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Acute Bowel Obstructions of the Elderly in a Low African Country

Surgical Science 2022年第3期13卷 164-173页

作者： kouame Bernadin Kouakou Kouakou Ibrahim Anzoua Mamadou Traore Ismael Kalou Leh Bi Ahou Bernadette N’Dri Aka Gerard Kakou Serge Amos Ekra Blaise Amos Kouakou Inza Bamba Djahou Ezechiel Akowendo Roger Lebeau Bamourou Diane General and Digestive Surgery Department University Hospital of Bouaké Bouake Ivory Coast

Background: Acute bowel obstruction is one of the main causes of non-traumatic gastro—intestinal surgical emergencies. When they occur in elderly patients, they seem to induce higher morbi-mortality. The aim of our study was to identify the causes of these bowel obstructions in elderly patients and to expose the results of their surgical management. Patients and Methods: Retrospective and analytical study of patients aged 65 years and over, operated on between January 2013 and December 2019 for acute bowel obstruction at the University Hospital of Bouake. Demographic, diagnostic, therapeutic and evolutionary data were analysed. Results: The study involved 36 men and 23 women (sex ratio = 1.6). The mean age of these patients was 70 ± 4.6 years (65 and 90 years). A history and/or co-morbidities were found in 67.8% of them. Patients were classified as ASA I (20.3%), ASA II (42.4%), ASA III (33.9%) or ASA IV (3.4%). The average consultation time was 5.3 ± 4.1 days (2 days and 28 days). Bowel obstructions were due to colonic volvulus (38.9%), colonic cancer (22%), postoperative adhesions (18.6%), strangulated groin hernia (16.9%) or internal bowel hernia (3.3%). Volvulated or necrotic bowel and resectable cancers were resected followed by immediate anastomosis or stoma. Near upstream stomas were performed for unresectable cancers. A herniorrhaphy for groin hernias and a mesenteric breach suture for internal hernia were performed after bowel disinterment. Adhesions were released. The time to surgery was 22.3 ± 12.4 hours (2 hours and 72 hours). The post-surgery morbidity was 32.2%, marked by parietal suppurations (47.4%). The post-surgery mortality was 16.9%. Hemodynamic or septic shock, ASA score ≥ III, bowel necrosis and ICU stay were the significant risk factors. Conclusion: Acute bowel obstructions in the elderly are dominated by colonic volvulus. The high mortality is related to various factors highlighting the frailty of the elderly. A multidisciplinary management i

关键词： Acute Bowel Obstruction Elderly Etiology Morbi Mortality Surgery

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Population Status and Trend of the Maasai Giraffe in the Mid Kenya-Tanzania Borderland

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Natural Resources 2015年第3期6卷 159-173页

作者： Moses Makonjio Okello Lekishon Kenana Honori Maliti John Warui Kiringe Erastus kanga Fiesta Warinwa Samwel Bakari Stephen Ndambuki Hamza Kija Noah Sitati David Kimutai Nathan Gichohi Daniel Muteti Philip Muruthi Machoke Mwita SFS Center for Wildlife Management Nairobi Kenya Kenya Wildlife Service Nairobi Kenya Tanzania Wildlife Research Institute Arusha Tanzania African Wildlife Foundation Nairobi Kenya

Among the nine sub-species of giraffes, the Maasai giraffe is the most widespread and common in Northern and Southern Kenya. Although it’s considered by the IUCN to be a species of no conservation concern, they have been reported to have declined in some of their range areas mostly due to bush meat activities, habitat fragmentation and loss. There are also concerns recent climatic changes especially prevalence of droughts is increasingly becoming another threat to their survival. In this regard, this study examined the status and trend of the Maasai giraffe in the Kenya-Tanzania border after the 2007 to 2009 drought. Amboseli had the highest giraffe number (averaging 2, 062.5 ± 534.7 giraffes), followed by a distant Lake Natron area (725.8 ± 129.4 giraffes), Magadi/Namanga (669.5 ± 198.0 giraffes), and lastly West Kilimanjaro area (236.5 ± 47.8 giraffes). Further, the proportion of giraffes were highest in Amboseli (55.09% ± 5.65%) followed by Lake Natron area (20.98% ± 3.42%), Magadi/Namanga area (16.35% ± 3.83%), and lastly West Kilimanjaro (7.58% ± 2.12%). But in terms of population growth after droughts, giraffe had positive growth in all locations in the borderland, with Magadi leading (+339.82 ± 329.99) followed Lake Natron area (+37.62 ± 83.27), Amboseli area (+38.11 ± 7.09), and lastly West Kilimanjaro (+3.21 ± 57.95.27). Their wet season population and density was much higher than that of the dry season. However, though the species was widely spread in the borderland, they seemed to avoid the region between Lake Magadi and Amboseli which is traversed by the Nairobi-Namanga highway both in wet and dry season. There is a need to develop a collaborative management framework for cross-border conservation to enhance their protection, conservation and genetic linkage.

