The general objective of our study was to describe the clinical and epidemiological aspects of anxiety disorders. This was a retrospective descriptive cross-sectional study, lasting 5 years, from January 01, 2019 to D...The general objective of our study was to describe the clinical and epidemiological aspects of anxiety disorders. This was a retrospective descriptive cross-sectional study, lasting 5 years, from January 01, 2019 to December 31, 2023, on 225 patients seen in consultation for anxiety disorders in the department. The prevalence of anxiety disorders was 2.5% in consultation. The 20 - 29 age group was the most represented at 33.3%. Females were slightly represented at 55.1%, with a sex ratio of 1.2. The secondary level was the most affected, accounting for 36.4% of cases. Insomnia was the most frequent reason for consultation, accounting for 71.1% of cases. A larger general population study would be necessary to better assess the extent of anxiety disorders in Guinea.展开更多
Introduction: The therapeutic approach to benign prostatic hyperplasia (BPH) has evolved profoundly. Surgical treatment is reserved for complicated cases and the reference surgical technique is transurethral resection...Introduction: The therapeutic approach to benign prostatic hyperplasia (BPH) has evolved profoundly. Surgical treatment is reserved for complicated cases and the reference surgical technique is transurethral resection of the prostate (TURP). This work aims to study the epidemiological, clinical and therapeutic aspects of monopolar transurethral resection of the prostate in our department. Materials and Methods: We conducted a descriptive study with retrospective data collection over a 12-month period from November 1, 2023 to December 31, 2024. The urology unit, an integral part of the surgery department, of the Sino-Guinean Friendship Hospital in Conakry served as the setting for this study. It included 27 patients with benign prostatic hypertrophy treated surgically by monopolar transurethral resection and having a usable medical record. The parameters studied were epidemiological, clinics and therapeutic. Results: The mean age of the patients was 68.57 ± 5.7 years with extremes from 50 to 79 years. The peak frequency was observed between 70 and 79 years (48.15%). All our patients had lower urinary tract disorders, i.e. 100% of cases. On digital rectal examination, an increase in the volume of the prostate of benign appearance was observed in all cases. The mean prostate volume was 43.7 cc on ultrasound with extremes from 34 cc to 58 cc. The total PSA level was less than 4 ng/ml in the majority of cases. The postoperative course was generally uncomplicated (n = 26) with removal of the urinary catheter on the second postoperative day (D2). However, one peroperative complication was observed in one patient;it was a bladder breach, leading to the passage of glycine into the peritoneum. Conclusion: Transurethral resection of the prostate has reduced the length of hospital stay of our patients, as well as the comorbidities associated with the treatment. The complications associated with it are rare but potentially serious. Its performance requires in-depth mastery of the endoscopic anatomy of the lower urinary tract as well as technical operative expertise.展开更多
Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can ...Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can be overlooked or confused with other pathologies. Treatment remains controversial. The aim of this work is to study the epidemiological, clinical and therapeutic data of urethral mucosal prolapse in young girls in our department. Materials and methods: Retrospective and descriptive study on urethral mucosal prolapse in little girls identified from the hospitalization records of the Sino-Guinean Friendship Hospital in Conakry. The study period was 5 years. Patients were selected randomly. Outcome assessment focused on the occurrence of recurrences and urinary incontinence. The mean follow-up duration was 24 months. The parameters studied were: Age, clinical and histological findings, therapeutic data and patient outcomes. Results: The incidence of urethral mucosal prolapse in girls in the urology department was 2.2 cases/year. The mean age of the patients was 6.7 years (with extremes of 5 months and 10 years). The age group of 7 to 10 years was the most represented, observed in 63.63% of patients. The most frequent reason for consultation was vulvar bleeding in 7 patients, or 63.63%. Malpighian hyperplasia with a congested chorion was the most observed histological type, in 4 patients. Surgical treatment consisting of complete excision of the prolapsed part had given excellent results. Conclusion: Urethral prolapse is a rare pathology, observed mainly in young black girls. Its diagnosis is based mainly on clinical examination. Surgical treatment gives satisfactory results, both clinically and aesthetically.展开更多
Toxocariasis is a helminthic zoonosis due to the presence in the human body of larvae of Toxocara sp., roundworms of the Ascaridae family. Less than 50 cases of central involvement related to toxocarasis have been rep...Toxocariasis is a helminthic zoonosis due to the presence in the human body of larvae of Toxocara sp., roundworms of the Ascaridae family. Less than 50 cases of central involvement related to toxocarasis have been reported in immunocompetent individuals. This involvement can result in epilepsy, meningoencephalitis, myelitis or encephalopathy. The standard treatment is albendazole at a dosage of 10 to 15 mg/kg/day. The duration of treatment varies greatly depending on the clinical cases reported, ranging from 5 days to several weeks in the case of severe forms. We report a case of myelitis due to Toxocara canis in a 14-year-old patient admitted for gait disorders. The laboratory assessment shows isolated hypereosinophilia at 8000 elements per mm3. Medullary magnetic resonance imaging (MRI) showed an intradural process of inflammatory and infectious appearance extended between T10 and L1 levels, hypointense in T1, hyperintense in T2, and homogeneous. Parasitological analysis of the stools noted the presence of high concentrations of Toxocara canis. Serology by ELISA (enzyme-linked immunosorbent assay) is strongly positive for toxocariasis, and western blot confirms the presence of antibodies directed against Toxocara larvae. Treatment with albendazole 400 mg × 2/day for 10 days associated with corticosteroid therapy (prednisone 50 mg/day for 5 days) allowed the disappearance of pain in 8 days, normalization of eosinophilia and improvement of walking.展开更多
Introduction: Pain has been defined for more than 20 years by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience associated with actual or potential tissue dam...Introduction: Pain has been defined for more than 20 years by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. It has been recognized as a feature of Parkinson’s disease (PD) since the first descriptions of the disease. Material and Methods: This was a prospective descriptive study lasting six (06) months from November 1, 2023 to April 30, 2024. We included all patients diagnosed with PD and who had pain. Sociodemographic, clinical, paraclinical and therapeutic data were evaluated for each patient. Results: We identified a sample of 62 Parkinson’s patients, of whom 52 patients or 85.2% had associated pain. We noted a male predominance (38M/14F) and a sex ratio of 2.71. Musculoskeletal pain was common in 80% of our respondents. WHO level I, antidepressants and background treatment for KD were the most prescribed molecules. Conclusion: Our study shows a frequency of pain in PD. However, musculoskeletal pain is the most frequently encountered type of pain in PD patients. WHO step I analgesics, antidepressants and background treatment of KD were the main prescriptions in our study.展开更多
