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Barriers to Utilization of Postnatal Care: A Qualitative Study in Guinea

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Open Journal of Obstetrics and Gynecology 2021年第4期11卷 391-402页

作者： Mamadou Dioulde Balde Aissatou Diallo Anne Marie Soumah Alpha Oumar Sall Boubacar Alpha Diallo Fanta Barry amadou oury touré Alpha amadou Barry Sadan Camara Center for Research in Reproductive Health/Cellule de recherche en santé de la reproduction en Guinée (CERREGUI) Conakry Guinée University Hospital Donka Clinic of Gynecology and Obstetrics Conakry Guinea

Maternal mortality remains very high in developing countries. In Guinea, it is 550 maternal deaths in 100.000 living birth. More than half of these deaths occur in the postpartum period. Hence the interests to have a better understanding of the factors that hinder the realization of post-natal care (PNC) arise. It is for this reason that the objective of this study is to identify barriers to the use of post-natal care in Guinea. Methods: A qualitative study was conducted in the prefectures of Kindia and Dubréka, in the Administrative Region of Kindia (Guinea) in April and May 2014. Fourteen focus group discussions of women and girls of the community, as well as fifteen individual in-depth interviews (9 with women and 6 with healthcare providers). Results: Most women do their PNC during their child vaccination or in case of postpartum complications. Financial constraints are the main barrier to using postnatal care identified by participants. In general, distance from the health center associated with lack of transport mean and insufficient staffs are factors related to the health system. In addition, poor reception of clients, women’s experience during childbirth, poor programming for PNC as well as the lack of trust and confidentiality between clients and health care providers are the barriers related to health p

关键词： Barriers Postnatal Consultation Maternal Mortality Guinea

Design of an Interconnection Architecture and Sizing of Two (2) EPC Core Networks: The Case of Orange-Guinea

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Journal of Energy and Power Engineering 2024年第2期18卷 59-70页

作者： Mamadou Sadigou Diallo Kadiatou Aissatou Barry amadou Lamarana Bah Mamadou Sanoussy Camara Janvier Fotsing amadou Barry amadou oury Bah Gamal Abdel Nasser University of Conakry(UGANC) P.O.BOX 1147Conakry 001BP 1147Republic of Guinea National Advanced School of Engineering University of Yaoundé1Yaoundé1001BP 337Republic of Cameroon

With the arrival of the 4G and 5G,the telecommunications networks have experienced a large expansion of these *** enabled the integration of many services and adequate flow,thus enabling the operators to respond to the growing demand of *** rapid evolution has given the operators to adapt,their methods to the new technologies that *** complexity becomes more important,when these networks include several technologies to access different from the heterogeneous network like in the 4G *** dimensional new challenges tell the application and the considerable increase in demand for services and the compatibility with existing networks,the management of mobility intercellular of users and it offers a better quality of ***,the proposed solution to meet these new requirements is the sizing of the EPC(Evolved Packet Core)core network to support the 5G access *** the case of Orange Guinea,this involves setting up an architecture for interconnecting the core networks of Sonfonia and *** objectives of our work are of two orders:(1)to propose these solutions and recommendations for the heart network EPC sizing and the deployment to be adopted;(2)supply and architectural interconnection in the heart network EPC and an existing heart *** our work,the model of traffic in communication that we use to calculate the traffic generated with each technology has link in the network of the heart.

关键词： 5G network 4G network(EPS(evolved packet system)) 3G network(UMTS:Universal Mobile Telecommunications System) EPC network of the heart architecture dimensional Orange Guinea technology service

Severe Head Trauma in a 39-Week Pregnant Woman with Amenorrhea (SA) Apropos of a Case at CHU Ignace Deen in Conakry

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Open Journal of Emergency Medicine 2023年第3期11卷 87-99页

作者： Abdoulaye touré amadou Yalla Camara Donamou Joseph Almamy Bangoura M’mah Lamine Camara Anesthesia-Resuscitation Department University Hospital of Ignace Deen of Conakry Conakry Guinea Medical and Surgical Emergency Department Donka University Hospital Conakry Guinea Anesthesia-Resuscitation Department Donka University Hospital Conakry Guinea

