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The Problem of Rehospitalisation for Heart Failure at the Cardiology Department of the Hôpital National Ignace Deen

World Journal of Cardiovascular Diseases 2024年第9期14卷 539-546页

作者： Samoura Sana Bah Mamadou Bassirou Soumaoro Morlaye Samoura Aly Koné Alpha sylla ibrahima sory Samoura Sekouba Barry Ibrahim sory Balde Elhadj Yaya Balde Mamadou Dadhi Hopital Sino-Guineen Conakry Guinea Hopital National Ignace Deen Conakry Guinea Hopital de L’amitié Sino-Guineenne Conakry Guinea

Introduction: Despite current therapeutic advances, heart failure in sub-Saharan Africa remains a common, serious and costly disease, particularly due to rehospitalizations. The objective of this work was to determine the proportion of rehospitalizations for heart failure and to identify etiological factors. Methodology: This was a retrospective descriptive study with a duration of 8 months from April 1 to November 30, 2021. This study included all patients rehospitalized in the department for Heart Failure and who agreed to participate in our study. Results: During the period of our study, 437 patients were hospitalized in the HF department, among which we collected 126 cases of rehospitalization for HF with a frequency of 28.83%. The mean age of our patients was 46.32 ± 18.98 years with the extremes of 15 to 84 years. The most affected age group was between 35 and 44 years old in 24 cases, i.e. a frequency of 19%. We observed a female predominance of 64 cases, i.e. a frequency of 50.8% compared to 62 cases, i.e. a frequency of 49.2% with a sex ratio (M/F) equal to 0.96. 98 cases of our patients, i.e. a frequency of 77.8%, were mutual insurance companies who felt they had the necessary support from those around them. In our sample, the underlying heart disease was mainly represented by valvular heart disease in 59 cases, followed by hypertensive heart disease in 42 cases with the respective frequencies of 46.82% and 33.33%. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. Conclusion: It appears in

关键词： Heart Failure Rehospitalisation Valvular Heart Disease

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Clinical, Therapeutic and Evolutionary Profiles of Hypertensive Emergencies in the Cardiology Department of the Ignace Deen National Hospital (Conakry)

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World Journal of Cardiovascular Diseases 2023年第12期13卷 827-836页

作者： Balde Elhadj Yaya Bah Mamadou Bassirou Barry ibrahima sory Kone Alpha Keita Fatoumata Binta Soumaoro Morlaye Toure Aboubacar Doumbouya Amadou Dioulde sylla ibrahima sory Diakite Souleymane Balde Mamadou Dadhi Cardiology Department of the Ignace Deen Hospital Conakry Guinea

Introduction: Hypertensive emergencies are a reality in the cardiology department of the Ignace Deen National Hospital. The aim of this study was to determine the clinical, therapeutic and evolutionary profile of hypertensive emergencies in the cardiology department of the Ignace Deen National Hospital. Methods: This was a longitudinal descriptive study of patients admitted to the cardiology department of the Ignace Deen National Hospital for hypertensive emergencies, over a period of six (6) months from 1 October 2020 to 31 March 2021. Results: Among the 638 patients admitted to the cardiology department during the study period, 102 cases of hypertensive emergencies were identified, representing a frequency of 15.99%. The mean age of the patients was 56.65 ± 13.33 years, with extremes of 23 and 90 years, and the sex ratio was 1.91 in favour of men. The associated cardiovascular risk factors were: age (76.47%), smoking (41.18%), sedentary lifestyle (31.37%), obesity (16.67%), dyslipidaemia (12.75%), diabetes (11.76%) and excessive alcohol consumption (11.76%). The various clinical pictures found were: acute pulmonary oedema 39 cases (38.23%), acute coronary syndrome 31 cases (30.39%), stroke 17 cases (16.67%), hypertensive encephalopathy 11 cases (10.78%), acute renal failure 3 cases (2.94%) and aortic dissection 1 case (0.98%). The drugs used on admission were calcium antagonists (Nicardipine 10mg) in 58 cases (56.86%), diuretics (Furosemide 20mg) in 44 cases (43.13%), nitrates (Risordan 20mg) in 39 cases (38.23%) and beta-blockers in 31 cases (30.39%). In terms of outcome, 88 (86.27%) patients had improved. However, 12 (11.76%) deaths were recorded. Conclusion: Hypertensive emergencies are a worrying condition with a high prevalence in the cardiology department of the Ignace Deen National Hospital.

