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Review of maternal Deaths over 3 and a Half Years at the Kara University Hospital Center, Northern Togo: About 65 Cases

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 682-692页

作者： Logbo-akey Kossi Edem Dédé Régine Diane Ajavon Kambote Yendoubé Tenete Assiaham Douaguibe Banguilane Agoro Sibabe Aboubakari Abdoul-Samadou Dé partement de Gyn&#233cologie-Obst&#233trique Universit&#233 de Kara Kara Togo Hopital mè re-Enfat SOS Kara Kara Togo Dé partement de Gyn&#233cologie-Obst&#233trique Universit&#233 de Lom&#233 Lom&#233 Togo Direction ré gionale de la sant&#233 Kara Togo

Objective: To analyze maternal deaths, identify causes and dysfunctions leading to these deaths in order to contribute to the implementation of strategies to reduce maternal mortality at CHU Kara. method: Cross-sectional descriptive study involving 65 cases of maternal deaths recorded at CHU-Kara from January 1, 2018 to June 30, 2021. Results: Our study focused on 65 cases of maternal deaths recorded at the maternity ward of CHU-Kara. The average age was 30 years, with a range of 15 to 45 years. They were mostly housewives (52.3%), uneducated (38.5%), multiparous (41.5%), and referred (86.2%). The causes were mainly direct obstetric causes (81.54%), with preeclampsia and its complications (28.30%) and immediate postpartum hemorrhage (20.75%) being the most common. However, uterine rupture (20.5%) and post-abortion sepsis (16.4%) were the most lethal etiologies. Delayed evacuation (46.43%), inadequate transportation (91%), and insufficient prenatal care (72.31%) were the dysfunctions before referral. Within the CHU Kara, delays in management (58.46%), unavailability of blood and labile products (18%), and insufficient monitoring were the dysfunctions identified. Ninety-five point four percent (95.4%) of the deaths were preventable. Conclusion: The magnitude of intrahospital maternal deaths, the various dysfunctions observed in the occurrence of maternal deaths before referral/evacuation and within the hospital highlight the importance of effectively implementing recommendations from audits in the fight against maternal mortality. The majority of the deaths were preventable (95.38%).

关键词： Review of maternal Deaths CHU Kara Togo

Female Contraception: Comparative Study of Biometrics and Vascularization of the Uterus at Sylvanus Olympio University Hospital (Togo)

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 162-174页

作者： Dédé Régine Diane Ajavon metoukam Andrée Josiane Douaguibe Baguilane Ketevi Améyo Ayoko Logbo akey Kossi Edem Kambote Yendoube m’bortche Bingo Amadou Abdoulatif Aboubakari Abdoul Samadou Faculty of Health Sciences University of Kara Kara Togo Faculty of Health Sciences University of Lomé Lomé Togo Service de gynécologie obstétrique du CHU Sylvanus Olympio Lomé Togo

Female contraception uses both hormonal and non-hormonal methods. The aim of the study is to determine the impact of female contraception on uterine vascularisation and the endometrium. method: It was a descriptive comparative study with an analytical aim. It took place at the University Clinic of Obstetrics Gynaecology and the Radiology and medical imaging Department of Sylvanus Olympio University Hospital in Lomé over a two-month period from may 15, 2023 to July 15, 2023. Group 1 included women using a modern contraceptive method and group 2 women not using a modern contraceptive method. Epidata 3.1 and R 4.0.4 software were used to process the data. Results: Each group included 50 women. There were no significant differences in uterine and endometrial biometrics. All women on contraception had their zone 1 vascularized, without vascularisation of zone 2, without significant difference with women without contraception The pulsatility index was greater than 3 in 51% (n = 51) of women, including 62.7% (n = 32) of women without contraception and 37.3% (n = 19) of women on contraception, with a statistically significant difference (p = 0.009). Conclusion: Contraceptive methods do not influence the biometry of the uterus. However, uterine artery Doppler indices can predict abnormal uterine bleeding.

关键词： Contraception Endometrium Uterine Artery Doppler

Evolution of DNaseI Hypersensitive Sites in Brain-Related Genes Regulatory Regions of Primates

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Evolution of DNaseI Hypersensitive Sites in Brain-Related Ge...

Evaluation of novel fusion proteins derived from extracellular matrix binding domains of LigB as vaccine candidates against leptospirosis in a hamster model

2018中国遗传学会第十次全国会员代表大会暨学术讨论会

作者： Yueer Lu Xiao Wang Hang Yu Wei Wang Shiping Liu Chongyin Han Zhiqiang Jiang Ying Ouyang joshua.m akey Chunbo Chen Weidong Tian Fei Ling School of Biology and Biological Engineering South China University of Technology State Key Laboratory of Genetic Engineering Collaborative Innovation Center of Genetics and DevelopmentDepartment of Biostatistics and Computational BiologySchool of Life SciencesFudan University Department of Genome Sciences University of Washington Department of Critical Care medicine Guangdong General HospitalGuangdong Academy of Medical Sciences

