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Experience with Open Prostatectomy in Lomé, Togo

Open Journal of Urology 2016年第5期6卷 73-79页

作者： Tchilabalo M. Kpatcha Boyodi Tchangai Kodjo Tengue fousséni alassani Gnimdou Botcho Tchin Darre Essomindedou Leloua Komi H. Sikpa Edoe V. Sewa Tsipa Anoukoum Komlan Gnassingbe Department of Urology the University Teaching Hospital of Lomé Togo Departement of Surgery the University Teaching Hospital of Lomé Togo Department of Pathology the University Teaching Hospital of Lomé Togo Department of Pediatric Surgery the University Teaching Hospital of Lomé Togo

Background: Open prostatectomy is the most commonly available surgical procedure for benign prostatic hyperplasia and this is the case in most countries in West African even with all the limitations of the procedure. Objective: The objective is to determine the pattern and outcomes of open prostatectomy in Lomé. Patients & Methods: From December 2011 to November 2012, we conducted a descriptive cross-sectional study on a series of patients treated for prostate adenoma. Dysuria was assessed using the International Prostate Symptom Score (IPSS). The history of each patient was recorded, as well as paraclinical data. All patients were surgically treated via abdominal incision procedure. The data obtained included the patients’ demographics, clinical features, the IPSS scores, investigations, type of open prostatectomy, outcome and follow-up. The data were analyzed for means and frequencies using Epi Info version 3.5.3. Results: Fifty-four consecutive patients underwent surgery consecutively, their ages ranging from 40 to 92 years, with an average of 67.27 ± 12.50 years. In all, 46 (85.2%) patients presented with obstructive symptoms and 26 (48.1%) presented with urinary retention. The average prostate volume was 114.31 ± 20.11 cm3 with a range of 31 - 485 cm3. The average blood loss at surgery was 425.92 ± 38.2 ml with an average operating time of 66.05 ± 15.75 mins and the main complications were hemorrhaging and clot retention in 7 (13%), epididymo-orchitis in 9 (16.7%), and urinary incontinence in 6 (11.1%) patients. IPSS scores were under 7 in 92% of patients three months after surgery and the mortality rate was 3.7%. Conclusion: This study has shown that open prostatectomy in our environment is still the commonest surgical option for benign prostatic hyperplasia with good outcomes though with manageable complications.

关键词： Open Prostatectomy Benign Prostate Hyperplasia Good Outcome Complications Lomé Togo

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Virological Therapeutic Failure and Associated Factors in People Living with HIV Followed up at the Regional Hospital and University of Borgou (RHU-B) in 2019

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Open Journal of Internal Medicine 2022年第2期12卷 121-128页

作者： Dovonou Comlan Albert alassani Adébayo Saké Alassan Khadidjatou Mama Cissé Ibrahim Attinsounon Cossi Angelo Faculty of Medicine University of Parakou Parakou Benin

Introduction: Antiretroviral treatment has made a considerable reduction in morbidity and mortality in HIV patients, but its effectiveness is compromised by the emergence of cardiovascular and metabolic diseases and also treatment failure. The goal is to study Virological therapeutic failure and the factors associated with HIV patients followed at RUH-B. Methods: This was a cross-sectional, descriptive and analytical study covering the period from 21st July to 21st September 2019. The study enrolled patients 18 years old and above, on antiretroviral treatment for at least 6 months. For the survey, a questionnaire and review of the medical records were used. The variable studied was virological treatment failure. Data analysis was performed using EPI-INFO version 7 and STATA 11 software. The significance level was 5%. Results: A total of 498 patients were included in the study. The mean age was 40 ± 9.90 years. The sex ratio was 0.3. The frequency of treatment failure was 15.3%. The factors associated with the occurrence of treatment failure were: phytotherapy, occurrence of opportunistic infections during follow-up, poor compliance with antiretrovirals, lack of weight gain and anemia during follow-up. Conclusion: This study had shown that treatment failure was frequent in patients. The systematic investigation for failure should be done in all people living with HIV patients on antiretrovirals.