关键词： Emergency Hypertension Prevalence National Hospital Ignace Deen

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Family Dyslipidemia Revealed by a Cornean Bow in a Guinean

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World Journal of Cardiovascular Diseases 2020年第7期10卷 455-459页

作者： Bah Mamadou Bassirou Balde El Hadj Yaya Balde Alpha ibrahima Beavogui Mariame Camara Abdoulaye Barry ibrahima sory Balde Mamadou Aliou sylla ibrahima sory Kone Alpha Ngaide Alhassane Aliou Mamy Adrien Balde Mamadou Dadh Ignace Deen National Hospital Cardiology Department Conakry Republic of Guinea Department of Ophthalmology Department of the Armed Forces Conakry Republic of Guinea Cardiology Department of Donka National Hospital Conakry Republic of Guinea Department of Hospital Cardiology of Grand Yoff Dakar Senegal

Object: The aim of this study was to describe a familial dyslipidemia revealed by a corneal arch. Familial hypercholesterolemia is a rare and severe hereditary dyslipidemia with an exceptional homozygous form. He was a 43-year-old patient admitted with visual disturbance, xanthomatous papule and orange coloring at the level evolving for 5 years, no personal history of cardiovascular disease, having a family history of lipid disorders in siblings, as a cardiovascular risk factor: age over 50 and the male gender, normal cardio pulmonary examination, blood pressure at 120/80 mmhg, heart rate 78 bpm, in whom the ophthalmological examination shows a yellowish spot on the cornea (Figure 1). We report the case of familial dyslipidemia revealed by a corneal spot in Guinea.More recent studies increasingly suggest that it is much more widespread than previously thought: 1/200 to 1/400. Familial dyslipidemia is a rare and severe metabolic abnormality. It should be screened as early as possible like any other cardiovascular risk factor for atheroma to avoi

关键词： Corneal Arch Familial Dyslipidemia Guinea

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A Very Severe Obstructive Sleep Apnea Syndrome: In a Cause of Resistant Hypertension with One Sample Case

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World Journal of Cardiovascular Diseases 2021年第3期11卷 223-229页

作者： Baldé Elhadj Yaya Bah Mamadou Bassirou Barry ibrahima sory Béavogui Mariama sylla ibrahima sory Baldé Mamadou Aliou Koné Alpha Diallo Mamadou Camara Abdoulaye Baldé Siradiou Baldé Mamadou Dadhi Dièye Ousmane Condé Mamady Cardiology Department of the Ignace Deen Hospital Conakry Guinea Cardiology Department of Donka Hospital Conakry Guinea Sakina Clinic in Dakar Dakar Senegal

When blood pressure values remain above the target in a hypertensive patient treated concomitantly with three anti-hypertensive drugs including a diuretic, maximum well-tolerated doses, this is a resistant arterial hypertension. In this case, it is advisable to look for a secondary cause such as a drug intake that influencing the blood pressure or the presence of obstructive sleeping syndrome (OSAS). We report a clinical case of a patient with a high cardiovascular risk at the age of 50, hypertensive and diabetic, with dyslipidemia and obesity. He was on anti-hypertensive triple therapy at an optimal dose. Her diabetes was balanced with 6.4% glycated hemoglobin. Dyslipidemia has being treated. Despite healthy diet including a low sodium diet and weight loss, blood pres- sure target was not reached. With self-measurement, the mean arterial pressure was 180/110 mmHg and on ABPM it was 167/113 mmHg. The ventilatory polygraphy finds a severe OSA with an IAH = 56.6. Treatment with PCP (Con- tinuous positive pressure) allowed this patient to control blood pressure. The search for OSA should be systematic in face of resistant hypertension, in par- ticular in overweight or obese patients.

