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Post-Operative Mortality Analysis in the Urology Department of Conakry University Hospital

Open Journal of Urology 2023年第4期13卷 122-131页

作者： Bah mamadou Bissiriou Kanté Daouda Cissé Demba diallo Thierno mamadou Oury Barry mamadou Dian diallo Alimou Bah mamadou Diao Bah Ibrahima diallo Abdoulaye Bobo Bah Oumar Raphiou Faculty of Health Sciences and Technique Gamal Abdel Nasser University of Conakry Urology Department CHU of Conakry Guinée

Introduction: Death is a major accident which constitutes an element whose evaluation and analysis are necessary in a surgical service. Such a study is especially important in our country where the health structure operates with limited resources and more than half of the population lives below the poverty line. The objective of this study was to determine the frequency of post-operative mortality, to describe the main comorbidity factors responsible for this mortality and to identify the main cause of post-operative death in the urology department of the Ignace Deen National Hospital Material and Method: This was a retrospective descriptive study lasting 5 years from January 1, 2015 to December 31, 2019. It had focussed on all the files of patients operated on at the Urology Department of the Ignace Deen National Hospital, either in an emergency or planned and who died in per or post-operative immediately or 30 days later. Results: We recorded 63 cases of post-operative death, or a frequency of 1.84%. The average age was 61.92 ± 16.91 with the extremes of 12 and 91 years. Bladder (20.63%) and prostate tumours (60.3%) were the main admission diagnoses. High blood pressure was the main comorbidity factor found with 38.09% of cases followed by diabetes with 12.69%. Transurethral resection of the prostate, transurethral resection of the bladder and prostate adenocomectomy were the most performed surgical procedure with respective proportion of 19.04%, 20.63% and 38.09%. Probable cause of death were anemia in 25 cases (39.68%), septic in 20 cases (31.75%), heart failure in 6 cases (9.52%), pulmonary embolism in 5 cases (7.94%), obstructive renal failure 4 cases (6.35%) and stroke in 3 cases (4.76%). Conclusion: The majority of deaths occurred in patients over the age of fifty. Anaemia was the main cause of deaths. Difficulties in procuring blood products as well as the lack of modern therapeutic means are factors that make it difficult for patients to adequately manage.

关键词： Post Operative Mortality Urology Ignace Deen

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Prevalence of Types of Arterial Hypertension in Pregnant Women at the Maternity Ward of the Centre Médical Communal Les Flamboyants Conakry Guinea

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Open Journal of Nephrology 2023年第3期13卷 234-245页

作者： Amadou Yaya diallo Kadiatou mamadou Bobo Barry mamadou Malal diallo Soriba Bangoura Bangoura diallo Fatoumata Binta Oury diallo mamadou Yacine Bah Aly Traoré Mohamed Lamine Kaba Department of Nephrology and Haemodialysis CHU Donka Conakry Guinea Centre Médical Communal les Flamboyants Conakry Guinea

Introduction: Arterial hypertension (AH) during pregnancy is defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg on two (2) successive visits separated by at least 4 hours in a woman who has been at rest for 10 to 15 minutes in the seated position and then in the left lateral decubitus position. The aim of this study was to determine the prevalence and types of arterial hypertension among pregnant women in the maternity ward of the CMC les Flamboyants. Methods: This was a prospective descriptive study lasting six (6) months, from 1 October 2021 to 31 March 2022, of all pregnant women and/or parturients admitted to the maternity ward of the CMC les Flamboyants with a resting blood pressure (BP) greater than or equal to 140/90 mm Hg during the study period. Results: During the study period, we recorded 707 cases of pregnant and/or parturient women, 50 (7.07%) of whom were hypertensive. The average age of the patients was 29 years, with extremes of 18 and 41 years. The 20 - 29 age group was the most affected, with 26 cases (52%). Headache, dizziness and oedema of the lower limbs were constant in all cases. The risk factors for arterial hypertension were dominated by familial hypertension in 19 cases (38%), multiple gestures in 17 cases (34%) and a history of gestational hypertension in 16 cases (32%). Gestational age between 28 and 36 weeks’ amenorrhoea was the most common, with 20 cases (40%). Type I hypertension was most common on admission, with 34 cases (68%), followed by type II hypertension, with 8 cases (16%). Pre-eclampsia was the most frequent maternal complication with 27 cases (54%) followed by eclampsia with 15 cases (30%). Fetal distress was the most frequent fetal complication, 19 cases (38%), followed by death in utero 9 cases (18%). Conclusion: Compliance with consultation programmes and correct patient follow-up could help reduce maternal-foetal complications.