关键词： Drought Effects Kenya-Tanzania Borderland Maasai Giraffe Status and Distribution

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Screening for Precancerous Cervical Lesions in Women of Reproductive Age in the Kara Region of Togo in 2022

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Open Journal of Epidemiology 2023年第4期13卷 293-305页

作者： Gatibe Yendu-Suglpak Gnatou Zézé Onivogui Latame Komla Adoli Fifonsi Adjidossi Gbeasor-Komlanvi Arnold Junior Sadio Yao Rodion Konu Martin kouame Tchankoni Wendpouiré Ida Carine Zida-Compaore Amegnona Agbonon Didier Koumavi Ekouevi Department of Public Health University of Lomé Faculty of Health Sciences Lomé Togo African Centre for Research in Epidemiology and Public Health (CARESP) Lomé Togo Institute of Public Health and Development University of Bordeaux Bordeaux France French School of Public Health (EHESP) University of Rennes Rennes France Laboratory of Pharmacology and Physiology University of Lomé Lomé Togo Center for Training and Research in Public Health University of Lomé Lomé Togo

Introduction: Worldwide, cervical cancer is the 4th most common cancer in women and is a public health problem. The objective of this study was to estimate the prevalence of precancerous cervical lesions and to describe its associated factors among women of reproductive age in the Kara region of Togo. Methods: A cross-sectional study was conducted from March 6 to 14, 2022 in 11 health centers in Kara. Data were collected using a standardized questionnaire and screening for precancerous cervical lesions was performed by visual inspection of the cervix, after application of 5% acetic acid and Lugol’s. Logistic regression analysis was performed to describe factors associated with precancerous lesions. Results: A total of 728 women with a median age of 36, interquartile range [31 - 41] were enrolled. The prevalence of precancerous cervical lesions was 3.9%, 95% confidence interval (95% CI: [2.6 - 5.4]. Factors associated with the presence of precancerous lesions were age at first sexual intercourse ≥ 18 years (adjusted odds ratio (aOR = 3.67;95% CI [1.17 - 18.4]) and being a sex worker (aOR = 8.14;95% CI [1.96 - 27.1]). HIV infection was not associated with the presence of precancerous lesions. Conclusion: The results of this study underscore the importance of intensifying cervical cancer screening efforts in resource-limited countries for better management. These efforts should prioritize vulnerable populations such as female sex workers.

关键词： Precancerous Lesions Cervix Visual Inspection Togo

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Focal Segmental Glomerulosclerosis in Côte d’Ivoire: Epidemiological, Clinical and Pathological Aspects

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Open Journal of Pathology 2022年第4期12卷 146-155页

作者： N’Dah kouame Justin Tia Weu Melanie Akpro Sedy Louess De Randorphe Lagou Delphine Amélie Toure Ibrahiman Kobenan Atta Anne Rebecca Abouna Alain Didier Guei Monley Cyr Tuo Wonko-Tian Alice Oka Kouamé Hubert Diopo Sery Patrick Olivier Delma Samuel Cherif Ibrahima Traore Moussa Amekoudi Eyram Ouattara Belarsi Safiatou Yao kouame Hubert Ackoundou Nguessan Clément Adonis Koffi Laurence Yao Gnangoran Victor Gnionsahie Dazé Apolinaire Mohenou Isidore Jean-Marie Diomandé Department of Anatomic Pathology University Teaching Hospital of Bouake Bouake Ivory Coast Department of Nephrology University Teaching Hospital of Bouake Bouake Ivory Coast Department of Nephrology University Teaching Hospital of Yopougon Abidjan Ivory Coast Department of Anatomic Pathology University Teaching Hospital of Cocody Abidjan Ivory Coast Department of Nephrology University Teaching Hospital of Treichville Abidjan Ivory Coast Department of Nephrology University Teaching Hospital of Blaise Compaore Ouagadougou Burkina Faso Department of Anatomic Pathology University Teaching Hospital of Donka Conakry Guinea Department of Nephrology University Teaching Hospital of Sylvanus Olympio Lome Togo Department of Nephrology University Teaching Hospital of Treichville Abidjan Ivory Coast

