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Management of Traumatic Brain Injuries at the Kara Regional Hospital

Surgical Science 2024年第2期15卷 19-27页

作者： Tamegnon Dossouvi Tchaa Hodabalo Towoezim Abdel kader moumouni Kokou Kanassoua Iroukora Kassegne Ekoue David Dosseh Department of General Surgery Dapaong Regional Hospital University of Kara Kara Togo Department of Traumatology and Orthopaedics Kara University Hospital University of Kara Kara Togo Department of Neurosurgery Kara University Hospital University of Kara Kara Togo Department of General Surgery Kara University Hospital University of Kara Kara Togo Department of General Surgery Kara Regional Hospital University of Kara Kara Togo Department of General Surgery Sylvanus Olympio University Hospital of Lomé University of Lomé Lomé Togo

Introduction: Traumatic Brain Injury (TBI) is a major public health problem causing significant morbidity and mortality in young adults. This study aimed to describe the epidemiological, diagnostic, therapeutic, and evolutionary aspects of TBI. Materials and Methods: This was a prospective, descriptive study conducted from 1 April 2022 to 31 March 2023 on patients admitted to and treated for cranioencephalic trauma in the General Surgery department of Kara Regional Hospital. Results: Eighty-three (83) patients with cranioencephalic trauma were managed out of 773 patients admitted to the department during the study period. The mean age was 34 ± 14.98 years and the sex ratio was 3.6 in favour of men. Motorbike taxi drivers were the social group most affected (n = 33, 40%). The causes of trauma were dominated by public road accidents (n = 80;96%). TBI was mild (n = 40;48%), moderate (n = 35;42%) and severe (n = 8;10%). Cerebral CT scans were performed in 19 patients (23%). Cerebral contusion (n = 4) was the most frequent cerebral lesion. Six patients (7%) with severe head injuries were transferred to Kara University Hospital. Six deaths (7%) occurred in patients with severe head injuries. The main sequelae were intermittent headaches in all patients reviewed, and memory problems (6%). Conclusion: Traumatic brain injuries are common at Kara Regional Hospital. Severe cranial trauma is less frequent but leads to death because of financial difficulties and limited technical facilities.

关键词： Traumatic Brain Injury Road Accident Motorcyclist Cerebral Contusion Togo

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Chronic Subdural Hematoma Associated with an Arachnoid Cyst in Elderly, an Intraoperative Finding after Re-Bleeding: Case Report

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Open Journal of Modern Neurosurgery 2024年第1期14卷 57-63页

作者： Komi Egu Agbéko Komlan Doléagbénou Messan Hobli Ahanogbé Abdel kader moumouni Essossinam Kpélao Katanga Anthony Békéti Department of Neurosurgery Sylvanus Olympio Teaching Hospital Lomé Togo Department of Neurosurgery Kara Teaching Hospital Kara Togo

Intracranial arachnoid cysts (AC) are believed to be congenital and chronic subdural hematomas tend to occur in elderly patients with a history of mild head injury. The association between these two entities sporadically occur in relatively young patients but rare in elderly patients. We report a 65-year-old man who presented with headache and dizziness of 2 months’ duration with a history of head injury. Brain computed tomography (CT) a CSDH in right side and a hygroma in left side. After first operation with burr holes in both sides, the patient underwent an early recurrence of acute subdural hematoma in the right side. The evacuation of this hematoma by a craniotomy allowed seeing an AC that we resected partially with complete recovery of the patient. The association CSDH/AC is rare and possible in elderly patients and there is no consensus on treatment.

关键词： Arachnoid Cyst Chronic Subdural Hematoma Elderly Patient

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Neurological Sequelae in Cranioencephalic Trauma Patients at the National Hospital in Zinder (Niger)

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Open Journal of Modern Neurosurgery 2022年第2期12卷 104-115页

作者： Mahaman Sani Rabiou Abd-el kader moumouni Abiba Tamou Tabe Essosinam Kpelao Stackys Hounkpatin Moussa Taofik Abdoulaye Adamou Babana Dede Regine Diane Ajavon Aminata Kelani Soumaila Sanoussi Depetement of Neurosurgery Zinder Hospital Zinder Niger Department of Neurosurgery Kara University Hospital Center KaraTogo Depeartment of Radiology Kara Regional Hospital Center Kara Togo Department of Neurosurgery Syvanus Olympio University Hospital Center Lome Togo Depetement of Traumatology Zinder Hospital Zinder Niger Department of Neurosurgery Maradi Niger Reference Hospital Maradi Niger Faculty of Health Sciences University of Kara Kara Togo Depetement of Neurosurgery CHU Niamey Niamey Niger