关键词： Virological Therapeutic Failure Antiretroviral Associated Factors HIV Parakou Benin

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Frequency and Factors Associated with Erectile Dysfunction in People Living with HIV Managed in the Department of Internal Medicine at the Departmental Hospital University of Borgou (DHU-B) in 2017

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Open Journal of Internal Medicine 2022年第2期12卷 112-120页

作者： Dovonou Comlan Albert alassani Adébayo Attinsounon Cossi Angelo Mama Cissé Ibrahim Sake Alassan Khadidjatou Faculty of Medicine University of Parakou Parakou Benin

Introduction: Highly active antiretroviral treatment has considerably reduced the morbidity and mortality associated with HIV infection. However, we are witnessing the emergence of cardiovascular and metabolic diseases. The aim of this work is to study erectile dysfunction (ED) and the associated factors with HIV positive people managed DHU-B. Methods: This was a cross-sectional, descriptive and analytical study covering the period from March 1, 2017 to June 31, 2017. The study involved HIV-positive patients 18 years old and above, male, under antiretroviral treatment and have given their consent. ED was assessed by the IIEF5 score (International Index of Erectile Function). The data collected had been recorded and processed with the EPI INFO software (Version 7.2). The significance level was 5%. Results: A total of 280 patients were included in the study. The average age was 42 ± 10.04 years with extremes of 23 and 67 years. The prevalence of ED was 52.14%. Among patients with ED, 41% had severe ED. Factors associated with ED in multivariate analysis were: age over 40 years, anxiety, depression, arterial hypertension, lipodystrophy, multiple sexual partners and protease inhibitor therapy. Conclusion: ED concerns half of HIV-infected patients followed in the Internal Medicine department. It is therefore essential to provide more comprehensive care, both clinically and psychologically, in order to improve the quality of life of people living with HIV.

关键词： Erectile Dysfunction Associated Factors HIV Parakou Benin

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Lower Limb Arteriopathy in Diabetics at the Oueme-Plateau Provincial Hospital in Porto-Novo: Frequency and Associated Factors

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Open Journal of Internal Medicine 2023年第4期13卷 295-303页

作者： Finangnon Armand Wanvoegbe Comlan Jules Gninkoun Corine Houehanou Kouessi Anthelme Agbodande François Akotegnon Hubert Dedjan Rolande Quenum Manchouhoud Alalade Adebayo alassani Albert Dovonou Angele Azon-Kouanou Internal Medicine/Endocrinology Department Oueme-Plateau Provincial Teaching Hospital Porto-Novo Benin Internal Medicine Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Department of Epidemiology Biostatistics Health Environmental and Fundamental Sciences National Training School for Senior Technicians in Public Health and Epidemiological Surveillance Parakou Benin Internal Medicine Department Borgou-Alibori Provincial Teaching Hospital Parakou Benin

Introduction: The distribution of arteriopathy of the lower limbs (ALL) is not familiar in the city of Porto-Novo. The aim of this study was to determine the prevalence and associated factors of ALL in diabetic patients in treatment at the Oueme-Plateau Provincial Teaching Hospital. Methods: This was a cross-sectional, descriptive, and analytical study from July 12 to October 10, 2021, at the Oueme-Plateau Provincial Teaching Hospital in Porto-Novo. ALL was screened by performing systolic pressure index (SPI) in all diabetic patients aged at least 18 years, seen in consultation or hospitalization during the study period and who had given their consent. Results: The study registered 165 diabetics and 98.2% of them were type 2. Subjects aged between 55 and 65 years were the most represented (33.9%), with an average age of 59.4 years. Women were in the majority (61.2%), with a sex ratio of 0.6. High blood pressure was associated with diabetes in 61.2% of patients. The prevalence of ALL was 48.5% (80 patients). Obliterative arteriopathy of the lower limbs (OALL) was observed in 70 patients (42.4%), mediacalcosis in 8 patients (4.8%), and mixed arteriopathy in 2 patients (1.2%). In 88.5% of patients, the pathology was symptomless. Factors significantly associated with ALL included advanced age (p = 0.01), the age of the glycemic imbalance (p = 0.03), lack of regular physical activity (p = 0.001) and dyslipidemia (p = 0.008). Conclusion: Pelvic limb arteriopathy is usual among diabetics at Oueme-Plateau Provincial Teaching Hospital. The use of SPI, which enables diagnosis, requires simple, low-cost means, and should be encouraged.

