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Outcomes of Hemodialysis Patients in Public Centres in Abidjan from September 2018 to October 2021: Data from the Renal Registry of Cote d’Ivoire

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Open Journal of Nephrology 2024年第3期14卷 413-426页

作者： Sery Patrick Diopoh arthur Kanganga Serge Didier Konan Kolo Claude Ouattara Marie-Dominique Kouadio Mohamed Alex Moudachirou Kouamé Hubert Yao Department of Medicine and Medical Specialties University Flix Houphout-Boigny Abidjan Cote dIvoire National Centre for Prevention and Treatment of Renal Failure Abidjan Cte dIvoire

Background: Hemodialysis is the most widely used renal replacement therapy in developing countries such as Cote d’Ivoire. Objective: To study the outcome of chronic hemodialysis patients in public centres in Abidjan using data from the Renal Registry of Cote d’Ivoire (2RCI). Method: This was a prospective analytical cohort study of End Stage Kidney Disease (ESKD) patients undergoing iterative hemodialysis in the network of public hemodialysis centres in Abidjan and who had been registered in the 2RCI register by September 2018. Results: Our study involved 363 cases out of 379 patients registered in the 2RCI registry database in 2018. The mean age of the patients was 47.3 ± 12.1 years, with a male predominance (sex ratio 1.97). In 70.24% of cases, they had no health insurance. The average duration of dialysis for our patients was 6.94 ± 4.1 years, with extremes of 2 and 28 years. This duration was less than 5 years in 44.3% of cases, between 6 and 10 years in 42.9% and more than 10 years in 12.6% of cases. The comorbidities found were hypertension in 95.6% of cases, diabetes in 7.8% and HIV in 4.6%. Anemia was found in 68% of cases and stroke in 8.6%. During the study period, 161 deaths were observed, representing a mortality rate of 44.35%. Acute lung oedema (29.8%), stroke (6.8%) and other cardiovascular diseases (19.3%) were the main causes of death. In multivariate analysis, factors such as age ≥ 65 years (HR = 3.66;CI 95% = 1.55 - 8.67;p = 0.003), “married/coupled” status (HR = 2.02;CI 95% = 1.24 - 3.31;p = 0.005) and normal weight at the start of dialysis (OR = 9.59, CI95% = 4.19 - 21.95;p = 0.001) were associated with the risk of death. Conclusion: Hemodialysis is performed in Abidjan on young patients. The mortality rate after three years of dialysis is very high. Hence the need to pursue the policy of decentralizing public centres and optimizing access to dialysis in terms of quality and quantity in order to improve patient survival.

关键词： Chronic Hemodialysis Death Renal Registry Cote d’Ivoire

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Intermediate Hip Arthroplasty in Gabon: Blood Loss and Risk Factor for Transfusion

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Open Journal of Anesthesiology 2024年第4期14卷 109-117页

作者： Ghislain Edjo Nkilly Pascal Christian Nze Obiang Raphael Okoue Ondo arthur Matsanga Stéphane Oliveira Léandre Nguiabanda Jean-Marcel Mandji-Lawson Department of Anaesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anaesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anaesthesia and Intensive Care Owendo University Hospital (CHUO) Libreville Gabon Department of Anaesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon Orthopedic Surgery Service Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon

Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. Method: It was a retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.

关键词： Hip Arthroplasty Risk Factors Patients Hemiarthroplasty Gabon

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Thoracoscopy in Cameroon: Indications, Technics and Short Term Results

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Surgical Science 2024年第4期15卷 278-288页

作者： Guy Aristide Bang Richard II Mbele Fabrice Stephane Arroye Betou Arlette Joelle Moukitek Banaken Amos Bella Ela Charles Mve Mvondo arthur Essomba Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences Yaound&#233 I University Yaound&#233 Cameroon Department of Surgery and Specialities Yaound&#233 Teaching Hospital Yaound&#233 Cameroon General Surgery Service Mvog-Ada District Hospital Yaound&#233 Cameroon Department of Cardiothoracic and Vascular Surgery Laquintinie Hospital Douala Cameroon Department of Cardiothoracic and Vascular Surgery Yaound&#233 General Hospital Yaound&#233 Cameroon Cardiac Center Shisong St. Elizabeth Catholic General Hospital Shisong Kumbo Cameroon

