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Prevalence of Types of Arterial Hypertension in Pregnant Women at the Maternity Ward of the Centre Médical Communal Les Flamboyants Conakry Guinea

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Open Journal of Nephrology 2023年第3期13卷 234-245页

作者： amadou Yaya Diallo Kadiatou Mamadou Bobo Barry Mamadou Malal Diallo Soriba Bangoura Bangoura Diallo Fatoumata Binta oury Diallo Mamadou Yacine Bah Aly Traoré Mohamed Lamine Kaba Department of Nephrology and Haemodialysis CHU Donka Conakry Guinea Centre Médical Communal les Flamboyants Conakry Guinea

Introduction: Arterial hypertension (AH) during pregnancy is defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg on two (2) successive visits separated by at least 4 hours in a woman who has been at rest for 10 to 15 minutes in the seated position and then in the left lateral decubitus position. The aim of this study was to determine the prevalence and types of arterial hypertension among pregnant women in the maternity ward of the CMC les Flamboyants. Methods: This was a prospective descriptive study lasting six (6) months, from 1 October 2021 to 31 March 2022, of all pregnant women and/or parturients admitted to the maternity ward of the CMC les Flamboyants with a resting blood pressure (BP) greater than or equal to 140/90 mm Hg during the study period. Results: During the study period, we recorded 707 cases of pregnant and/or parturient women, 50 (7.07%) of whom were hypertensive. The average age of the patients was 29 years, with extremes of 18 and 41 years. The 20 - 29 age group was the most affected, with 26 cases (52%). Headache, dizziness and oedema of the lower limbs were constant in all cases. The risk factors for arterial hypertension were dominated by familial hypertension in 19 cases (38%), multiple gestures in 17 cases (34%) and a history of gestational hypertension in 16 cases (32%). Gestational age between 28 and 36 weeks’ amenorrhoea was the most common, with 20 cases (40%). Type I hypertension was most common on admission, with 34 cases (68%), followed by type II hypertension, with 8 cases (16%). Pre-eclampsia was the most frequent maternal complication with 27 cases (54%) followed by eclampsia with 15 cases (30%). Fetal distress was the most frequent fetal complication, 19 cases (38%), followed by death in utero 9 cases (18%). Conclusion: Compliance with consultation programmes and correct patient follow-up could help reduce maternal-foetal complications.

关键词： Hypertension Pregnant Women Maternity Unit Conakry Guinea

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Profile of the Infertile Man at the University Hospital of Conakry (Guinea)

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Open Journal of Urology 2023年第7期13卷 223-237页

作者： Bah Mamadou Bissiriou Kanté Daouda Sow Thierno amadou oury Thierno Mamadou oury Diallo Koulalerou Aimon Axel Cédric Cissé Demba Mamadou Diawo Bah Barry Mamadou Dian Thierno Oumar Diallo Diallo Alimou Ibrahima Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Urology Department CHU of Conakry Guinea

Introduction: Male infertility is defined as the inability of a man to impregnate a woman after 12 months of regular sexual intercourse without contraception. Objective: To improve the state of knowledge on the profile of the infertile man in Guinea. Methodology: We conducted a prospective, descriptive study over a period of 6 months from October 1st, 2020 to March 31st, 2021. Results: We collected an overall number of 71 patients seen onroutine consultation for infertility. They had a mean age of 36.4 years. More than half of our patients were monogamous (79% of cases). Civil servants were the most affected with 38.02% of cases. Primary infertility was dominant in 65% (n = 46) of cases. On clinical examination, varicocele was the most remarkable abnormality with 88.73% (n = 63) followed by testicular hypotrophy with 59.15% (n = 42). Azoospermia was the most frequent sperm abnormality with 22.54% (n = 16) followed by oligospermia with 15.49% (n = 11). Hormonal assessment based on FSH and LH was performed in 16 patients with azoospermia (22.53%). FSH elevation was associated with azoospermia in 6 patients, i.e. 8.45%, azoospermia associated with a normal FSH level accounting for 14.08% in our series. Conclusion: In our practice, male infertility is becoming more and more of a concern due to the increasing number of patients seeking treatment. The scarcity of a medical assistance for procreation unit alongside with more efficient diagnostic means constitutes a handicap for its management.

