A total of fifty (50) samples of water from Lake Fitri (Chad), with 25 samples per island (Domoro and Maguite). The aim of this study was to analyze the bacteriological, biochemical and physico-chemical quality of the...A total of fifty (50) samples of water from Lake Fitri (Chad), with 25 samples per island (Domoro and Maguite). The aim of this study was to analyze the bacteriological, biochemical and physico-chemical quality of the water in Lake Fitri in Chad. Standard microbiology methods were used. Isolated strains of enterobacteria were characterized by API 20E and API Staph galleries and confirmed by API Web. Antibiotic resistance was performed according to the recommendations of the antibiogram committee (CA-SFM, 2019). Physico-chemical analysis of the water was carried out by (Rodier, 2009). The microbiological results revealed an abundance on the Domoro islands (5.37.106 ± 1.5.105 and 1.97.105 ± 4.94.104), successively for total aerobic mesophilic flora (FMAT), and thermotolerant coliform (E. coli) and on the Maguite Islands (4.71.106 ± 7.14.105 and 2.32.105 ± 2.86.104), alternately for total aerobic mesophilic flora (FMAT), and thermotolerant coliform (E. coli). The results obtained after incubation of the biochemical tests using the API 20E and API Staph galleries and their proposed numerical profile analyzed using Api software and confirmed by Api Web confirmed the contamination of the waters of Lake Fitri by pathogenic strains of E. coli, Staphylococcus and Salmonella spp. The results of the antibiogram carried out show the emergence of certain resistances to Tobramycin, Flucytosine and Teicoplanin. The average levels of BOD5, COD, SS, Nitrate (NO3) and Nitrite (NO2) for Domoro Island were 32.14 ± 2.37 mg/L, 423.86 ± 4.78 mg/L, 65.42 ± 2.27 mg/L, 0.04 ± 0.01 mg/L and 3.32 ± 1.48 mg/L respectively. The water from the islands of Lake Fitri must therefore be rigorously treated before consumption.展开更多
Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-born...Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-borne parasitic diseases (VBPDs) transmission in Chad and provide recommendations for policy improvements. Methods: The study adopts the WHO Conceptual Framework of SDOH to compare two regions in Southern Chad: Kouh-Est, which has an ongoing vector control program, and Grand-Sido, which lacks such a program. The study includes both nomadic and sedentary populations to provide a comprehensive understanding of the SDOH influencing VBPDs. Households were randomly selected. Data on sociodemographic characteristics, literacy, knowledge of VBPDs and protective measures, and access to education and health facilities were collected. Results: A total of 202 households from 17 villages, including 820 participants, were surveyed. Agriculture, livestock, and fishing were the main occupations, involving 84.1% of participants. Literacy was low, with 36.7% non-educated, 47.7% completing primary school, 14.5% secondary school, and only 0.3% reaching tertiary education. Most villages lacked schools beyond the primary level, and nomadic populations were significantly less educated than sedentary ones (p Conclusion: Educational deficiencies, lack of protective measures against vectors, inadequate healthcare resources, and lifestyle conditions aggravated by poor road infrastructure, limited transportation, and economic constraints contribute to worsened VBPDs outcomes in these rural populations. Addressing these systemic issues in the surveyed communities is essential for improving health equity and VBPDs outcomes in these regions specifically and in similar populations settings more broadly.展开更多
The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient...The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient on follow-up for asymptomatic chronic aortic insufficiency who was referred to us for a preoperative invasive hemodynamic assessment. The indication for surgery was based on the left ventricular dilation criteria. The echocardiography and cardiac catheterization showed a disappearance between the aortic insufficiency and the left ventricular repercussion. Upon discovery of the sinus bradycardia, the patient received a single chamber pacemaker set at a base rate of 70 seconds in AAIR at first and then the patient was measured remotely. At five months, cardiac pacing resulted in a significant reduction in the left ventricular diameter and volume on the echocardiography and magnetic resonance imaging;therefore surgery was postponed.展开更多
Introduction: To compare the measured dose distributions to calculated ones in dose-to-water (Dw) and dose-to-medium (Dm) reporting modes for simple plans and patient-specific intensity modulated radiation therapy (IM...Introduction: To compare the measured dose distributions to calculated ones in dose-to-water (Dw) and dose-to-medium (Dm) reporting modes for simple plans and patient-specific intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans using ArcCHECK with a fixed phantom density. Methods: The recommended density value of 1.18 g/cm3 for Acuros XB and X-ray voxel Monte Carlo was assigned to ArcCHECK on CT images. A total of 45 simple plans, including a 1-field plan, a 3-field plan, a 4-field plan, a half-arc plan from 270° to 90°, and a full-arc plan, were assessed. Subsequently, the patient-specific 96 IMRT and VMAT plans were evaluated. Gamma analysis with a 3% normalized global dose error and a 3 mm distance-to-agreement criteria (γ3%G/3mm) was performed in the Dw and Dm. The change in γ3%G/3mm between Dw and Dm were statistically analyzed using JMPPro11 software. Results: The median values of γ3%G/3mm for all simple plans for Dw and Dm were 98.1% (range, 75.2% - 100%) and 95.5% (range, 23.7% - 100%), respectively (p 0.01). In the patient-specific IMRT and VMAT plans, the median values of γ3%G/3mm for Dw and Dm were 98.6% (range, 90.1% - 100%) and 90.5% (range, 38.5% - 97.2%), respectively (p 0.01). Conclusion: Our results showed that the calculated and measured dose distributions were in good agreement for Dw, but were not for Dm. From the viewpoint of the rationale of dosimetry, Dw shows better agreement with measured dose distribution when using the fixedphantom density recommended by the vendor.展开更多
