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Computer Modeling in Engineering & Sciences 2024年第3期138卷 2519-2547页

作者： Hassen Louati Ali Louati Elham Kariri slim Bechikh College of Information Technology Kingdom UniversityRiffa40434Bahrain SMART Lab University of TunisISGTunisTunisia Department of Information Systems College of Computer Engineering and SciencesPrince Sattam bin Abdulaziz UniversityAl-Kharj11942Saudi Arabia

Recent developments in Computer Vision have presented novel opportunities to tackle complex healthcare issues,particularly in the field of lung disease diagnosis.One promising avenue involves the use of chest X-Rays,which are commonly utilized in radiology.To fully exploit their potential,researchers have suggested utilizing deep learning methods to construct computer-aided diagnostic systems.However,constructing and compressing these systems presents a significant challenge,as it relies heavily on the expertise of data scientists.To tackle this issue,we propose an automated approach that utilizes an evolutionary algorithm(EA)to optimize the design and compression of a convolutional neural network(CNN)for X-Ray image classification.Our approach accurately classifies radiography images and detects potential chest abnormalities and infections,including COVID-19.Furthermore,our approach incorporates transfer learning,where a pre-trainedCNNmodel on a vast dataset of chest X-Ray images is fine-tuned for the specific task of detecting COVID-19.This method can help reduce the amount of labeled data required for the task and enhance the overall performance of the model.We have validated our method via a series of experiments against state-of-the-art architectures.

关键词： Computer-aided diagnosis deep learning evolutionary algorithms deep compression transfer learning

Morel-Lavallée Lesion: A Case Report of a Large Post-Traumatic Subcutaneous Lumbar Hematoma and Literature Review

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Open Journal of Modern Neurosurgery 2016年第1期6卷 29-36页

作者： Dominique N’Dri Oka Daouda Sissoko alban slim mbende Neurosurgery Unit Yopougon Teaching Hospital Abidjan Cote d’Ivoire

Morel-Lavallée Lesions (MLL), described in 1863 by French surgeon Victor-Auguste-Francois Morel-Lavallée, are rare posttraumatic closed degloving injuries, occurring as a result of tangential sheer forces, in which the skin and subcutaneous tissue separate abruptly from the underlying deep fascia, causing fluid collection with liquefied fat. A 31-year-old policeman involved in a road traffic accident, presented with a gradually expanding lumbar swelling, which was soft, fluctuant and painful with contused skinon examination. Computed Tomography (CT) scan of the lumbar spine revealed a large subcutaneous hematoma on axial view, extending from the 12th thoracic vertebra down to the first sacral vertebra. There was no skeletal lesion. The treatment consisted of surgical excision/drainage of the collection followed by continuous suction with drainage tubes for two days. The collection is completely resolved;the patient made a full recovery and has been asymptomatic. Since there was a history of blunt trauma and given the nature and the location of the collection over osseous prominences, we report this rare case of a large posttraumatic lumbar hematoma diagnosed on clinical and CT scanning grounds as a Morel-Lavallée lesion. The patient was informed that non-identifying information from the case would be submitted for publication, and he provided consent.

关键词： Morel-Lavallée Lesions (MLL) Subcutaneous Hematoma Lumbar Trauma

Spinal Cord Compression Caused by Multifocal Histoplasmosis Treated Conservatively: Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2016年第1期6卷 20-24页

作者： Dominique N’Dri Oka alban slim mbende Daouda Sissoko Neurosurgery Unit Yopougon Teaching Hospital Abidjan Cote d’Ivoire

We present the case of a 39-year-old patient admitted for a slow thoracic spinal cord compression syndrome associated with lumbar rachialgia. CT scan and MRI of the thoracic spine showed lysis of T4, T5, T6 and T7 vertebrae, an epiduritis and paravertebral abscesses. CT scan of the lumbar spine demonstrated osteolysis of the left iliac wing with skin invasion. This lesion infiltrated the sacrum and the body of L5. The iliac lesion was biopsied and the analysis revealed a granulomatous osteitis caused by Histoplasma duboisii. The treatment consisted of ketoconazole 400 mg daily for six months. Spinal decompressive surgery was not performed. Following antifungal treatment the patient had satisfying clinical and radiological outcome. After three years’ follow-up, the clinical course was uneventful. The patient had neither symptoms of spinal cord compression nor signs of further localizations.

