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Therapeutic Itinerary and Causes of Delay in Specialized Consultation of Patients Admitted for Diabetic Foot

Journal of Diabetes Mellitus 2018年第4期8卷 125-130页

作者： Comlan Jules Gninkoun Mensah S.Attikleme Roberto Dossou Tores Prudencio adebayo sabi cossi alassani Francois Djrolo Endocrinology Metabolism and Nutrition UnitFaculty of Health Sciences of CotonouCotonouBenin University Clinic of Internal Medicine and Medical Oncology CotonouBenin Teaching Hospital of Borgou-Alibori ParakouBenin

Introduction: Amputation remains a common practice in patients admitted for diabetic foot. The delay in consultation is one of the main reasons. The objective of this work was to analyze patients’ itinerary care and to identify the causes of delay in consultation in patients admitted for diabetic foot. Method: This is a descriptive cross-sectional study, including all patients hospitalized for diabetic foot. A wait of at least seven (7) days before consulting the Endocrinology department of Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) after the foot injury occurred was considered as delay in consultation. The data were recorded and analyzed in the EPI INFO software. The description of the sample was made according to the usual statistics (frequency, average, standard deviation). Results: Seventy-six (76) diabetic foot cases were admitted during the period of the study. The mean age of the patients was 56.64 ± 10.71 years with extremes of 29 years and 84 years. Patients were most often received at an advanced stage of the foot injury, 3D stage of Texas classification in 87% of cases and Wagner grades 4 and 5 in 52% of cases. The amputation rate was 38.16%. An analysis of the first care places reveals that 90.8% of patients had consulted conventional medicine, 13.2% in traditional medicine;1.2% had religious practices and 18.7% had declared self-medication at home. Consultation period at CNHU HKM was more than 7 days in 80% of cases and less than 7 days in 20% of cases. The average consultation time was 44.08 ± 26.43 days with extremes of 1 and 480 days. The main reasons for the delay in seeking hospital care cited by diabetic patients were fear of amputation (47.8% of cases), economic difficulties (32.5% of cases) and awareness lack of the situation seriousness (22.4%). Conclusion: The therapeutic itinerary of patients with diabetic foot was particularly long. The main reasons of late appeal to specialized care were fear of amputation and economic difficulties.

关键词： Therapeutic Itinerary Diabetic Foot Delay Complication Amputation

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Diabetic Ketosis Decompensations at the National Hospital in Benin (West Africa), What Did We Learn about the Precipitating Factors?

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Journal of Diabetes Mellitus 2016年第4期6卷 301-306页

作者： Comlan Jules Gninkoun Adébayo sabi cossi alassani Yempabou Sagna Philippe Adjagba François Djrolo Department of Internal Medicine-Endocrinology Metabolism and Nutrition Unit Cotonou Benin University Hospital of Borgou Parakou Benin Department of Internal Medicine University Hospital Yalgado Ouedraogo Ougadougou Burkina Faso Cardiology and Vascular Disease Unit Cotonou Benin

We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of ketosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the ketosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of ketosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that ketosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.

关键词： Ketoacidosis Diabetes Complications Ketosis-Prone

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Frequency and Factors Associated with Gender-Based Violence in the Northern Region of Benin from 2016 to 2022

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Open Journal of Internal Medicine 2024年第3期14卷 287-298页

作者： Comlan Albert Dovonou cossi Adébayo alassani Khadidjatou Saké Alassan Sero Tamou cossi Angelo Attinsounon Séraphin Ahoui Finangnon Armand Wanvoegbe Departmental University Hospital Center of Borgou and Alibori Parakou Benin Departmental University Hospital Center of Oum and Plateau Porto-Novo Benin

Introduction: Gender-based violence constitutes a public health problem. The objective of this study is to determine the frequency and factors associated with gender-based violence. Study Framework and Method: This was a retrospective, descriptive, cross-sectional study with an analytical aim over the period from January 2016 to December 2022. The study took place in the Integrated Support Center for Victims and Survivors of Gender-Based Violence located in the Departmental University Hospital Center of Borgou and Alibori. The study population consisted of people who were victims of gender-based violence in the northern region of Benin, regardless of their age and gender. Results: The study population consisted of 1198 subjects. The average age of the victims was 21.76 ± 10.02;female victims represented 96.4%, with a sex ratio equal to 0.037 (43/1155). Sexual violence was the most represented (50.25%), followed by psychological (29.30%), physical (24.37%), economic (13.77%) and property (2%). The factors associated with violence were married people and monthly income (physical violence), minors, female gender and single people (sexual violence), polygamous households and monthly income (economic violence), the absence of children burden, married people and monthly income (psychological violence), married people (property violence). Conclusion: Gender-based violence is frequent in the North of Benin and is dominated by sexual violence. The victims are mainly female.

