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Assessment of Haemostasis in Anaesthesia for Surgery at the Sylvanus Olympio University Hospital Center in Lomé

Open Journal of Anesthesiology 2021年第6期11卷 184-193页

作者： Essohanam T. Mouzou Sarakawabalo Assénouwè abd el kader moumouni Pikabalo Tchètikè Akala-Yoma Gnimdou Anesthesilogy Department University Teaching Hospital of Kara Kara Togo Anesthesiology Department Sylvanus Olympio Teaching Hospital Lome Togo Neurosurgery Department University Teaching Hospital of Kara Kara Togo

Title: Assessment of haemostasis in anaesthesia for surgery at the Sylvanus Olympio University Hospital Center in Lomé. Objectives: Evaluate the prescription of the preoperative haemostasis assessment. Methodology: This was a prospective descriptive and observational study which had taken place in the central operating room and in the operating room of the ENT department at UHC SO of Lomé from January 1 to June 31, 2016. It had concerned all patients who had anaesthesia for scheduled surgery after pre-anesthetic consultation and the haemostasis assessment carried out according to the anaesthesia technique and the type of surgery. Results: Two hundred and sixty (260) patients underwent anaesthesia during the study period. The male sex predominated (60%), the age group 18 - 40 years predominated (50.4%). GA was more practiced (62.7%) followed by spinal anaesthesia (30.3%). Minor ENT surgery was more performed (28%). ASA1 patients predominated (48.5%). The pre-anesthetic haemostasis assessment including platelet count, prothrombin rate, activated partial thromboplastin time and bleeding time was almost always done. The platelet count was achieved in all patients followed by the activated partial thromboplastin time (94%). No haemorrhagic complication related to a haemostasis disorder was observed in the perioperative period in anaesthesia than in surgery. Conclusion: The prescription of the pre-anesthetic haemostasis assessment should not be systematic. It must take into account the clinical history, the patient’s bleeding history during the anaesthesia consultation, the type of anaesthesia, the surgery planned and the age.

关键词： Haemostasis Assessment Anaesthesia Surgery UHC Lomé

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Intradural Extra Medullary Cervical Anaplastic Ependymoma. Case Report and Review of the Literature

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Open Journal of Modern Neurosurgery 2018年第4期8卷 414-423页

作者： Daniel Memia Zolo abd el kader moumouni Anabi Daouda Diakhate Dabou Abiba Tamoutabe abderrahman Hamlat Department of Neurosurgery CHU Martinique France Department of Neurosurgery CHU Kara Togo Department of Neurosurgery CHU Sylvanus Olympio Lomé Togo Department of Radiology HIA Parakou Benin

Introduction: Intra-dural and extramedullary ependymomas are rare lesions. We report a clinical case confirmed by the histology supported by the neurosurgery department of Martinique University Hospital. Clinical, paraclinical and therapeutic data will be compared to a literature review. Observation: A 38-year-old patient was admitted for tetraparesthesia evolving since 3 months, associated with a left hemiparesis. The clinical examination revealed deterioration of the general condition and a tetrapyramidal syndrome. MRI of the cervical spine revealed extensive cervical extra-medullary intradural lesion of C3 to C5. The treatment had been an excisional surgery that had been subtotal in two stages, supplemented by craniospinal radiotherapy because the pathological examination had found a grade III anaplasic ependymoma. Conclusion: Because of their rarity, the treatment of these forms of ependymoma is not yet well codified.

关键词： Intradural Extramedullary Anaplasic Ependymoma Surgery Radiotherapy

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Pre-Hospital Management of Craniocerebral Trauma in South Saharan Africa: Cotonou Experience

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Open Journal of Modern Neurosurgery 2019年第3期9卷 221-226页

作者： abd el kader moumouni Essossinam Kpelao Holden Olatoundji Fadigba Agbeko Achille Doleagbenou Ibrahima Berete Dabou Abiba Tamou Tabe Emile Mensah Martin Chobli CHU KARA Kara Togo SAMU Benin Cotonou Benin CHU Sylvanus Olympio Lomé Togo University of Parakou Borgou Benin Universite Gamal de Conakry Conakry Guinee HIA Parakou Parakou Benin SAMU Benin of Parakou Borgou Benin

The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emergency Aid Medical Service (EMAS) of BENIN in the pre-hospital management of craniocerebral trauma. 146 head injuries were cared for. 116 were male. The mean age was 32 years with extremes ranging from 2 to 77 years. Etiology in 68% of patients was a public road accident. And the request for the use of the EMAS was made by highway users for 41% of the injuries. About 5.5% were severe cranio-brain injuries, more than 75% of which had died in intensive care. In 77% of the EMAS interventions, there was an intensive care physician in the team. 34 wounded had been transported in a vacuum mattress. The rigid cervical collar was used in 8 major traumas. All the wounded were transported by ambulance. The duration of hospitalization varied from a few hours in the emergency department to 90 days in the hospital ward. 9 patients died. One of them, who died in an ambulance, was a woman. The prehospital medical care of head trauma in BENIN is still progressing.