Introduction: Cranioencephalic trauma is a frequent reason for admission to emergency departments and is a source of mild to severe neuropsychological defects that will persist over time. Their management remains difficult. Objectives: To evaluate the sequelae presented by patients suffering from cranioencephalic trauma. Methods: This was a retrospective, descriptive, cross-sectional study conducted at the National Hospital of Zinder. It will include all patients admitted and hospitalised in the emergency, intensive care and neurosurgery departments of Zinder National Hospital for head injury over a period of 28 months from 1 January 2016 to 30 April 2018. Brain scan, X-ray were the imaging tests used. Results: Out of a total of 974 admissions, 367 were retained, i.e. 37.6%, with a male predominance (82.6%). The average age was 26.5 years. MVAs were represented in 89.7% of cases. Moderate CTE accounted for 64% of cases. Altered consciousness was reported in 295 patients (80.38% of cases). Brain scans were used in 76.7% of cases and skull X-rays in 4.2% of cases. Medical management was performed in all patients. Treatment was operative in 78 patients (21.25%). Recovery without immediate sequelae was found in 187 patients (50.9%). Persistent headache represented 47.7% of the late sequelae observed in the patients, epileptic seizures represented 16.8% of the late sequelae, neurological deficit represented 14.7%. Conclusion: Cranioencephalic trauma represents a major public health issue. Although their in-hospital management remains a challenge, post-hospital management related to the appearance of sequelae remains another.

关键词： Cranioencephalic Trauma CT Scan X-Ray Sequelae Niger

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Hospital Information Systems Shortage in Sub-Saharan African Hospitals: Opportunities and Challenges

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E-Health Telecommunication Systems and Networks 2022年第1期11卷 1-13页

作者： Abd El kader moumouni Dede Regina Ajavon Komlan Agbeko Doleagbenou Dabou Abiba Tamou Tabe Kodjo Mensah Hobli Ahanogbe Massaga Dagbe Akoete Simon Gbessena Komi Amagnga Desama-Esso Banawe Tchilabalo Bamazi Amona Department of Surgery CHU Kara Kara Togo Department of Gynaecology and Obstetrics CHR Tomde Kara Togo Department of Surgery CHU Sylnanus Olympio Lomé Togo Radilogy Department CHR Tomde Kara Togo Radilogy Department CHU Kara Kara Togo Department of Network and Computer Maintenance CHU Kara Kara Togo

The HIS is recognised as an essential tool for optimising the management of a health establishment in particular and the health system in general. But it is still very little implemented in hospitals in the South. Open source HIS software, available on the Internet, can be a solution for starting a (HIS) project in these hospitals. A search on the Internet for open source HIS software allowed us to choose MedBoard, the second most popular open source software out of 381, to start an HIS project called PERFORMANCE at the Kara University Hospital in northern Togo. A questionnaire allowed us to assess the level of knowledge of health actors on hospital information systems. The results of this evaluation allowed us to strengthen our proposal. The analysis of the current computer park of the CHU Kara does not allow whatever the functionalities of MedBoard to implement PERFORMANCE at the CHU Kara. Logistics are needed to make PERFORMANCE work. The real difficulty to start and perpetuate HIS project is linked to the human factor.

关键词： Free Software Hospital Information System Performance Chu Kara

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Assessment of Haemostasis in Anaesthesia for Surgery at the Sylvanus Olympio University Hospital Center in Lomé

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Open Journal of Anesthesiology 2021年第6期11卷 184-193页

作者： Essohanam T. Mouzou Sarakawabalo Assénouwè Abd El kader moumouni Pikabalo Tchètikè Akala-Yoma Gnimdou Anesthesilogy Department University Teaching Hospital of Kara Kara Togo Anesthesiology Department Sylvanus Olympio Teaching Hospital Lome Togo Neurosurgery Department University Teaching Hospital of Kara Kara Togo

Title: Assessment of haemostasis in anaesthesia for surgery at the Sylvanus Olympio University Hospital Center in Lomé. Objectives: Evaluate the prescription of the preoperative haemostasis assessment. Methodology: This was a prospective descriptive and observational study which had taken place in the central operating room and in the operating room of the ENT department at UHC SO of Lomé from January 1 to June 31, 2016. It had concerned all patients who had anaesthesia for scheduled surgery after pre-anesthetic consultation and the haemostasis assessment carried out according to the anaesthesia technique and the type of surgery. Results: Two hundred and sixty (260) patients underwent anaesthesia during the study period. The male sex predominated (60%), the age group 18 - 40 years predominated (50.4%). GA was more practiced (62.7%) followed by spinal anaesthesia (30.3%). Minor ENT surgery was more performed (28%). ASA1 patients predominated (48.5%). The pre-anesthetic haemostasis assessment including platelet count, prothrombin rate, activated partial thromboplastin time and bleeding time was almost always done. The platelet count was achieved in all patients followed by the activated partial thromboplastin time (94%). No haemorrhagic complication related to a haemostasis disorder was observed in the perioperative period in anaesthesia than in surgery. Conclusion: The prescription of the pre-anesthetic haemostasis assessment should not be systematic. It must take into account the clinical history, the patient’s bleeding history during the anaesthesia consultation, the type of anaesthesia, the surgery planned and the age.