Introduction: Thoracoscopy is a video-assisted surgical approach that mirrors the techniques used in thoracotomy. Our aim is to map the current state of thoracoscopy practice in Cameroon’s hospitals. Methods: This was a descriptive study that collected both retrospective and prospective data over 57 months across four hospitals in Cameroon. It included 13 patients and focused on variables such as socio-demographic factors, clinical profiles, surgical procedures, and postoperative follow-up. Results: Thirteen patients, predominantly male (84.6%, n = 11), with a mean age of 37.5 ± 16 years, were enrolled. Alcohol use (61.5%) and smoking (38.5%) were the most common past histories. The major complaints were dyspnea (84.6%) and chest pain (58.3%). The primary surgical procedure was clot-free thoracoscopy in 30.8% of cases, mainly for persistent hemothorax (41.8%). Most surgeries were elective (76.9%) and performed under general anesthesia with selective intubation (61.5%). The most common approach was single-port thoracoscopy (U-VATS) (76.9%), with no reported difficulties;however, one intraoperative incident occurred and was successfully treated. Drainage was performed systematically in all patients, and one case required conversion to open surgery. Postoperative complications were minor (Clavien-Dindo grade I) and mainly consisted of pain, with a mortality rate of 15.4%. No significant association was found between risk factors and the occurrence of complications or postoperative mortality. Conclusion: Thoracoscopy, a novel approach in our context, primarily focuses on minor thoracic surgeries.

关键词： Thoracoscopy Single-Port Hemothorax Cameroon

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Abiotic Factors Associated with Abundance Dynamics and Antibiotic Multidrug Resistance of Escherichia coli and Enterococcus faecalis Isolated from Some Ombessa Aquatic Systems (Central Cameroon Region)

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Journal of Geoscience and Environment Protection 2024年第9期12卷 335-369页

作者： Lucie Leme Banock Blandine Pulchérie Tamatcho Kweyang Fabrice Ezo’o Mengo Stephane arthur Noah Eric Donald Mbo Zang Olive Vivien Noah Ewoti Laboratory of Hydobiology and Environment Department of Animal Biology and Physiology Faculty of Sciences University of Yaounde 1 Yaounde Cameroon Laboratory of Microbiology of Soil and Environment Department of Microbiology Faculty of Sciences University of Yaounde 1 Yaounde Cameroon

The present study conducted in the town of Ombessa aims to assess the influence of abiotic factors on the abundance dynamics and antibiotic susceptibility of Escherichia coli and Enterococcus faecalis isolated from some aquatic systems from February to July 2022, monthly samples were taken at 10 water points used by the population (8 groundwater points and 2 surface water points). Samples were analyzed for physico-chemical parameters such as temperature, pH, electrical conductivity. Bacteriological variables such as BHAM, E. coli and E. faecalis abundances were also assessed. Antibiotic susceptibility of E. coli and E. faecalis was assessed using 06 antibiotics using the Kirby-Bauer diffusion disk method. The results show that bacterial abundances were the highest in surface waters. Bacterial densities were the highest in May and the lowest in February. The average densities recorded were 3845 CFU/100mL for BHAM, 380 CFU/100mL for E. coli and 14 CFU/100mL for E. faecalis in groundwater;and 8583 CFU/100mL for BHAM, 6878 CFU/100mL for E. coli and 812 CFU/100mL for E. faecalis in surface water. Antibiotic susceptibility tests showed that these bacterial species are sensitive to Gentamicin, Chloramphenicol, Azithromycin and Ciprofloxacin. They are all resistant to Trimethoprim/Sulfamethoxazole, E. coli is resistant to Doxycycline and E. faecalis has an intermediate sensitivity to Gentamicin. Overall, the Multiresistance to Antibiotics (MRA) indices obtained were above 0.2, indicating the presence of multidrug resistance in bacterial communities. The physico-chemical properties of the water varied over time and space, but on the whole remained below the threshold values of WHO guidelines. The degree of linkage between abiotic water variables and bacteriological parameters has shown that bacterial densities are more abundant in rainy seasons and increased O2 levels favor bacterial growth, while TSS, CO2 and dissolved nitrate levels affect the sensitivity of these bacteria