How the human brain differs from that of non-human primates is largely unknown. Studies have shown that brain expression profiles differ among humans and other primates, and increasing evidence strongly suggests that accelerated evolution of regulatory sequences plays an important role in the evolution of human-specific phenotypes. In this study, we selected 243 brain-related genes in Gene Ontology and leveraged 184,113 DNaseI hypersensitive sites（DHSs） within their regulatory regions, termed brain-related DHSs. Our results showed that 2397 DHSs（6%） were under accelerated evolution（aceDHSs）, of which was much higher than the reported aceDHSs contribution of genome-wide scale. The target genes of brainaceDHSs were enriched in brain development and exhibited differential expression levels between humans and chimpanzees. According to FImO and ChIP-seq data from Ensembl, 58 potential human-specific transcription factor binding sites located in brain-aceDHSs were characterized by alignment comparison, including TCF4, FOXH1 and FOXQ1. Based on genome-wide association study（GWAS）, Hi-C and expression quantitative trait loci（eQTL） data, 15 GWAS single nucleotide polymorphisms（SNPs） and 37 eQTL SNPs were closely associated with brain disorders by affecting the brain-aceDHSs target genes. Using CRISPR-Cas9, we confirmed that one aceDHS enhanced the expression of GPR133, a gene that influenced glioblastoma, indicating the variants within DHSs could be potential SNPs involved in brain disorders. Western blotting result also showed that GPR133 protein expression decreased after knocking out corresponding DHS. These findings suggested that brain-related gene regulatory regions are under adaptive evolution and contribute to the differential expression profiles among primates, providing new insights into the genetic basis of brain phenotypes or disorders between humans and other primates.

关键词： Brain DNaseI Hypersensitive Sites Evolution,Primates

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Evaluation of novel fusion proteins derived from extracellul...

Outcome of Pregnancies under Cupper Intrauterine Device: Experience of 10 Cases Collected at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF)

第三届中国兽医临床大会

作者： Syed m.Faisal Sean P.mcDonough Bruce L.akey Department of Population medicine and Diagnostic Sciences Cornell UniversityIthacaNY 14853United States Department of Biomedical Sciences College of Veterinary Medicine Cornell UniversityIthacaNY 14853United States

Leptospira binds to host extracellular matrix(ECm)through surface exposed outer membrane proteins called adhesin in order to initiate *** various adhesins present on the surface of the spirochete, Leptospira-immunoglobulin like proteins(Lig proteins)and LipL32 are most abundant,widely distributed among pathogenic serovars and well *** fragments of Lig proteins(Ligcon4,Ligcon4-7.5,LigBcen2) and C-terminus fragment of LipL32 all of that bind to host ECm were fused,expressed and purified in soluble form as *** week hamsters were immunized subcutaneously with various fusion proteins emulsified in EmULSIGEN-D adjuvant and subsequently boosted at 3 *** protective efficacy of these novel fusion proteins was evaluated against subsequent challenge with highly virulent *** serovar Pomona(mLD50-100).Our results indicate that fusion protein based vaccine induced significant protection against acute infection with respect to PBS-adjuvant vaccinated controls as revealed by enhanced survival and reduced pulmonary ***,the protection mediated by these novel proteins was higher than that of conserved region of Lig protein(Ligcon,established protective antigen)and correlated to the level of ***32 failed to impart significant protection,however fusing its immunogenic C-terminus domain to Lig fragments slightly delayed the morbidity of the infected *** results demonstrate that this novel strategy could be promising in developing effective subunit vaccine to combat this zoonotic infection.

关键词： Fusion protein Extracellular matrix Lig proteins Leptospira interrogans

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Open Journal of Obstetrics and Gynecology 2022年第7期12卷 616-623页

作者： Bingo Kignomon m’bortche Kossi Edem Logbo-akey Tina Ayoko Ketevi Baguilane Douaguibe Francis Baramna-Bagou Abdoul-Samadou Aboubakari Koffi Akpadza Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) Lomé Togo Department of Gynaecology-Obstetrics The University Hospital Kara Kara Togo Department of Gynaecology-Obstetrics The University Hospital Sylvanus Olympio Lomé Togo

Aims: Although the copper intrauterine device (Cu-IUD) is an effective contraceptive device, cases of pregnancy under the Cu-IUD have been reported. We here report 10 women who got pregnant under this condition, with special reference to etiologies and pregnancy outcomes. methodology: We analyzed all women who got pregnant under Cu-IUD at ATBEF main Clinic from July 1, 2015 to June 30, 2020. Results: We retrieved 10 patients. The durations of Cu-IUD use were 3 months to 6 years. The etiologies were poor insertion;migration and spontaneous expulsion. The occurrence of pregnancy was poorly accepted by the women: 20% of women considered it was due to the providers’ incompetence. Of the 10 pregnancies, 5 women had given vaginal birth spontaneously;2 induced abortions, 2 spontaneous abortions and 1 ectopic pregnancy. The contraceptive method adopted after pregnancy was jadelle implants in 8 cases and spousal vasectomy in 2 cases. Conclusion: The prevention of IUD pregnancies may require adequate insertion time, insertion technique and follow-up.

