No. 92 April 2005

Banda Aceh: helping the needyNewsletterNewsletterBanda Aceh: helping the needy

SICOTSOCIÉTÉ INTERNATIONALE de CHIRURGIE ORTHOPÉDIQUE et de TRAUMATOLOGIETHE INTERNATIONAL SOCIETY OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY

LE 10 OCTOBRE 1

929

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SICOTSociété Internationale de Chirurgie Orthopédique et de Traumatologie

International Society of Orthopaedic Surgery and Traumatology w w w. s i c o t . o r g

Evidence based orthopaedics 2

Editorial by Prof Rocco P. Pitto 3

Country to country: Orthopaedics in Saudi Arabia 4

On the web: Istanbul TWC 2005 on-line 6

Committee life: Officer Nominating Committee 8

Young surgeons:Training in the UK 9

Worldwide news: Dr Courtenay in Banda Aceh 11

In this issue

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Effects of participation in RCTs vs non-trial treatment of patientsreceiving similar interventions

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Background: Some people believe that patientswho take part in randomised controlled trials (RCTs)face risks that they would not face if they opted fornon-trial treatment. Others think that trial partici-pation is beneficial and the best way to ensure ac-cess to the most up to date physicians and treat-ments.

Objectives: To assess the effects of patient partici-pation in RCTs (“trial effects”) independent both ofthe effects of the clinical treatments being compa-red ('treatment effects') and any differences bet-ween patients who participated in RCTs and thosewho did not.

Search strategy: In May 2001, we searched TheCochrane Central Register of Controlled Trials(CENTRAL), MEDLINE, EMBASE, The CochraneMethodology Register, SciSearch and PsycINFO forpotentially relevant studies. Our search yielded over10,000 references. In addition, we reviewed the re-ference lists of relevant articles and wrote to over250 investigators to try to obtain further informa-tion.

Selection criteria: Randomised studies and cohortstudies with data on clinical outcomes of RCT par-ticipants and similar patients who received similartreatment outside of RCTs.

Data collection and analysis: At least two reviewers independently assessed studies for inclu-sion, assessed study quality and extracted data.Study authors were contacted for additional infor-mation.

Main results: We included five randomised studies(yielding 6 comparisons) and 50 non-randomised

cohort studies (85 comparisons), with 31,140 pa-tients treated in RCTs and 20,380 patients treatedoutside RCTs. In the randomised studies, patientswere invited to participate in an RCT or not; thesecomparisons provided limited information becauseof small sample sizes (a total of 412 patients) andthe nature of the questions they addressed.Therewas statistically significant heterogeneity (P <0.00001, I2 = 89.0%) among the 73 dichotomousoutcome comparisons; none of the potential expla-natory factors we investigated helped to explain thisheterogeneity. No statistically significant differenceswere found for 59 of the 73 comparisons.Ten com-parisons reported statistically significant better out-comes for patients treated within RCTs, and fourcomparisons reported statistically significant worseoutcomes for patients treated within RCTs.Therewere no statistically significant differences in hetero-geneity (P = 0.53,I2 = 0%) or in outcomes (SMD 0.01,95% CI -0.10 to 0.12) of patients treated within andoutside RCTs in the 18 comparisons which had usedcontinuous outcomes.

Authors' conclusions: This review indicates thatparticipation in RCTs is not associated with greaterrisks than receiving the same treatment outsideRCTs.These results challenge the assertion that theresults of RCTs are not applicable to usual practice.

■

Citation: Vist GE, Hagen KB, Devereaux P, Bryant D,Kristoffersen DT, Oxman AD.

The Cochrane Database of Methodology Reviews 2004, Issue 4.

Art. No.: MR000009.pub2.DOI: 10.1002/14651858.MR000009.pub2.

Evidencebased

orthopaedics

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A few words from the Editorial Secretary…

Editorial

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Dear Colleagues and Friends,

2005 will be an exciting and challenging year for the Editorial Office.TheExecutive Committee has appointed Mr Charles Sorbie to publish a“Celebration Book” to mark the occasion of the 75th Anniversary ofthe Society, and we will assist him in accomplishing this difficult task.Thebook will not only cover a historical review of SICOT, but will also inclu-de facts and anecdotes about the development of various new activitiesundertaken during more recent years.For example the Trainees’ Meetings,the SICOT World portal, the Young Surgeons Committee to mention afew.