关键词： Bacterial Abundance Multiresistance Abiotic Aquatic

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Broad Hormonal Responses Induced by Aluminum in Roots of Dwarf Transgenics of Solanum lycopersicum L. cv “Micro-Tom”

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American Journal of Plant Sciences 2024年第5期15卷 349-358页

作者： arthur B. Rates Daniela Boanares Daniele S. G. Pianetti Felipe Della-Torre Joni E. Lima Marcel G. C. França Department of Botany and Plant Physiology Laboratory Federal University of Minas Gerais Belo Horizonte Brazil

The spatial pattern distribution of plant hormones in response to aluminum (Al) toxicity in roots remains to be shown. This study was performed to assess the root hormonal accumulation and gene expression in response to Al toxicity in five transgenic miniature dwarf tomatoes cv. Micro-Tom (MT). MT and MT transgenics to acid indole acetic, cytokinin, gibberellin, abscisic acid and ethylene were cultivated in nutrient solutions containing different Al concentrations. Root growth elongation was measured and cellular damage was visualized by staining Evans’s blue. The GUS reporter gene staining technique was used to visualize hormonal changes in MT apex root tissues. Data indicated that the MT is sensitive to Al that induced significant growth inhibition and cellular damage. Al concentration of 27 μM was significantly toxic, inducing root apex darkening and inhibition of root development. The qualitative evaluation of GUS reporter gene expression showed intense crosstalk among all hormones studied, underscoring the complexity of signaling induced by Al in apex roots. Results point out to a major understanding of the hormonal signaling in response to Al toxicity, which may induce a change of root growth and architecture with growth inhibition and cell constraints modulated by all different hormones evaluated.

关键词： Gene Reporter Metal Plant Hormones Root Staining

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Results of Surgical Management of Malignant Obstruction of the Common Bile Duct in Yaoundé

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Surgical Science 2024年第4期15卷 265-277页

作者： Eric Patrick Savom Gaël Tsanga Nomo Richard II Mbele Mahamat Yannick Ekani Boukar Cédric Paterson Atangana Fred Dikongue Dikongue Guy Aristide Bang arthur Essomba Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the Universityof Yaoundé I Yaound&#233 Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Yaoundé Teaching Hospital Yaound&#233 Cameroon

Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical treatment of MOCBD, evaluate the results and detect the factors associated with postoperative morbidity and mortality. Patients and Methods: We conducted an analytical observational study, with retrospective data collection from the files of patients operated upon for MOCBD. This was done in four referral hospitals in the city of Yaoundé for a 42-month period spanning from January 1, 2020 to June 30, 2023. Demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results: We collected 71 files. The sex ratio was 1.4 and the mean age was 56 ± 11 years. Fifty-three (53) patients (74.6%) were overweight or obese and 10 patients (14.1%) were hypertensive. A clinical cholestasis syndrome was present in 69 patients (97.2%). Fifty-five (55) patients (77.5%) had a cancer of the head of the pancreas, 8 patients (11.3%) had an extra-hepatic cholangiocarcinoma and 8 patients (11.3%) had an ampullary adenocarcinoma. Eight (8) resections (11.3%) with curative intent had been carried out and in 63 cases (88.7%), surgery was palliative. Postoperative morbidity was 55.7%, influenced by advanced WHO stage (p = 0.02). Postoperative mortality was 25.7%, associated with a high ASA score (p = 0.01). Conclusion: Pancreatic head cancer is the main etiology of malignant obstructions of the common bile duct in Cameroon. Surgical treatment is most often palliative. Postoperative morbidity and mortality are high, influenced by high WHO and ASA scores.

