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Introduction the objective was to identify the predictive factors contributing to COVID-related deaths in Intensive Care Unit. Methods this was a 4-month (12 th March to 12 th July 2020) cross sectional study carried out in the intensive care unit of the COVID treatment center of Donka National Hospital, the only hospital with a COVID intensive care unit in Guinea. Results during our period of study 140 patients were hospitalized in the COVID intensive care unit and 35 patients died (25%). In univariate analysis, the occurrence of death was associated with: confusional syndrome (p<0.001), time to admission (p<0.001), use of an inotropic or vasopressor (p<0.001), Brescia score ≥ 2 (p=0.004), non-invasive ventilation (p=0.011), stroke (p=0.014), Acute Respiratory Distress Syndrome (ARDS) (p=0.015), male (p=0.021), provenance (p=0.021), acute renal failure (p=0.022), pulmonary embolism (p=0.022), invasive ventilation (p=0.022), and age > 60 years (p=0.047). In multivariate analysis, the factors predictive of mortality were: Acute Respiratory Distress Syndrome (ARDS) (OR= 6.33, 95% CI [1.66-29]; p=0.007), a Brescia score ≥ 2 (OR =5.8, 95% CI [1.7-19.2]; p=0.004) and admission delay (OR =5.6, 95% CI [1.8-17.5]; p=0.003). Conclusion our study shows that the acute respiratory distress syndrome, then the Brescia score ≥ 2, and finally the time to admission to intensive care were all associated with an increased risk of death for patients. These results are different from those reported in Asia, Europe and North America.

We report the case of a 28-month-old male child with no particular history who was admitted to the emergency room for severe abdominal pain associated with vomiting, asthenia and fever at 39.1˚C that had progressed for 4 days. He was conscious, polypneic at 32 cycles/min on admission. On palpation the abdomen was distended, painful as a whole, more pronounced in the epigastrium. There was abdominal contracture, generalized defense, a cry with sudden decompression of the umbilicus. On abdominal auscultation, there was a disappearance of prehepatic dullness, a decrease in the dullness of the flanks and absence of hydro-aeric noises. On the digital rectal examination, Douglas's cul de sac was bulging and sensitive. An unprepared X-ray of the abdomen revealed diffuse grayness, lateral gas crescent pneumoperitoneum under diaphragm. The preoperative resuscitation consisted of the placement of a nasogastric tube, a urinary catheter, a peripheral venous route and the fluid electrolyte rebalancing adapted according to the blood ionogram, early antibiotic therapy with broad aero and anaerobic spectrum. Surgical management under general anesthesia found at laparotomy a perforation of the anterior surface of the duodenal bulb which we estimate to be 1 cm in diameter with fibrin deposits. The gesture was the toilet of the peritoneal cavity; suture of the bank and the operative consequences were simple.

Transurethral resection of the prostate (TURP) remains the gold standard treatment for benign prostatic hyperplasia (BPH). Objective: To report the results of TURP to the Urology Department of Ignace Deen National hospital Patients and methods: This was a prospective, descriptive study of 2 years 5 months (January 1, 2015 to May 31, 2017), carried out in the urology department of the Ignace Deen National Hospital. We included 86 patients who benefited from an isolated TURP or associated with another surgical procedure. Results: TURP accounted for 51.19% of endoscopic surgery and 20.18% of prostate surgery. The mean age was 69.21 years (48 and 89). The mean total PSA level was 17.7ng / ml. The mean prostate volume was 54, 22 cm 3 (27 and 107). The indication for surgery was dominated by chronic retention of bladder urine (93.02%). The mean duration of TURP was 41.84 min (28 and 58). Postoperative complications were dominated by orchi-epididymitis (5.81%) and UVR (4.66%). The mean length of stay was 5.63 days. The histologic types were: benign prostatic hyperplasia (69.77%), prostatic adenocarcinoma (29.07%) and high grade intraepithelial prostate neoplasia (1.16%). After a mean followup of 2.21 months, the result was good in 95.35% of cases. Conclusion: It offers low morbidity and a good result in almost all cases.

In December 2019, coronavirus disease (COVID-19) due to infection with the novel SARS-CoV-2 virus began to break out. Hemodialysis patients are at high risk because of the co-morbidities. We report the clinical and biological characteristics of two patients who developed COVID-19 infection in our dialysis center in Donka National Hospital. None of the patients had contact with an infected person. The age was 38 and 54 years. The symptoms common to both patients were: fatigue, diarrhea, fever. Lymphopenia was present in both patients. None of them had a chest X-ray or chest scan because they were positive for the test before admission.