关键词： Male Infertility Varicocele Azoospermia Spermogram

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Post Antibiotic Grade IV Anaphylaxis: A Case Report from the Emergency Department of Chu Donka

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Open Journal of Emergency Medicine 2023年第3期11卷 110-114页

作者： amadou Yalla Camara Abdoulaye touré Ernest Ahounou Almamy Bangoura M’mah Lamine Camara Thierno Sadou Diallo Alhassane Barry Boubacar Atigou Dramé Joseph Donamou Medical and Surgical Emergency Department CHU-Donka National Hospital Conakry Guinea Anesthesia and Intensive Care Unit Ignace Deen National Hospital Conakry Guinea Department of Anaesthesia and Intensive Care Donka National Hospital Conakry Guinea Department of Anaesthesia and Intensive Care HKM National University Hospital Cotonou Benin

Anaphylaxis is a serious systemic reaction that is part of the general pattern of potentially fatal hypersensitivity reactions requiring immediate management. We report the case of a patient presenting to emergency with signs of malaria and pneumonia who was diagnosed with grade 4 anaphylaxis following antibiotic injection in the emergency department. The patient was 30 years old, with no previous history of anaphylaxis, and presented to the emergency department with fever, dry cough, headache and dizziness associated with prostration. Physical examination showed stable hemodynamics (BP = 110/80 mmHg, HR = 95 p/min,) and respiratory function with SpO2 = 98%, HR = 22 c/min and crepitus rales at the base of the lungs. The laboratory work-up carried out in the emergency department revealed a biological inflammatory syndrome associated with hyperleukocytosis of 11,260/mm3, a positive thick drop with GE(+) dp = 1183 T/microlitre;blood glucose = 0.83 g/l;Covid 19 RDT = (negative). A diagnosis of malaria and pneumonia was made and antibiotic therapy (ceftriaxone) and artesunate were indicated. During the injection of ceftriaxone 1 g, the patient became agitated, followed by cardiorespiratory arrest, confirming the diagnosis of stage 4 anaphylaxis. Treatment consisted of stopping the ceftriaxone injection, external cardiac massage and ventilation, intravenous adrenaline and vascular filling, which enabled the patient to recover and stabilize. The diagnosis of anaphylaxis is clinical. Early administration of adrenaline is the mainstay of treatment.

关键词： Grade 4 Anaphylaxis Adrenaline Antibiotics Emergencies

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Factors Associated with the Continuum of Prenatal Care in the Post-Ebola Context in Guinea

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Open Journal of Epidemiology 2022年第2期12卷 207-220页

作者： Anne Marie Soumah Mamadou Dioulde Balde Bienvenu Salim Camara Karifa Kourouma Aissatou Diallo Alpha Oumar Sall amadou oury toure Ramata Diallo Sadan Camara Ibrahima Sory Cherif Center for Research in Reproductive Health in Guinea (CERREGUI) Conakry Guinea National Center for Training and Research in Rural Health of Maferinyah Forecariah Guinea University Gamal Abdel Nasser of Conakry Conakry Guinea

Background: The 2018 demographic and health survey reports low coverage in the continuum of antenatal care over the period 2013 to 2018. However, little remains known about this indicator since the Ebola epidemic crisis was over. This epidemic has been reported to decrease utilization of maternal health services. This study aims to determine the coverage and factors associated with four or more antenatal care visits in Guinea in the post-Ebola context. Methods: This was a cross-sectional study using secondary data from the most recent (2018) Guinea Demographic and Health Survey. Women aged 15 to 49 years constituted our study population. Our sample included women who had their most recent birth over the last 24 months preceding data collection and whether or not they had performed 4 antenatal care (ANC) visits. Factors associated with performing four or more antenatal visits were assessed through a multivariate logistic regression analysis using Stata software version 15.1. The final model was constructed using the bottom-up stepwise method. Hosmer and Leeshawn’s goodness-of-fit test was used for model specification. Results: Among the 2634 women in the sample, 41% had four or more ANC visits. Factors associated with attending four or more ANC visits included education level, poverty quintile and region. Women with a secondary or higher education were 44% more likely to attend four or more ANC visits (OR = 1.44, 95% CI = [1.07 - 1.92]. Those whose spouses had secondary or education level were 1.66 times more likely to attend four or more ANC visits. Women from moderately wealthy households were 76% more likely to attend four or more ANC visits (OR = 1.76, 95% CI = [1.30 - 2.39]. Women from wealthier households were 2.52 times more likely to attend four or more ANC visits (OR = 2.52, 95% CI = [1.30 - 2.39]). Women living in Boké and Nzérékoré regions were 44% and 47% less likely to attend four or more ANC visits, respectively (OR = 0.56, IC 95% = [0.35 - 0.94]) and (

