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Complications of Obesity in Cesarized Parturients in the Teaching Centers of Cotonou

Open Journal of Endocrine and Metabolic Diseases 2018年第6期8卷 137-144页

作者： Annelie Kerekou Hode Eugène Zoumenou Benjamin Hounkpatin Serge Mewanou Blaise Tchaou martin chobli Service of Endocrinology Hospital and University National Center Hubert Koutoukou Maga of Cotonou Cotonou Benin Service of Anesthesia and Reanimation Hospital Mother and Child of Cotonou Cotonou Benin Service of Gynecology and Obstetrics Hospital Mother and Child of Cotonou Cotonou Benin Service of Anesthesia and Reanimation Hospital and University National Center Hubert Koutoukou Maga of Cotonou Cotonou Benin Department of Anesthesia and Reanimation Hospital and University of Parakou Parakou Benin Emergency Department of Hospital and University National Center Hubert Koutoukou Maga of Cotonou Cotonou Benin

This survey had the objective to determine the frequency of the obesity at the parturient, to value the impact of the obesity on the childbirth by Caesarean and the complications postoperative immediate in the teaching hospitals of Cotonou. Patients and Method: We did a prospective, comparative and analytic survey from January 13 to April 13, 2012. Eight hundred ninety-one consecutive parturients having had a Caesarean were included. We studied the anesthetic techniques, the techniques of control of the aerial ways, the number of necessary tests for the tracheal intubation, the complications and aftercare of the first 48 hours. A comparison has been made according to the BMI. The obesity has been defined by a BMI ≥ 30 kg/m2. The parturient has been classified in two groups: Non-obese: BMI ≤ 30 kg/m2, obese: BMI ≥ 30. Results: There were 703 (78.90%) Caesareans in emergency and 188 (21.09%) programmed Caesareans. The obesity which has been recovered at 286 parturient is 32.10%. The obese parturient also required more frequently several lumbar punctures (p Conclusion: Many changes led by pregnancy are added to those of the obesity to drive to functional changes, a reduction of the physiological reserve and finally to an increased anesthetic and obstetric risk. The obesity is frequent at the parturient in Benin. The post-operative complications are more frequent after the Caesarean at the obese parturient.

关键词： Obesity Caesarean Anesthesia Complication Benin

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Study of the Management of Diabetic Metabolic Emergency in the National Teaching Hospital HKM of Cotonou

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Journal of Diabetes Mellitus 2014年第4期4卷 359-370页

作者： Annelie Kerekou Eugene Zoumenou Medard Agbantey Corneille Tiomon Daniel Amoussou-Guenou Francois Djrolo martin chobli Clinical Service of Endocrinology and Metabolism National Teaching Hospital HKM of CotonouUniversity of AbomeyCalaviBenin Clinical Service of Emergency Aid National Teaching Hospital HKM of CotonouUniversity of AbomeyCalaviBenin

Objective: To study the epidemiological, clinical and therapeutic profile of diabetic metabolic emergencies. Patients and methods: This was a prospective study in descriptive and analytical referred conducted over a period of 6 months in the National Teaching Hosptial HKM of Cotonou December 1, 2011 to May 31, 2012. The patients included in the case of our study were those who, conscious or comatose, had submitted a diabetic hypoglycemia or abnormal blood sugar (2.5 g/l), with a positive glycosuria and ketonuria positive or not. All patients gave their consent for this study. Results: 2786 patients were admitted to the emergency room, 57 (2%) of acute metabolic decompensation of diabetes. DKA accounted for 1.1%, hyperosmolar hyperglycemic syndrome 0.5% and 0.4% hypoglycemia. For hyperglycemic decompensation, sex ratio was 0.8 for females with a mean age of 50.7 ± 16.9 (16-84). For hypoglycemia, male gender was predominant. As decompensation factors for hyperglycemia, infection was found in 54% (n = 30) of cases and stroke by 29% hypertension (n = 15). As for hypoglycemia triggers were dominated by dietary error (50%) and therapeutic errors (25%). 63% (n = 36) of patients underwent resuscitation. More than 3 out of 4 patients were resuscitated to insulin. 98% of patients were rehydrated. The outcome was favorable in 56% of cases. The death rate was 25 % (n = 14). Conclusion: Diabetes mellitus is a serious condition and its severity is mainly due to complications which can be acute or chronic.