Purpose: The elderly are often faced with multiple diseases, in particular hemodialysis (HD) which requires many kinds of medication. This study examined the factors influencing the behavior of taking medicine in elde...Purpose: The elderly are often faced with multiple diseases, in particular hemodialysis (HD) which requires many kinds of medication. This study examined the factors influencing the behavior of taking medicine in elderly patients undergoing HD. Subjects and Methods: The subjects comprised 70 outpatients > 65 years undergoing HD (48 male and 22 female). The mean age of the patients was 72.5 ± 4.4 years. The mean duration of dialysis history was 6.1 ± 5.2 years. We performed a questionnaire survey using Medication Assessment Tool, The Kidney Disease Quality of Life (QOL)-Short Form and Acceptance for Dialysis Instrument. Result: Two factors related to poor behavior of taking medicine: dialysis history < 2 years and poor acceptance of dialysis. The multiple regression analysis showed patient satisfaction (β = –0.329, p < 0.01) and symptoms/problems (β = –0.273, p<0.05) as significant independent variables relating to behavior of taking medicine. Conclusion: Poor behavior of taking medicine is related to a short dialysis period, poor acceptance and poor satisfaction of dialysis therapy in elderly patients.展开更多
<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</str...<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong> All pregnant women are at risk of obstetric complications </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">leading to high fetal-maternal mortality and morbidity. The aim of this work was to evaluate the maternal and fetal prognosis of evacuated parturients.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Patient and Method</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: we conducted a prospective analytical survey for four months, from April 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to July 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2018 in the Maternity of N’Djamena Mother and Child Hospital about the maternal and fetal prognosis of evacuated parturients. Any parturient evacuated or referred for obstetric complications was included. Study parameters were epidemiological, clinical, para-clinical, therapeutic and prognosis order. These parameters were analyzed in the SPSS 18 French version software.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: Evacuated parturients represented 20% of maternity admissions. The average age was 23.9 years, with extremes ranging from 15 and 43 years. They were uneducated in 72.9%, primiparous in 46.8% of cases. The three delays were dominated by the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> delay, which represented 34.1% of cases. In this series, 26.3% parturients had presented obstetric com</span><span style="font-family:Verdana;">plications. Preruptive syndrome was the most common complication with</span><span style="font-family:Verdana;"> 29.3% cases. Predisposing factors to maternal-fetal complications were low attendance antenatal care, late evacuation and distance travelled. The mater</span><span style="font-family:Verdana;">nal mortality rate was 3%. Fetal complications were observed in 28.3% of cas</span><span style="font-family:Verdana;">es and the neonatal mortality rate was 24.6%.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: The maternal </span><span style="font-family:Verdana;">and fetal complications of evacuated parturients are a real public health</span><span style="font-family:Verdana;"> problem in our regions. The suppression of delays, capacity reinforcement of peripheral maternity and the periodic recycling peripheral centers to recognize </span><span style="font-family:Verdana;">obstetric emergencies will contribute to improve the maternal and fetal</span><span style="font-family:Verdana;"> prognosis of evacuated parturients.</span></span></span></span>展开更多
Introduction: Miliary tuberculosis (MT) is a rare form of tuberculosis (TB) and it is a major public health problem in our countries with limited resources. Materials and Methods: It is a retrospective and descriptive...Introduction: Miliary tuberculosis (MT) is a rare form of tuberculosis (TB) and it is a major public health problem in our countries with limited resources. Materials and Methods: It is a retrospective and descriptive study that started from 1st January 2018 to 31 December 2020 at the pneumo-phtisiology service of the CHU-RN of N’Djamena., All records of patients aged at least 15 years treated for miliary tuberculosis confirmed by X-ray chest were included in our study. Results: The prevalence of TD was 1.5% (n = 103) of all TB diagnosed in the service. The sex ratio was 1.34. The average age was 37.7 years with extremes ranging from 19 to 80 years. A low social economic level was found in 75.7%. The principal comorbidity found in this study was HIV with the prevalence of (22.3%). The general signs were dominated by deterioration of general condition (96.1%) and fever (91.3%). The main symptoms were cough (85.4%) and dyspnea (52.4%). The radiology of chest found a homogeneous dissemination and symmetrical in both lung fields in 100% of cases. Our study reported that 14 (13.6%) of death cases were found among patients. Conclusion: TM is a severe form of TB;it affects a young population in our context. Mortality remains high with prevalence of 13.6% of cases. Early management would improve the prognosis.展开更多
Introduction: Cardiac Insufficiency is progressively taking over as the leading cause of morbidity and mortality in the world and a major public health problem in Chad. Our study was to contribute and provide a deeper...Introduction: Cardiac Insufficiency is progressively taking over as the leading cause of morbidity and mortality in the world and a major public health problem in Chad. Our study was to contribute and provide a deeper understanding of the clinical and etiological aspects concerning the etiology and management of Cardiac Insufficiency in N’Djamena, Chad. Due to having no published data to distinctly understand this pathology in this part of the world, we represent here a summary of available data which could be used to describe the clinical and etiological aspects of Cardiac Insufficiency and to help in changing practices for an optimal management as a baseline for comparison in future studies. Patients and Methods: This was a prospective, descriptive study conducted from November 30th 2011 to May 30th 2013 at the Good Samaritan Hospital of N’Djamena. Results: 100 hospitalized patients were included consecutively. The sex ratio was 1.08 with an average age of 40.21 ± 21.30 years. The main cardiovascular risk factors were high blood pressure (15%), obesity (12%) and diabetes (11%). Clinically, exertional dyspnea was found in 95% of cases, and signs of congestive heart failure in 61% of cases. The etiologies were 50% of Rheumatic valvulopathy, 22% of Dilated cardiomyopathy, 13% of Hypertensive cardiomyopathy and 12% of Congenital heart disease. Conclusion: The most common etiologies were Rheumatic valvulopathy, Congenital heart disease, Dilated cardiomyopathy and Hypertensive cardiomyopathy.展开更多