关键词： Associated Factors Antenatal Care Post-Ebola Guinea

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Urinary Sphincter Disorders of Neurological Origin: Prognostic Aspects in the Neurology Department of the Ignace Deen National Hospital

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Open Journal of Urology 2023年第3期13卷 92-99页

作者： Mohamed Asmaou Bangoura Mohamed Lamine touré Mohamed Traoré Aliou Talibé Diallo Mamadou oury Mané Alhassane Fadiga Gouled Houssein Moussa Karinka Diawara Ibrahima Siré Diallo Cissé Fodé Abass Neurology Department CHU of Conakry Conakry Guinea

Introduction: Complications of Urinary sphincter disorders of neurological origin can be life threatening. The objective of this study was to describe the prognosis of urinary sphincter disorders during neurological conditions. Methods: This was a six-month analytical study conducted at the neurological unit of the Hôpital national Ignace Deen. Including patients with urinary sphincter disorders following a neurological condition;Chi-square, Fischer, and Student’s t-tests were used for variables with a p value less than 0.10 and then included in a logistic model with a significance level set at 0.05 and a 95% confidence interval. Results: We collected 1081 patients among whom, 324 presented, that is to say a frequency of 30%, which concerned subjects aged 57.3 ± 16.4 years with a slight female predominance 50.3%. Urinary incontinence (80.6%) was associated with complications such as urinary tract infection with a high proportion of cerebral damage (92.3%). HIV infection (P = 0.015), bedsores (P = 0.049), and inhalation pneumonia (P = 0.001) were the main poor prognostic factors. Conclusion: Urinary sphincter disorders are elements of poor prognosis, both vital and functional, concerning elderly subjects with a predominance of urinary incontinence. HIV infection, bedsores, pneumopathy are poor prognostic factors.

关键词： Urinary Sphincter Disorders Incontinence Retention Neurology

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Nutritional Profile of Children with Major Sickle Cell Syndrome at the Centre of Medical and Health Advice of Kipé, Conakry, 2018

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Case Reports in Clinical Medicine 2024年第3期13卷 73-84页

作者： Mamadou Aliou Doukoure Ibrahima Sory Diallo M’mah Aminata Bangoura amadou oury toure Mamadou Moustapha Diop Fatoumata Binta Diallo Mohamed Sama Cherif Thierno Saidou Diallo Saidouba Cherif Camara Abdoulaye toure Faculty of Health Science and Technology Gamal Abdel Nasser University Conakry Guinea National AIDS Control Programme Ministry of Health Gamal Abdel Nasser University Conakry Guinea

Introduction: Growth is a reflection of a child’s health and nutritional status. Children with sickle cell disease often have slower statural and weight development. The aim of this study was to evaluate the nutritional profile of children with sickle cell disease (SCD) registered in the CEMECO centre database. Methodology: This was a cross-sectional study with simple random sampling of children aged 1 to 16 years registered in the clinic database. Results: We collected information on 208 children, 121 of whom had sickle cell disease and 87 of whom were normal, with a sex ratio of 1.02. The mean age of the sickle cell patients was 8.7 ± 4.4 years, while that of the non-sickle cell patients was 9.5 ± 4 years. Haemoglobin electrophoresis revealed 103 homozygous (SS), 18 double heterozygous (SC, SBetaThal, SE) and 87 normal (AA) and/or sickle cell trait (AS) sickle cell cases. We observed a significant difference in the height/age ratio (P ¥). Conclusion: The results of our study revealed stunted growth in children with sickle cell disease.