Objective: Was to present the management of a pregnant woman at 39 SA received for severe head trauma in the emergency room. Severe trauma in pregnant women can have serious maternal and especially fetal consequences in the absence of a diagnostic and therapeutic strategy. We report the case of serious trauma in a 39 WA pregnant woman, nulliparous. Admitted to the emergency room for serious head trauma following a public road accident. The clinical picture was dominated by impaired consciousness with a Glasgow score of 8/15, right otorrhagia, desaturation at 89% AA and respiratory rate at 36 cycles/min. The obstetrical examination noted a fundal height of 32 cm, a fetal heart sound (BCF) of 167 beats/min, a cephalic presentation, a cervical opening of 3 cm and uterine contractures. Imaging examinations outside the hospital because not available. The abdominopelvic ultrasound shows a monofetal pregnancy without placental abruption. The cerebral scanner shows an edemato-haemorrhagic contusion intra parenchymatous frontotemporal left. Respiratory support and an indication for caesarean section allowed the extraction of a live male child, Apgar at one minute 10/10 to five minutes 10/10, weighing 3000 g without abnormality on clinical examination. The evolution was favorable after 27 days of resuscitation. Conclusion: The care of a severely traumatized pregnant woman relies above all on good multidisciplinary coordination, based on close collaboration between emergency physicians, anesthetists-resuscitators, obstetricians, pediatricians, neonatologists and biologists.

关键词： Trauma Emergencies Pregnancy Resuscitation

Post-COVID-19 Late Pulmonary Embolism in a Young Woman about a Case

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Open Journal of Emergency Medicine 2020年第4期8卷 79-85页

作者： Abdoulaye touré Joseph Donamou amadou Yalla Camara Boubacar Atigou Dramé Ousmane Aminata BAH Anesthesia-Intensive Care Unit Ignace Deen Hospital Conakry Guinea Anesthesia-Intensive Care Unit Donka Hospital Conakry Guinea Army Reference Imaging Center (CIRA) Conakry Guinea Chair of Biophysics and Medical Radiology-Imaging FSTS-University of Conakry Conakry Guinea

COVID-19 appears to be associated with a disproportionate risk of thrombosis. The occurrence of thrombosis is a frequent complication of many medical and surgical conditions. Their prevention by LMWH is the option of choice as well as their early diagnosis in this pandemic context. In addition, several recent observations support that severe pulmonary embolism is very common in hospitalized patients with COVID-19. We report the case of late pulmonary embolism in a 26-year-old patient with a medical history of (SARS-CoV2) and newly discovered diabetes. The clinical examination found exertional dyspnea, intense chest pain, blood pressure at 145/85mmHg, heart rate at 129 bpm, respiratory rate at 25 cycles/min, blood sugar at 1.45 g/l, oxygen saturation at 92%. In front of this clinical picture, the thoracic CT angiography to ask shows a pulmonary embolism of the right segmental and sub-segmental branches less marked on the left, involving the lingular and basal branches; the management was limited to anticoagulation associated with rehabilitation sessions (respiratory physiotherapy).

关键词： Resuscitation SARS-CoV2 Thromboembolism Ignace Deen

The Reasons for Admission of Elderly Subjects in Intensive Care at the CHU Ignace Deen

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Open Journal of Emergency Medicine 2023年第3期11卷 100-109页

作者： Abdoulaye touré amadou Yalla Camara Almamy Bangoura Donamou Joseph M’mah Lamine Camara Anesthesia-Resuscitation Service University Hospital of Ignace Deen of Conakry Conakry Guinea Medical and Surgical Emergency Department Donka University Hospital Conakry Guinea Anesthesia-Resuscitation Service Donka University Hospital Conakry Guinea