关键词： Emergency Craniocerebral Africa South-Sahara Pre Hospital Management

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Contribution of Surgery in the Care of Intracranial Hematomas in Developing Countries: Case Series of 30 Patients in Abidjan

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Open Journal of Modern Neurosurgery 2018年第4期8卷 406-413页

作者： abd el kader moumouni Romuald Kouitcheu Essohanam Kpelao abdoulaye Ouattara Moussa Diallo Dabou Abiba Tamou Tabe Ibrahima Berete Daniel Memia Zolo Pascal Compaore Aderehime Haidara Department of Neurosurgery CHU Yopougon Abidjan Ivory Coast Intensive Care Unit CHU Cocody Abidjan Ivory Coast Department of Neurosurgery CHU Sylvanus Olympio Lomé Togo Department of Radiology HIA Parakou Benin Department of Neurosurgery Faculty of Medicine University Gamal Abdel Nasser Guinea Conakry Department of Neurosurgery CHU Martinique Martinique

Intracranial hematomas, whatever its causes, represent an important disabling, and dreaded adult’s lesion. This brain’s condition has not well been studied in developing countries. The aim of our study is to overview the management of intracaranial hematomas in Abidjan. It is a retrospective analytical and descriptive study, involving patients who had been admitted and monitored by neurosurgeons for intracranial hematomas, documented in brain CT scan and had been operated on from 1 January 2007 to December 31, 2009 in Abidjan. These 30 patients were 23 men and 7 women. The average age was 58.6 years old. 90% of the patients were admitted with wakefulness issues. Half had a Glasgow score of less than 8. The brain scanner allowed identification of an intraparenchymal hematoma associated or not with a cerebral ventricle contamination in 28 patients. There were 18 external ventricle derivations with or without decompressive craniectomy and 12 independent decompressive craniectomy. The evolution was marked by 20 deaths. 10 patients (33.3%) survived. Among the survivors, the first attack and arterial hypertension were the only illness before the attack. None had blood in the membranes and all had Glasgow scores greater than or equal to 9 at admission. Around 7 out of 10 patients were operated on during the first 48 hours. The operative indications of intracranial hematomas are still the subject of controversy. By basing itself on criteria and rigorous clinical and neuroimaging selection, surgery could eventually contribute to the management of this pathology which has become very frequent in Africa.

关键词： Spontaneous Intracranial Hematomas Surgery Developing Countries

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Neurological Sequelae in Cranioencephalic Trauma Patients at the National Hospital in Zinder (Niger)

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Open Journal of Modern Neurosurgery 2022年第2期12卷 104-115页

作者： Mahaman Sani Rabiou abd-el kader moumouni Abiba Tamou Tabe Essosinam Kpelao Stackys Hounkpatin Moussa Taofik abdoulaye Adamou Babana Dede Regine Diane Ajavon Aminata Kelani Soumaila Sanoussi Depetement of Neurosurgery Zinder Hospital Zinder Niger Department of Neurosurgery Kara University Hospital Center KaraTogo Depeartment of Radiology Kara Regional Hospital Center Kara Togo Department of Neurosurgery Syvanus Olympio University Hospital Center Lome Togo Depetement of Traumatology Zinder Hospital Zinder Niger Department of Neurosurgery Maradi Niger Reference Hospital Maradi Niger Faculty of Health Sciences University of Kara Kara Togo Depetement of Neurosurgery CHU Niamey Niamey Niger

Introduction: Cranioencephalic trauma is a frequent reason for admission to emergency departments and is a source of mild to severe neuropsychological defects that will persist over time. Their management remains difficult. Objectives: To evaluate the sequelae presented by patients suffering from cranioencephalic trauma. Methods: This was a retrospective, descriptive, cross-sectional study conducted at the National Hospital of Zinder. It will include all patients admitted and hospitalised in the emergency, intensive care and neurosurgery departments of Zinder National Hospital for head injury over a period of 28 months from 1 January 2016 to 30 April 2018. Brain scan, X-ray were the imaging tests used. Results: Out of a total of 974 admissions, 367 were retained, i.e. 37.6%, with a male predominance (82.6%). The average age was 26.5 years. MVAs were represented in 89.7% of cases. Moderate CTE accounted for 64% of cases. Altered consciousness was reported in 295 patients (80.38% of cases). Brain scans were used in 76.7% of cases and skull X-rays in 4.2% of cases. Medical management was performed in all patients. Treatment was operative in 78 patients (21.25%). Recovery without immediate sequelae was found in 187 patients (50.9%). Persistent headache represented 47.7% of the late sequelae observed in the patients, epileptic seizures represented 16.8% of the late sequelae, neurological deficit represented 14.7%. Conclusion: Cranioencephalic trauma represents a major public health issue. Although their in-hospital management remains a challenge, post-hospital management related to the appearance of sequelae remains another.