关键词： Histoplasma duboisii Bone Multiple Localization Spinal Cord Compression

Surgical Clipping of a Basilar Tip Aneurysm: Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2017年第3期7卷 55-64页

作者： Médard Kakou alban slim mbende Fulbert Kouakou Phanré Doua Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast

Basilar tip aneurysms account for 5% - 8% of all intracranial aneurysms. They are known to rupture more frequently than aneurysms in other locations. Surgical clipping of basilar apex aneurysms however challenging;remains the treatment of choice in Ivory Coast due in part, to multiple technical barriers. A 60-year-old right-handed patient presented to our Neurosurgical Unit in February 2nd 2013 after a sudden onset of altered consciousness. Neurological examination revealed both an upper motor neuron and meningeal syndromes with a Glasgow Coma Scale of 12. Brain NECT scan and a subsequent brain CT angiography showed a subarachnoid haemorrhage and a 3.8 mm (height) × 5.2 mm (width) basilar tip aneurysm respectively. Surgical clipping of the aneurysm was indicated but due to multiple technical barriers, surgery was delayed and the patient underwent surgery after the critical vasospasm period. The patient developed a hospital acquired pneumonia after surgery and was successfully treated with antibiotics. Since her discharge, she has been asymptomatic. We sought to report this case of a basilar apex aneurysm successfully occluded with non-ferromagnetic SUGITA clips and to share our experience of clipping these lesions through the frontotemporal approach. The patient was informed that non identifying information from the case would be submitted for publication, and she provided consent.

关键词： Basilar Artery Basilar Tip Aneurysm Surgical Clipping

Pericallosal Artery Aneurysms: Twenty-Six Years of Microneurosurgical Endeavor in Three Major Neurosurgical Centers in Abidjan

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Open Journal of Modern Neurosurgery 2017年第4期7卷 129-141页

作者： Médard Kakou alban slim mbende Daouda Sissoko Fulbert Kouakou Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast

We present our experience of microsurgical treatment of pericallosal artery aneurysms (PCAA) in three neurosurgical centers in Abidjan (Ivory Coast) from 1990 to 2016. This present study aimed to evaluate characteristics of 6 patients with PCAA treated during a 26-year period and to establish the rate, clinical nuances, anatomical variations and respective microsurgical approaches of PCAA in Abidjan. We analyzed medical files of all 93 patients admitted for an intracranial aneurysm between 1990 and 2016 and focused on the 6 patients who were treated for a PCCA. The mean age of patients was 37 years, half of whom were less than 30 years old. They were 3 men and 3 women. The time from first symptom to admission was more than 3 days, but less than 16 days. Five out of six patients had ruptured aneurysms and the clinical condition on admission was WFNS grade 0 one patient (16.67%) and WFNS I-III five patients (83.33%). Analysis of radiological data revealed Fischer grade IV three patients and Fischer grade I-II three patients. A total of 7 PCCA were recorded and they accounted for 6.19% of all intracranial aneurysms and 9.72% of all anterior circulation aneurysms. Six out of seven aneurysms (85.71%) were either smaller (2 - 6 mm) or middle sized (6 - 15 mm). There was only one (14.29%) giant PCA aneurysm (>25 mm). According to the location, two aneurysms (28.57%) were located on the A2 segment of the pericallosal artery (PCA) and five (71.43%) on the A3 segment of the artery. We found 4 cases of saccular aneurysms (57.14%) and 3 cases of fusiform aneurysms (42.86%), two of which were located on A2 segments of the 2 PCA on the same patient (16.67%). We didn’t find any PCA anatomical variation associated with any of the 7 aneurysms. Two patients developed perioperative rebleeding and in 1 case a severe preoperative hydrocephalus was diagnosed. The median time from rupture to surgery was 59.5 days with a range of 14 to 180 days. Treatment techniques included 4 clipping (57.14%) and 3 wrapping (42.86%). In 2 cases there