The capital of Guinea, Conakry, faces a notable difficulty due to a water shortage, which is worsened by the rapid increase in population and urban development. The Guinean Water Company (SEG) faces challenges in supp...The capital of Guinea, Conakry, faces a notable difficulty due to a water shortage, which is worsened by the rapid increase in population and urban development. The Guinean Water Company (SEG) faces challenges in supplying water to the entire city due to its limited area of approximately 420 km<sup>2</sup> and a population of 2 million. Moreover, the population growth rate is anticipated to increase dramatically, exacerbating the difficulty of fulfilling future water requirements. As a result, this study employs data from the Knoema website and the Institute of National Statistics of Guinea (INS) to examine the water production and distribution process by the SEG. The study examines the challenges related to water scarcity in Conakry and suggests strategies to assist the city in managing the present circumstances and planning for the future. The primary objective is to get a long-lasting water supply and uphold water quality to advance public health.展开更多
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dates back to December 29, 2019, in Wuhan, China. It quickly spreads like wildfire to all continents in ...The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dates back to December 29, 2019, in Wuhan, China. It quickly spreads like wildfire to all continents in the following months. In Guinea, the first case of COVID-19 and death were all reported respectively on March 12 and April 16, 2020. Since then, several studies have found a relationship between certain environmental conditions such as the meteorological factors to have the potential of contributing to the spread of the virus. Thus, this study aims at examining the extent to which observed meteorological factors might have contributed to the spread of the coronavirus disease 2019 (COVID-19) cases in Conakry, from March 1 to May 31, 2020. Meteorological factors such as temperature (T</span><sub><span style="font-family:Verdana;">min</span></sub><span style="font-family:Verdana;">, T</span><sub><span style="font-family:Verdana;">mean</span></sub><span style="font-family:Verdana;"> and T</span><sub><span style="font-family:Verdana;">max</span></sub><span style="font-family:Verdana;">) and relative humidity (RH</span><sub><span style="font-family:Verdana;">min</span></sub><span style="font-family:Verdana;">, RH</span><sub><span style="font-family:Verdana;">mean</span></sub><span style="font-family:Verdana;"> and RH</span><sub><span style="font-family:Verdana;">max</span></sub><span style="font-family:Verdana;">) were analyzed together with the data on the COVID-19. The dynamic of the COVID-19 in Guinea was analyzed along with that of some west African countries. The analysis on the dynamic of the COVID-19 pandemic in West Africa indicated Guinea as one of the most affected countries by the pandemic after Nigeria and Ghana. The study found that in general an increase in the temperature is linked to a decline in the COVID-19 number of cases and deaths, while an increase in the humidity is positively correlated to the number of cases and deaths. Nevertheless, from this study it was also observed that low temperature, mild diurnal temperature and high humidity are likely to favor its transmission. The study therefore, recommends that habitations and hospital rooms should be kept in relatively low humidity and relatively higher temperature to minimize the spread of the (SARS-CoV-2).展开更多
Summary: Estimate the incidence of endometrial hyperplasia according to socio-demographic parameters and the type of lesions histological. Methodology: This was a retrospective, and 15-year descriptive study from Janu...Summary: Estimate the incidence of endometrial hyperplasia according to socio-demographic parameters and the type of lesions histological. Methodology: This was a retrospective, and 15-year descriptive study from January 1, 2000 to December 31, 2014 conducted at the Department of Anatomy and Pathological Cytology of the National Hospital Donka in collaboration with the obstetric gynecology departments of the Conakry University Hospital. Results: We collected 296 cases of malignant and benign endometrial hyperplasia in 15 years, accounting for 37% of all endometrial biopsy curettages examined. The age group 47 to 56 years was the most affected (81 cases) or 27, 36%. The mean age was 53.6 years with extremes of 27 and 83 years. Metrorrhagia was the main reason for consultation (206 cases), i.e. 69.59%. The suspicion of endometrial hyperplasia by physicians was the most frequently diagnosed circumstance (149 cases) or 50.33%. Biopsy curettage was the most frequently used method (176 cases), is 59.45%. Histological endometrial lesions of atypical complex adenomatous hyperplasia (79 cases) represented 26.69%. Benign behavior was most frequently observed in (235 cases) or 79.39%. Conclusion: Endometrial hyperplasia is an endometrial lesion whose atypical histological types represent the borderline lesions between benignity and malignancy.展开更多
Objectives: The objectives of this work were to describe the socio-demographic, clinical and prognostic characteristics of forceps deliveries at the maternity ward of the Donka National Teaching Hospital of Conakry. P...Objectives: The objectives of this work were to describe the socio-demographic, clinical and prognostic characteristics of forceps deliveries at the maternity ward of the Donka National Teaching Hospital of Conakry. Parturients and Method: This was a prospective and descriptive study of all forceps deliveries performed at the Donka National Hospital maternity ward over a 6-month period from April 1, 2018 to September 30, 2018. Results: We performed 90 fetal extractions by forceps on 3518 deliveries i.e. a frequency of 2.55%. The socio-demographic profile of the parturient women was that of a young primiparous woman with an average age of 21.20 years and a full-term pregnancy with an average gestational age of 39 weeks of amenorrhoea. Fore position varieties were the most frequent with, in order of frequency, the fore left occipito-iliac (61.3%) and the fore right occipito-iliac (22.22%). Posterior varieties accounted for 15.55% of cases. Clinical pelvimetry showed that 88.89% of parturients had a practicable pelvis, while 11.11% had a moderately narrow pelvis. Acute fetal suffering was the most common indication (55.56%), followed by maternal exhaustion (27.78%) and prolonged expulsion (16.67%). All forceps were performed by doctors. We noted 8 cases of forceps failure (8.88%) that required a cesarean section. Maternal complications were dominated by soft tissue lesions, including 7 cases of perineal tearing (7.77%);4 cases of vaginal tearing (4.44%);3 cases of cervical tearing (3.33%) and 2 cases of hemorrhage of delivery by uterine atony (2.22%). No cases of maternal death have been recorded. The majority of newborns had a normal birth weight (88.88%) and more than half of newborns (66.66%) had an Apgar score below 7 out of 10 at the first minute. By the fifth minute there was an improvement in Apgar’s score from an average of 5 to 8 out of 10. Five newborns died, or 5.55%. Conclusion: Forceps extractions are less and less practiced in our maternity wards. Their bad reputation has something to do with it, but this is not always justified, because complications are rare and minimal if the indications are well laid out and the operator experienced. It therefore seems important to reposition this instrument, which still retains its place in obstetrical practices.展开更多