关键词： Ketoacidosis Diabetes Decompensation Ketosis

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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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Prognosis Value of Two Gravity Scores in Patients Admited to the Intensive Care Unit at University Hospital of Parakou in Benin

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Open Journal of Anesthesiology 2020年第4期10卷 144-156页

作者： Blaise Adelin Tchaou Nvènonfon Charles Frédéric Tchégnonsi Hervé Philippe Minsili Bikolo Patrick Stéphane Kouomboua Mfin martin chobli Service d’Anesthésie-Réanimation et des Urgences Centre Hospitalier Universitaire et Départemental du Borgou/Alibori Parakou Benin

Introduction: The gravity of the clinical state of the patient of intensive care is linked to the existence of one or several lesions and visceral defaults putting its forecast into play. Objective: To determine the prognosis value of two general graveness’ scores of patients admitted to intensive care at University Hospital of Parakou in Benin. Patients and Methods: Descriptive and analytical observational study data were collected from March 1st to June 30th, 2017. The SAPS II and APACHE II were calculated during first 24 hours of hospitalization to assess the clinical graveness and predict patient’s mortality. Results: We enrolled 185 patients representing 89.37% of admissions, majority were men (63.78%). Mean age was 38.89 ± 17.92 years (16 to 99), mean of hospitalization duration was 4.36 ± 2.2 days. Neurological failure was the most common disorder observed (58.37%). Mean SAPS II and APACHE II were 29.54 ± 19.04 and 14.24 ± 10.49 respectively. Mean predicted mortality of SAPS II and APACHE II was 19.12 ± 5.05 and 25.69 ± 5.00 respectively. The mortality rate was 25.95% and increased with severity scores. The sensibility of APACHE II and SAPS II score was 72.90% and 66.70% respectively. SAPS II score was found to be more specific (85.40%) than APACHE II (80.03%). Conclusion: Those severity patient scores accurately predicted the prognosis of patients in intensive care unit and should be integrated into our practice.

关键词： Indications of Gravities Prognosis Mortality Intensive Care

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The Bispectral Index Interest during General Anesthesia at the University Hospital of Parakou (Republic of Benin) in 2019

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Open Journal of Anesthesiology 2021年第3期11卷 59-71页

作者： Tchaou Blaise Adelin Tchégnonsi N'vènonfon Charles Frédéric Ezadjomo Evouna Ndoh Agnès Nina Zoumenou Eugene Brouh Yapo chobli martin Department of Anesthesia-Resuscitation and Emergency Borgou-Alibori University Hospital Center Parakou Benin Anesthesia-Resuscitation and Pediatric Emergencies Hospital of Mother and Child of Bingerville Bingerville Rep. Cote d’Ivoire

Background: The bispectral index (BIS) derived from the electroencephalogram is an additional means of monitoring the depth of narcosis. Objective: To compare the monitoring of the depth of narcosis by the BIS associated with clinical data versus standard monitoring at the University Hospital of Parakou in Benin in 2019. Methods: This was an observational study for descriptive and analytical purposes with prospective data collection, carried out in general surgery and intensive care unit for 4 months. The inclusion criteria were: an age ≥ 18 years, an ASA score ≤ 3, surgery under general anesthesia and informed consent of the patient. Two groups were formed: non-BIS group monitored by clinical parameters (PA, FC, FR, EtCO2, and SpO2) only and BIS group monitored by bispectral index in addition to clinical parameters. Patients were seen 48 hours after the procedure. Results: 36 patients were collected. The mean age was 40.63 ± 16.77 years with a sex ratio of 3. ASA 1 patients represented 86.11% of the sample and ASA2 patients 13.89%. The average doses of Propofol were not significantly reduced in the BIS group (p = 0.555). On the other hand, the period of intraoperative recovery (p-value = 0.007) and the NVPO (p = 0.043;O

关键词： General Anesthesia Narcosis Bispectral Index Monitoring

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