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Therapeutic Itinerary of Patients Living with Viral Hepatitis B and C in Guinea

Open Journal of Gastroenterology 2022年第10期12卷 299-306页

作者： Diallo Kadiatou Barry Fatoumata Diaraye Diallo thierno Saidou Diallo Djenabou Sow Ousmane Diallo mamadou Sarifou Sylla Mariétou Salifou Sylla Djibril Leno Niouma Nestor Diallo Alpha Amadou Sank tounkara thierno mamadou Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Department of Internal Medicine and Hepato-Gastroenterology National Hospital Donka Conakry Guinea National Programme for the Fight against HIV and Viral Hepatitis Ministry of Health and Public Hygiene Conakry Guinea Inter-Army Medical and Surgical Centre Conakry Guinea Department of Dermatology-MST National Hospital Donka Conakry Guinea

Introduction: The therapeutic pathway affects the patient who changes care facilities. This change is linked to factors such as financial means, geographical accessibility of care facilities, quality of care and the socio-cultural perception of the patient. In countries with limited resources such as Guinea, the therapeutic itinerary remains multiple and hampered by obstacles. The objective of this study was to describe the therapeutic itinerary of patients living with hepatitis B and C at the Donka National Hospital. Material and methods: This was a retrospective, descriptive study lasting 43 months (24 January 2017 - 27 August 2020);it focused on patients living with hepatitis B or C or viral cirrhosis. We collected sociodemographic, clinical and treatment history variables. The data were analysed with SPSS software version 21.0. Results: Out of 5400 patients, the proportion of viral hepatitis B or C represented 393 patients (7.3%). The mean age of our patients was 35 ± 10 years, with extremes of 16 - 77 years. The sex ratio was 2.5. Three hundred and forty-two patients (87%) had recourse to modern medicine, mostly in private facilities (50.6%). One hundred and twenty-five patients (31.8%) had received previous treatment, half of whom (57.6%) had received inappropriate treatment. The delay in treatment was long in 45% of cases. The main reasons for delaying treatment were feeling unwell in 33.3%;not knowing to consult a specialist in 29.9% and feeling that they were being treated with useful drugs in 24.3%. Conclusion: The lack of training of general practitioners on the management of viral hepatitis and the scarcity of awareness campaigns on viral hepatitis contributed to the inadequacy of the management.

关键词： Therapeutic Itinerary Hepatitis B Hepatitis C Guinea

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Congenital Heart Disease Referred for Surgery: Analysis and Epidemiological Description in the Cardiology Department of CHU Ignace Deen

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World Journal of Cardiovascular Diseases 2024年第4期14卷 234-251页

作者： Bah mamadou Bassirou Diallo mamadou Tahirou Doumbouya Amadou Dioulde Balde Elhadj Yaya Camara Abdoulaye Diallo mamadou Balde thierno Siradio Bah Abdoulaye Bah mamadou Dian Samoura Sana Balde mamadou Dadhi Cardiology Department of the Ignace Deen Hospital Conakry Guinea

Introduction: Congenital heart disease includes all cardiac and vascular malformations. It accounts for approximately one third of all congenital malformations and is a public health problem, particularly in developing countries. The aim of this study was to analyze the epidemiological, clinical and paraclinical aspects of congenital heart disease. Methods: This was a retrospective descriptive and analytical study based on the records of 135 patients referred for surgery and followed up in the cardiology department of the Ignace Deen University Hospital, collected in November 2022. Results: Hospital prevalence was 5%. The mean age was 71 months, ranging from 1 month to 19 years. The age group over 24 months was the most represented (62%). The M/F sex ratio was 1.36. Urban origin was predominant (58%). The rate of children not attending school or dropping out was high (16%). Siblings with fewer than 4 children were the most common (88%). A heart murmur was the most frequent sign (78%), followed by cyanosis (36%) and heart failure (29%). The association between heart murmurs and CHD was proven with a p-value Conclusion: CHDs represent the main indication for paediatric cardiac surgery and follow-up (95%). We stress the importance of implementing a screening and management strategy for congenital heart disease.