The use of medicinal plants occupies an important place in traditional Chadian medicine, this study was carried out with the aim of listing the medicinal plants sold in the markets of the city of N’Djamena, and knowl...The use of medicinal plants occupies an important place in traditional Chadian medicine, this study was carried out with the aim of listing the medicinal plants sold in the markets of the city of N’Djamena, and knowledge of the medicinal flora Chad, such as the leaves of Guiera senegalensis in Arabic called Khibeche, the roots of Cassia occidentalis called Am kwala-Kinkéliba in Arabic;the bark of Khaya senegalensis (Desv) A. Juss called Muraї in Arabic and the seeds of Trigonella foenum-graecum called Helbé in Arabic in order to treat the most frequently cited diseases such as malaria, the common cold, mother and newborn care, and typhoid. Ethnobotanical surveys were conducted from September to December 2022, in three markets in the city of N’Djamena, based on individual interviews using a semi-structured questionnaire, with 30 herbalists and traditional practitioners. Phytochemical screening analyses of the organs of four plants were carried out in the chemistry and biology laboratory of the Faculty of Exact and Applied Sciences (FSEA) following a standard protocol established by [1] and slightly modified by [2] [3]. The results of the surveys identified 68 species divided into fifty-five (55) genera and twenty-seven (27) families, the most represented of which were Caesalpiniaceae (10 species), Mimosaceae (5 species) and Combretaceae (4 species). The leaves were the most commonly used parts (43%), with decoction (70%) the most frequently used method of preparation. The oral route was the most popular with 73% of recipes. The phytochemical study revealed a wealth of secondary metabolites such as Trapezoidal Sterols, Alkaloids, Tannins, Flavonoids, Free Quinones, Anthocyane, Anthraquinones, Saponosides and Heterosides. These results can be considered as a source of information for scientific research in the field of phytochemistry and pharmacology.展开更多
Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one m...Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one million inhabitants per year and its evolution can be fatal. Materials and Methods: We report the observation of a 60-year-old patient, with no significant pathological history, admitted to our intensive care unit at the Renaissance University Teaching Hospital in N’Djamena for the treatment of Toxic Epidermal Necrolysis. In whom the onset of symptoms dates back to few hours after vaccination against COVID-19 with Ag Johnson and Johnson. Results: An ophthalmology opinion was requested and the patient was put on Fucithalmic. In our case, in addition to the advanced age of the patient (60 years old), her SCORTEN was ≥5. Conclusion: The late management as well as the absence of a specific department for severe burns, which condition the presence of a technical plate was fatal to her despite multidisciplinary care: Resuscitators, Traumato-Orthopedist and ophthalmologist.展开更多
<p style="text-align:justify;"> <span style="font-family:Verdana;">Giant cell tumor of the wrist is a rare, benign and usually symptomatic condition. The discovery is sometimes made fol...<p style="text-align:justify;"> <span style="font-family:Verdana;">Giant cell tumor of the wrist is a rare, benign and usually symptomatic condition. The discovery is sometimes made following a medical imaging examination or a painful symptomatology or more often a visible or palpable swelling with or without vascular and/or nerve compression. At an advanced stage, the X-ray is of paramount importance. The well codified complete surgical resection is part of the therapeutic arsenal.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We present a clinical case report of a young woman with a giant cell tumor localized in the wrist in N’Djamena, Chad. This case concerns a 25-year-old patient who presented in July 2020 of a painful swelling lateral to her left wrist bone and whose X-ray radiography showed lysis of the cortical bone in the lower third of the ulna. After the operative resection of the tumor mass, the pathological examination of the operative specimen revealed the diagnosis of a giant cell tumor.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">A giant cell tumor is a benign condition, with a few symptoms and the location at the ulna is exceptional. Complete surgical resection is a viable treatment option.</span> </p>展开更多
The problem of access to quality water is a major challenge, as it has a major impact on the socio-economic conditions of people in developing countries. The water from the islands of Lake Fitri is one of the main sou...The problem of access to quality water is a major challenge, as it has a major impact on the socio-economic conditions of people in developing countries. The water from the islands of Lake Fitri is one of the main sources of drinking water for the population. The aim of this study is to characterise and assess the quality of the water and sediment from the islands (Moudou and Birguime) of Lake Fitri, and to confirm the strains isolated using the PCR method. A total of fifty (50) samples of water and fifty (50) sediments from the islands of Lake Fitri were analyzed. Standard methods of microbiological and biochemical analysis of water and sediments were used. Isolated Enterobacteriaceae strains were characterized by API 20 E and API Staph galleries and Salmonella was confirmed by PCR method. Antibiotic resistance was determined using a technique recommended by the antibiogram committee of the French microbiology society (CA-SFM, 2019). The microbiological results for the water showed an abundance of total aerobic mesophilic flora (TAMF) (4.31 × 106 ± 8.05 × 105 and 5.29 × 106 ± 2.55 × 105) on the Birguime and Moudou islands successively. The microbiological results for the sediment from Birguime and Moudou islands showed an abundance of thermotolerant coliforms (E. coli) (2.05 × 105 ± 5.43 × 104 and 2.27 × 105 ± 3.49 × 104) alternately. The results obtained after incubation of the biochemical tests by the API 20E, API Staph gallery and their numerical profile proposed by the Api software confirmed the contamination. The antibiogram results showed the emergence of certain resistances to the antibiotics Tobramycin, Flucytosine, Amikacin and Teicoplani. The PCR results for Salmonella spp strains were confirmed. As a result, strict monitoring of the water on the various islands of Lake Fitri must be carried out throughout the annual cycle, by specialized personnel, to ensure proper bio-monitoring of these ecosystems.展开更多
Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a ra...Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.展开更多
Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteris...Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteristics of the epidemiological, clinical, biological, etiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective and descriptive study from January 2021 to December 2021 which took place in the pediatrics department of the Mother and Child University Teaching Hospital of N’Djamena (CHU-ME). All the children in whom we observed abnormal involuntary movements whose age was less than or equal to 15 years were concerned. Result: there were three female children. The average age was 7.5, of which the two are 7 years old and the third is 8 years old. Two had a history of angina. A notion of polyarthralgia and dental caries was found in the third. The diagnosis of post-streptococcal chorea was retained on the basis of clinical arguments: observation of abnormal movements of the limbs and the face, which are involuntary, sudden with an insidious and progressive onset, muscular hypotonia, and psychic disorder. Medical imaging, in particular echocardiography, which objectified two cases of associated rheumatic valvular disease. Remission was observed in all three children after two weeks of treatment with haloperidol, penicillin. Those with associated rheumatic valve disease also received corticosteroid therapy. Complete remission of chorea was observed in all three girls. Prophylaxis in two patients based on Penicillin V was instituted. Conclusion: Although less frequent, post-streptococcal chorea is still seen in our country and is still an important health problem that needs more real medical efforts.展开更多
Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowl...Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% respectively. Conclusion: This study revealed that the medicinal plants are variously used in the treatment of infection urinary tract in the city of N’Djamena.展开更多
Introduction: Urolithiasis in children is not sufficiently documented in Chad. Objectives: The aim of this work was to report the epidemiological, clinical and therapeutic aspects of urolithiasis in children in our en...Introduction: Urolithiasis in children is not sufficiently documented in Chad. Objectives: The aim of this work was to report the epidemiological, clinical and therapeutic aspects of urolithiasis in children in our environment. Patients and methods: This was a descriptive retrospective study of patients aged 0 - 15 years treated for urolithiasis between January 2015 and July 2020. The variables studied were age, gender, clinical, paraclinical and therapeutic aspects. Results: Among the 191 children, there were 164 boys (85.9%) and 19 girls (9.9%). The sex ratio was 8.63. The average age was 5.86 years with extremes (1 and 15 years). The symptomatology was dominated by dysuria. The ASP-ultrasound pair allowed the diagnosis in 183 cases (95.8%). The site of the calculus was bladder in 128 cases (67%). The average calculation size was 2.81mm. A supporting cause was found in only 1 case (posterior urethral valve). Treatment was surgical and dominated by cystolithotomy. The postoperative course was marked by 5 cases of parietal infections (2.6%) and 3 cases of vesico-cutaneous fistulas (1.6%). No case of death has been reported. Conclusion: Lithiasis is more common in boys in the lower urinary tract. Open surgery remains the only one practiced. Etiological research must be carried out to develop prevention strategies.展开更多
Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hosp...Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena Mother and Child University Hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.展开更多
Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the De...Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the Department of Mayo-Boneye. Methodology: This is a prospective observational study that took place from October to December 2021, including 168 patients with their sociodemographic characteristics. The venous blood of the patients was collected in dry tubes and centrifuged to obtain the serum. The Chlamydia IgG Rapid Test Cassette was used for the detection of antibodies to Chlamydia infection. The Epi Info 7<sup>TM</sup> software was used to perform the statistical analyses. Results: A total of 168 patients were included in this study. The average age was 26.36 ± 9.21 years, the median was 25.5 years with the extremes of 14 years and 70 years. Among these patients, 46.43% were illiterate, 5.95% and 20.83% were primary and secondary school students, respectively, and 26.79% university students. For marital status, 66.67% were single, 16.67% married, 10.71% divorced and 5.95% widowed. Regarding the profession, 26.79% were traders, 8.93% were employees and 64.29% unemployed. In this study, the 168 patients had performed Chlamydia trachomatis serology among whom 02 (1.19%) were excluded for invalid results and 10.71% presented positive cases. The city of Bongor was the most infected with 61% of cases. Among these patients, 54.22% were linked to risk factors for Chlamydia trachomatis. The most infected age group was between 25 and 35 with a seroprevalence of 5.36% of cases. Conclusion: In this study, Chlamydia trachomatis was positive for 10.71% of diagnosed cases. The most affected age groups are young, sexually active women. The State should emphasize the screening of women, the awareness of students and academics.展开更多
Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of...Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of morbidity and mortality which varies between 6% - 33%;their management remains a big challenge. These patients frequently face complications, and a well-organized multidisciplinary approach must be implemented in their management to improve outcomes. Objectives: Our study aims to assess the prevalence, management and outcomes of enterocutaneous fistulas in Buea regional hospital and Laquintinie hospital of Douala over the past 5 years. Methods: This was a hospital-based retrospective study in Buea regional hospital and Laquintinie hospital of Douala. Records of patients who had enterocutaneous fistulas within the period of 1<sup>st</sup> January 2017 to 31<sup>st</sup> December 2020 in the surgical departments. Data included demographics, pre-operative diagnosis, comorbidities, type of fistula, management modality and means, the indication of operative treatment, length of stay in the hospital and outcomes. Data was analysed using SPSSv26. Results: The study constituted 1343 medical records of which 83 medical records of patients with enterocutaneous fistulas, giving a prevalence of 6.2%, female predominance at 59% (n = 49), 42.2% (n = 35) were referred cases from the periphery for better management. A vast majority (96.4%) occurred as post-operative complications with appendectomy the most common indication (18.8%). High output fistulas were predominant (43.4%). 59% (n = 47) were managed medically, 6% (n = 5) received both conservative and surgical modalities while 35% (n = 5) were managed surgically. 