关键词： Haemostasis Assessment Anaesthesia Surgery UHC Lomé

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Intradural Extra Medullary Cervical Anaplastic Ependymoma. Case Report and Review of the Literature

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Open Journal of Modern Neurosurgery 2018年第4期8卷 414-423页

作者： Daniel Memia Zolo Abd el kader moumouni Anabi Daouda Diakhate Dabou Abiba Tamoutabe Abderrahman Hamlat Department of Neurosurgery CHU Martinique France Department of Neurosurgery CHU Kara Togo Department of Neurosurgery CHU Sylvanus Olympio Lomé Togo Department of Radiology HIA Parakou Benin

Introduction: Intra-dural and extramedullary ependymomas are rare lesions. We report a clinical case confirmed by the histology supported by the neurosurgery department of Martinique University Hospital. Clinical, paraclinical and therapeutic data will be compared to a literature review. Observation: A 38-year-old patient was admitted for tetraparesthesia evolving since 3 months, associated with a left hemiparesis. The clinical examination revealed deterioration of the general condition and a tetrapyramidal syndrome. MRI of the cervical spine revealed extensive cervical extra-medullary intradural lesion of C3 to C5. The treatment had been an excisional surgery that had been subtotal in two stages, supplemented by craniospinal radiotherapy because the pathological examination had found a grade III anaplasic ependymoma. Conclusion: Because of their rarity, the treatment of these forms of ependymoma is not yet well codified.

关键词： Intradural Extramedullary Anaplasic Ependymoma Surgery Radiotherapy

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Environment Development and Health Safety System in Rural Areas of Bangladesh (Noakhali and Lakshmipur Districts)

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Journal of Environmental Protection 2024年第2期15卷 193-225页

作者： Asif kader Department of Environmental Sciences and Management Jahangirnagar University Savar Bangladesh

At present time, Bangladesh is developing its position in all sectors of world prosperity. Economic development of Bangladesh depends on working ability of whole population of this country, although Bangladesh is not developed in health status of its whole population. A large percentage of people live in rural areas without any proper shelter. This study revealed the environmental development and health safety system in rural areas of Bangladesh, which is located in Noakhali and Lakshmipur districts of Bangladesh. Many sections were studied, which are the main structure of environmental development and health safety system of southeastern region of Bangladesh. The study found that there were three types of handicraft enterprises in the surveyed area such as handicraft input, like palm leaf, factories, Betel nut businesses, and Coconut businesses were headed and owned by the women and they were unaware of their health, environment and waste management or reduction of pollution. This study also reveals that microentrepreneurs did not ensure purified water supply and hygienic toilets within enterprises in the study area. The study also found that a significant portion of the microentrepreneurs are workers, and their family members were always fewer users of protective equipment during the COVID-19 pandemic. This study identified that most MEs faced transport or carrying facilities or big costing problems, including problems in available services for raw materials in the high category. In contrast, the high cost of transport facilities was very intensive in the study area. Moreover, it found that Microentrepreneurs (MEs) faced high product marketing costs for transport facilities, and a lack of proper pricing of the products in the study area. In addition, it explored that most of the microentrepreneurs did not receive sufficient credit support, and they faced negative attitudes and delayed responses from the credit services providers in the study area. It also found th

关键词： COVID-19 Handicraft Ingredients Microenterprise Environment Climate-Change Waste-Management

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Intracranial Suppurations in Togo: Etiologies and Treatment

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Open Journal of Modern Neurosurgery 2023年第1期13卷 9-17页

作者： Essossinam Kpélao Messan H. Ahanogbé Komi Egu Agbéko K. Doléagbénou kader moumouni Assila Komlanvi Kossi K. Ségbédji Solim Bakondé Dzidoula Lawson Abaltou Bawoubad Abdoulaye Hima-Maïga Katanga A. Békéti Neurosurgery Unit Sylvanus Olympio Hospital Lomé Togo Neurosurgery Unit Kara University Hospital Kara Togo Infectious Disease Unit Sylvanus Olympio Hospital Lomé Togo