关键词： Contraception Pregnancy Etiologies Outcome Lomé

Cervical Cancer Screening by midwives in the Kara Region of Northern Togo: Knowledge, Attitudes and Practices

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Open Journal of Obstetrics and Gynecology 2022年第2期12卷 140-146页

作者： Kossi Edem Logbo-akey Dede Regina Ajavon Kignomon Bingo m’bortche Pierre Yendoubé Kambote Kbando Noé Patidi Abdoul Samadou Aboubakari Department of Gynecology and Obstetrics CHU Kara University of Kara Kara Togo Gynecology and Obstetrics Department of CHR Tomdé University of Kara Kara Togo Clinic of the Togolese Association for Family Welfare (ATBEF) University of Lome Lome Togo University of Lome Lome Togo

Introduction: cervical cancer is common with high mortality. It is diagnosed late in developing countries. Reducing mortality requires better knowledge and screening for cervical cancer. Objective: To study the knowledge, attitudes and practices of midwives in the Kara region of cervical cancer screening. methods: Cross-sectional, descriptive study from January 2020 to June 2020 conducted with midwives from the Kara region. Results: Fifty midwives participated in the study. The average age was 32.46 years and the majority (92%) had less than 10 years work experience. Thirty seven (74%) said that cervical cancer was due to human papillomavirus oncogenes and 32% to know the two commonly used screening methods (cervical cytology and VIA/VILI). Only 30% and 8% respectively know the pace and target of screening. They had all expressed the desire to be trained and to carry out routine screening. All of the respondents had never practiced a cervical cytology, and only 01 had once practiced VIA/VILI. Conclusion: midwives have little knowledge of uterine cancer screening and do not practice it. They express the need to be trained in order to popularize the practice.

关键词： Cancer of the Cervix Knowledge Screening midwives Kara

Female Contraception: Comparative Study of Biometrics and Vascularization of the Uterus at Sylvanus Olympio University Hospital (Togo)

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Cystic Degeneration of Uterine Leiomyoma misdiagnosed as Ovarian malignancy: A Case Report

Open Journal of Obstetrics and Gynecology（妇产科期刊） 2024年第1期

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 745-751页

作者： Kossi Edem Logbo-akey Kignomon Bingo m’bortche Pierre Yendoubé Kambote Kibandou Noe Patidi Dédé Régine Diane Ajavon Abdoul-Samadou Aboubakari 1Department of Gynecology and Obstetrics of the University Hospital of Kara University of Kara Kara Togo Department of Gynecology and Obstetrics of the University Hospital of Kara University of Kara Kara Togo Togolese Association for Family Welfare (ATBEF) Clinic University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the University Hospital Sylvanus Olympio University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the Regional Hospital Center of Tomdé University of Kara Kara Togo

Background: massive cystic degeneration of the uterine myoma might mimic an ovarian tumor, especially a malignant ovarian tumor, causing misdiagnosis. We present a case of a woman with marked cystic degeneration of a uterine leiomyoma mimicking an ovarian neoplasm. Case: A 65-year-old woman (gravida 6, para 6) visited us due to an abdominal tumor. Clinical examination and radiology exploration suggested the presence of an ovarian tumour. The patient underwent a total abdominal hysterectomy with bilateral adnexectomy. Histopathology confirmed a final diagnosis of a degenerated leiomyoma. The patient’s postoperative course was uneventful and she was discharged on her 5th post-operative day. Conclusions: When a patient has a huge abdomino-pelvic mass, mimicking an ovarian tumor, cystic degeneration of uterine myoma should be considered as a differential diagnosis.

关键词： Leiomyoma Cystic Degeneration Ovarian Tumor

Placental Abruption Following Snakebites Envenomation: A Case Report and Literature Review

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 247-251页

作者： Kossi Edem Logbo-akey Kignomon Bingo m’bortche Pierre Yendoubé Kambote Solim Biou Djato Kibandou Noe Patidi Dédé Régine Diane Ajavon Abdoul-Samadou Aboubakari Department of Gynecology and Obstetrics of the University Hospital of Kara University of Kara Kara Togo Togolese Association for Family Welfare (ATBEF) Clinic University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the Regional Hospital Center of Tsévié University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the University Hospital Sylvanus Olympio University of Lomé Lomé Togo Department of Gynecology and Obstetrics of the Regional Hospital Center of Tomdé University of Kara Kara Togo

Background: Snakebite envenomation in pregnancy is uncommon. It can lead to a poor outcome in both the mother and the fetus. We describe our approach to envenomation in pregnancy based on the currently available evidence. Case: We reported two case of snakebite in the third trimester of pregnancy having caused placental abruption with expelling a fresh still born baby and a live baby. In both cases, consumption coagulopathy occurred. managed by polyvalent anti-snake and blood transfusion. Their investigations became normal and they were discharged of hospitalization. Conclusion: Snakebite envenomation in pregnant is a maternal and fetal emergency. Treatment must be quick and well adapted.

关键词： Snake Bite Dic Pregnancy Abruption Placenta Intra-Uterine Demise