique, Hpital Gynco-obsttrique et pdiatrique de Yaound, Cameroun. Email:faustintambo@yahoo.fr Background: Posterior urethral valves (PUV) account for up to 50% of the obstructive causes of chronic kidney disease in the pediatric age group. Antenal diagnosis is possible in 80% of cases. The incidence of PUV is approximately 1 for 5000-8000 male live births. Objective: This study aimed at evaluating the outcome of children operated for PUV at the YGOPH. Methodology: This was a retrospective study including all cases of PUV managed in the pediatric surgery service of the YGOPH over a period of 8 years (october 2007-march 2015). Patients with a vesicostomy were excluded. Data was analysed for growth, survival and kidney function. Results: Fourteen patients were managed during the study period. Age at the time of diagnosis ranged from 2 days to 8 years. Antenatal diagnosis was made in 4 patients but no details on the quantity of amniotic were precised. With a minimal follow-up of 11 months, growth rate was satisfactory, the blood pressure was within normal range for height. Seven patients developed chronic kidney disease (stage 2 and 3), one patient is undergoing dialysis in Milan and one died. Conclusion: The outcome of PUV depends on the progression to end stage renal disease that requires kidney transplant. Nephroprotection is the only means to slowdown or prevent this poor evolution. Key words: valves, follow-up, chronic kidney disease. SUIVI DES VALVES DE LURETRE POSTERIEUR OPEREES A HGOPY Guemkam G*, Mouafo Tambo FF**,Mbouche L**, Kamadoju C**,Mure PY***, Angwafo FFF**, Ondobo AG** Centre Mre et Enfant/ Fondation Chantal Biya Yaound Hpital Gynco-Obsttrique et Pdiatrique de Yaound (HGOPY) Hospices Civils de Lyon/Universit Claude Bernard Lyon1 Correspondance: Pr Mouafo Tambo FaustinFlicien Service de chirurgie pdiatrique, Hpital Gynco-obsttrique et pdiatrique de Yaound, Cameroun. BP 4362 Yaound Email:faustintambo@yahoo.fr Contexte : Les valves de l'urtre postrieur (VUP) reprsentent jusqu' 50 % des causes malformatives de maladie rnale chronique terminale en ge pdiatrique. Le diagnostic antnatal chographique est possible plus de 4 fois sur 5. Ltiologie reste mal connue et leur frquence est estime un cas sur 5 000 8000 naissances. Objectifs : Le but de ce travail tait dvaluer le devenir rnal de ces enfants oprs des VUP. Mthodologie : Il sest agi dune tude rtrospective sur 8 ans (octobre 2007 mars 2015), incluant tous les enfants oprs des valves de lurtre postrieur dans le service de chirurgie pdiatrique de lHGOPY. Tous les enfants ayant t mis en colostomie avait t exclus. Les paramtres tudis taient; croissance, survie et degr datteinte rnale. Rsultats : Quatorze cas de VUP ont t oprs HGOPY. Lge au moment du diagnostic variait de 2 jours 8 ans. Quatre patients avaient bnficis dun diagnostic antnatal mais sans aucune mention du liquide amniotique. Avec un recul de 11 mois minimum, la croissance tait acceptable, la pression artrielle dans les limites de la normale pour la taille. Sept patients ont volus vers la maladie rnale chronique (stade 2 et 3), un enfant est en hmodialyse Milan et 1 tait dcd. Conclusion : Le pronostic des VUP dpend de lvolution vers linsuffisance rnale terminale (IRT) ncessitant une transplantation rnale. La nphroprotection est indispensable pour ralentir lvolution fatale vers lIRT. Mots cls: Valves, suivi, maladie rnale chronique. CHALLENGES IN THE DIAGNOSIS AND MANAGEMENT OF NON TRAUMATIC URETHRAL STRICTURES BOYS AT YGOPH Mouafo Tambo FF (1), Fossi G(1), Kamadjou C (1), Mbouche L (1), NwahaMakon AS (1), Birraux J(2), Andze OG (1), Angwafo FF(1), Mure PY (2) *Pediatric surgery department, Gyneco-Obstetric and Pediatric Hospital of Yaound (YGOPH) **Lyon Teaching Hospital, France ***University teaching hospitals of Geneva Corresponding author: Pr Mouafo Tambo Faustin Pediatric surgery Department,Gyneco-Obstetric and Pediatric Hospital of Yaound (YGOPH)P.O Box: 4362 Yaound, Cameroon, Email:  HYPERLINK "mailto:faustintambo@yahoo.fr" faustintambo@yahoo.fr, Tl: 00237 696098325 Background: Non-traumatic urethral strictures in male children are not uncommon, especially in an African setting. Objective: Highlight the diagnostic and therapeutic difficulties in the management of non-traumatic urethral strictures in boys at the YGOPH. Methodology: The authors report five cases of non-traumatic urethral strictures managed at the paediatric surgery department of the YGOPH over a two-year period (November 2012-November 2014). Results: In order to confirm the diagnosis of urethral stricture, all patients were assessed both with cystuoretrography and urethrocystoscopy. The findings were; either an inflammatory urethra (n=2), either a single or multiple stenosis. The actions were performed included: internal urethrotomy (N = 1), urethral dilatation (n = 1), vesicostomy (n = 2) and urethral catheterization (n = 3). With a median follow-up of 8.2 months all patients remained symptoms free. Conclusion: The authors report the difficulties encountered in the diagnosis and management of non-traumatic urethral strictures in boys at the HGOPY. The existence of an inflammatory aetiology of urethral strictures in boys deserves to be considered. DFIS LIS AU DIAGNOSTIC ET LA PRISE EN CHARGE DES STNOSES URTRALES NON TRAUMATIQUES CHEZ LES GARONS HGOPY* Mouafo Tambo FF (1), Fossi G(1), Kamadjou C (1), Mbouche L (1), NwahaMakon AS (1), Birraux J(2), Andze OG (1), Angwafo FF(1), Mure PY (2) *Pediatric surgery department, Gyneco-Obstetric and Pediatric Hospital of Yaound (YGOPH) **Lyon Teaching Hospital, France ***University teaching hospitals of Geneva Corresponding author: Pr Mouafo Tambo Faustin Pediatric surgery Department,Gyneco-Obstetric and Pediatric Hospital of Yaound (YGOPH)P.O Box: 4362 Yaound, Cameroon, Email:  HYPERLINK "mailto:faustintambo@yahoo.fr" faustintambo@yahoo.fr, Tl: 00237 696098325 Contexte: La stnose urtrale non traumatique chez les enfants de sexe masculin nest pas rare, surtout dans un contexte africain. Objectif: Relever les difficults diagnostiques et thrapeutiques dans la prise en charge de la stnose urtrale non traumatique chez les garons HGOPY. Mthodologie: Les auteurs rapportent cinq cas de stnose urtrale non traumatique pris en charge au Service de chirurgie pdiatrique dHGOPY sur une priode de deux ans (de novembre 2012 novembre 2014). Rsultats: Dans le but de confirmer le diagnostic de la stnose urtrale, tous les patients ont t valus la fois avec la cystourtrographie et lurtrocystoscopie. Les rsultats ont rvl soit une inflammation de lurtre (n = 2), soit une stnose unique ou multiple. Des actes ont t effectus, notamment: lurtrotomie interne (N = 1), la dilatation urtrale (n = 1), la vsicostomie (n = 2) et cathtrisme urtral (n = 3). Avec un suivi mdian de 8,2 mois, tous les patients nont prsent aucun symptme. Conclusion: Les auteurs rapportent les difficults rencontres dans le diagnostic et la prise en charge des stnoses urtrales non-traumatiques chez les garons HGOPY. Lexistence dune tiologie inflammatoire du rtrcissement de lurtre chez les garons mrite dtre prise en compte. COMPLICATIONS OF CIRCUMCISION AT THE GYNAECO-OBSTETRIC AND PEDIATRIC HOSPITAL OF YAOUNDE (YGOPH): A REPORT OF 15 CASES Mouafo Tambo FF, Fadi S, Ditope JJ, Nyanit Bob D, Mbouche L, Andze OG. Corresponding author: Pr Mouafo Tambo Faustin Pediatric surgery department, Gynaeco-Obstetric and Pediatric Hospital of Yaound. Background: Complications arising from the practice of circumcision in our environment are numerous and pose major therapeutic difficulties involving the functional prognosis, aesthetic and sometimes potential vital risks. Objective: This study aimed at describing the anatomic, clinical and therapeutic aspects of circumcision accidents at the Gynaeco-Obstetric and Pediatric Hospital of Yaound. Methodology: Our study was retrospective and descriptive; over a period of 10 years, we recorded cases of complications related to circumcision occurring in patients less than 15 years and managed at the pediatric surgical unit of the Gynaeco-Obstetrics and Pediatric Hospital of Yaound. Results: Overall 15 patients were managed in our unit during the study period, representing 1.5cases/year. The average age of the patients was 5.57 years (7months-14 years). The mean time before consultation was 10 months (3hrs - 2 years). The circumcision was carried out as a ritual in all cases. Clinical patterns encountered were dominated by urethrocutaneous fistulae (53.3%), followed by glanular and/or penile amputation (6.7%). Therapeutic procedures performed varied with respect to the indication: closure of urethral fistula (46.7%), meatoplasty (13.3%), wet dressing + antibiotics (6.7%), buccal mucosa graft urethroplasty (6.7%), correction of chordee (6,7%), vesicostomy (6.7%) and control of haemorrhage and suturing(6.7%). Conclusion: Adverse events related to the ritual practice circumcision as a routine in our setting are quite high. Some of these complications require major surgical procedures are sometimes required for their management. ASPECTS ANATOMOCLINIQUES ET THERAPEUTIQUES DES ACCIDENTS DE LA CIRCONCISION A LHOPITAL GYNECO-OBSTETRIQUE ET PEDIATRIQUE DE YAOUNDE (HGOPY): propos de 15 cas. Mouafo Tambo FF, Fadi S, Ditope JJ, Nyanit Bob D, Mbouche L, Andze OG. Corresponding author: Pr Mouafo Tambo Faustin Pediatric surgery department, Gynaeco-Obstetric and Pediatric Hospital of Yaound. Contexte: Les accidents gnrs par la pratique de la circoncision dans notre milieu sont nombreux et posent des difficults thrapeutiques majeures mettant en jeu les pronostics fonctionnel, esthtique et parfois vital des patients. Objectif: Le but de ce travail tait de dcrire les aspects anatomo-cliniques et thrapeutiques des accidents de circoncision lHpital gynco-obsttrique et pdiatrique de Yaound. Mthodologie: Notre tude a t rtrospective et descriptive, portant sur 15 accidents de circoncision colligs et traits sur une priode de 10 ans chez les patients de J0 15 ans dans le service de chirurgie Pdiatrique de lHpital Gynco-obsttrique et Pdiatrique de Yaound. Rsultats: Quinze accidents de circoncision ont t colligs et traits en 10 ans, soit une frquence hospitalire de 1,5 cas/an. Lge moyen des patients tait de 5,57 ans (7 mois - 14 ans). Le dlai moyen de consultation tait 10 mois (3 heures - 2 ans). Lindication de la circoncision tait rituelle dans tous les cas. Les aspects lsionnels rencontrs taient domins par les fistules urtro-cutanes (53,3%), suivies des amputations totales du gland (6,7%) et ou de la verge (6,7%).Les gestes thrapeutiques raliss taient varis: fermeture de fistule urtro-cutane ( 46,7%),matoplastie (13,3%), pansement humide + antibiothrapie ( 6,7%), urtroplastie par lambeau de muqueuse buccale (6,7%), dsenlisement de verge (6,7%), vsicostomie ( 6,7%) et hmostase de lartre du frein (6,7%). Conclusion: Les accidents gnrs par la pratique intempestive de la circoncision dans notre milieu sont graves et les gestes chirurgicaux indiqus pour leur correction suffisamment lourds. OUR EXPERIENCE IN THE MANAGEMENT OF POSTERIOR URETHRAL VALVES AT A TERTIARY HOSPITAL IN YAOUNDE Mouafo Tambo FF(1), Mbouch L(1), Nyanit D(1), Ditop J(1), Fadi S(1), Malagal R(1), Angwafo III FF(1), Andz OG(1). 1. Service de Chirurgie Pdiatrique, Hpital Gynco-Obsttrique et Pdiatrique de Yaound (HGOPY*) Correspondance: Pr Mouafo Tambo Faustin Service de Chirurgie Pdiatrique, Hpital Gynco-Obsttrique et Pdiatrique de Yaound (HGOPY) BP: 4362 Yaound, Cameroun, Email:  HYPERLINK "mailto:faustintambo@yahoo.fr" faustintambo@yahoo.fr, Tl: 00237 696098325 Background: Posterior urethral valves (PUV) are the most common cause of bladder out let obstruction in boys. Objective: The authors share their experience in the management of PUV in a resource-poor country. Methodology: This was a retrospective and descriptive study of all patients aged 0-15 years managed for PUV at the pediatric surgery service of the YGOPH, over a period of 5 years. The data collected from patients medical records was analyzed for age, duration of symptoms before presentation, presenting features, findings on the cystourethrogram and at endoscopy, surgical procedure performed, follow-up, morbidity and mortality. Results: Fifteen patients including 8 infants and 6 newborns were managed during the study period. Average duration of symptoms was 12 months (1day-96months). Majority of patients presented with symptoms of urethral obstruction, mainly difficulty in urinating. The diagnosis of urethral valves was made on the basis of voiding cystourethrogram (n=11) and /or urethrocytoscopy (n=4). Endoscopic ablation of the urethral valves and cutaneous vesicostomy were performed in 13 and 7 patients respectively. After a median follow-up of 2 years (4-64months), 2 patients presented with urethral strictures and 2 others died of chronic renal failure. Conclusion: The authors put forth a plea for early diagnosis in their context and highlight the need for a constant nephrological out-patient follow-up of patients who undergo initial urethral valve resection. Key words: urethral valves, endoscopic ablation, YGOPH. NOTRE EXPERIENCE DE LA PRISE EN CHARGE DES VALVES DE LURETRE POSTERIEUR A LHGOPY Mouafo Tambo FF(1), Mbouch L(1), Nyanit D(1), Ditop J(1), Fadi S(1), Malagal R(1), Angwafo III FF(1), Andz OG(1). 1. Service de Chirurgie Pdiatrique, Hpital Gynco-Obsttrique et Pdiatrique de Yaound (HGOPY*) Correspondance: Pr Mouafo Tambo Faustin Service de Chirurgie Pdiatrique, Hpital Gynco-Obsttrique et Pdiatrique de Yaound (HGOPY) BP: 4362 Yaound, Cameroun, Email:  HYPERLINK "mailto:faustintambo@yahoo.f" faustintambo@yahoo.f, Tl: 00237 696098325 Contexte: Les valves de lurtre postrieur(VUP) reprsentent la cause la plus frquente dobstruction du bas appareil urinaire chez le garon. Objectif: Le but de ce travail tait de rendre compte de notre exprience de la prise en charge des valves de lurtre postrieur dans le contexte dun pays en dveloppement. Mthodologie: Il sest agi dune tude rtrospective de type descriptif portant sur les dossiers mdicaux des patients gs de J0 15 ans, colligs et traits dans le service de Chirurgie Pdiatrique de lHGOPY sur une priode de 5 ans. Ont t inclus, les seuls patients dont le diagnostic de valves de lurtre postrieur a t document. Les paramtres suivant ont t retenus: ge, dlai de consultation, symptmes rvlateurs, rsultats cysto-urthrographie mictionnelle, urthrocystoscopie, gestes raliss, recul, morbidit et mortalit. Rsultats: Quinze patients dont 8 nourrissons et 6 nouveau-ns ont t traits. Le dlai moyen de consultation tait de 12 mois (1jour-96mois). Les signes urinaires taient au premier plan des symptmes rvlateurs de la maladie, domines par la dysurie. Le diagnostic a t confirm par la cysto-urthrographie mictionnelle (n=11) et/ ou luretrocystoscopie (n=4). Treize patients ont t lobjet dune rsection endoscopique des VUP et la vsicostomie a t pratique chez 7 patients. Avec un recul moyen de 24 mois (4-64mois), 2 enfants ont prsents une stnose urthrale et 2 sont dcds dans un tableau dinsuffisance rnale chronique. Conclusion:Les auteurs font un plaidoyer pour un diagnostic prcoce des VUP dans leur contexte. Ils soulignent la ncessit dun suivi rgulier en nphropdiatrie de toute VUP resque. Mots-cls: valves, rsection endoscopique, HGOPY. OUR EXPERIENCE IN THE MANAGEMENT OF DISORDERS OF SEX DEVELOPMENT: A REPORT OF 400 CASES Mouafo Tambo FF(1), Birraux J(2), Wonkam A(1), Boubakary S (1), Joko WY(1), Ditope JJ(1), Nyanit BD(1), Fossi G(1), Lyhmi NS(1), Salihou AS(1), Fadi S(1), Ngowe NgoweM(1), Andze OG(1), Sosso MA(1), Dahoun S(2), Chatelain P(3), Tardy V(3), Morel Y(3), Le Coultre C(2), Mure PY(3). Hpital Gynco-Obsttrique et Pdiatrique de Yaound Hpitaux universitaires de Genve Hospices Civils de Lyon/Universit Claude Bernard Lyon1 Correspondance: Pr Mouafo Tambo FaustinFlicien Service de chirurgie pdiatrique, Hpital Gynco-obsttrique et pdiatrique de Yaound, Cameroun. BP 4362 Yaound, Email:faustintambo@yahoo.fr Background: The prevalence of disorders of sex development (DSDs) is not known in our African milieu where late diagnosis is common. The management of DSDs is in full expansion in our country through the support from an ongoing partnership with the North. Objective: The aim of this study was to assess the importance of the local need and assert the feasibility of providing optimal care for children with DSDs in the context of a developing country. Methodology: From November 2009 to November 2015, 12 surgical team trips concerning DSDs were carried out at the YGOPH. All patients aged less than 18 years presenting with malformations of the external genitalia in whom a precise diagnosis had been made were included in the study. Results: Overall 1000 patients were seen during the study period of which 179 had a precise diagnosis. The mean age of the patients was 7.2 years. During this same period, 200 surgeries were carried out at YGOPH of which 130 hypospadias reconstructions and 15 feminizing genitoplasties. After a median follow-up of 3 years (7months -6 years) no infectious nor serious metabolic complications was recorded. Six patients had a total breakdown of the urethroplasty and 5 others had a urethocutaneous fistula. Conclusion: The authors stress on the need for a high index of suspicion and immediate referral of any abnormality of the external genitalia and immediate referral to HGOPY, they affirm the feasibility of confirm the optimal management of these disorders. Key words: disorders of sex development, management, YGOPH. LEXPERIENCE CAMEROUNAISE DE LA PRISE EN CHARGE DES ANOMALIES DU DEVELOPPEMENT SEXUEL APROPOS DE 400 CAS. Mouafo Tambo FF(1), Birraux J(2), Wonkam A(1), Boubakary S (1), Joko WY(1), Ditope JJ(1), Nyanit BD(1), Fossi G(1), Lyhmi NS(1), Salihou AS(1), Fadi S(1), Ngowe NgoweM(1), Andze OG(1), Sosso MA(1), Dahoun S(2), Chatelain P(3), Tardy V(3), Morel Y(3), Le Coultre C(2), Mure PY(3). Hpital Gynco-Obsttrique et Pdiatrique de Yaound Hpitaux universitaires de Genve Hospices Civils de Lyon/Universit Claude Bernard Lyon1 Correspondance: Pr Mouafo Tambo FaustinFlicien Service de chirurgie pdiatrique, Hpital Gynco-obsttrique et pdiatrique de Yaound, Cameroun. BP 4362 Yaound, Email:faustintambo@yahoo.fr Contexte: Les anomalies du dveloppement sexuel (ADS) ont une frquence mal connue dans notre contexte. Leur diagnostic est en gnral tardif et leur prise en charge mdico-chirurgicale en plein essor sous le couvert dune coopration Nord-Sud structure. Objectif: Lobjectif de ce travail tait de souligner limportance de la demande et daffirmer la faisabilit dune prise en charge optimale de ces anomalies y compris dans le contexte dun pays en dveloppement. Mthodologie: De novembre 2009 novembre 2015, 12 missions chirurgicales portant sur les anomalies du dveloppement sexuel ont t effectues lHGOPY. Ont t inclus dans cette tude les patients de moins de 18 ans prsentant des anomalies supposes ou avres des organes gnitaux, avec un diagnostic prcis Rsultats: 1000 patients ont t colligs. Lge moyen des patients tait de 7 ans 2 mois. Pour 179 patients (50%) un diagnostic prcis a pu tre port. Pendant cette priode nous avons effectu 200 interventions lHGOPYdont 130 reconstructions pour hypospadias et 15 gnitoplasties fminisantes. Avec un recul mdian de 3 ans (7 mois-6 ans), aucune complication systmique infectieuse ou mtabolique svre na t note. Six garons ont prsent une dhiscence complte de la reconstruction aprs chirurgie de lhypospade et 5 autres ont prsent une fistule. Conclusion: Les auteursinsistent sur lintrt dun fort index de suspicion devant la moindre anomalie des organes gnitaux externes qui doit tre rfre lHGOPY et affirment la faisabilit dune prise en charge optimale de ces affections l HGOPY. Mots cls: Anomalies du dveloppement sexuel, prise en charge, HGOPY. OUR EXPERIENCE OF FEMINISING GENITOPLASTY AT YGOPH A REPORT OF 15 CASES Mouafo Tambo FF, Birraux J, Gorduza D, Mbouche L, Kamadjou C, Dahoun S, Paturel B, Angwafo III FF, Andz OG, Le Coultre C, Mure PY Background: Feminising genital surgery involves reconstruction of the external genitalia to obtain the appearance of female external sexual characterisitcs. This procedure is known to be complex especially in under-musicalized countries due to the absence of an experienced multi- disciplinary team and an initial management from birth. Objective: The aim of this study was to share our experience on feminizing genital surgery in a developing country. Methodology: This was a descriptive cross-sectional study, over a period of 6 years concerning all patients with a precise diagnosis who had undergone feminizing genitoplasty in the pediatric surgery service of the YGOPH. Data recorded was reviewed for age at moment of diagnosis, sex of rearing, time to diagnosis and surgery, surgical technique used and results. Results: Fifteen patients were managed during the study period.Themean age before diagnosis was 3.8years (1day -17days). The average time to diagnosis was 9 months (1day -3years). One patient had been brought up as amale. The surgical indications were mainly congenital adrenal hyperplasia (n=9) and ovotesticular DSD (n=4). Surgical techniques included; gonadectomy, vaginoplasty, clitoroplasty vaginoplasty, perineoplasty and vaginal dilatations. After a follow-up of 2.8 years no metabolic disorder was recorded. Conclusion: The authors plead for the promotion of local laboratories for genetic andmolecular biology studies. Key words: Feminising genitoplasty, child, YGOPH. NOTRE EXPERIENCE DE LA GENITOPLASTIE FEMINISANTE A HGOPY A PROPOS DE 15 CAS. Mouafo Tambo FF, Birraux J, Gorduza D, Mbouche L, Kamadjou C, Dahoun S, Paturel B, Angwafo III FF, Andz OG, Le Coultre C, Mure PY Contexte: La gnitoplastie fminisante est une procdure chirurgicale par laquelle les caractristiques sexuelles dune personne sont modifies pour obtenir lapparence du sexe fminin. Elle a une rputation de complexit en particulier dans les pays sous mdicaliss en labsence dquipes multidisciplinaires exprimentes et dune prise en charge effective ds la naissance. Objectif: Le but de ce travail tait de partager notre exprience de la gnitoplastie fminisante dans le contexte dun pays en dveloppement. Mthodologie: Il sest agi dune tude transversale de type descriptif, sur une priode de six ans, dans le service de chirurgie pdiatrique de lHGOPY. Ont t inclus les seuls patients avec un diagnostic prcis chez qui une gnitoplastie fminisante a t ralise. Lge au moment de la consultation, les dlais diagnostique et thrapeutique, le sexe dlevage, les indications, les gestes raliss, les rsultats ont t tudis. Rsultats: Quinze patients ont t retenus. Lge moyen lors de la consultation tait de 3 ans 9 mois( 1 jour-17 ans). Le dlai diagnostique moyen tait de 9 mois (1jour-3ans). Le sexe dlevage tait masculin dans un seul cas. Les indications chirurgicales taient domines par les hyperplasies congnitales des surrnales (n= 9) et les ovotestis (n= 4), Les gestes raliss taient: gonadectomie, vaginoplastie, clitoridoplastie, prinoplastie, dilatations vaginales. Avec un recul moyen de 2 ans 10 mois (4 mois -5 ans), aucun dsordre mtabolique na t enregistr. Conclusion: Les auteurs font un plaidoyer pour la promotion locale de laboratoires danalyses cytogntiques et molculaires. Mots-cls: gnitoplastie fminisante, enfant, HGOPY. Surgical Treatment of Recurrent Multiple Pancreatic & Renal Cysts, in a 44-year old man, Case Presentation Kuwong Patrick , Moun Andr Hopital Catholique Notre Dame de L'Amour, Logpom, Douala, Cameroun. A 44-year old man presented with left lumbar & hypochondrial pain of several years' duration associated with a left flank mass. He had had laparotomy 8 years ago for similar complaints. Physical examination revealed a fairly healthy man with a huge cystic left flank mass. A diagnosis of Left Hydronephrosis was entertained. A C.A.T. scan showed a huge thin-walled, non-calcifiedmulti-loculated renal cyst measuring (30X18x19) cm. Estimated at, about 4.8L in volume, with pressure effects on the tail of the pancreas and marked thinning of the renal parenchma. At laparotomy he was found to have a multi-loculated distal pancreatic cyst containing about 2.5L of murky green fluid, apartly shrunken and partly cystic left kidney containing about 300cc of clear fluid/urine. The patient underwent partial distal pancreatic cystectomy, pancreaticocystogastrostomy and left renal cystectomy. And was discharged home on the 10th. Post-operative day. Poster will show the pre-operative C.A.T. Scan and the post-operative ultrasound scan (and possibly the post-op C.A.T. scan), the histology report of the cysts; and a picture ofthe abdominal scar. PRISE EN CHARGE CHIRURGICALE DE MULTIPLES KYSTES PANCREATICO-RENAUX CHEZ UN HOMME DE 44 ANS. CAS CLINIQUE. Kuwong Patrick , Moun Andr, Hopital Catholique Notre Dame de L'Amour, Logpom, Douala, (Poster) Il s'agit d'un homme de 44 ans qui a e t reu pour douleurs lombaires et de l'hypochondre gauche depuis plusieurs annes associes a une tumfaction kystique du flanc ipsilatral avec des antcdents chirurgicaux pour les mmes symptmes de sept ans. A l'examen physique son tat gnral tait bon; Il prsentait une grosse masse kystique du flanc gauche. Diagnostic: Hydronphrose gauche? Scanner: volumineux kyste rnal gauche multiloculaire paroi fine non calcifie de (30x18x19) cm avec un volume estim 4.8L, refoulant les structures avoisinantes en particulier la queue du pancras, avec laminage complet du parenchyme rnal. Laparotomie:gros kyste pancratique contenant environ 2;5L de liquide verdtre et un kyste rnale contenant environ 300cc.d'urine claire, sur un parenchyme rnal trs rduit. Le malade a bnfici d'une kystctomie pancratique distale partielle gastro- kystopancrastomie et dune kystctomie rnale gauche. Il est sorti de l'hpital au J10 post-op. Laffiche comprendra le scanner pr-opratoire, l'chographie abdomino-pelvienne post-opratoire et probablement un scanner aussi. Les rsultats de l'Anapath et une photo de l'abdomen. ENDOSCOPIC INCISION AND URETEROSCOPY FOR THE TREATMENT OF URETEROCELE AND PELVIC URETERAL CALCULI: EXPERIENCE WITH 6 PATIENTS AT A SINGLE CENTER KAMADJOU C. ; KAMENI A. ;TENKE C. ; **NJINOU NGNINKEU B. Centre Mdico-Chirurgical d'Urologie de Douala-Cameroun Kamadjou Cyril, Centre Mdico-chirurgical de Douala: HYPERLINK "mailto:Cyrkamadjou@yahoo.fr"Cyrkamadjou@yahoo.fr < HYPERLINK "mailto:Cyrkamadjou@yahoo.fr"Cyrkamadjou@yahoo.fr> Purpose: To retrospectively evaluate the safety and effectiveness of endoscopic incision and ureteroscopic lithotripsy in adults with orthotopic ureterocele and associated calculi. Methods: From January 2011 to December 2014 at our center, 6 adults underwent transurethral incision of an ureterocele and pelvic ureteroscopic lithotripsy for associated calculi. The perioperative data of these patients were retrospectively analyzed. The literature was reviewed to identify all the reported options for management of this relatively rare condition. Results: Ureterocele was associated with a single system in all patients. 3 patients had associated pelvic ureteral stones. Endoscopic ureterocele incision and ureteroscopy were used for complete stone clearance. The procedure was uneventful in all patients. The average postoperative hospital stay was 1, 5 days. All patients were stone free after the procedure. 5 patients were available for follow-up at 3 and 6 months. None of these patients had any evidence of residual ureterocele and/or hydronephrosis when evaluated at 3 months. Micturating cystourethrography (MCU) at 3 months revealed low-grade vesicoureteral reflux (VUR) in 3 patients; no reflux was found with MCU at 6 months. Conclusion: Endoscopic management of adult orthotopic ureterocele and associated calculi effectively decompressed ureterocele and removed stones in all patients without any significant postoperative morbidity. Low-grade VUR that may occur postoperatively resolved at 6 months. A literature review suggests that the management of both ureterocele and calculi simultaneously should make endoscopicaly. INCISION ENDOSCOPIQUE ET URTROSCOPIE POUR LE TRAITEMENT DE LURTROCLE ET DES CALCULS URTRAUX PELVIENS: EXPERIENCE MONOCENTRIQUE AVEC 6 PATIENTS KAMADJOU C. ; KAMENI A. ; TENKE C. ; **NJINOU NGNINKEU B. Centre Mdico-Chirurgical d'Urologie de Douala-Cameroun Kamadjou Cyril, Centre Mdico-chirurgical de Douala:HYPERLINK "mailto:Cyrkamadjou@yahoo.fr"Cyrkamadjou@yahoo.fr <HYPERLINK "mailto:Cyrkamadjou@yahoo.fr"Cyrkamadjou@yahoo.fr Objectif: valuer de faon rtrospective l'innocuit et l'efficacit de l'incision endoscopique et la lithotritie urtroscopique chez les adultes atteints de lurtrocle orthotopique et de calculs associs. Mthodologie: De janvier 2011 dcembre 2014, dans notre centre, 6 adultes ont subi une incision transurtrale pour une urtrocle et une lithotripsie urtroscopique pelvienne pour les calculs associs. Les donnes peropratoires de ces patients ont t analyses rtrospectivement. On a procd la revue de la littrature afin didentifier toutes les options dclares pour la prise en charge de cette pathologie relativement rare. Rsultats: Lurtrocle tait associe un systme unique pour tous les patients. 3 patients avaient des calculs de lurtre pelvien associs. Lurtroscopie a t utilise pour llimination complte des calculs. Lopration sest droule sans incident chez tous les patients. Lhospitalisation moyenne postopratoire tait de 1,5 jour. Tous les patients taient soulags de la douleur aprs limination des calculs. 5 patients taient disponibles pour le suivi 3 et 6 mois. Aucun de ces patients navait de preuve durtrocle rsiduelle et/ou hydronphrose lors de lvaluation 3 mois. HYPERLINK "https://www.google.cm/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwi1-5Sxn9zJAhUBWCwKHdNHBvkQFggcMAA&url=http%3A%2F%2Ffr.healthline.com%2Fhealth%2Fcysto-uretrographie-mictionnelle-cum&usg=AFQjCNEn5BaJflSBup1W3dXb-ohIQPloPA&sig2=tInH52allRrz04CZ9Q-JiA"La cysto-urtrographie mictionnelle (CUM) 3 mois a rvl un bas grade du reflux vsico-urtral (RVU) chez 3 patients; aucun reflux a t trouv avec la CUM 6 mois. Conclusion: La prise en charge endoscopique des adultes atteints durtrocle orthotopique et des calculs associs a efficacement dcompress lurtrocle aprs extraction des calculs chez tous les patients sans aucune morbidit postopratoire importante. Le bas grade du RVU pouvant survenir aprs l'intervention est rsolu 6 mois. Une revue de la littrature suggre que la prise en charge simultane de lurtrocle et des calculs devrait se faire par voie endoscopique. TRANSURETHRAL LITHOTRIPSY WITH RIGID URETEROSCOPY FOR PROXIMAL AND DISTAL URETERAL STONES: RESULTS OF A SINGLE CENTER IN CAMEROON KAMADJOU C**.(1) ; TENKE C.(1) ; KAMENI A.(1) ; NJINOU NGNINKEU B.