关键词： Sickle Cell Disease Nutrition Growth Puberty Guinea

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Gastric Perforation in a 28-Month-Old Child: Complicated by Peritonitis Admitted to the Surgical Emergency Room after a Case

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Open Journal of Emergency Medicine 2020年第4期8卷 118-124页

作者： Abdoulaye touré Fofana Naby amadou Yalla Camara Joseph Donamou Boubacar Atigou Dramé Oularé Ibrahima Camara M’mah Lamine Bangoura Almamy Camara Mariama Mohamed Emile Camara Godwe Justin Naibe Anesthesia-Intensive Care Unit at the National Ignace Deen Hospital Conakry Guinea General Surgery Department of the National Ignace Deen Hospital Conakry Guinea Anesthesia-Intensive Care Unit at the Donka National Hospital Conakry Guinea

We report the case of a 28-month-old male child with no particular history who was admitted to the emergency room for severe abdominal pain associated with vomiting, asthenia and fever at 39.1˚C that had progressed for 4 days. He was conscious, polypneic at 32 cycles/min on admission. On palpation the abdomen was distended, painful as a whole, more pronounced in the epigastrium. There was abdominal contracture, generalized defense, a cry with sudden decompression of the umbilicus. On abdominal auscultation, there was a disappearance of prehepatic dullness, a decrease in the dullness of the flanks and absence of hydro-aeric noises. On the digital rectal examination, Douglas’s cul de sac was bulging and sensitive. An unprepared X-ray of the abdomen revealed diffuse grayness, lateral gas crescent pneumoperitoneum under diaphragm. The preoperative resuscitation consisted of the placement of a nasogastric tube, a urinary catheter, a peripheral venous route and the fluid electrolyte rebalancing adapted according to the blood ionogram, early antibiotic therapy with broad aero and anaerobic spectrum. Surgical management under general anesthesia found at laparotomy a perforation of the anterior surface of the duodenal bulb which we estimate to be 1 cm in diameter with fibrin deposits. The gesture was the toilet of the peritoneal cavity;suture of the bank and the operative consequences were simple.

关键词： Resuscitation Gastric Perforation Child Peritonitis Ignace Deen

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Digestive Manifestation in COVID-19 Patient Complicated by Occlusive Syndrome Admitted to Intensive Care in a Case

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Open Journal of Emergency Medicine 2020年第4期8卷 110-117页

作者： Abdoulaye touré amadou Yalla Camara Joseph Donamou Boubacar Atigou Dramé Fofana Naby Oularé Ibrahima Camara M’mah Lamine Bangoura Almamy Camara Mariama Mohamed Emile Camara Godwe Justin Naibe Anesthesia-Intensive Care Unit at the National Ignace Deen Hospital Conakry Guinea Anesthesia-Intensive Care Unit at the Donka National Hospital Conakry Guinea General Surgery Department of the National Ignace Deen Hospital Conakry Guinea

We report the case of a 39-year-old patient with a history of chronic gastritis, functional colopathy and appendectomy, referred by another public institution for severe abdominal pain. He had been admitted 6 days previously for nausea, vomiting, diarrhea, fever, asthenia since the onset of dyspnea with 89% desaturation in ambient air and a dry cough. A diagnosis of gastroenteritis was made and treated without success. The appearance of abdominal distension and bloating motivated his transfer to the CTPI where the rRT-PCR was carried out positive and an X-ray of the abdomen without preparation which had demonstrated a significant aerocoly with agglutination of handle. Surgical management under general anesthesia found a clean cavity after coeliotomy, multiple intestino-intestinal, intestino-parietal and omentum-parietal adhesions. The gesture consisted of an adhesiolysis, omentectomy. The postoperative follow-up was favorable with resumption of transit on D5 postoperative. Put under the COVID-19 treatment protocol, the rRT-PCR was negative on D13, output on D14 and removal of the D19 files without postoperative complications.