关键词： Hypertension Pregnant Women Maternity Unit Conakry Guinea

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Factors Associated with the Continuum of Prenatal Care in the Post-Ebola Context in Guinea

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Open Journal of Epidemiology 2022年第2期12卷 207-220页

作者： Anne Marie Soumah mamadou Dioulde Balde Bienvenu Salim Camara Karifa Kourouma Aissatou diallo alpha Oumar Sall Amadou Oury Toure Ramata diallo Sadan Camara Ibrahima Sory Cherif Center for Research in Reproductive Health in Guinea (CERREGUI) Conakry Guinea National Center for Training and Research in Rural Health of Maferinyah Forecariah Guinea University Gamal Abdel Nasser of Conakry Conakry Guinea

Background: The 2018 demographic and health survey reports low coverage in the continuum of antenatal care over the period 2013 to 2018. However, little remains known about this indicator since the Ebola epidemic crisis was over. This epidemic has been reported to decrease utilization of maternal health services. This study aims to determine the coverage and factors associated with four or more antenatal care visits in Guinea in the post-Ebola context. Methods: This was a cross-sectional study using secondary data from the most recent (2018) Guinea Demographic and Health Survey. Women aged 15 to 49 years constituted our study population. Our sample included women who had their most recent birth over the last 24 months preceding data collection and whether or not they had performed 4 antenatal care (ANC) visits. Factors associated with performing four or more antenatal visits were assessed through a multivariate logistic regression analysis using Stata software version 15.1. The final model was constructed using the bottom-up stepwise method. Hosmer and Leeshawn’s goodness-of-fit test was used for model specification. Results: Among the 2634 women in the sample, 41% had four or more ANC visits. Factors associated with attending four or more ANC visits included education level, poverty quintile and region. Women with a secondary or higher education were 44% more likely to attend four or more ANC visits (OR = 1.44, 95% CI = [1.07 - 1.92]. Those whose spouses had secondary or education level were 1.66 times more likely to attend four or more ANC visits. Women from moderately wealthy households were 76% more likely to attend four or more ANC visits (OR = 1.76, 95% CI = [1.30 - 2.39]. Women from wealthier households were 2.52 times more likely to attend four or more ANC visits (OR = 2.52, 95% CI = [1.30 - 2.39]). Women living in Boké and Nzérékoré regions were 44% and 47% less likely to attend four or more ANC visits, respectively (OR = 0.56, IC 95% = [0.35 - 0.94]) and (

关键词： Associated Factors Antenatal Care Post-Ebola Guinea

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Ectopic Pelvic Leiomyoma and Diagnostic Difficulty in Imaging: A Case Report from Conakry, Guinea

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Case Reports in Clinical Medicine 2022年第9期11卷 375-379页

作者： alpha Abdoulaye Balde mamadou diallo Aboubacar Sidiki Keita Thierno Hamidou Balde Adama Kouyate Sekou Traore Ousmane Aminata Bah Faculty of Health Science and Technology UGAN de Conakry Guinea Imaging Department H&ocirc pital Nord Franche Comté Trévenans France Reference Imaging Centre of the Armed Forces (RICA) Conakry Guinea

Introduction: Fibromyomas are benign tumours of frequent uterine location, most often found in black women, whose diagnosis of certainty is histological. The extra uterine location is rare and the physio-pathogenesis is poorly understood. This location poses diagnostic problems on imaging. Management is based on tumour resection. Observation: The authors report a clinical case of a 31-year-old woman who was seen for non-febrile hypogastric pain with a large abdominopelvic mass on physical examination. There was no particular history. The biology did not show any abnormality. Ultrasound with Doppler found a mass that was difficult to characterize, and was completed by a CT scan and a pelvic MRI. The management was surgical with an evolution marked by complications. Conclusion: Ectopic leiomyoma is a rare condition. This location poses diagnostic problems on imaging. Management depends on the type of extra uterine presentation of the myoma.

