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Outcomes of Hemodialysis Patients in Public Centres in Abidjan from September 2018 to October 2021: data from the Renal Registry of Cote d’Ivoire

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Open Journal of Nephrology 2024年第3期14卷 413-426页

作者： Sery Patrick diopoh Arthur Kanganga serge d.d.er konan Kolo Claude Ouattara Marie-dominique Kouadio Mohamed Alex Moudachirou Kouamé Hubert Yao department of Medicine and Medical Specialties University Flix Houphout-Boigny Abidjan Cote dIvoire National Centre for Prevention and Treatment of Renal Failure Abidjan Cte dIvoire

Background: Hemodialysis is the most widely used renal replacement therapy in developing countries such as Cote d’Ivoire. Objective: To study the outcome of chronic hemodialysis patients in public centres in Abidjan using data from the Renal Registry of Cote d’Ivoire (2RCI). Method: This was a prospective analytical cohort study of End Stage Kidney disease (ESKd) patients undergoing iterative hemodialysis in the network of public hemodialysis centres in Abidjan and who had been registered in the 2RCI register by September 2018. Results: Our study involved 363 cases out of 379 patients registered in the 2RCI registry database in 2018. The mean age of the patients was 47.3 ± 12.1 years, with a male predominance (sex ratio 1.97). In 70.24% of cases, they had no health insurance. The average duration of dialysis for our patients was 6.94 ± 4.1 years, with extremes of 2 and 28 years. This duration was less than 5 years in 44.3% of cases, between 6 and 10 years in 42.9% and more than 10 years in 12.6% of cases. The comorbidities found were hypertension in 95.6% of cases, diabetes in 7.8% and HIV in 4.6%. Anemia was found in 68% of cases and stroke in 8.6%. during the study period, 161 deaths were observed, representing a mortality rate of 44.35%. Acute lung oedema (29.8%), stroke (6.8%) and other cardiovascular diseases (19.3%) were the main causes of death. In multivariate analysis, factors such as age ≥ 65 years (HR = 3.66;CI 95% = 1.55 - 8.67;p = 0.003), “married/coupled” status (HR = 2.02;CI 95% = 1.24 - 3.31;p = 0.005) and normal weight at the start of dialysis (OR = 9.59, CI95% = 4.19 - 21.95;p = 0.001) were associated with the risk of death. Conclusion: Hemodialysis is performed in Abidjan on young patients. The mortality rate after three years of dialysis is very high. Hence the need to pursue the policy of decentralizing public centres and optimizing access to dialysis in terms of quality and quantity in order to improve patient survival.

关键词： Chronic Hemodialysis death Renal Registry Cote d’Ivoire

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Cardio-Renal Syndrome: Frequency and Associated Factors in the Abidjan Heart Institute’s Medical department

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Open Journal of Nephrology 2023年第3期13卷 292-305页

作者： diane Meto Arnaud Ekou serge d. konan Rodrigue Hazoume Kolo Claude Ouattara Roland Nguetta Hubert Yao Nephrology department of the Teaching Hospital of Treichville Abidjan Ivory Coast Heart Institute of Abidjan Abidjan Ivory Coast

Introduction: Cardio-renal syndrome (CRS) is a pathophysiological disorder of the heart and kidneys in which acute or chronic dysfunction of one organ can lead to acute or chronic dysfunction of the other. In Africa, particularly in C?te d’Ivoire, the incidence of cardio-renal syndrome is not precisely known. The aim of this study was to assess the frequency of CRS and to contribute to a better understanding of the condition in the medical department of the Abidjan Heart Institute. Materials and Methods: We conducted a prospective analytical study including all patients with heart failure hospitalised in the medicine department of the Abidjan Heart Institute from March to October 2020. data were analysed using SPSS software version 22. Results: We included 111 patients in the study. The incidence of CRS was 64%, with a predominance of males (sex ratio 1.8). The mean age was 53 ± 15 years. Patients’ medical history was dominated by hypertension (56.8%), diabetes (15%), dyslipidaemia (18%), obesity (17.1%) and smoking (14.4%). The main causes of heart failure were dilated cardiomyopathy (22.8%) and ischaemic heart disease (21.4%). Symptomatology was mainly congestive heart failure (42.8%). Mean evaluated clearance (MdRd) was 39.9 ± 17.1 ml/min/m2. doppler echocardiography showed a decrease in left ventricular ejection fraction in 74.3% of patients. Factors statistically associated with the occurrence of cardio-renal syndrome were: age > 60 years (p = 0.04), diabetes (p = 0.03), arterial hypertension (p = 0.001) and Hb Conclusion: The cardio-renal syndrome is a reality and marks an important point in the evolution of cardiac and renal diseases. It is highly frequent in the medical department of the Abidjan Heart Institute, as well as a high rate of CKd.