Objective: To determine the reasons for admission of elderly subjects and the prognosis in general intensive care. Patients and Methods: Observational descriptive and analytical study with prospective collection of data over a period of one year from January 1 to December 31, 2021. Patients aged 65 or over were included. Abstract: During the study period, 223 cases were collected out of 587 patients admitted, giving a prevalence of 37.9%. The average age was 74.127.39 ± years with extremes of 65 and 96 years and a male predominance (58.7%). The comorbidities were dominated by arterial hypertension (71.3%). The patients were: transferred from medical and surgical emergencies (75.8%). The average admission time was 48.8 ± 29.8 hours. One hundred and eight patients had a Glasgow score between 3 and 7. The reasons for admission were dominated by vascular causes (51.6%). Strokes of any type accounted for 43.9% of these reasons for admission. The average time for carrying out the biological assessments and imaging was 41.8 ± 27.3 hours with the extremes of 3 and 89 hours, 37.2% had a complete assessment within 24 hours. The average duration of hospitalization was 7.10 ± 8.87 days with extremes of 1 and 72 days. The mortality rate was 71.7%. Conclusion: This study has made it possible to take stock of the reasons for the admission of elderly subjects to intensive care. It appears that vascular causes are the main reasons for admission with heavy comorbidities which results in high mortality.

关键词： Reasons for Admission Elderly Subject Resuscitation

Peritonitis: Perioperative Care in Surgical Emergencies CHU Ignace Deen

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Open Journal of Anesthesiology 2023年第4期13卷 85-94页

作者： Abdoulaye touré amadou Yalla Camara Almamy Bangoura M’Mah Lamine Camara Marie Paul Sidohon Okou Anesthesia-Resuscitation Service Ignace Deen Hospital Conakry Guinea Department of Medical and Surgical Emergency Donka University Hospital Conakry Guinea Anesthesia-Resuscitation Service Donka University Hospital Conakry Guinea

Objective: Describe the perioperative management of peritonitis in surgical emergencies. Methodology: This was a prospective observational study of the descriptive type over a period of 12 months from January 01 to December 31, 2020 in the surgical emergency room at the CHU Ignace Deen. Included in the study were all patients admitted for peritonitis aged greater than or equal to 18 years. The parameters were epidemiological, clinical and anesthetic. Results: Of the 653 admissions to surgical emergencies in 2020, 185 cases presented with peritonitis, i.e. 29.3%. The average age was 38.6 ± 16.64 years with extremes of 18 and 90 years. The sex ratio was 1.89. The comorbidities were dominated by gastritis and hypertension, i.e. 22%. The patients were classified as ASA 3U (52.4%), ASA2 U (39.5%) and ASA 4 U (8.1%). Preoperative resuscitation was provided only with 100% saline. 25.5% of patients had received a blood transfusion. The response time was less than 48 hours, i.e. 77.6%. General anesthesia was performed for all patients. Ketamine was the most used IV hypnotic (56.3%) combined with 100% halothane. The curares used were suxamethonium at (81.6%), Atracurium (81.6%) and rocuronium at (18.3%). Fentanyl was the only morphine used. Senior anesthesia technicians provided anesthesia in (63.2%). Intraoperative incidents were dominated by hypotension, difficult intubation, cardiac arrest, respectively 10.3%, 8% and 0.5%. The immediate postoperative incidents were arterial hypotension, nausea and desaturation, respectively 52.9%, 80% and 32.4%. Mortality was 3.4%. Conclusion: The perioperative management of peritonitis in the emergency room must be as early as possible in order to reduce morbidity and mortality.