关键词： Ectopic Histology Imaging Leiomyoma Pelvic

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Cervicofacial Cystic Lymphangiomas and Review of the Literature: About 2 Cases at Donka National Hospital

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第6期11卷 292-299页

作者： Abdoulaye Keïta Ibrahima diallo Mamady Fofana Sayon Kourouma mamadou Mouctar Ramata diallo mamadou Aliou diallo Sory Sacko Mohamed Casimir Kaman Department of ENT-HNS Donka University Hospital Conakry Republic of Guinea Department of ENT-HNS Kankan Regional Hospital Kankan Republic of Guinea Department of ENT-HNS Camp Samory Touré Conakry Republic of Guinea Department of ENT-HNS Mamou Regional Hospital Mamou Republic of Guinea

In this retrospective study, conducted over 7 years (2009-2016) at the ENT and Head and Neck Surgery Department of the Donka National Hospital, we report 2 cases of cervicofacial cystic lymphangiomas. They were a 28-month-old girl and a 2-year-old boy. The symptomatology was noted after their birth. Dyspnea and dysphagia were found in the boy. They had a satisfactory general condition. ENT examination noted a cystic-like tumor syndrome. Imaging showed evidence of a cystic lymphangioma of the cervicofacial region. Pathological examination confirmed the diagnosis. All patients underwent exeresis cervicotomy. We found adhesion of the lymphangioma cyst to the internal jugular vein in the children. The boy presented a paralysis of the chin branch of the facial nerve after the surgery. We did not find any tumor recurrence. However, cystic cervicofacial lymphangiomas are a particular aspect of surgical pathology in children in Africa. In spite of the advent of sclerosing products, surgery remains for us the treatment of choice.

关键词： Cystic Lymphangioma Management Literature Review African Setting

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Management of the Torsion of Spermatic Cord in the Urology-Andrology Department of the Ignace Deen National Hospital in Conakry

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Open Journal of Urology 2023年第10期13卷 399-406页

作者： Thierno mamadou Oury diallo mamadou Bissiriou Bah mamadou Diawo Bah Boris Amougou Daouda Kanté Alimou diallo Demba Cissé Abdoul Haqq Bah L’Imam mamadou Dian Oury diallo Abdoulaye Bobo diallo Oumar Raphiou Bah Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon

Introduction: Torsion of the spermatic cord is an emergency whose delay in treatment conditions the functional prognosis of the testicle. The aim of this study was to analyze the management of spermatic cord torsion in the Urology Andrology Department of the Ignace Deen National Hospital in Conakry. Material and methods: This was a ten-year retrospective descriptive study from January 1, 2012 to December 31, 2021. It involved all patients admitted for torsion of the spermatic cord, confirmed at surgical exploration. Results: We identified 21 cases of torsion of the spermatic cord. The mean age of the patients was 17.9 ± 4.4 years. The average consultation time was 19.2 ± 21.4 hours with extremes of [2 h and 98 h]. Only 6 patients (28.6%) consulted before the sixth hour. All patients presented with scrotal swelling. At scrototomy, all torsions were intravaginal with two turns of spiral in 13 cases and three turns in 8 cases. Orchiectomy followed by contralateral orchidopexy was performed in 6 cases. In the other cases, bilateral orchidopexy was performed after detorsion. The average hospital stay was 4.5 days. We recorded 4 cases of testicular atrophy after orchidopexy. Conclusion: Spermatic cord torsion is an infrequent emergency in our department. The delay in consultation remains the main predictive factor of testicular necrosis. Emergency exploratory scrotomy should be the rule.

关键词： Spermatic Cord Torsion Delay in Consultation Orchidopexy Orchiectomy Testicular Atrophy

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Profile of the Infertile Man at the University Hospital of Conakry (Guinea)

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Open Journal of Urology 2023年第7期13卷 223-237页

作者： Bah mamadou Bissiriou Kanté Daouda Sow Thierno Amadou Oury Thierno mamadou Oury diallo Koulalerou Aimon Axel Cédric Cissé Demba mamadou Diawo Bah Barry mamadou Dian Thierno Oumar diallo diallo Alimou Ibrahima Bah Abdoulaye Bobo diallo Oumar Raphiou Bah Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Urology Department CHU of Conakry Guinea