We will do our very best to achieve the goal of producing in a pleasing,modern format a memorable collection of the historical records and ofthe many recent accomplishments of our Society.A considerable num-ber of members are contributing to the task, in order to make the bookas comprehensive and appealing as possible. I would like to express inadvance my gratitude for their assistance!

75 years after the foundation of SICOT in Paris by a group of enthusias-tic surgeons from Europe and North America in quest of “Progress andFraternisation”, our Society has become a global organisation, dedicatedto the challenging mission of keeping all countries in the world up todate with the latest advances in orthopaedics and traumatology. I wouldlike to recall the words of Vittorio Putti on that historical evening of 10October 1929: “…the older men to lead the younger in serious work…”.

Nowadays, the goal of providing general orthopaedics and traumatologyeducation at an international level is becoming increasingly difficult dueto the inevitable trend of sub-specialisation.Against the background ofthe many major changes involving our discipline at this time, I trust thatthe Celebration Book will serve to acknowledge formally the tremen-dous contribution of the pioneers of SICOT, as well as the many accom-plishments of all Society members, past and present.

Best wishes from Down-Under,

Rocco P. Pitto

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The Kingdom ofSaudi Arabia has anarea of 2,250,000km2 and consists of80% of the ArabianPeninsula.The popu-

lation has increased from 18,000,000in the year 1981 to 23,400,000 indivi-duals today.This vast area with poc-keted distribution of individuals pre-sents its own unique health care chal-lenges.

Health care facilities range fromindividual doctors in family and com-munity medicine oriented clinics toultramodern large hospitals.The me-dical services are administered by anumber of governmental bodieswhich include the Ministry of Health,

the Ministry of Higher Education, theMinistry of Defence and Aviation, theMinistry of Interior and The NationalGuard. In addition,there are ranges ofprivate health care facilities includingthose which provide modern stan-dards of care. Prestigious institutionsinclude King Faisal Specialist Hospitaland Research Centre in Riyadh andother modern major medical institu-tions under development such as KingFahd Specialist Hospital in the Eas-tern Province and the King Fahd Me-dical City in Riyadh. It is worth men-tioning that the health care facility inthe Holy City of Mecca not only ser-ves the city inhabitants but at least 2million pilgrims annually in the hajjseason.

The pattern of major health pro-blems has changed with the introduc-tion of compulsory vaccination, mo-dern health care facility and healtheducation. Conditions such as tuber-culosis and brucellosis are much lesscommon.The major health problemconfronting orthopaedic surgeons inthe Kingdom is the increasing inci-dence of trauma as a result of expan-ding modern industrialisation androad traffic accidents, the building ofsuper highways and increasing num-bers of modern automobiles contri-buting to the latter.

Historically,orthopaedic problemswere tackled by native doctors andbonesetters who still practise in re-mote areas of the Kingdom.Fifty yearsago however, modern facilities wereintroduced in the Kingdom and theseservices have progressively improvedenabling citizens to obtain the mostmodern care available in the world.Currently, orthopaedic surgeons andtraumatologists in the Kingdomconsist of both expatriates and Saudinationals.The proportion of Saudi or-thopaedic surgeons, however, is stea-dily increasing.

The Saudi Council for Health Spe-cialities has established a structuredresidency-training programme withits own examination thereby produ-cing Saudi orthopaedic surgeons ofgood quality.An excellent environ-ment for health education exists in

The art of orthopaedic surgery in Saudi Arabia

u Country name: Saudi Arabiau Location: bordered to the northwest by Jordan,

to the north by Iraq and Kuwait, to the west by the Red Sea and to the east by Qatar, the UnitedArab Emirates and Oman, and to the south by Yemen.

u Population: 23,400,000u Capital: Riyadh u Surface area: 2,250,000 km2

u Language: Arabicu Type of government: absolute monarchy

u No. of doctors: ± 1/700u No. of orthopaedic surgeons: ± 1/10,000u No. of hospitals: 324u No. of beds: 46,622u No. of medical schools: 8u Ratio private/public health patients: 1/4u No. of SICOT active members: 21

Riyadh

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Dr Abdullah Al-Othman | National Delegate of Saudi Arabia

Country to

countryseries

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and meetings to which our memberscan travel and from which they bene-fit.

