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Cost of Medical Treatment for Primary Open-Angle Glaucoma in Relation to Patients’ Income and Its Impact on the Prognosis of the Disease, in Bouaké University Hospital

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Open Journal of Ophthalmology 2024年第1期14卷 8-17页

作者： Yves Ouattara Liliane Ella Godé Zana Diabaté Franck Hermann koffi Mamadou Korka diallo Philippe Emile France koffi Bilé Diomandé François Gossé Ibrahim Abib Diomandé Ophthalmology Department of Bouaké University Hospital (CHU de Bouaké) Bouaké C&#244te d’Ivoire

Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .

关键词： Primary Open-Angle Glaucoma Treatment Cost Medical Treatment Income Blindness

Interest of Non-Invasive Markers (APRI, FIB-4) for Assessing Hepatic Fibrosis in Patients with Chronic Viral Hepatitis B without Cytolysis and with Low Viral Replication

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Open Journal of Gastroenterology 2024年第5期14卷 192-201页

作者： Mamadou Diakité Kouassi Olivier Claver koffi Amadou Koné Akoun Fabrice Aké Oury diallo Ahmadou Stellart Jean M. Brou Anassi Jean-Baptiste Okon Department of Medicine and Hepato-Gastroenterology Teaching Hospital of Bouak&#233 Bouak&#233 C&#244te d&#8217Ivoire Faculty of Medical Sciences Alassane Ouattara University Bouak&#233 C&#244te d&#8217Ivoire

Background and Objectives: The indication for treatment in HBsAg-positive patients with low viral load and normal transaminases requires an assessment of fibrosis. In resource-limited settings, free hepatic fibrosis evaluation tests can aid in therapeutic decision-making. Our study aims to demonstrate the utility of assessing hepatic fibrosis using non-invasive markers (APRI and FIB-4) in patients with chronic B viral hepatitis without cytolytic activity and low viral replication in our context. Patients and Methods: This is a retrospective cross-sectional study conducted between January 2018 and December 2021 at the University Hospital Center of Bouaké. Included were all patients aged ≥18 with normal transaminases (Results: Our study included 241 patients, with a mean age of 36.19 years (±10.52 years) and a male predominance of 52%. The mean FibroScan® value was 6.44 ± 2.3 kPa, and 68 patients (28.22%) had fibrosis >7 kPa. To exclude significant fibrosis (FS Conclusion: A significant proportion of HBV-infected patients with normal ALT and low viral load have active liver disease. Both FIB-4 and APRI biological scores are useful in identifying individuals without significant fibrosis with a good negative predictive value (>50%).

关键词： HBV Infection APRI FIB-4 Impulse Elastography BouakéUniversity Hospital

Spontaneous Infection of Ascites Fluid at the National and University Hospital Hubert Koutoukou Maga in Cotonou: Prevalence and Associated Factors

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Open Journal of Gastroenterology 2024年第1期14卷 1-10页

作者： Aboudou Raïmi Kpossou Comlan N’dehougbèa Martin Sokpon Chloé Andréa Obekandon Opè Mahouton Jacques Tovizounkou Kadiatou diallo Rodolph koffi Vignon Jean Séhonou University Clinic of Hepato-Gastroenterology National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin University Clinic of Internal Medicine CNHU-HKM Cotonou Benin Department of Internal Medicine Donka National Hospital Conakry Guinea

Background: Spontaneous ascites fluid infection (SAFI) is an extremely serious and frequently encountered complication in cirrhotic patients. We aimed to determine the prevalence of SAFI and the factors associated with it in the largest hospital in Cotonou. Methods: This was a retrospective descriptive and analytical study conducted from January 2013 to July 2019, at the National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) in Cotonou, Benin. All patients followed in the University Clinic of Hepato-Gastroenterology and diagnosed with SAFI were included. Results: Eighty-two patients were included, predominantly males (69.5%), with a mean age of 51.5 ± 14.5 years. Among them, 32 had SAFI, i.e., a prevalence of 39%. Of the 32 cases of SAFI, the culture of ascites fluid was positive in 6 cases (18.7%). The most frequent germ found in SAFI was Escherichia coli (5 patients, 83.3%). The factors associated with SAFI in this study were: abdominal pain (p = 0.004), increased bilirubinemia (p = 0.009), decreased prothrombin level 20 (p = 0.001). Conclusion: SAFI was common in cirrhotic patients in the department. Certain clinical and paraclinical factors were associated with it, as was the severity of cirrhosis. Early diagnosis and aetiological management of cirrhosis could reduce its frequency.