关键词： ALL Diabetes OALL Porto-Novo Systolic Pressure Index

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Staged Surgery for Giant Fecaloma Complicating Idiopathic Megacolon

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Open Journal of Gastroenterology 2016年第12期6卷 418-422页

作者： Boyodi Tchangai fousseni alassani Mazamesso Tchaou Komla Attipou Department of Surgery Sylvanus Olympio Teaching Hospital Lome Togo Department of Radiology Sylvanus Olympio Teaching Hospital Lome Togo

Fecalomas that need surgical management are uncommon. We report a rare case of giant fecaloma in a 22 years old female, with a history of constipation since childhood and an abdominal mass. Abdomen CT scan revealed a giant fecaloma filling sigmoid lumen without signs of ischemia or either complications. Laparotomy and fecaloma extraction trough colotomy was undertaken after failure of conservative measures and endoscopic removal attempt. Hirschsprung disease having been ruled out, sigmoidectomy was performed for idiopathic megacolon. Post operative course was uneventful with good functional outcomes.

关键词： Giant Fecaloma Idiopathic Megacolon Sigmoidectomy CT Scan

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Contribution to the Study of Irritable Bowel Syndrome in Medical Students at the University of Parakou in Republic of Benin

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Open Journal of Gastroenterology 2023年第7期13卷 256-266页

作者： Khadidjatou Saké Aboudou Raimi Kpossou Adébayo Cossi alassani Doriane Berline Magatsing Nzekou Serge Ade Angelo Cossi Attinsounon Comlan Albert Dovonou Stéphane Kofi-Mensa Savi de Tovè Jean Sehonou Department of Medicine and Medical Specialties Faculty of Medicine University of Parakou Parakou Republic of Benin Department of Medicine and Medical Specialties Faculty of Medicine University of Abomey-Calavi Abomey-Calavi Republic of Benin

Introduction: Irritable bowel syndrome is the most common functional gastrointestinal disorder. The objective of this work is to contribute to improving the medical follow-up of medical students at the University of Parakou through a study of irritable bowel syndrome. Study Methods: This was a descriptive and analytical cross-sectional study with prospective data collection. Data were collected from medical students from May 2018 to July 2018 using a pre-established questionnaire. Sampling was probabilistic using a two-stage survey. The diagnostic tools were: Rome IV criteria, Bristol scale and HAD (hospital anxiety and depression) scale. Data analysis was performed using Epi Info 7.***.3.14 software. CDC. Results: Thirty-two (7.55%) of the 424 students included had irritable bowel syndrome. Out of the 32 students with IBS, 24 (75%) were female. Their average age was 21.38 ± 2.39 years. For 24 students (75%), the symptoms occurred at the same time as exam preparation or the intense course period. Of the 32 students with IBS, 1 (3.12%) was regularly physically active. In this series, 8 students (28%) consulted a doctor for their symptoms. The factors associated with this syndrome were female sex (p = 0.022), sleep disorders (p = 0.008) and the presence of a doubtful depression (p = 0.021). Absenteeism due to irritable bowel syndrome was noted in 18 (56.25%) students. Conclusion: Irritable bowel syndrome is a common condition among medical students in Parakou. Support for better management of psychological disorders could improve the quality of life of these students.