关键词： Cranioencephalic Trauma CT Scan X-Ray Sequelae Niger

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Brain Amyloidoma: Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2020年第4期10卷 403-421页

作者： abd el kader moumouni Daniel Memia Zolo Essossinam Kpelao Pascal Compaore Dabou Abiba Tamou Tabe Latevi Lawson Pwerew Rodolphe Plante Edem Kossi Gueouguede Benedicte Souho abderrahmane Hamlat Department of Neurosurgery CHU Martinique Martinique France Department of Neurosurgery CHU Kara Kara Togo Department of Neurosurgery CHU Sylvanus Olympio Lomé Togo Departments of Radiology CHR Kara Kara Togo

Introduction: Primary deposition of amyloid can take several forms including amyloidoma organ restricted among which is brain. Brain amyloidoma can mimic several lesions and offers a diagnostic challenge to the physician. The present work reports an additional case and summarizes the salient characteristics of previously published cases. Case Report: A 61-year-old, woman experienced paroxystic auditory hallucinations followed at times by generalized tonico-clonic seizures. Examination revealed a mild left pyramidal weakness. Head CT scan and MRI revealed a lobular lesion of the right atrium with contrast enhancement. The diagnosis of amyloidoma Lambda light chain (λLC) type was performed by means of a stereotactic biopsy. The patient was treated by 3 cures of high dose methotrexate (15 mg/m2). At 24 months follow up the patient remains stable clinically and biologically. The 2 years follow-up MRI showed the same findings. Conclusion: No guidelines can be suggested for brain amyloidoma treatment;the “wait and see” was the mind-set in the literature. However, a non-tumour like pattern of a cerebral mass developing near the ventricle with a fine, irregular radiating margin enhancement and lack of oedema, and mass effect are important MRI clues for brain amyloidoma diagnosis. The diagnosis is histological after biopsy or excision.

关键词： Amyloidoma Brain Literature Review

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Hospital Information Systems Shortage in Sub-Saharan African Hospitals: Opportunities and Challenges

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E-Health Telecommunication Systems and Networks 2022年第1期11卷 1-13页

作者： abd el kader moumouni Dede Regina Ajavon Komlan Agbeko Doleagbenou Dabou Abiba Tamou Tabe Kodjo Mensah Hobli Ahanogbe Massaga Dagbe Akoete Simon Gbessena Komi Amagnga Desama-Esso Banawe Tchilabalo Bamazi Amona Department of Surgery CHU Kara Kara Togo Department of Gynaecology and Obstetrics CHR Tomde Kara Togo Department of Surgery CHU Sylnanus Olympio Lomé Togo Radilogy Department CHR Tomde Kara Togo Radilogy Department CHU Kara Kara Togo Department of Network and Computer Maintenance CHU Kara Kara Togo

The HIS is recognised as an essential tool for optimising the management of a health establishment in particular and the health system in general. But it is still very little implemented in hospitals in the South. Open source HIS software, available on the Internet, can be a solution for starting a (HIS) project in these hospitals. A search on the Internet for open source HIS software allowed us to choose MedBoard, the second most popular open source software out of 381, to start an HIS project called PERFORMANCE at the Kara University Hospital in northern Togo. A questionnaire allowed us to assess the level of knowledge of health actors on hospital information systems. The results of this evaluation allowed us to strengthen our proposal. The analysis of the current computer park of the CHU Kara does not allow whatever the functionalities of MedBoard to implement PERFORMANCE at the CHU Kara. Logistics are needed to make PERFORMANCE work. The real difficulty to start and perpetuate HIS project is linked to the human factor.