关键词： Cardio-Renal Syndrome Heart Failure Renal Failure

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Implementing uterine balloon tamponade(UBT)device for immediate postpartum hemorrhage management:Leveraging resource allocation and highlighting noteworthy experiences

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Gynecology and Obstetrics Clinical Medicine 2023年第3期3卷 175-180页

作者： Mian dehi Boston Guie Privat Apollinaire Horo Aka Edele Kouakou konan Virginie Aholoupke Bruno KonéSeydou Rochon Sarah Boni serge Burke Thomas F Felix Houphouet Boigny University Cote d’Ivoire division of Global Health and Human Rights Department of Emergency MedicineCote d’Ivoire National Mother and Child Health Program Côte d'Ivoire Cote d’Ivoire Massachusetts General Hospital division of Global Health and Human Rights BostonMAUSA Harvard T.H.Chan School of Public Health BostonMAUSA Harvard Medical School BostonMAUSA

Background The use of uterine balloon tamponade(UBT)devices for intrauterine packing and management of vaginal bleeding by uterine atony has shown promising results in improving the quality of care and reducing maternal *** This report aims to provide an overview of progress made in implementing UBT devices in northern Cote d'*** and methods A four-year retrospective study was conducted in the North-East(163,645),North-Center(351,909),and North-West(57,983).In 2017,UBT was adopted by members of the healthcare ***,5 national and 32 regional trainers have been *** training session was a theoretical and practical program with a low *** is a male condom tied to a urinary catheter,filled with *** outcomes included stopping bleeding,avoiding the need for surgery,and preventing maternal deaths(Md).In 2018,3,515 UBT devices were *** 2019,monitoring tools and transmission circuits of the data were *** 2020,the collection of data and local manufacturing was *** during the process,978 health workers,mainly midwife(52.0%)and nurses(32.2%)out of the 1,295 assigned were *** number of trained individuals decreased from 209 in 2019 to 160 in 2020.A total of 1,715 UBT devices were locally manufactured,adding to the existing gift of 5,080 devices,with total availability of 6,*** distribution of devices increased from 2017 to 2019 but decreased in *** rates increased from 87.3%in 2017(365/418)to 95.0%in 2019(556/585)and slightly decreased in 2020 to 98.0%(681/695).Adverse outcomes(144/2,193),included Md(35/2,193)and medical evacuation to the surgical center(109/2,193).Conclusion The implementation of UBT in northern Cote d'Ivoire successfully reduced maternal death rates caused by immediate post-partum hemorrhage(IPPH).However,to ensure sustainability,further improvements are needed,including increased monitoring,ongoing training,and device availability.

关键词： Implementation Uterine balloon tamponade Post-partum hemorrhage Health providers Health regions

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Spontaneous disappearance of a Ruptured Intracranial Aneurysm

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Open Journal of Modern Neurosurgery 2019年第2期9卷 164-171页

作者： André Tokpa Louis derou konan serge Yao dominique Oka N’dri department of Neurosurgery Teaching Hospital of Bouaké Bouaké C&#244 te d’Ivoire department of Neurosurgery Teaching Hospital of Yopougon Abidjan C&#244 te d’Ivoire

The spontaneous disappearance of a ruptured intracranial aneurysm is unusual and its mechanism remains incompletely understood. However, several hypotheses are put forward and are mostly found in Virchow’s triad. We report the case of a man who suffered subarachnoid hemorrhage by rupture of a blister aneurysm of the P1 segment of the left posterior cerebral artery. A control arteriography performed one week after the rupture showed a disappearance of the aneurysm and a significant vasospasm of the carrier artery. Angiograms performed at 3 weeks and 3 months confirmed this disappearance of the aneurysm and a return to normal artery size. Clinically the patient was doing well. Therefore his aneurysm was spontaneously declared cured. Several studies are needed to clarify the natural history of spontaneously thrombosed aneurysms and elucidate their occurrence mechanism in order to improve the management of intracranial aneurysmal pathology.

关键词： Intracranial Aneurysm Subarachnoid Hemorrhage Cerebral Angiography Spontaneous Thrombosis

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A Rare Case of a Thoracic Spinal Hemangiopericytoma

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Open Journal of Modern Neurosurgery 2019年第1期9卷 1-6页

作者： derou Keableon Louis Irié Bi Gohi serge Tokpa André konan serge Yao Bougaci Nassim Lonjon Michel Neurosurgery department Bouake Teaching Hospital Bouake Ivory Coast Anesthesia-Intensive Care Unit Bouake Teaching Hospital Bouake Ivory Coast Neurosurgery department Pasteur Hospital Nice France

Spinal hemangiopericytomas are rare tumors. To date, only 80 cases of spinal hemangiopericytomas have been reported in the literature. The postoperative evolution of this condition in rare cases can be complicated by a symptomatic compressive epidural hematoma that can be the source of serious neurological complications requiring emergency surgery. We report a rare case of intradural and extramedullary spinal hemangiopericytomas with favorable evolution after treatment in an 82 years old woman.