Focal segmental glomerulosclerosis (FSGS) is characterized histologically by hyalinosis and sclerosis of glomeruli associated or not with podocyte involvement. The objective of our work was to clarify the epidemiological aspects and histological variants of FSGS in Côte d’Ivoire. Materials and Methods: This was a descriptive retrospective study, conducted from January 2015 to December 2019 using the renal biopsy registers (RB) of the Pathological Anatomy and Cytology departments of the Teaching Hospital of Cocody and Bouake in collaboration with the Nephrology Services of Côte d'Ivoire and the sub-region. The biopsies underwent conventional histopathology and/or immunofluorescence techniques. The parameters analyzed were: frequency, age, gender, proteinuria, biopsy indications and histological aspects and the different correlations between histological aspects and socio-demographic characteristics. Results: FSGS represented 58.1% (n = 104) of glomerular nephropathies. The average age of patients was 32.1 ± 13.3 years, with extremes of 13 and 70 years. The sex ratio was equal to 1. Nephrotic syndrome (68.9%), chronic renal failure (14.3%) and acute renal failure (10.1%) were the main indications for renal biopsy (RB). The mean proteinuria at the time of diagnosis was 4 ± 3.7 g/24 h. It was massive (3.5 g/24 h) in 42.3% of patients. FSGS was primary in 29.8% (n = 31) and secondary in 70.2% (n = 73) of patients, of which 27.9% (n = 35) was due to HIV. According to the Columbia classification, 62.5% NOS type was found;23.1% collapsing type;7.7% tip lesion type;4.8% cell type and 1.9% perihilary type. Conclusion: FSGS is a complex heterogeneous entity. It affects young people in our context with a homogeneous gender distribution. Understanding its histogenesis is essential for optimal patient management.

关键词： Kidney Glomerulus Histology FSGS Côte d’Ivoire

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药物刺激肝细胞合成分泌载脂蛋白AI的分子生物学机制

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胃肠病学和肝病学杂志 1995年第1期4卷 23-27页

作者： Fu-You Jin kanga Morgan Moti Kashyap (VA Medical Center Long Beach University of California,Irvine CA 90822)

本文检测了Ｇｅｍｆｉｂｒｏｚｉｌ（ＧＦ，商品名Ｌｏｐｉｄ降脂灵是一种常用的抗动脉硬化药物，具有降低甘油三脂和升高高密度脂蛋白（ＨＤＬ）的作用）对肝细胞载脂蛋白ＡＩ的合成与分泌的作用以及可能的作用机制。在本研究中我们使... 详细信息

本文检测了Ｇｅｍｆｉｂｒｏｚｉｌ（ＧＦ，商品名Ｌｏｐｉｄ降脂灵是一种常用的抗动脉硬化药物，具有降低甘油三脂和升高高密度脂蛋白（ＨＤＬ）的作用）对肝细胞载脂蛋白ＡＩ的合成与分泌的作用以及可能的作用机制。在本研究中我们使用了ＥＬＩＳＡ，免疫沉淀、分子生物学技术（如ｍＲＮＡ定量、半寿期和新ｍＲＮＡ合成率等）和特异性抗体。结果发现，ＧＦ可增加载脂蛋白ＡＩ（ａｐｏＡＩ）的分泌及放射标记蛋氨酸的掺入（合成）。与对照组相比使用２００μｍ的ＧＦ可以增加ａｐｏＡＩ的分泌及合成分别达１５８％和１３０％（短期冲击）。分子生物学结果显示，使用不同浓度的ＧＦ可以增加稳定状态的ｍＲＮＡ表达（最高达２０４％）。ｍＲＮＡ的半寿期由１４．５ｈ延长到３５ｈ。而新的ｍＲＮＡ的合成率无变化。结论：ＧＦ的心脏保护作用是因为该药刺激肝脏增加ａｐｏＡＩ的合成及分泌。其机制则为延长ａｐｏＡＩｍＲＮＡ的半寿期从使ｍＲＮＡ在肝细胞内的含量增加，而与新的ｍＲＮＡ的生成无关。

关键词：降脂灵载脂蛋白AI 信使核糖核酸分子生物学

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Prevalence of Viral Hepatitis B among Women of Childbearing Age in the Kara Region of Togo in 2022

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Open Journal of Preventive Medicine 2023年第12期13卷 319-328页