关键词： Irritable Bowel Syndrome Medical Students Parakou Republic of Benin

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Helicobacter Pylori Infection: Epidemiological, Clinical and Pathological Aspects in a Digestive Endoscopy Unit and the Pathological Anatomy Service of Parakou in Benin Republic

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Open Journal of Gastroenterology 2023年第7期13卷 225-236页

作者： Khadidjatou Saké Marie Claire Ballè Luc Valère Codjo Brun Nonvignon Murielle Somitondji Cossi Angelo Attinsounon Serge Adè Cossi Adébayo alassani Lionel David Togbenon Comlan Albert Dovonou Marie Thérèse Akélé Akpo Department of Medicine Departmental University Hospital Center of Borgou Parakou Benin Pathological Anatomy and Cytology Service Departmental University Hospital Center of Borgou Parakou Benin Pathological Anatomy and Cytology Service Faculty of Health Sciences National Hospital and University Center Cotonou Benin

Introduction: Helicobacter pylori (Hp) infection is the most common bacterial infection in the world. World Health Organization has classified this bacterium as a Class I carcinogen. The objective of this work is to study the epidemiological, clinical and pathological aspects of Helicobacter pylori infection among adults in a digestive endoscopy unit and the pathological anatomy service of Parakou. Patients and Methods: This was a descriptive and analytical cross-sectional study conducted from January 2020 to September 2020 in the digestive endoscopy unit and pathological anatomy service at the Departmental University Hospital Center of Borgou. Patients aged 18 years and older, who had undergone a gastroscopy with biopsies and who gave their oral consent were included. Three antral biopsies and two fundic biopsies were performed. The search for Hp was done under an optical microscope after staining with hematoxylin eosin. Results: A total of 151 patients were included and 51.66% were infected with Hp. Their average age was 40.63 ± 15.32 years and the sex ratio was 0.9. Epigastric pain was the most reported symptom (71.01%). Endoscopically, the prevalence of erythematous gastropathy was 98.72%. The study of chronic Hp gastritis according to Sydney system had shown signs of activity in 100% of patients with Hp and glandular atrophy in 83.33% of them. Intestinal metaplasia and dysplasia accounted for 24.35% and 29.48% of cases, respectively. Factors associated with Hp infection were: absence of proton pump inhibitor intake prior to examination, absence of handwashing with soap and water before eating, erythematous aspect of gastritis on gastroscopy, absence of intestinal metaplasia of the fundus, active and chronic aspects of gastritis on histology. Conclusion: The frequency of Hp infection in hospitals among adults admitted to the Digestive Endoscopy Unit of Parakou is high. To reduce this prevalence, it will be necessary to act on the factors identified.

关键词： Helicobacter pylori Gastroscopy Pathological Anatomy Parakou Benin Republic

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Diabetic Ketosis Decompensations at the National Hospital in Benin (West Africa), What Did We Learn about the Precipitating Factors?

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Journal of Diabetes Mellitus 2016年第4期6卷 301-306页

作者： Comlan Jules Gninkoun Adébayo Sabi Cossi alassani Yempabou Sagna Philippe Adjagba François Djrolo Department of Internal Medicine-Endocrinology Metabolism and Nutrition Unit Cotonou Benin University Hospital of Borgou Parakou Benin Department of Internal Medicine University Hospital Yalgado Ouedraogo Ougadougou Burkina Faso Cardiology and Vascular Disease Unit Cotonou Benin

We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of ketosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the ketosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of ketosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that ketosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.

关键词： Ketoacidosis Diabetes Complications Ketosis-Prone

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Self-Medication Practice against Malaria and Associated Factors in the City of Parakou in Northern Benin: Results of a Population Survey in 2017

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Advances in Infectious Diseases 2019年第3期9卷 263-275页

作者： Cossi Angelo Attinsounon Yollande Sissinto Euripide Avokpaho Adébayo alassani Majid Sanni Marcel Zannou Faculty of Medicine CHUD-Borgou Teaching and Research Unit of Infectious and Tropical Diseases University of Parakou Parakou Bénin University of Parakou CHUD-Borgou Clinic of Internal Medicine Parakou Bénin University of Abomey Calavi CNHU-HKM Laboratory of Parasitology-Mycology Cotonou Bénin University of Abomey Calavi CNHU-HKM Clinic of Internal Medicine Cotonou Bénin