关键词： Resuscitation COVID-19 Digestive Manifestation Occlusive Syndrome Donka

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Overview of Adrenals Tumors in Dakar Hospitals

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Open Journal of Internal Medicine 2024年第2期14卷 141-150页

作者： Nafy Ndiaye Yakham Mohamed Leye Mouhamadou Moustapha Ndong Ngoné Diaba Diack amadou Fall Cisse Abdoulaye Leye Baidy Sy Kane Alpha Omar touré Cherif Mohamed Dial Pape Saloum Diop Internalmedeccine and Endocrinology Department Teaching Hospital of Pikine Dakar Senegal General Surgery Department Aristide Le Dantec Teaching Hospital of Dakar Dakar Senegal Anatomo-Pathology Department General Hospital of Grand Yoff Dakar Dakar Senegal General Surgery Department General Hospital of Grand Yoff Dakar Dakar Senegal

Introduction: Adrenal tumours (AT) are commonly encountered in clinical practice. For any patient presenting an adrenal mass, there are two crucial points to consider: is the adrenal mass malignant and is it hormonally active? The objective of our study was to evaluate the epidemiological, diagnostic, therapeutic, and evolutionary aspects of AT in a developing country. Methodology: We conducted a retrospective study spanning 17 years (from January 2005 to October 2022) in four Dakar hospital services. We included all patient medical records with explored AT. Results: AT was diagnosed in 35 patients who had a mean age of 36.62 years (range: 12-79), and a female predominance (26 women to 9 men). Among these patients, 17.2 % had incidental AT. Hypertension was the commonest presenting symptom in 27 patients (77%), which was associated with Mnards triad in 14 patients (40%). Abdominal pain was reported by 20 patients (57%), and 14 presented with an abdominal mass. Among the patients, 29 had functional AT: 22 with pheochromocytoma, 5 with primary hyperaldosteronism, and 2 with hypercortisolism. Imaging evaluations revealed that 33 patients had unilateral AT and one had bilateral AT. Tumour sizes varied, 5 patients had tumours 10 cm. Two patients presented with metastases. The therapeutic approach involved adrenalectomy in 32 patients. Perioperative complications were observed in five patients, including haemorrhage (two patients), hypotension (two cases), and hypertensive crisis (one case). One patient with bilateral pheochromocytoma developed acute adrenal insufficiency postoperatively, followed by abdominal herniation. Histopathological examination confirmed pheochromocytoma in 21 patients, Conns adenoma in 5, adrenocortical carcinoma in 3, cortisol adenoma in 2, and adrenal cyst in 1 patient. Non-functional AT included adrenocortical carcinoma (three patients), adrenal cyst (one patient), and pheochromocytoma (two patients). After a one-year follow-up, 29 patients wit

关键词： Tumour Adrenal Pheochromocytoma Conn Adrenocortical Carcinoma Dakar

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Case Report for Two Hemodialysed Patients Diagnosed for COVID-19 at the Donka National Hemodialysis Center

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Open Journal of Nephrology 2020年第3期10卷 241-244页

作者： Mamadou Saliou Baldé Abdoulaye touré amadou Yalla Camara Joseph Donamou Aly Traoré Boubacar Atigou Drame M’mah Lamine Camara Almamy Bangoura Mariam Mohamed Camara Mohamed Lamine Kaba Department of Nephrology-Hemodialysis Hospital National Donka Conakry Guinea Department of Reanimation Hospital Ignace Deen Conakry Guinea Department of Reanimation Hospital National Donka Conakry Guinea

In December 2019, coronavirus disease (COVID-19) due to infection with the novel SARS-CoV-2 virus began to break out. Hemodialysis patients are at high risk because of the co-morbidities. We report the clinical and biological characteristics of two patients who developed COVID-19 infection in our dialysis center in Donka National Hospital. None of the patients had contact with an infected person. The age was 38 and 54 years. The symptoms common to both patients were: fatigue, diarrhea, fever. Lymphopenia was present in both patients. None of them had a chest X-ray or chest scan because they were positive for the test before admission.

关键词： Hemodialysis COVID-19 Coronavirus Donka

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