关键词： Ascites Infection Cirrhosis Cotonou

Diabetes Screening and Cardiovascular Risk in Tuberculosis Patients in Conakry and Surrounding Towns

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Open Journal of Endocrine and Metabolic Diseases 2024年第1期14卷 7-13页

作者： Mamadou Chérif diallo Mamadou Dian Mamoudou diallo Mody Abdoulaye Barry Kadija Dieng Alpha Mamadou diallo Mamadou Mansour diallo Oumou diallo Amadou Kaké Gamal Abdel Nasser University of Conakry Conakry Guinea Endocrinology-Diabetology Department of Donka University Hospital Conakry Guinea Foundation for The Fight against Diabetes and Non-Communicable Diseases Conakry Guinea

Objective: To determine the prevalence of diabetes and the level of cardiovascular risk in tuberculosis patients treated in Conakry and surrounding towns. Method: This was a cross-sectional study carried out at tuberculosis treatment centers in Conakry and surrounding towns (Coyah and Dubréka) on World TB Day, November 14, 2022, among 350 tuberculosis patients. We determined the proportion of TB patients with diabetes and high hyperglycemia. We determined the Chi-square to identify the factors associated with the occurrence of diabetes in tuberculosis patients, and a significance threshold with p Results: The average age of participants was 33.5 ± 14.5 years, and they were predominantly male (59.7%). The majority of participants lived in Conakry (96.3%). 5.7% were known diabetics and 4.6% were known hypertensives. We found a prevalence of diabetes of 9.4%. Among diabetics, 39% were diabetes discoveries. 30% were hypertensive or had high blood pressure. Of these hypertensive patients, 26.4% were unrecognized hypertensives. Age and hypertension were statistically significantly associated with the onset of diabetes in tuberculosis patients. Medium, high and very high levels of cardiovascular risk were present in 23.4%, 8.9% and 3.4% respectively. Conclusion: Diabetes is common in tuberculosis patients. Cardiovascular risk factors, notably hypertension and cardiovascular risk level, are frequently associated with tuberculosis. Tuberculosis patients with cardiovascular risk factors should be screened for diabetes.

关键词： Screening Diabetes Tuberculosis Cardiovascular Risk Conakry

Causes and Prognosis of Cases of Acute Obstructive Renal Failure Managed at the Donka National Hemodialysis Center

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Open Journal of Nephrology 2024年第2期14卷 136-146页

作者： Amadou Yaya diallo Mamadou Mouctar diallo Mamadou Dian Barry Kadiatou Mamadou Bobo Barry Saikou Oumar diallo Djenabou diallo Soriba Bangoura Mamadou Malal diallo Thierno Mamadou Oury diallo Mohamed Lamine Kaba Alpha Oumar Bah Department of Nephrology-Hemodialysis CHU Donka Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of the Republic of Guinea Conakry Guinea Department of Urology-Andrology CHU Ignace Deen Conakry Guinea