(1) Kamadjou Cyril, Centre Mdico-chirurgical d'Urologie de Douala:  HYPERLINK "mailto:Cyrkamadjou@yahoo.fr" Cyrkamadjou@yahoo.fr< HYPERLINK "mailto:Cyrkamadjou@yahoo.fr"Cyrkamadjou@yahoo.fr> 1.Centre Mdico-Chirurgical d'Urologie de Douala-Cameroun Purpose: To evaluate the efficacy and safety of intracorporeal lithotriptors, Lithoclast (EMS, Switzerland) in retrograde rigid ureteroscopy of proximal and distal ureteric calculi. Methods: Out of 20 patients with ureteral calculi underwent Lithoclast lithotripsy using a 8/9.8F rigid ureteroscope. We reviewed the medical records from January 2010 to December 2014. Of the stones treated 14 were lower ureteric, 1 were middle ureteric and 9 were upper ureteric stones. The mean diameter of the stones was 8 mm (4-15). Two senior consultants performed the procedure. Results: Of the 24 stones, 100% were successfully fragmented: 35% of the lower, 5%of the middle and 45% of the upper ureteric stones. Median operative time was 45 minutes (range, 25-65 minutes). The average number of procedures was 1 with 18 patients requiring one, and 2 patients requiring two because of bilateral ureteral calculi. Postoperative stenting was done in all patients for 2 weeks. The post-operative hospitalization was 1 days. Significant complications include 2 case of ureteric perforation who needed prolonged internal ureteral stenting. Conclusion: In sub-saharian Africa, Rigid ureteroscopy was associated with shorter operation time and postoperative hospitalization period. These data also suggest that it was safe and more effective than open surgery in the aspect of high stone-free rate with low complication rates. We believe that it is an excellent treatment modality for managing ureteral calculi. URETEROSCOPIE RIGIDE AVEC LITHOTRITIE TRANSURETRALE POUR DES CALCULS URETERAUX PROXIMAUX ET DISTAUX: RESULTATS DUNE ETUDE MONOCENTRIQUE AU CAMEROUN KAMADJOU C**.(1) ; TENKE C.(1) ; KAMENI A.(1) ; NJINOU NGNINKEU B.(1) Kamadjou Cyril, Centre Mdico-chirurgical d'Urologie de Douala: HYPERLINK "mailto:Cyrkamadjou@yahoo.fr"Cyrkamadjou@yahoo.fr<HYPERLINK "mailto:Cyrkamadjou@yahoo.fr"Cyrkamadjou@yahoo.fr> 1.Centre Mdico-Chirurgical d'Urologie de Douala-Cameroun OBJECTIF: Evaluer lefficacit et la scurit des lithotriteurs intracorporels, Lithoclast (EMS, Suisse) dans lurtroscopie rigide par voie rtrograde des calculs urtraux proximaux et distaux. METHODES: 20 patients souffrant de calculs urtraux ont subi une lithotritie avec Lithoclast laide dun uretroscope rigide de 8/9.8F. Nous avons examin les dossiers mdicaux de janvier 2010 dcembre 2014. 14 des calculs traits se trouvaient dans le tiers infrieur de luretre, 01 dans le tiers moyen et 09 dans le tiers suprieur. Le diamtre moyen des calculs tait de 8 mm (4-15).Les interventions ont t effectues par deux spcialistes expriments. RESULTATS: Les 24 calculs ont t fragments avec succs 100%: 35% dans le tiers infrieur de luretre, 5% dans le tiers moyen et 45% dans le tiers suprieur. Le temps opratoire moyen tait de 45 minutes (entre 25 65 minutes). Le nombre moyen dintervention se rsumait 01 intervention; 18 patients ont ncessit une seule intervention et 02 en ont subi deux en raison de calculs urtraux bilatraux. Une sonde a t mise en place en postopratoire chez tous les patients pendant 02 semaines. La dure dhospitalisation aprs lopration tait dun jour. En termes de complications importantes, il y a eu 02 cas de perforation de luretre qui ont ncessit une prolongation de la dure de conservation de la sonde urtrale interne. CONCLUSION: En Afrique sub-saharienne, luretroscopie rigide ncessite un temps opratoire et une dure dhospitalisation postopratoire plus courts. Les prsentes donnes suggrent que cette intervention est plus sre et plus efficace que la chirurgie ouverte avec des taux sans calculs levs et de faibles taux de complications. Nous pensons quil sagit dun excellent mode de traitement pour la prise en charge des calculs urtraux. Laparoscopic radical prostatectomy using an extraperitoneal approach:initial experience in 20 cases in a single center in Douala, Cameroun KAMADJOU C.(1) ; TENKE C.(1) ; SANDJON J.P (2) ; KAMGA J.(3) ; KAMENI A.(1) ; **NJINOU NGNINKEU B.**(1) NjinouNgninkeubertin, Centre Mdico-Chirurgical d'Urologie de Douala:  HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com< HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com>* 1. Centre Mdico-Chirurgical d'Urologie de Douala-Cameroun* 2.Centre Mdical d'Urgence et de ranimation de Douala-Cameroun* 3.HopitalGnral de Yaound-Cameroun* Purpose: To evaluate the operative, oncologic, and functional results oflaparoscopic radical prostatectomy based on an initial series of 20 patients. We developed a pure extraperitoneal approach with pelviclymph-node dissection. This approach seems more comparable to the open technique and avoid potential risks. We evaluated the perioperative parameters (blood loss, operating time, transfusion rate) and postoperativeresults (oncological results, continence and potency) after our first 20 cases. Material and Method: Between January 2011 and April 2014, we performed 20 laparoscopic radicalprostatectomy. On average, patients were 62 years old (range 53-73), hadpreoperative mean PSA values of 20.44 ng/ml (3.2-44,30). The clinical stagewas T1 in 90%, T2 and T3 in 10%. In large majority of cases (17 patients), Gleason score was less than 7. We used a pure extraperitoneal approach and we performed a descending technique starting with the dissection at the bladder neck. The seminal vesicles dissection is comparable to the openapproach. Results: No deaths were observed in this series. No Conversion was required. Themean operating time was 198 minutes (120-300), including the lymphadenectomyphase that was considered necessary in 75% of patients. The meanpostoperative bladder catheterization time was 10 days. The mean hospitalstay was 3 postoperative days. Pathological stage was less than pT2 in 16patients (80%). Positive nodes were found in 15% of patients (3/20). At a mean follow-up of6 months, 65% of patients were free of biochemical recurrence. Detectablepostoperative PSA at 3 month was observed in 6 patients. The continencerate (no pad) was 45% at 3 months. After a nerve-sparing procedure in 13patients, the total potency rate at 6 months was 30%. Conclusions: This study confirms the value, in our experience, of the laparoscopicapproach to radical prostatectomy, which allows satisfactory cancer controlassociated with low perioperative morbidity and encouraging functionalresults in terms both of continence and erectile function. PROSTATECTOMIE RADICALE PAR VOIE LAPAROSCOPIQUE EXTRA-PERITONEALE:EXPERIENCE INITIALE MONOCENTRIQUE SUR 20 CAS A DOUALA CAMEROUN KAMADJOU C.(1) ; TENKE C.(1) ; SANDJON J.P (2) ; KAMGA J.(3) ; KAMENI A.(1) ; **NJINOU NGNINKEU B.**(1) NjinouNgninkeubertin, Centre Mdico-Chirurgical d'Urologie de Douala: HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com<HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com>* 1. Centre Mdico-Chirurgical d'Urologie de Douala-Cameroun* 2.Centre Mdical d'Urgence et de ranimation de Douala-Cameroun* 3.HopitalGnral de Yaound-Cameroun* Objectif: Evaluer les rsultats opratoires, carcinologiques et fonctionnels de la prostatectomie radicale coelioscopique sur une srie initiale de 20patients. Nous avons utilis une voie dabord extra-pritonale totale avec dissection des ganglions lymphatiques pelviens. Cette intervention chirurgicale est plus proche de la chirurgie ouverte et permet dviter dventuels risques. Nous avons valu les paramtres peropratoires (pertes sanguines, temps opratoire, taux de transfusion) et les rsultats postopratoires (rsultats oncologiques, continence et virilit) aprs les 20 premiers cas. Matriel et Mthode: Entre janvier 2011 et avril 2014, nous avons effectu 20 prostatectomies radicales par clioscopie. Les patients taient gs en moyenne de 62 ans (intervalle 53-73), la valeur moyenne de leur PSA propratoire tait de 20,44 ng/ml (3,2-44,30). Le stade clinique tait de 90% en T1, 10% en T2 et T3. Chez la grande majorit des cas (17 patients), le score de Gleason tait infrieur 7. Nous avons utilis une voie dabord extra-pritonale totale ainsi quune technique descendante en commenant par la dissection du col de la vessie. La dissection des vsicules sminales se fait comme durant lopration ouverte. Rsultats: Aucun dcs na t enregistr dans la srie ltude. Aucune conversion na t ncessaire. Le temps opratoire moyen a t de 198 minutes (120-300), y compris la phase dablation des ganglions qui sest rvle ncessaire chez 75% des patients. La dure moyenne de la conservation du cathter aprs lopration a t de 10 jours. La dure moyenne dhospitalisation a t de 03 jours aprs lopration chirurgicale. Le stade pathologique tait infrieur pT2 chez 16 patients (80%). Des ganglions positifs ont t retrouvs chez 15% des patients (3/20). A environ 06 mois de suivi, 65% des patients ne prsentaient plus de rcidive biochimique. On a not la prsence de PSA postopratoires dtectables au 3me mois chez 6 patients. Le taux de continence (absence de couches) tait de 45% 3 mois. Aprs une opration de conservation des nerfs chez 13patients, le taux de virilit total 06 mois tait de 30%. Conclusions: La prsente tude confirme limportance, dans notre exprience, de la clioscopie dans la prostatectomie radicale car elle permet de lutter efficacement contre les cancers, de garantir une faible morbidit propratoire et dobtenir des rsultats encourageants en ce qui concerne la continence et de la fonction rectile. Laparoscopic pyelolithotomy and Ureterotomy : a feasible minimally invasive treatment option in a single center in Cameroun. KAMADJOU C.(1) ; TENKE C.(1) ; SANDJON J.P (2) ; KAMGA J.(3) ; KAMENI A.(1) ; NJINOU NGNINKEU B.**(1) Njinou Ngninkeu Bertin. Centre Medico-Chirurgical d'Urologie de Douala,  HYPERLINK "mailto:Njinou@gmail.com" Njinou@gmail.com< HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com> 1. Centre Mdico-Chirurgical d'Urologie de Douala-Cameroun 2. Centre Mdical d'Urgence et de ranimation de Douala-Cameroun 3. Hopital Gnral de Yaound-Cameroun Purpose: Laparoscopy can be an alternative modality in the management of renal and ureteral stones. We present our experience with laparoscopic renal and ureteral stone surgery. Although most ureteral and renal stones are managed using endourologic techniques, open surgery or shockwave lithotripsy. Method: 31 patients (20 renal units and eleven urtral unit) underwent transperitoneal laparoscopic pyelolithotomy and ureterolithotomy at our institution. Twenty males, 11 females with mean age of 42 years (range 25-70 years) underwent 30 laparoscopic procedures. The mean stone number and size, were 3 (range 1-5) and 2 cm (range 1-4.5 cm), respectively. Five patients had staghorn calculus. After insertion of abdominal trocart, pneumoperitoneum was achieved, and the kidney or ureter was exposed. The renal pelvis and ureter was identified, dissected, and opened. The stones were extracted using laparoscopic forceps. This rigid forceps was used to extract any caliceal stones. The renal pelvis and ureter was sutured after placement of antgrade ureteral DJ stent, and the stones were removed from the peritoneal cavity. The procedure was concluded after placement of an intraperitoneal drain. Results: All procedures were completed laparoscopically. The mean operative time was 140 min. The estimated blood loss was less than 20 mL, and none of the patients received a blood transfusion.There were no major intraopertive or postoperative complications. The stone-free rate was 100%. The mean hospital stay was 3 days (range 1-5 days). All patients needed D J stent placement. One patient with infected staghorn calculus had prolonged urinary leak, which stopped with conservative management. DJ stent was removed after 40 days. Within a mean follow-up period of 3 months, no stone recurrence occurred. Conclusions: Laparoscopic removal of renal and ureteral calculi plays a role in special cases of urolithiasis. In experienced hands, it can be performed safely and efficiently and may therefore replace open stone surgery in most indications. The benefits of laparoscopy are lower postoperative morbidity, shorter hospitalization, shorter convalescence time, and better cosmetic results. PYELOLITHOTOMIE ET URETEROTOMIE PAR VOIE COELIOSCOPIQUE: UNE OPTION DE TRAITEMENT MINI-INVASIVE REALISABLE DANS UN CENTRE HOSPITALIER AU CAMEROUN KAMADJOU C.(1) ; TENKE C.(1) ; SANDJON J.P (2) ; KAMGA J.(3) ; KAMENI A.(1) ; NJINOU NGNINKEU B.**(1) Njinou Ngninkeu Bertin. Centre Medico-Chirurgical d'Urologie de Douala, Njinou@gmail.com 1. Centre Mdico-Chirurgical d'Urologie de Douala-Cameroun 2. Centre Mdical d'Urgence et de ranimation de Douala-Cameroun 3. Hopital Gnral de Yaound-Cameroun Objectif: La clioscopie peut tre une mthode alternative dans le traitement des calculs rnaux et urtraux. Nous prsentons notre exprience en matire de chirurgie coelioscopique des calculs rnaux et urtraux traits laide de techniques endo-urologiques, par chirurgie ouverte ou lithotripsie par ondes de choc. Methode: 31 patients (20 avec des calculs rnaux et onze avec des calculs urtraux) ont subi une pylolithotomie et une urtrolithotomie par clioscopie transpritonale dans notre formation sanitaire. Vingt hommes et 11 femmes pour une moyenne dge de 42 ans (entre 25-70 ans) ont subi 30 clioscopies. Le nombre moyen de calculs tait de 03 (entre 1-5) et la taille de 2 cm (entre 1-4,5 cm) respectivement. Cinq patients prsentaient des calculs coraliformes. Aprs insertion du trocart abdominal, le pneumopritoine a t atteint et le rein ou luretre expos. Le bassinet rnal et luretre ont t identifis, dissqus et ouverts. Les calculs ont t extraits laide de forceps laparoscopiques. Ce type de forceps rigide a t utilis pour extraire les calculs caliciels. Le bassinet rnal et luretre ont t suturs aprs la mise en place dune sonde DJ par voie antrograde et les calculs enlevs de la cavit pritonale. Lintervention sest acheve par la mise en place dun drain intrapritonal. Rsultats: Toutes les interventions ont t faites par voie clioscopique. Le temps opratoire moyen tait de 140 minutes et les pertes sanguines de moins de 20 ml environ. Aucun patient na ncessit une transfusion sanguine. Il ny a eu aucune complication peropratoire ou postopratoire majeure. Le taux de retrait de calcul a t de 100%. La dure moyenne dhospitalisation a t de 03 jours (entre 1-5 jours). La mise en place dune sonde DJ sest avre ncessaire pour tous les patients. Un patient souffrant de calculs coraliformes a eu des fuites urinaires prolonges qui ont t arrtes par un traitement conservatoire. La sonde DJ a t enleve aprs 40 jours. Pendant la priode moyenne de suivi de trois mois, il ny a eu aucune rapparition des calculs. Conclusions: Le retrait des calculs rnaux et urtraux par clioscopie joue un rle majeur en particulier en cas de lithiase urinaire. Effectue par un professionnel expriment, elle peut tre sre et efficace et, par consquent, elle peut tre une alternative la chirurgie ouverte pour le retrait des calculs dans la majorit des cas. La clioscopie a pour avantages de rduire la morbidit postopratoire, le sjour lhpital, la convalescence et elle produit un meilleur rsultat esthtique. Extracorporeal shock wave lithotripsy in the treatment of urinary calculi: A single center experience in Douala, Cameroun KAMADJOU C. (1) ; TENKE C. (1) ; KAMENI A. (1) ; NJINOU B. (1)* Kamadjou Cyril. Centre mdico-chirurgical d'Urologie de Douala.  HYPERLINK "mailto:cyrkamadjou@yahoo.fr"cyrkamadjou@yahoo.fr< HYPERLINK "mailto:cyrkamadjou@yahoo.fr"cyrkamadjou@yahoo.fr>* 1.Centre Mdico Chirurgical dUrologie. Douala Cameroun Purpose: The aim of this prospective study was to assess the efficiency of extracorporeal shockwave lithotripsy (SWL) in a single center in Douala-Cameroun. Materials and Methods: Between Febuary and may 2015, a total of 30 ( 18 male and 12 female) consecutive adult patients with the mean age of 42,46 years (range 19-59) presenting with stones located in renal pelvis (56,6%), Urtral JPU (23,3%), and upper ureter (20%) were treated using the DIREX Integra lithotripter. 3 patients underwent SWL after double-J ureteral catheter insertion. Treatments was performed without anesthesia and delivered in outpatients setting. Results: 19 patients (63.3%) had their calculi completely fragmented after 2 sessions and 10 (33,3%) patients had residual fragments calculi. Of these ten patients, 2 (20%) patients need retrograde ureteroscopy with double J stent placement. In one patient fragmentation was uncessful even after 4 sessions. Only one patients (12.5%) were admitted to hospital because of fever, and 8 ( 26,6%) patients presented colics, and of these 3 (37,5%) patients underwent double J stent placement. Conclusion: The management of urinary calculi in adults using SWL was proved to be safe, suitable and efficient, particularly for ureteral stones <15 mm, renal pelvic stones <20 mm. SWL delivered in an outpatient setting as an anaesthesia-free treatment is still considered the first option for the majority of stones with a minimal number of complications. TRAITEMENT DES CALCULS URINAIRES PAR LITHOTRITIE EXTRACORPORELE. UNE ETUDE MONOCENTRIQUE A DOUALA-CAMEROUN KAMADJOU C. (1) ; TENKE C. (1) ; KAMENI A. (1) ; NJINOU B. (1)* Kamadjou Cyril. Centre mdico-chirurgical d'Urologie de Douala. HYPERLINK "mailto:cyrkamadjou@yahoo.fr"cyrkamadjou@yahoo.fr 1.Centre Mdico Chirurgical dUrologie. Douala Cameroun Objectif: La prsente tude prospective vise valuer lefficacit de la lithotritie extracorporelle (LEC) dans une formation sanitaire deDouala, Cameroun. Matriels et Mthodes: Entre fvrier et mai 2015, 30 (18 hommes et 12 femmes) patients adultes conscutifs dge moyen 42,46 ans (entre 19-59)prsentant des calculs du bassinet rnal (56,6%), de la JPU(23,3%), et de luretre suprieur (20%) ont t traits laide du lithotripteur Integra - DIREX. 03 patients ont bnfici dune LEC aprs la mise en place dun cathter double-J dans luretre. Les traitements ont t administrs en ambulatoire sans anesthsie. Rsultats: Les calculs chez 19 patients (63,3%) ont t totalement fragments aprs deux sances et 10 patients (33,3%) avaient des fragments rsiduels. De ces dix patients, 02 (20%) ont ncessit une urtroscopie rtrograde avec insertion dune sonde double J. La fragmentation a chou chez un patient mme aprs 04 sances. Un seul patient (12,5%) a t admis lhpital pour un tat fbrile, et 08(26,6%) souffraient de coliques; une sonde double J a t place chez 03 (37,5%) de ces 08 patients. Conclusion: La prise en charge des calculs urinaires chez les adultes par LEC sest avre sre, approprie et efficace, en particulier pour les calculs urtraux <15 mm, les calculs du bassinet rnal <20 mm. La LEC effectue en ambulatoire sans anesthsie reste le premier choix pour la majorit des calculs avec un minimum de complications. LAPAROSCOPIC PYELOTOMY WITH COMBINED PYELOPLASTY FOR A SEVEN YEAR OLD BOY: REPORT OF ONE CASE TENKE C., KAMADJOU C., KUITCHE J., KAMENI A., NJINOU NGNINKEU B.* *Tenke christelle et Njinou Ngninkeu Bertin. Centre mdico-chirurgical d'Urologie de Douala: HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com Purpose: We present a case of a child who was referred, with a diagnosed right renal calculi and a left uretero-hydronephrosis without obstacle associated with both rightinguinal and umbilical hernias. An indication of laparoscopic pyelolithotomy with combined pyeloplasty and umbilical and inguinal hernia repair as an alternative to standard open surgery. Case presentation: A seven year-old boy, 31kg, 146cm was referred to us for a shock-wave extracorporeal lithotripsy treatment of a 1,5 cm right renal calculi, associated with a left hydronephrosis Stage: I and normal renal function. The medical history revealed several urinary tract infections since the age of 9 months, with episodes of right abdominal pains without fever or hematuria. At the age of two years, a posthectomy was performed, with a urethral calibration and a bladder catheter was left in place for 2 days. At the age of four, IVP (IntraVenous Pyelogram) and Cystography showed a mild amount of post-micturition residual urine. From five to six years old, he was recommended abundant hydration. The abdominal pain was persisting, associated with fever and an antibacterial therapy with co-amoxiclav was instituted three months before the transfer to our center. Physical examination demonstrated umbilical and rightinguinal hernia. The biological data were in the range of normal. The abdominal X-ray and ultrasonography revealed the presence of a renal stone of 15mm. If we had to do shock wave lithotripsy for the renal calculi treatment, the boy would need sedation; for the double J stent and inguinal hernia repair surgery, he would require general anesthesia. We have thereforedecided to do a right-sited laparoscopic pyelolithotomy with pyeloplasty plus double J stent and open inguinal hernia repair surgery. The patient did not need any special pre operative preparation. General anesthesia with endotracheal intubation plus controlled ventilation and maintenance with Sevoflurane, was performed. Intermittent bolus of Sufentanil and Atracurium was given. We monitored throughout the procedures the ECG, pulse oxymetry, NIBP, capnography, temperature and a nasogastric tube was placed before the surgery. In the first operative time, pyelothomy, pyeloplasty and placement of the double J were realized, drain placement and stone extraction. Then the patient was placed in the supine position. The second operative time consist of rightinguinal repair. Result: Complete stone clearance was achieved. Operative time was 124 minutes. Estimated blood loss was <50 mL. No notable complications were encountered. Intravenous analgesics drugs were administered for the post operative pain management during 48 hours. The intraperitoneal drain was removed on day 2, and the patient was discharged 72 hours after surgery. The double J stent was removed 2 weeks after surgery under general anesthesia as we performed open umbilical hernia repair. Conclusion: Laparoscopic surgery can be safely and effectively performed in the pediatric population. The procedure promotes lesser pain and complications, early rehabilitation, short hospital stay. It also minimizes the cosmetic impacts. Requiring open surgery is the last resort, because of anatomical abnormalities, or failed MIS. PYELOPLASTIE ET PYELOTOMIE PAR VOIE COELIOSCOPIQUE CHEZ UN PETIT GARON DE SEPT ANS: A PROPOS DUN CAS TENKE C., KAMADJOU C., KUITCHE J., KAMENI A., NJINOU NGNINKEU B.* *Tenke christelle et Njinou Ngninkeu Bertin. Centre mdico-chirurgical d'Urologie de Douala:HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com Objectif: Nous prsentons le cas dun enfant qui a t rfr dans notre formation sanitaire avec un diagnostic de calcul dans le rein droit, une hydronphrose sans obstacle de luretre gauche, ainsi que deux hernies, lune inguinale droite et lautre ombilicale. Une indication pour une pylolitothomie et une pyloplastie coelioscopique en vue dviter une chirurgie ouverte standard ainsi quune rparation des hernies ombilicale etinguinale. Observation: Un garon de sept ans pesant 31 kg et mesurant 146 cm nous a t envoy pour le traitement dun calcul de 1,5 cm dans le rein droit par une lithotripsie extracorporelle par ondes de choc. Il prsentait galement une hydronphrose gauche de stade I et sa fonction rnale tait normale. Les antcdents mdicaux ont mis en vidence de nombreuses infections urinaires depuis lge de 09 mois, avec des pisodes de douleurs abdominales du ct droit, afbrile et sans hmaturie. A 02 ans, il a subi une posthectomie, avec un calibrage de lurtre et la mise en place dun cathter dans la vessie pendant deux jours. A 04 ans, la prsence dune quantit modre de rsidus durine post-mictionnelle a t rvle par une IVP (Pyelogram intraveineuse) et une cystographie. De 05 06 ans, il lui a t recommand de boire beaucoup deau. Comme la douleur abdominale persistait, accompagne de fivre, il a t mis sous co-amoxiclav, un traitement antibiotique, pendant trois mois avant sa rfrence dans notre formation sanitaire. Lexamen physique a rvl une hernie ombilicale et une hernie inguinale droite. Les donnes biologiques taient normales. La radiographie abdominale et lchographie ont rvl la prsence dun calcul rnal de 15mm. Pour effectuer la lithotripsie par ondes de choc dans le traitement du calcul rnal, il aurait fallu mettre le garon sous sdatif; la mise en place de la sonde double J et la chirurgie rparatrice de la hernie inguinale, auraient ncessit une anesthsie gnrale. Nous avons donc dcid deffectuer une pylolithomie par voie laparoscopique sur le ct droit associe une pyloplastie; nous avons plac une sonde double J et procd la chirurgie rparatrice ouverte de la hernie inguinale. Le patient na ncessit aucune prparation particulire pr-opratoire. Il a t mis sous anesthsie gnrale avec intubation endotrachale, la ventilation tait contrle et son tat maintenu avec du Sevoflurane. Des bolus de Sufentanil et dAtracurium ont t administrs intervalles rguliers. Tout au long de lintervention, nous avons surveill lECG, loxymtrie du pouls, le NIBP, la capnographie et la temprature; un tube nasogastrique a t mis en place avant lintervention chirurgicale. Durant la premire heure de lopration, nous avons effectu une pylothomie et une pyloplastie, mis en place la sonde double J et un drain et enlev le calcul. Lepatient tait couch plat sur le dos. La seconde heure de lopration a t consacre la rparation de la hernie inguinale droite. Rsultat: Le calcul a t compltement enlev. Lopration a dur 124 minutes. Les pertes sanguines ont t estimes <50 ml. Aucune complication particulire na t enregistre. Des analgsiques ont t administrs en intraveineuse pendant 48 heures pour soulager la douleur post-opratoire. Le drain intrapritonal a t enlev au J2,et le patient a quitt lhpital 72 heures aprs lopration. La sonde double J a t retire 02 semaines aprs lopration sous anesthsie gnrale lors de la rparation de la hernie ombilicale. Conclusion: La coelioscopie peut tre ralise en toute scurit et efficacit chez les enfants. Cet acte chirurgical est moins douloureux et cause moins de complications, permet une radaptation rapide et raccourcit le temps dhospitalisation. Il limite galement les consquences esthtiques. La chirurgie ouverte doit tre ralise en dernier recours, en raison danomalies anatomiques ou dchec de la MIS. PEDIATRIC ANESTHESIA FOR LAPAROSCOPY: A CASE REPORT OF A SEVEN YEARS OLD BOY TENKE C., KAMADJOU C., KUITCHE J., KAMENI A., NJINOU NGNINKEU B. Centre medico-chirurgical d'Urologie. Centre Mdico-Chirurgical d'Urologie de Douala ANESTHESIE POUR COELIOSCOPIE PEDIATRIQUE: UNE ETUDE DE CAS DUN GARON AGE DE SEPT ANS TENKE C., KAMADJOU C., KUITCHE J., KAMENI A., NJINOU NGNINKEU B. Centre medico-chirurgicald'Urologie. Centre Mdico-Chirurgical d'Urologie de Douala Objectif: La cliochirurgie chez lenfant est encore une pratique rare dans les pays dAfrique sub-saharienne. La gestion de lanesthsie pdiatrique prsente des dfis en raison des spcificits lies lanatomie et la physiopathologie. Lexamen anesthsique est compliqu dans les chirurgies laparoscopiques cause des principaux effets physiologiques de pneumopritoine et le positionnement extrme du patient. Prsentation de cas: Nous prsentons une tude mene sur un enfant de sept ans ASA1, qui a t programm pour une pyloplastie lective associe une pylolithotomie laparoscopique droite et mise en place dune sonde double J. Lanesthsie gnrale a t injecte en intraveineuse. Le patient a t maintenu par une ventilation contrle laide du Sevoflurane, Sufentanil et de lAtracurium. LECG, le N.I.B.P, loxymtrie du pouls, la temprature et la capnographie ont fait lobjet dune surveillance constante. Lair de convection a t rchauff pendant lintervention afin de prvenir une hypothermie. Un tube nasogastrique a t insr pendant lintervention chirurgicale. La douleur postopratoire a t contrle par une approche multimodale: les sites dintroduction des trocarts ont t infiltrs avec de la Ropivacaine; du Tramadol et du Paractamol ont t administrs pendant 48 heures par voie intraveineuse. Au J3, des analgsiques ont t administrs par voie orale et rectale et le garon a t renvoy la maison ce jour-l. Il a t revu deux semaines plus tard pour une rparation ombilicale ouverte non urgente et le retrait de la sonde endoscopique double J. Il ny a eu aucune complication trois mois aprs les deux interventions. Conclusion: La connaissance des diffrences subtiles de lanesthsie pdiatrique, des principaux changements physiologiques induits par la clioscopie, du matriel appropri pour la surveillance, rendent la gestion de lanesthsie sre pour la cliochirurgie pdiatrique. URO040 Prostate Cancer: Experience with 100 patients in a single center in Douala, Cameroon KAMADJOU C. (1); KAMGA J. (2); EYONGETA D. (3); TENKE C.(1); KAMENI A. (1) ; NJINOU B. (1) 1. Centre Mdico Chirurgical dUrologie, Douala Cameroun 2. Hpital Gnral, Yaound Cameroun 3. Hpital Gnral, Douala Cameroun Correspondance: Dr Kamadjou Cyril : Centre Mdico Chirurgical dUrologie. Valle Manga Bell, Bali Douala Cameroun. HYPERLINK "mailto:cyrkamadjou@yahoo.fr"cyrkamadjou@yahoo.fr Purpose: Describe and evaluate how to manage patients with prostate cancer in a single center in Cameroon. Materials and methods: Between January and April 2015, 100 patients were diagnosed with a prostate cancer after prostate biopsy. A CT scan was performed in many cases to initiate the treatment. Results: The mean age was 65 and the digital examination was pathologic in 65% of cases. Prostate cancer history was found in 7% of patients. 64% of the patients had low urinary tract symptoms and the mean PSA was 432,35 ng/ml. Prostate biopsy was performed in all patients by trans rectal ultrasonography and in 93% the histology was an adenocarcinoma. The Gleason score was superior to 7 in 53% of patients. Bone mets were discribed in 20 patients. Radical prostatectomy was performed in 24% of patients, 16 patients underwent orchiectomy, 27 a deprivation hormone therapy and we proposed an active surveillance in only one patient. A first line Chemotherapy was initiated in 5 patients. At least, 32 patients did not start a treatment and 2 deaths were observed before starting the treatment. Conclusion: In our experience, prostate cancer is often diagnosed late in life when curative treatment is not an option. Patients do not accept radical prostatectomy due to urinary incontinence and impotence. CANCER DE LA PROSTATE: EXPERIENCE MONOCENTRIQUE AVEC 100 PATIENTS A DOUALA AU CAMEROUN KAMADJOU C. (1); KAMGA J. (2); EYONGETA D. (3); TENKE C.(1); KAMENI A. (1) ; NJINOU B. (1) 1. Centre Mdico Chirurgical dUrologie, Douala Cameroun 2. Hpital Gnral, Yaound Cameroun 3. Hpital Gnral, Douala Cameroun Correspondance: Dr Kamadjou Cyril : Centre Mdico Chirurgical dUrologie. Valle Manga Bell Bali Douala Cameroun.HYPERLINK "mailto:cyrkamadjou@yahoo.fr"cyrkamadjou@yahoo.fr Objectif: Dcrire et valuer la prise en charge les patients atteints du cancer de la prostate dans un seul centre au Cameroun. Matriels et mthodes: Entre janvier et avril 2015, 100 patients ont t diagnostiqus atteints de cancer de la prostate aprs une biopsie de la prostate. Un scanner a t ralis dans de nombreux cas pour initier le traitement. Rsultats: Lge moyen tait de 65 ans et l'examen numrique tait pathologique dans 65% des cas. Un antcdent de cancer de la prostate a t rvl chez 7% des patients. 64% des patients avaient des symptmes au niveau des voies urinaires basses et le PSA moyen tait de 432,35 ng / ml. Une biopsie de la prostate a t ralise chez tous les patients par chographie transrectale et 93% l'histologie tait un adnocarcinome. Le score de Gleason tait suprieur 7 chez 53% des patients. Les mtastases osseuses ont t dcrites chez 20 patients. La prostatectomie radicale a t ralise chez 24% des patients, 16 patients ont subi une orchidectomie, 27 un traitement par privation dhormone et nous avons propos une surveillance active chez un seul patient. La chimiothrapie de premire intention a t initie chez 5 patients. Au moins, 32 patients nont pas commenc un traitement et 2 dcs ont t enregistrs avant le dbut du traitement. Conclusion: Daprs notre exprience, le cancer de la prostate est souvent diagnostiqu tardivement lorsque le traitement curatif nest plus possible. Les patients nacceptent pas la prostatectomie radicale en raison de l'incontinence urinaire et de limpuissance. LAPAROSCOPIC PROMONTO-FIXATION FOR GENITAL PROLAPSE: EXPERIENCE OF 300 CASES NJINOU NGNINKEU Bertin* Clinique des Ormeaux-Vauban, Le Havre, France.* HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com < HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com> Introduction: We describe the series of our initial 300 patients treated with laparoscopic promonto-fixation (LPF). Methods: Since November 2002 and January 2015, Three hundred patients were scheduled for LPF alone for genital prolapse or combined to TVT or TOT for urinary stress incontinence. Eight had previous cure of prolapse, 50 hysterectomy and 31 vaginal vault prolapse. 30 had cystocele grade 4, 180 grade 3, 70 grade 2 and 20 grade 1. Five had rectocele grade 4, 55 grade 3, 220 grade 2 and 20 grade 1. Four presented uterine prolapse grade 4 and 6 grade 3. 120 were incontinent and 30 presented occult incontinence. No patient had overactive bladder. The procedure consists by correction of rectocele and cystocele by using 2 meshes, which are fixed, to the promontory. A TVT or TOT was placed if warranted. Results: Mean follow-up (FU) was 130 months (6-720). Patients were evaluated postoperatively at 6 and 12 months FU. LPF alone was performed to 15 patients and combined to 135 patients. Operating time<2 hours, blood loss<80 cc and mean hospital stay were 4 days. Ten patients presented recurrent cystocele grade 1, 5 rectocele grade 2, 20 de novo urgency, and 4-urge incontinence. Six urinary retention requires TVT section. Complications consist to 1 ureteral and 4 anterovaginal wounds. Conclusions: Laparoscopic promonto-fixation is feasible with good results in the cure of genital prolapse. Laparoscopy is performing the same procedure as the open technique with the advantages of the minimal invasive surgery. TRAITEMENT DU PROLAPSUS GNITAL PAR PROMONTOFIXATION COELIOSCOPIQUE : EXPRIENCE SUR 300CAS NJINOU NGNINKEU Bertin* Clinique des Ormeaux-Vauban, Le Havre, France.*HYPERLINK "mailto:Njinou@gmail.com"Njinou@gmail.com Introduction: Nous dcrivons une srie constitue de nos 300 premiers patients traits parpromontofixation coeloscopique (LPF). Mthodes: De novembre 2002 janvier 2015, trois cent patients ont t enregistrs pour un traitement par LPF du prolapsus gnital uniquement ou par une intervention de type TVT ou TOT pour prolapsus gnital associ une incontinenceurinaire deffort. Huit patients avaient dj t prcdemment traits pour un prolapsus, 50 avaient subi une hystrectomie et 31 un prolapsus de la vote vaginale. 30 patients prsentaient un cystocle de stade 4, 180 un cystocle de stade 3, 70 un cystocle de stade 2 et 20 un cystocle de stade 1. Cinq patients prsentaient un rectocle de stade 4, 55 de stade3,220 de stade 2 et 20 de stade 1. Quatre patientes prsentaient un prolapsus de lutrus de stade 4 et 6 de stade 3. 120 patients souffraient dincontinence urinaire et 30 dincontinence masque. Aucun patient ne prsentait des symptmes dhyperactivit vsicale.La procdure a consist corriger lerectocle et le cystocle laide de deux 2 prothses en treillis fixes sur le promontoire. Une intervention de type TVT ou TOT a t effectue selon le cas. Rsultats: La dure moyenne du suivi tait de 130 mois (6-720). Les patients ont t valu en postopratoire 06 et 12 mois de suivi. 15patients ont subi une LPF exclusivement et 135 patients ont bnfici dune LPF associe une TVT ou TOT. Le temps opratoire a t de <2 heures. Les pertes sanguines ont t de <80 cc et la dure moyenne dhospitalisation tait de 04 jours. Dix patients prsentaient une rcidive de cystoclede stade 1, 05 prsentaient un rectocle de stade 2, 20 prsentaient une vessie hyperactive de novo, et 04 une incontinence par impriosit. Six cas de rtention urinaire ont ncessit une intervention de type TVT. En termes de complications, nous avons enregistr 01 blessure dans luretre et 04 blessures antro-vaginales. Conclusions: La promontofixation coelioscopique est ralisable et produit dexcellents rsultats dans le traitement du prolapsus gnital. La clioscopie consiste effectuer la mme intervention que la chirurgie ouverte mais avec les avantages dune chirurgie mini-invasive. Post-Traumatic Emergency Treatment with EMDR Phil. Samuel Som The psychological psychotherapy SOM, Bonn, Germany. Psychologischer Psychotherapeut und Kinder- und Jugendlichenpsychotherapeut Dipl.-Psych. Samuel Som, Rurweg 5, 53129, Bonn, Germany. Telefon: (0228) 24 00 34 12, Telefax: (0228) 2 07 94 34 EMDR means (Eye Movement Desensitization and Reprocessing). It is a psychotherapy treatment discovered by Francine Shapiro in 1987, which was originally designed to alleviate the distress associated with traumatic memoriesFrancine Shapiro, 1989a, 1989b). Shapiros (2001) Adaptive Information Processing model posits that EMDR facilitates the accessing and processing of traumatic memories and other adverse life experience to bring these to an adaptive resolution. After successful treatment with EMDR, affective distress is relieved, negative beliefs are reformulated, and physiological arousal is reduced. During EMDR therapy the client attends to emotionally disturbing material in brief sequential doses while simultaneously focusing on an external stimulus. Therapist directed lateral eye movements are the most commonly used external stimulus but a variety of other stimuli including hand-tapping and audio stimulation are often used (Shapiro, 1991). Shapiro (1995, 2001) hypothesizes that EMDR facilitates the accessing of the traumatic memory network, so that information processing is enhanced, with new associations forged between the traumatic memory and more adaptive memories or information. These new associations are thought to result in complete information processing, new learning, elimination of emotional distress, and development of cognitive insights. EMDR therapy uses a three pronged protocol: (1) the past events that have laid the groundwork for dysfunction are processed, forging new associative links with adaptive information; (2) the current circumstances that elicit distress are targeted, and internal and external triggers are desensitized; (3) imaginal templates of future events are incorporated, to assist the client in acquiring the skills needed for adaptiv Twenty positive controlled outcome studies have been done on EMDR. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. TRAITEMENT POST-TRAUMATIQUE DURGENCE AVEC EMDR Phil. Samuel Som The psychological psychotherapy SOM, Bonn, Germany. Psychologischer Psychotherapeut und Kinder- und Jugendlichenpsychotherapeut Dipl.-Psych. Samuel Som Rurweg 5, 53129 Bonn, Telefon: (0228) 24 00 34 12, Telefax: (0228) 2 07 94 34 EMDR est un sigle amricain signifiant Eye Movement Desensitization and Reprocessing, soit en franais Mouvement des yeux, Dsensibilisation et Retraitement (de linformation). Cest une trs grande dcouverte faite en 1987 aux Etats-Unis dans le domaine des psychothrapies, par une amricaine, Francine Shapiro. LEMDR utilise lattention bifocale de la personne sur elle-mme, ce qui veut dire qu la fois, elle revit son problme dans tout son corps, parfois avec beaucoup dmotion et la fois elle considre ce qui se passe en elle au cours de cette reviviscence. Ceci nest donc pas proprement parler original, puisque la mditation utilise le mme moyen. Ce qui lest davantage, cest lutilisation dune stimulation concomitante bilatrale (de chaque cot du corps) alterne par des mouvements oculaires ou un toucher ou des sons, en mme temps que la personne revit son problme comme dcrit ci-dessus. Nous savons que ces stimulations remettent en route le retraitement des informations dysfonctionnelles lorigine des troubles. LEMDR mobilise un processus naturel de gurison psychique analogue ceux qui, par exemple, permettent la cicatrisation de lorganisme aprs une coupure. LEMDR remet en route des processus bloqus. Les motions et les reprsentations se sparent. La personne ne souffre plus quand elle repense lvnement traumatisant. LEMDR nefface pas le pass, mais il ne fait plus mal. Lestime de soi remonte. Les symptomatologies anxieuses, phobiques ou dpressives sont considrablement rduites. LEMDR est applicable avec de trs bons rsultats aussi bien pour les enfants que pour les adultes. En matire de traumatismes psychiques les tudes contrles montrent 80% de taux de gurison. La pathologie est dsormais conue comme un dsordre non seulement psychologique, mais affectant un ensemble psycho-neuro-physiologique. Mais surtout dsormais on considre que la personne dispose de moyens naturels de traitement et de gurison des traumatismes psychiques, analogues ceux qui permettent la cicatrisation dune plaie. Le traitement EMDR en tiendra compte et se servira donc de la stimulation bilatrale alterne (motricit et neurologie), pour relancer ces processus naturels. Ainsi il pourra retraiter des reprsentations (niveau psychologique) dysfonctionnelles puisque leur vocation entrane des ractions motionnelles neurovgtatives (niveau somatique et comportemental) incompatibles et inadaptes avec la situation actuelle du sujet. Laparoscopic deroofing/excision of symptomatic renal cysts in Ibadan: Initial experience 1,2Takure AO, 1,3Afuwape O, 1,2Adebayo SA, 2Chibuzo IN, 1,2Olaopa-Olapade EO, 1,2Okeke LI, 1,2Shittu OB Affiliation: 1Department of Surgery (Division of Urology), College of Medicine, University of Ibadan, Ibadan, Nigeria 2Department of Surgery (Division of Urology), University College Hospital, Ibadan, Nigeria 3Department of Surgery (Division of Gastrointestinal Surgery), University College Hospital, Ibadan, Nigeria Background: The routine use of abdominal ultrasound scan and computed tomographic (CT) scan in the investigation of abdominal symptoms has increased the detection of asymptomatic renal cysts. Symptomatic renal cysts are eminently suitable for treatment through laparoscopic approach. We report our initial experience with the laparoscopic treatment of symptomatic renal cysts in Ibadan. Results: A total of 4 patients were treated between June and October, 2015. There were2 males and 2 female. The mean age was 61.25 (age range, 40-75) years. Three of them presented with recurrent left loin pain and one had cough and fever. The comorbid conditions in the patients were hypertension in 3 and peptic ulcer disease in one patient. The complete blood count, electrolyte, urea and creatinine were all within normal limits. Abdominal ultrasound and CT scan showed thin-walled cortical cysts with sizes varing from 3.5cmx4cmx5cm to 9.8cmx8.1cmx7.4cm. All the cysts were in the left kidney, with two each located in the upper pole and middle pole respectively. The mean operating time was 200 minutes (range 180-225). The estimated blood loss was 20-80mls. All four patients had laparoscopic transperitoneal deroofing and excision of the renal cortical cysts. The postoperative period was uneventful and all were discharged on the second day after surgery. Conclusion: laparoscopic deroofing/ excision of simple renal cystsis feasible and safe in our environment. Period of hospital stay for the treatment of symptomatic simple renal cysts after surgery is short. Keywords: symptomatic renal cyst, laparoscopic deroofing/excision, Ibadan RESECTION/EXCISION LAPAROSCOPIQUE DE KYSTES RENAUX SYMPTOMATIQUES A IBADAN: PREMIERE EXPERIENCE 1,2Takure AO, 1,3Afuwape O, 1,2Adebayo SA, 2Chibuzo IN, 1,2Olaopa-Olapade EO, 1,2Okeke LI, 1,2Shittu OB 1Department of Surgery (Division of Urology), College of Medicine, University of Ibadan, Ibadan, Nigeria 2Department of Surgery (Division of Urology), University College Hospital, Ibadan, Nigeria 3Department of Surgery (Division of Gastrointestinal Surgery), University College Hospital, Ibadan, Nigeria Rsum: Lutilisation systmatique de lchographie abdominale et de la tomodensitomtrie (TDM) dans la recherche des symptmes abdominaux a augment la dtection des kystes rnaux asymptomatiques. Les kystes rnaux symptomatiques peuvent trs facilement tre traits par laparoscopie. Nous rapportons notre premire exprience de traitement par voie coelioscopique des kystes rnaux symptomatiques Ibadan. Rsultats: 04 patients au total ont t traits entre juin et octobre 2015. Il sagissait de 02 hommes et 02 femmes. La moyenne dge tait de 61,25 (tranche d'ge 40 75 ans). Trois dentre eux prsentaient une lombalgie rcurrente du ct gauche et lautre avait la toux et de la fivre. Les comorbidits taient lhypertension chez 03 patients et lulcre gastroduodnal chez un patient. La numration formule sanguine complte, llectrolyte, lure et la cratinine taient tous dans les limites normales. Lchographie abdominale et la tomodensitomtrie ont montr des kystes corticaux parois minces avec des tailles allant de 3,5 cm x4cm x5cm 9,8 cm x 8,1 cm x7,4 cm. Tous les kystes taient dans le rein gauche, avec deux situs chacun respectivement dans le ple suprieur et la partie moyenne. Le temps opratoire moyen tait de 200 minutes (intervalle: 180-225). Les pertes sanguines taient estimes 20-80ml. Les quatre patients ont subi une rsection et excision laparoscopique des kystes rnaux corticaux par voie trans-pritonale. Aucun incident na t report en post-opratoire et tous les patients sont sortis le deuxime jour aprs lintervention chirurgicale. Conclusion: la rsection/excision laparoscopique des kystes simples du rein peut tre effectue en toute scurit dans notre environnement. La priode dhospitalisation pour le traitement des kystes simples rnaux symptomatiques aprs lintervention chirurgicale est courte. Mots cls: kyste rnal symptomatique, rsection/excision laparoscopique, Ibadan Profile of major limb amputations in Zaria, north-west Nigeria Amaefule K.E, Dahiru I.L, Maitama M.I, Ejagwulu F.S PRESENTING AUTHOR: Amaefule K.E, E-mail: kenamaefule @yahoo.com Department of Orthopedics and Trauma Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria Backround: Amputation is one of the oldest surgical procedures in history. Till date, it remains one of the commonest surgical procedures. The indications cut across almost all pathologies, and the predominant ones in any region depend on certain predisposing factors in that region. Over the past six years, the northern Nigeria has witnessed increasing wave of insurgency attacks; and the Nigerian economy has grown to be the largest in Africa with the attendant change in citizens lifestyle expected of such economy. Objective: To determine if there has been a change in the profile of major amputations in Zaria, north-west Nigeria. Methodology: A retrospective descriptive study of patients who had major amputations in Ahmadu Bello University teaching hospital from January 2009 to May 2015. Results: Two hundred and two major amputations in 199 patients were studied. There were 47 children (0 -16 years) and 152 adults. The commonest indication for amputation in children was traditional bone setters post-splintage gangrene (48.9%); while diabetic foot disease was the commonest indication in adults (37.5%). Non-diabetes related peripheral vascular disease accounted for 19 amputations (12.3%). Amongst adults, the commonest indication for upper limb amputations was trauma, followed by electric burns; while diabetic foot disease was the commonest indication for lower limb amputations. Conclusion: There has been a change in the pattern of amputations amongst our adult populations with emerging disease conditions which can be attributed to a change towards a western type of lifestyle with the growth in the Nigerian economy; while that of children remains unchanged. More needs to be done on checkmating the traditional bone setters indelible mark on this vulnerable group. Profil des amputations majeures de membres Zaria, au nord-ouest du Nigeria. Amaefule K.E, Dahiru I.L, Maitama M.I, Ejagwulu F.S PRESENTING AUTHOR: Amaefule K.E E-mail: kenamaefule @yahoo.com INSTITUTION: Department of Orthopedics and Trauma Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria Contexte: Lamputation est lune des pratiques les plus anciennes de lhistoire de la chirurgie. ce jour, elle reste lune des interventions chirurgicales les plus courantes. Les indications regroupent presque toutes les pathologies, et celles qui prdominent dans toute rgion dpendent de certains facteurs prdisposants dans cette rgion. Au cours des six dernires annes, le nord du Nigeria a connu une augmentation du nombre dattaques des insurgs. En mme temps, lconomie nigriane a prospr pour devenir la premire en Afrique avec naturellement un impact sur le mode de vie des citoyens. Objectif: Dterminer le changement intervenu dans le profil des amputations majeures Zaria, au nord-ouestdu Nigeria. Mthodologie: Il sagit dune tude descriptive et rtrospective des patients ayant subis des amputations majeures au CHU Ahmadu Bello de janvier 2009 mai 2015. Rsultats: 202 amputations majeures chez 199 patients ont t tudies. Parmi ces patients, nous avions 47 enfants (de 0 16 ans) et 152 adultes. Lindication la plus courante pour lamputation chez les enfants tait la gangrne post-opratoire de la fixation osseuse traditionnelle (48,9%); tandis que le pied diabtique est lindication la plus frquente chez ladulte (37,5%). La maladie vasculaire priphrique chez les non-diabtiques reprsentait 19 amputations (12,3%). Parmi les adultes, lindication la plus frquente pour les amputations de membres suprieurs tait les traumatismes, suivis des brlures lectriques; alors que le pied diabtique tait lindication la plus frquente pour lamputation des membres infrieurs. Conclusion: Un changement est intervenu dans le profil des amputations des personnes adultes atteintes de maladies mergentes attribuables au passage un mode de vie occidental, en raison de la croissance de lconomie nigriane alors que celles des enfants restent inchanges. Beaucoup reste donc faire pour lutter contre la marque indlbile de la fixation osseuse traditionnelle dans ce groupe vulnrable. Bilateral Shoulder Dislocation presenting as a thoracic trauma: Case Report Nguene Nyemb A.G., Minyem J.R. Presenter: NGUENE NYEMB Andr Georges Fondation rodolphe dOrthopdie et Traumatologie, P.O. Box : 13666 Yaound/Cameroon  HYPERLINK "mailto:nguenenyemb@yahoo.fr"nguenenyemb@yahoo.fr Institutions: Fondation Rodolphe dOrthopdie et Traumatologie (F.R.O.T.) P.O. Box: 13666 Yaound/Cameroon Background: Unilateral anterior shoulder dislocations account for 95% of all shoulder dislocations. Bilateral shoulder dislocations are rare, and if they occurred, posterior type of dislocations is common. Bilateral anterior shoulder dislocations are very rare Objectives: We report a case of simultaneous bilateral anterior dislocations of shoulder with associated greater tuberosity fracture. Case report: A forty-year-old man presented to our center with thoracic pain following a backward fall by extending both arms behind his back. On examination there was loss of round contour of shoulder with restricted range of movements of arms. Radiographs revealed that the shoulders were dislocated with associated greater tuberosity fracture on one side. The dislocations were reduced with closed method followed by immobilization in arm sling and subsequent rehabilitation. Discussion: Shoulder dislocations typically present unilaterally and are anterior in nature. Bilateral simultaneous posterior shoulder dislocations are typically associated with seizure or electrocution and are more common than bilateral simultaneous anterior dislocations. This lesion affects mainly men with a mean age of 33.5 years. The most common cause is trauma, followed by muscle contractions due to seizures or electrocution. In 15.7% of the cases, the diagnosis of bilateral anterior dislocation was not acute (<3 weeks), and in virtually all of these cases it was not traumatic. Conclusion: All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment. An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. Luxation antrieure bilatrale dpaule prsentation thoracique: Cas clinique Nguene Nyemb A.G., Minyem J.R. Presenter: NGUENE NYEMB Andr Georges Fondation rodolphe dOrthopdie et Traumatologie, P.O. Box : 13666 Yaound/Cameroon HYPERLINK "mailto:nguenenyemb@yahoo.fr"nguenenyemb@yahoo.fr Institutions: Fondation Rodolphe dOrthopdie et Traumatologie (F.R.O.T.), P.O. Box: 13666 Yaound/Cameroon Contexte: La luxation antrieure et unilatrale de lpaule reprsente 95% de toutes les luxations dpaule. Les luxations bilatrales sont rares et sont majoritairement postrieures. Les luxations antrieures bilatrales sont trs rares. Objectifs: Nous rapportons ici un cas de luxation antrieure bilatrale associe une fracture du trochiter. Case report: Un home de 40 ans nous a t rfr pour douleur thoracique la suite dune chute en arrire sur les deux membres suprieurs en extension. Lors de lexamen clinique, on a not une perte des contours des deux paules avec une limitation des mouvements des deux bras. Les radiographies ont rvles des luxations antrieures des deux paules avec une fracture du trochiter dun ct. Les luxations ont t rduites foyers ferms avec immobilisation des deux membres suivis de rducation approprie. Discussion: Les luxations dpaule sont typiquement unilatrales et antrieures. Les luxations postrieures bilatrales sont causes par des convulsions ou des lectrocutions et sont de loin plus frquentes que les luxations antrieures bilatrales. Cette lsion touche prfrentiellement les hommes avec une moyenne dge de 33,5 ans. Ltiologie la plus frquente est reprsente par les traumatismes suivie des contractures musculaires dues aux convulsions ou aux lectrocutions. Dans 15,7% des cas, le diagnostic de luxation antrieure bilatrale nest pas fait en phase aige. Conclusion: Tous les orthopdistes et les mdecins urgentistes doivent tre sensibiliss sur la possibilit de cette association lsionnelle afin dinitier un traitement prcoce. La rduction avec immobilisation suivi dun protocole de rducation permettent dobtenir un rsultat fonctionnel satisfaisant. EPIDEMIOLOGICAL AND LESIONAL ASPECTS OF FRACTURES IN THE ELDERLY IN COTONOU, BENIN CHIGBLO Pascal, AGAVOEDO Gipsy, GOUKODADJA Oswald, TIDJANI Fiacre, LAWSON Eric, MADOUGOU Soumala, HANS - MOEVI Aristote Service de Traumatologie-Orthopdie, CNHU-HKM Cotonou-BENIN Auteur Correspondant: CHIGBLO Pascal,  HYPERLINK "mailto:chispaer@yahoo.fr"chispaer@yahoo.fr Introduction: Trauma of osteoporotic elderly are common and pose management problems. Objective: The aim of this study was to describe the epidemiological and lesional aspects of fractures in the elderly. Methodology: This is a retrospective study over a period of 3 years (2011-2013) on patients aged at least 60 years, with a fracture of the locomotor apparatus after trauma. Pathological fractures were excluded. Results: We identified 95 cases. The mean age was 70.52 years. There were 44 women and 51 men. Most patients (81%) had at least one comorbidity dominated by high blood pressure and diabetes. The mean preoperative Parker score was 8.61 and the patients were ASA 1 or 2 in 78.94% of cases. The etiologies were dominated by falls (50.53%) and traffic road accidents (46.32%). The trauma was severe in 51.58% of cases. The average admission time was 12 days. There were 119 fractures dominated by fractures of the proximal femur (39 cases). Morbidity was 53.68%. Anemia was common and 20% of patients were transfused. The average hospital stay was 36.74 days with extremes between 15 months and two days. Mortality was 5.26%. Conclusion: fractures in the elderly are relatively common and unfortunately associated with a high morbidity and mortality. Keywords: Elderly, Falls, Fractures. ASPECTS EPIDEMIOLOGIQUES ET LESIONNELS DES FRACTURES DU SUJET AGE A COTONOU, BENIN CHIGBLO Pascal, AGAVOEDO Gipsy, GOUKODADJA Oswald, TIDJANI Fiacre, LAWSON Eric, MADOUGOU Soumala, HANS - MOEVI Aristote Service de Traumatologie-Orthopdie, CNHU-HKM Cotonou-BENIN Auteur Correspondant: CHIGBLO Pascal, HYPERLINK "mailto:chispaer@yahoo.fr"chispaer@yahoo.fr Introduction: Les traumatismes du sujet g ostoporotique sont frquents et posent des problmes de prise en charge. Objectif: Le but de ce travail tait de dcrire les aspects pidmiologiques et lsionnels des fractures du sujet g. Mthodologie: Il sagit dune tude rtrospective sur une priode de 3 ans (2011-2013) portant sur les patients gs de 60 ans au moins, prsentant une fracture de lappareil locomoteur suite un traumatisme. Les fractures pathologiques taient exclues. Rsultats: Nous avons retenus 95 cas. Lge moyen tait de 70,52 ans. Il avait 44 femmes pour 51 hommes. La plupart des patients (81%) avaient au moins une comorbidit domine par lhypertension artrielle et le diabte. Le score de Parker propratoire moyen tait de 8,61 et les patients taient ASA 1 ou 2 dans 78,94% des cas. Les tiologies taient domines par les chutes (50,53%) et les accidents de la voie publique (46,32%). Le traumatisme tait violent dans 51,58% des cas. Le dlai moyen dadmission tait de 12 jours. Il avait 119 fractures domines par les fractures de lextrmit suprieure du fmur (39 cas).La morbidit tait de 53,68%. Lanmie est frquente et 20% des patients ont t transfuss. La dure moyenne dhospitalisation tait 36,74 jours avec des extrmes entre 2 jours et 15 mois. La mortalit tait de 5,26%. Conclusion: les fractures du sujet g sont relativement frquentes et malheureusement associes une morbidit et une mortalit leves. Mots-cls: sujets gs, chutes, fractures. TRAUMATIC HIP DISLOCATION IN COTONOU, BENIN CHIGBLO Pascal, TIDJANI Fiacre, PADONOU Franck, LAWSON Eric, HANS-MOEVI Aristote Service de Traumatologie-Orthopdie, CNHU-HKM Cotonou-BENIN Auteur Correspondant: CHIGBLO Pascal, E-mail:  HYPERLINK "mailto:chispaer@yahoo.fr"chispaer@yahoo.fr Introduction: Hip dislocations are a trauma emergencies. Objective: We studied their epidemiological, clinical and therapeutic aspects at the CNHU HKM. Methodology: This was a retrospective study of patients treated for traumatic hip dislocation between 2006 and 2014 and with a minimum follow up of one year. Results: we selected 23 cases out of 40. The male predominance was with a sex ratio of 4,7. Patients had a mean age of 39.6 years (18-70 years). The workers were the most affected. We noted 19 (82.6%) including 18 regular posterior dislocations. This was mainly fracture dislocation (17 of 23 cases) .The average of the dislocation reduction was 41.0 hours (2h-20 days). The final treatment was 16 times (69.6%).Orthopaedic and 7 times (30.4%) surgical including a total hip replacement. We noted few complications, 2 cases of hip osteoarthritis, and one death. The average of total weight bearing was 125 days (90-180 days). The average follow-up was 53.5 months (12-108 months). The functional results were excellent, very good and good respectively in 8 (36.4%), 4 (18.2%), and 8 patients (36.4%) by the score of Merle d'Aubign and Postel. Conclusion: Traumatic hip dislocations are an absolute emergency that can initiate the functional prognosis of the pelvic limb. They must be reduced as soon as possible in order to avoid complications. Keywords: Traumatic dislocation; hip; reduction, evolution. LES LUXATIONS TRAUMATIQUES DE HANCHE A COTONOU CHIGBLO Pascal,TIDJANI Fiacre, PADONOU Franck, LAWSON Eric, HANS-MOEVI Aristote Service de Traumatologie-Orthopdie, CNHU-HKM Cotonou-BENIN Auteur Correspondant: CHIGBLO Pascal, E-mail: HYPERLINK "mailto:chispaer@yahoo.fr"chispaer@yahoo.fr Introduction: Les luxations de hanche constituent une urgence traumatologique. Objectif: Nous avons tudi leurs aspects pidmiologiques, cliniques et thrapeutiques au CNHU-HKM. Mthodologie: Il sagissait dune tude rtrospective portant sur les patients pris en charge pour luxation traumatique de hanche entre 2006 et 2014 et ayant un suivi minimal dun an. Rsultats: nous avons retenu 23 dossiers sur 40. La prdominance tait masculineavec une sex-ratio de 4,7. Les patients taient gs en moyenne de 39,6 ans (18-70 ans). Les ouvriers taient les plus atteints. On notait 19 (82,6%) luxations rgulires dont 18 postrieures. Il sagissait majoritairement de fractures-luxation (17 cas sur 23).le dlai moyen de rduction de la luxation tait de 41,0 heures (2h-20 jours). Le traitement dfinitif tait 16 fois (69,6%) orthopdique et 7 fois (30,4%) chirurgical dont une arthroplastie totale de hanche. On notait peu de complications, dont 2 coxarthroses, et un dcs. Le dlai moyen de mise en appui total tait de 125 jours (90-180 jours). Le recul moyen tait de 53,5 mois (12-108 mois). Les rsultats fonctionnels taient excellents, trs bons et bons respectivement chez 8 (36,4%), 4 (18,2%), et 8 patients (36,4%) selon le score de Postel et Merle dAubign. Conclusion: Les luxations traumatiques de hanche sont une urgence absolue pouvant engager le pronostic fonctionnel du membre pelvien. Elles doivent tre rduites le plus tt que possible afin den viter les complications. Mots-cls: luxation traumatique; hanche; rduction, volution. Challenges of setting up an Arthroplasty: Experience of a Tertiary health care facility in a poor resource setting. Dahiru I L, Amaefule K E, Lawal Y Z, Maitama M I, Ejagwulu F S, Ogirima M O. Department of Trauma and Orthopaedic Surgery, Ahmadu Bello Univerity Teaching Hospital, Zaria. Presenter: DrDahiru I.L. E-mail:  HYPERLINK "mailto:ldismail@yahoo.com"ldismail@yahoo.com Background: The evolution of Total joint replacement operations have revolutionize the management of irreversible painful joint disorders and has also found usefulness by being extended to other pathological conditions. The present decade has and is still witnessing a rise in the number of cases being performed in different centres with variable outcomes. The sustenance of these high tech operations are not without their challenges. Ahmadu Bello University Teaching Hospital, a tertiary health care facility in Nigeria, has in the last three years established an arthroplasty unit offering mainly Total hip and Knee replacement operations. The challenges we faced sustaining this important aspect of Orthopaedic Surgery prompted us to report our experience. Method: This is a prospective study carried out over a period of three years, March 2012 to march 2015, involving 52 consecutive patients with clear indications for either THR or TKR. They were adequately councelled after diagnosis and encouraged to get funds for the operations. 7 patients out rightly rejected the procedures after councelling and opted out. Results: 52 patients with clear indications for THR or TKR were seen during the study period. There were 31 females and 21 males. The age range is 16 60years. 12 and 8 patients require bilateral THR and TKR respectively. 22 patients require unilateral THR 10 patients require unilateral TKR.17 total joint replacements were carried out on 13 patients with 4 knees and 13 hips replaced. Procedures were done periodically after pooling patients.5 patient were operated in the first year, 6 patients in the second year, and 6 patients in the third year. 12 patients require 6 12 months period to be financially ready while only one was financially ready at the time of diagnosis. 3 patients were declared unsuitable for the procedure despite being financially ready. 15 patients gave up because of prohibitive cost of operation. 