关键词： Surgical Emergencies Peritonitis Anesthesia Perioperative

Cerebral Malaria: Epidemiological, Clinical and Prognosis Aspects in the Anesthesia-Resuscitation Department CHU Ignace Deen

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Open Journal of Emergency Medicine 2023年第4期11卷 162-173页

作者： Abdoulaye touré amadou Yalla Camara Almamy Bangoura M’mah Lamine Camara Mohamed Soumah Saramba Nabe Department of Anesthesia-Resuscitation University Hospital of Ignace Deen of Conakry Conakry Guinea Department of Medical and Surgical Emergency Donka University Hospital Conakry Guinea Department of Anesthesia-Resuscitation Donka University Hospital Conakry Guinea

Objective: To describe the epidemiological, clinical, paraclinical and prognostic aspects of cerebral malaria received in the anesthesia-resuscitation department. Methodology: This was a prospective descriptive type study carried out in the anesthesia-resuscitation department over a period of three (03) months (June 01 to August 31, 2022). All patients admitted for cerebral malaria were included. Sociodemographic, clinical and prognostic parameters were studied. Results: We collected 25 cases out of 105 admitted patients (23.8%). The average age was 27.6 ± 9.5 years with extremes of 11 and 50 years. The sex ratio was 0.7 (M/F). Students and housewives were in the majority, i.e. 52% and 24%. Neurological disorders were found on admission in all patients, dominated by impaired consciousness at 100% followed by convulsion (60%), prostration (44%), confusion (36%) associated with deep coma in (68%). Gross hemoglobinuria was present in (84%) of cases. On the blood count, anemia was present in (70%) of the patients followed by thrombocytopenia in more than half of the cases (60%) and transfusion was necessary in 19 cases. P Falciparum malaria was found in all patients (100%), the average parasite density was 60342.8 ± 30425.6 trophozoites/μl with extremes of 9000 to 100000 trophozoites/μl. All our patients were treated with intravenous injectable artesunate. Transfusion was performed in 76% of our patients. Eighty percent of the patients had benefited from dialysis. High oxygen therapy was performed in (92%) of cases. The average duration of hospitalization was 5.74 ± days with extremes of 1 to 17 days. Mortality was 48%. Conclusion: Cerebral malaria can take different clinical forms, the most important of which is cerebral involvement. Prompt initiation of appropriate resuscitation can reduce mortality.

关键词： Cerebral Malaria Mortality Resuscitation

Roles of the Apolipoprotein E Gene and Its Polymorphisms in the Etiopathophysiology of Type 2 Diabetes Mellitus and Its Atherosclerotic Complication in Senegalese Females

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Journal of Diabetes Mellitus 2023年第4期13卷 300-324页

作者： Maïmouna touré Fatou Diallo Agne amadou Dieng Rokhaya Ndiaye Diallo Lamine Gueye Abdoulaye Samb Laboratoire de Physiologie Humaine et d’Explorations Fonctionnelles Faculté de Médecine de Pharmacie et d’Odonto-Stomatologie (FMPOS) de l’Université Cheikh Anta Diop (UCAD) Dakar Senégal IRL3189 ESS “Environnement-Santé-Sociétés” Centre National de la Recherche Scientifique (CNRS)/Centre National de la Recherche Scientifique et Technologique (CNRST) Bamako-UCAD Dakar Sénégal Laboratoire de Biochimie et de Biologie Moléculaire Faculté de Médecine de Pharmacie et d’Odonto-Stomatologie (FMPOS) de l’Université Cheikh Anta Diop (UCAD) Dakar Sénégal Service de Santé Publique Institut d’Odontologie et de Stomatologie Faculté de Médecine de Pharmacie et d’Odonto-Stomatologie (FMPOS) de l’Université Cheikh Anta Diop (UCAD) Dakar Sénégal Laboratoire de Génétique Pharmaceutique Faculté de Médecine de Pharmacie et d’Odonto-Stomatologie (FMPOS) de l’Université Cheikh Anta Diop (UCAD) Dakar Sénégal