关键词： Obstructive Sleep Apnea Syndrome (OSAS) Resistant Hypertension Continuous Positive Airway Pressure (CPAP)

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Arterial and Venous Thrombosis following Vaccination against COVID-19 with Astra-Zeneca Vaccine Revealing Thrombophilia

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World Journal of Cardiovascular Diseases 2023年第4期13卷 198-204页

作者： Bah Mamadou Bassirou Doumbouya Amadou Dioulde Balde Mamadou Aliou Balde Thierno Hamidou sylla ibrahima sory Balde Elhadj Yaya Kone Alpha Barry ibrahima sory Samoura Sana Beavogui Mariam Diakité Souleymane Balde Mamadou Dadhi Cardiology Department Ignace Deen Hospital Conakry Guinea Imaging Department Ignace Deen Hospital Conakry Guinea

Vaccination against COVID-19 is the most recognised means of containing the pandemic. Vaccines are not without side effects, particularly vascular thrombosis. But before blaming the vaccines, a thorough assessment of thrombotic risk factors is necessary. We report a case of arterial and venous thrombosis after vaccination with AstraZeneca revealing an exaggeration of factor VIII in a 37-year-old female patient. The angioscanner showed a venous thrombosis of the right subclavian, a pulmonary embolism and the presence of a thrombus in the aorta. The biology was in favour of a high level of factor VIII. The patient was treated with an antivitamin K, and the clinical evolution was favourable.

关键词： Thrombophilia Thrombosis Vaccine AstraZeneca

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Epidemiological, Clinical and Therapeutic Aspects of Arterial Hypertension at the General Medicine Department of Nzerekore Regional Hospital

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World Journal of Cardiovascular Diseases 2021年第11期11卷 533-538页

作者： Beavogui Mariama Balde Elhadj Yaya Doumbouya Idrissa Barry ibrahima sory Samoura Aly Camara Abdoulaye Bah Mamadou Bassirou Mariama sylla ibrahima sory Balde Mamadou Dadhi Bah Abdoul Mazid Mariama Kone Alpha Balde Mamadou Aliou Conde Mamady Cardiology Department Ignace Deen National Hospital Conakry Guinea Department of Neurology Ignace Deen National Hospital Conakry Guinea Cardiology Department Donka National Hospital Conakry Guinea

Introduction: High blood pressure is a public health problem in Guinea as well as everywhere in Africa. The objective of our study was to assess the epidemiological, clinical and therapeutic aspects of High blood pressure in the general medicine department of the Nzérékoré regional hospital. Methodology:This was a prospective study of a descriptive type, lasting 06 months, from July 1 to December 31, 2014. Results: We recorded 156 cases of High blood pressure among a total of 570 patients, for a hospital frequency of 27%. The 56 - 65 age group was the most affected, at 29.4%, with a predominance of men (sex ratio: 1.5). Alcoholism was the most common cardiovascular risk factor with a frequency of 51.2%, smoking and physical inactivity were found in 35.8% and 30.7% respectively;psychosocial stress was found in 24.3% of patients. The clinic was dominated by headache (100%) and dizziness (57.6%). All our patients were subjected to a healthy diet. Fixed dual therapy was the most widely used treatment regimen, i.e. 91 patients (58.3%) and included a diuretic in 37.1% of cases, a calcium channel blocker in 25% of cases and an ACE inhibitor in 24.3%. Conclusion: This study revealed a high frequency of hypertension in the general medicine department of the regional hospital of N’zérékoré.