Tubal ligation is a surgical sterilization procedure that provides permanent and reliable contraception to women.?Tubal obstruction is a method of permanent birth control that can be performed after mini-laparotomy un...Tubal ligation is a surgical sterilization procedure that provides permanent and reliable contraception to women.?Tubal obstruction is a method of permanent birth control that can be performed after mini-laparotomy under local anesthesia. Objective:?To determine the outcome of tubal sterilizations by mini-laparotomy under local anesthesia performed in clients who underwent the surgical operation in the Maternity Ward of Ignace Deen National Hospital. Patients and Methods:?The Gynecology and Obstetrics Department of Ignace Deen National Hospital was used as the place for the study. The study involved all the women seeking voluntary surgical contraception. This was a retrospective study of a descriptive type carried out from January 1, 2017 to December 31, 2018. A consent form was filled out and signed by spouses after an interview and a systematically carried out pre-operative clinical and para-clinical assessment. Results:?During the study period, 56 tubal ligations were performed i.e. 4.72 percent of all family planning methods. The recruiting for the surgical contraception involved clients whose typical profile is that of women with an average age of 35, mostly housewives (35.71%), major multiparous (69.63%) with 6 living children on average. Married women made up the bulk of the recruiting i.e. 96.44%. Unmarried women made much more use of other methods. Indications of personal convenience were the most frequently encountered common reason. Among medical causes, high blood?pressure concerned the majority of cases: 38% of the indications. Surgical contraception in between was more practiced than the post-partum one. The recorded complication was the parietal hematoma due to a lack of hemostasis and it accounted for 1.79% of cases. The progress was uncomplicated in?98.68% of cases. Forty couples (71.42%) expressed their feelings of satisfaction against only 6 cases of regret (10.71%). Conclusion:?The surgical contraception has become a requirement for modern couples. Tubal ligation by?mini-laparotomy is a simple operation and a harmless method of contraception that allows clients to use permanent contraception. Carried out on an outpatient basis, incidents and accidents are rare and may have psychological repercussions that are difficult to assess. The technical mastery of the gesture helps to minimize these incidents.展开更多
Observed rainfall data of the National Meteorological Service of Guinea (NMS) exhibit that synoptic station usually records the largest rainfall amount in Guinea. Only few studies have been done on this rainfall peak ...Observed rainfall data of the National Meteorological Service of Guinea (NMS) exhibit that synoptic station usually records the largest rainfall amount in Guinea. Only few studies have been done on this rainfall peak observed in Conakry. This work better analyses the atmospheric dynamics leading to rainfall particularity. Using NMS data from 1981 to 2010, the monthly contribution and mean seasonal cycle of each station has been done. These findings of the study show that between July and August (rainfall season peak), the coastline particularly Conakry records the largest amount of rainfall. Using Era Interim data for the common period (1981-2010), we also investigate the rainfall dynamics in the lower level (1000 hPa - 850 hPa) from precipitable water, divergence, and moisture flow transport. There is a west and southwest moisture flow transport explained by a strong moisture convergence in the coastal region (Lower-Guinea). Furthermore, values of precipitable water in the same region are found, in agreement with the high moisture flow transport gradient. These incoming flow (west and south-west) undergo a return by blocking’s Kakoulima range (foehn effect) and Fouta Djallon massif to initiate convection clouds on the Guinean coast. These processes enhance a convergence of moisture associated with orographic origin convection. This has an important effect by increasing the rainfall amount in Conakry.展开更多
Introduction: High blood pressure is a real public health problem affecting more than one in three adults. The objective of this study was to evaluate the level of knowledge, attitudes and practices of health care per...Introduction: High blood pressure is a real public health problem affecting more than one in three adults. The objective of this study was to evaluate the level of knowledge, attitudes and practices of health care personnel in the management of hypertension in Conakry. Methods: Descriptive transversal study of 6 months, from April 20, 2018 to September 20, 2018, which took place in the internal medicine departments of the two university hospital centers (CHU) of Conakry (Donka and Ignace Deen). The study population consisted of general practitioners and specialists, practicing in both departments for at least two years and who agreed to submit to our questionnaire. Results: At the end of the study, we included 140 doctors, 61% at Donka University Hospital and 39% at Ignace Deen University Hospital. The predominance was male with 113 men for 27 women with a sex ratio H/F = 4.18. General practitioners were the most represented with 95% against 5% specialists. Sixty-four percent of physicians gave an exact definition of hypertension, 56% of physicians confirmed the diagnosis of hypertension after 2 to 3 consultations. 19% offered monotherapy as first-line treatment, only 72% said that the duration of Antihypertensive treatment was for life. Conclusion: Theseresults demonstrate that it is essential to reflect on our daily practices for a good improvement in the quality of care for patients.展开更多
<strong>Introduction: </strong>Temporomandibular joint ankylosis (TMJA) is a fusion of joint surfaces by fibrous or bone tissue and the resulting limitation of mouth opening. The objectives of this study w...<strong>Introduction: </strong>Temporomandibular joint ankylosis (TMJA) is a fusion of joint surfaces by fibrous or bone tissue and the resulting limitation of mouth opening. The objectives of this study were to determine the frequency of TMJA, describe the clinical aspects and assess management. <strong>Materials and Method:</strong> It was a retrospective study that was carried out in the Department of Odontostomatology and Maxillofacial Surgery of Donka National Hospital for a period of 5 years (January 2016 to December 2020). Included were all records of inpatients and managed cases of TMJA during the study period. Socio-demographic, clinical and therapeutic variables were analyzed. <strong>Results:</strong> During the study 13 TMJA cases were collected with the frequency of 0.47%. The age group 1 - 9 was the most affected (61.54%) with extremes of 4 and 28 years. Men were the most concerned (53.87%). Restriction of mouth opening was the main reason for consultation (69.23%). The etiologies of ankylosis were dominated by infection including cellulitis of dental origin (53.85%) followed by facial trauma (30.77%). Arthroplasty was the most commonly used technique (73%), two cases of recurrence were noted (15.38%). <strong>Conclusion: </strong>TMJA affects mainly children and the etiology is dominated by cellulite of dental origin hence the interest of sensitization of the population for early management of oral diseases.展开更多
Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis t...Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). Methods: This was a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, i.e. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. Results: Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis;29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined status and 24 14.11% had a normal FLI. Conclusion: Identifying subjects at risk of metabolic steatopathy, diagnosing and managing these patients is a public health issue and one of the future challenges of hepato-gastroenterology. Fibroscan is an increasingly popular screening tool for hepatic fibrosis and steatosis. The fight against obesity must be a priority.展开更多
Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompete...Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.展开更多