Objective: Intracranial suppurations are a cosmopolitan pathology whose prevalence depend of the region of the world. They are mostly caused by otolaryngological infections. Despite the progress, they remain serious diseases in Africa. The objective of this study was to report the epidemiology, clinical and etiological aspects of intracranial suppurations in Togo. Method: This was a retrospective and descriptive study carried out from January 1, 2012 to December 31, 2020 including all cases of intracranial suppuration treated in the neurosurgery unit of Sylvanus Olympio university hospital in Lomé. The evolution was evaluated at discharge, at 3 and 6 months after. Results: We collected 185 cases of intracranial suppuration. The average age of the patients was 12.6 years with a male predominance (72.4%). The main clinical signs were the infectious syndrome (92.4%), intracranial high pressure (51.4%), focal deficit (38.4%) and seizures (20.5%). An otolaryngological infections history was noted within 3 months in 72.4%. The brain CT scan noted a predominance of empyema (63.8%) mostly subdural (64.4%). Radiological sinusitis was found in 57.3%. We identified etiology in 69.2% predominated by otolaryngological causes. Patients received medical and surgical treatment in 77.3%. The bacteriology was positive only in 7 cases. The mortality rate was 15.1%, mostly no operated cases (78.6%). At 6 months 84% recovered without sequelae. The predictive prognostic factors for mortality were: coma (p 0.001), absence of surgical treatment (p 0.02). Conclusion: Intracranial suppuration remains frequent in our country, mainly due to otolaryngological pathologies. The clinical presentation is not always specific and Bergman’s triad is rarely complete. The results of treatment are good if it is early.

关键词： Intracranial Abscess Empyema Togo

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Effects of warming and drought stress on the growth characteristics,photosynthetic-transpiration rates,and yield of winter wheat

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International Journal of Agricultural and Biological Engineering 2024年第3期17卷 121-129页

作者： Qian Li Yang Gao Abdoul kader Mounkaila Hamani Guangshuai Wang Junming Liu Yuanyuan Fu Xingpeng Wang College of Water Resource and Architecture Engineering Tarim UniversityAlar 843300XinjiangChina Institute of Farmland Irrigation Chinese Academy of Agricultural SciencesXinxiang 453002HenanChina

Climate change has limited crop productivity *** crop response to global climate changes is vital to maintaining agricultural sustainable development.A two-year experiment was conducted to investigate the effects of warming and drought on crop growth and winter wheat yield *** results showed that both warming and drought shortened the crop growth period,reduced the leaf area index,and increased winter wheat biomass *** sufficient water supply conditions,warming would increase photosynthetic and transpiration rates and water use efficiency,while under water deficit conditions,the opposite was *** warming conditions,the grain yield of the water deficit treatment was 8.9%lower than that of the sufficient water supply *** non-warming conditions,the grain yield of water deficit treatment was 12.4%lower than that of the sufficient water *** the conditions of water-sufficient supply,the grain yield of the warming treatment was 4.4%lower than that of the non-warming treatment,and under the conditions of water deficit,the grain yield of the warming treatment was 1.3%lower than that of the non-warming *** tends to decrease wheat growth and grain yield,but sufficient water supply could improve winter wheat’s water use efficiency and reduce the warming limitation on wheat production.

关键词： winter wheat warming leaf area index photosynthetic rate yield biomass

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Pre-Hospital Management of Craniocerebral Trauma in South Saharan Africa: Cotonou Experience

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Open Journal of Modern Neurosurgery 2019年第3期9卷 221-226页

作者： Abd El kader moumouni Essossinam Kpelao Holden Olatoundji Fadigba Agbeko Achille Doleagbenou Ibrahima Berete Dabou Abiba Tamou Tabe Emile Mensah Martin Chobli CHU KARA Kara Togo SAMU Benin Cotonou Benin CHU Sylvanus Olympio Lomé Togo University of Parakou Borgou Benin Universite Gamal de Conakry Conakry Guinee HIA Parakou Parakou Benin SAMU Benin of Parakou Borgou Benin

The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emergency Aid Medical Service (EMAS) of BENIN in the pre-hospital management of craniocerebral trauma. 146 head injuries were cared for. 116 were male. The mean age was 32 years with extremes ranging from 2 to 77 years. Etiology in 68% of patients was a public road accident. And the request for the use of the EMAS was made by highway users for 41% of the injuries. About 5.5% were severe cranio-brain injuries, more than 75% of which had died in intensive care. In 77% of the EMAS interventions, there was an intensive care physician in the team. 34 wounded had been transported in a vacuum mattress. The rigid cervical collar was used in 8 major traumas. All the wounded were transported by ambulance. The duration of hospitalization varied from a few hours in the emergency department to 90 days in the hospital ward. 9 patients died. One of them, who died in an ambulance, was a woman. The prehospital medical care of head trauma in BENIN is still progressing.

关键词： Emergency Craniocerebral Africa South-Sahara Pre Hospital Management

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