作者： Gatibe Yendu-Suglpak Gnatou Fatoumata Binta Tidiane Diallo Fifonsi Adjidossi Gbeasor-Komlanvi Sibabe Agoro Arnold Junior Sadio Latame Komla Adoli Wendpouire Ida Carine Zida-Compaore Yao Rodion Konu Martin kouame Tchankoni Amegnona Agbonon Didier Koumavi Ekouevi Department of Public Health Faculty of Health Sciences University of Lomé Lomé Togo African Centre for Research in Epidemiology and Public Health (CARESP) Lomé Togo Togo Office World Health Organization (WHO) Lomé Togo Center for Training and Research in Public Health University of Lomé Lomé Togo Ministry of Health Public Hygiene and Universal Access to Health Care Lomé Togo Laboratory of Pharmacology and Physiology University of Lomé Lomé Togo Institute of Public Health and Development University of Bordeaux Bordeaux France

Introduction: The hepatitis B virus (HBV) is one of the major causes of morbidity and mortality in the world. Few up-to-date data on this disease are available in developing countries, including Togo. The aim of this study was to estimate the prevalence of hepatitis B among women of childbearing age in the Kara region of Togo. Methods: A cross-sectional study was carried out from 23 to 25 September 2022 during a fairground campaign. Data were collected using a standardised questionnaire. HBV screening was performed using “SD-BIOLINE HBsAg WB” rapid immunochromatographic tests. HBV prevalence was reported with its 95% confidence interval (CI). Regression analyses were performed to identify factors associated with HBV infection. Results: A total of 327 women were enrolled, with a median age of 34 years and an interquartile range of [25 - 43]. Nearly half (49.5%) of the women had had their first sexual intercourse before the age of 18 and 2.1% had at least 2 sexual partners at the time of the survey. The majority (91.7%) had not used a condom the last time they had sex. The prevalence of hepatitis B was 10.4% (95% CI: 7.5 - 14.2]). In multivariable analysis, having had sexual intercourse for the first time after the age of 18 (ORa = 0.17;95% CI [0.06 - 0.43];p Conclusion: The results of this study underline the importance of monitoring the prevalence of hepatitis B in women of childbearing age, and of implementing targeted prevention and screening measures to eliminate mother-to-child transmission of HBV.

关键词： Hepatitis B Virus Women of Childbearing Age Togo

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Surgical Management of a Giant Hydrocele of the Vagina in Adult

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Surgical Science 2020年第9期11卷 274-280页

作者： Anzoua Kouakou Ibrahim Kouakou kouame Bernadin Traore Mamadou Gnangoran Koffi Marcelin Leh Bi Kalou Ismael N’Dri Ahou Bernadette Ekra Amos Kouakou Amos Bamba Inza Avion Kouassi Patrick Assohoun Krahibouet Toussaint Lebeau Roger Diane Bamourou General and Digestive Surgery Department Bouaké Hospital and University Center Bouaké C&ocirc te d’Ivoire General and Digestive Surgery Department Yopougon Hospital and University Center Yopougon C&ocirc te d’Ivoire

Introduction: Vaginal hydrocele is an amber-colored, sterile collection found between the parietal and visceral testis. It is said to be giant when it is larger than the patient’s skull or when it contains more than two liters of liquid. Objective: To report our method and the result of the surgical treatment. Observation: The authors reported an observation of a 50-year-old patient who consulted for a painless large left bursa. Clinical and paraclinical investigations, in particular scrotal ultrasound, have made it possible to diagnose a giant hydrocele of the vagina. The patient had surgical treatment which consisted of resecting of the vagina with hemostatic suture of the resected vaginal slice. The post-operation effects were not complicated. After a six-month setup, we did not notice any recurrence. Conclusion: Resection of the vagina with hemostatic suture of the resected vaginal slice in case of giant hydrocele could certainly give good results.

关键词： Giant Hydrocele Surgical Treatment

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Delayed Diagnosis of Isolated Traumatic Rupture of Bladder

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Open Journal of Urology 2022年第1期12卷 69-73页

作者： Mamadou Traoré N’diamoi Akassimadou Kouakou Ibrahim Anzoua kouame Bernadin Kouakou Inza Bamba Kouassi Patrice Avion Brice Aguia Kalou Ismaë l Leh Bi Ahou Bernadette N’Dri Serge Amos Ekra Blaise Amos Kouakou Roger Lebeau Bamourou Diané Department of General and Digestive Surgery University Hospital of Bouaké Bouaké C&#244 te d’Ivoire Department of Urology University Hospital of Bouaké Bouaké C&#244 te d’Ivoire

Traumatic ruptures of the bladder are relatively rare lesions. They are associated in more than 80% of cases with a fracture of the pelvic girdle. The lesion mechanism is usually a sudden compression on the full bladder. Hypogastric pain and macroscopic hematuria suggest the diagnosis, which is confirmed by cystography. This diagnosis can be difficult and delayed in the absence of these call signs. We report a case of isolated traumatic intraperitoneal rupture of the bladder, diagnosed 24 hours after a public road accident in a 44-year-old patient.