关键词： Epidemiology Clinical Therapeutic Hypertension

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Extensive Bi-Atrial Remodeling on Hypertensive Patient with Permanent Atrial Fibrillation Delayed Diagnosis of Fatal Cardiac Lambda Amyloidosis

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World Journal of Cardiovascular Diseases 2024年第6期14卷 409-420页

作者： Houzéiph Abdou Lassissi Ngardjibem Djita ibrahima sory sylla Thome Masset Abdelrhani Moumen Sedjolo Emmanuelle Bibiane Kpomalegni Centre Hospitalier Nord Mayenne Mayenne France Centre Hospitalier Le Mans Le Mans France Centre Hospitalier Vierzon Vierzon France Centre Hospitalier Universitaire de Grenoble Grenoble France

Background: Amyloidosis is a disease characterized by the deposition of fibrillar proteins in tissues. The nature of the protein defines the type of amyloidosis. Cardiac involvement is most often secondary to deposits of transthyretin and immunoglobulin light chains. Treatment depends on the type of amyloidosis. Cardiac light chain amyloidosis is a medical emergency. Aim: To highlight the importance of an early diagnosis of cardiac light chain amyloidosis. Case Presentation: We report the case of an 88-year-old hypertensive female patient with sustained atrial fibrillation and recurrent heart failure, in whom echocardiography showed concentric left ventricle hypertrophy with mildly reduced left ventricle ejection fraction (LVEF) to 45%. Bone scintigraphy was normal. Serum analysis showed increased lambda free light chains. Accessory salivary gland biopsy revealed weak Kappa light chain staining and clear overexpression of lambda light chain deposits. The diagnosis of stage 3B cardiac amyloidosis secondary to lambda light chain myeloma was made. After a multidisciplinary meeting, it was decided to start treatment with DARATUMUMAB + LENALIDOMIDE. Patient’s general condition deteriorated with the occurrence of febrile pancytopenia. Chemotherapy was stopped and management was limited to comfort care until the patient’s death. Conclusion: Cardiac light-chain amyloidosis must be diagnosed early as it can be rapidly fatal.

关键词： Myeloma Cardiac Lambda Light Chain Amyloidosis Monoclonal Gammopathy Heart Failure

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Isolated Ventricular Septal Defect: Ultrasound, Therapeutic and Evolutionary Aspects of 85 Cases in the Cardiology Department of the Ignace Deen National Hospital in Conakry

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World Journal of Cardiovascular Diseases 2024年第8期14卷 465-479页

作者： Mamadou Bassirou Bah Amadou Diouldé Doumbouya Elhdj Yaya Balde Mamadou Aliou Balde Alpha Kone ibrahima sory sylla Mamadou Dian Bah Aboulaye Bah Mamadou Diallo Thierno Siradjo Balde Abdoulaye Camara Morlaye Soumaoro ibrahima sory Barry Souleymane Diakité Mamadou Dadhi Balde Cardiology Department of the Ignace Deen Hospital Conakry Guinea Cardiology Department Donka Hospital Conakry Guinea

Introduction: Ventricular septal defect (VSD) is the most common congenital heart disease of all congenital heart defects. The aim of this study was to investigate the echographic, therapeutic and evolutionary aspects of ventricular septal defects (VSD) in the general cardiology department of the Hôpital National Ignace Deen. Methods: A retrospective data collection was carried out from January 2018 to December 2023 including 85 cases of isolated IVC was performed. The variables studied were epidemiological, clinical, paraclinical, therapeutic and evolutionary. Results: Of the 320 patients seen during the study period for congenital heart disease, 85 (26.556%) were isolated IVCs. Age at diagnosis ranged from 3 months to 16 years, with an average age of 3.59 years. The most represented ethnic group was the Fulani (50.58%). The 8.24% came from consanguineous marriage versus 22.35%. 91.76% of children had a history of bronchitis. The most common clinical signs found were systolic murmur (90.58%), growth retardation (51.76%). Only 4 cases (4.70%) had a malformation associated with IVC represented by DiGeorges disease (2.35%) and trisomy 21 (2.35%). Nearly half the patients had type IIb VIC (44.71%). The other half were represented by type 1 (18.82%), type IIa (20%), type III (10.59%) and type IV (5.88%). According to site more than two-thirds of VICs (71.64%) were perimembranous in location, followed by infundibular (16.47%) and muscular (11.76%) VICs. In our study 55.29% presented an indication for both surgical intervention and medical treatment, while 16.47% required only medical treatment. In contrast, 28.23% were placed under exclusive surveillance. Of the 47 patients for whom surgery was indicated, 29 (61.17%) underwent surgical repair, while 18 (38.83%) were awaiting confirmation for surgery. Conclusion: VIC is the most common congenital heart disease. An early detection strategy and the establishment of specialized centers could improve the outcome of these chil