64.1% (n = 50) were placed on enteral nutrition while 35.9% (n = 28) were placed on parenteral nutrition. Peritonitis/infection 50% (n = 18) was the commonest indication of surgical treatment, followed by failure of medical treatment 25% (n = 9) then high output fistulas 16.7% (n = 6). Resection with end-to-end anastomosis was the preferred repaired work at 61% (n = 22). The mortality rate was 38.5% (n = 32), 29% (n = 24) healed after conservative treatment, 21.7% (n = 18) healed after surgery, 7.2% (n = 6) persisted after surgery while 3.6% (n = 3) persisted after conservative treatment. Anaemia, sepsis, electrolyte imbalance, dehydration and malnutrition were the commonest complications. Conclusion: The prevalence of enterocutaneous fistulas was high, with a female predominance and a mean age of 38 years. Most cases were seen as a referral from the periphery for better management. The greatest majority of fistulas occurred as a postoperative complications. Conservative management with enteral feedings was preferred, they had better outcomes and gave more chances of healing. The commonest indication of surgical treatment was an infection. Resection with end-to-end anastomosis was the preferred repaired work. The mortality rate was high, and anaemia, sepsis and electrolyte imbalance were the commonest complications.展开更多
文摘A total of fifty (50) samples of water from Lake Fitri (Chad), with 25 samples per island (Domoro and Maguite). The aim of this study was to analyze the bacteriological, biochemical and physico-chemical quality of the water in Lake Fitri in Chad. Standard microbiology methods were used. Isolated strains of enterobacteria were characterized by API 20E and API Staph galleries and confirmed by API Web. Antibiotic resistance was performed according to the recommendations of the antibiogram committee (CA-SFM, 2019). Physico-chemical analysis of the water was carried out by (Rodier, 2009). The microbiological results revealed an abundance on the Domoro islands (5.37.106 ± 1.5.105 and 1.97.105 ± 4.94.104), successively for total aerobic mesophilic flora (FMAT), and thermotolerant coliform (E. coli) and on the Maguite Islands (4.71.106 ± 7.14.105 and 2.32.105 ± 2.86.104), alternately for total aerobic mesophilic flora (FMAT), and thermotolerant coliform (E. coli). The results obtained after incubation of the biochemical tests using the API 20E and API Staph galleries and their proposed numerical profile analyzed using Api software and confirmed by Api Web confirmed the contamination of the waters of Lake Fitri by pathogenic strains of E. coli, Staphylococcus and Salmonella spp. The results of the antibiogram carried out show the emergence of certain resistances to Tobramycin, Flucytosine and Teicoplanin. The average levels of BOD5, COD, SS, Nitrate (NO3) and Nitrite (NO2) for Domoro Island were 32.14 ± 2.37 mg/L, 423.86 ± 4.78 mg/L, 65.42 ± 2.27 mg/L, 0.04 ± 0.01 mg/L and 3.32 ± 1.48 mg/L respectively. The water from the islands of Lake Fitri must therefore be rigorously treated before consumption.
文摘Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-borne parasitic diseases (VBPDs) transmission in Chad and provide recommendations for policy improvements. Methods: The study adopts the WHO Conceptual Framework of SDOH to compare two regions in Southern Chad: Kouh-Est, which has an ongoing vector control program, and Grand-Sido, which lacks such a program. The study includes both nomadic and sedentary populations to provide a comprehensive understanding of the SDOH influencing VBPDs. Households were randomly selected. Data on sociodemographic characteristics, literacy, knowledge of VBPDs and protective measures, and access to education and health facilities were collected. Results: A total of 202 households from 17 villages, including 820 participants, were surveyed. Agriculture, livestock, and fishing were the main occupations, involving 84.1% of participants. Literacy was low, with 36.7% non-educated, 47.7% completing primary school, 14.5% secondary school, and only 0.3% reaching tertiary education. Most villages lacked schools beyond the primary level, and nomadic populations were significantly less educated than sedentary ones (p Conclusion: Educational deficiencies, lack of protective measures against vectors, inadequate healthcare resources, and lifestyle conditions aggravated by poor road infrastructure, limited transportation, and economic constraints contribute to worsened VBPDs outcomes in these rural populations. Addressing these systemic issues in the surveyed communities is essential for improving health equity and VBPDs outcomes in these regions specifically and in similar populations settings more broadly.
文摘The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient on follow-up for asymptomatic chronic aortic insufficiency who was referred to us for a preoperative invasive hemodynamic assessment. The indication for surgery was based on the left ventricular dilation criteria. The echocardiography and cardiac catheterization showed a disappearance between the aortic insufficiency and the left ventricular repercussion. Upon discovery of the sinus bradycardia, the patient received a single chamber pacemaker set at a base rate of 70 seconds in AAIR at first and then the patient was measured remotely. At five months, cardiac pacing resulted in a significant reduction in the left ventricular diameter and volume on the echocardiography and magnetic resonance imaging;therefore surgery was postponed.
文摘Introduction: To compare the measured dose distributions to calculated ones in dose-to-water (Dw) and dose-to-medium (Dm) reporting modes for simple plans and patient-specific intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans using ArcCHECK with a fixed phantom density. Methods: The recommended density value of 1.18 g/cm3 for Acuros XB and X-ray voxel Monte Carlo was assigned to ArcCHECK on CT images. A total of 45 simple plans, including a 1-field plan, a 3-field plan, a 4-field plan, a half-arc plan from 270° to 90°, and a full-arc plan, were assessed. Subsequently, the patient-specific 96 IMRT and VMAT plans were evaluated. Gamma analysis with a 3% normalized global dose error and a 3 mm distance-to-agreement criteria (γ3%G/3mm) was performed in the Dw and Dm. The change in γ3%G/3mm between Dw and Dm were statistically analyzed using JMPPro11 software. Results: The median values of γ3%G/3mm for all simple plans for Dw and Dm were 98.1% (range, 75.2% - 100%) and 95.5% (range, 23.7% - 100%), respectively (p 0.01). In the patient-specific IMRT and VMAT plans, the median values of γ3%G/3mm for Dw and Dm were 98.6% (range, 90.1% - 100%) and 90.5% (range, 38.5% - 97.2%), respectively (p 0.01). Conclusion: Our results showed that the calculated and measured dose distributions were in good agreement for Dw, but were not for Dm. From the viewpoint of the rationale of dosimetry, Dw shows better agreement with measured dose distribution when using the fixedphantom density recommended by the vendor.