关键词： Frequency Gender-Based Violence North Benin

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Virological Therapeutic Failure and Associated Factors in People Living with HIV Followed up at the Regional Hospital and University of Borgou (RHU-B) in 2019

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Open Journal of Internal Medicine 2022年第2期12卷 121-128页

作者： Dovonou Comlan Albert alassani Adébayo Saké Alassan Khadidjatou Mama Cissé Ibrahim Attinsounon cossi Angelo Faculty of Medicine University of Parakou Parakou Benin

Introduction: Antiretroviral treatment has made a considerable reduction in morbidity and mortality in HIV patients, but its effectiveness is compromised by the emergence of cardiovascular and metabolic diseases and also treatment failure. The goal is to study Virological therapeutic failure and the factors associated with HIV patients followed at RUH-B. Methods: This was a cross-sectional, descriptive and analytical study covering the period from 21st July to 21st September 2019. The study enrolled patients 18 years old and above, on antiretroviral treatment for at least 6 months. For the survey, a questionnaire and review of the medical records were used. The variable studied was virological treatment failure. Data analysis was performed using EPI-INFO version 7 and STATA 11 software. The significance level was 5%. Results: A total of 498 patients were included in the study. The mean age was 40 ± 9.90 years. The sex ratio was 0.3. The frequency of treatment failure was 15.3%. The factors associated with the occurrence of treatment failure were: phytotherapy, occurrence of opportunistic infections during follow-up, poor compliance with antiretrovirals, lack of weight gain and anemia during follow-up. Conclusion: This study had shown that treatment failure was frequent in patients. The systematic investigation for failure should be done in all people living with HIV patients on antiretrovirals.

关键词： Virological Therapeutic Failure Antiretroviral Associated Factors HIV Parakou Benin

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Self-Medication Practice against Malaria and Associated Factors in the City of Parakou in Northern Benin: Results of a Population Survey in 2017

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Advances in Infectious Diseases 2019年第3期9卷 263-275页

作者： cossi Angelo Attinsounon Yollande Sissinto Euripide Avokpaho Adébayo alassani Majid Sanni Marcel Zannou Faculty of Medicine CHUD-Borgou Teaching and Research Unit of Infectious and Tropical Diseases University of Parakou Parakou Bénin University of Parakou CHUD-Borgou Clinic of Internal Medicine Parakou Bénin University of Abomey Calavi CNHU-HKM Laboratory of Parasitology-Mycology Cotonou Bénin University of Abomey Calavi CNHU-HKM Clinic of Internal Medicine Cotonou Bénin

Introduction: Self-medication is a common practice in Benin. It has many consequences on people’s health in general and develops chemoresistance in particular. Aim: The aim of this work is to study the practice of anti-malarial self-medication in the city of Parakou and to identify the associated factors with this practice. Methods: This was a descriptive cross-sectional analytical survey that took place in the period from April 15 to June 24, 2017. Adults who reported having had malaria symptoms in the last 6 months before the survey and living in 9 neighbourhoods randomly selected in the city of Parakou were included. A structured questionnaire collected their self-medication habit, the drugs used, the supply places and the reasons for this practice. Data were analysed using the Epi-data 3.1 software. Results: Of the 335 respondents included in this study, 141 (42.09%) had self-medicated including 130 (38.81%) with anti-malarial drugs. Fever is the main symptom of malaria cited by respondents (129% or 38.51%) followed by headache (93% or 27.76%). The most commonly used anti-malarial drugs for self-medication are quinine (60% or 44.45%) followed by artemisinin-based combination therapy (46% or 34.07%). Eighty-seven respondents (66.92%) did not have a good knowledge of the drug dosage. Reasons for self-medication were mainly the high cost of consultation fees (99% or 54.10%) and good knowledge of one’s illness (53% or 28.96%). Self-medication associated factors were fever (p = 0.04), non-prescription drugs supply in pharmacies (p Conclusion: Self-medication is a common practice in the city of Parakou. Medicines purchased without prescription in pharmacies and drugs availability in street facilitate this practice, which may compromise the effectiveness of anti-malarial drugs.