Saudi Arabia can contribute to SICOT by hosting the above activitiesincluding the international meetingsand providing training fellowships toyounger SICOT Members. SICOT inturn could contribute to the develop-

the Kingdom where many internatio-nal and local conferences, symposiaand workshops are conducted. Facili-ties are also provided for surgeons totravel abroad to improve educationand experience. In the mid 1980s or-thopaedic surgeons from the GCCcountries (see short article) establis-hed the GCC Orthopaedic Associa-tion, a body which serves to shareknowledge and experience, and toeducate orthopaedic surgeons in theregion.

The connection with SICOT wasestablished in 1990. I have the privile-ge of being the SICOT National Re-presentative for the Saudi ArabianKingdom.This has provided a forumfor sharing experiences from theKingdom in the field of orthopaedic,educational facilities such as symposia

GCC countriesGCC is used for “Gulf CooperationCouncil”.Arabia, the area made up ofthe Arabian Peninsula, is located inthe southwestern region of the Asiancontinent. Politically, the Arabian Pe-ninsula consists of Saudi Arabia, Ku-wait, Bahrain, Qatar, the United ArabEmirates, the Sultanate of Oman, andthe Republic of Yemen.Together, the-se countries (excluding the Republicof Yemen) constitute the Gulf Co-operation Council. Founded on 26May 1981, the aim of this collective isto promote coordination betweenmember states in all fields in order toachieve unity.

Saudi desert

In the next newsletter read moreabout orthopaedic surgery in Turkey,the destination of the next SICOT/SIROT 2005 XXIII TriennialWorld Congress.

An article by Prof Ridvan Ege,Congress President and National Delegate of Turkey.

ment of orthopaedics in Saudi Arabiaby conducting symposia and work-shops and by arranging visits by inter-national experts to share their expe-riences and train orthopaedic sur-geons. ■

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SICOT/SIROT 2005XXIII Triennial World CongressIstanbul TWC 2005 on-line

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Scientific programme

Hotels and toursHotels and tours can be booked on-line by using the links below:

http://www.sicot.org/?page=istanbul#hotels

http://www.sicot.org/?page=istanbul#tours

or by contacting our Agent, Sorelcomm (1985) Inc. on: si2005@sorelcomm.ca

A meeting of the CongressScientific Advisory Committee(CSAC) was held at the SICOTOffice in Brussels on 28-29 January2005 to update the data on sym-posia and lectures, which the SICOT/SIROT 2005 XXIII TriennialWorld Congress in Istanbul willfeature and to kick off the peer re-view of some 1,200 abstracts.

It was the third time that theSICOT Office organised on-linesubmission, and it is remarkablethat more than 99% of the ab-stracts of the SICOT/SIROT 2005XXIII Triennial World Congress,Istanbul have been received on-line.Even more remarkable was theabsence of any technical incident oruser complaint, confirming the ef-forts of the SICOT Office to usemodern methods.

For the second time in historythe peer review process is takingplace on-line, and the first impres-sions and comments indicate sa-tisfaction with the ease of use andgain of time the on-line system isoffering. Peer reviewers of the

SICOT/SIROT 2005 XXIII TriennialWorld Congress receive 20 to 40abstracts each from the SICOTOffice by e-mail; each e-mailcontains a cover letter,the abstractto score and a grid.Peer reviewersare requested to click on the sco-re from 1 to 10 on the grid, thento click on the “send” button tosend their score to the SICOTOffice.They may modify their sco-

re by going through the processagain as the new score will over-write the previous one.The SICOTOffice receives all scores by e-mail(as simple as “abstract nr XXXX,scored Y/10 by ZZZZZZZZ”), ma-kes sure that each abstract hasbeen reviewed by two experts andcomputes the score average. ■

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On the web

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Congress registrationhttp://www.sicot.org/?page=registration

http://www.sicot.org/?page=confexam

On-line registration opened end of 2004 and SICOTand SIROT members, once they have identifiedthemselves by keying in their ID number and pass-

word, have a direct access to their personal data andto the reduced registration fees shown below:

Third SICOT Diploma Examination(2 and 4 september 2005)

The third SICOT Diploma Exami-nation will be held during the SICOT/SIROT 2005 XXIII Trien-nial World Congress, Istanbul.Thewritten part (2 September 2005)is comprised of 200 MCQ basedon the Hyperguide and lasts twohours from 10.00 am to 12.00noon.The oral part (4 september2005), also lasting two hours, isbased on the Intercollegiate FRCSof the UK and Ireland and willtake place from 08.30 am. Each

candidate will be examined by twoexaminers in each of the four ma-jor subjects: adult orthopaedicsand pathology, trauma, childrenand hands, and the basic sciences.