文摘Purpose: The elderly are often faced with multiple diseases, in particular hemodialysis (HD) which requires many kinds of medication. This study examined the factors influencing the behavior of taking medicine in elderly patients undergoing HD. Subjects and Methods: The subjects comprised 70 outpatients > 65 years undergoing HD (48 male and 22 female). The mean age of the patients was 72.5 ± 4.4 years. The mean duration of dialysis history was 6.1 ± 5.2 years. We performed a questionnaire survey using Medication Assessment Tool, The Kidney Disease Quality of Life (QOL)-Short Form and Acceptance for Dialysis Instrument. Result: Two factors related to poor behavior of taking medicine: dialysis history < 2 years and poor acceptance of dialysis. The multiple regression analysis showed patient satisfaction (β = –0.329, p < 0.01) and symptoms/problems (β = –0.273, p<0.05) as significant independent variables relating to behavior of taking medicine. Conclusion: Poor behavior of taking medicine is related to a short dialysis period, poor acceptance and poor satisfaction of dialysis therapy in elderly patients.
文摘<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong> All pregnant women are at risk of obstetric complications </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">leading to high fetal-maternal mortality and morbidity. The aim of this work was to evaluate the maternal and fetal prognosis of evacuated parturients.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Patient and Method</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: we conducted a prospective analytical survey for four months, from April 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to July 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2018 in the Maternity of N’Djamena Mother and Child Hospital about the maternal and fetal prognosis of evacuated parturients. Any parturient evacuated or referred for obstetric complications was included. Study parameters were epidemiological, clinical, para-clinical, therapeutic and prognosis order. These parameters were analyzed in the SPSS 18 French version software.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: Evacuated parturients represented 20% of maternity admissions. The average age was 23.9 years, with extremes ranging from 15 and 43 years. They were uneducated in 72.9%, primiparous in 46.8% of cases. The three delays were dominated by the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> delay, which represented 34.1% of cases. In this series, 26.3% parturients had presented obstetric com</span><span style="font-family:Verdana;">plications. Preruptive syndrome was the most common complication with</span><span style="font-family:Verdana;"> 29.3% cases. Predisposing factors to maternal-fetal complications were low attendance antenatal care, late evacuation and distance travelled. The mater</span><span style="font-family:Verdana;">nal mortality rate was 3%. Fetal complications were observed in 28.3% of cas</span><span style="font-family:Verdana;">es and the neonatal mortality rate was 24.6%.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: The maternal </span><span style="font-family:Verdana;">and fetal complications of evacuated parturients are a real public health</span><span style="font-family:Verdana;"> problem in our regions. The suppression of delays, capacity reinforcement of peripheral maternity and the periodic recycling peripheral centers to recognize </span><span style="font-family:Verdana;">obstetric emergencies will contribute to improve the maternal and fetal</span><span style="font-family:Verdana;"> prognosis of evacuated parturients.</span></span></span></span>
文摘Introduction: Miliary tuberculosis (MT) is a rare form of tuberculosis (TB) and it is a major public health problem in our countries with limited resources. Materials and Methods: It is a retrospective and descriptive study that started from 1st January 2018 to 31 December 2020 at the pneumo-phtisiology service of the CHU-RN of N’Djamena., All records of patients aged at least 15 years treated for miliary tuberculosis confirmed by X-ray chest were included in our study. Results: The prevalence of TD was 1.5% (n = 103) of all TB diagnosed in the service. The sex ratio was 1.34. The average age was 37.7 years with extremes ranging from 19 to 80 years. A low social economic level was found in 75.7%. The principal comorbidity found in this study was HIV with the prevalence of (22.3%). The general signs were dominated by deterioration of general condition (96.1%) and fever (91.3%). The main symptoms were cough (85.4%) and dyspnea (52.4%). The radiology of chest found a homogeneous dissemination and symmetrical in both lung fields in 100% of cases. Our study reported that 14 (13.6%) of death cases were found among patients. Conclusion: TM is a severe form of TB;it affects a young population in our context. Mortality remains high with prevalence of 13.6% of cases. Early management would improve the prognosis.
文摘Introduction: Cardiac Insufficiency is progressively taking over as the leading cause of morbidity and mortality in the world and a major public health problem in Chad. Our study was to contribute and provide a deeper understanding of the clinical and etiological aspects concerning the etiology and management of Cardiac Insufficiency in N’Djamena, Chad. Due to having no published data to distinctly understand this pathology in this part of the world, we represent here a summary of available data which could be used to describe the clinical and etiological aspects of Cardiac Insufficiency and to help in changing practices for an optimal management as a baseline for comparison in future studies. Patients and Methods: This was a prospective, descriptive study conducted from November 30th 2011 to May 30th 2013 at the Good Samaritan Hospital of N’Djamena. Results: 100 hospitalized patients were included consecutively. The sex ratio was 1.08 with an average age of 40.21 ± 21.30 years. The main cardiovascular risk factors were high blood pressure (15%), obesity (12%) and diabetes (11%). Clinically, exertional dyspnea was found in 95% of cases, and signs of congestive heart failure in 61% of cases. The etiologies were 50% of Rheumatic valvulopathy, 22% of Dilated cardiomyopathy, 13% of Hypertensive cardiomyopathy and 12% of Congenital heart disease. Conclusion: The most common etiologies were Rheumatic valvulopathy, Congenital heart disease, Dilated cardiomyopathy and Hypertensive cardiomyopathy.