关键词： Pericallosal Artery Aneurysm Pericallosal Artery Microsurgery Treatment Abidjan

Late Post-Traumatic Cerebrospinal Rhinorrhoea

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Open Journal of Modern Neurosurgery 2017年第3期7卷 103-111页

作者： Fulbert Kouakou Romuald Kouitcheu alban slim mbende Dominique N’Dri Oka Guy Varlet Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast

Cerebrospinal fluid (CSF) rhinorrhoea results from anatomical breach between the subarachnoid space and air sinus cavities of the skull base and traumatic CSF rhinorrhoea accounts for 80% - 90% of all cases of CSF leaks. We sought to report the case of a 16-year-old patient with a history of head injury following a fall from a tree, who developed a post-traumatic CSF rhinorrhoea after an onset of meningitis. The patient sustained a fall from a 6-meter tree in 2008, and was reviewed by our neurosurgical team in February 2016 for a 1-month history of progressive headaches associated with fever, asthenia and left CSF rhinorrhoea. Clinical examination revealed frank meningism and abundant CSF leak from the left nostril. CT scanning showed fractures of the left frontal bone and sinus wall associated with a massive pneumocephalus. The patient benefited from surgical repair of the tear and post-operative lumbar punctures at day 15. The patient’s guardian was informed that non-identifiable information from the case would be submitted for publication and he provided consent.

关键词： Post-Traumatic Cerebrospinal Rhinorrhoea Meningitis Surgical Repair

Vertebral Localization of Multifocal Skeletal Tuberculosis: Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2017年第2期7卷 11-18页

作者： Fulbert Kouakou alban slim mbende André Tokpa Nicole Adou Dominique N’Dri Oka Neurosurgery Unit Yopougon Teaching Hospital Ivory Coast

Multifocal skeletal tuberculosis is a rare condition. The diagnosis is difficult and the treatment is delayed in the vast majority of cases. A 30-year-old immunocompetent jobless male complained of thoracic and lumbar spine pain for several weeks, associated with progressive weight loss without fever. Neurological examination was normal. CT scanning demonstrated hypodense multifocal lesions of the spine and the hip. Vertebroplasty was performed successfully. But a pathological examination of the biopsy of spinal lesions was not conclusive. One month later, the patient developed an acute spinal cord compression syndrome. Emergency decompression surgery was performed, which demonstrated the purulent epidural abscess and osteolysis. The pathological examination was in favor of tuberculosis. Despite surgical stabilization and cementoplasty, anti-TB therapy and kinesitherapy, the patient was still significantly limited a few months later with a flaccid paraplegia. TB infection was cleared at the end of the two-phase regimen. Atypical tuberculosis ormultifocal TB poses diagnostic problems especially with metastases, malignant lymphoma, and multiple myeloma. We report this rare case of mutifocal skeletal tuberculosis to show the place of vertebroplasty in the management of spinal tuberculosisor if there is indeed a potential role that vertebroplasty could have played in spreading spinal lesions. The patient was informed that non identifying information from the case would be submitted for publication, and he provided consent.

关键词： Multifocale Vertebroplasty Skeletal Tuberculosis Diagnosis Treatment

Voluminous Cystic Trigeminal Schwannoma: Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2017年第4期7卷 142-152页

作者： Médard Kakouc alban slim mbende Romuald Kouitcheu Fulbert Kouakou Paulette Yapo Isidore Diomandé Neurosurgery Unit Yopougon Teaching Hospital Abidjan Ivory Coast Neuroradiology Unit Treichville Teaching Hospital Abidjan Ivory Coast Pathology Laboratory Cocody Teaching Hospital Abidjan Ivory Coast