关键词： Self-Medication Anti-Malarial Drugs Urban Setting Parakou Benin

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Frequency and Factors Associated with Erectile Dysfunction in People Living with HIV Managed in the Department of Internal Medicine at the Departmental Hospital University of Borgou (DHU-B) in 2017

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Open Journal of Internal Medicine 2022年第2期12卷 112-120页

作者： Dovonou Comlan Albert alassani Adébayo Attinsounon cossi Angelo Mama Cissé Ibrahim Sake Alassan Khadidjatou Faculty of Medicine University of Parakou Parakou Benin

Introduction: Highly active antiretroviral treatment has considerably reduced the morbidity and mortality associated with HIV infection. However, we are witnessing the emergence of cardiovascular and metabolic diseases. The aim of this work is to study erectile dysfunction (ED) and the associated factors with HIV positive people managed DHU-B. Methods: This was a cross-sectional, descriptive and analytical study covering the period from March 1, 2017 to June 31, 2017. The study involved HIV-positive patients 18 years old and above, male, under antiretroviral treatment and have given their consent. ED was assessed by the IIEF5 score (International Index of Erectile Function). The data collected had been recorded and processed with the EPI INFO software (Version 7.2). The significance level was 5%. Results: A total of 280 patients were included in the study. The average age was 42 ± 10.04 years with extremes of 23 and 67 years. The prevalence of ED was 52.14%. Among patients with ED, 41% had severe ED. Factors associated with ED in multivariate analysis were: age over 40 years, anxiety, depression, arterial hypertension, lipodystrophy, multiple sexual partners and protease inhibitor therapy. Conclusion: ED concerns half of HIV-infected patients followed in the Internal Medicine department. It is therefore essential to provide more comprehensive care, both clinically and psychologically, in order to improve the quality of life of people living with HIV.

关键词： Erectile Dysfunction Associated Factors HIV Parakou Benin

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Epidemiological, Clinical and Paraclinical Aspects of Cirrhosis at Borgou Departmental University Hospital Center (Benin)

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Open Journal of Internal Medicine 2018年第2期8卷 113-122页

作者： Comlan Albert Dovonou cossi Adébayo alassani Kadidjatou Sake cossi Angelo Attinsounon Angèle Azon-Kouanou Agossou Romaric Tandjiekpon Djimon Marcel Zannou Fabien Houngbe Medicine Department and Medical Specialities Medical Faculty Parakou University Parakou Benin Internal Medicine Department Departmental Hospital Center of Borgou Parakou Benin Medicine Department and Medical Specialities of Cotonou Health and Science Faculty Cotonou Benin

Objective: To study the epidemiological, clinical and paraclinical aspects of cirrhosis at Borgou Departmental University hospital Center. Methods: This is a retrospective study for descriptive purpose conducted in the Internal Medicine Department. The study population consists of patients hospitalized in the Internal Medicine Department during the period from 1st January 2009 to 31st December 2016. Results: The frequency of cirrhosis was 1.35%. The sex ratio was 3.76. The average age of patients was 45.22 ± 15.23 years old, with a range from 15 to 82 years. There is a post hepatitis Bcirrhosis predominance in 87.5% of cases, followed by alcoholic cirrhosis in 21.59% of cases. The complications of cirrhosis are dominated by ascites (78.4%) and jaundice (52%). Conclusion: Cirrhosis is a condition that is wide spread. The hepatitis B virusis the main cause of liver cirrhosis followed by alcoholism. Ascites is the most encountered complication. It’s very important now to educate the populations for a behaviour change and to promote vaccination against viral hepatitis.

关键词： Epidemiology Hepatic Cirrhosis Parakou Benin

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Factors Associated with Hypovitaminosis D in People Living with HIV/AIDS (PLWHA) Followed up in Porto-Novo in 2019

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Food and Nutrition Sciences 2021年第11期12卷 1020-1027页

作者： alassani Adébayo Gninkoun Comlan Jules Mizèhoun-Adissoda Carmelle Dovonou C. Albert Attinsounon cossi Wanvoégbè Armand Medicine and Medical Specialties Faculty of Medicine University of Parakou Parakou Benin Medicine and Medical Specialties Faculty of Medicine University of Abomey-Calavi Abomey-Calavi Benin

Background: Vitamin D deficiency is very common among PLWHA compared to the general population and is promoted by several factors. Aim: To identify the factors associated with hypovitaminosis D in people living with HIV/AIDS (PLWHA) followed up in Porto-Novo in 2019. Methods: This was a cross-sectional, descriptive and analytical study. PLWHA who were monitored on an outpatient basis and who gave their consent were included in this work. Subjects unable to answer questions or under ongoing vitamin D supplementation or suffering from chronic liver diseases were not included. Hypovitaminosis D was defined by a blood level of 25 hydroxy-vitamin D less than 30 ng/mL. Results: A total of 270 PLWHA were included in the study. The mean age of the patients was 39.51 ± 6.85 years with a female predominance (73.3%). The frequency of hypovitaminosis D was 56%. Hypertension, low protein intake, anemia and low glomerular filtration rate were associated with vitamin D deficiency. Conclusion: Vitamin D deficiency is common among PLWHA, which justifies routine screening, especially among those at risk.