关键词： Congenital Heart Disease Cardiology Epidemiology Surgery Ignace Deen University Hospital

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Evaluating the Influence of the Prostate Weight on the Morbidity and Mortality of Transvesical Open Prostatectomy: Prospective Analysis of 108 Cases in the Urology-Andrology Department of the Ignace Deen National Hospital in Conakry

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Open Journal of Urology 2024年第4期14卷 252-261页

作者： thierno Oumar Diallo Alimou Diallo Alpha Oumar Barry thierno mamadou Oury Diallo Alseny Bah Youssouf Keita Daouda Kanté mamadou Bissiriou Bah Demba Cissé Ibrahima Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah Urology Department National Hospital of Ignace Deen Conakry University Conakry Guinea Urology Department Sino-Guinean Friendship Hospital Conakry University Conakry Guinea

Introduction: Open transvesical prostatectomy remains today one of the most effective approaches for the management of benign prostatic hyperplasia despite the fact that, this method is associated with multiple complications. The objective of this study was to evaluate the influence of prostate weight on the morbidity and mortality of transvesical prostatectomy for adenoma in the urology-andrology department of the Ignace Deen National Hospital. Materials and Methods: This was a prospective, longitudinal and analytical study lasting 6 months, from March 1, 2022 to August 31, 2022 including patients admitted and operated on by open transvesical prostatectomy by assessing the influence of prostate weight on the morbidity and mortality of transvesical adenomectomies. Results: 108 patients were included in our study, the average age of our patients was 70 ± 7.7 years, cultivators were the most represented profession with 38.89%, and hypertension was the most represented comorbidity with 75%. 33.06% of cases became complicated and surgical wound infection was the main complication with a frequency of 17.40%. Statistical analysis did not conclude that, the prostate weight does not have a statistically significant influence on the morbidity and mortality of transvesical open prostatectomy for benign prostatic hyperplasia. Conclusion: Prostate weight has no influence on the morbidity and mortality of transvesical prostate adenoma.

关键词： Benign Prostatic Hyperplasia (BPH) Adenomectomy Prostate Weight Complication

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Oesophageal Mycosis: Epidemiological and Clinical Aspects and Risk Factors for Occurrence in the Digestive Endoscopy Unit of the Donka National Hospital, Conakry CHU

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Open Journal of Gastroenterology 2024年第2期14卷 31-40页

作者： Diallo mamadou Sarifou Youssouf Oumarou Yaogo Abdoulatif Diallo Kadiatou Diallo Djéinabou Wann thierno Amadou Bah mamadou Lamine Yaya Diakhaby mamadou Kanté mamadou Aliou Sylla Djibril Hepato-Gastroenterology Department of the Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Centre Hospitalier Universitaire Communautaire de Bangui Internal Medicine Department Bangui République Centrafricaine Hepato-Gastroenterology Department Angré University Hospital Abidjan Ivory Coast Department of Internal Medicine Donka National Hospital Conakry Guinea

Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1st January to 31st December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factor

关键词： Endoscopy CHU Conakry Risk Factors Immunosuppression Oesophageal Mycosis

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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

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Evaluation of the “Helicobacter pylori” Eradication Rate by Bismuth Quadritherapy or Concomitant Quadritherapy in Black Africans

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Open Journal of Gastroenterology 2024年第3期14卷 69-79页

作者： Diallo mamadou Sarifou Youssouf Oumarou Yaogo Abdoulatif Diallo Kadiatou Diallo Djenabou Wann thierno Amadou Bah mamadou Lamine Yaya Diallo Ahmed Tidiane Diakhaby mamadou Kanté mamadou Aliou Sylla Djibril Hepato-Gastroenterology Department of the Donka National Hospital CHU Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Internal Medicine Department Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic Hepato Gastroenterology Department Angré University Hospital Abidjan Ivory Coast Department of Internal Medicine Donka National Hospital CHU Conakry Guinea

Introduction: Gastric infection by “Helicobacter pylori” remains a topical issue due to the evolving scientific data concerning its pathophysiology, the diseases and pathologies concerned, which now extend beyond the gastric or digestive sphere, and the treatment methods faced with the development of antibiotic resistance. Diagnosis of infection involves two inseparable aspects: identification of the bacterium itself and identification of the endoscopic and histological lesions caused by the bacterium. Objective: To evaluate the rate of eradication of Helicobacter pylori infection by bismuth quadruple therapy and concomitant treatment. Patients and methods: This was a prospective, cross-sectional, analytical study of all outpatients in the hepato-gastroenterology department during the study period from 1 January 2022 to 30 November 2023. All patients had undergone oeso-gastroduodenal fibroscopy and the diagnosis was made by histological examination of the gastric biopsy. Results: Our 113 patients comprised 68 men and 46 women. The sex ratio was 1.48 in favour of men. The mean age of our patients was 40.28 years, with extremes of 13 and 80 years. The clinical signs that prompted oeso-gastroduodenal fibroscopy were as follows: epigastralgia (69.91%), dyspepsia (14.16%), vomiting (7.08%), gastro-oesophageal reflux (6.19%) and altered general condition with weight loss (2.65%). The endoscopic lesions were: gastropathy (antral, fundic and diffuse: antro-fundial) (69.02%), bulbar ulcer (6.19%), gastric ulcer (5.31%). Helicobacter pylori infection was associated with chronic gastritis in all our patients;it was mild in 50%, moderate in 41% and severe in 9%. The eradication rate of Helicobacter pylori according to the treatment protocol used was 92.30% for bismuth quadruple therapy and 94.12% for concomitant quadruple therapy. Conclusion: The eradication rate of Helicobacter pylori in our study was 92.30% and 94.12% respectively for bismuth quadritherapy and concomitant the