7 patients rejected the offer of joint replacement and 14 patients are still at various stages of getting funds. Implants used in the first 2 years were those of Johnson and Johnson while for the third year implants were those of Smith and nephew. Conclusion: Total joint replacement operations are important advances recorded in the field of Orthopaedics with patients requiring the procedures available globally. Setting up of Arthroplasty units in poor resource settings are however not without challenges. Strenghtening the National Health Insurance policy in Nigeria can go a long way in making this important aspect of Orthopaedic Surgery well grounded. Dfis lis la ralisation dune arthroplastie: Cas dun tablissement de soins de sant tertiaires dans un milieu faibles ressources Dahiru I L, Amaefule K E, Lawal Y Z, Maitama M I, Ejagwulu F S, Ogirima M O. Department of Trauma and Orthopaedic Surgery, Ahmadu Bello Univerity Teaching Hospital, Zaria. Presenter: DrDahiru I.L. E-mail: HYPERLINK "mailto:ldismail@yahoo.com"ldismail@yahoo.com Contexte: Lvolution des oprations pour le remplacement total des articulations a rvolutionn la prise en charge des troubles articulaires douloureuses irrversibles et est galement utilis pour dautres pathologies. La dcennie actuelle a enregistr et enregistre toujours un nombre croissant de cas actuellement pris en charge dans diffrents centres avec des rsultats variables. Loffre de ces soins chirurgicaux de pointe comporte des dfis. Le Centre hospitalier universitaire Ahmadu Bello, un tablissement de soins de sant tertiaires au Nigeria, a au cours des trois dernires annes cre une Unit darthroplastie offrant principalement des oprations de remplacement total de la hanche et du genou. Les difficults auxquelles nous avons t confronts dans lappui de cet aspect important de la chirurgie orthopdique nous ont amen rapporter notre exprience. Mthode: Il sagit dune tude prospective ralise sur une priode de trois ans (de mars 2012 mars 2015), impliquant 52 patients conscutifs avec des indications claires pour lATH ou lATG. Ils ont t conseills de manire approprie aprs le diagnostic et encourags trouver des fonds pour les oprations. 7 patients ont rejet juste titre ces interventions aprs conseil et se sont dsengags. Rsultats: 52 patients (31 femmes et 21 hommes) avec des indications claires dATH ou dATG ont t observs pendant la priode dtude. Lge variait entre 16 et 60 ans. 12 et 8 patients ont eu besoin dune ATH et dune ATG bilatrale respectivement. 22 patients ont eu besoin dune ATH unilatrale, 10 patients ont eu besoin dune ATG unilatrale. 17 arthroplasties totales ont t effectues sur 13 patients avec 4 genoux et 13 hanches remplacs. Les interventions ont t effectues priodiquement aprs avoir recens les patients. 5 ont t oprs la premire anne, 6 au cours de la deuxime anne, et 6 autres patients au cours de la troisime anne. 12 patients ont eu besoin de 6 12 mois pour tre prt financirement alors quun seul tait financirement prt au moment du diagnostic. Bien que financirement prts, 3 patients ont t dclars inligibles pour ces interventions. 15 patients ont abandonn en raison du cot prohibitif de lopration. 7 patients ont rejet loffre de remplacement articulaire et 14 patients sont encore en qute de fonds. Les implants utiliss au cours des 2 premires annes taient ceux de Johnson and Johnson tandis que les implants de la troisime anne taient ceux de Smith and nephew. Conclusion: Les oprations de remplacement articulaire total constituent une avance majeure enregistre dans le domaine de lorthopdie pour les patients ncessitant les interventions disponibles lchelle mondiale. La cration d'units d'arthroplastie dans les milieux ressources limites nest cependant pas sans difficults. Le renforcement de la politique nationale dassurance maladie au Nigeria peut contribuer considrablement la mise en place de cet aspect important de la chirurgie orthopdique. Lower extremity reconstruction: the present and future - Our Experience Isiguzo C M1 ,Opara K2 Presenter: Isiguzo C M Federal Medical Centre Owerri, Imo State, Nigeria1 Email mcisiguzo@yahoo.com Federal medical Centre Owerri/ Imo State University Teaching Hospital Orlu, Imo State, Nigeria2 Background: Lower extremity reconstruction can be challenging. Management has evolved in the last two decades. Multidisciplinary approach involving the Plastic surgeons, Orthopaedic surgeons and vascular surgeons has produced the best result. A plastic surgeon with microvascular surgery expertise is a great advantage. The study presents our current experience. It demonstrates our challenges and determined our future plans. Objective: To highlight common and complex presentations of lower extremity injuries in our environment along with the challenges Methodology: A case series involving a total of 4 cases Results: The cases were managed successfully using various pedicled flap techniques Conclusion: There is need to for us to work closely with Orthopaedic surgeons in our centres to facilitate early presentation of the patients. Importantly there is a mandatory need for plastic surgeons to develop microsurgical skills in our region now more than any area of plastic surgery. RECONSTRUCTION DU MEMBRE INFERIEUR: LE PRESENT ET L'AVENIR - NOTRE EXPERIENCE Isiguzo C M1 ,Opara K2 Presenter: Isiguzo C M Federal Medical Centre Owerri, Imo State, Nigeria1 Email mcisiguzo@yahoo.com Federal medical Centre Owerri/ Imo State University Teaching Hospital Orlu, Imo State, Nigeria2 Contexte: La reconstruction du membre infrieur peut savrer difficile. La prise en charge a volu au cours des deux dernires dcennies. Lapproche multidisciplinaire impliquant les chirurgiens plasticiens, orthopdistes et vasculaires a donn les meilleurs rsultats. Etre chirurgien plasticien avec des comptences en chirurgie microvasculaire est un grand atout. L'tude prsente notre exprience actuelle, nos dfis et nos plans futurs. Objectif: Mettre en vidence les formes courantes et complexes des lsions de membres infrieurs dans notre milieu ainsi que leurs dfis. Mthodologie: Une srie de cas impliquant un total de 4 cas. Rsultats: Les cas ont t grs avec succs en utilisant diffrentes techniques de lambeau pdicul Conclusion: Il est ncessaire pour nous de travailler en troite collaboration avec les chirurgiens orthopdiques dans nos centres pour faciliter le diagnostic prcoce. Plus important encore, il est impratif pour les chirurgiens plasticiens de dvelopper les comptences en microchirurgie dans notre rgion aujourd'hui plus que tout autre domaine de la chirurgie plastique. Perforator flaps - A useful tool in reconstructive surgery Isiguzo C M1 ,Opara K2 Presenter: Isiguzo C M Federal Medical Centre Owerri, Imo State, Nigeria1 Email mcisiguzo@yahoo.com Federal medical Centre Owerri/ Imo State University Teaching Hospital Orlu, Imo State, Nigeria2 Background: Perforator flaps are among the recent inclusions to the armamentarium of the plastic surgeon which is almost becoming mainstream. This new inclusion makes it possible for any skin flaps to be harvested as long as the perforator vessels can be dissected. Objective: To present our experience and challenges in the use of perforator flaps in reconstructive surgery Methodology: Case reports Results: Good results were achieved with the use of perforator flaps in reconstruction of left elbow joint defect and post burn axillary reconstruction Conclusions: All plastic surgeons should be encouraged to explore the use of the perforator flaps in their practice as it removes most of the impediments to use of traditional pedicled flaps. LE LAMBEAU PERFORANT UNE TECHNIQUE UTILE DANS LA CHIRURGIE RECONSTRUCTIVE Isiguzo C M1 ,Opara K2 Presenter: Isiguzo C M Federal Medical Centre Owerri, Imo State, Nigeria1 Email mcisiguzo@yahoo.com Federal medical Centre Owerri/ Imo State University Teaching Hospital Orlu, Imo State, Nigeria2 Contexte: Le lambeau fait partie des dernires techniques introduites dans larsenal du chirurgien esthtique. Il en devient presque la principale. Lintroduction de cette technique permet le prlvement de tout lambeau cutan aussi longtemps que les vaisseaux perforants peuvent tre dissqus. Objectif: Prsenter notre exprience et les dfis de lutilisation des lambeaux perforants en chirurgie reconstructive Mthodologie: Rapport de cas Rsultats: Des rsultats satisfaisants ont t obtenus avec lutilisation de la technique du lambeau perforant dans la reconstruction de larticulation du coude gauche et la reconstruction axillaire suite aux brlures Conclusions: Lon devrait encourager tous les chirurgiens esthtiques utiliser la technique du lambeau perforant dans leur pratique, car elle permet dviter la plupart des obstacles lis l'utilisation des lambeaux pdiculs traditionnels. LOW BACK PAIN: ARE HOSPITALSTAFFS AT RISK? Mohammed Kabir Abubakar, Abdurrahman Mamuda, Kabiru Musa Adamu, Shamsudeen Mohammed, Mustapha Ibrahim Orthopaedic unit, Dept. of Surgery Aminu Kano Teaching Hospital, P.M.B. 3452, Kano Nigeria Presenter; Dr Mohammed Kabir Abubakar email:emkeabubakr@gmail.com Background: 80% of adult will experience low back pain at one point in their life. While most will resolve with or without medication, some may experience persistence of symptoms. Some patient may develop back pain by virtue of their work which predisposes them to mechanical back due to wrong posture. The varied nature of activities of hospital workers may predispose them to mechanical low back pain. Objective: To determine the prevalence of low back pain among hospital workers. To identify risk of low back pain among hospital workers. Methodology: The study was a cross sectional study. Two hundred health workers from the biggest Four Public Hospitals within the Kano metropolis were interviewed using questionnaire. A total of 32 stem questions were asked. Data gotten was analysed using the SPSS software. Result: 88(44%) of respondents were females while 122 (56%) were males. The mean age was 34.3years. 146(73%) of respondents have had low back pain within the last two years. Of this, 46% had their work activity affected by the low back pain. 6 patients (36%) were given excuse because of the back pain. 15.15% 0f all respondent have family history of low back pain. Equal numbers of respondents think that low back pain is preventable. Conclusion: Health workers may be at special risk due to the nature of their activities. Though it is common it may be prevented by increasing awareness among health workers on the posture and activities that reduce risk. LOMBALGIE: LE PERSONNEL DE SANT EN DANGER? Mohammed Kabir Abubakar, Abdurrahman Mamuda, Kabiru Musa Adamu, Shamsudeen Mohammed, Mustapha Ibrahim Orthopaedic unit, Dept. of Surgery Aminu Kano Teaching Hospital, P.M.B. 3452, Kano Nigeria Presenter: Dr Mohammed Kabir Abubakar email:emkeabubakr@gmail.com CONTEXTE: 80% des adultes souffriront de lombalgie un moment donn dans leur vie. Les uns sen tireront avec ou sans un traitement mdical, tandis que les autres pourraient ressentir de symptmes plus persistants. Certains patients peuvent souffrir de lombalgie en raison de la nature de leur travail qui les prdispose des lombalgies occasionnes par de mauvaises postures. La diversit des activits conduites lhpital pourrait prdisposer le personnel de sant des lombalgies mcaniques. OBJECTIF: Dterminer la prvalence des lombalgies chez le personnel de sant. Identifier les risques de lombalgies chez le personnel de sant. MTHODOLOGIE: Il sagit dune tude transversale. Des questionnaires ont t distribus deux cent personnels de sant slectionns dans les quatre plus grandes formations sanitaires publiques de la ville de Kano. Au total, 32 questions avec des sous-questions ont t poses. Les donnes recueillies ont t analyses laide du logiciel SPSS. RSULTATS: 88 (44%) des rpondants taient de sexe fminin et 122 (56%) taient de sexe masculin. Lge moyen tait de 34,3 ans. 146 (73%) des rpondants avaient souffert de lombalgies au cours des deux annes prcdentes. Le travail de 46% dentre eux en avait t affect. 06 patients (36%) avaient bnfici dune permission cause des douleurs dans le dos. 15,15% de tous les rpondants prsentaient des antcdents de lombalgies. A nombre gal, les rpondants pensent que les lombalgies sont vitables. CONCLUSION: Les personnels de sant semblent tre particulirement susceptibles de souffrir de lombalgie en raison de la nature de leur activit professionnelle. Bien que courantes, les lombalgies sont vitables par la sensibilisation des personnels de sant sur ladoption dune bonne posture et les activits permettant de rduire les risques. A simple technique for the management of coxavara deformity 1Henry Ndasi, 2Levis Nguku 1Baptist Hospital Mutengene Cameroon (E-mail:hndasi111@gmail.com) 2Cure International Childrens Hospital Kijabe, Kenya Background: Coxavara is an abnormality of the proximal femur with a decreased neck-shaft angle and resulting leg-length discrepancy. It has been associated with conditions such as congenital coxavara, traumatic injury, sepsis, rickets, vascular damage, or metabolic disorders Hilgenreinerphyseal angle (or simply the physeal angle) < 35 degrees or a neck shaft angle less than 120 degrees is used to make a diagnosis of coxavara. . Proximal femoral osteotomy is the only effective intervention, and sufficient valgus must be achieved to reduce shear forces along the physis. Current literatures describes various methods of valgus osteotomy to achieve correction with the use of elaborate instrumentation and image intensifier (C-arm) ,not available in many resource poor settings Objective: The aim of this study was to demonstrate the effectiveness of achieving this correction to a similar extent through a subtrochanteric osteotomy and an intramedullary SIGN interlocking nail Methods: Eight patients; 5 males and 3 females, age range of 6yrs -52 years were operated for coxavara deformity using a subtrochantericosteotomy and fixation with the SIGN Intramedullary locking nail. Results: All achieved correction of the deformity and had a neck shaft angle >120 degrees as gain in leg length. Conclusion: It can be concluded that Caxavara deformity can be corrected with a simple osteotomy and intramedullary nail and achieve similar good results. Une technique simple pour la prise en charge de la coxa vara 1Henry Ndasi, 2Levis Nguku 1Baptist Hospital Mutengene Cameroon (E-mail:hndasi111@gmail.com) 2Cure International Childrens Hospital Kijabe, Kenya Contexte: La coxa-vara est une anomalie du fmur proximal avec un angle cervico-diaphysaire rduit et rsultant dune ingalit de longueur des jambes. Elle a t associe des conditions telles que la coxa-vara congnitale, la lsion traumatique, la septicmie, le rachitisme, les lsions vasculaires, ou les troubles mtaboliques Langle piphysaire de Hilgenreiner (ou simplement langle piphysaire) < 35 degrs ou un angle cervico-diaphysaire de moins de 120 degrs est utilis pour poser le diagnostic de la coxa vara. Lostotomie fmorale proximale est la seule intervention efficace, et la valgisation suffisante doit tre effectue pour rduire les forces de friction le long de la physe. La littrature disponible dcrit diverses mthodes dostotomie de valgisation pour russir la correction laide dinstruments complexes et dintensificateur dimage (bras en C), non disponibles dans de nombreux milieux faibles ressources. Objectif: Le but de cette tude tait de dmontrer l'efficacit de la ralisation de cette correction un degr similaire travers une ostotomie sous-trochantrienne et le clou de verrouillage intramdullaire. Mthodologie: Huit patients: 5 hommes et 3 femmes, gs de 6 52 ans ont t oprs pour cause de coxa vara laide dune ostotomie sous-trochantrienne et dun systme intramdullaire de fixation avec clou de verrouillage. Rsultats: Tous ont eu une correction russie de la malformation avec un angle cervico-diaphysaire > 120 degrs comme gain en longueur de la jambe. Conclusion: Nous pouvons conclure que la coxa vara peut tre corrige laide dune ostotomie simple et un clou mdullaire et produire daussi bons rsultats. Arthroscopic meniscectomy: Outcome of a Cameroonian experience Nguene Nyemb A.G., Minyem J.R. Presenter: NGUENE NYEMB Andr Georges,  HYPERLINK "mailto:nguenenyemb@yahoo.fr"nguenenyemb@yahoo.fr Institutions: Fondation Rodolphe dOrthopdie et Traumatologie (F.R.O.T.) P.O. Box: 13666 Yaound/Cameroon Background: Meniscal lesions are among the most frequent surgical procedures in orthopedic surgery. Arthroscopic knee surgery is a reliable, technically sophisticated and standardized technique to treat meniscal damages of all patients. In the literature, there has been little mention of the role of arthroscopy or the treatment of sports-related injuries in a developing nation. Objectives: We report here experience of arthroscopic meniscectomy performed in an orthopedic centre in Yaound, Cameroon (in West Africa), from 2012 to 2015. Methodology: From 2012 to 2015, 19 arthroscopic meniscectomy were performed. There were 18 males (94.73%). The mean age was 22.2 (16-33) years. Among these patients, 11 (57.89%) of them were competitive athletes. Among all arthroscopic interventions 17 (89.47%) were partial meniscectomy and 2 were subtotal meniscectomy. Medial meniscectomy was performed in 13 (68.42%) patients and lateral meniscectomy in 6 (31.58%). Results: The mean follow-up was 9.4 (5-43) months. We assessed level of activity, pain, return to sports and complications. Twelve (63.16%) returned to sports at the same previous level. There were 4 (21.05%) late complications: 3 cases had synovial effusion, and one had a painful knee. Conclusion: Arthroscopy of the knee is a relatively new in our country. Arthroscopic surgery is exhibited advantages in different ways and significantly contributes to improve the outcome of knee surgery even in developing nations. It has a definite place in orthopaedics centres which has a special interest in sports-related injuries. MENISCECTOMIES ARTHROSCOPIQUES: RESULTATS DUNE SERIE CAMEROUNAISE Nguene Nyemb A.G., Minyem J.R. Presenter: NGUENE NYEMB Andr Georges, HYPERLINK "mailto:nguenenyemb@yahoo.fr"nguenenyemb@yahoo.fr Institutions: Fondation Rodolphe dOrthopdie et Traumatologie (F.R.O.T.), P.O. Box: 13666 Yaound/Cameroon Contexte: Larthroscopie est une technique chirurgicale adapte tous types de pathologie mniscale. Dans la littrature internationale, il est peu fait mention du rle de larthroscopie dans la prise en charges des accidents lis au sport dans les pays en voie de dveloppement. Objectifs: Nous rapportons dans ce travail les rsultats de mniscectomies sous arthroscopie ralises dans un centre orthopdique Yaound (Cameroun) de 2012 2015. Mthodologie: De 2012 2015, 19 mniscectomies sous arthroscopie ont t effectues. Il sagissait de 18 hommes (94.73 %) et dune femme. L'ge moyen tait 22.2 ans (de 16 33 ans). Parmi ces patients, 11 (57.89 %) taient des comptiteurs. Parmi toutes ces interventions arthroscopiques, 17 (89.47 %) taient des mniscectomies partielles et 2 taient des mniscectomies subtotales. Il sagissait chez 13 patients (de 68.42 %) du mnisque mdian et chez 6 patients (31.58 %) du mnisque latral. Rsultats: Le recul moyen tait 9.4 mois (de 5 43 mois). Le niveau d'activit, la douleur, le retour au sport et des complications ont t valus. Douze patients (63.16 %) ont pu retourner au mme niveau de pratique sportive. Quatre (21.05 %) complications tardives ont t enregistres : il sagissait de 3 hydarthroses du genou et une douleur invalidante du genou. Conclusion: Larthroscopie du genou est une pratique relativement rcente dans notre pays. Elle a de nombreux avantage qui permettent de contribuer significativement amliorer les rsultats de la chirurgie de genou dans les pays en voie de dveloppement. PROGNOSTIC FACTORS IN THE MANAGEMENT OF OSTEOSARCOMA M Oboirien, SP Agbo, OA Ajiboye, BA Galadima, RC Nwashili Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria Presenter: Dr. Muhammad Oboirien, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Email: moboirien@yahoo.com Background: Osteosarcoma remains a challenging condition to treat especially in resource poor countries. With recent advances in limb salvage procedures and chemotherapy, hopes for improved survival in patients have been renewed. Problems of late presentation, delay diagnosis, lack of resources for treatment affects the outcome of patients in our sub-region. Objectives: We aim to document the prognostic factors determining outcome of patients with osteosarcoma in our sub-region. Methodology: It was a retrospective study of cases of osteosarcoma seen in a tertiary hospital in North west Nigeria from January 2014 and June 2015. A pro-format was used to obtain data were obtained from patients clinical records, ward records, and theatre operation register. Statistical analysis was done with IBM SPSS 20. Results: There were twenty-one cases of histological confirmed osteosarcoma with age range of between 7 and 35 years and a mean age of 20.2 7.90. There were 15(71.4%) males and 6(28.6%). All the patients were of the Hausa/Fulani ethnic group. Seventy-one percent of patient were of low socioeconomic status. Majority of patients 90.5% presented with pain and swelling of the affected limb and 71.4% presented within 6 months of onset. The distal femur was the most affected in 52.4% of cases. Cross tabulation and correlation of the socioeconomic status, presenting complaints and Enneking stage of the disease with the disease showed a statistical significance (p=0.03) with the latter. Conclusion: The study showed that most patients with osteosarcoma are young individuals with advance disease and a poor prognostic outlook. FACTEURS DE PROGNOSTIC DANS LE TRAITEMENT DE LOSTEOSARCOME M Oboirien, SP Agbo, OA Ajiboye, BA Galadima, RC Nwashili Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria Presenter: Dr. Muhammad Oboirien, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Email: HYPERLINK "mailto:moboirien@yahoo.com"moboirien@yahoo.com Contexte: Lostosarcome reste une affection difficile traiter en particulier dans les pays faibles ressources. Avec les rcents progrs en matire dintervention conservatrice des membres et la chimiothrapie, les espoirs damlioration de la survie des patients ont t renouvels. Les problmes de prsentation tardive lhpital, de diagnostic tardif, de manque de ressources pour le traitement affectent le pronostic des patients dans notre sous-rgion. Objectifs: Notre objectif est de documenter les facteurs de pronostic dterminant le devenir des patients souffrant dostosarcome dans notre sous-rgion. Mthodologie: Il sagit dune tude rtrospective des cas d'ostosarcome observs dans un hpital de soins tertiaires dans le nord-ouest du Nigeria de janvier 2014 juin 2015. Une pro-forma a t utilise, des donnes ont t extraites des dossiers cliniques des patients, des dossiers de service, et du registre doprations. Lanalyse statistique a t ralise laide dIBM SPSS 20. Rsultats: Il y avait 21 cas dostosarcome histologique confirms avec une tranche dge comprise entre 7 et 35 ans et un ge moyen de 20,2 ( 7,90. Il y avait 15 (71,4%) hommes et 6 femmes (28,6%). Tous les patients taient dethnie Hausa /Foulani. 61% des patients taient de faible statut socio-conomique. La majorit des patients, 90,5%, avaient une douleur et une hypertrophie du membre affect et 71,4% se sont prsents 6 mois aprs lapparition des symptmes. Le fmur distal tait le plus touch dans 52,4% des cas. Un tableau crois et la corrlation entre le statut socio-conomique, les raisons de consultation, le stade Enneking et la maladie ont montr une importance statistique (p = 0,03) avec ce dernier. Conclusion: Ltude a montr que la plupart des patients atteints d'ostosarcome sont des jeunes. Ils se prsentent un stade avanc de la maladie avec un mauvais pronostic. Isolated dyaphyseal femoral fractures of older children: comparison between the orthopedic management and intra medullary pinning Jean-Marie Bob'Oyono1, Boris Franck BobAbessolo1, Dorcas Nyanit Bob1 Urpose/aim: The management of isolated dyaphyseal femoral fractures of older children still has some controversy as regards surgical and orthopedic management in our less favored context. In our study, we compared the orthopedic management with resin cast, and Metaizeau intra medullary pinning. The goal of this study was to determine the most adapted treatment method in our context. Methods: Our study included 40 cases with 20 treated non-operatively and 20 treated operatively by stable elastic intramedullary nailing. The orthopedic treatment consisted of placing a spica cast with pelvic immobilization for 45 days. Intramedullary nailing was done using stainless steel pins under anesthesia. The pins were removed 4 to 6 months later needing another surgical intervention. The methods of treatment were compared according to the following criteria: clinical and functional results, complications, technical difficulties and overall cost. Results: With respect to the criteria derived from the Venn diagram, we found that the clinical and functional results were the same. Stable elastic intramedullary nail however with its infectious risks was found to be more technically demanding. There was a decrease in cost of about 84% and of the days of hospitalization in the subjects treated non operatively. Conclusion: There were no differences in the clinical and functional results in the two groups of patients. However the ease of the non operative treatment associated with its accessibility makes it more reliable and is therefore recommended in our financially deprived context. Key words: Pelvi-pedious plaster cast. Stable elastic intramedullary nailing Closed isolated femoral fracture Fractures Fermes Isoles de la Diaphyse Fmorale du Grand Enfant en Milieu Africain : Comparaison entre le Traitement Orthopdique et lEmbrochage Centromdullaire Jean-Marie Bob'Oyono1, Boris Franck BobAbessolo1, Dorcas Nyanit Bob1 Objectifs: a prise en charge des fractures fermes isoles de la diaphyse fmorale du grand enfant reste un sujet controverses quant la mthode orthopdique ou chirurgicale proposer en contexte dfavoris comme le ntre. Dans cette tude, nous avons compar la mthode orthopdique par rsine synthtique pelvi-pdieuse demble lembrochage centromdullaire lastique stable de Mtaizeau. Le but de ce travail tait de dterminer la mthode thrapeutique la mieux adapt notre contexte. Mthodes: Notre tude a port sur 40 cas dont 20 traits par mthode orthopdique et 20 traits par embrochage centromdullaire lastique stable. La mthode orthopdique consistait en une immobilisation pelvi-pdieuse en rsine synthtique confectionne demble et porte pendant 45 jours. Lembrochage centromdullaire lastique stable tait fait avec des broches en acier sous anesthsie gnrale. Les broches taient retires 4 6 mois aprs leur mise en place au cours dune nouvelle intervention chirurgicale. Les deux mthodes ont t compares en termes de rsultats anatomiques et fonctionnels, de complications, de facilit de ralisation et de cot. Rsultats: Selon les critres drivs du diagramme de Venn, il en ressort entre les deux mthodes une quivalence des rsultats cliniques et fonctionnels. Par contre, lembrochage centromdullaire lastique stable, en plus du risque infectieux stait avr techniquement plus exigeant que la mthode orthopdique. Il yavait une baisse des cots dau moins 84% et du sjour hospitalier dans un rapport de 1,5/11,7 avec la mthode orthopdique. Conclusion: Ce travail a dmontr une quivalence des rsultats cliniques et fonctionnels entre les deux mthodes, mais une plus grande faisabilit, innocuit et accessibilit de limmobilisation pelvi-pdieuse demble et suggre donc de la recommander en contexte dfavoris comme le ntre. Mots-cls: Pltre pelvi-pdieux ; embrochage centromdullaire lastique stable ; fracture ferme isole du fmur Management of congenital malformations of the musculoskeletal system in Africa. Our experience about 66 cases reported in Cameroon Ibrahima Farikou, Mouafo Tambo Faustin, Ngongang Franck-Olivier. Introduction: Very little is known currently about congenital malformations of the musculoskeletal system in Africa. Ironically, the archaeologists around the world are interested in congenital malformations of the members of Akhenaten, one of the most famous pharaohs of ancient Egypt. Materials and methods: We reviewed all exploitable medical records of patients treated for congenital malformations of the musculoskeletal system in the Department of Orthopaedic Surgery of the National Centre for Rehabilitation of Disabled Persons of Yaounde, Cameroun, from 1998 to 2004. Results : They were 66 patients, 39 females for 27 males with a mean age of 7.4 years (from 1 year to 34 years). Clubfoot came first with 42 cases (56.7%) followed by hyperextension or subluxation of the knee with 5 cases (6.7%) and malformation syndrome with 4 cases (5.4%). Other rare malformations encountered were: congenital elevation of the scapula or Sprengel's disease, syndactyly, the macrodactyly etc... Discussion: These results are discussed in light of rare series published in Africa in the field. Conclusion: The new-born with birth defects is still dismissed by some ethnic customs in Africa. This study could generate interest when urban people increasingly consult modern medicine that offers orthopaedic or surgery treatment. Prise en charge des malformations congnitales de lappareil locomoteur en Afrique. Notre exprience propos de 66 cas observs au Cameroun Ibrahima Farikou, Mouafo Tambo Faustin, Ngongang Franck-Olivier. Introduction: On connat trs peu actuellement des malformations congnitales de lappareil locomoteur en Afrique. Paradoxalement, les archologues du monde entier sont intresss par les malformations congnitales des membres dAkhenaton, lun des pharaons les plus clbres de lancienne Egypte. Matriels et mthodes: Nous avons revus tous les dossiers mdicaux exploitables des malades traits pour malformations congnitales de lappareil locomoteur dans le Service de Chirurgie Orthopdique du Centre National de Rhabilitation des Personnes Handicapes de 1998 2004. Rsultats: Il y avait 66malades, 39 de sexe fminin pour 27 de sexe masculin avec une moyenne dge de 7,4 ans (de 1 an 34 ans). Le pied bot est venu en tte avec 42 cas (56.7%) suivi par lhyperextension ou la subluxation du genou avec 5 cas (6,7%) et le syndrome polymalformatif avec 4 cas (5.4%). Dautres malformations rares rencontres taient: la surlvation congnitale de lomoplate ou maladie de Sprengel, la syndactylie, la macrodactylie ou mgadactylie etc Discussion: Ces rsultats sont discuts la lumire de rares sries publies en Afrique dans le domaine. Conclusion: Le nouveau-n porteur de malformations est encore rejet par quelques coutumes ethniques en Afrique. Cette tude pourrait susciter un intrt au moment o en zones urbaines des gens consultent de plus en plus la mdecine moderne qui propose un traitement orthopdique ou chirurgical. Limb lengthening in Africa: tibial lengthening indicated for limb length discrepancy and Post Osteomyelitis Pseudarthrosis Farikou Ibrahima1,2 Pius Fokam* Flicien Faustin Mouafo Tambo1 Department of Surgery and Specialties. Faculty of Medicine and Biomedical Sciences, University Of YaoundeI,Yaounde, Department of Surgery, Douala General Hospital, Douala. Cameroon Background: We present a case of lengthening of a tibia to treat postosteomyelitis pseudarthrosis and limb length discrepancy by the Ilizarov device. Objective: The objective was to treat the pseudarthrosis and correct the consequent limb length discrepancy of 50 mm. Materials and methods: The patient was a 5-year-old boy. Osteotomy of the tibia, excision of fibrosis, and decortications were carried out. After a latency period of 5 days, the lengthening started at a rate of 1 mm per day. Results: The pseudarthrosis healed and the gained correction was 21.73%. The index consolidation was 49 days/cm. Minor complications were reported. Discussion: Osteomyelitis of long bones is a common poverty-related disease in Africa. The disease usually is diagnosed at an advanced stage with complications. In these conditions, treatment is much more difficult. Most surgical procedures treating this condition use the Ilizarov device. The most common reported surgical complications are refractures and recurrence of infection. Conclusion: This technique should be popularized in countries with