Objectives: To describe the socio-demographic aspects of transferred parturient women;To identify the means of transport used by the evacuated parturient women to the Donka maternity ward at the University Hospital of...Objectives: To describe the socio-demographic aspects of transferred parturient women;To identify the means of transport used by the evacuated parturient women to the Donka maternity ward at the University Hospital of Conakry;To describe the difficulties met;And to assess maternal and fetal prognosis. Methodology: It consisted of a prospective study over a period of 6 months from 01/02 to 31/07/2018. All patients transferred to the maternity ward of the Donka National Hospital of Conakry University Hospital. Results: The frequency of obstetric transfers was 13.79%. The epidemiological profile was that of a parturient woman of an average age of 25.7 years, married, and housewife, unschooled, who was on her first pregnancy and from the city of Conakry. The average distance covered was 16 km with extremes of 3 and 50 km. The transfer to the referral maternity clinic was not medicalized in 94% of cases. The venous route was not taken in 96% of cases. The parturient was not escorted by a health worker in 98% of cases. Bleeding was the most frequent reason for evacuation, followed by acute fetal sufferings. The average number of prenatal consultation was 2 with extremes of 0 and 9. The average length of stay was 3.6 days with extremes of 1 and 28 days. The majority of transferred women had a full-term pregnancy. The Cesarean section was 79.4%. The Retro placental hematoma was the most common complication found and was 29.4%. The counter-reference was not made in 97.79%. We recorded 8 maternal deaths, for a lethality rate of 1.77%. Possible interventions to reduce the dramatic situation of obstetric evacuations require first of all the decentralization of health care structures capable of performing a cesarean section. This approach should aim to create medical centers with a surgical antenna in all municipalities. These decentralized units would reduce the delay in case management and thus, limit the number of complications.展开更多
Introduction: The birth of conjoined twins is an event extremely rare that offers unique therapeutic challenges and circumstances. We must examine each situation with the many questions that arise and which sometimes ...Introduction: The birth of conjoined twins is an event extremely rare that offers unique therapeutic challenges and circumstances. We must examine each situation with the many questions that arise and which sometimes require a long reflection. We report a case of separation of pygopages conjoined twins as well as a review of the literature. Patients and Observations: a pair of conjoined twins aged 11 days, weighing 3080 g between them, was referred to the neonatology department from the Faranah prefecture, 300 km from Conakry, for care. The mother, a 30-year-old housewife, multipara, eight gestures and nine parities, had not followed any prenatal consultation. The delivery took place at home in a village with the death of the mother immediately postpartum. The clinical and paraclinical investigation had concluded with the diagnosis of Siamese type pygopage. After multidisciplinary consultation, the surgical treatment by separation of the twins was carried out at the age of 50 days with success and preservation of the physiological functions. Conclusion: The birth of conjoined twins is extremely rare. Each pair of Siamese is different and the surgical strategy must be adapted according to the shared organs. The perfect multidisciplinary work of the medical staff has been the main contributor to our success.展开更多
<strong>Introduction:</strong><span style="font-family:Verdana;"> Deep vein thrombosis is a frequent disease, its origin is most often multifactorial. Venous thromboembolic disease (MVTE) a...<strong>Introduction:</strong><span style="font-family:Verdana;"> Deep vein thrombosis is a frequent disease, its origin is most often multifactorial. Venous thromboembolic disease (MVTE) and cancer are two frequently entangled pathologies. Here we report the diagnosis of deep vein thrombosis that discovered prostate cancer in an 88-year-old Guinean man. On clinical examination, there was a painful and hot swelling of the right leg, an absence of sloshing of the calf, a positive sign of Homans. The digital rectal examination revealed an enlarged prostate with an irregular surface. Cardiopulmonary auscultation was normal. The electrocardiogram showed a regular sinus rhythm at 65 cycles/min, with no sign of enlarged cavities or conduction disturbance. Venous Doppler ultrasound of the lower limbs showed the presence of an extensive acute deep venous thrombosis of the right sural vein extended to the popliteal and to the homolateral deep femoral. The reino-vesico-prostatic ultrasound c</span><span style="font-family:Verdana;">o</span><span style="font-family:Verdana;">ncluded in a heterogeneous prostatic hypertrophy with projection of a median lobe associated with a bladder of fight with an important post voiding residue evaluated at 170 ml</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">the rate of specific antigen of the prostate PSA was at 84.87 ng/ml. The pathology analysis made after a prostate biopsy puncture concluded with an adenocarcinoma with a Gleason score of 3.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The association of venous thromboembolic disease (MVTE) and neoplasia is frequent. The existence of active cancer in a patient is a known risk factor for MVTE and, conversely, the discovery of a first episode of deep vein thrombosis (DVT) or pulmonary embolism (PE) may be the mode of revelation of cancer.</span>展开更多
<strong>Objective:</strong> Azoospermia is one of the most important causes of couple infertility. The objective of our study is to report the clinical-biological profile of the azoosperm patient to the Ur...<strong>Objective:</strong> Azoospermia is one of the most important causes of couple infertility. The objective of our study is to report the clinical-biological profile of the azoosperm patient to the Urology-Andrology Department of the Conakry University teaching Hospital. It aims to take stock of the diagnostic management of azoospermia at this time where the world scientific community seems to be turned towards the intracytoplasmic sperm injection in the treatment of men with severe spermiological dysfunction. <strong>Patients and Method:</strong> This was a descriptive retrospective study lasting 12 months from January 1 to December 31, 2015. It collected 151 patients out of a set of 544 follow-ups for desire to have children. Were included the patients whose files contained all the information of the clinical observation (general information, reason for consultation, evolution, history, data of the physical examination) and a paraclinical assessment consisting of the FSH level and two spermograms spaced three months, confirming the diagnosis of azoospermia. <strong>Results:</strong> The mean age was 36.4 years with extremes of 23 and 56 years old. Urogenital infections (36.4%) followed by a notion of inguinal surgery had been the main patients’ history. Primary infertility accounted for 76.8% of cases. The mean duration of infertility was 6.5 years with extremes of 2 and 19 years. Azoospermia affected 27.76% of patients who consulted for the desire to have a child. It was judged secretory in 59.6% of cases, excretory in 25.8% of cases, and undetermined in 14.6% of cases. Varicocele was the main associated abnormality (46.3%) followed by testicular hypotrophy (36.4%). Neisseria Gonorrhoeae was the most common germ in sperm culture (21.7%). Chlamydia serology was positive in 21.7% of patients. <strong>Conclusion:</strong> Azoospermia affects a non-negligible proportion of men admitted by consulting for desire to have a child in our context. Strengthening the diagnostic and therapeutic arsenal is necessary to improve the care of affected patients.展开更多
Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically...Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically search for it in patients with multiple comorbidities. The objective of this study was to determine the prevalence of orthostatic hypotension;describe their socio- demographic profile, the various clinical and paraclinical aspects and the predisposing factors of orthostatic hypotension in treated hypertensives, controlled or not. Method: This was a descriptive cross-sectional study, from January 2 to June 30, 2022 in the cardiology department of the Ignace Deen National Hospital. Included in this study were all patients who presented with orthostatic hypotension under antihypertensive treatment, regardless of age and sex, and who agreed to participate in the study. The non-inclusion criteria were hypertensive patients without OH and those who had not agreed to participate in the study. Each patient had blood pressure and heart rate measured in the supine position at room temperature and with an empty bladder. Then the measurement is taken again three (3) minutes after the switch to orthostatism. We retained the diagnosis of OH if the SBP drops by at least 20 mmHg and/or the PAD by at least 10 mmHg three (3) min after the transition to orthostatism. Our data obtained were analyzed in the Epi-info 7.4.0 software. Results: During our study period, we investigated 385 presented with OH, 12.2%. The mean age of the patients was 60.83 years ± 10.01 years and hypertensive patients, 47 of whom the M/F sex ratio was 0.81. In our study, blood pressure was not controlled in 36.2% of our patients with a predominance of grade 3 hypertension, a rate of 55.32%. Renal failure, anemia, heart failure and stroke were the main comorbidities associated with the occurrence of HO. The most incriminated factors were age with a frequency of 74.47%, followed by obesity at 44.68% and diabetes at 27.66%. BP was normally controlled with a rate of 68.8% in treated hypertensive patients with OH. It is found much more in patients using triple therapy, a rate of 61.71%. Conclusion: The prevalence of OH is high in our department. It is found much more in patients using triple therapy. The most incriminated factors were age followed by obesity and diabetes.展开更多
文摘The general objective of our study was to describe the clinical and epidemiological aspects of anxiety disorders. This was a retrospective descriptive cross-sectional study, lasting 5 years, from January 01, 2019 to December 31, 2023, on 225 patients seen in consultation for anxiety disorders in the department. The prevalence of anxiety disorders was 2.5% in consultation. The 20 - 29 age group was the most represented at 33.3%. Females were slightly represented at 55.1%, with a sex ratio of 1.2. The secondary level was the most affected, accounting for 36.4% of cases. Insomnia was the most frequent reason for consultation, accounting for 71.1% of cases. A larger general population study would be necessary to better assess the extent of anxiety disorders in Guinea.
文摘Introduction: The therapeutic approach to benign prostatic hyperplasia (BPH) has evolved profoundly. Surgical treatment is reserved for complicated cases and the reference surgical technique is transurethral resection of the prostate (TURP). This work aims to study the epidemiological, clinical and therapeutic aspects of monopolar transurethral resection of the prostate in our department. Materials and Methods: We conducted a descriptive study with retrospective data collection over a 12-month period from November 1, 2023 to December 31, 2024. The urology unit, an integral part of the surgery department, of the Sino-Guinean Friendship Hospital in Conakry served as the setting for this study. It included 27 patients with benign prostatic hypertrophy treated surgically by monopolar transurethral resection and having a usable medical record. The parameters studied were epidemiological, clinics and therapeutic. Results: The mean age of the patients was 68.57 ± 5.7 years with extremes from 50 to 79 years. The peak frequency was observed between 70 and 79 years (48.15%). All our patients had lower urinary tract disorders, i.e. 100% of cases. On digital rectal examination, an increase in the volume of the prostate of benign appearance was observed in all cases. The mean prostate volume was 43.7 cc on ultrasound with extremes from 34 cc to 58 cc. The total PSA level was less than 4 ng/ml in the majority of cases. The postoperative course was generally uncomplicated (n = 26) with removal of the urinary catheter on the second postoperative day (D2). However, one peroperative complication was observed in one patient;it was a bladder breach, leading to the passage of glycine into the peritoneum. Conclusion: Transurethral resection of the prostate has reduced the length of hospital stay of our patients, as well as the comorbidities associated with the treatment. The complications associated with it are rare but potentially serious. Its performance requires in-depth mastery of the endoscopic anatomy of the lower urinary tract as well as technical operative expertise.
文摘Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can be overlooked or confused with other pathologies. Treatment remains controversial. The aim of this work is to study the epidemiological, clinical and therapeutic data of urethral mucosal prolapse in young girls in our department. Materials and methods: Retrospective and descriptive study on urethral mucosal prolapse in little girls identified from the hospitalization records of the Sino-Guinean Friendship Hospital in Conakry. The study period was 5 years. Patients were selected randomly. Outcome assessment focused on the occurrence of recurrences and urinary incontinence. The mean follow-up duration was 24 months. The parameters studied were: Age, clinical and histological findings, therapeutic data and patient outcomes. Results: The incidence of urethral mucosal prolapse in girls in the urology department was 2.2 cases/year. The mean age of the patients was 6.7 years (with extremes of 5 months and 10 years). The age group of 7 to 10 years was the most represented, observed in 63.63% of patients. The most frequent reason for consultation was vulvar bleeding in 7 patients, or 63.63%. Malpighian hyperplasia with a congested chorion was the most observed histological type, in 4 patients. Surgical treatment consisting of complete excision of the prolapsed part had given excellent results. Conclusion: Urethral prolapse is a rare pathology, observed mainly in young black girls. Its diagnosis is based mainly on clinical examination. Surgical treatment gives satisfactory results, both clinically and aesthetically.
文摘Toxocariasis is a helminthic zoonosis due to the presence in the human body of larvae of Toxocara sp., roundworms of the Ascaridae family. Less than 50 cases of central involvement related to toxocarasis have been reported in immunocompetent individuals. This involvement can result in epilepsy, meningoencephalitis, myelitis or encephalopathy. The standard treatment is albendazole at a dosage of 10 to 15 mg/kg/day. The duration of treatment varies greatly depending on the clinical cases reported, ranging from 5 days to several weeks in the case of severe forms. We report a case of myelitis due to Toxocara canis in a 14-year-old patient admitted for gait disorders. The laboratory assessment shows isolated hypereosinophilia at 8000 elements per mm3. Medullary magnetic resonance imaging (MRI) showed an intradural process of inflammatory and infectious appearance extended between T10 and L1 levels, hypointense in T1, hyperintense in T2, and homogeneous. Parasitological analysis of the stools noted the presence of high concentrations of Toxocara canis. Serology by ELISA (enzyme-linked immunosorbent assay) is strongly positive for toxocariasis, and western blot confirms the presence of antibodies directed against Toxocara larvae. Treatment with albendazole 400 mg × 2/day for 10 days associated with corticosteroid therapy (prednisone 50 mg/day for 5 days) allowed the disappearance of pain in 8 days, normalization of eosinophilia and improvement of walking.