Candidates must be SICOT (As-sociate) members and should re-gister on-line before 1 May 2005by filling in the registration formand paying the examination fee ofEUR 300.

Registration fees (in €) Early fee Normal fee Late (after 31.05.05)for Members (before 30.12.04) and on site fee

SIROT Meeting(2-4 September)

280 380 450

SICOT Meeting(5-9 September)

480 580 700

SICOT/SIROT Istanbul TWC 2005 650 750 1000(2-9 September)

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Report of the Officer Nominating Committee

Prof Dr Rainer I.P. Kotz | Chairman, Officer Nominating Committee

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Committeelife

The Officer No-minating Com-mittee has, as itsChairman ex of-ficio, the Imme-diate Past Presi-dent who, toge-

ther with the President Elect andtwo other National Delegates, hasto compile an election proposalfor the National Delegates in theInternational Council.The mostimportant position is, of course,the election of the new PresidentElect, who then automatically be-comes President of the Society af-ter three years. Further officersnominated by this Committee arethe Secretary General,who is elec-ted for one three-year term, andnormally not more than two terms(under extraordinary circumstan-ces, the Secretary General may beappointed for an additional termof three years) and the Treasurer,who is elected for a maximum oftwo terms.The First Vice Presi-dent is not elected by this Com-mittee, as he is nominated fromthe Vice Presidents of the differentregions in a separate vote, just asthe Vice Presidents are elected bythe National Delegates from theirregion.When setting up the Exe-cutive Committee, one has to en-sure that every region is equallyrepresented in the Committee.This was not the case when the ex

officio Belgian representative waselected, with more Europeans inthe Executive Committee of SICOT.

Who is elected and the way to be selected?Firstly, the President of the Societyshould have an international repu-tation based on the contributionmade to improve and develop or-thopaedics worldwide.This meanshe should be an internationally,academically recognised ortho-paedic surgeon (the position ofthe Society also largely dependsupon the international reputationof its President). On the otherhand he should have national re-putation based on the contribu-tion made to improve and developorthopaedics in his own country.The best qualification is usually tobe President of the national or-thopaedic association of his coun-try. Finally, the candidate qualifiesalso by the importance of servicesrendered to SICOT, for instance asa member of the Executive Com-mittee or as SICOT Congress Pre-sident.

Secondly, the Secretary Generalhas to be elected.Traditionally, thispost was taken over by a signifi-cant orthopaedic surgeon fromBrussels, as the office is located

there. Only when Tony Hall waselected Secretary General (1993-2002) it showed that in today’s eraof modern communication it is notreally necessary to have a Secreta-ry General based in the immediatearea. Nevertheless, travelling oncea month to Brussels proved timeconsuming. Maurice Hinsenkampwas designated as an ad interimSecretary General (December1991-August 1993) by the Presi-dent Zamudio and he was electedin 2002.With his great experience,he now directs business from Brus-sels.

Thirdly, the last vote for the Exe-cutive Committee is the Treasurer,who is responsible for the financesof the Society.The last appoint-ment made by the Officer Nomi-nating Committee is that of theEditorial Secretary, who is a mem-ber of the Publications and Com-munications Committee and ofthe Editorial Board of InternationalOrthopaedics. As Editor, he isresponsible for the SICOT News-letter, which is a very importantcommunications tool. ■

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Training in trauma and orthopaedics in the United Kingdom

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Young surgeons

In the UK health care withinthe National Health Service (NHS)is free at the point of delivery andis funded by taxation. Postgradua-te training occurs in NHS hospi-tals.

Following the successful com-pletion of a Bachelor of Medicineand Bachelor of Surgery degree ata recognised medical school, doc-tors are granted a provisional li-cence to practise medicine by theGeneral Medical Council. In orderto qualify for full registration, alldoctors must complete a year as apre-registration house officer(PRHO).This usually consists oftwo approved six-month posts,one in general medicine and onein general surgery.

The trainee who intends topursue a career in trauma and or-thopaedics undertakes a basic sur-gical training rotation.These rota-tions last two to three years. Inorder to demonstrate satisfactorycompletion of basic surgical trai-ning, trainees must gain members-hip of one of the Royal Collegesof Surgeons (England, Scotland orIreland).The membership exami-nation (MRCS) consists of MCQ,

essays, oral examinations and cli-nical examinations.