limited resources because it would be an attractive alternative to the amputations that are sometimes performed. Keywords: Limb length discrepancy (LLD), bone gap, Ilizarov device ALLONGEMENT DE MEMBRE EN AFRIQUE: INDICATION POUR LALLONGEMENT DE MEMBRE DANS LES CAS DE PSEUDARTHROSE POST-OSTEOMYELITE Farikou Ibrahima1,2 Pius Fokam* Flicien Faustin Mouafo Tambo1 Department of Surgery and Specialties. Faculty of Medicine and Biomedical Sciences, University Of YaoundeI,Yaounde, Department of Surgery, Douala General Hospital, Douala. Cameroon Contexte: Nous prsentons un cas dallongement du tibia pour traiter la pseudarthrose post-ostomylite et lingalit de longueur des membres par la technique dIlizarov. Objectif: Lobjectif tait de traiter la pseudarthrose et corriger lingalit delongueur des membres de 50 mm. Matriel et mthodes: Le patient tait un garon de 5 ans. Lostotomie tibiale, lexcision de la fibrose, et la dcortication ont t ralises. Aprs une priode de latence de 5 jours, lallongement a commenc une vitesse de 1 mm par jour. Rsultats: La pseudarthrose a t gurie et la correction tait russie 21,73%. Lindice de consolidation tait de 49 jours/cm. Des complications mineures ont t signales. Discussion: Lostomylite des os longs est une maladie courante lie la pauvret en Afrique. Cette maladie est gnralement diagnostique un stade avanc avec des complications. Dans ces conditions, le traitement savre plus difficile. La plupart des interventions chirurgicales pour traiter cette maladie utilisent la technique dIlizarov. Les complications chirurgicales les plus couramment signales sont les nouvelles fractures et la rcurrence de linfection. Conclusion: Cette technique devrait tre vulgarise dans les pays aux ressources limites, car elle serait une alternative intressante aux amputations qui sont parfois effectues. Mots-cls: Ingalit delongueur des membres, cart osseux, technique dIlizarov. Disease Etiologies Emphasized in Pediatric Orthopedic Clinical Research Projects Conducted in Low and middle Income Countries Liu M1, Wu HH2, Patel KR2, Turner W2, Caldwell AM2, Coughlin R2, Morshed S2, Shearer D2 1Stanford University School of Medicine, Stanford, CA, USA, 2University of California, San Francisco, San Francisco, California, USA Presenter: Max Liu, 1220 Earnest Street, Hercules, California, 94547, USA Correspondence to: Max Liu, +1(510)691-8034, maxliu@stanford.edu Background: Despite the high burden of pediatric orthopedic disease in low-and-middle income countries (LMICs), little is known about the research efforts to address this burden. Objectives: The purpose of this scoping review is to assess the breadth and quality of pediatric orthopedic research conducted in LMICs. Methods: Pediatric orthopedic clinical studies conducted in LMICs from 2004-2014 were retrieved and evaluated based on the following: disease etiology, region, and type of collaboration, study design, level of evidence, study population size, and outcome measures reported. Findings: Of the 129 included studies, 21% were collaborative between an LMIC and a high-income country (HIC), and 5% were multicenter studies between two or more LMICs.84.7% of studies generated low quality evidence (Level IVor lower) and 18 (14%) studies utilized a control group. The most frequently studied diseaseetiologies were traumatic (37%) and congenital (36%).Congenital papers primarily focused on clubfoot (43%) and hip dysplasia (15%).The majority of papers (74%) were conducted in either Sub-Saharan Africa or South Asia. Collaborative papers were more likely than non-collaborative papers to generate Level III evidence or higher (40% versus 19%, respectively). Interpretation: The low quality papers highlight the need for improved research methodology in pediatric orthopedic studies conducted in LMICs. ETIOLOGIES DES MALADIES PRESENTEES DANS LES PROJETS DE RECHERCHE CLINIQUE EN ORTHOPEDIE PEDIATRIQUE MENEE DANS LES PAYS A REVENU FAIBLE ET MOYEN Liu M1, Wu HH2, Patel KR2, Turner W2, Caldwell AM2, Coughlin R2, Morshed S2, Shearer D2 1Stanford University School of Medicine, Stanford, CA, USA, 2University of California, San Francisco, San Francisco, California, USA Contexte: Malgr la forte charge des maladies orthopdiques pdiatriques dans les pays revenu faible et moyen (PFR-PRI), on en sait peu sur les efforts de recherche pour faire face ce fardeau. Objectifs: L'objectif de cette tude de porte est d'valuer l'ampleur et la qualit de la recherche en pdiatrie orthopdique dans les PFR-PRI. Mthodes: les tudes cliniques orthopdiques pdiatriques menes dans les PFR-PRI de 2004-2014 ont t colliges et values sur la base suivante: tiologie de la maladie, rgion, type de collaboration, conception de l'tude, niveau de preuve, taille de la population d'tude, et mesures de rsultats dclars. Rsultats: Sur les 129 tudes considres, 21% taient le fruit dune collaboration entre un PFR-PRI et un pays revenu lev (HIC), et 5% taient des tudes multicentriques entre deux ou plusieurs PFR-PRI. 84,7% des tudes ont produit des preuves de qualit mdiocre (niveau IV ou infrieur) et 18 (14%) tudes ont utilis un groupe tmoin. Les tiologies des maladies les plus couramment tudies taient traumatiques (37%) et congnitales (36%). Les tudes congnitales taient principalement axes sur le pied bot (43%) et la dysplasie de la hanche (15%). La majorit des tudes (74%) ont t ralises soit en Afrique subsaharienne soit en Asie du Sud. Les tudes collaboratives taient plus susceptibles de gnrer des preuves de niveau III ou suprieur, comparativement aux tudes non-collaboratives, (40% contre 19%, respectivement). Interprtation: Les tudes de qualit mdiocre mettent en vidence la ncessit d'amliorer la mthodologie de la recherche dans les tudes orthopdiques pdiatriques menes dans les PFR-PRI. EPIDEMIOLOGICAL, DIAGNOSTIC AND THERAPEUTIC ASPECTS OF CHRONIC OSTEOMYELITIS IN CHILDREN AT YGOPH Mouafo Tambo FF(1), Nyanit D(1), AwonaTsogo RMM(1), Fossi G(1), Ditope JJ(1), Mbouche L(1), Andze OG (1) *Pediatric surgery department, Gyneco-Obstetric and Pediatric Hospital of Yaound (YGOPH) Corresponding author:PrMouafo Tambo Faustin Pediatric surgery Department, Gyneco-Obstetric and Pediatric Hospital of Yaound (YGOPH) P.O Box: 4362 Yaound, Cameroon, Email:  HYPERLINK "mailto:faustintambo@yahoo.fr"faustintambo@yahoo.frTl: 00237 696098325 Background: Currently, osteomyelitis remains a relatively common disease in Cameroon and we frequently encounter complex and unusual patterns in our daily pediatric surgical practice. Objective: This study aimed at describing the epidemiologic, diagnostic and therapeutic particularities of these infections at the YGOPH. Methodology: We carried out a retrospective, descriptive and analytic study over a period of 10 years in the pediatric surgery department of the YGOPH. Data was collected from medical records of all patients aged 0-15 years presenting with chronic osteomyelitis who had been managed at our service during the study period. Results: Twenty patients with chronic osteomyelitis were managed with an average of two cases per year. The age at presentation ranged from 6 months to 14 years, with a mean of 8 years. Average duration of symptoms before consultation was 12 months. Patients with sickle cell hemoglobinopathy represented 12.5% of our study population. Pattern of chronic osteomyelitis with no sinus tract formation was seen in 68.8% of our patients at the time of diagnosis. Long bones were the most commonly affected. Radiologic assessment done solely with the standard x-ray showed: sub-periosteal new bone formation (56.3%), lytic lesions (37.5%), sequestrum (18.8%) and pathological fractures (12.6%). Staphylococcus aureus was the most common infectious organism (58.3%). Surgical management required sequestrectomy and surgical resection of all infected tissues (43.8% each). After a median follow up of 2years and a half, 50% of our patients were lost to follow up, 20% presented with sequelae and 30%were healed. Conclusion: Late presentation of patients with chronic osteomyelitis in our setting indicates that most parents seek treatment for their children in an inappropriate place like herbal homes, the routine practice of automedication and ignorance of acute osteomyelitis by some practitioners. Key-words: chronic osteomyelitis, child, epidemiology, diagnosis treatment. PARTICULARITES EPIDEMIOLOGIQUES, DIAGNOSTIQUES ET THERAPEUTIQUES DE LOSTEOMYELITE CHRONIQUE DE LENFANT A LHGOPY* Mouafo Tambo FF(1), Nyanit D(1), AwonaTsogo RMM(1), Fossi G(1), Ditope JJ(1), Mbouche L(1), Andze OG (1) *Pediatric surgery department, Gyneco-Obstetric and Pediatric Hospital of Yaound (YGOPH) Corresponding author:PrMouafo Tambo Faustin Pediatric surgery Department, Gyneco-Obstetric and Pediatric Hospital of Yaound (YGOPH) P.O Box: 4362 Yaound, Cameroon, Email: HYPERLINK "mailto:faustintambo@yahoo.fr"faustintambo@yahoo.frTl: 00237 696098325 Introduction: Les ostomylites chroniques (OMC) de lenfant sont des affections frquentes en pratique chirurgicale pdiatrique en Afrique et en particulier au Cameroun. Le but de ce travail tait de prciser les spcificits pidmiologiques, diagnostiques et thrapeutiques de ces affections lHGOPY*. Matriel et mthodes: Notre tude a t rtrospective, descriptive et analytique sur une priode de 10ans, de 2006 2015 dans le service de chirurgie pdiatrique de lHGOPY. Elle a port sur les dossiers mdicaux complets des patients entre J0 et 15 ans de vie dont la prise en charge diagnostique et thrapeutique a t effectue a HGOPY. Rsultats : Vingt dossiers ont t colligs soit une frquence hospitalire de 2 cas par an. Lge moyen tait de 8 ans avec des extrmes de 6mois et 14 ans, et la tranche dge 6-10 ans reprsentait 50% de notre effectif. Le sex ratio tait de 1,6 en faveur des garons. Le dlai moyen de consultation tait de 12 mois avec des extrmes de 1 mois et 5 ans. Le niveau dinstruction des parents tait celui du primaire dans 56% de notre effectif. Le terrain drpanocytaire reprsentait 12,5% de notre casuistique. Au plan diagnostique, la prdominance des formes non-fistulises tait remarquable avec 68,8% de notre srie. La topographie de linfection osseuse chronique quant elle mettait au premier plan latteinte des os longs, avec quitablement 31,3% pour le fmur au membre pelvien et lhumrus au membre thoracique. Limagerie mdicale domine par la radiographie standard rvlait: appositions prioste lamellaire (56,3%), lacunes (37,5%), squestres (18,8%) et fractures pathologiques (12,6%). Le staphylocoque dor tait le germe le plus retrouv (58,3%). Le dlai therapeutique moyen tait de 9 jours, avec des extrmes de 3 et 29 jours. Les gestes chirurgicaux taient domins par trpanation, squestrectomie (43,8% chacun), curetage osseux et myoplastie de comblement, en un seul temps opratoire, et lirrigation drainage lavage tait systmatique de mme que limmobilisation pltre. Au recul moyen de 30 mois, 50% des patients taient perdu de vue, 20% prsentaient des squelles type dingalit de longueur des membres dau moins 2,5cm et 30% taient guris. Conclusion : Le retard la consultation des patients porteurs dOMC dans notre contexte tmoigne du poids des thrapeutes traditionnels et du recours systmatique lautomdication, mais aussi rend compte de la mconnaissance de lostomylite aigue par certains praticiens. Le programme en un seul temps opratoire prend en compte le bas niveau socio-conomique des populations et labsence dun systme de protection sociale dans notre milieu. Mots-cls : ostomylite chronique, enfant, pidmiologie, diagnostic, traitement. Results of Ponseti method for the treatment of congenital clubfoot Nguene Nyemb A.G1,2,3., Azanguim M.1,2,3, De Chabot G.3., Necdem S.2, Presenter: NGUENE NYEMB Andr Georges ,  HYPERLINK "mailto:nguenenyemb@yahoo.fr"nguenenyemb@yahoo.fr Fondation Rodolphe dOrthopdie et Traumatologie P.O. Box / B.P. 13666 Yaounde/Cameroon Institutions:(1) Fondation rodolphe dOrthopdie et Traumatologie, P.O. Box: 13666 Yaound/Cameroon (2) Promhandicam Association, P.O. Box: 4018 Yaound/Cameroon (3) Centre de Sant catholique de Bikop Background: The Ponseti method is the preferred treatment for clubfoot. Success reports with this method in the treatment of congenital clubfoot have led to a renewed interest in this method among medical community. Objectives: In 2013, Ponseti method was introduced for treating clubfoot. The present multicentric study was conducted to evaluate results of this method. Methodology: This study was carried out on 37 consecutive infants with a total of 58 clubfeet. Thirty-one children (83.78%) were idiopathic. The mean age of the patients at initial treatment was 17.98 months (range 7 days - 14 years-old). Feet were classified using the Pirani score, the average score was 4 (range 1.5 - 6). Results: The average follow-up was 9 months (range 2-19months). Infants required a median of 5 casts (range 2 11 casts) to correct the clubfoot deformity with 64.86% of tenotomy or Achilles tendon lengthening. The initial correction rate for all patients with the Ponseti technique was 57/58 feet (98.28%), only one infant (1/58 feet) failed to show any improvement. Recurrences was observed in 9 patients, all but one of them responded to the same method and were put back on brace. Conclusion: We thus support this treatment for the management of clubfeet as most infants responded satisfactorily in terms of deformity correction and achieved plantigrade feet. These results compare favourably to other specialist orthopaedic-based services for Ponseti management of clubfeet. Rsultats de lutilisation de la mthode Ponseti dans la prise en charge du pied-bot varus quin Nguene Nyemb A.G1,2,3., Azanguim M.1,2,3, De Chabot G.3., Necdem S.2, Presenter: NGUENE NYEMB Andr Georges, HYPERLINK "mailto:nguenenyemb@yahoo.fr"nguenenyemb@yahoo.fr Institutions: (1) Fondation rodolphe dOrthopdie et Traumatologie, P.O. Box: 13666 Yaound/Cameroon (2) Promhandicam Association, P.O. Box: 4018 Yaound/Cameroon (3) Centre de Sant catholique de Bikop Contexte: La mthode Ponseti est le traitement le plus largement rpandu du pied-bot varus quin. Les bons rsultats en utilisant cette mthode dans le traitement du pied-bot congnital suscitent un intrt de plus en plus croissant de la communaut mdicale. Objectifs: En 2013, la mthode a t introduite dans notre pratique pour traiter le pied-bot. La prsente tude multicentrique a t mene afin dvaluer les rsultats de ce traitement. Mthodologie: Cette tude a t mene sur 37 enfants pour un total de 58 pieds-bots. Trente et un enfants (83,78 %) prsentaient des pieds-bots idiopathiques. L'ge moyen des patients au dbut du traitement tait de 17,98 mois (de 7 jours 14 ans). La svrit de la dformation a t grade en utilisant le score de Pirani, le score moyen tait de 4 (de 1,5 6). Rsultats: Le recul moyen tait de 9 mois (de 2 19 mois). Le nombre moyen de pltrage pour corriger la dformation tait de 5 (de 2 11 pltrages). Vingt-quatre enfants (64,86 %) ont eu une tnotomie ou un allongement de tendon d'Achille. Le taux de correction initial pour tous les patients tait de 57/58 pieds (98.28 %), dans un cas la dformation na pas pu tre corrige. Neuf patients ont prsent des rcidives, parmi eux 8 ont pu tre corrig en utilisant la mme mthode. Conclusion: Lutilisation de la mthode de Ponseti dans la prise en charge des pieds-bots donne des rsultats satisfaisants et comparables aux autres sries de la littrature. THE PROFILE AND SURGICAL TREATMENT OF SYRINGOMYELIA IN NIGERIAN PATIENTS Ukachukwu AK2, Tiamiyu LO2, Adeleye AO1,2, Adeolu AA1,2, Malomo AO1,2, Shokunbi MT1,2 1Department of Surgery, College of Medicine, University of Ibadan, and 2Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria. Presenting author: Ukachukwu AK - Department of Neurological Surgery - University College Hospital - PMB 5116, Ibadan, Nigeria - Phone: +234 816 733 5934 HYPERLINK "mailto:dr_alvan@yahoo.com"dr_alvan@yahoo.com Background/Objective: Syringomyelia is a rare degenerative disorder of the spinal cord of variable aetiology. There is a dearth of reports on this condition in the African population, thus this study describes the profile and outcome of surgical treatment in our population of patients. Methods: We retrospectively reviewed ten patients who were surgically treated over the period 2004-2014 and extracted data on the patients gender, age, aetiology, location of syrinx, diagnosis, operative procedure and outcome. We analysed the data with simple statistical tools. Results: There were 7 males and 3 females, with average age 33.1+/-13.1 years (range 2-55 years). The aetiologies were: Chiari malformation (3), intramedullary spinal tumour (3), foramen magnum tumour (1), post-traumatic (1), iatrogenic chemical arachnoiditis (1) and idiopathic (1). The syrinx was located in the cervical region in six patients and cervicothoracic region and multi-level in two patients each. The operative procedures were posterior fossa decompression (3 patients), sub-occipital craniectomy with laminectomy and tumour excision (2 patients), laminectomy and syringomyelotomy (2 patients), laminectomy and tumour excision (2 patients), ventriculoperitoneal shunting (1 patient). The duration of follow up ranged from 2 weeks to 35 months. The outcome is satisfactory in eight patients (improvement in clinical status, with five patients returning to pre-operative occupation). A child who had an initial ventriculoperitoneal shunt died at home before definitive surgery could be done, and another patient (an adult male) died of respiratory insufficiency. Conclusion: Syringomyelia is a rare clinical entity in our population with similar aetiologies to previously described data. The outcome of surgical treatment in our small group of patients is satisfactory. PROFIL ET TRAITEMENT CHIRURGICAL DE LA SYRINGOMYLIE CHEZ LES PATIENTS NIGERIANS Ukachukwu AK2, Tiamiyu LO2, Adeleye AO1,2, Adeolu AA1,2, Malomo AO1,2, Shokunbi MT1,2 1Department of Surgery, College of Medicine, University of Ibadan, and 2Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria. Presenting author:Ukachukwu AK - Department of Neurological Surgery - University College Hospital - PMB 5116, Ibadan, Nigeria - Phone: +234 816 733 HYPERLINK "mailto:5934%20dr_alvan@yahoo.com"5934 dr_alvan@yahoo.com Contexte/Objectif: La syringomylie est un trouble dgnratif rare de la moelle pinire d'tiologie variable. Il existe trs peu dinformations concernant cette maladie au sein de la population africaine; cette tude dcrit donc le profil et les rsultats du traitement chirurgical de nos patients. Mthode: De faon rtrospective, nous avons pass en revue le cas de dix patients qui ont t oprs entre 2004-2014 ainsi que les donnes recueillies sur le sexe, lge, ltiologie, la localisation du syrinx, le diagnostic, lacte chirurgical et les rsultats. Nous avons analys les donnes avec des outils statistiques simples. Rsultats: Il y avait 7 hommes et 3 femmes, avec un ge moyen de 33,1 +/- 13,1 ans (intervalle de 2 55 ans). Les tiologies taient: la malformation de Chiari (3), la tumeur de la moelle mdullaire (3), la tumeur du foramen magnum (1), post-traumatique (1), liatrogne arachnodite chimique (1) et idiopathique (1). Chez six patients, le syrinx tait situ dans la rgion du col utrin et dans la rgion cervico-thoracique chez lun et plusieurs niveaux chez lautre. Les actes chirurgicaux taient la dcompression de la fosse postrieure (3 patients), la craniectomie sous-occipitale avec laminectomie et excision de la tumeur (2 patients), la laminectomie et la syringomylotomie (2 patients), la laminectomie et excision de la tumeur (2 patients), une drivation ventriculo-pritonale (1 patient). La dure du suivi variait de 2 semaines 35 mois. Le rsultat a t satisfaisant chez huit patients (amlioration de l'tat clinique, avec cinq patients revenus pour une activit propratoire). Un enfant qui avait un dbut de drivation ventriculo-pritonale est dcd la maison avant quon ne puisse effectuer une chirurgie dfinitive; un autre patient (un homme adulte) est dcd des suites dinsuffisance respiratoire. Conclusion: La syringomylie est une entit clinique rare au sein de notre population avec des tiologies similaires aux donnes dcrites ci-dessus. Le rsultat du traitement chirurgical dans notre petit groupe de patients est satisfaisant. RECENT EXPERIENCE WITH SURGICAL TREATMENT OF INTRACRANIAL ANEURYSMS AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA Shokunbi MT1,2, Malomo AO1,2, Adeolu AA1,2, Adeleye AO1,2, Ukachukwu AK2, Oremakinde AA2 1Department of Surgery, College of Medicine, University of Ibadan, and 2Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria. Presenting author: Ukachukwu AKDepartment of Neurological SurgeryUniversity College HospitalPMB 5116, Ibadan, And NigeriaPhone: +234 816 733 5934 HYPERLINK "mailto:dr_alvan@yahoo.com"dr_alvan@yahoo.com Objective/justification: We retrospectively reviewed surgically treated intracranial aneurysms between 2009 and 2015 in order to describe the dominant presentation, mode of diagnosis, and clinical outcome. Materials and Methods: Descriptive analysis of demographic, clinical and radiologic data retrieved from the patients records. Results: We managed 52 patients (12 male, 40 female), with mean age 50.4+/-16.1 years (range: newborn to 75 years). Two patientshad asymptomatic lesions, detected during cranial computerized tomography (CT) for chronic sinusitis in one and routine obstetric ultrasonography in another. The remaining patients had ruptured aneurysmswith clinical status according to the WFNS scale as follows: grade I: 20; grade II: 12; grade III: 13; grade IV: 4; grade V: 1. The interval from the first clinical ictus to correct clinical diagnosis was 4 days to 6 weeks. The aneurysms were localized radiologically by CT angiography and were predominantly in the anterior circulation. Five patients died pre-operatively, while four were referred abroad on request. Twenty-two patients had surgery 17 had aneurysm clipping, 3 had aneurysm packing because of inadvertent intra-operative rupture, and 2 had initial cerebrospinal fluid diversion. Seventeen are awaiting surgery. The interval to clipping was 3-16 weeks. The patients who had surgery have been followed up for 1-96 months, with good outcome in 17, moderate disability in 2, severe disability in 1, and post-operative mortality in 2. Conclusion: The advent of CT angiography has increased the ease of diagnosis of intracranial aneurysms. Clipping, the results of which are good in this series, is the currently available modality for surgical treatment at this centre. RECENTE EXPERIENCE DE TRAITEMENT CHIRURGICAL DANEVRISMES INTRACRANIENS AU CENTRE HOSPITALIER UNIVERSITAIRE DIBADAN, NIGERIA Shokunbi MT1,2, Malomo AO1,2, Adeolu AA1,2, Adeleye AO1,2, Ukachukwu AK2, Oremakinde AA2 1Department of Surgery, College of Medicine, University of Ibadan, and 2Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria. Presenting author: Ukachukwu AKDepartment of Neurological SurgeryUniversity College HospitalPMB 5116, Ibadan, And NigeriaPhone: +234 816 733 5934 dr_alvan@yahoo.com Objectif/justification: Nous avons examin rtrospectivement des anvrismes intracrniens traits chirurgicalement entre 2009 et 2015 afin de dcrire la principale prsentation, le mode de diagnostic et les rsultats cliniques. Matriels et thodes: Analyse descriptive des donnes dmographiques, cliniques et radiologiques extraites des dossiers des patients. Rsultats: 52 patients ont t pris en charge (12 hommes, 40 femmes), pour une moyenne dge de 50,4+/-16,1 ans (de nouveau-n 75 ans). Deux patients prsentaient des lsions asymptomatiques dtectes lors de la tomodensitomtrie du crne pour une sinusite chronique chez lun et lors dune chographie obsttrique chez lautre. Les autres patients prsentaient une rupture danvrisme de diffrents grades sur lchelle WFNS: grade I: 20; grade II: 12; grade III: 13; grade IV: 4; grade V: 01. Lintervalle entre le premier ictus clinique et le diagnostic clinique exact a t de 04 jours 06 semaines. Les anvrismes ont t localiss par angio-scanner et se situaient principalement dans la circulation antrieure. Cinq patients sont dcds en pr-opratoire et quatre ont t vacus ltranger leur demande. Vingt-deux patients ont t oprs: 17 ont ncessit la pose dun clip, 03 ont t bnfici de la technique du packing en raison dune rupture accidentelle intra-opratoire, et chez 02 un dtournement du liquide cphalo-rachidien a t effectu. Dix-sept attendaient dtre oprs. Lintervalle de pose du clip sur le collet tait de 03-16 semaines. Les patients oprs ont t suivis pendant 01-96 mois, 17 ont eu de bons rsultats, 02 ont prsent un lger handicap, 01 un handicap grave et il y a eu 02 dcs en post-opratoire. Conclusion: Lavnement de langio-scanner a davantage facilit le diagnostic danvrismes intracrniens. La pose dun clip sur le collet de lanvrisme, qui a produit de bons rsultats dans cette srie, est le type de traitement chirurgical actuellement propos dans ce centre. CAUSES OF DELAY IN PATIENTS PRESENTATION WITH HYDROCEPHALUS OZOR I.I 1, ILOABACHIE I.C1,OKORIE E.C11, IKPEGBU I.O1, AMUTA D.S.1, ANIAKU D.I 1, ERECHUKWU U.A2, OKWUNODULU O.2, EKUMA M.E2, NKWEREM SPU2, ORJI B. I2, IROEGBU L. U2, EJEMBI G.2 , NDUBUISI C.A I, ONYIA E.E 1, UCHE E.O1 CHIKANI M.C, MEZUE W.C.1 OHAEGBULAM S.C.2. 1. NEUROSUGERY UNIT, DEPARTMENT OF SURGERY, UNTH, ITUKU/OZALLA, ENUGU, NIGERIA 2. MEMFYS HOSPITAL FOR NEUROSURGERY, ENUGU PRESENTER: OZOR I.I. CORRESPODENCE:DR OZOR IGNATIUS IKEMEFUNA, DEPARTMENT OF SURGERY UNTH, ITUKU/OZALLA, ENUGU NIGERIA; ikemozor@yahoo.com;+2348033641955. Background: Delay in presentation of patients with hydrocephalus to neurosurgeons is common in developing countries. The main reasons for delays have largely been speculative. Objectives: To identify the frequency of delayed presentation to neurosurgeons in Enugu, causes of delay and to proffer solution. Methodology: This is an ongoing prospective study in UNTH and Memfys hospital, Enugu. Structured questionnaires have been administered to 60 patient caregivers. Delay is defined as time lag of four weeks and above between onset of symptoms and presentation to neurosurgeons for treatment. Information was analyzed using descriptive statistics. Results: Sixty patients between one week and 25 years old were recruited. Only 45% and 6.7% of the caregivers attained secondary and tertiary education respectively. Commonest symptom was big head (73.4%). Majority of symptoms were noticed at age of five months. Only 10% received initial care in tertiary hospital. Fifty-two (86.7%) of the referrals were initiated by doctors and 46.7% of referrals were due to worsening symptom. Only 11.69% of the patients have doctor relatives. Duration of management by referring doctors varied from one week to five months. Patients were not aware of any media or community awareness programme for hydrocephalus. Major reasons for delay were poor awareness, poor communication, religious beliefs and fund (25.05%). Majority agreed that awareness is very important in eliminating this delay (93%). Conclusion: The most common causes of delay include ignorance, low educational level of caregivers and poor communication. Fund is often a secondary issue. Awareness campaign to targeted groups would likely shorten the delay. Keywords: Hydrocephalus, Delay presentation, Awareness. LES CAUSES DU RETARD PRE-HOSPITALIER DES PATIENTS ATTEINTS DHYDROCPHALIE Ozor I.I 1, Iloabachie I.C1, Okorie E.C11, Ikpegbu I.O1, Amuta D.S.1, Aniaku D.I 1, Erechukwu U.A2, Okwunodulu O.2, Ekuma M.E2, Nkwerem Spu2, Orji B. I2, Iroegbu L. U2, Ejembi G.2 , Ndubuisi C.A I, Onyia E.E 1, Uche E.O1 Chikani M.C, Mezue W.C.1 Ohaegbulam S.C.2. 1. Neurosugery Unit, Department Of Surgery, Unth, Ituku/Ozalla, Enugu, Nigeria 2. Memfys Hospital For Neurosurgery, Enugu Presenter: Ozor I.I. Correspodence: Dr Ozor Ignatius Ikemefuna, Department Of Surgery Unth, Ituku/Ozalla, Enugu Nigeria; HYPERLINK "mailto:ikemozor@yahoo.com;+2348033641955"Ikemozor@Yahoo.Com;+2348033641955. Contexte: La prsentation tardive des patients atteints d'hydrocphalie aux neurochirurgiens est courante dans les pays en dveloppement. Les principales raisons de ces retards ont fait l'objet de nombreuses tudes. Objectifs : Identifier la frquence et les causes de prsentations tardives aux neurochirurgiens Enugu, et proposer des solutions. Mthodologie : il sagit dune tude prospective en cours l'UNTH et Memfys hospital d'Enugu. Des questionnaires structurs ont t distribus 60 proches des patients. Le retard est dfini comme un intervalle de quatre semaines et plus entre l'apparition des symptmes et la visite chez le neurochirurgien pour le traitement. Les donnes ont t analyses l'aide de la statistique descriptive. Rsultats : 60 patients gs d'une semaine 25 ans ont t recruts. 45% et 6,7% des proches seulement avaient atteint un niveau d'tudes secondaires et universitaires respectivement. Le symptme le plus courant tait l'hydrocphalie (73,4%). La majorit des symptmes ont t observs l'ge de cinq mois. 10% seulement ont reu les premiers soins l'hpital universitaire. 52 (86,7%) cas ont t rfrs par des mdecins et 46,7% des cas de rfrence taient dus l'aggravation des symptmes. 11,69% des patients seulement ont un parent mdecin. La dure de la prise en charge par les mdecins traitant variait d'une semaine cinq mois. Les patients ignoraient l'existence des moyens ou des programmes de sensibilisation communautaire sur l'hydrocphalie. Les principales raisons du retard taient le manque de sensibilisation, de communication, les croyances religieuses et le manque de moyens financiers (25,05%). La majorit a reconnu que la sensibilisation est trs importante pour mettre fin retards pr-hospitaliers (93%). Conclusion : Les causes les plus frquentes du retard pr-hospitalier sont l'ignorance, le faible niveau d'ducation des proches de malades et le manque de communication. Le manque de moyens financiers vient parfois en seconde position. Des campagnes de sensibilisation des groupes cibles permettraient de rduire ce retard. Mots-cls: hydrocphalie, prsentation tardive, sensibilisation. MENINGOMYELOCELES WITH FAECAL INCONTINENCE IN SUB-SAHARAN AFRICA: ROLE OF ANTEGRADE COLONIC ENEMA Musa Ibrahim Department of Surgery, Children Surgery Unit, Murtala Mohammad Specialist Hospital, Kano, Nigeria, Presenter: Musa Ibrahim Aim: Congenital neural tube defects are among the major causes of sphincteric disturbances. Faecal incontinence due to meningomyelecels leads to decreased quality of life and various morbidities. We are presenting our single-unit, single-centre experience of Ante-grade Continence Enema (ACE) in children with neural tube defects. Materials and method: This is a retrospective study from September 2008 to November 2015. There were 18 patients with various forms of neural tube defects that were seen, managed, operated and rehabilitated in our centre. The clinical outcomes of the ACE were retrieved, reviewed, analyzed and discussed. Results: There were eighteen n=18 children with various forms neural tube defects with faecal incontinence that were treated in our centre from September, 2008 to November, 2015. The ages of the patients ranged from 3 years to 17 years old. Males were 11 while females were 7 with male to female ratio M:F=1.57:1. All the eighteen patients had ACE procedure done with satisfactory outcomes. Conclusion: Patients with congenital neural tube defects benefit from ACE procedure with satisfactory results. Inter-disciplinary approach between neurosurgeons and pediatric-surgeons will improve timely ACE creation and reduction of post-meningomyelocele surgery disabilities. Incontinence anale associe la mylomningocle en Afrique Sub-Saharienne : rle du lavement clonique antrograde (ACE) Musa Ibrahim Murtala Mohammad Specialist Hospital, Department of Surgery, Children Surgery Unit, Kano, Nigeria, Objectif: Parmi les principales causes des troubles sphinctriens figurent les anomalies congnitales du tube neural. Lincontinence anale associe la mylomningocle entraine la dtrioration de la qualit de vie et diverses morbidits. Nous prsentons une tude monocentrique conduite dans un seul service sur le lavement clonique antrograde (ACE) chez des enfants prsentant des anomalies du tube neural. Matriels et mthode: Il sagit dune tude rtrospective mene de septembre 2008 novembre 2015. 