文摘The use of medicinal plants occupies an important place in traditional Chadian medicine, this study was carried out with the aim of listing the medicinal plants sold in the markets of the city of N’Djamena, and knowledge of the medicinal flora Chad, such as the leaves of Guiera senegalensis in Arabic called Khibeche, the roots of Cassia occidentalis called Am kwala-Kinkéliba in Arabic;the bark of Khaya senegalensis (Desv) A. Juss called Muraї in Arabic and the seeds of Trigonella foenum-graecum called Helbé in Arabic in order to treat the most frequently cited diseases such as malaria, the common cold, mother and newborn care, and typhoid. Ethnobotanical surveys were conducted from September to December 2022, in three markets in the city of N’Djamena, based on individual interviews using a semi-structured questionnaire, with 30 herbalists and traditional practitioners. Phytochemical screening analyses of the organs of four plants were carried out in the chemistry and biology laboratory of the Faculty of Exact and Applied Sciences (FSEA) following a standard protocol established by [1] and slightly modified by [2] [3]. The results of the surveys identified 68 species divided into fifty-five (55) genera and twenty-seven (27) families, the most represented of which were Caesalpiniaceae (10 species), Mimosaceae (5 species) and Combretaceae (4 species). The leaves were the most commonly used parts (43%), with decoction (70%) the most frequently used method of preparation. The oral route was the most popular with 73% of recipes. The phytochemical study revealed a wealth of secondary metabolites such as Trapezoidal Sterols, Alkaloids, Tannins, Flavonoids, Free Quinones, Anthocyane, Anthraquinones, Saponosides and Heterosides. These results can be considered as a source of information for scientific research in the field of phytochemistry and pharmacology.
文摘Introduction: Lyell’s syndrome (SL), called Toxic Epidermal Necrolysis is one of the most serious forms of medication accidents. It is an acute, rare pathology, its incidence is estimated at 1 to 2 cases out of one million inhabitants per year and its evolution can be fatal. Materials and Methods: We report the observation of a 60-year-old patient, with no significant pathological history, admitted to our intensive care unit at the Renaissance University Teaching Hospital in N’Djamena for the treatment of Toxic Epidermal Necrolysis. In whom the onset of symptoms dates back to few hours after vaccination against COVID-19 with Ag Johnson and Johnson. Results: An ophthalmology opinion was requested and the patient was put on Fucithalmic. In our case, in addition to the advanced age of the patient (60 years old), her SCORTEN was ≥5. Conclusion: The late management as well as the absence of a specific department for severe burns, which condition the presence of a technical plate was fatal to her despite multidisciplinary care: Resuscitators, Traumato-Orthopedist and ophthalmologist.
文摘<p style="text-align:justify;"> <span style="font-family:Verdana;">Giant cell tumor of the wrist is a rare, benign and usually symptomatic condition. The discovery is sometimes made following a medical imaging examination or a painful symptomatology or more often a visible or palpable swelling with or without vascular and/or nerve compression. At an advanced stage, the X-ray is of paramount importance. The well codified complete surgical resection is part of the therapeutic arsenal.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">We present a clinical case report of a young woman with a giant cell tumor localized in the wrist in N’Djamena, Chad. This case concerns a 25-year-old patient who presented in July 2020 of a painful swelling lateral to her left wrist bone and whose X-ray radiography showed lysis of the cortical bone in the lower third of the ulna. After the operative resection of the tumor mass, the pathological examination of the operative specimen revealed the diagnosis of a giant cell tumor.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">A giant cell tumor is a benign condition, with a few symptoms and the location at the ulna is exceptional. Complete surgical resection is a viable treatment option.</span> </p>
文摘The problem of access to quality water is a major challenge, as it has a major impact on the socio-economic conditions of people in developing countries. The water from the islands of Lake Fitri is one of the main sources of drinking water for the population. The aim of this study is to characterise and assess the quality of the water and sediment from the islands (Moudou and Birguime) of Lake Fitri, and to confirm the strains isolated using the PCR method. A total of fifty (50) samples of water and fifty (50) sediments from the islands of Lake Fitri were analyzed. Standard methods of microbiological and biochemical analysis of water and sediments were used. Isolated Enterobacteriaceae strains were characterized by API 20 E and API Staph galleries and Salmonella was confirmed by PCR method. Antibiotic resistance was determined using a technique recommended by the antibiogram committee of the French microbiology society (CA-SFM, 2019). The microbiological results for the water showed an abundance of total aerobic mesophilic flora (TAMF) (4.31 × 106 ± 8.05 × 105 and 5.29 × 106 ± 2.55 × 105) on the Birguime and Moudou islands successively. The microbiological results for the sediment from Birguime and Moudou islands showed an abundance of thermotolerant coliforms (E. coli) (2.05 × 105 ± 5.43 × 104 and 2.27 × 105 ± 3.49 × 104) alternately. The results obtained after incubation of the biochemical tests by the API 20E, API Staph gallery and their numerical profile proposed by the Api software confirmed the contamination. The antibiogram results showed the emergence of certain resistances to the antibiotics Tobramycin, Flucytosine, Amikacin and Teicoplani. The PCR results for Salmonella spp strains were confirmed. As a result, strict monitoring of the water on the various islands of Lake Fitri must be carried out throughout the annual cycle, by specialized personnel, to ensure proper bio-monitoring of these ecosystems.
文摘Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.
文摘Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteristics of the epidemiological, clinical, biological, etiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective and descriptive study from January 2021 to December 2021 which took place in the pediatrics department of the Mother and Child University Teaching Hospital of N’Djamena (CHU-ME). All the children in whom we observed abnormal involuntary movements whose age was less than or equal to 15 years were concerned. Result: there were three female children. The average age was 7.5, of which the two are 7 years old and the third is 8 years old. Two had a history of angina. A notion of polyarthralgia and dental caries was found in the third. The diagnosis of post-streptococcal chorea was retained on the basis of clinical arguments: observation of abnormal movements of the limbs and the face, which are involuntary, sudden with an insidious and progressive onset, muscular hypotonia, and psychic disorder. Medical imaging, in particular echocardiography, which objectified two cases of associated rheumatic valvular disease. Remission was observed in all three children after two weeks of treatment with haloperidol, penicillin. Those with associated rheumatic valve disease also received corticosteroid therapy. Complete remission of chorea was observed in all three girls. Prophylaxis in two patients based on Penicillin V was instituted. Conclusion: Although less frequent, post-streptococcal chorea is still seen in our country and is still an important health problem that needs more real medical efforts.