关键词： “Helicobacter pylori” Eradication Quadritherapy Antibiotics Conakry

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Prostatic Adenomectomy and Comorbidities: Frequency and Management at the Urology Department of the Ignace Deen National Hospital in Conakry

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Open Journal of Urology 2024年第4期14卷 217-226页

作者： Demba Cisse Alpha Oumar Barry Morlaye Fatoumata Bangoura Alimou Diallo mamadou Dian Bah Youssouf Keita Daouda Kanté thierno mamadou Oury Diallo mamadou Bissiriou Bah mamadou Diawo Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah Maitre-Assistant à la Facult&#233 des Sciences et Techniques de la Sant&#233 Universit&#233 Gamal Abdel Nasser de Conakry Conakry Guin&#233e

Goal: To determine the type of comorbidity and highlight the complications of adenomectomy and comorbidities. Material and Methods: This is a prospective, descriptive, cross-sectional study lasting six (6) months, from July 1, 2022 to December 31, 2022. Patients with BPH on comorbidity condition taken care of during the study period AND have agreed to participate in the study. Results: During our study, 49 cases of benign prostatic hypertrophy with comorbidities were collected, representing a frequency of 29%. The average age ranges for the patients were 43 - 70 years. The age group most affected was 70 to 79 years old (38.80%). Nocturnal urinary frequency was the main reason for consultation present in all our patients. The most frequent comorbidity was hypertension, i.e. 83.70%. The PSA rate between 4 and 10 was the most represented, i.e. 42.86%. The prostate volume was between 61 and 100 ml in 40.82% of patients. Histology showed that it was a benign adenomatous hypertrophy of the prostate in 85.70% and a prostatic adenomyoma in 14.29%. Trans-bladder adenomectomy alone was the most performed technique, i.e. 49%, followed by trans urethral resection of the prostate, i.e. 38.80%. Retention of urine after removal of the catheter was the most observed complication, i.e. 12.20%. Conclusion: Benign prostatic hypertrophy with comorbidities constitutes a frequent association. Because their presence can affect effectiveness and lead to complications.

关键词： Prostatic Hypertrophy Comorbidities Conakry University Hospital

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Seroprevalence of Human Immunodeficiency Virus and Hepatitis B in Blood Donors at the N’Zérékoré Regional Blood Transfusion Centre in Guinea

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Open Journal of Immunology 2024年第2期14卷 33-45页

作者： Alimou Camara Ernest Thea Ives Nyankoye Haba Yamoussa Youla Ibrahima Sory Diallo Mariama Sadio Diallo Djiba Kaba Jacob Camara Moussa Condé Barré Soropogui Kaba Kourouma thierno mamadou tounkara Babacar Mbengue Abdoulaye Touré Sanaba Boumbaly Virology Research Centre Guinea Viral Haemorrhagic Fevers Laboratory Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea National Blood Transfusion Centre Ministry of Health and Public Hygiene Conakry Guinea Institute of Health and Childhood Donka National Hospital Conakry Guinea African Centre of Excellence for the Prevention and Control of Communicable Diseases Conakry Guinea Department of Dermatology and Venereology Donka University Hospital Conakry Guine Immunology Laboratory Cheikh Anta Diop University Dakar Senegal Centre for Research and Training in Infectious Diseases of Guinea Conakry Guinea