关键词： Malignant Obstruction Common Bile Duct Palliative Treatment Morbidity Mortality

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Determination of the Mineral Composition of the Pulp and Evaluation of the Acute Toxicity of the Seeds of Carica papaya L. Consumed in Lubumbashi and Kinshasa in the Democratic Republic of the Congo

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Journal of Biosciences and Medicines 2024年第9期12卷 266-279页

作者： Guelord Inkalaba Janvier Arnauld Kiza Magain Mihatano Mathilde Bushiri Furaha arthur Duki Olivier Nzingula Armelle Naniwambote Maguy Luvandu Nicole Misengabu Désiré Musuyu Fridolin Kodondi Kule-Koto Laboratory of Biochemistry Nutrition and Hematology Faculty of Pharmaceutical Sciences University of Kinshasa Kinshasa Democratic Republic of the Congo Faculty of Pharmaceutical Sciences University of Lubumbashi Lubumbashi Democratic Republic of the Congo Food Technology and Food Analysis Laboratory Faculty of Pharmaceutical Sciences University of Kinshasa Kinshasa Democratic Republic of the Congo Higher Institute of Medical Techniques Nutrition and Dietetics Section Kinshasa Democratic Republic of the Congo Laboratory of the National Institute of Biomedical Research (NIBR) Kinshasa Democratic Republic of the Congo

This work aimed, on the one hand, to determine the mineral and phytochemical composition of Carica papaya in order to guarantee the food safety of consumers and on the other hand, to evaluate the acute toxicity of papaya seeds. The papayas were bought at the Mzée market in Lubumbashi and Selembao in Kinshasa. Fruit sampling was done according to the ISO 7002 standard on agricultural and food products;the papayas were firm, mature, and without stains or physical damage. The analysis results of the papaya pulp showed both for the samples from the city of Lubumbashi and for the city province of Kinshasa that it contains respectively 85.87% and 84.46% water, 0.59% and 0.53% ash content. The mineral evaluation of our two samples presented a potassium content of 200 ± 8 mg, magnesium 13.12 ± 3 mg, calcium 22.15 ± 2 mg, sodium 3 mg ± 0.5 for the sample from Lubumbashi and 192.32 ± 8 mg of potassium, 14.458 ± 3 mg of magnesium, 20.58 ± 2 mg of calcium and 3.58 ± 0.5 mg of sodium for the sample from Kinshasa in macroelements. Concerning the trace elements, after analysis, we found zinc content (0.29 ± 0.1 mg and 0.12 ± 0.1 mg), copper (0.02 ± 0.01 mg and 0.14 ± 0.01 mg), and iron (2.22 ± 0.5 mg and 2.04 ± 0.5 mg) respectively for Lubumbashi and Kinshasa. The chemical screening indicates the presence of alkaloids, saponosides, tannins catechics, flavonoids and anthocyanins in the palm wine and ethanolic extract of the seeds of Carica papaya and an absence of cyanogenic glycosides and gallic tannins. With mild toxicity, the seeds of the fruit of Carica papaya L. can be used with moderate risk by the population.

关键词： Carica papaya Mineral Composition Acute Toxicity

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Surgical Management of Perforated Colon Tumours in Yaoundé: A Multicentre Retrospective Review of 30-Day Postoperative Outcome

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Surgical Science 2024年第5期15卷 330-341页

作者： Eric Patrick Savom Richard II Mbele Colman Tamboh Tankou Mahamat Yannick Ekani Boukar Cédric Paterson Atangana Fred Dikongue Dikongue Daniel Biwole Biwole Guy Aristide Bang arthur Essomba Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 I Yaound&#233 Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Dschang Dschang Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon Yaoundé University Teaching Hospital Yaound&#233 Cameroon