文摘Introduction: Pain has been defined for more than 20 years by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. It has been recognized as a feature of Parkinson’s disease (PD) since the first descriptions of the disease. Material and Methods: This was a prospective descriptive study lasting six (06) months from November 1, 2023 to April 30, 2024. We included all patients diagnosed with PD and who had pain. Sociodemographic, clinical, paraclinical and therapeutic data were evaluated for each patient. Results: We identified a sample of 62 Parkinson’s patients, of whom 52 patients or 85.2% had associated pain. We noted a male predominance (38M/14F) and a sex ratio of 2.71. Musculoskeletal pain was common in 80% of our respondents. WHO level I, antidepressants and background treatment for KD were the most prescribed molecules. Conclusion: Our study shows a frequency of pain in PD. However, musculoskeletal pain is the most frequently encountered type of pain in PD patients. WHO step I analgesics, antidepressants and background treatment of KD were the main prescriptions in our study.
文摘The capital of Guinea, Conakry, faces a notable difficulty due to a water shortage, which is worsened by the rapid increase in population and urban development. The Guinean Water Company (SEG) faces challenges in supplying water to the entire city due to its limited area of approximately 420 km<sup>2</sup> and a population of 2 million. Moreover, the population growth rate is anticipated to increase dramatically, exacerbating the difficulty of fulfilling future water requirements. As a result, this study employs data from the Knoema website and the Institute of National Statistics of Guinea (INS) to examine the water production and distribution process by the SEG. The study examines the challenges related to water scarcity in Conakry and suggests strategies to assist the city in managing the present circumstances and planning for the future. The primary objective is to get a long-lasting water supply and uphold water quality to advance public health.
文摘The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dates back to December 29, 2019, in Wuhan, China. It quickly spreads like wildfire to all continents in the following months. In Guinea, the first case of COVID-19 and death were all reported respectively on March 12 and April 16, 2020. Since then, several studies have found a relationship between certain environmental conditions such as the meteorological factors to have the potential of contributing to the spread of the virus. Thus, this study aims at examining the extent to which observed meteorological factors might have contributed to the spread of the coronavirus disease 2019 (COVID-19) cases in Conakry, from March 1 to May 31, 2020. Meteorological factors such as temperature (T</span><sub><span style="font-family:Verdana;">min</span></sub><span style="font-family:Verdana;">, T</span><sub><span style="font-family:Verdana;">mean</span></sub><span style="font-family:Verdana;"> and T</span><sub><span style="font-family:Verdana;">max</span></sub><span style="font-family:Verdana;">) and relative humidity (RH</span><sub><span style="font-family:Verdana;">min</span></sub><span style="font-family:Verdana;">, RH</span><sub><span style="font-family:Verdana;">mean</span></sub><span style="font-family:Verdana;"> and RH</span><sub><span style="font-family:Verdana;">max</span></sub><span style="font-family:Verdana;">) were analyzed together with the data on the COVID-19. The dynamic of the COVID-19 in Guinea was analyzed along with that of some west African countries. The analysis on the dynamic of the COVID-19 pandemic in West Africa indicated Guinea as one of the most affected countries by the pandemic after Nigeria and Ghana. The study found that in general an increase in the temperature is linked to a decline in the COVID-19 number of cases and deaths, while an increase in the humidity is positively correlated to the number of cases and deaths. Nevertheless, from this study it was also observed that low temperature, mild diurnal temperature and high humidity are likely to favor its transmission. The study therefore, recommends that habitations and hospital rooms should be kept in relatively low humidity and relatively higher temperature to minimize the spread of the (SARS-CoV-2).
文摘Summary: Estimate the incidence of endometrial hyperplasia according to socio-demographic parameters and the type of lesions histological. Methodology: This was a retrospective, and 15-year descriptive study from January 1, 2000 to December 31, 2014 conducted at the Department of Anatomy and Pathological Cytology of the National Hospital Donka in collaboration with the obstetric gynecology departments of the Conakry University Hospital. Results: We collected 296 cases of malignant and benign endometrial hyperplasia in 15 years, accounting for 37% of all endometrial biopsy curettages examined. The age group 47 to 56 years was the most affected (81 cases) or 27, 36%. The mean age was 53.6 years with extremes of 27 and 83 years. Metrorrhagia was the main reason for consultation (206 cases), i.e. 69.59%. The suspicion of endometrial hyperplasia by physicians was the most frequently diagnosed circumstance (149 cases) or 50.33%. Biopsy curettage was the most frequently used method (176 cases), is 59.45%. Histological endometrial lesions of atypical complex adenomatous hyperplasia (79 cases) represented 26.69%. Benign behavior was most frequently observed in (235 cases) or 79.39%. Conclusion: Endometrial hyperplasia is an endometrial lesion whose atypical histological types represent the borderline lesions between benignity and malignancy.
文摘Objectives: The objectives of this work were to describe the socio-demographic, clinical and prognostic characteristics of forceps deliveries at the maternity ward of the Donka National Teaching Hospital of Conakry. Parturients and Method: This was a prospective and descriptive study of all forceps deliveries performed at the Donka National Hospital maternity ward over a 6-month period from April 1, 2018 to September 30, 2018. Results: We performed 90 fetal extractions by forceps on 3518 deliveries i.e. a frequency of 2.55%. The socio-demographic profile of the parturient women was that of a young primiparous woman with an average age of 21.20 years and a full-term pregnancy with an average gestational age of 39 weeks of amenorrhoea. Fore position varieties were the most frequent with, in order of frequency, the fore left occipito-iliac (61.3%) and the fore right occipito-iliac (22.22%). Posterior varieties accounted for 15.55% of cases. Clinical pelvimetry showed that 88.89% of parturients had a practicable pelvis, while 11.11% had a moderately narrow pelvis. Acute fetal suffering was the most common indication (55.56%), followed by maternal exhaustion (27.78%) and prolonged expulsion (16.67%). All forceps were performed by doctors. We noted 8 cases of forceps failure (8.88%) that required a cesarean section. Maternal complications were dominated by soft tissue lesions, including 7 cases of perineal tearing (7.77%);4 cases of vaginal tearing (4.44%);3 cases of cervical tearing (3.33%) and 2 cases of hemorrhage of delivery by uterine atony (2.22%). No cases of maternal death have been recorded. The majority of newborns had a normal birth weight (88.88%) and more than half of newborns (66.66%) had an Apgar score below 7 out of 10 at the first minute. By the fifth minute there was an improvement in Apgar’s score from an average of 5 to 8 out of 10. Five newborns died, or 5.55%. Conclusion: Forceps extractions are less and less practiced in our maternity wards. Their bad reputation has something to do with it, but this is not always justified, because complications are rare and minimal if the indications are well laid out and the operator experienced. It therefore seems important to reposition this instrument, which still retains its place in obstetrical practices.