关键词： Ventricular Septal Defect Congenital Heart Disease Ignace Deen

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Child Victims of Road Traffic Accidents: Epidemiological and Clinical Aspects in the Medical and Surgical Emergency Department of the Donka National Hospital

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Case Reports in Clinical Medicine 2024年第3期13卷 63-72页

作者： ibrahima sory Diallo Mamadou Moustapha Diop Amadou Oury Toure Mamadou Aliou Doukouré Aîssata Barry M’mah Aminata Bangoura Mariama Sadjo Diallo Abdoulaye Oumare Diallo Salimatou Hassimiou Camara Thierno Mamadou Aliou Touré Ouo Ouo Kolié Mohamed Lamine Diallo Fatoumata Binta Diallo ibrahima sory Souaré Institute of Child Nutrition and Health Conakry Guinea Department of Pediatrics Donka National Hospital Conakry Guinea UNICEF-Guinea Community Health Section Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Children involved in road accidents most often suffer head or limb injuries. The severity of these injuries varies according to the age of the child, the type of road user and whether or not protective devices are used. The aim of this study was to carry out a census of admissions and to identify the epidemiological and clinical profile of children involved in road traffic accidents at Donka National Hospital. Methods: This is a descriptive cross-sectional study of children involved in traffic accidents over a 3-month period from September 1 to November 30, 2021. All children admitted to the emergency department for a traffic accident were included in the study. Results: During the study period, 435/530 children (82.1%) were victims of road accidents. Boys accounted for 54.94% of cases, compared with 45.06% for girls. The age group most affected was 12-17 years old (48.97%). October had the highest accident rate (36.4%). Pedestrians are most affected (52.87%). Bicycles and mopeds were involved in 59.77% of accidents. Head injury was the most frequent pathology (33.33%). The study showed that 12.64% of victims were referred to intensive care, pediatric surgery, etc. We recorded 8 cases of death (1.84%). Conclusion: This study highlighted the characteristics, incidence and risk factors for accidents in children admitted to emergency departments. Accident prevention, particularly serious accidents in children, requires more precise knowledge of the factors and circumstances leading to their occurrence.

关键词： Child Accident Public Highway Donka

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Mechanical Complications of Osteosynthesis: Frequency and Management at the Orthopedics-Traumatology Department of CHU Ignace DEEN

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Open Journal of Orthopedics 2024年第9期14卷 404-410页

作者： Tafsir Camara Amira Aboud ibrahima sory Bangoura Madjirabe Nassaradengar Hippolyte Mohamed Youla Urbain Judicael Adou Kouassi Bah Mohamed Lamine Léopold Lamah Orthopedics-Traumatology Department of Ignace Deen University Hospital Conakry Guinea Orthopedics-Traumatology Department of Donka University Hospital Conakry Guinea

Introduction: Mechanical complications after osteosynthesis are spontaneous and harmful modifications of the joint compromising the consolidation process. The aim of this study is to report on the frequency of these complications and their management in the Orthopaedic-Traumatology Department of CHU Ignace Deen. Patients and Methods: we conducted a retrospective descriptive and analytical cross-sectional study from January 2017 to December 2022. It focused on the records of patients hospitalized and treated in the department for a mechanical complication after osteosynthesis. Results: The frequency of mechanical complications was 1.2%, with an average age of 44.2 years and a sex ratio of 3.2 in favor of men. Non-compliance with postoperative instructions, non-compliance with surgical technique, postoperative infection and early loading were the main contributing factors. Disassembly of the screw-plate was the most common cause in 6 cases (35.5%), with a mean delay of 4.1 months. Revision osteosynthesis was carried out using screw plates in 8 cases (47.1%). Conclusion: Mechanical complications of osteosynthesis are less frequent traumatic conditions in our department. Several factors contribute to their occurrence.

关键词： Mechanical Complications Frequency Therapeutics Osteosynthesis

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