18 patients prsentant diverses anomalies du tube neural ont t examines, pris en charge, oprs et rhabilits dans notre formation sanitaire. Les rsultats cliniques de lACE ont t extraits, examins, analyss et dbattus. Rsultats: Dix-huit enfants, soit n=18, prsentant diverses formes danomalies du tube neural ont t soigns dans notre formation sanitaire de septembre 2008 novembre 2015. Lge des patients variait de 3 17 ans. Lchantillon tait constitu de 11 patients de sexe masculin et 07 de sexe fminin, soit un ratio homme-femme de 1,57:1. Des lavements cloniques antrogrades ont t raliss sur les dix-huit patients avec des rsultats satisfaisants. Conclusion: Les patients prsentant des anomalies congnitales du tube neural ont bnfici de lACE avec suites opratoires satisfaisantes. Une approche interdisciplinaire entre neurochirurgiens et chirurgiens pdiatriques contribuera amliorer la ralisation de lACE dans les meilleurs dlais et rduire les invalidits lies la prise en charge chirurgicale de la mylomningocle. ENDOSCOPIC THIRD VENTRICULOSTOMY IN THE MANAGEMENTOF HYDROCEPHALUS IN CHILDREN: CASE OF THE YAOUNDE GENERAL HOSPITAL. EYENGA VC, ELOUNDOU NGAH J, BANG GA, MAGADJI JP, GIMBERT E, VIGNES JR. Prsentateur: Dr BANG Guy Aristide Chirurgien, Mail:  HYPERLINK "mailto:guyaristidebang@yahoo.fr"guyaristidebang@yahoo.fr Introduction: Endoscopic third ventriculostomy (ETV) is the standard treatment for non-communicating hydrocephalus in children. ETV still remains almost non-existent in our context to the benefit of ventricular-peritoneal shunts which nevertheless have many shortcomings. Objectives: The purpose of this study was to promote, in our country, the current use of ETV in the treatment of non-communicating hydrocephalus in children. Patients and Methodology: Prospectively from September 2013 to August 2014, patients of both sexes aged 0-15 years old presenting with a non-communicating hydrocephalus that registered underwent treatment by ETV. Results: The records of six patients were compiled including 5 females. The average age was 3 years 7 months. Congenital stenosis of the Sylvius aqueduct was the main etiology found in 5 cases. Our ETV technique differed from the primary technique in 4 points. We had experienced a ventriculitis postoperative complication. With a mean follow-up regression of 5.33 months, a marked clinical improvement was achieved in 5 cases. Conclusions and recommandations: ETV is a simple and reproducible technique in our environment. In the case of a non-communicating hydrocephalus in the child, it should be the first therapeutic indication before shunt valves. Keywords: Endoscopic ventriculostomy - Non-communicating hydrocephalus - Child - Cameroon. LA VENTRICULOCISTERNOSTOMIE ENDOSCOPIQUE DANS LE TRAITEMENT DES HYDROCEPHALIES DE LENFANT: LEXPERIENCE DE LHOPITAL GENERAL DE YAOUNDE. EYENGA VC, ELOUNDOU NGAH J, BANG GA, MAGADJI JP, GIMBERT E, VIGNES JR. Prsentateur: Dr BANG Guy Aristide Chirurgien, Mail : HYPERLINK "mailto:guyaristidebang@yahoo.fr"guyaristidebang@yahoo.fr Introduction: La ventriculocisternostomie endoscopique (VCSE) est le traitement de rfrence des hydrocphalies non communicantes de lenfant. Son usage demeure nanmoins quasi-inexistante dans notre contexte au profit des drivations ventriculo-pritonales qui prsentent pourtant de nombreux inconvnients. Objectifs : Le but de cette tude tait de promouvoir dans notre pays, lutilisation courante de la VCSE dans le traitement des hydrocphalies non communicantes de lenfant. Patients et mthodes : Prospectivement de septembre 2013 aout 2014, les patients des deux sexes, gs de 0 15 ans et prsentant une hydrocphalie non communicante documente ont t pris en charge par une VCSE. Rsultats : Six patients ont t colligs dont 5 de sexe fminin. Lge moyen tait de 3 ans 7 mois. La stnose congnitale de laqueduc de Sylvius tait la principale tiologie, retrouve dans 5 cas. Notre technique de VCSE diffrait de la technique princeps en 4 points. Nous avons eu une complication post-opratoire type de ventriculite. Avec un recul moyen de suivi de 5,33 mois, une nette amlioration clinique a t obtenue dans 5 cas. Conclusions et recommandations: La VCSE est une technique simple et reproductible dans notre environnement. Devant une hydrocphalie non communicante de lenfant, elle doit tre la premire indication thrapeutique avant les valves de drivations. Mots-cls: Ventriculocisternostomie endoscopique Hydrocphalie non communicante Enfant Cameroun. OUTCOME OF CLOSED REDUCTION OF CERVICAL SPINE INJURIES IN A COHORT OF NIGERIAN PATIENTS Adeolu AA1,2,Ukachukwu AK2, Adeleye AO1,2, Ogbole GI3, Malomo AO1,2, Shokunbi MT1,2 1Department of Surgery, College of Medicine, University of Ibadan, Nigeria 2Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria 3Department of Radiology, College of Medicine, University of Ibadan, Nigeria Presenting author:Ukachukwu AK Department of Neurological Surgery, University College Hospital, PMB 5116, Ibadan, Nigeria Phone: +234 816 733 5934,  HYPERLINK "mailto:dr_alvan@yahoo.com" dr_alvan@yahoo.com Background/Objectives: The advantages of closed reduction of cervical spine injury (CSI) include avoidance of anaesthesia and surgery, as well as probable low cost. There is dearth of publications on the effectiveness of closed reduction technique, thus we aimed to evaluate the effectiveness of closed reduction of CSI using cervical traction and identify probable complications. Methodology: We prospectivelystudied all consecutive CSIs managed by closed reduction using Gardener-Wells Tongs (GWT) traction from February 2012 to February 2015. Ethical approval was obtained for the study. Data collected included the demography, presenting symptoms and duration, aetiology, diagnosis, imaging findings (pre, intra and post traction reduction TR), bony and neurologic levels of injury (pre and post TR), Frankel grading (pre and post TR), interval between injury and TR, minimum weight to achieve maximal reduction, and complications of closed traction reduction. Reduction up to 95% or more was deemed as satisfactory. The primary outcome measures were extent/degree of reduction and neurologic status following closed reduction. The complications of closed TR were the secondary outcome measures. Data was analysed using SPSS version 16. Results: Ninety-three patients (62 male: 31 female; mean age 36.5+/-11.4 years) were included in the study. Most (77%) presented within 72 hours of injury. Majority (82.8%) were involved in road traffic crashes. Anterior subluxation was seen in 71%. The degree of displacement was <25% in 40.8%, 25-50% in 24.7%, >75% in 14%, 50-75% in 10.8%. Traction-reduction was done after 7 days of injury in 47.3%and 4-7 days in 25.8%. Reduction weight ranged from 1kg to 60kg. Reduction was satisfactory in 71% and failed in 29%. 82.8% remained neurologically same, while 17.2% improved. The causes of failed reduction/traction were facet lock (17), old injury (8), new-onset/worsening pain (2), poor patient compliance (3) and over-distraction (4). The complications of closed reduction were over-distraction (5), tong pull-out (3) and new-onset/worsening pain (4). Conclusion: Satisfactory reduction is feasible with GWT traction in many of our patients with CSI and significant mal-alignment. The method is associated with few complications. RESULTAT DE LA RDUCTION FERMEE DES LESIONS DE LA COLONNE CERVICALE DANS UNE COHORTE DE PATIENTS NIGRIANS Adeolu AA1,2, Ukachukwu AK2, Adeleye AO1,2, Ogbole GI3, Malomo AO1,2, Shokunbi MT1,2 1Department of Surgery, College of Medicine, University of Ibadan, Nigeria 2Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria 3Department of Radiology, College of Medicine, University of Ibadan, Nigeria Presenting author:Ukachukwu AK Department of Neurological Surgery, University College Hospital, PMB 5116, Ibadan, Nigeria Phone: +234 816 733 5934, HYPERLINK "mailto:dr_alvan@yahoo.com"dr_alvan@yahoo.com Contexte/Objectifs: Parmi les avantages de la rduction ferme des lsions de la colonne vertbrale cervicale nous pouvons citer labsence danesthsie et de chirurgie, ainsi que le cot probablement modr. Etant donn la pnurie de littrature sur lefficacit de la rduction ferme, notre objectif est dvaluer lefficacit de la rduction ferme des LCC par traction cervicale et identifier dventuelles complications. Mthodologie: Nous avons men une tude prospective de toutes les LCC successives traites par une rduction ferme avec traction par pinces Gardener-Well (GWT) de fvrier 2012 fvrier 2015. Nous avons obtenu une approbation thique pour ltude. Les donnes recueillies concernaient la dmographie, la prsence de symptmes et leur dure, ltiologie, le diagnostic, les rsultats chographiques (pr, intra et post rduction par traction RT), les niveaux osseux et neurologiques des lsions (pr, intra et post rduction par traction RT), la classification de Frankel (pr, intra et post rduction par traction RT), lintervalle entre la lsion et la RT, le poids minimum en vue de raliser une rduction maximale, et les complications de la rduction ferme par traction. Une rduction ralise jusqu 95% ou plus a t juge satisfaisante. Les premires mesures du rsultat concernaient ltendue/degr de la rduction et le statut neurologique aprs la rduction ferme. Les mesures de rsultats secondaires concernaient les complications de la RT ferme. Les donnes ont t analyses laide du SPSS version 16. Rsultats: Quatre-vingt-treize patients (62 hommes: 31 femmes; ge moyen 36,5+/-11,4 ans) ont fait lobjet de la prsente tude. La plupart (77%) se sont prsents dans les 72 heures suivant les lsions. La plupart (82,8%) taient des victimes daccidents de la route. 71% prsentaient des subluxations antrieures. Le degr de dplacement tait de <25% chez 40,8% des patients, 25-50% chez 24,7%, >75% chez 14%, 50-75% chez 10,8%. 47,3% et 25,8% des patients ont subi une traction-rduction sept (07) jours et 4-7 jours aprs laccident respectivement. Le poids de la rduction variait de 1kg 60kg. La rduction a t un succs pour71% et un chec pour 29% des patients. Les niveaux neurologiques sont rests inchangs chez 82,8% des patients tandis que chez 17,2% ils se sont amliors. Lchec de la rduction/ traction taient li au syndrome facettaire (17), une ancienne lsion (8), une nouvelle apparition/aggravation de la douleur (2), mauvaise observance du patient (3) et une distraction excessive (4). Les complications de la rduction ferme taient une distraction excessive (5), le retrait de la pince (3) et une nouvelle apparition /aggravation de la douleur (4). Conclusion: Il est possible de raliser une rduction avec succs par traction laide de pinces GW chez de nombreux patients souffrant dune LCC et dun mauvais alignement grave. Cette mthode prsente peu de complications. PATTERNS OF BRAIN TUMOUR IN A TERTIARY HOSPITAL IN GHANA Ubong Ekpene1, Mawuli Ametefe1, Thomas Darkurah2, Harry Akoto3, Patrick Bankah4 Background: Brain tumours are relatively common neurosurgical conditions. Variable patterns have been described in the literature. Outcome is dependent on the type of tumour and the stage at presentation. This study seeks to unravel the pattern of intracranial tumours in Korle Bu Teaching Hospital (KBTH) based on patient demographics, clinical presentation, and histological findings. Method: Study design is retrospective, descriptive. Data was obtained from theatre and ward records of patients treated at the neuroscience unit of Korle Bu Teaching Hospital between January 2010 to October 2015, and histology reports obtained from the histopathology unit. Patients with intracranial tumours without definitive histological diagnosis were excluded. Histological and demographic patterns of tumours were analyzed with SPSS. Results: Preliminary result shows that of the 96 histologically diagnosed brain tumours, 56 (58.3%) were females and 40 (41.7%) were males. Glioma were the commonest intracranial tumours - 38 (39.6%) followed by Meningioma with 33 (34.4%) and pituitary adenoma 8(8.3%). Astrocytoma was the commonest type of Glioma comprising 29(76.3%) of the 38 cases. Meningotheliomatous meningioma was the commonest type of meningioma with 10 (30.3%) of 33 cases. Of the Glioma 17 were males and 21 were females while for the Meningioma 14 were males and 19 were females. Age of patient at diagnosis varied with the tumour with the youngest age affected being 1 year and oldest age 73 years. The commonest symptom was headache (64%) and the commonest tumour location was supratentorial. Conclusion: Intracranial tumours are relatively common in Ghana, with Glioma being the commonest. Overall females are more commonly affected than males. Females are more affected with both gliomas and meningioma than males. Key words: Intracranial tumours, Korle Bu Teaching Hospital, histological diagnosis. RENAL MORPHOLOGICAL AND VASCULAR SONOGRAPHIC FINDINGS IN PREGNANT AND NON-PREGNANT WOMEN OF CHILDBEARING AGE AT THE UNIVERSITY OF NIGERIAN TEACHING HOSPITAL, ENUGU STATE NIGERIA Abah I.U, Ibewuike C.U.,Obikili E., Mgbor S.O.,Ibezim E.O., Obieze C.A., Nnabuenyi I.P. Author: Dr.Abah I.U., Niny216@yahoo.com Department of radiation Medicine, University of Nigerian Teaching Hospitalk, Ituku/Ozalla Enugu Background: Morphological and vascular changes occur in the maternal renal system in pregnancy. Baseline reference data of such renal parameters will help to improve antenatal care. Objectives: The aim of this study was to establish baseline data of the normal renal morphological and vascular sonographic dimensions in pregnant and non-pregnant women. Methodology: This was a prospective cross sectional descriptive and comparative study of the sonographic renal parameters in 400 pregnant women, and 400 age-matched non-pregnant controls comprising staff and patients at UNTH. Data obtained was analyzed using SPSS version 17. Results: The mean renal volume was 126.50 27.63cm3 and 139.34 36.74cm3 for the right and left kidneys respectively in the non-pregnant women, while the pregnant women, it was 147.18 28.90cm3 and 156.45 38.21cm3 for the right and left kidneys respectively. In all the women, the mean renal volume was significantly higher on the left than on the right. A mean renal resistive index of 0.62 0.03 and 0.61 0.02 for the right and left kidneys respectively were obtained for the non-pregnant women, and 0.630.03 and 0.620.03 for the right and left kidneys for the pregnant subjects. The mean values of the renal dimensions of the pregnant women were significantly higher (p 0.05, there was no statistical significance on distribution of mean Hb, standard deviation based on sex and treatment type. Conclusion: At 95% confidence interval, Chemotherapy had greatest impact on Hb level during therapy. Thus Chemotherapy; 9.60-10.62g/dl, Radiotherapy; 11.52-12.1 3g/dl, Chemoradiation therapy; 10.98-11.3 6gIdl. Lanmie chez les patients atteints de cancer sous traitement par radiothrapie et chimiothrapie lHpital national dAbuja, au Nigeria Chinedu Simeon Aruah1 Dr. Oyesegun Rasaaq2 Igbinoba Festus3, Emeka Abalu4,Vitalis Okwor5 Correspondent Address: Dr. Chinedu Simeon Aruah, Department of Radiation Oncology, National Hospital Abuja, P.M.B 425 Garki Abuja, Nigeria. E-mail:  HYPERLINK "mailto:aruasimeonedu@yahoo.com" aruasimeonedu@yahoo.com, Phone: +2348037419877 Introduction: De nombreux patients atteints de cancer souffrent danmie avant la radiothrapie et la chimiothrapie ou risque de souffrir danmie/aggravation de l'anmie un certain moment au cours du traitement. Objectifs: Lobjectif de l'tude tait de prsenter limpact de lanmie chez les patients cancreux sous traitement par radiothrapie et chimiothrapie. Mthodologie: ltude portait sur 201 patients des deux sexes atteints de tumeur maligne confirme au plan histopathologique (cancers solides). Les patients avaient suivi un prtraitement par lhmoglobine. Ils ont t rpartis en radiothrapie, en chimiothrapie et en chimio radiothrapie. Leur taux Hb tait contrl une fois toutes les 2 semaines. Les frottis sanguins des patients ont t effectus. Lensemble du processus a t interrompu aprs 3 contrles conscutifs de lhmoglobine ou aprs la 6e semaine. Lanmie a t classe comme suit: Moins de 10g/dl - anmie svre 10 - 10.9g/dl - anmie modre 11-12 g/dl - Anmie lgre 12 g/dl et plus - absence danmie. Rsultats et analyse: sur 201 patients atteints de cancer, 86,1% taient des femmes et 13,9% des hommes. La tranche dge variaient entre 25 et 75 ans, 100 patients ont suivi le traitement par la chimiothrapie, 63 patients la radiothrapie et 38 patients la chimio-radiothrapie. la fin de la thrapie, 62% (100) des patients qui suivaient la chimiothrapie et 55,6% (63 patients) qui suivaient la radiothrapie avaient leur taux dHb entre 11 et 12g/dl, 39,5% (38) qui suivait la chimio-radiothrapie avaient une valeur de 10 10,9 g Hb/dl. la valeur P > 0,05, il ny avait pas de signification statistique sur la distribution de la moyenne de lhmoglobine, lcart-type bas sur le sexe et le type de traitement. Conclusion: lintervalle de confiance de 95%, la chimiothrapie avait plus dimpact sur le taux dhmoglobine au cours du traitement. Ainsi, pour la chimiothrapie: 9.60-10.62g /dl, la radiothrapie: 11,52 12,1 3g/dl, la chimio-radiothrapie: 10,98 11,3 6gIdl. Mullerian duct abnormalities in Hysterosalpingography: experience from Benin City and Nnewi, Nigeria Eze KC, **Benka-Coker LBO, **Enukegwu SU, *Anajuba O Presenter: Dr Anajuba Odira, E-mail (=  HYPERLINK "mailto:ezechallenge@yahoo.co.uk"ezechallenge@yahoo.co.uk Department of Radiology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria. **St. Briget X-ray Centre, Benin City. Background: Mullerian duct anomalies are causes of female infertility and pregnancy wastages. Hysterosalpingography is simple and invaluable tool for its diagnosis for accurate treatment. Objectives: To study the prevalence and pattern of mullerian duct abnormalities in patients who undertook hysterosalpingography (HSG) procedure on account of infertility. Methodology: All the women who presented with complaint of infertility or sub-fertility over a period of two years and who had no history of previous uterine surgery prospectively underwent hysterosalpingography procedure after informed consent was obtained. The HSGs were done using vacuum uterine cannula and water soluble contrast medium. The HSG images were viewed by three radiologists and the diagnosis arrived at by consensus. Result: For the study period of 1st January 2012 to 31st December 2014 (three years) a total of 7, 832 HSG were done at the centre. Of this 6, 824 (87.1%) was for infertility in women who have not had previous uterine surgery and thus selected for the study. 268 of the selected 6,824 (3.9%) various types of mullerian duct abnormalities. Patients with secondary infertility had more abnormalities compared to those primary infertility. Septate uterus (36.4%) and arcuate uterus (28.5%) were the commonest mullerian duct abnormalities identified. Mullerian duct anomalies are responsible for complications and unfavourable pregnancy outcome in both fertile and infertile couples. Conclusion: The prevalence of mullerian duct anomalies in this study is 3.9%. Knowledge of the wide spectrum of mullerian duct anomalies manifested in hysterosalpingograms will enhance its accurate diagnosis and treatment of mullerian duct anomalies. Anomalies du conduit de Muller dans l'hystrographie: lexprience de Benin City et de Nnewi au Nigria Eze KC, **Benka-Coker LBO, **Enukegwu SU, *Anajuba O Presenter: Dr Anajuba Odira, E-mail: HYPERLINK "mailto:ezechallenge@yahoo.co.uk"ezechallenge@yahoo.co.uk Department of Radiology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.**St. Briget X-ray Centre, Benin City. Contexte: Les anomalies du conduit de Muller sont des causes de strilit chez les femmes et de fausses couches. Lhystrographie est un outil de diagnostic simple et inestimable pour un traitement prcis. Objectif: tudier la prvalence et les formes danomalies du conduit de Muller chez les patientes ayant subi l'hystrographie (HSG) pour cause de strilit. Mthodologie: Toutes les femmes qui se plaignaient de strilit ou de sous-fertilit sur une priode de deux ans et qui n'avaient pas d'antcdent d'opration intra-utrine ont, de manire prospective, t soumises l'hystrographie aprs consentement clair. Les HSG ont t ralises au moyen d'une canule utrine sous vide et dun agent de contraste soluble dans l'eau. Les images dHSG ont t visualises par trois radiologues et le diagnostic prononc par consensus. Rsultats: Pour la priode d'tude allant du 1er janvier 2012 au 31 dcembre 2014 (trois ans) un total de 7. 832 HSG ont t raliss au centre, dont 6.824 (87, 1%) taient pour la strilit chez les femmes n'ayant pas subi d'opration intra-utrine antrieure et slectionnes pour l'tude. Sur les 6 .824 HSG, 268 (3,9%) diffrentes formes d'anomalies du conduit de Muller ont t slectionnes. Les patientes souffrant de strilit secondaire avaient plus danomalies compares celles prsentant une infertilit primaire. L'utrus cloisonn (36,4%) et l'utrus arqu (28,5%) taient les anomalies les plus courantes du conduit de Muller identifies. Les anomalies du conduit de Muller sont responsables des complications et de lissue dfavorable des grossesses tant chez les couples fconds que chez les couples striles. Conclusion: Dans cette tude, le taux de prvalence des anomalies du conduit de Muller est de 3,9%. La connaissance du large spectre des anomalies du conduit de Muller observes dans les hystrographies permettra damliorer le diagnostic et la prise en charge de ces anomalies. Problem-solving approach to conflicts resolution in the radiology department : Experience from NAUTH, Nnewi, Nigeria. Kenneth C Eze, **Ozoemenam Ugochukwu, *Kingsley C. Obilo, *Ifeanyi Uzukwu, Odira Anajuba. Presenter: Odira Anajuba Department of Radiology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria. Department of History and international relation, Nnamdi Azikiwe University, Awka, Nigeria. Background: Radiology department interprofessional conflicts exist, the thorniest being between radiographers and doctors. The manner these are handled are critical to department effectiveness and efficiency. Objectives: To elucidate conflict sources in radiology department and methods used to resolve conflicts with the aim of achieving harmonious interprofessional relationship. Methodology: Over twelve months period, prospective record was taken of the sources of inter-professional conflict within the department that reached the attention of the head. The methods used to resolve these conflicts are highlighted as well as their outcome and respective drawbacks. Result: The conflicts bedrock is poor job satisfaction of most radiographers complaining of finances, advancement line and marginalisation. Other radiology workers feel that radiographers are antisocial, snobbish and megalomaniac in attempt to use various means to try to put themselves superior to other workers and equal to doctors. Radiographers reject these appellations but rather feel that it is doctors that feel superior while the other workers downgrade them. In most conflicts, departmental head empathised with staff, tried to understand their problems from their own perspective, and while not losing ground, looked for ways to genuinely solve or advice them on routes to achieve self-actualization. Conclusion: Many radiology workers were high flyers in their college days. Inability to read medicine does not make them less intelligent or inferior to doctors. Radiologists should play a father role, aiming to achieving win-win situation for all the staff-staff problems as has been very rewarding in our experience. Approche de rsolution de conflits au Service de radiologie: Cas du CHU de Nnamdi Azikiwe Nnewi au Nigeria. Kenneth C Eze, **Ozoemenam Ugochukwu, *Kingsley C. Obilo, *Ifeanyi Uzukwu, Odira Anajuba. Presenter: Odira Anajuba Department of Radiology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria.Department of History and international relation, Nnamdi Azikiwe University, Awka, Nigeria. Contexte: Les conflits interprofessionnels existent au Service de radiologie, le plus pineux tant le conflit entre radiologues et mdecins. La manire avec laquelle ces conflits sont rsolus est dterminante pour efficacit du service. Objectifs: Dterminer les sources de conflits au Service de radiologie et les mthodes utilises pour les rsoudre dans le but dtablir une relation interprofessionnelle harmonieuse. Mthodologie: Pendant une priode de douze mois, un dossier prospectif a pris en compte les sources du conflit interprofessionnel au sein du service qui ont t ports lattention de la hirarchie. Les mthodes utilises pour rsoudre ces conflits sont soulignes, ainsi que leurs rsultats et inconvnients respectifs. Rsultat: La principale source du conflit est le manque de satisfaction au travail de la plupart des radiologues qui se plaignent du manque de finances, davancement professionnel et dtre marginaliss. Dautres employs du service de radiologie estiment que les radiologues sont antisociaux, snobs et mgalomanes et utilisent divers moyens pour essayer de se placer au-dessus des autres employs et se croient gaux aux mdecins. Les radiologues rejettent ces qualificatifs et estiment par contre que ce sont les mdecins qui se sentent suprieurs tandis que les autres employs les mprisent. Dans la plupart des conflits, le chef de service a fait montre dempathie avec le personnel, il a essay de comprendre leurs problmes de leur propre point de vue, et sans se compromettre. Il a sincrement cherch des moyens de les rsoudre ou de les conseiller sur la faon de parvenir la ralisation de soi. Conclusion: De nombreuses personnes qui travaillent au service de radiologie avaient du potentiel lorsquelles taient au secondaire. Quelles naient pas fait dtudes en mdecine ne signifie pas quelles sont moins intelligentes ou infrieures aux mdecins. Les radiologues devraient jouer un rle de pre, visant tablir une situation de gagnant-gagnant pour tous les problmes entre le personnel. Cette exprience a t trs enrichissante. Impact of Standardized Scheme on the Detection of Chest X-Ray Abnormalities and Radiographic Diagnosis of Pulmonary Tuberculosis in Adult Boniface Moifo*,Marie Laure Gharingam, Jean Roger MoulionTapouh,Eric Walter PefuraYone, Annick Laure Edzimbi,Georges Nguefack-Tsague,Samuel NkooAmvene  HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=Faculty+of+Medicine+and+Biomedical+Sciences%2C+The+University+of+Yaound+I%2C+Yaounde%2C+Cameroon&searchField=affs&page=1&SKID=0" \n _blankFaculty of Medicine and Biomedical Sciences, The University of Yaound I, Yaounde-Cameroon. *Email: HYPERLINK "mailto: bmoifo@yahoo.fr" bmoifo@yahoo.fr Purpose: The complexity of chest radiography (CXR) is a source of variability in its interpretation. We assessed the effect of an interpretation grid on the detection of CXR anomalies and radio-graphic diagnosis of tuberculosis in an endemic area for tuberculosis. Methods: The study was conducted in Yaounde (Cameroon). Six observers (2 pulmonologists, 2 radiologists and 2 senior residents in medical imaging) interpreted 47 frontal CXR twice two months apart without (R1) and with (R2) the aid of an interpretation grid. We focused on the detection of micro nodules (n = 16), cavitations (n = 12), pleural effusion (n = 6),adenomegaly (n = 6), and diagnosis of tuberculosis (n = 23) and cancer (n = 7). Results: The average score for accurate detection of elementary lesions was 40.4% [95%CI: 25% - 58.3%] in R1 and 52.1% [36.9% - 65.3%] in R2. The highest improvement was observed for micro nodules (19.8%). Cavitations had the highest proportions of accurate detections (58.3% in R1 and 65.3% in R2). The average score of accurate diagnosis was 46.1% in R1 and 57.4% in R2. Accurate diagnosis improved by 3.6% for tuberculosis and 19% for cancer between R1 and R2. Intra-observer agreement was higher for the diagnosis of cancers (0.22 d"kd" 1) than for diagnosing tuberculosis (0.21 d"kd" 0.68). Inter-observer agreement was highly variable with a modest improvement for the diagnosis of tuberculosis in R2. Conclusion: Standardized interpretation scheme improved the detection of CXR anomalies and diagnosis of tuberculosis. It significantly improved inter-observers agreement in diagnosing tuberculosis but not in detecting most lesions. Keywords:  HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=Chest+Radiography&searchField=keyword&page=1&SKID=0" \n _blankChest Radiography, HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=+Interpretation+Scheme&searchField=keyword&page=1&SKID=0" \n _blankInterpretation Scheme, HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=+Tuberculosis&searchField=keyword&page=1&SKID=0" \n _blankTuberculosis, HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=+Micro+Nodules&searchField=keyword&page=1&SKID=0" \n _blankMicro Nodules, HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=+Cavitations&searchField=keyword&page=1&SKID=0" \n _blankCavitations, HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=+Agreement&searchField=keyword&page=1&SKID=0" \n _blankAgreement. Impact du systme normalis de dtection des anomalies de la radiographie pulmonaire et diagnostic radiographique de la tuberculose pulmonaire chez les adultes Boniface Moifo*, Marie Laure Gharingam, Jean Roger MoulionTapouh, Eric Walter PefuraYone, Annick Laure Edzimbi, Georges Nguefack-Tsague, Samuel NkooAmvene Faculty of Medicine and Biomedical Sciences, The University of Yaound I, Yaounde-Cameroon. *Email: HYPERLINK "mailto:bmoifo@yahoo.fr"bmoifo@yahoo.fr Objectif :La nature complexe de la radio du thorax (CXR) la rend sujette diverses interprtations. Nous avons valu leffet dune grille dinterprtation sur le dpistage des anomalies de la CXR et le diagnostic radiographique de la tuberculose dans une zone dendmie tuberculeuse. Mthodes : Ltude a t mene Yaound (Cameroun). Six observateurs (02 pneumologues, 02 radiologues et 02 rsidents principaux en imagerie mdicale) ont interprt 47 CXR frontales deux fois en deux mois dcart sans (R1) et avec (R2) laide dune grille dinterprtation. Nous nous sommes focaliss sur la dtection de micro nodules (n = 16), cavitations (n = 12), effusions pleurales (n = 6),adnomgalies (n = 6), et le diagnostic de la tuberculose (n = 23) et du cancer (n = 7). Rsultats :Le score moyen en ce qui concerne le dpistage prcis des lsions lmentaires tait de 40,4% [95% CI: 25% - 58,3%] en R1 et 52,1% [36,9% - 65,3%] en R2. Une plus forte amlioration a t note pour les micro nodules (19,8%). Les cavitations ont enregistr le plus grand taux de prcision dans le dpistage. (58,3% en R1 et 65,3% en R2). Le score moyen de diagnostic prcis tait de 46,1% en R1 et 57,4% en R2. La prcision des diagnostics sest amliore de 3,6% pour la tuberculose et 19% pour le cancer entre R1 et R2. Laccord intra-observateurs tait plus lev dans les diagnostics de cancers (0,22 d"kd" 1) que dans les diagnostics de la tuberculose (0,21 d"kd" 0,68). L accord inter-observateurs tait trs variable avec une lgre amlioration pour le diagnostic de la tuberculose en R2. Conclusion: Le systme normalis d interprtation a amlior le dpistage des anomalies de la CXR et le diagnostic de la tuberculose. Elle a augment de faon significative laccord inter-observateurs dans le diagnostic de la tuberculose mais pas dans la dtection de la plupart des lsions. Mots cls:HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=Chest+Radiography&searchField=keyword&page=1&SKID=0" \t "_blank" Radio du thorax,systme dinterprtation,HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=+Tuberculosis&searchField=keyword&page=1&SKID=0" \t "_blank"Tuberculose,HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=+Micro+Nodules&searchField=keyword&page=1&SKID=0" \t "_blank"Micro Nodules,HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=+Cavitations&searchField=keyword&page=1&SKID=0" \t "_blank"Cavitations,HYPERLINK "http://www.scirp.org/journal/articles.aspx?searchCode=+Agreement&searchField=keyword&page=1&SKID=0" \t "_blank"Accord. PREDICTIVE FACTORS FOR ABNORMAL BRAIN CT-SCAN IN CHILDHOOD EPILEPSY AT YAOUND, CAMEROON Boniface Moifo1,3*, Sraphin Nguefack2,3, Jean Roger Moulion Tapouh3, Evelyn Mah2,3, Elie Mbonda2,3, Joseph Gonsu Fotsin1,3. 