文摘Tubal ligation is a surgical sterilization procedure that provides permanent and reliable contraception to women.?Tubal obstruction is a method of permanent birth control that can be performed after mini-laparotomy under local anesthesia. Objective:?To determine the outcome of tubal sterilizations by mini-laparotomy under local anesthesia performed in clients who underwent the surgical operation in the Maternity Ward of Ignace Deen National Hospital. Patients and Methods:?The Gynecology and Obstetrics Department of Ignace Deen National Hospital was used as the place for the study. The study involved all the women seeking voluntary surgical contraception. This was a retrospective study of a descriptive type carried out from January 1, 2017 to December 31, 2018. A consent form was filled out and signed by spouses after an interview and a systematically carried out pre-operative clinical and para-clinical assessment. Results:?During the study period, 56 tubal ligations were performed i.e. 4.72 percent of all family planning methods. The recruiting for the surgical contraception involved clients whose typical profile is that of women with an average age of 35, mostly housewives (35.71%), major multiparous (69.63%) with 6 living children on average. Married women made up the bulk of the recruiting i.e. 96.44%. Unmarried women made much more use of other methods. Indications of personal convenience were the most frequently encountered common reason. Among medical causes, high blood?pressure concerned the majority of cases: 38% of the indications. Surgical contraception in between was more practiced than the post-partum one. The recorded complication was the parietal hematoma due to a lack of hemostasis and it accounted for 1.79% of cases. The progress was uncomplicated in?98.68% of cases. Forty couples (71.42%) expressed their feelings of satisfaction against only 6 cases of regret (10.71%). Conclusion:?The surgical contraception has become a requirement for modern couples. Tubal ligation by?mini-laparotomy is a simple operation and a harmless method of contraception that allows clients to use permanent contraception. Carried out on an outpatient basis, incidents and accidents are rare and may have psychological repercussions that are difficult to assess. The technical mastery of the gesture helps to minimize these incidents.
文摘Observed rainfall data of the National Meteorological Service of Guinea (NMS) exhibit that synoptic station usually records the largest rainfall amount in Guinea. Only few studies have been done on this rainfall peak observed in Conakry. This work better analyses the atmospheric dynamics leading to rainfall particularity. Using NMS data from 1981 to 2010, the monthly contribution and mean seasonal cycle of each station has been done. These findings of the study show that between July and August (rainfall season peak), the coastline particularly Conakry records the largest amount of rainfall. Using Era Interim data for the common period (1981-2010), we also investigate the rainfall dynamics in the lower level (1000 hPa - 850 hPa) from precipitable water, divergence, and moisture flow transport. There is a west and southwest moisture flow transport explained by a strong moisture convergence in the coastal region (Lower-Guinea). Furthermore, values of precipitable water in the same region are found, in agreement with the high moisture flow transport gradient. These incoming flow (west and south-west) undergo a return by blocking’s Kakoulima range (foehn effect) and Fouta Djallon massif to initiate convection clouds on the Guinean coast. These processes enhance a convergence of moisture associated with orographic origin convection. This has an important effect by increasing the rainfall amount in Conakry.
文摘Introduction: High blood pressure is a real public health problem affecting more than one in three adults. The objective of this study was to evaluate the level of knowledge, attitudes and practices of health care personnel in the management of hypertension in Conakry. Methods: Descriptive transversal study of 6 months, from April 20, 2018 to September 20, 2018, which took place in the internal medicine departments of the two university hospital centers (CHU) of Conakry (Donka and Ignace Deen). The study population consisted of general practitioners and specialists, practicing in both departments for at least two years and who agreed to submit to our questionnaire. Results: At the end of the study, we included 140 doctors, 61% at Donka University Hospital and 39% at Ignace Deen University Hospital. The predominance was male with 113 men for 27 women with a sex ratio H/F = 4.18. General practitioners were the most represented with 95% against 5% specialists. Sixty-four percent of physicians gave an exact definition of hypertension, 56% of physicians confirmed the diagnosis of hypertension after 2 to 3 consultations. 19% offered monotherapy as first-line treatment, only 72% said that the duration of Antihypertensive treatment was for life. Conclusion: Theseresults demonstrate that it is essential to reflect on our daily practices for a good improvement in the quality of care for patients.
文摘<strong>Introduction: </strong>Temporomandibular joint ankylosis (TMJA) is a fusion of joint surfaces by fibrous or bone tissue and the resulting limitation of mouth opening. The objectives of this study were to determine the frequency of TMJA, describe the clinical aspects and assess management. <strong>Materials and Method:</strong> It was a retrospective study that was carried out in the Department of Odontostomatology and Maxillofacial Surgery of Donka National Hospital for a period of 5 years (January 2016 to December 2020). Included were all records of inpatients and managed cases of TMJA during the study period. Socio-demographic, clinical and therapeutic variables were analyzed. <strong>Results:</strong> During the study 13 TMJA cases were collected with the frequency of 0.47%. The age group 1 - 9 was the most affected (61.54%) with extremes of 4 and 28 years. Men were the most concerned (53.87%). Restriction of mouth opening was the main reason for consultation (69.23%). The etiologies of ankylosis were dominated by infection including cellulitis of dental origin (53.85%) followed by facial trauma (30.77%). Arthroplasty was the most commonly used technique (73%), two cases of recurrence were noted (15.38%). <strong>Conclusion: </strong>TMJA affects mainly children and the etiology is dominated by cellulite of dental origin hence the interest of sensitization of the population for early management of oral diseases.
文摘Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). Methods: This was a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, i.e. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. Results: Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis;29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined status and 24 14.11% had a normal FLI. Conclusion: Identifying subjects at risk of metabolic steatopathy, diagnosing and managing these patients is a public health issue and one of the future challenges of hepato-gastroenterology. Fibroscan is an increasingly popular screening tool for hepatic fibrosis and steatosis. The fight against obesity must be a priority.
文摘Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1<sup>st </sup>January to 31<sup>st</sup> December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.
文摘Objectives: To describe the socio-demographic aspects of transferred parturient women;To identify the means of transport used by the evacuated parturient women to the Donka maternity ward at the University Hospital of Conakry;To describe the difficulties met;And to assess maternal and fetal prognosis. Methodology: It consisted of a prospective study over a period of 6 months from 01/02 to 31/07/2018. All patients transferred to the maternity ward of the Donka National Hospital of Conakry University Hospital. Results: The frequency of obstetric transfers was 13.79%. The epidemiological profile was that of a parturient woman of an average age of 25.7 years, married, and housewife, unschooled, who was on her first pregnancy and from the city of Conakry. The average distance covered was 16 km with extremes of 3 and 50 km. The transfer to the referral maternity clinic was not medicalized in 94% of cases. The venous route was not taken in 96% of cases. The parturient was not escorted by a health worker in 98% of cases. Bleeding was the most frequent reason for evacuation, followed by acute fetal sufferings. The average number of prenatal consultation was 2 with extremes of 0 and 9. The average length of stay was 3.6 days with extremes of 1 and 28 days. The majority of transferred women had a full-term pregnancy. The Cesarean section was 79.4%. The Retro placental hematoma was the most common complication found and was 29.4%. The counter-reference was not made in 97.79%. We recorded 8 maternal deaths, for a lethality rate of 1.77%. Possible interventions to reduce the dramatic situation of obstetric evacuations require first of all the decentralization of health care structures capable of performing a cesarean section. This approach should aim to create medical centers with a surgical antenna in all municipalities. These decentralized units would reduce the delay in case management and thus, limit the number of complications.