Introduction: Acute obstructive renal failure (AORF) is a frequent clinical situation, secondary to obstruction of the urinary excretory tract. Whatever the cause, urinary tract obstruction suddenly opposes glomerular filtration and is responsible for tubulointerstitial lesions. It accounts for 10% of acute renal failure (ARF). The aim of this study was to identify the causes and prognosis of cases of acute obstructive renal failure managed at the Centre National d’hémodialyse Donka. Material and Methods: This was a prospective descriptive study lasting 6 months, from September 1, 2022 to February 29, 2023. All patients undergoing haemodialysis for acute obstructive renal failure who agreed to participate in the study and whose medical records were complete were included. Results: During the course of the study, we registered 97 haemodialysis patients, including 20 cases (20.62%) of acute obstructive renal failure. The mean age of the patients was 57.8 ± 10.54 years, with a male predominance of 11 cases (55%) and a sex ratio of 1.22. The reasons for consultation were dominated by physical asthenia 11 cases (55%), lumbar pain 9 cases (50%), vomiting 6 cases (30%) and acute urine retention 6 cases (30%). Arterial hypertension 16 cases (80%) and urinary tract infection 10 cases (50%) were the most common antecedents. The etiologies of RAOI were dominated by lithiasis 10 cases (50%), neoplasia 6 cases (30%) and benign prostatic hypertrophy 3 cases (15%). mean creatinine was 1267.60 ± 710.76 μmol/l with extremes of 243 μmol/l and 2822 μmol/l, mean urea was 39.56 ± 18.36, hyperkalemia in 14 cases (70%) and hyponatremia in 8 cases (40%). After hemodialysis, 9 cases (45%) recovered renal function, 4 cases (20%) became chronic and 7 cases (35%) died. Conclusion: The frequency of AKI remains non-negligible in our department, and early detection and prompt management would considerably reduce the morbidity and mortality associated with this pathology.

关键词： Acute Obstructive Renal Failure Hemodialysis Prognosis Donka

Psychosocial Aspects of Male Infertility at the Service of Urology-Andrology of the Hospital of the Sino-Guinean Friendship

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Open Journal of Urology 2024年第7期14卷 400-406页

作者： Alimou diallo Thierno Oumar diallo Alpha Oumar Barry Ibrahima Bah Abdoulaye Bobo diallo Oumar Raphiou Bah Urology Department of the Hospital of the Sino-Guinean Friendship Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea Urology Department of National Ignace Deen Hospital Faculty of Health Sciences and Technologies Gamal Abdel Nasser University of Conakry Conakry Guinea

Objective: Describe the psychosocial aspects of male infertility at the hospital of the Sino-Guinean Friendship. Patients and method: It is a prospective study of a descriptive type covering a period of 6 months. The study covered 17 patients, all received for a desire to conceive after at least one year of regular sexual intercourse without contraception. The data were collected from patient interviews using a pre-established questionnaire. Results: The average age of the patients was 32.07 years with extremes of 23 years and 42 years. During this study, 64.70% of patients were no longer participating in community ceremonies. The patients’ relationships with their spouse and family deteriorated in 52.94% and 47.06%, respectively. Conversely, relations with the family of origin remained unchanged in 70.59 percent of cases. The reduction in economic activity was by 13 patients (76.48%). Conclusion: Male infertility causes a real psychic earthquake in men with its corollaries of negative feelings. The rather complex moral repercussions of male infertility affect not only the individual, his/her partner, and family, but also economic activity.

关键词： Male Infertility Psycho-Social Aspect Psychic Earthquake

Frequency and Risk Factors of Neonatal Macrosomia at Labe Regional Hospital in Guinea

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Open Journal of Endocrine and Metabolic Diseases 2024年第2期14卷 26-32页

作者： Mamadou Dian Mamoudou diallo Mamadou Mansour diallo Mamadou Chérif diallo Alpha Mamadou diallo Kadija Dieng Mody Abdoulaye Barry Mamadou Alpha diallo Kadidiatou Bah Abdou Mazid diallo El’hadj Zainoul Bah Mamadou Malal Bori diallo Mamadou Sanou Sylla Amadou Kaké Diabetes Unit Labe Regional Hospital Labe Guinea Faculty of Health Sciences and Technology University of Conakry Conakry Guinea Department of Diabetes and Endocrinology Donka Hospital and University Center Conakry Guinea Neonatology Unit Labe Regional Hospital Labe Guinea