1Department of Radiology and Medical Imaging, Yaound Gynaeco-Obstetrical and Pediatric Hospital (YGOPH), Yaound, Cameroon 2Department of Pediatrics and Subspecialties, Yaound Gynaeco-Obstetrical and Pediatric Hospital (YGOPH), Yaound, Cameroon 3Faculty of Medicine and Biomedical Sciences; The University of Yaound I, Yaound, Cameroon *Email:  HYPERLINK "mailto:bmoifo@yahoo.fr"bmoifo@yahoo.fr Purpose: CT-scan remains an important diagnostic tool in epilepsy in poor countries where MRI is neither available nor affordable. The aim of this study was to determine clinical or electroencephalogram variables which could predict brain CT-scan abnormalities in childhood epilepsy. Methods: It was a cross-sectional study including 151 epileptic children who underwent head CT-scan from October 2011 to march 2012, in one university-affiliated hospital in Cameroon (YGOPH). The data collected were clinical, type of seizure, Electroencephalogram and head CT-scans results. Independent predictive factors for CT abnormalities were sought by logistic regression. A p value < 0.05 was considered. Results: Eighty-two over 151 children (54.3%) were boys. The median age was 54 months [2 - 190 months] with 74.8% of more than 2 years old. Birth asphyxia, mental retardation and neurologic deficit were respectively associated in 62.4%, 54.3% and 51.7% of cases. 56.3% had focal epilepsy, 61.6% had abnormal head CT-scan, 68.9% abnormal EEG, with no significant gender difference. The factors most significantly associated with abnormal head CT-scan were: child age d" 2years, maternal hypertension/eclampsy, cerebral palsy, and child microcephaly, with 89% to 92% abnormal CT. The two independent predictors of abnormal CT were patients age d" 2years and microcephaly. The two main CT-scan lesions were cerebral atrophy (28.5%) and brain infarct (16.6%). None of these abnormalities was correlated to any type of epilepsy. Conclusion: Almost two-third of head CT-scan performed in epileptic children are abnormal in our setting. Patients of 2 years old or less and those with microcephaly are very likely to have brain anomalies on CT-scan. Keywords: Epilepsy; Childhood; Electroencephalogram; CT-Scan; Predicting Factor; Microcephaly; Cameroon. Les facteurs prdictifs danomalies du scanner crbral dans les pilepsies de lenfant Yaound, Cameroun Boniface Moifo1,3*, Sraphin Nguefack2,3, Jean Roger Moulion Tapouh3, Evelyn Mah2,3, Elie Mbonda2,3, Joseph Gonsu Fotsin1,3. 1Department of Radiology and Medical Imaging, Yaound Gynaeco-Obstetrical and Pediatric Hospital (YGOPH), Yaound, Cameroon 2Department of Pediatrics and Subspecialties, Yaound Gynaeco-Obstetrical and Pediatric Hospital (YGOPH), Yaound, Cameroon 3Faculty of Medicine and Biomedical Sciences; The University of Yaound I, Yaound, Cameroon *Email: bmoifo@yahoo.fr Objectif: Le scanner est un outil important du diagnostic de lpilepsie dans les pays pauvres o lIRM nest ni disponible ni accessible. Le but de la prsente tude est de dterminer les variables cliniques ou lectroencphalographiques susceptibles de prdire des anomalies du scanner crbral dans les pilepsies de lenfant. Mthodes: Il sagit dune tude transversale incluant 151 enfants pileptiques ayant subi un scanner crbral doctobre 2011 mars 2012 dans un centre hospitalier universitaire affili (HGOPY) au Cameroun. Les donnes recueillies taient cliniques, type de convulsions, lectroencphalographe et les rsultats du scanner crbral. Les facteurs prdictifs indpendants danomalies du scanner ont t recherchs par rgression logistique. Une valeur p < 0,05 a t prise en considration Rsultats: Quatre-vingt-deux des 151 enfants (54,3%) taient des garons. Lge moyen tait de 54 mois [2-190 mois] dont 74,8% gs de plus de 02 ans. Lasphyxie la naissance, le retard mental et le dficit neurologique ont t associs respectivement 62,4%, 54,3% et 51,7% des cas. 56,3% souffraient dpilepsie focale, 61,6% prsentaient un scanner anormal de la tte, 68,9% avaient un EEG anormal, sans diffrence majeure lie au genre. Les facteurs importants les plus couramment associs une anomalie du scanner crbral taient: l ge de l enfant d" 2 ans, hypertension de la mre /clampsie, paralysie crbrale et microcphalie des enfants avec de 89% 92% de scanners anormaux. Les deux facteurs indpendants prdicteurs d anomalies du scanner taient l ge des enfants d" 02 ans et la microcphalie. Les deux principales lsions mises en vidence par le scanner taient l atrophie crbrale (28,5%) et l infarctus crbral (16,6%). Aucune de ces anomalies n a t relie un type d pilepsie. Conclusion: Environ deux tiers des scanners crbraux des enfants pileptiques sont anormaux dans notre milieu. Les patients gs de 02 ans ou moins et ceux souffrant de microcphalie sont susceptibles de prsenter des anomalies du scanner crbral. Mots cls: Epilepsie; enfance; Electroencphalographe; Scanner; Facteur prdictif; Microcphalie; Cameroun. RELIABILITY OF THYROID IMAGING REPORTING AND DATA SYSTEM (TIRADS) CLASSIFICATION IN DIFFERENTIATING BENIGN FROM MALIGNANT THYROID NODULES Boniface Moifo1, Joshua Tambe1, Sylviane Dongmo Fomekong1, Franois Blanc2, Joseph Gonsu Fotsin1 1Department of Radiology and Radiation Oncology, Faculty of Medicine and Biomedical Sciences, The University of Yaound I, Yaound, Cameroon 2Centre Hospitalier de Lagny, Marne La Valle, France 1Email: HYPERLINK "mailto: bmoifo@yahoo.fr" bmoifo@yahoo.fr Background: Ultrasonography (US) is the best diagnostic tool in the initial assessment of thyroid nodule. Giving its appropriateness and accessibility, ultrasound-based thyroid imaging reporting and data systems (TIRADS) classifications have been developed with main goal to standardize reporting and facilitate communication between practitioners, and to indicate when fine-needle aspiration biopsy (FNAB) should be performed. Objective: To determine the reliability of Russ modified TIRADS classification in predicting thyroid malignancy. Materials and Methods: It was a cross sectional study carried out at Centre Hospitalier de Lagny, Marne La Valle (France). Consecutive records of patients with focal thyroid nodules on ultrasound (US) for which US-guided FNAB was performed and pathology results were available, from January 2007 to August 2012, were selected for review. The risk of malignancy of each TIRADS category was determined and correlation with pathology assessed. Statistical performances of some US features were also assessed. The threshold for statistical significance was set at 0.05. Results: A total of 430 records of patients were eligible. Twenty-three out of 430 (5.3%) nodules were malignant. The risk of malignancy of the TIRADS categories were as follows: TIRADS2 0%, TIRADS3 2.2%, TIRADS4A 5.9%, TIRADS4B 57.9%, TIRADS5 100% (Gamma statistic = 0.85; Spearman correlation = 0.30, Pearsons R = 0.37, p < 0.001). Some US features were associated with a higher risk of malignancy: irregular contours (OR = 22.4), taller-than-wide shape (OR = 19.5), microcalcifications (OR = 15.2), and marked hypoechogenicity (OR = 12.7). Conclusion: Russ modified TIRADS classification is reliable in predicting thyroid malignancy. More evidence is nevertheless necessary for widespread adoption and use. Keywords: TIRADS; Thyroid Nodule; Thyroid Cancer; Ultrasonography; Fine-Needle Biopsy Fiabilit du systme de classification TIRADS (Thyroid Imaging Reporting and Data System) dans lidentification des nodules thyrodiens bnins et malins Boniface Moifo1, Joshua Tambe1, Sylviane Dongmo Fomekong1, Franois Blanc2, Joseph Gonsu Fotsin1 1Department of Radiology and Radiation Oncology, Faculty of Medicine and Biomedical Sciences, The University of Yaound I, Yaound, Cameroon 2Centre Hospitalier de Lagny, Marne La Valle, France 1Email: HYPERLINK "mailto:bmoifo@yahoo.fr"bmoifo@yahoo.fr Contexte: Lchographie est le meilleur outil diagnostique dans lvaluation initiale des nodules thyrodiens. En raison de leur pertinence et leur accessibilit, des classifications chographiques TIRADS ont t labores avec pour principal objectif de normaliser les rapports dchographie et faciliter la communication entre les mdecins, mais aussi pour indiquer quand la cytoponction laiguille fine (FNAB) doit tre faite. Objectif: Dterminer la fiabilit de la classification TIRADS modifie de Russ dans la prdiction des tumeurs malignes de la thyrode. Matriels et mthodes: Il sagit dune tude transversale mene au Centre Hospitalier de Lagny, Marne La Valle (France). Dans le cadre de la prsente tude, nous avons slectionn les dossiers conscutifs, de janvier 2007 aot 2012, de patients dont lchographie a montr des nodules thyrodiens focaux pour lesquels une FNABchographique a t effectue, et dont les rsultats pathologiques taient disponibles. Le risque de malignit pour chaque catgorie du TIRADS a t dtermin et la corrlation avec la maladie a t value. Les performances statistiques de certaines caractristiques chographiques ont galement t values. Le seuil de signification statistique a t fix 0,05. Rsultats: Au total, 430 dossiers de patients ont t ligibles. Vingt-trois sur 430 (5,3%) nodules taient malins. Le risque de malignit des catgories TIRADS taient les suivants: TIRADS2 0%, TIRADS3 2,2%, TIRADS4A 5,9%, TIRADS4B 57,9%, TIRADS5 100% (statistiques Gamma = 0,85; corrlation de Spearman = 0,30, R de Pearson = 0,37, p < 0,001). Certaines caractristiques de lchographie ont t associes un risque plus lev de malignit: contours irrguliers (OR = 22,4), forme plus longue que large (OR = 19,5), microcalcifications (OR = 15,2), ethypochognicit marque (OR = 12,7). Conclusion: La classification TIRADS modifie de Russ est fiable dans la prdiction des tumeurs malignes thyrodiennes. Cependant, il est ncessaire de recueillir davantage dinformations en vue de gnraliser son adoption et son utilisation. Mots cls: TIRADS; Nodule thyrodien; Cancer de la thyrode; chographie; cytoponction laiguille fine. INTERVENTIONAL BREAST PROCEDURES IN NIGERIA - EXPERIENCE FROM 3 CENTRES Z. Mustapha, H. Mdagas, N. Tahir, M. A. Halliru. PRESENTING AUTHOR Dr. Nasiru Tahir Dept. of Radiology, Federal Medical Center, Gombe email -  HYPERLINK "mailto:fatimazarau2006@yahoo.com"fatimazarau2006@yahoo.com University of Maiduguri Teaching Hospital (UMTH), Federal Medical Center (FMC, Gombe) Aminu Kano Teaching Hospital (AKTH) Objective: To evaluate the value of interventional breast procedures in the early and accurate diagnosis of breast diseases in Nigeria. Methodology: This prospective study reviews the records of all patients who had breast interventional procedures from three tertiary centers in Nigeria in the last 5 years. These centers are UMTH, FMC Gombe and AKTH and all used identical imaging protocols and indications for biopsy which are in accordance with ACR BI-RADS and practice parameters for performing image guided procedure. Results: A total of 396 interventional breast procedures were performed on 387 Female and 11 Males in three centers over the five years under review. Most Interventional procedures (except Stereotactic guided breast biopsy) were done under ultrasound guidance and included 152 Fine needle aspiration cytology (FNAC), 4 Fine needle aspiration biopsy (FNAB), 216 Core needle biopsy (CNB) , 7 Cyst aspirations and 17 Abscess drainage. We assessed the correlation between the imaging findings and histological outcome and made recommendations on improving accuracy all interventional procedures. Conclusion: Core needle biopsy was the most frequent biopsy done and gave the most accurate histological diagnosis while FNAC was the most frequent interventional procedure with the least accurate histological result. Breast biopsies are the fastest ways to achieve early and accurate diagnosis. PROCEDURES MAMMAIRESINTERVENTIONNELLES AU NIGERIA LEXPRIENCE DE 3 CENTRES Z. Mustapha, H. Mdagas, N. Tahir, M. A. Halliru. PRESENTING AUTHOR Dr. Nasiru Tahir Dept. of Radiology, Federal Medical Center, Gombe email - fatimazarau2006@yahoo.com University of Maiduguri Teaching Hospital (UMTH), Federal Medical Center (FMC, Gombe) Aminu Kano Teaching Hospital (AKTH) Objectif: valuer la valeur des procdures mammaires interventionnelles dans le diagnostic prcoce et prcis des maladies du sein au Nigeria. Mthodologie: La prsente tude prospective est une revue des dossiers de tous les patients qui ont subi des procdures mammaires interventionnelles dans trois centres de soins tertiaires au Nigeria au cours des 5 dernires annes. Ces centres sont lUMTH, le CMF de Gombe et lAKTH et tous les protocoles dimagerie identiques utiliss et les indications de la biopsie qui sont en conformit avec les paramtres ACR BI-RADS et les paramtres pratiques pour effectuer lintervention guide par limage. Rsultats: Au total, 396 procdures mammaires interventionnelles ont t effectues sur 387 femmes et 11 hommes dans trois centres au cours des cinq annes considres. La plupart des procdures interventionnelles (sauf la biopsie guide par la strotaxique mammaire) ont t ralises sous guidage chographique et comportait 152 cytologie daspiration aiguille fine (CAAF), 4 biopsie daspiration laiguille fine (BAAF), 216 biopsies au trocart, 7 aspirations de kyste et 17 drainage dabcs. Nous avons valu la corrlation entre les rsultats de limagerie et les rsultats histologiques et les recommandations formules sur lamlioration de la prcision de toutes les procdures interventionnelles. Conclusion: la biopsie au trocart tait la biopsie le plus frquent effectue et donnait le diagnostic histologique le plus prcis alors que la CAAF tait la procdure interventionnelle la plus frquent avec le rsultat histologique moins prcis. Les biopsies mammaires sont les moyens les plus rapides pour obtenir un diagnostic prcoce et prcis. Ultrasound values of spleen length and spleen to left kidney ratio in school aged children in YAOUNDE NKADA Christelle Valrie, ZEH Odile Fernande, NKOO AMVENE Samuel Introduction : Ultrasound detection of changes in spleen size requires reference to a pre-established biometric normo Objectives: Our main objective was to determine sonographically the normal range of spleen length and spleen to left kidney ratio with respect to gender, age and other anthropometric parameters among school aged children. Materials and methods: A cross-sectional descriptive study was conducted from March to August 2015 involving 343 asymptomatic children (178 boys and 165 girls) aged from 6 to 14. Participants were recruited from two primary schools in the city of Yaounde. Measurements of spleen and left kidney lengths were performed using an EMP 860 portable ultrasound machine with a 2-5MHz convex probe. Participants were placed in the supine or right lateral positions. Results: There was no statistically significant difference in the values of spleen length and spleen to left kidney ratio between girls and boys (p>0,05). The spleen length was significantly correlated to body surface area and weight. The normal limits of spleen length were defined according to weight. The spleen to left kidney ratio ranged from 0.76 to 1.3 in the studied population. Conclusion: Knowledge of the normal range of spleen to kidney ratio and spleen length with respect to weight improve on the ultrasound detection of changes in spleen size in school aged children in Yaounde. Keywords: Ultrasound; biometry; spleen size; spleen to kidney ratio; school aged children. VALEURS ECHOGRAPHIQUES DE LA FLECHE SPLENIQUE ET DU RATIO SPLENO RENAL CHEZ LENFANT EN AGE SCOLAIRE A YAOUNDE NKADA Christelle Valrie, ZEH Odile Fernande, NKOO AMVENE Samuel Introduction: La dtection chographique des changements de taille de la rate ncessite la rfrence un normogramme biomtrique pr tabli et spcifique chaque population. Objectifs: Notre objectif principal tait de dterminer chographiquement les valeurs normales de la flche splnique et du ratio splno rnal en fonction du sexe, de lge et des autres paramtres anthropomtriques, chez lenfant en ge scolaire. Matriel et mthodes: Une tude transversale descriptive a t mene de Mars Aout 2015 sur 343 enfants (178 garons et 165 filles) asymptomatiques, gs de 6 14 ans, de deux tablissements scolaires primaires de Yaound. Les mesures de la flche splnique et de la longueur du rein gauche ont t ralises laide dun chographe portable EMP 860 (Chine, 2004) dot dune sonde convexe de 2-5MHz, chez les sujets en dcubitus dorsal ou latral droit. Rsultats: Il nexistait pas de diffrence statistiquement significative des valeurs de la flche splnique et du ratio splno rnal entre filles et garons (p>0,05). La flche splnique tait significativement corrle la surface corporelle et au poids. Les limites normales de la longueur de la rate ont t dfinies en fonction du poids. Le ratio splno rnal tait compris entre 0,76 et 1,3 dans la population dtude. Conclusion: La connaissance des valeurs normales du ratio splno rnal et de la flche splnique en fonction du poids amliore la dtection chographique des modifications de taille de la rate chez lenfant en ge scolaire Yaound. Mots cls: Echographie; biomtrie; taille de la rate; ratio splno rnal; enfants en ge scolaire. PATTERN OF EARLY TRANSFONTANELLE ULTRASOUND FINDINGS IN TERM NEWBORNS WITH NEONATAL ENCEPHALOPATHY AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN Atalabi Omolola Mojisola1, Tongo Olukemi2, Odafe-Oyibotha Olubunmi Olubisi1. 1. Department of Radiology, University College Hospital, Ibadan, Oyo-State, Nigeria 2. Department of Paediatrics, University College Hospital, Ibadan, Oyo-State, Nigeria Presenter: Odafe-Oyibotha O.O., Email:  HYPERLINK "mailto:orogbemi2001@yahoo.com"orogbemi2001@yahoo.com Institution: University College Hospital, Ibadan. Background: Neonatal encephalopathy (NE) is a major cause of neonatal mortality and neurodevelopmental disability in childhood which may continue into adulthood. Ultrasonography, a portable, non-invasive and readily available imaging tool has been found to be sufficiently sensitive in detecting brain injury in infants and may be useful in prognosticating the neurologic outcome in NE. Objective: To describe the early transfontanelle ultrasound (TFUS) findings in NE and predict immediate outcome on 7th day of life. Methodology: A total of 100 term neonates with clinical features of NE developing within 24 hours of birth were recruited for the study. Antenatal and peripartum history were obtained while serial TFUS were done on the 1st, 3rdand 7th day of life. Results: Sixty patients (60%) showed normal pattern while 40 (40%) showed different forms of abnormal findings. Of this 40%, 32 (80%) showed features suggestive of perinatal injury while 8 (20%) showed features suggestive of antenatal injury. Basal ganglia and thalamic lesions were the most predominant of the hypoxic ischemic injury occurring in 78.1% while cortical lesions accounted for 21.9%. There was positive correlation between the clinical severity of NE and the US findings. Stages 2 and 3 NE had five and thirty-fold likelihood of abnormal findings compared to stage 1NE. There was also positive correlation between the clinical staging, US findings and the immediate clinical outcome on day 7. Conclusion: TFUS is a useful tool in assessing the pattern of brain injury in NE and alsoin predicting immediate neurologic outcome. TYPES DE RSULTATS DE LCHOGRAPHIE TRANSFONTANELLAIRE PRECOCE DES NOUVEAUX-NES A TERME ATTEINTS DENCPHALOPATHIE NONATALE AU CENTRE HOSPITALIER UNIVERSITAIRE D'IBADAN Atalabi Omolola Mojisola1, Tongo Olukemi2, Odafe-Oyibotha Olubunmi Olubisi1. 1. Department of Radiology, University College Hospital, Ibadan, Oyo-State, Nigeria 2. Department of Paediatrics, University College Hospital, Ibadan, Oyo-State, Nigeria Presenter: Odafe-Oyibotha O.O. Email: orogbemi2001@yahoo.com Institution: University College Hospital, Ibadan. Contexte: Lencphalopathie nonatale (EN) est une cause majeure de mortalit nonatale et de troubles du dveloppement neurologique de l'enfant susceptibles de se poursuivre jusqu' l'ge adulte. L'chographie, un outil d'imagerie portable, non-invasif et facilement accessible a t considre suffisamment sensible en vue de dtecter les lsions crbrales chez les nourrissons et elle peut s'avrer utile dans le pronostic des effets neurologiques chez les nouveau-ns. Objectif: lobjectif est de dcrire les rsultats de lchographie transfontanellaire (ETF) prcoce chez les nouveau-ns et prdire le rsultat immdiat 7 jours d'existence. Mthodologie: Au total 100 nouveau-ns terme, prsentant des signes cliniques d'EN dans les 24 heures suivant leur naissance ont t recruts pour l'tude. Les antcdents prnatal et prinatal ont t recueillis et une srie d'ETF ont t ralises au 1er, 3me et 7me jour d'existence. Rsultats: Les ETF chez soixante patients (60%) taient normales tandis que 40 (40%) ont rvl diffrents types de rsultats anormaux. Sur les 40%, 32 (80%) ont montr des signes vocateurs de lsions prinatales alors que 8 (20%) ont rvl des signes vocateurs de lsions prnatales. Les types de lsions hypoxiques ischmiques les plus courantes taient les lsions des noyaux gris centraux et du thalamus survenant dans 78,1% des cas alors que les lsions corticales ont reprsent 21,9%. Il y avait une corrlation positive entre la gravit clinique des EN et les rsultats des chographies. Les EN de stades 2 et 3 et celles de stade 1 laissaient entrevoir une probabilit de 5 et 30 fois plus de rsultats anormaux respectivement. Il y avait galement une corrlation positive entre le stade clinique, les rsultats des chographies et le rsultat clinique immdiat au 7me jour. Conclusion: L'ETF est un outil essentiel pour valuer le type de lsions crbrales dues a lEN et donner le pronostic de l'volution neurologique immdiate. EVALUATION OF INTRARENAL RESISTIVE INDEX IN DIABETIC NEPHROPATHY Odafe-Oyibotha Olubunmi Olubisi1, Atalabi Omolola Mojisola1,2 Department of Radiology, University College Hospital1, Ibadan and College of Medicine, University of Ibadan2, Nigeria Presenting author: Odafe-Oyibotha O.O. Correspondence email:  HYPERLINK "mailto:orogbemi2001@yahoo.com"orogbemi2001@yahoo.com Institution: University College Hospital, Ibadan, Oyo State, Nigeria. Background: Diabetic nephropathy (DN) is the leading cause of end stage renal disease globally and the 3rd commonest cause in sub-Saharan African. Objective: To assess the intrarenal resistive index (RI) among the various stages of DN. Methodology: One hundred and seven known diabetic patients were recruited from the endocrinology clinic of the University College Hospital, Ibadan. Renal Doppler Ultrasound as well as laboratory evaluation of renal function was carried out in them. The patients were stratified based on the urinary albumin excretion level and the data obtained was analysed using statistical package for social sciences version 20. Results: Mean RI increased with advancing nephropathy, RI- 0.665, 0.706 and 0.762 in diabetes without nephropathy, diabetes with incipient nephropathy and diabetes with overt nephropathy respectively (p<0.001). There was significant correlation between RI, serum creatinine and creatinine clearance (r=0.397 and 0.404 respectively). Weak association was noted between RI, age and duration of hypertension (r=0.24 and 0.28 respectively). The coexistence of hypertension also had significant impact on the mean RI value. Diabetic subjects with coexisting hypertension were 11 times at increased likelihood of having RI>0.7. There was however no significant correlation between RI and control of diabetes. Conclusion: RI may be the first indicator of renal function loss and can therefore be used as a non-invasive, easily accessible and affordable means to monitor patients with type 2 diabetes mellitus. VALUATION DE LINDICE DE RESISTANCE INTRARNALE DANS LES CAS DE NPHROPATHIE DIABTIQUE Odafe-Oyibotha Olubunmi Olubisi1, Atalabi Omolola Mojisola1,2 Department of Radiology, University College Hospital1, Ibadan and College of Medicine, University of Ibadan2, Nigeria Presenting author: Odafe-Oyibotha O.O. Correspondence email: HYPERLINK "mailto:orogbemi2001@yahoo.com"orogbemi2001@yahoo.com Institution: University College Hospital, Ibadan, Oyo State, Nigeria. Contexte: La nphropathie diabtique est la principale cause d'insuffisance rnale terminale l'chelle mondiale et la 3me cause la plus courante en Afrique subsaharienne. Objectif: valuer l'indice de la rsistance intra-rnale (IR) dans les diffrents stades de nphropathie diabtique. Mthodologie: Cent sept patients diabtiques connus ont t recruts partir du Service d'endocrinologie du Centre Hospitalier Universitaire dIbadan. Lchographie rnale Doppler ainsi que l'valuation en laboratoire de la fonction rnale ont t ralises. Les patients ont t classs selon la teneur en albumine de l'excrtion urinaire et les donnes obtenues ont t analyses laide du progiciel de statistiques pour les sciences sociales version 20. Rsultats: La moyenne de lIR augmente avec la progression de la nphropathie, IR- 0,665, 0,706 et 0,762 dans le diabte sans nphropathie, diabte avec nphropathie naissante et le diabte avec nphropathie manifeste respectivement (p<0,001). Il y avait corrlation significative entre lIR, la cratininmie et la clairance de la cratinine (r = 0,397 et 0,404 respectivement). Une faible association a t observe entre lIR, l'ge et la dure de l'hypertension (r=0,24 et 0,28 respectivement). La coexistence de l'hypertension a galement eu des rpercussions significatives sur la moyenne de la valeur de lIR. Les sujets atteints la fois de diabte et dhypertension taient 11 fois plus susceptibles d'avoir lIR>0.7. Il n'y a cependant aucune corrlation significative entre lIR et le contrle du diabte. Conclusion: LIR peut tre le premier indicateur de perte de la fonction rnale et peut donc tre utilis comme moyen non-invasif, facilement accessible et abordable pour surveiller les patients atteints de diabte sucr de type 2. COMPUTED TOMOGRAPHIC PREDICTORS OF OUTCOME OF ACUTE AND SUBACUTE STROKE IN ADULT PATIENTS AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN Olusunmade D1, Agunloye AM2, Yaria JO3 Author Information Department of Radiology, University College Hospital, Ibadan, Nigeria Department of Radiology, College of Medicine, University of Ibadan, Ibadan, Nigeria Department of Medicine, University College Hospital, Ibadan Presenting Author: Olusunmade D Background: Cranial CT is frequently requested in patients with stroke. The potential use of cranial CT findings to predict the expected outcome of stroke will help in tailoring the management of stroke to each patient. Aims: The study aims to determine how lesion type, size, location, vascular distribution, atrophy and midline shift on cranial CT can accurately predict the clinical outcome of acute and subacute stroke. Methodology: Cranial CT scan was performed on 121 consecutive patients with acute and subacute stroke. Clinical details recorded included demographic data, comorbidities, Glasgow Coma Score, National Institute of Health Stroke Scale, and Modified Rankin Score determined at 30 days using an interviewer-administered questionnaire. Student t-test, Chi square test, and multiple logistic regression were used for statistical analysis. Results: The male: female ratio of acute and subacute stroke was 1.3:1. Ischemic stroke was commoner than hemorrhagic stroke (1.4:1 ). On CT scan, patients with hemorrhagic stroke had fewer lesions and higher total volumes of lesions. The middle cerebral artery and the lateral lenticulostriate artery were the vascular territories with the most frequent involvement. The case fatality rate was 38% and 62% of patients had Modified Rankin Score greater than 4. The independent predictors of adverse outcome were midline shift > 5mm, low Glasgow Coma Score and aspiration pneumonia. The degree of midline shift was a better predictor of functional outcome than the volume of the lesion. Conclusion: This study has shown the CT findings and comorbidities associated with poor outcomes in stroke patients. With prompt interventions focused at these factors, it may be possible to improve the functional outcomes following strokes. INDICATEURS TOMODENSITOMETRIQUES DU PRONOSTIC DE L'AVC AIGU ET SUBAIGU CHEZ LES PATIENTS ADULTES AU CENTRE HOSPITALIER UNIVERSITAIRE DIBADIAN Olusunmade D1, Agunloye AM2, Yaria JO3 1.Department of Radiology, University College Hospital, Ibadan, Nigeria 2.Department of Radiology, College of Medicine, University of Ibadan, Ibadan, Nigeria 3.Department of Medicine, University College Hospital, Ibadan Presenting Author: Olusunmade D Contexte: La tomographie crnienne est frquemment recommande chez les patients victimes d'AVC. L'utilisation potentielle des conclusions d'une tomographie crnienne pour prdire le rsultat d'un AVC aidera adapter la prise en charge des accidents vasculaires chaque patient. Objectifs: L'tude a pour objectif de dterminer comment le type de lsion, la taille, la localisation, la distribution vasculaire, l'atrophie et le changement de la ligne mdiane sur la tomographie crnienne, peuvent prdire exactement le rsultat clinique dun AVC aigu et subaigu. Mthodologie: La tomographie crnienne a t effectue sur 121 patients conscutifs victimes d'AVC aigu et subaigu. Les dtails cliniques enregistrs comprenaient les donnes dmographiques, les comorbidits, l'chelle de coma de Glasgow, l'chelle de graduation de l'Institut National de Sant et le rsultat Rankin dtermin 30 jours laide dun questionnaire administr par un enquteur. Le test dtudiant, le test du chi carr, et la rgression logistique multiple ont t utiliss pour l'analyse statistique. Rsultats: Le ratio hommes/femmes de l'AVC aigu et subaigu tait de 1, 3:1. L'AVC ischmique tait plus frquent que l'AVC hmorragique. Sur la tomodensitomtrie, les patients victimes d'AVC hmorragique avaient moins de lsions et des volumes totaux de lsions plus levs. L'artre crbrale moyenne et l'artre lenticulostriate latrale taient les territoires vasculaires les plus impliqus. Le taux de ltalit tait de 38% et 62% des patients avaient un Score de Rankin modifi suprieur 4. Les prdicteurs indpendants des mauvais rsultats taient la modification de la ligne mdiane> 5mm, le faible score lchelle de coma de Glasgow et la pneumonie par aspiration. Le degr de modification de la ligne mdiane tait un meilleur indicateur du rsultat fonctionnel que le volume de lsion. Conclusion: Cette tude a donn les conclusions de la tomographie et des comorbidits associes aux mauvais pronostics chez les patients victimes d'AVC. Avec des interventions rapides axes sur ces facteurs, il serait possible d'amliorer les rsultats fonctionnels aprs un AVC. SONOGRAPHIC EVALUATION OF ENDOTHELIAL FUCTION