文摘Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% respectively. Conclusion: This study revealed that the medicinal plants are variously used in the treatment of infection urinary tract in the city of N’Djamena.
文摘Introduction: Urolithiasis in children is not sufficiently documented in Chad. Objectives: The aim of this work was to report the epidemiological, clinical and therapeutic aspects of urolithiasis in children in our environment. Patients and methods: This was a descriptive retrospective study of patients aged 0 - 15 years treated for urolithiasis between January 2015 and July 2020. The variables studied were age, gender, clinical, paraclinical and therapeutic aspects. Results: Among the 191 children, there were 164 boys (85.9%) and 19 girls (9.9%). The sex ratio was 8.63. The average age was 5.86 years with extremes (1 and 15 years). The symptomatology was dominated by dysuria. The ASP-ultrasound pair allowed the diagnosis in 183 cases (95.8%). The site of the calculus was bladder in 128 cases (67%). The average calculation size was 2.81mm. A supporting cause was found in only 1 case (posterior urethral valve). Treatment was surgical and dominated by cystolithotomy. The postoperative course was marked by 5 cases of parietal infections (2.6%) and 3 cases of vesico-cutaneous fistulas (1.6%). No case of death has been reported. Conclusion: Lithiasis is more common in boys in the lower urinary tract. Open surgery remains the only one practiced. Etiological research must be carried out to develop prevention strategies.
文摘Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena Mother and Child University Hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.
文摘Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the Department of Mayo-Boneye. Methodology: This is a prospective observational study that took place from October to December 2021, including 168 patients with their sociodemographic characteristics. The venous blood of the patients was collected in dry tubes and centrifuged to obtain the serum. The Chlamydia IgG Rapid Test Cassette was used for the detection of antibodies to Chlamydia infection. The Epi Info 7<sup>TM</sup> software was used to perform the statistical analyses. Results: A total of 168 patients were included in this study. The average age was 26.36 ± 9.21 years, the median was 25.5 years with the extremes of 14 years and 70 years. Among these patients, 46.43% were illiterate, 5.95% and 20.83% were primary and secondary school students, respectively, and 26.79% university students. For marital status, 66.67% were single, 16.67% married, 10.71% divorced and 5.95% widowed. Regarding the profession, 26.79% were traders, 8.93% were employees and 64.29% unemployed. In this study, the 168 patients had performed Chlamydia trachomatis serology among whom 02 (1.19%) were excluded for invalid results and 10.71% presented positive cases. The city of Bongor was the most infected with 61% of cases. Among these patients, 54.22% were linked to risk factors for Chlamydia trachomatis. The most infected age group was between 25 and 35 with a seroprevalence of 5.36% of cases. Conclusion: In this study, Chlamydia trachomatis was positive for 10.71% of diagnosed cases. The most affected age groups are young, sexually active women. The State should emphasize the screening of women, the awareness of students and academics.
文摘Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of morbidity and mortality which varies between 6% - 33%;their management remains a big challenge. These patients frequently face complications, and a well-organized multidisciplinary approach must be implemented in their management to improve outcomes. Objectives: Our study aims to assess the prevalence, management and outcomes of enterocutaneous fistulas in Buea regional hospital and Laquintinie hospital of Douala over the past 5 years. Methods: This was a hospital-based retrospective study in Buea regional hospital and Laquintinie hospital of Douala. Records of patients who had enterocutaneous fistulas within the period of 1<sup>st</sup> January 2017 to 31<sup>st</sup> December 2020 in the surgical departments. Data included demographics, pre-operative diagnosis, comorbidities, type of fistula, management modality and means, the indication of operative treatment, length of stay in the hospital and outcomes. Data was analysed using SPSSv26. Results: The study constituted 1343 medical records of which 83 medical records of patients with enterocutaneous fistulas, giving a prevalence of 6.2%, female predominance at 59% (n = 49), 42.2% (n = 35) were referred cases from the periphery for better management. A vast majority (96.4%) occurred as post-operative complications with appendectomy the most common indication (18.8%). High output fistulas were predominant (43.4%). 59% (n = 47) were managed medically, 6% (n = 5) received both conservative and surgical modalities while 35% (n = 5) were managed surgically. 64.1% (n = 50) were placed on enteral nutrition while 35.9% (n = 28) were placed on parenteral nutrition. Peritonitis/infection 50% (n = 18) was the commonest indication of surgical treatment, followed by failure of medical treatment 25% (n = 9) then high output fistulas 16.7% (n = 6). Resection with end-to-end anastomosis was the preferred repaired work at 61% (n = 22). The mortality rate was 38.5% (n = 32), 29% (n = 24) healed after conservative treatment, 21.7% (n = 18) healed after surgery, 7.2% (n = 6) persisted after surgery while 3.6% (n = 3) persisted after conservative treatment. Anaemia, sepsis, electrolyte imbalance, dehydration and malnutrition were the commonest complications. Conclusion: The prevalence of enterocutaneous fistulas was high, with a female predominance and a mean age of 38 years. Most cases were seen as a referral from the periphery for better management. The greatest majority of fistulas occurred as a postoperative complications. Conservative management with enteral feedings was preferred, they had better outcomes and gave more chances of healing. The commonest indication of surgical treatment was an infection. Resection with end-to-end anastomosis was the preferred repaired work. The mortality rate was high, and anaemia, sepsis and electrolyte imbalance were the commonest complications.