Introduction: Self-medication is a common practice in Benin. It has many consequences on people’s health in general and develops chemoresistance in particular. Aim: The aim of this work is to study the practice of anti-malarial self-medication in the city of Parakou and to identify the associated factors with this practice. Methods: This was a descriptive cross-sectional analytical survey that took place in the period from April 15 to June 24, 2017. Adults who reported having had malaria symptoms in the last 6 months before the survey and living in 9 neighbourhoods randomly selected in the city of Parakou were included. A structured questionnaire collected their self-medication habit, the drugs used, the supply places and the reasons for this practice. Data were analysed using the Epi-data 3.1 software. Results: Of the 335 respondents included in this study, 141 (42.09%) had self-medicated including 130 (38.81%) with anti-malarial drugs. Fever is the main symptom of malaria cited by respondents (129% or 38.51%) followed by headache (93% or 27.76%). The most commonly used anti-malarial drugs for self-medication are quinine (60% or 44.45%) followed by artemisinin-based combination therapy (46% or 34.07%). Eighty-seven respondents (66.92%) did not have a good knowledge of the drug dosage. Reasons for self-medication were mainly the high cost of consultation fees (99% or 54.10%) and good knowledge of one’s illness (53% or 28.96%). Self-medication associated factors were fever (p = 0.04), non-prescription drugs supply in pharmacies (p Conclusion: Self-medication is a common practice in the city of Parakou. Medicines purchased without prescription in pharmacies and drugs availability in street facilitate this practice, which may compromise the effectiveness of anti-malarial drugs.

关键词： Self-Medication Anti-Malarial Drugs Urban Setting Parakou Benin

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Therapeutic Itinerary and Causes of Delay in Specialized Consultation of Patients Admitted for Diabetic Foot

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Journal of Diabetes Mellitus 2018年第4期8卷 125-130页

作者： Comlan Jules Gninkoun Mensah S.Attikleme Roberto Dossou Tores Prudencio Adebayo Sabi Cossi alassani Francois Djrolo Endocrinology Metabolism and Nutrition UnitFaculty of Health Sciences of CotonouCotonouBenin University Clinic of Internal Medicine and Medical Oncology CotonouBenin Teaching Hospital of Borgou-Alibori ParakouBenin

Introduction: Amputation remains a common practice in patients admitted for diabetic foot. The delay in consultation is one of the main reasons. The objective of this work was to analyze patients’ itinerary care and to identify the causes of delay in consultation in patients admitted for diabetic foot. Method: This is a descriptive cross-sectional study, including all patients hospitalized for diabetic foot. A wait of at least seven (7) days before consulting the Endocrinology department of Hubert Koutoukou Maga Teaching Hospital (CNHU-HKM) after the foot injury occurred was considered as delay in consultation. The data were recorded and analyzed in the EPI INFO software. The description of the sample was made according to the usual statistics (frequency, average, standard deviation). Results: Seventy-six (76) diabetic foot cases were admitted during the period of the study. The mean age of the patients was 56.64 ± 10.71 years with extremes of 29 years and 84 years. Patients were most often received at an advanced stage of the foot injury, 3D stage of Texas classification in 87% of cases and Wagner grades 4 and 5 in 52% of cases. The amputation rate was 38.16%. An analysis of the first care places reveals that 90.8% of patients had consulted conventional medicine, 13.2% in traditional medicine;1.2% had religious practices and 18.7% had declared self-medication at home. Consultation period at CNHU HKM was more than 7 days in 80% of cases and less than 7 days in 20% of cases. The average consultation time was 44.08 ± 26.43 days with extremes of 1 and 480 days. The main reasons for the delay in seeking hospital care cited by diabetic patients were fear of amputation (47.8% of cases), economic difficulties (32.5% of cases) and awareness lack of the situation seriousness (22.4%). Conclusion: The therapeutic itinerary of patients with diabetic foot was particularly long. The main reasons of late appeal to specialized care were fear of amputation and economic difficulties. The implementation of universal health insuranc

关键词： Therapeutic Itinerary Diabetic Foot Delay Complication Amputation

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