关键词： Hemangiopericytoma Spine Intradural Extramedullary Radiotherapy Emergency Surgery

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Congenital depressed Skull Fracture Lifting with Suction Cup: A Therapeutic Alternative to Surgery

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Open Journal of Modern Neurosurgery 2019年第2期9卷 115-122页

作者： André Tokpa Louis derou konan serge Yao Oka dominique N’dri department of Neurosurgery Teaching Hospital of Bouaké Bouaké Cote d’Ivoire department of Neurosurgery Teaching Hospital of Yopougon Abidjan Cote d’Ivoire

Congenital skull fractures of newborn are rare and create medico-legal problems. Their management is controversial. Between surgery considered too aggressive and uncertain conservative attitude, reduction by suction cup or breast pump is an alternative. The authors report their experience through a case of successful resolution of a congenital depressed skull fracture using a suction cup in a newborn at 13 day of life followed by a literature review. This technique avoids the usual complications of surgery and reduces the anxiety of parents related to surgery. It also avoids the anxiety of having a newborn with a recessed skull and a conservative attitude with uncertain outcome.

关键词： Congenital Skull Fracture depressed Skull Fracture Suction Cup

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Evaluation of Pollution due to Gold Mining at Ity-Floleu Area in Sub-Prefecture of Zouan-Hounien, Western Côte d’Ivoire

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Journal of Geoscience and Environment Protection 2019年第12期7卷 20-41页

作者： Gbamélé Kouassi serge konan Kouakou Séraphin Kouassi Kouakou Lazare Brou Loukou Alexis konan Koffi Félix Bini Kouamé dongui Laboratory of Geosciences and Environment University Jean Lorougnon Guede Daloa Côte d’Ivoire departement of Geology University Jean Lorougnon Guede Daloa Côte d’Ivoire Laboratory of Ecology Biodiversity and Evolution University Jean Lorougnon Guede Daloa Côte d’Ivoire Laboratory of Environment Chemistry and Materials University Jean Lorougnon Guede Daloa Côte d’Ivoire

This study aims to evaluate the mineral pollution of a gold mining environment in the sub-Prefecture of Zouan-Hounien (C?;te d’Ivoire). Samples were taken from surface water and flesh and skin samples of the Cavally River fish species over a period of two successive years. Concentrations in major elements, trace elements (As, Cd, Cr, Cu, Hg, Ni, Pb and Zn), nutrients () and physico-chemical parameters in situ were measured. The results obtained show that the surface waters have very low pH with an average of 5.70. For nutrient salts, the deterioration of water quality in the study area is mainly related to alterations by nitrates, phosphates and sulphates. The concentrations of Fe, Cu, Hg and Pb are above the existing standards (international, FAO/WHO) for the majority of the stations, thus causing the deterioration of the surface water quality. Therefore, their use for agricultural irrigation could have negative impact on the health of the population and on biodiversity. Regarding the bioindicating species, the results obtained after analysis of samples showed that the fish (carp and machoiron) have Fe, Cu, Hg and Pb concentrations higher than the existing standards (international, FAO/WHO) exposing consumers to high health risks. This study showed good correlation between the high values of surface water turbidity and the proximity of gold washing sites. The use of the principal component analysis (PCA) of the physicochemical dataset revealed comparable behaviors for certain minerals within the groups (Fe, K, Mg, Mn and Na) and (As, Cd, Cu, Ni, Pb, Zn and Ca) in water. The Ascending Hierarchical Classification (AHC) analysis has defined three different classes of surface water in the study area. The presence of mineral trace elements in these receiving environments is of natural origin but would be strongly accentuated by human activities.

关键词： Cavally River Fish Gold Mining Major Elements Nutritious Salts Surface Water Trace Elements

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Multiple Antihypertensive Therapy in Nephrology Practice

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Open Journal of Nephrology 2017年第3期7卷 80-93页

作者： Yao Kouame Hubert doro Arouna Guehi Monlet Cyr konan serge d.d.er Gnionsahe daze Appolinaire department of Nephrology Treichville Teaching HospitalAbidjanCote d'Ivoire