Lipid metabolism disorders would be among the components responsible for the risk of the onset of T2DM and its vascular complications. Apolipoprotein E plays an important role in lipid metabolism. We studied the involvement of the APOE gene in the onset of T2DM and its vascular complications. Clinical and biochemical parameters were assessed in each participant. APOE genotypes were identified by PCR-RFLP. Arterial stiffness was studied using a pOpmetre® which evaluates the pulse wave velocity (ft-PWV). Endothelial dysfunction was studied using an EndoPAT2000® which measures endothelium-dependent vasodilation (RHI). In control subjects, the ε3 allele was associated with an increase in fasting blood glucose (r = 2.36, p = 0.018), and a decrease in LDL cholesterol levels (r = −2.17, p = 0.03), and ε4 was associated with an increase in total cholesterol (r = 2.59, p = 0.01), LDL cholesterol (r = 2.84, p = 0.004), and No-HDL cholesterol (r = 2.74, p = 0.006). In type 2 diabetes subjects, the ε2 was associated with a decrease in diastolic blood pressure (r = −2.25, p = 0.02). The ε3 was associated with a decrease in ft-PWV (r = −2.26, p = 0.024) while the ε4 was associated with an increase in ft-PWV (r = 2.52, p = 0.012). Carrying the ε2ε3 genotype would have in 99% a limited risk of developing T2DM, and in event of T2DM, only 1 to 2% would have a significant risk of developing atherosclerosis, which would be severe in 17%. Of the ε2ε4 genotype, 93% had a limited or even possible risk of developing T2DM, the remaining 7% had a very high risk of developing T2DM. Diabetics carrying ε2ε4 had in 7% very high risk of developing atherosclerosis. The latter had a 20% very high risk of being very severe. Subjects carrying the ε3ε4 genotype had a 67% possible or even probable risk of developing T2DM and in the event of diabetes, there was in 34% very high risk of developing atherosclerosis which will not have even the time to evolve towards severity. For subj

关键词： APOE Gene Polymorphisms Type 2 diabetes Mellitus Vascular Dysfunctions

Surgical Treatment of Upper Urinary Tract Lithiasis in Conakry

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Open Journal of Urology 2024年第9期14卷 487-498页

作者： Barry Mamadou Madiou Diallo Thierno Oumar Sow Thierno amadou oury Diallo Thierno Mamadou oury Bah Ibrahima Bah Mamadou Diao Cissé Demba Bah Oumar Raphiou Service dUrologie Hpital National Ignace Deen Universit Gamal Abdel Nasser de Conakry Conakry Guinea

Introduction: The management of urinary lithiasis in our settings has long been conventional surgery. The recent introduction of endoscopy of the upper urinary tract represents a major advance in our department. The aim was to contribute to the study of the treatment of lithiasis of the upper urinary tract in Conakry and to report on our initial experience of ureteroscopy in Conakry. Methodology: This is a prospective descriptive study lasting one year, from January 1 to December 31, 2022, carried out at the Urology Department of the Ignace Deen National Hospital and at the PERCHIN Urological Clinic. The study included all patients treated surgically for lithiasis of the upper urinary tract who met the selection criteria. Results: The study included 57 patients. The mean age was 30 years, with extremes of 20 and 73 years;the most represented age group was 31 to 40 years, followed by 20 to 30 years with 29.9% and 26.3% respectively. Males predominated in 36 cases (63.15%), with a M/F sex ratio of 1.71. Left-sided renal colic was the most common, at 75.43% (n=43), and right-sided renal colic at 40.35%, associated with digestive signs at 43.85%. 77.19% had normal creatinine levels before surgery, versus 22.81% with elevated creatinine levels, i.e. 15.78% improvement in renal function after surgery. Urinary tract infection was found in 47.36%, and Escherichia coli in 31.57%, followed by staphylococcus aureus in 8.77%. Overall, 82.45% of patients had organic damage to the kidneys or ureters. Right ureterohydronephrosis was noted in 56.14%, followed by left hydronephrosis in 26.32%. Open surgery was predominant in 52.63% of cases, with endoscopic surgery (URS) accounting for a significant 47.36% during the study period. The endoscopic treatment used was laser ureteroscopy. In our study, 73.68% underwent drainage of the upper excretory tract, including 64.91% with a JJ catheter. The average length of stay was 07 days, with extremes of 02 and 28 days, and 81.4% of patients

关键词： Urinary Lithiasis Surgical Treatment Ureteroscopy Upper Urinary Tract Conakry