Having obtained membership,the trainee is eligible to apply forspecialist training in trauma andorthopaedic surgery. Only on sa-tisfactory completion of specialisttraining is he permitted to applyfor a consultant post in the NHS.Consultant posts become availa-ble through retirement, death orde novo (if there is a justified needfor an additional position and go-vernment funding for the post ismade available). In order to avoida mismatch between the numberof specialist registrars completingtraining each year and the numberof available consultant posts, entryinto a specialist training program-me is regulated by a strict quotasystem. Since there is no similarrestriction on basic surgical trai-ning, many more trainees apply forspecialist training than there arepositions.

Specialist surgical training un-derwent a radical overhaul in 1993.In trauma and orthopaedics, it nowlasts six years.Trainees usually ro-tate every six months in a diffe-rent subspeciality and every year

in a different hospital in the pro-gramme. There is a curriculumproduced by the British Ortho-paedic Association, which outlinesthe operative and clinical expe-rience as well as the knowledgeeach trainee must attain.

Trainees are assessed every sixmonths by each consultant withwhom they work,also at least oncea year by a panel (consisting of thetraining director, a member of thespecialist training committee, amember of the regional postgra-duate deanery and other consul-tants).This is known as the Regis-trar In-Training Assessment (RITA).There is rigorous scrutiny of thereport by the trainee’s consultants,the logbook of operative procedu-res performed, research, coursesand meetings attended, and tea-ching activity. Only if agreed stan-dards of competence have beenmet is a trainee allowed to prog-ress to the next stage of training.

Following completion of fouryears of clinical training, the trai-nee is eligible to sit the Intercolle-giate Board Examination, theFRCS.This consists of written,oraland clinical examinations. Successin the FRCS as well as the com-pletion of six years of recognisedtraining is mandatory in order toreceive the Certificate of Com-pletion of Surgical Training (CCST).

■

E. O. Pearse, MA, MRCSSt Peter's Hospital

Ashford and St Peter's Hospitals NHS trust

Chertsey, UK

YemiPearse@aol.com

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World Congresses, SIROT could join easily. Beingembedded in a larger combined conference askedhowever for another approach. It gave birth to sym-posia in cooperation with smaller but highly speciali-sed societies as, for instance,AADO (fracture care)and APASTB (tissue banking) in Cairo. Finding thebest formula to cope with the changed conditionswill mean intensifying the close cooperation withthe SICOT Executive, the Congress Scientific Advi-sory Committee, the SICOT/SIROT Research Com-mission and the professional team, so successfullycreated by SICOT at its Headquarters in Brussels.Whether SIROT will join the SICOT website andwill cooperate administratively is in discussion.

More frequent meetings create also the opportu-nity to support more presentations. SIROT has al-ready enhanced substantially the number of awards(in Cairo and Havana) and will also do so in Istanbul.Information can be found on the SICOT website athttp://www.sicot.org/?page=istanbul#award ■

SIROT: Growing concernDr Marc Speeckaert | Membership Chairman and Treasurer

Banda Aceh: helping the needy

Mr Brett G. Courtenay | National Delegate of Australia

SIROT was founded in Kyo-to in 1978 as the researchbranch of SICOT. SIROT Mee-tings were organised in the firstyears at the Triennial WorldCongresses.The easiest way torealise one of the goals of SIROT was to provide a forum

to present advances in orthopaedic research.Alrea-dy in the nineties, SIROT felt the need to organiseintercongress meetings between the congresses de-dicated to such specialised items as biomaterials,chondrogenesis, growth factors, tissue engineering,genetics, etc.This coincided with a growing interestin orthopaedic research, the flourishing of more or-thopaedic research societies all over the world andlarger parts of research programmes in orthopaedicmeetings, especially the specialised ones.

When SICOT also decided to organise AnnualInternational Conferences between the Triennial

shed or were so affected by personal tragedy thatthey were not able to return to work.The effectiveaid groups were those who were completely self-sufficient, with not only medical and nursing staff, butalso patient holding capacity, as well as a reliable re-supply chain. Some smaller groups linked with othersand they were able to be effective.