关键词： Hypovitaminosis D PLWHA Malnutrition Denutrition Porto-Novo

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Contribution to the Study of Irritable Bowel Syndrome in Medical Students at the University of Parakou in Republic of Benin

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Open Journal of Gastroenterology 2023年第7期13卷 256-266页

作者： Khadidjatou Saké Aboudou Raimi Kpossou Adébayo cossi alassani Doriane Berline Magatsing Nzekou Serge Ade Angelo cossi Attinsounon Comlan Albert Dovonou Stéphane Kofi-Mensa Savi de Tovè Jean Sehonou Department of Medicine and Medical Specialties Faculty of Medicine University of Parakou Parakou Republic of Benin Department of Medicine and Medical Specialties Faculty of Medicine University of Abomey-Calavi Abomey-Calavi Republic of Benin

Introduction: Irritable bowel syndrome is the most common functional gastrointestinal disorder. The objective of this work is to contribute to improving the medical follow-up of medical students at the University of Parakou through a study of irritable bowel syndrome. Study Methods: This was a descriptive and analytical cross-sectional study with prospective data collection. Data were collected from medical students from May 2018 to July 2018 using a pre-established questionnaire. Sampling was probabilistic using a two-stage survey. The diagnostic tools were: Rome IV criteria, Bristol scale and HAD (hospital anxiety and depression) scale. Data analysis was performed using Epi Info 7.***.3.14 software. CDC. Results: Thirty-two (7.55%) of the 424 students included had irritable bowel syndrome. Out of the 32 students with IBS, 24 (75%) were female. Their average age was 21.38 ± 2.39 years. For 24 students (75%), the symptoms occurred at the same time as exam preparation or the intense course period. Of the 32 students with IBS, 1 (3.12%) was regularly physically active. In this series, 8 students (28%) consulted a doctor for their symptoms. The factors associated with this syndrome were female sex (p = 0.022), sleep disorders (p = 0.008) and the presence of a doubtful depression (p = 0.021). Absenteeism due to irritable bowel syndrome was noted in 18 (56.25%) students. Conclusion: Irritable bowel syndrome is a common condition among medical students in Parakou. Support for better management of psychological disorders could improve the quality of life of these students.

关键词： Irritable Bowel Syndrome Medical Students Parakou Republic of Benin

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Clinical and Immunological Characteristics in HIV-Infected Patients at the Treatment Initiation at the University Hospital of Parakou (Benin)

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Open Journal of Immunology 2017年第3期7卷 51-58页

作者： Dovonou Albert Comlan alassani Adébayo cossi Attinsounon cossi Angelo Saké Kadidjatou Adè Serge Ahoui Séraphin Degla Jivather Tchégnonsi Tognon Francis Zannou Djimon Marcel Adè Gabriel Houngbé Fabien Departemental Teaching Hospital of Borgou Parakou Benin National Teaching Hospital Cotonou Benin

Goal: To describe the clinical and immunological characteristics in the HIV-infected patients at the antiretroviral treatment initiation. Methods: This was a descriptive and retrospective study on the cohort of the patients living with HIV followed at Parakou teaching hospital from the 1st January 2004 to the 31st December 2012. Persons under the age of 15 and the pregnant women have been excluded from the study. Results: The active file was composed of 988 patients under antiretroviral treatment. They were 339 men and 649 women. The sex ratio was 0.52. The average age of the patients was 35.49 ± 9.72 years. The immunodeficiency was profound with 57.65% of patients at the stage 3 of WHO and 42.35% at the stage 4. Opportunistic infections at the antiretroviral treatment initiation were dominated by oral candidiasis (30.16%), the diarrhea (20.45%) and zona (11.03%). Conclusion: HIV infection touched young adults who consult at an advanced stage of immunodeficiency.

关键词： Clinical Immunological HIV Parakou Benin

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