Introduction: Colon cancer is often diagnosed late in our context and there is a high prevalence of complicated forms, this including perforation. The optimal surgical treatment remains controversial. The aim of this study was to improve the short-term postoperative outcomes of patients operated upon for perforated colon cancer, by identifying factors associated with complications occurring within 30 days after surgery. Patients and methods: We carried out an analytical observational study, with a retrospective collection of data from the files of patients operated upon for an in situ tumoral colon perforation. This was done in four referral hospitals in the city of Yaoundé. The period was from the 1st of January, 2012 to the 31st of December, 2021. Cox regression identified the factors associated with postoperative morbidity and mortality. Results: We collected files of 46 patients. The mean age was 54.7 ± 19.9 years with a sex ratio of 1.4. The clinical presentation on admission was dominated by the presence of signs of peritoneal irritation (91.3%) and bowel obstruction (28.3%). The diagnosis was made preoperatively in 16 cases (34.8%). The surgical procedures consisted of colectomy with anastomosis in 28 cases (60.9%) and without anastomosis in 14 cases (30.4%). Postoperative morbidity was 60.9% dominated by surgical site infection (37%). Postoperative mortality was 39.1%. The existence of generalized peritonitis was associated with the occurrence of postoperative complications (p = 0.019). The main factors associated with postoperative mortality were resection with primary anastomosis (p = 0.027), enterocutaneous fistula (p = 0.005). Conclusion: Colic resection with primary anastomosis or ideal colectomy is associated with an increased risk of mortality and should therefore not be performed in this setting.

关键词： Perforated Colon Cancer Postoperative Morbidity and Mortality Colectomy Acute Generalized Peritonitis

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Laparoscopic Surgery of Incisional Hernia: Technique and Short-Term Results in Three Surgical Units in Cameroon

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Surgical Science 2024年第4期15卷 232-243页

作者： Guy Aristide Bang Eric Patrick Savom Achille Aimé Bekolo Otiti Fred Dikongue Dikongue Mahamat Yannick Ekani Boukar Richard II Mbele Cédric Paterson Atangana Daniel Biwole Biwole arthur Essomba Yaoundé Teaching Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaound&#233 Cameroon Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon

Introduction: Incisional hernia is a common medical situation and its treatment has always been a challenge for general surgeons. If laparoscopic repair has become a gold standard elsewhere, it is increasingly done in our milieu, but no data has been found. The aim of this study was to review this surgery done in our country so far, to describe the operative technique and to evaluate the postoperative outcomes. Patients and Methods: We conducted an observational descriptive study with retrospective collection of data from the 1st of July 2018 to 30th of June 2022, in three hospitals in Cameroon. Data on socio-demographic and clinical characteristics, surgical technique and postoperative outcomes of patients who had a laparoscopic repair of their incisional hernia were collected. Results: We reviewed 20 files. There were 14 women with an average age of 54.6 years. The average BMI was 32.8 kg/m2. Thirteen patients had a moderate size hernia and the hernia was localized at the midline in 18 cases. Only composite biface meshes were used with dimensions chosen to obtain at least 5 cm overlap. Spiral tacks were the only fixation means used. We registered 3 complications. One case of generalized peritonitis secondary to missed digestive perforation, one case of seroma and one case of postoperative ileus. We registered no death. Conclusion: Laparoscopic repair of incisional hernias is feasible in a resource-limited setting like ours. Compliance with the operative technique and recommendations is important to obtain short-term results closed to that put forward by literature.

关键词： Incisional Hernia Laparoscopy Repair Composite Biface Mesh Postoperative Outcomes

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Urethroplasty among Elderly Men, Surgical Techniques and Outcomes

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Open Journal of Urology 2024年第3期14卷 179-187页

作者： Kwaku Addai Arhin Appiah George Amoah Patrick Opoku Manu Maison Roland Azorliade Kwaku Otu-Boateng Douglas arthur Dominic Annor Mintah Joseph Yorke George Asafu Adjaye Frimpong Christian Kofi Gyasi-Sarpong Department of Surgery School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana Department of Surgery Komfo Anokye Teaching Hospital Kumasi Ghana Department of Surgery School of Medical Sciences University of Cape Coast Cape Coast Ghana Department of Radiology School of Medicine and Dentistry Kwame Nkrumah University of Science and Technology Kumasi Ghana

Introduction: Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy postoperatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bulbar urethral strictures. The repair methods employed were anastomotic urethroplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethroplasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Complications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the pr

关键词： Urethral Stricture Elderly Men Urethroplasty Surgical Techniques

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