Introduction: Hypertension (HT) can be the cause or consequence of chronic kidney disease. Its management often requires a multiple therapy due to its severity. Objective: To describe the profile of patients receiving a multiple anti-hypertensive therapy in nephrology practice. Materials and Methods: This was a prospective, descriptive study conducted in the department of Nephrology, Yopougon Teaching Hospital, from January 1 to October 31, 2016. We included all patients admitted to this department who had received at least three anti-hypertensive drugs. Results: Out of a total of 625 hypertensive patients admitted over the study period, we included 120 patients on multiple therapy, i.e. a 19% prevalence. HT was essential in 60% of cases, secondary to chronic glomerulonephritis (CGN) in 25%, to diabetes in 13.3% and to polycystic kidney disease (PKd) in 1.7%. The therapy consisted of the combination of 3 antihy-pertensive drugs in 36.7% of cases, 4 drugs in 49.2% and 5 drugs in 4.2%. The antihypertensive classes used were Calcium channel blockers (CCB) in 99.2% of cases, diuretics (d) in 87.5%, Angiotensin Converting Enzyme Inhibitors (ACEI) in 70%, Centrally acting medication (C) in 66.7%, Angiotensin Receptor Blockers (ARB) in 25.8% and Beta-blockers (β-) in 6.7%. The main combinations were CCB + d + ACEI + C in 34.2% of cases, CCB + d + ACEI in 23.3%, and CCB + d + ARB + C in 12.5%. The combinations of antihypertensive drugs varied according to the cause of HT with a non-significant difference. Patient outcome was characterized by normal blood pressure in 64.2% of cases and normal renal function in 13.3%. The mortality rate was 17.5%. In multivariate analysis, stage 5 renal disease (p = 0.001), hypertensive retinopathy (p = 0.04) and hemoglobin level dl (p = 0.039) were associated with mortality. Conclusion: Multiple antihypertensive therapy, which is common in nephrology, is related to the severity of HT and not to its cause. We still use centrally acting

关键词： Hypertension Multiple Therapy Nephrology

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Practical Artificial Ventilation in an African Tropical Environment: Experience of the Intensive Care Unit of the University Hospital of Treichville

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Open Journal of Anesthesiology 2018年第4期8卷 123-129页

作者： Irié Bi Gohi serge Ango Privat désiré Netro djohoui Pete Yaich Nabintou Koné Kouadio konan Stéphanie Ogondon Bernard Able Edmond Boua Narcisse Brouh Yapo Resuscitation department University Hospital Center of Bouake Bouake Ivory Coast Resuscitation department University Hospital Center of Treichville Abidjan Ivory Coast Resuscitation department University Hospital Center of Cocody Abidjan Ivory Coast

Objective: To describe the practice of artificial ventilation (VA) in a resuscitation unit of a developing country with a view to its improvement. Patients and Methods: Prospective study for descriptive and analytical purposes, carried out in the intensive care unit of the University and Hospital Center of Treichville (Ivory Coast) from April 2009 to June 2010. All the patients having benefited from a artificial ventilation for a duration greater than 6 hours were included in this study. The studied parameters were: Socio-demographic (age, sex), diagnostic, therapeutic (indications, duration and complications of artificial ventilation), evolutionary. Results: Out of a total of 204 admissions during the study period, 81 patients received artificial ventilation, an incidence of artificial ventilation in the order of 39.7%. There were 49 men and 32 women. The ventilated patients had an average age of 43.9 years (range: 4 years and 85 years). Pathologies requiring artificial ventilation were neurological (46%) and traumatic (28%). Stroke was the leading medical condition (65%) while polytrauma was the major traumatic condition (65%). The most commonly used ventilatory modes were controlled volume ventilation (52.4%) and assisted ventilation (34.9%). The mean duration of artificial ventilation was 5.98 ± 3.73 days (range: 1 day and 21 days). The nosocomial pneumonia acquired under mechanical ventilation (PAVM) constituted 27% of the complications observed under artificial ventilation. The average length of ICU stay for all ventilated patients was 9.85 +/- 7.51 days (range: 1 day and 31 days). The lethality in our series was 80%. Patient age was the only prognostic factor associated with death (P = 0.003). Conclusion: The practice of artificial ventilation is still difficult in Ivory Coast and is at the origin of many complications such as nosocomial pneumonia acquired under mechanical ventilation which complicate the life threatening of the patients.

关键词： Artificial Ventilation Resuscitation Complications Ivory Coast

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PETROPHYSICAL CHARACTerIZATION OF THE LATE CRETACEOUS MARINE ANd LACUSTRINE dEPOSITS

PETROPHYSICAL CHARACTERIZATION OF THE LATE CRETACEOUS MARINE...

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2018年中国地球科学联合学术年会

作者： KOUAMELAN Kouamelan serge 邹长春彭诚 ASSIE konan Roger MONdAH Ohouo Rebecca 中国地质大学(北京)地球物理与信息技术学院

＜正＞The Cretaceous is the last and longest segment of the Mesozoic Period. It represents the warmest Period in the Mesozoic with high sea level and ocean anoxic events. The Cretaceous sediments in Marine and oceanic environments are well studied through the dSdP/OdP/IOdP. However, until now, continental scientific drilling projects based on Cretaceous Terrestrial records are proving insufficient, so the understanding of Cretaceous terrestrial climate change remains very fragmentary.

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