Voluminous trigeminal schwannomas are rare, predominantly benign growth encapsulated tumors composed of Schwann cells with controversial surgical treatment. They account for 20% to 40% of all trigeminal schwannomas and share the same imaging findings of neurinomas elsewhere. Surgery remains the treatment of choice for most lesions as long as complete excision is feasible. A 35-year-old house wife complained of a 3-month history of progressive right visual field impairment associated with headaches. Neurological examination revealed a complete cavernous sinus syndrome. CT scanning showed a voluminous cystic mass of the right parasellar compartment extending to the optic nerve and the orbit. A concomitant MRI scan revealed more exquisite anatomical details of the lesion. The patient benefitted from a subsequent CT-angiography (not included) which excluded any vascular abnormalities associated with the tumor. Surgical excision of the tumor was warranted and the patient underwent surgery a few days after admission. A pterional extradural-intradural approach combined with incision of the lateral wall of the parasellar compartment via a standard frontotemporal craniotomy was performed and pathological examination was in favor of a cystic trigeminal schwannoma. Post-operative MRI showed a complete excision of the tumor. A 2-year follow-up yielded persistent right monocular blindness. Given this typical appearance of this lesion indicative of both cisternal and parasellar compartment extension, as well as the level of controversy surrounding surgical treatment of these particular tumors;we sought to report this rare case of a voluminous cystic trigeminal schwannoma and share our humble surgical experience of dealing with these lesions. The patient was informed that non-identifying information from the case would be submitted for publication, and she provided consent.

关键词： Schwannoma Cystic Cavernous Sinus Syndrome Trigeminal Nerve

“FISH VERTEBRA” about 3 Sickle Cell Patients Followed at Laquintinie Hospital, Douala

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第1期14卷 20-25页

作者： Same Bebey Francine Mbono Betoko Ritha Eloundou Onomo Paul Mantho Fopa Pauline Eposse Ekoube Charlotte Megne Tamo Estelle Ebene mbende Romain Singwe Ngandeu Madeleine Rheumatology Unit Laquintinie Hospital Douala Douala Cameroon Paediatric Unit Laquintinie Hospital Douala Douala Cameroon La Cite Verte Hospital Yaounde Yaounde Cameroon Paediatric Surgery Unit Laquintinie Hospital Douala Douala Cameroon La Cite des palmiers Hospital Douala Douala Cameroon Rheumatology Unit Central Hospital Yaounde Yaounde Cameroon

Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Douala. When the vertebral fractures were diagnosed, the 3 patients had back pain and kyphosis deformities of the dorsal spine. Treatment with an infusion of biphosphonates (zoledronic acid at a dose of 0.5 mg·per·kg) was offered to all three patients. Two out of three patients received treatment with biphosphonates with a successful outcome. Profound vitamin D deficiency is associated with increased bone remodeling and a history of fractures. In sickle cell anemia, vertebral fractures may also result from bone fragility, which is often overlooked as aseptic osteonecrosis and osteomyelitis, which are very often suspected.

关键词： Vertebral Fractures Sickle Cell Anemia Vertebral Bone Fragility

Obturator Dislocation of the Hip at Yopougon/Abidjan Teaching Hospital

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Open Journal of Orthopedics 2015年第10期5卷 319-325页

作者： Alidou Traoré Daouda Kanaté Soumaro Christel Mobiot-Aka alban slim mbende Rebecca Eva Boka Mamadou Dosso Kader Sy Jean Baptiste Sie Essoh Insa Bamba Yves Lambin Trauma and Orthopaedic Surgery Unit Yopougon Teaching Hospital Abidjan Cote d’Ivoire Neurosurgery Unit Yopougon Teaching Hospital Abidjan Cote d’Ivoire

Obturator dislocation of the hip is caused by high-velocity accidents as evidenced by its frequent association with other traumatic injuries and, seldom found. Its main complication remains femoral head avascular necrosis. We report on four cases of obturator dislocation of the hip. The mean age of patients was 30 years, and all their injuries followed a road traffic accident. Associated lesions were a contralateral femur fracture in two cases and an osteochondral fracture in one case. Reduction of dislocations was achieved orthopedically under general anaesthesia and the average waiting time before reduction was 20 hours. One patient had an intra-articular incarcerated fragment visible on X-ray, and another patient showed signs of early coxarthrosis 15 months later. The average follow-up time was 24 months.

关键词： Dislocation Anterior Obturator Hip Adult