文摘Introduction: The birth of conjoined twins is an event extremely rare that offers unique therapeutic challenges and circumstances. We must examine each situation with the many questions that arise and which sometimes require a long reflection. We report a case of separation of pygopages conjoined twins as well as a review of the literature. Patients and Observations: a pair of conjoined twins aged 11 days, weighing 3080 g between them, was referred to the neonatology department from the Faranah prefecture, 300 km from Conakry, for care. The mother, a 30-year-old housewife, multipara, eight gestures and nine parities, had not followed any prenatal consultation. The delivery took place at home in a village with the death of the mother immediately postpartum. The clinical and paraclinical investigation had concluded with the diagnosis of Siamese type pygopage. After multidisciplinary consultation, the surgical treatment by separation of the twins was carried out at the age of 50 days with success and preservation of the physiological functions. Conclusion: The birth of conjoined twins is extremely rare. Each pair of Siamese is different and the surgical strategy must be adapted according to the shared organs. The perfect multidisciplinary work of the medical staff has been the main contributor to our success.
文摘<strong>Introduction:</strong><span style="font-family:Verdana;"> Deep vein thrombosis is a frequent disease, its origin is most often multifactorial. Venous thromboembolic disease (MVTE) and cancer are two frequently entangled pathologies. Here we report the diagnosis of deep vein thrombosis that discovered prostate cancer in an 88-year-old Guinean man. On clinical examination, there was a painful and hot swelling of the right leg, an absence of sloshing of the calf, a positive sign of Homans. The digital rectal examination revealed an enlarged prostate with an irregular surface. Cardiopulmonary auscultation was normal. The electrocardiogram showed a regular sinus rhythm at 65 cycles/min, with no sign of enlarged cavities or conduction disturbance. Venous Doppler ultrasound of the lower limbs showed the presence of an extensive acute deep venous thrombosis of the right sural vein extended to the popliteal and to the homolateral deep femoral. The reino-vesico-prostatic ultrasound c</span><span style="font-family:Verdana;">o</span><span style="font-family:Verdana;">ncluded in a heterogeneous prostatic hypertrophy with projection of a median lobe associated with a bladder of fight with an important post voiding residue evaluated at 170 ml</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;">the rate of specific antigen of the prostate PSA was at 84.87 ng/ml. The pathology analysis made after a prostate biopsy puncture concluded with an adenocarcinoma with a Gleason score of 3.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The association of venous thromboembolic disease (MVTE) and neoplasia is frequent. The existence of active cancer in a patient is a known risk factor for MVTE and, conversely, the discovery of a first episode of deep vein thrombosis (DVT) or pulmonary embolism (PE) may be the mode of revelation of cancer.</span>
文摘<strong>Objective:</strong> Azoospermia is one of the most important causes of couple infertility. The objective of our study is to report the clinical-biological profile of the azoosperm patient to the Urology-Andrology Department of the Conakry University teaching Hospital. It aims to take stock of the diagnostic management of azoospermia at this time where the world scientific community seems to be turned towards the intracytoplasmic sperm injection in the treatment of men with severe spermiological dysfunction. <strong>Patients and Method:</strong> This was a descriptive retrospective study lasting 12 months from January 1 to December 31, 2015. It collected 151 patients out of a set of 544 follow-ups for desire to have children. Were included the patients whose files contained all the information of the clinical observation (general information, reason for consultation, evolution, history, data of the physical examination) and a paraclinical assessment consisting of the FSH level and two spermograms spaced three months, confirming the diagnosis of azoospermia. <strong>Results:</strong> The mean age was 36.4 years with extremes of 23 and 56 years old. Urogenital infections (36.4%) followed by a notion of inguinal surgery had been the main patients’ history. Primary infertility accounted for 76.8% of cases. The mean duration of infertility was 6.5 years with extremes of 2 and 19 years. Azoospermia affected 27.76% of patients who consulted for the desire to have a child. It was judged secretory in 59.6% of cases, excretory in 25.8% of cases, and undetermined in 14.6% of cases. Varicocele was the main associated abnormality (46.3%) followed by testicular hypotrophy (36.4%). Neisseria Gonorrhoeae was the most common germ in sperm culture (21.7%). Chlamydia serology was positive in 21.7% of patients. <strong>Conclusion:</strong> Azoospermia affects a non-negligible proportion of men admitted by consulting for desire to have a child in our context. Strengthening the diagnostic and therapeutic arsenal is necessary to improve the care of affected patients.
文摘Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically search for it in patients with multiple comorbidities. The objective of this study was to determine the prevalence of orthostatic hypotension;describe their socio- demographic profile, the various clinical and paraclinical aspects and the predisposing factors of orthostatic hypotension in treated hypertensives, controlled or not. Method: This was a descriptive cross-sectional study, from January 2 to June 30, 2022 in the cardiology department of the Ignace Deen National Hospital. Included in this study were all patients who presented with orthostatic hypotension under antihypertensive treatment, regardless of age and sex, and who agreed to participate in the study. The non-inclusion criteria were hypertensive patients without OH and those who had not agreed to participate in the study. Each patient had blood pressure and heart rate measured in the supine position at room temperature and with an empty bladder. Then the measurement is taken again three (3) minutes after the switch to orthostatism. We retained the diagnosis of OH if the SBP drops by at least 20 mmHg and/or the PAD by at least 10 mmHg three (3) min after the transition to orthostatism. Our data obtained were analyzed in the Epi-info 7.4.0 software. Results: During our study period, we investigated 385 presented with OH, 12.2%. The mean age of the patients was 60.83 years ± 10.01 years and hypertensive patients, 47 of whom the M/F sex ratio was 0.81. In our study, blood pressure was not controlled in 36.2% of our patients with a predominance of grade 3 hypertension, a rate of 55.32%. Renal failure, anemia, heart failure and stroke were the main comorbidities associated with the occurrence of HO. The most incriminated factors were age with a frequency of 74.47%, followed by obesity at 44.68% and diabetes at 27.66%. BP was normally controlled with a rate of 68.8% in treated hypertensive patients with OH. It is found much more in patients using triple therapy, a rate of 61.71%. Conclusion: The prevalence of OH is high in our department. It is found much more in patients using triple therapy. The most incriminated factors were age followed by obesity and diabetes.