Macrosomia is defined as a term birth weight greater than or equal to 4000 grams, or greater than the 90 percentile of intrauterine growth curves. Excessive weight has harmful consequences for the newborn and is a major health concern. Objectives: To determine the frequency of neonatal macrosomia, describe risk factors and neonatal and maternal complications. Materials and methods: This was a cross-sectional study carried out between January and December 2022, involving newborns whose birth weight was greater than or equal to 4000 grams admitted to the neonatology unit of the Labe regional hospital. Results: 591 deliveries were recorded, 15 of which were macrosomic, representing a frequency of 2.54%. The average age of the women was 30.26 years. History of fetal macrosomia and diabetes was 93.33 and 71.43% respectively. The mean gestational age was 38.71 ± 0.75 SA, the mean antenatal consultation was 3 ± 0.8 and the mode of delivery was caesarean section (66.67%). Third-trimester ultrasound was performed in 53.33% of cases. Macrosomic newborns were male in 80% of cases. Neonatal complications were asphyxia (60%), hypoglycemia (20%) and hypocalcemia (13.33%). Factors associated with neonatal macrosomia were diabetes (P < 0.001), history of macrosomia (P Conclusion: this study shows that the frequency of neonatal macrosomia is 2.54% with high neonatal morbidity among newborns hospitalized in the neonatology unit of the Labé regional hospital. Screening for macrosomia risk factors during pregnancy is essential to prevent perinatal complications.

关键词： Frequency Macrosomia Labe

Prevalence of Diabetes and Hypertension on World Diabetes Day 2022 in Guinea

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Open Journal of Endocrine and Metabolic Diseases 2024年第1期14卷 1-6页

作者： Mamadou Dian Mamoudou diallo Mamadou Mansour diallo Mamadou Chérif diallo Mamadou Alpha diallo Alpha Mamadou diallo Mody Abdoulaye Barry Kadija Dieng Abdoul Mazid diallo El’Hadj Zainoul Bah Kadidiatou Bah Amatoulaye diallo Amadou Kaké Naby Moussa Baldé Oumou Baldé Unité de Diabétologie H&#244pital régional de Labé Labe Guinea Université de Conakry Conakry Guinea Service de Diabétologie CHU Donka Conakry Guinea Fondation de Lutte Contre le diabète et MNT Conakry Guinea

Introduction: Diabetes mellitus and hypertension are chronic diseases that are on the rise and pose a major public health problem among the priorities of healthcare systems. Objectives: Determine the prevalence of diabetes and hypertension and describe the sociodemographic characteristics of those screened. Materials and Methods: This was a cross-sectional study organized during a diabetes and hypertension screening campaign that took place in Conakry and five (05) inland regions on November 14, 2022. Results: 2050 people were screened, of whom 33.12% were housewives, the average age was 44.78 ± 16.23 years, and 55.27% were women. The screening sites were the city of Conakry 741 (36.15%), the Labé region 424 (20.68%), the N’Zérékoré region 298 (14.54%), the Faranah region 241 (11.75%), the Mamou region 210 (10.24%) and the Boké region 136 (6.63%). The prevalence of diabetes and hypertension were respectively 12.5% and 43.38% for the Boké region;6.19% and 16.19% for the Mamou region;3.02% and 21.81% for the N’Zérékoré region;31.95% and 13.69% for the Faranah region;9.67% and 20.28% for the Labé region;2.83% and 20.28% for the city of Conakry. Conclusion: Despite the limitations of the study duration, our series highlighted the high prevalence of diabetes and hypertension among people screened on World Diabetes Day 2022. Raising public awareness of a healthy lifestyle is essential for the prevention and control of diabetes and hypertension.

关键词： Prevalence Diabetes Hypertension

Practice of Glycemic Self-Monitoring in Diabetic Patients Followed at the Endocrinology Department of Donka University Hospital in Guinea

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Open Journal of Endocrine and Metabolic Diseases 2024年第2期14卷 33-38页

作者： Mamadou Dian Mamoudou diallo Mamadou Mansour diallo Mamadou Chérif diallo Alpha Mamadou diallo Kadija Dieng Abdoul Mazid diallo Mody Abdoulaye Barry Kadidiatou Bah El’Hadj Zainoul Bah Mamadou Alpha diallo Ibrahima Condé Ousmane Kourouma Amadou Kaké Diabetology Unit Labe Regional Hospital Labé Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Endocrinology and Diabetology Department of Donka University Hospital Conakry Guinea Pediatrics Department of Donka University Hospital Conakry Guinea

Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.

关键词： Self-Monitoring of Blood Glucose Diabetes Conakry University Hospital