Blood transfusion saves lives and reduces morbidity and mortality for a large number of diseases and clinical conditions, but it is not without danger. The aim of this study was to determine the seroprevalence of HIV and hepatitis B in blood donors received at the regional Blood Transfusion Centre of N’Zérékoré (Guinea). This was a 5-year retrospective analytical study. We included records of blood donors aged 18 to 60 years admitted to the N’Zérékoré Regional Blood Transfusion Centre for blood donation from January 2016 to December 2020. We performed a descriptive analysis followed by Chi-2 or Fish-er-exact tests and the Student or Wilcoxon test, followed by multivariate logistic regression. In this study, donor age ranged from 18 - 60 years, with a pre-dominance of donors aged 25 - 34 (44.2%). Male donors were the most represented in our study (79.0% versus 21.0% female). More than half of the donors were blood group O (55.6%). We observed a seroprevalence of 3.6% for HIV, 13.4% for HBsAg and 0.2% for co-infection. In our series, age 25 - 34 (OR = 1.89 and P = 0.001) and 35 - 44 for HIV (OR = 2.01 and P = 0.001), HBsAgserostatus (OR = 3.04 and P = 0.001) and blood donation history (OR of 3.04 and P = 0.001) were factors associated with HIV positivity (P < 0.05). In our study, HIV serostatus (OR = 3.04 and P = 0.001) and blood donation history (OR = 0.01 and P = 0.001) were factors associated with HBsAgseropositivity. We reported a high prevalence of HIV and HBsAg. Sex, serological status and blood donation history were associated factors.

关键词： Seroprevalence HIV Hepatitis B Blood Donors N’Zérékoré Guinea

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Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN/CAP) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry

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Open Journal of Gastroenterology 2024年第4期14卷 125-138页

作者： mamadou Sarifou Diallo Oumarou Youssouf Abdoulatif Yaogo Djenabou Diallo Kadiatou Diallo thierno Amadou Wann Ahmed Tidiane Diallo mamadou Lamine Yaya Bah Mamdou Diakhaby mamadou Aliou Kanté Djibril Sylla Department of Hepato-Gastroenterology The Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Internal Medicine Department Centre Hospitalier Universitaire Communautaire de Bangui Bangui Central African Republic Department of Hepato Gastroenterology Angr&#233 University Hospital Abidjan Ivory Coast Department of Internal Medicine Donka National Hospital Conakry Guinea

Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). Methods: This was a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, i.e. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. Results: Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis;29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined st

关键词： Cirrhosis Fibrosis Fibroscan/CAP Non-Alcoholic Hepatic Steatosis Steatosis CHU Conakry

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Comparative Study of Transvesical and Retropubic Prostatic Adenomectomies in the Urology-Andrology Department of Ignace Deen University Hospital Center

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Open Journal of Urology 2024年第4期14卷 227-243页

作者： Lahoumbo Ricardo Gnammi Demba Cissé Vahina Alexandre Gamamou Daouda Kanté mamadou Diawo Bah El-Mouksitou Akinocho Sabi Couscous Hassiatou Abdul-Haqq Bah-L’Imam thierno Oumar Diallo thierno mamadou Oury Diallo Ibrahima Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah Department of Urology-Andrology Ignace Deen UHC Conakry Republic of Guinea School of Public Health Free University of Brussels Brussels Belgium Medical Imaging Department Ambroise Pare Clinic Conakry Guinea

Objective: To compare the results of transvesical and retropubic prostatic adenomectomies at the Urology-Andrology Department of Conakry University Hospital. Methodology: This was a prospective multi-operator analytical study lasting 6 months. It included 70 patients operated on for benign prostatic hypertrophy (BPH), divided into 2 groups of 35 according to the retropubic or transvesical technique. The data was collected using a questionnaire and entered into the Epi info application. The analysis was initially descriptive and then univariate. To identify confounding factors, a multivariate analysis was performed. The application conditions of each test were checked before their application. A p-value Results: Upper adenomectomies represented 53.6% of surgeries performed for BPH. The average age was 73.2 years. The mean prostate volume was 117 ± 51.6 cc and the mean total PSA was 9.2 ± 11.4 ng/ml. The majority of patients had an ASA1 (60%) and ASA2 (37.1%) score. Spinal anesthesia, a double-current silicone probe with hinged hinge 22, and drainage of the prevesical space were carried out in all patients, i.e. 100%. The average overall blood loss was 229 ± 98.2 ml. It was lower in the group of patients operated via the retropubic route (187 ± 60.4 ml). The same was true for the duration of intervention (49.1 ± 7.17 vs 55.4 ± 7.9 min), the catheter wearing time (5.14 ± 0.97 vs 9.29 ± 2 .9 days) and the length of hospitalization (=6.26 ± 1.15 vs 12.1 ± 5.74 days). Conclusion: The retropubic technique has advantages over the transvesical one. These advantages are translated by a gain in the duration of the intervention, blood loss, catheter wearing time and length of hospitalization.

关键词： Upper Adenomectomies BPH Retropubic Approach Transvesical Approach Conakry

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