IN BRACHIAL ARTERIES OF ADULT STROKE PATIENTS: A CASE CONTROLLED STUDY Omisore A.D, Ibitoye B.O, Ayoola O.O, Famurewa O.C, Asaleye C.M, Fawale Bimbo M, Adetiloye V.A. Presenting Author: Omisore A.D, MBBS, FWACS, Email- omisoreadeleye@yahoo.com Address: Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria Background: Endothelial dysfunction, a functional vascular abnormality predates atherosclerosis which is a structural vascular abnormality. Atherosclerosis has been implicated in the pathophysiology of stroke especially the ischemic type. Objective: The aim of this study was to determine associations between endothelial dysfunction by measurement of brachial artery percent flow mediated dilatation (%FMD) and incident stroke. Methods: We evaluated the right brachial arteries of stroke patients and non-stroke controls with B mode ultrasound before and after cuff application to their forearm. In addition, detailed clinical history and laboratory examination were done to measure cardiovascular risk factors. Result: Brachial artery evaluation for FMD was performed on 50 stroke cases and 100 non-stroke controls. FMD was significantly worse in the stroke cases compared to the controls. Controls with risk factors present in them also had significantly worse FMD than controls without risk factors. FMD was seen to be worse in ischemic stroke group than their haemorrhagic stroke group but no difference was found between the ischemic stroke subtypes. Conclusions: Impaired FMD which signifies endothelial dysfunction is seen in the presence of cerebrovascular risk factors and stroke. FMD however worsens in incident stroke than just presence of cerebrovascular risk factors. EVALUATION ECHOGRAPHIQUE DE LA FONCTION ENDOTHELIALE DE LARTERE BRACHIALE CHEZ LES PATIENTS ADULTES AYANT FAIT UN AVC: UNE ETUDE DE CAS CONTRLEE Omisore A.D, Ibitoye B.O, Ayoola O.O, Famurewa O.C, Asaleye C.M, Fawale Bimbo M, Adetiloye V.A. Presenting Author: Omisore A.D, MBBS, FWACS, Email- omisoreadeleye@yahoo.com Address: Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria Contexte: Le dysfonctionnement endothlial, une anomalie de la fonction vasculaire, est un facteur prdictif de lathrosclrose qui est une anomalie de la structure vasculaire. Lathrosclrose a t incrimine dans la physiopathologie de lAVC, en particulier celui de type ischmique. Objectif: La prsente tude a pour but de dterminer le lien entre le dysfonctionnement endothlial travers lvaluation du pourcentage de vasodilatation induite par le flux au niveau de lartre brachiale (%VMF) et lincidence de lAVC. Mthodes: Nous avons valu les artres brachiales droites des patients ayant fait un AVC et ceux du groupe-tmoin nen nayant pas fait laide de lchographie mode B avant et aprs la pose du brassard sur lavant-bras. En outre, un bilan clinique approfondi et des analyses mdicales ont t faites afin dvaluer les facteurs de risque cardiovasculaires. Rsultats: Afin de dterminer la VMF, nous avons valu lartre brachiale chez 50 cas dAVC et chez 100 cas-tmoins nayant pas fait dAVC. La VMF tait sensiblement plus mauvaise chez les cas dAVC que chez les autres. Les cas-tmoins prsentant des facteurs de risque avaient galement une VMF plus mauvaise que celle des cas-tmoins nayant pas de facteurs de risque. La VMF semblait plus grave chez le groupe des patients ayant fait un AVC ischmique par rapport au groupe de ceux ayant fait un AVC hmorragique, cependant aucune diffrence na t trouve dans les sous-types des AVC ischmiques. Conclusions: Lon retrouve une mauvaise VMF qui est un signe de dysfonctionnement endothlial en prsence dun facteur de risque crbro-vasculaire et dAVC. Cependant, la VMF est pire chez les cas dAVC que chez ceux prsentant seulement des facteurs de risque crbro-vasculaires. Anatomopathology and intracranial tumour MRI at the General Hospital of Douala Seme Introduction: Intracranial tumor pathology is a rich, diverse, varied and vast field of research. The cross-sectional imaging, mainly the CT scan and the magnetic resonance imaging plays an essential role in the diagnosis, the treatment and the post therapeutic follow up of this pathology. The general objective of our study was to determine the diagnostic concordance between the two modes of imaging (CT scans and MRI) and the anatomopathological diagnosis of the intracranial tumors at the General Hospital of Douala. Materials and methods: It is a retrospective, transversal and descriptive study on 133 files of patients admitted in the services of medical radiology, imaging and anatomopathology of the General Hospital of Douala for suspicion of intracranial tumor for the period covering January 2014 to March 2015. Results: Of the 133 patient files selected for the study, 79 (59.5%) were males as opposed to 54 (40.7%) who were females, in other words a gender ratio of 1.46 in favor of males. The global prevalence of intracranial tumors was 5.6%. The average age was 38.38 years and the most represented age groups were those between 30 and 69 years old. The clinical chart of the patients was dominated by: headache (71.4%), intracranial hypertension syndrome (23.3%), and epilepsies (13.5%). The CT scan (of the brain) was the most predominant test done by the patients (82 patients, which is the equivalent of a rate of 61.7%). MRIs were achieved on 51 patients (38.3 %) out of 133. The radiological diagnostics evoked were dominated by glial tumors (45.9%), the hypophyseal adenoma (20.3%) and the meningioma (13.5%). Within the pediatrics population, astrocytoma and ependymoma were the types of tumors most frequently found. We have obtained a histological analysis of 51 patients out of 133, which is 38.3%. The radiological diagnostic was confirmed for 44 patients, that is a histological confirmation rate of 86.3%. The radiological aspect of the intracranial tumors is not specific to benignity or malignancy in the radiological diagnosis of this pathology and the MRI is the modality of imaging which allows the best, to characterize the intracranial tumour lesions. COonclusion: The intracranial tumor pathology is common and affects preferably people over 30 years old. The combination of clinical data and cross-sectional imaging, mainly the CT scan and the magnetic resonance imaging permits, in a reliable manner, to make a diagnosis in accordance with the anatomopathological data. Key words: intracranial tumor; CT scan; Magnetic Resonance Imaging; Anatomopathology. Anatomopathologie et IRM des tumeurs intracrniennes lHpital Gnral de Douala Seme Introduction: La pathologie tumorale intracrnienne est un vaste champ de recherche riche, divers et vari. Limagerie en coupe, notamment le scanner et limagerie par rsonnance magntique jouent un rle essentiel dans le diagnostic, le traitement et le suivi post thrapeutique de cette pathologie. Lobjectif gnral de notre tude tait de dterminer une concordance diagnostique entre lanatomopathologie et limagerie en coupe (TDM et IRM) des tumeurs intracrniennes lHpital Gnral de Douala. Matriels et mthodes: Il sagissait dune tude rtrospective, transversale et descriptive sur 133 dossiers de patients admis dans les services de radiologie et dimagerie mdicale et danatomopathologie de lHpital Gnral de Douala pour suspicion de tumeur intracrnienne pendant la priode allant de janvier 2014 mars 2015. Rsultats: Parmi les 133 dossiers de patients retenus dans ltude, 79 (59,5%) taient de sexe masculin, contre 54 (40,6%) de sexe fminin, soit un sex ratio de 1,46 en faveur du sexe masculin. La prvalence globale des tumeurs intracrniennes tait de 5,6%. La moyenne dge tait de 38,38 ans et les tranches dges les plus reprsentes taient celles allant de 30 69 ans. Le tableau clinique des patients tait domin par: les cphales (71,4%), le syndrome dhypertension intracrnienne (23,3%) et les pilepsies (13,5%). Le scanner crbral tait lexamen le plus ralis par les patients (82 patients, ce qui quivaut un taux de 61,7%). LIRM avait t ralise chez 51 patients (38,3%) sur 133. Les diagnostics radiologiques voqus taient domins par les tumeurs gliales (45,9%), Les adnomes hypophysaires (20,3%) et les mningiomes (13,5%). Dans la population pdiatrique, les astrocytomes et les pendymomes taient les types de tumeurs les plus frquemment rencontrs. Nous avons obtenu une analyse histologique chez 51 patients sur 133, soit un pourcentage de 38,3%. Le diagnostic radiologique a t confirm chez 44 patients, soit un taux de 86,3%. Laspect radiologique des tumeurs intracrniennes nest pas spcifique de bnignit ou de malignit dans le diagnostic radiologique de cette pathologie et lIRM est la modalit dimagerie qui permet le mieux de caractriser les lsions tumorales intracrniennes. Conclusion: La pathologie tumorale intracrnienne est frquente et touche plus souvent les populations de plus de 30 ans. Lassociation des donnes cliniques et de limagerie en coupe, notamment le scanner et limagerie par rsonnance magntique permettent de manire fiable de poser un diagnostic concordant avec les donnes anatomopathologiques. Mots cls: Tumeurs intracrniennes; Scanner; Imagerie par Rsonance Magntique; Anatomopathologie. CT SCAN AND MRI FEATURES OF INTRACRANIAL TUMORS AT THE GENERAL HOSPITAL OF DOUALA SEME Introduction: The intracranial pathology of tumors is a vast field of research. The CT scan and MRI are essential in the diagnosis and the follow up of this pathology. The general objective was to determine the diagnostic concordance between the two modes of imaging (CT scans and MRI) and the anatomopathological diagnostic. Materials and methods: It is a retrospective, transversal and descriptive study on 133 files of patients admitted in the service of radiology for suspicion of intracranial tumor for the period covering January 2014 to March 2015. Results: Of the 133 files of patients retained, 79 (59.5%) were. The average age was 38.38 years old and the age groups most represented were those between 30 and 69 years old. The clinical chart of the patients was dominated by: headaches (71.4%), intracranial hypertension (23.3%), and convulsions (13.5%). The CT scan (of the brain) was the most undergone test by the patients (82 patients). MRIs were realized on 51 patients (38.3 %). The radiological diagnostics evoked were dominated by glial tumors (45.9%), the hypophyseal adenoma (20.3%) and the meningioma (13.5%). Within the pediatrics population, astrocytoma and ependymoma were the types of tumors most frequently found. We have obtained a histological analysis of 51 patients out of 133, which is 38.3%. The radiological diagnostic has been confirmed for 44 patients, that is a histological confirmation rate of 86.3%. The radiological aspect of the intracranial tumors is not specific to benignity or malignity in the radiological diagnostic of this pathology and the MRI is the modality of imaging which allows the best, to characterize the intracranial lesions of the tumors. Conclusion: The intracranial pathology of tumor is frequent and affects preferentially populations over 30 years old. The combine clinical data and cross-sectional imaging, mainly the CT scan and the magnetic resonance imaging allow, in a reliable manner, to establish a diagnostic in consistence with the anatomopathological data. Key words: intracranial tumor; CT scan; Magnetic Resonance Imaging; Anatomopathology. ASPECTS SCANOGRAPHIQUES ET REMNOGRAPHIQUES DES TUMEURS INTRACRANIENNES A LHOPITAL GENERAL DE DOUALA SEME Introduction: La pathologie tumorale intracrnienne est un vaste champ de recherche. La TDM et lIRM sont essentiels dans le diagnostic et la prise en charge de cette pathologie. Lobjectif gnral de ltude tait de dterminer une concordance diagnostique entre lanatomopathologie et limagerie en coupe. Matriels et mthodes: Il sagissait dune tude rtrospective, transversale et descriptive sur 133 dossiers de patients admis en radiologie pour suspicion de tumeur intracrnienne pendant la priode allant de janvier 2014 mars 2015. Rsultats: Parmi les 133 dossiers de patients, 79 (59,5%) taient de sexe masculin, contre 54 (40,6%) de sexe fminin. La moyenne dge tait de 38,38 ans. Les tranches dges les plus reprsentes taient celles allant de 30 69 ans. Le tableau clinique tait domin par: les cphales (71,4%), lhypertension intracrnienne (23,3%) et les convulsions (13,5%). Le scanner tait ralis par 82 patients (61,7%). LIRM avait t ralise par 51 patients (38,3%). Les diagnostics radiologiques voqus taient domins par les tumeurs gliales (45,9%), Les adnomes hypophysaires (20,3%) et les mningiomes (13,5%). Dans la population pdiatrique, les astrocytomes et les pendymomes taient les types de tumeurs les plus frquemment rencontrs. Nous avons obtenu une analyse histologique chez 51 patients (38,3%). Le diagnostic radiologique a t confirm chez 44 patients (86,3%). Laspect radiologique des tumeurs intracrniennes nest pas spcifique de bnignit ou de malignit dans le diagnostic radiologique de cette pathologie et lIRM est la modalit dimagerie qui permet le mieux de caractriser les lsions tumorales intracrniennes. Conclusion: La pathologie tumorale intracrnienne est frquente et touche plus souvent les populations de plus de 30 ans. Lassociation des donnes cliniques et de limagerie en coupe permet de manire fiable de poser un diagnostic concordant avec les donnes anatomopathologiques. Mots cls: Tumeurs intracrniennes; Scanner; Imagerie par Rsonance Magntique; Anatomopathologie. CORRELATION BETWEEN THE LEVEL OF ACCURACY OF INDICATIONS AND THE NORMALCY OF IMAGING EXAMS AT THE YAOUNDE GYNAECO-OBSTETRIC HOSPITAL Temgoua NM1,*, Zeh OF1, 2, Nzina TZ3, Badjang G1, Gonsu JF1, 2 1Facult de Mdecine et des Sciences Biomdicales 2Dpartement de Radiologie et Imagerie Mdicale 3Institut Suprieure de Technologie Mdicale *Correspondance: Dr Temgoua Ngou Mazou, Facult de Mdecine et des Sciences Biomdicales, Interne des Hpitaux, Yaound-Cameroun, Email:  HYPERLINK "mailto:neurotemgoua@yahoo.fr"neurotemgoua@yahoo.fr Background: Health professionals do not usually correctly specify indications on their imaging request forms. The correlation between the normalcies of imaging request results based on their indication was not found in the literature. Purpose: To determine the proportion of normal imaging tests depending on the level of precision of their indications. Methodology: This was an analytical cross-sectional study of 123 selected imaging request forms in the Medical Imaging Department of the Yaounde Gynaeco-Obstetrics and Paediatrics Hospital. Routine and control checkups were excluded. Statistical analysis was made using the Chi2 and Fisher tests. P-value<0.05 was considered statistically significant. Results: Fifty-six (45.5%) requests were normal. Based on the level of precision of indications, fifteen (68%) were normal without any indication, twenty-five (51%) when it was a symptom, zero (0%) in the presence of a syndrome and sixteen (34%) when the indication was a specific purpose. Using linear regression, the precision of an indication was positively related to the result (p = 0.02). Conclusion: The proportion of normal imaging requests without any specific indication is high. An awareness of prescribers is needed to reduce the number of unnecessarily requested imaging tests, which are important sources of financial expenditure and radiation. Keywords: Imaging request forms, specific indications, normalcy of results Corrlation entre le niveau de prcision des indications et la normalit des examens dimagerie lHpital Gynco-Obsttrique et Pdiatrique de Yaound Temgoua NM1,*, Zeh OF1,2, Nzina TZ3, Badjang G1, Gonsu JF1,2 1Facult de Mdecine et des Sciences Biomdicales 2Dpartement de Radiologie et Imagerie Mdicale 3Institut Suprieure de Technologie Mdicale *Correspondance : Dr TemgouaNgouMazou, Facult de Mdecine et des Sciences Biomdicales, Interne des Hpitaux, Yaound-Cameroun, Email : neurotemgoua@yahoo.fr Contexte: Les prescripteurs dexamen ne prcisent pas souvent correctement les indications sur le bulletin dexamen dimagerie. La corrlation entre la prcision de lindication dexamen et les rsultats na pas t retrouve dans la littrature. Objectif: Dterminer la proportion des examens dimagerie normaux en fonction de la prcision de lindication. Mthodologie: Il sagissait dune tude transversale analytique portant sur 123 bulletins dexamen dimagerie slectionns dans le service dimagerie mdicale de lHpital Gynco-Obsttrique et Pdiatrique de Yaound. Les bilans de contrle et de routine, ont t exclus. La comparaison des variables sest faite laide des tests de Khi2 et de Fisher, une valeur p0,05 tait considre comme statistiquement significative. Rsultats: Cinquante six (45,5%) examens demands taient normaux. Selon la prcision de l indication, quinze (68%) taient normaux en absence d indication, vingt-cinq (51%) lorsqu il s agissait dun symptme, zro (0%) en prsence dun syndrome et seize (34%) quand lindication tait une finalit prcise. En rgression linaire le niveau dindication tait li au rsultat (p=0,02). Conclusion: La proportion des examens dimagerie normaux est leve en absence dindication prcise. Une sensibilisation des prescripteurs est ncessaire pour rduire le nombre dexamen demand inutilement, qui sont sources de dpenses financires importantes et dirradiation. Mots cls: Demande dexamen dimagerie, indication prcise, normalit des rsultats Epileptic seizure: electro-clinical aspects and brain morphological MRI features at Douala General Hospital (DGH) ZOUHARATOU HAMAN, MAPOURE NJANKOUO Yacouba, MOIFO Boniface Abstract: Epilepsy is a serious public health problem in sub-Saharan Africa with an estimated prevalence between 5.2 and 74. The etiological diagnosis of epileptic seizure is relevant to the patients management. Magnetic resonance imaging (MRI) is the best imaging modality in this indication because it is very sensitive in the detection of brain pathology with no radiation. Objective: The aim of this study was to describe the morphological MRI features of the epileptic seizures at Douala General Hospital (DGH). Patients and methods: it was a cross-sectional descriptive study carried out in Radiology and Neurology units of DGH from September 1st2014 to August 31th 2015. We included 103 patients (children and adults) aged 0 to 77 years old with a diagnosis of epileptic seizure in whom a brain MRI was performed. The studied variables were epidemiological factors (age, sex), etiological factors, type of epileptic seizure, EEG abnormalities, indications of MRI imaging and the abnormalities in brain MRI. Results: the sex ratio was 1, 4 M/ 1F. The mean age of patient was 9.59 years in children and 38.97 years in patients aged 16 years and more. Generalized tonic-clonic seizure was the most frequent type of seizure (60.2%). Etiological factors were found in 34% of patients, it was mainly neonatal asphyxia, brain trauma and family history of epilepsy. The EEG showed an epileptic focus in 80.8% and the main foci were: temporal (35.5%), frontal (13.7%) and generalized focus (23.2%). The mainly indications of MRI imaging were: pharmaco resistance to epileptic drugs and psychomotor retardation in children; focal EEG abnormality and simple epileptic seizure in patients aged 16 years or more. The MRI was abnormal in 66 (65%) patients with as majors abnormalities: after-effects lesions (38.5%) and cortical development malformations (15.4%) in children; hippocampal sclerosis (27%) and brain tumors (22%) in patients aged 16 years and more. Conclusion: Generalized tonic-clonic seizure was the most frequent type of seizure. The mainly indications of MRI imaging were: pharmaco resistance to epileptic drugs and psychomotor retardation in children; focal EEG abnormality and simple epileptic seizure in patients aged 16 years or more. The main MRI abnormalities were hippocampal sclerosis and brain tumors in adults; after-effects lesions and cortical development malformations in children. Key-words: Epileptic seizure, Magnetic resonance imaging, electro encephalogram, hippocampal sclerosis, brain tumors, after-effects lesions, Douala General Hospital. Crise dpilepsie: aspects lectro cliniques et trouvailles lIRM morphologique crbrale ZOUHARATOU HAMAN, MAPOURE NJANKOUO Yacouba, MOIFO Boniface Rsum: Lpilepsieest un problme de sant publique dont la prvalence en Afrique subsaharienne est estime entre 5,2 et 74.Elle se caractrise par la rptition des crises dpilepsie. La survenue dune crise pileptique impose une dmarche clinique minutieuse, la recherche tiologique afin de classer la crise et ou le syndrome pileptique. Lavnement de limagerie crbrale a constitu une avance indniable dans la dmarche diagnostique. Il est actuellement prouv la supriorit de lImagerie crbrale par Rsonance Magntique (IRM) compare au scanner crbral dans la recherche de ltiologie. Objectifs: lobjectif de cette tude tait de dterminer les diffrentes trouvailles lIRM morphologique crbrale des patients ayant prsent au moins une crise dpilepsie. Patients et mthodes: il sagissait dune tude transversale descriptive ralise dans le service de Radiologie et dans lUnit de Neurologie de lHGD du 1er Septembre 2014 au 30 Aot 2015. Elle incluait 103 patients (enfants et adultes), ayant prsent au moins une crise pileptique et chez qui une IRM crbrale avait t ralise. Les variables tudies taient: lge, le sexe, le type de crise, les facteurs tiologiques, les anomalies EEG, lindication de lIRM, le protocole ralis ainsi que les anomalies retrouves lIRM. Rsultats: le sex-ratio tait de 1,4 en faveur du sexe masculin; lge moyen tait de 9,59 ans avec une mdiane de 10 ans pour les enfants, et de 38,97 ans pour la population de 16 ans et plus avec une mdiane de 37 ans. Les crises pileptiques taient majoritairement de type gnralis tonico-clonique (60,2%). Les facteurs tiologiques taient retrouvs chez 34% de nos patients; il sagissait principalement de lasphyxie nonatale, du traumatisme crnien et des antcdents familiaux dpilepsie. LEEG rvlait un foyer pileptique dans 80,8% des cas et les principaux foyers taient: temporal (35,5%), frontal (13,7%) et gnralis (23,2%). Les principales indications de lIRM crbrale taient la pharmaco-rsistance et le retard psychomoteur pour les enfants; une anomalie focale lEEG et une crise pileptique inaugurale chez les patients de 16 ans et plus. LIRM tait pathologique pour 65% de nos patients avec pour principales anomalies: la sclrose hippocampique (27%) et les tumeurs crbrales (22%) pour les patients de 16 ans et plus; les lsions squellaires (38,5%) et les malformations du dveloppement cortical (15,4%) pour les enfants. Conclusion: les crises pileptiques sont en majorit de type gnralis tonico-clonique. Les principales indications dIRM sont lpilepsie pharmaco-rsistante et/ou avec retard psychomoteur chez lenfant, et lexistence dune anomalie focale lEEG et une crise inaugurale chez ladulte. Les anomalies lIRM sont domines par la sclrose hippocampique et les tumeurs crbrales pour ladulte, et chez lenfant par les lsions squellaires dasphyxie prinatale et les malformations du dveloppement cortical. 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La chirurgie plastique dans la pratique courante au Service de chirurgie gnrale du CHU de Yaound: A propos de 50 Cas Guifo Marc Leroy; Eseme Ebai; Nana Oumarou Blondel; Biwole Daniel; Essomba Arthur; Takongmo.Samuel; Tegomoh Bryan. Presentation: Eseme Ebai, General surgery Email:dresemeebai@yahoo.com Institution: University Hospital center Contexte: La chirurgie plastique et rparatrice fait partie des comptences encore inaccessibles aux populations en Afrique subsaharienne. Cest le cas au Cameroun mme dans les hpitaux de rfrence. Au C.H.U de Yaound, nous avons men une tude pour valuer les indications gnralement rencontres dans la pratique et dfinir les perspectives damlioration soit en termes de renforcement des capacits ou de formation en chirurgie plastique. Mthodes: Nous avons men une tude rtrospective et descriptive, allant de janvier 2012 juillet 2015 au CHUY. Etaient inclus dans notre tude, tous patients oprs laide des techniques de chirurgie plastique durant cette priode. Les donnes ont t collectes partir des dossiers des malades, des registres de service et des comptes rendu opratoires. Rsultat: Un total de 50 dossiers rpondait nos critres dinclusion. La majorit des patients tait dans la tranche dge de 31 40 ans, soit 48%. Les hommes taient plus reprsents que les femmes soit 32 (63.3%) et 18(36.7%), respectivement. Le membre suprieur tait plus affect 28 (56%). Le traumatisme tait ltiologie la plus courante 21 (42%) avec une prdominance des accidents de la voie publique (85.7%), suivis des brlures 14 (28%). Parmi les interventions chirurgicales effectues, les greffes de la peau taient les plus utilises 29 (58%), suivies des lambeaux pdiculs 14 (28%). Le taux des complications slevait 8%. Conclusion: Les indications rsultant des traumatismes reprsentent environ 70% de la pratique de chirurgie plastique et 30% couvre les indications lies aux malformations, aux squelles et lesthtique. Dou la ncessit de prendre en compte ces besoins dans la formation en chirurgie gnrale dans notremilieu et dencourager la spcialisation en chirurgie plastique. PLASURG002 Cure prothtique des ventrations abdominales lHpital Central de Yaound: rsultats prliminaires dune srie de 16 cas. Dr SANGO Joseph, Dr BOLA SIAFA Antoine, Dr NONO Jean Jacques, Pr NGO NONGA Bernadette, Pr ESSOMBA Arthur Introduction: Lventration abdominale, est une complication de la chirurgie abdominale. Son traitement utilise des prothses non rsorbables. Depuis environ cinq ans les patients sont pris en charge par cure de prothses non rsorbable lHpital Central de Yaound. Objectifs: Evaluer lutilisation des prothses non rsorbables, dans la cure des ventrations abdominales lHpital Central de Yaound. Apprcier le devenir des patients en post opratoire. Mthodologie: Une tude descriptive et transversale, a t conduite dans le service de Chirurgie Digestive et Viscrale de lHpital Central de Yaound. Tous les patients oprs dAot 2010 Aot 2015 par cure prothtique non rsorbable et dont les dossiers taient complets ont t inclus. Les donnes recueillies ont t analyses grce au logiciel STATA. Rsultats: 16 dossiers complets ont t analyss. Lge moyen tait de 52 ans, les femmes taient plus touches (sex-ratio=1,66). Linfection post-opratoire (68,8%) tait la premire cause dventration abdominale. La tumfaction inesthtique (56,3%) tait le motif de consultation le plus frquent. Neuf patients (59,2%) prsentaient une trs grande ventration. Tous les patients avaient t oprs par cure prothtique en position rtro musculaire. La dure moyenne dhospitalisation tait de 7,5 jours. Nous avons not une complication-post opratoire prcoce type dhmatome rtro-musculaire soit 6,25%. Aucune rcidive na t dcele aprs un recul moyen de deux ans. Le cot reste lev pour un citoyen moyen dans notre pays. Conclusion: Ces rsultats prliminaires suggrent leffectivit de la cure prothtique dventrations abdominales dans notre milieu, ainsi que des suites post opratoires simples. Mots cls: ventrationabdominale, cure prothtique, rsultats prliminaires, hpital central de Yaound. Le rle des centres PIUTA dans le renforcement des capacits en urologie en Afrique sub-saharienne E.Oluwabunmi Olapade-Olaopa+ and Serigne M Gueye++ Affilations: +University College Hospital, Ibadan, NIGERIA and ++Grand Yoff Hospital, Darkar, SENEGAL. Corresponding author: Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: HYPERLINK "mailto:piutaibadan@yahoo.com"piutaibadan@yahoo.com Introduction: lurologie fait face de nombreux dfis en Afrique sub-saharienne. Au nombre de ces dfis figurent une population dmunie forte croissance, des faibles dpenses de sant lies au manque dinfrastructures sanitaires modernes et lexistence de problmes scuritaires et des pidmies. Par ailleurs, il y a relativement peu de programmes de formation en urologie et durologues, ainsi quune fuite de cerveaux considrable. Mthodes: linitiative PAUSA pour la formation durologues en Afrique sub-saharienne (PIUTA) afin de renforcer les capacits en urologie et amliorer ainsi la qualit des soins dans la sous-rgion est ne en 2008. Deux hpitaux (Hpital Grand Yoff de Dakar au Sngal et University College Hospital, dIbadan au Nigeria) ont t retenus comme centres pionniers et dvelopps selon les normes internationales, avec laide du Global Philantropic Committee et dautres partenaires nationaux et internationaux. Rsultats: En 30 mois de fonctionnement, les deux centres ont form plus de 140 personnels de sant notamment des urologues qualifis, des rsidents, des tudiants de 3me cycle, des infirmiers et des techniciens grce des bourses, des ateliers, des confrences et des colloques scientifiques. Les autres contributions incluent plusieurs prsentations, des publications, des livres et un brevet. En outre, deux nouveaux centres ont bnfici du soutien de la GPC Yaound (Cameroun) et Moshi en Tanzanie. Le rle des autres acteurs (notamment le COAC) dans le renforcement des capacits en Afrique mrite galement dtre salu. Conclusion: Les Centres PIUTA et autres partenaires ont contribu de manire significative au renforcement des capacits en urologie en Afrique. Ces efforts doivent tre soutenus et intensifis pour la cration de nouveaux centres de formation et la rtention du personnel qualifi. 2me Programme dinterventions chirurgicales en stratgie avance 2015 du COAC Ibadan, NIGERIA Presenters: Herve K Yagni- Angate and E.Oluwabunmi Olapade-Olaopa 651142629 Affilations: On behalf of the WACS Outreach Committee. Corresponding author: Professor E.O. Olapade-Olaopa, Urology Division, Department of Surgery, University of Ibadan, Nigeria. Email: piutaibadan@yahoo.com Introduction: Lide du programme dinterventions chirurgicales en stratgie avance du COAC est ne en 2013 dans le cadre des efforts du Collge Ouest-africain des Chirurgiens (COAC) de remdier la grave pnurie de chirurgiens dans la sous-rgion. Le Comit de stratgie avance a par consquent organis des programmes pilotes au Nigria et la premire stratgie avance a t mene Abuja en 2014 au cours de laquelle 25 interventions chirurgicales gratuites ont t effectues. A prsent, nous vous prsentons le rapport de la deuxime stratgie avance qui sest droule Ibadan en novembre 2015. Mthodes: Un comit local dorganisation (CLO) constitu de Fellows de toutes les facults du COAC a t dsign et des runions ont eu lieu avec les parties prenantes. Lappui du Ministre de la Sant dOyo, de la Facult de Mdecine de lUniversit dIbadan et du Centre Hospitalier Universitaire dIbadan a t assur. LAssociation des Mdecins de Famille, lAssociation des Mdecins Gnralistes et des Mdecins exerant dans le secteur priv au Nigria, lAssociation des Femmes Mdecins du Nigria, le Food Basket of Nigeria, lindustrie pharmaceutique et plusieurs socits donatrices ont galement accept dy participer. Le lieu de la campagne et les services offrir ont t slectionns. Rsultats: Pendant les 04 jours qua dur la stratgie avance, 1 485 adultes et enfants ont t examins afin de rechercher des maladies mdicales et chirurgicales. En outre, 709 ont subi un examen ophtalmologique, tandis que 356 ont subi des interventions de chirurgie gnrale, dentaire, oto-rhino-laryngologique, gyncologique et de radiologie. 429 ont bnfici dune valuation individuelle du rgime alimentaire et reu des conseils. Plus de trois cent personnels de sant, administratifs et de scurit ont pris part cet vnement. Conclusion: Le 2me Programme dinterventions chirurgicales en stratgie avance du Collge Ouest-africain des Chirurgiens (COAC) organis Ibadan en collaboration avec plusieurs autres parties prenantes a t une russite. Toutes les facults du Collge ont particip cet vnement. 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