关键词： Contusion Cystography Rupture Bladder

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Assessment of the Efficacy of Rifaximin in the Management of Irritable Bowel Syndrome (IBS)

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Open Journal of Gastroenterology 2017年第10期7卷 261-270页

作者： Stanislas A. Doffou Kissi Henriette Anzouan-Kacou Eugene K. Messou Demba A. Bangoura Dimitri H. Kouamé kouame M. Alassan Constant Assi Fulgence Mamert Y. Bathaix Alain K. Attia Marie-Jeanne K. Lohoues Yopougon University Hospital Abidjan C&ocirc te d’Ivoire Treichville University Hospital Abidjan C&ocirc te d’Ivoire Cocody University Hospital Abidjan C&ocirc te d’Ivoire

The aim of our study was to assess in our context, the efficacy of Rifaxim in improving the symptoms of irritable bowel syndrome particularly in its diarrheal (IBS-D) or mixed (IBS-DC) component and therefore assess its impact on patients’ quality of life. Patients and methods: This was an uncontrolled, non-comparative prospective cohort study of a single group of patients. Patients recruitment was done in two University Hospitals for 6 months (September 2015-February 2016). Were included ambulatory patients, male or female, aged 18 - 75 years, with diarrheic IBS (IBS-D) or mixed IBS (IBS-DC) diagnosed according to Rome III criteria and who agreed to participate in the study. Each patient received 400mg Rifaximin × 2/d for 15 days. The overall assessment of the efficacy of treatment at D15 (end of treatment) and D30 (2 weeks post-treatment) was the primary criterion of judgment. The statistical tests used were the Chi-square test and Fisher’s exact test for the qualitative variables and Student’s test for the quantitative variables. Results: A total number of 30 patients (16 women) with an average age of 44.5 ± 13.9 years were included. The overall assessment of symptoms by the patient with the Likert scale found 28 (93.3%) patients, 12 (40%) patients and 10 patients (33.3%) for a scale ≥2 at D0, D15 and D30 respectively. The assessment of the intensity of pain or abdominal discomfort found at D0, D15 and D30 respectively: 27(90%), 13(43.4%) and 6(20.1%) patients who had an EVA score > 2. The mean score for Francis to assess the improved quality of life was 247.1 ± 97.4 at D0, 99.8 ± 63.1 at D15 and 128.8 ± 70.6 at D30. Conclusion: There is a good overall improvement of symptoms in our patients suffering from IBS-D or mixed (IBS-DC) on Rifaximin with improvement of the quality of life.

关键词： Rifaximin Irritable Bowel Diarrhea Quality of Life

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Caroli Disease: A Case Report Observed at the Cocody Teaching Hospital of Abidjan (Cote D’Ivoire)

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Open Journal of Gastroenterology 2017年第1期7卷 28-31页

作者： A. Ouattara S. Koné E. Allah-Kouadio D. Soro A. W. Ndjitoyap E. Kouadio K. A. kanga C. D. Fanou M. J. Lohoues-Kouacou B. M. Camara Service D’Hépato-Gastro Entérologie CHU Cocody Abidjan C&#244te D’Ivoire Service De Pédiatrie Médicale CHU Cocody Abidjan C&#244te D’Ivoire Service D’Imagerie Médicale CHU Cocody Abidjan C&#244te D’Ivoire

Caroli disease is a rare affection. It’s commonly associated to polycystic kidneys. We report a case of a nine-year-old girl. She was hospitalized at the pediatric unit of the Cocody Teaching Hospital for an intermittent fever. During the clinical examination, we found a likely cirrhotic hepatomegaly associated to an edematous-ascitic syndrome. Biological exams showed an infectious syndrome with a hyperleukocytosis at 13.000 per mm3, a hyperneutrophilia at 9.600 per mm3. Serological viral markers of B, C and D hepatitis were negative. We saw an intra-hepatic cystic picture at the liver CT-scan with a vascular lesion at his center called a “dot sign”. The diagnosis of Caroli disease could be evocated.

关键词： Carolisyndrom Congenital Cystic Dilation Cholangitis Liver CT-Scan

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