关键词： Free Software Hospital Information System Performance Chu Kara

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Pseudotumoral Chronic Subdural Hematomas on Two Cases

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Open Journal of Modern Neurosurgery 2018年第1期8卷 72-76页

作者： Essossinam Kpélao Kadanga Anthony Békéti Komi Egu Komlan Messan Hobli Ahanogbe abd el kader moumouni Agbeko Komlan Doléagbenou Essolim Hodabalo Bakondé abdoul Kérim Ouiminga Service de Neurochirurgie CHU Sylvanus Olympio Lomé Togo Service de Neurochirurgie CHU Yalgado Ouagadougou Burkina Faso

Introduction: Calcified forms with pseudo-tumor symptomatology of chronic subdural hematomas are rare. They are the result of slow bleeding over several years. The main etiology is related to the complications of the ventriculo-peritoneal shunt (VP). The purpose of this study was to recall the peculiarities and physiopathology of its pseudotumoral hematomas through 2 observations. Observation: Case 1: 8-year-old patient with a history of ventriculoperitoneal shunt at 3 months of age for congenital hydrocephalus, was admitted for functional impotence of the left-side of the body of insidious onset spreading over 9 months in a chronic headache, blurred vision and generalized seizure. CT scan showed a heterogeneous subdural hematoma of the right frontoparietal with calcifications. The patient underwent an excision by morcellation of a yellowish, friable partly calcific mass. The postoperative history was marked by a total recovery of the neurological deficit. There was no recurrence at 6 months postoperatively. Case 2: 11-year-old adolescent, treated with VP shunt at 6 months of age for post-meningitic hydrocephalus, was admitted for helmet headache, dizziness, lightheadedness and apathy progressing for 3 years. CT scan showed hypodensity of right peri-hemisphere with calcified linings, exerting a mass effect on the medial structures. The patient was given a block excision of a calcific mass with blood content. The evolution was marked by the complete resolution of seizures and hemiparesis. There was no recurrence at 6 months postoperatively. Conclusion: Calcified subdural hematomas are rare and consecutive to the complications of VPS. The clinical signs are those of a benign brain tumor. Treatment is dominated by the difficulties of cerebral reexpression.

关键词： Calcified Subdural Hematomas Pseudo Tumor Symptomatology Overdrainage

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Spondylodiscitis, an Exceptional Complication of Prostate Biopsy: Case Report

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Open Journal of Modern Neurosurgery 2021年第2期11卷 97-101页

作者： abd el kader moumouni Tchilabalo Matchonna Kpatcha Massaga Dagbe Katanga Anthony Beketi Mawouto Akpalou Gnimdou Botcho Komi Hola Sikpa Detema Wenkouda Maba Fabie Opeku Komi Awume Bidamin Ntimon Tchin Darre Neurosurgery Department University Teaching Hospital of Kara Kara Togo Urology Department University Teaching Hospital of Kara Kara Togo Radiology Department University Teaching Hospital of Kara Kara Togo Neurosurgery Department Sylvanus Olympio Teaching Hospital Lomé Togo Surgery Department CHR Atakpamé Atakpamé Togo Bacteriology Laboratory University Teaching Hospital of Kara Kara Togo Pathologyanatomy Laboratory Sylvanus Olympio Teaching Hospital Lomé Togo

Background: Transrectal prostate biopsy is a major prostate cancer diagnosis procedure that can cause infectious complications. Osteoarticular localization is uncommon. Aim: To report a case of spondylodiscitis due to a transrectal prostate biopsy and highlight therapeutical principles. Case Presentation: A 60-year-old male underwent transrectal prostate biopsy performed because of high PSA level, and presented 48 hours later with back pain, fever at 40°C associated with an obnubilation. He was treated for malaria without favorable evolution. Persistance of pain and occurrence of neurologic manifestations motivated dorso-lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) which permitted diagnosis of spondylodiscitis. The treatment was made by triple antibiotic therapy combining Imipenem 500 mg/8h (IV);Ofloxacin 200 mg/12h (IV) and Metronidazole 500 mg/8h (IV) over four weeks. Evolution under treatment was favorable. Conclusion: Spondylodiscitis is an exceptional complication of transrectal prostate biopsy. It may be evocated in case of bones pain after prostate biopsy.

关键词： Spondylodiscitis Prostate Biopsy Complication

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SYSTEMS ENGINEERING RESEARCH

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Journal of Systems Science and Systems Engineering 2008年第3期17卷 319-333页

作者： abd-el-kader SAHRAOUI Dennis M.BUEDE Andrew P.SAGE LAAS-CNRS and Universitéde Toulouse 7 Avenue du Colonel Roche Toulouse31077France Innovative Decisions Inc.2139 Golf Course Dr.RestonVA 20191 USA Dept.of Systems Engineering and Operations Research George Mason UniversityFairfaxVA 22030 USA

In this paper, we propose selected research topics that are believed central to progress and growth in the application of systems engineering （SE）. As a professional activity, and as an intellectual activity, systems engineering has strong links to such associated disciplines as decision analysis, operation research, project management, quality management, and systems design. When focussing on systems engineering research, we should distinguish between subjects that are of systems engineering essence and others that more closely correspond to those that are more relevant for related disciplines.

关键词： Systems engineering systems of systems requirements engineering systems families

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