The effort to help Banda Aceh was hampered bymany factors.The area has seen a bloody strugglesince 1976 for freedom.This presented very real se-curity issues for aid workers in more remote partswhere fear of kidnap and ransom was a real possibi-lity. In addition the roads to this city of 400,000

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On 26 December 2004 an earthquake of 9.0 sca-le was followed by a tsunami that seriously damaged12 South East Asian and African nations.As a mem-ber of the Australian Army Reserves I was deployedto Banda Aceh with 90 other members of 1 HealthSupport Company (1HSC) to re-establish servicesat the Dr Zaionel Abidin Hospital, the 450 bed Uni-versity Teaching Hospital in Banda Aceh.The hospitalwas flooded to a level of 1.6 m of water.

Civilian medical teams had previously been sentto re-establish services in other hospitals not affec-ted by water damage.With at least 200,000 lives lostin the area most of the hospital staff had either peri-

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Worldwidenews

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that 90% of the hospital’s doctors had been lost inthe disaster.

The casualties treated included a lot of tetanus,aspiration pneumonia and very grossly contamina-ted wounds.There were few fractures and very fewchildren treated, whose absence in the streets wasvery striking.The overall number of patients waslow considering the number of lives lost indicatingthe completeness of the destruction.Well meaningbut inadequate wound treatment in the very earlystages created a lot of problems later.The principlesoutlined by the International Red Cross for manage-ment of War Wounds certainly applied here.The in-ability to follow up wound surgery with adequatenursing was also a problem.The previous lack of te-tanus vaccination in this community was an addedburden.

At the time of my leaving after four weeks thetsunami injuries were decreasing but road traumawas increasing as was a flood of patients with morecomplex cancer and other chronic conditions whichwas beyond our ability to adequately manage. Ourinitial Field Hospital role is scaling down and thisrole is being taken up by a larger German MilitaryField Hospital.

The reconstruction of the area is the next pro-blem.This large provincial capital is now half the sizeit used to be.The reality is that this once academic450 bed facility only needs to be about 200 beds.And those surviving senior doctors, who helped tobuild up their departments, will see these institu-tions will not be needed in the same capacity in thenext few decades.This will add professional tragedyto what has already been a personal tragedy of uni-maginable scale. ■

For contact: bgccourt@bigpond.net.au

inhabitants were initially poor but had been des-troyed as was half of the city.All drains for waterand sewerage were full of putrid mud.This extendedfor many kilometres, a situation not helped by themonsoonal rains which fell each day.The airstrip wasunaffected, except for minor earthquake damage,and even though it was of adequate length for me-dium-sized jets, it did not have large capacity.

The first group of our Unit arrived on 28 De-cember with a water purification plant capable ofproducing 20,000 litres of potable water per hour. Iwas initially on standby to go with this group withthe Parachute Surgical Team (PST).This was delayedfor a few days and we all travelled as a Unit.The PSTis very mobile and can set up a field hospital imme-diately in the open or under tentage in six hours.On this occasion it was deployed in a truck and notby parachute.After arriving in Banda Aceh the PSThad established a functioning operating theatre, re-suscitation area and holding area for 10 patients wi-thin six hours.At the same time, the remainder ofthe HSC with a group of New Zealanders werebrought forward and, after extensive cleaning of re-maining buildings, established another operatingtheatre, ICU, HDU X-ray and Pathology in what waspreviously the Institute of Cardiology.This allowedthe PST to be packed up and ready to move off toanother location.

With civilian groups from Singapore, Belgium,Spain, a German Field Hospital Unit and other indi-viduals offering services at the Emergency Depart-ment a functioning 120 bed hospital was under wayin under two weeks. Indonesian doctors and nursescame on 10 day rotations from Jakarta and slowlylocal workers returned. However it would seem

Author examining patient in hospital

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Editorial DepartmentEditorial Secretary: Prof Rocco P. PittoExternal Affairs: Nathalie Pondeville

Rue Washington 40-b.9, 1050 Brussels, BelgiumPhone : + 32 2 648 68 23 - Fax : + 32 2 649 86 01 E-mail : edsecr@sicot.org - Website : http://www.sicot.org

LE 10 OCTOBRE 1929

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À PA R I S

How to join SICOT? Complete the application form:http://www.sicot.org/?page=application

http://www.sicot.org/?page=istanbul

LE 10 OCTOBRE 1929

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À PA R I S

http://www.sicot.org/?page=tmbudapest

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