Introduction: Male infertility is defined as the inability of a man to impregnate a woman after 12 months of regular sexual intercourse without contraception. Objective: To improve the state of knowledge on the profile of the infertile man in Guinea. Methodology: We conducted a prospective, descriptive study over a period of 6 months from October 1st, 2020 to March 31st, 2021. Results: We collected an overall number of 71 patients seen onroutine consultation for infertility. They had a mean age of 36.4 years. More than half of our patients were monogamous (79% of cases). Civil servants were the most affected with 38.02% of cases. Primary infertility was dominant in 65% (n = 46) of cases. On clinical examination, varicocele was the most remarkable abnormality with 88.73% (n = 63) followed by testicular hypotrophy with 59.15% (n = 42). Azoospermia was the most frequent sperm abnormality with 22.54% (n = 16) followed by oligospermia with 15.49% (n = 11). Hormonal assessment based on FSH and LH was performed in 16 patients with azoospermia (22.53%). FSH elevation was associated with azoospermia in 6 patients, i.e. 8.45%, azoospermia associated with a normal FSH level accounting for 14.08% in our series. Conclusion: In our practice, male infertility is becoming more and more of a concern due to the increasing number of patients seeking treatment. The scarcity of a medical assistance for procreation unit alongside with more efficient diagnostic means constitutes a handicap for its management.

关键词： Male Infertility Varicocele Azoospermia Spermogram

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Aetiological Diagnosis of Infertility at Conakry University Hospital: Role of Hysterosalpingography and Pelvic Ultrasound

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Open Journal of Radiology 2023年第4期13卷 210-217页

作者： diallo mamadou Bah Ousmane Aminata Sow Ibrahima Sory Baldé alpha Abdoulaye Traoré Sekou diallo Fatoumata Binta Tchaou Mazamaesso Sonhaye Lantam Agoda Koussema Lama-Kègdigoma Adjenou Victor Department of Radiology Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Department of Gyneco-Obstetrics Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Department of Radiology Faculty of Medicine and Health Sciences University of Kara Kara Togo Department of Radiology Faculty of Medicine and Health Sciences University of Kara Lomé Togo

Objective: The objective of this study was to investigate the etiologies of infertility and to determine the contribution of hysterosalpingography coupled with ultrasound in the exploration of female infertility at Donka University Hospital. Methodology: This was a prospective descriptive cross-sectional study carried out in the Radiology Department of Donka National Hospital over a period of ten (10) months. It involved 78 women who came to the department for hysterosalpingography and/or pelvic ultrasound examinations, as part of the exploration of infertility. Data collection involved the use of pre-established survey forms to gather information on the parameters studied. Sociodemographic parameters, ultrasound and hysterosalpingography results were studied. A correlation was made between age at marriage and infertility to determine whether early marriage has an impact on primary infertility, with a statically significant result for p value greater than 0.05. Results: The mean age of our patients was 33.7 ± 5.6 years, with extremes of 18 and 35 years. The 18-35 age group was the most represented, with a frequency of 80.7%. The 34% of our patients were married before the age of 18, with a marriage duration ranging from 6 months to 15 years. The indication for investigations was dominated by secondary infertility, with a frequency of 65%, followed by primary infertility (35%). All our women underwent ultrasound-hysterosalpingography, i.e. 100%, in search of the cause of infertility. Ultrasound was pathological in 35.8%. The most common ultrasound lesions were myomas and ovarian dystrophies, with 12.8% each. However, hysterosalpingography was pathological in 35%. Tubal obstructions affected almost a third of our women (29.5%), followed by phimosis and tubo-peritoneal adhesions. Conclusion: Diagnostic evaluation of infertility requires a multidisciplinary approach, including collaboration between infertility gynecologists, radiologists and other infertility specialist

关键词： Infertility Female Etiology Hysterosalpingography Pelvic Ultrasound

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Atypical Coarctation of the Aorta Revealed by Arterial Hypertension in a 22-Year-Old Young Man

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World Journal of Cardiovascular Diseases 2023年第7期13卷 359-365页

作者： mamadou Bassirou Bah Elhdj Yaya Balde Thierno Hamidou Balde Fatoumata Biro Bah Aissatou Tiguidanké Balde Amadou Diouldé Doumbouya mamadou diallo alpha Kone Ibrahima Sory Sylla Thierno Siradjo Balde Abdoulaye Camara mamadou Dadhi Balde Cardiology Department Ignace Deen Hospital Conakry Guinea Department of Imaging Ignace Deen Hospital Conakry Guinea Cardiology Department Donka Hospital Conakry Guinea

Non-isthmic coarctation of the aorta is a rare congenital malformation in adults. Arterial hypertension is a frequent circumstance of discovery. We reported the case of a 22-year-old Guinean man who had been followed for 5 years for hypertension. Clinically, he presented with hypertension of the upper limbs with a systolic pressure gradient of 100 mmHg. The diagnosis was confirmed by thoracic angioscan, which showed a 65.8% coarctation of the abdominal aorta. He was on triple antihypertensive therapy combining Atenolol 100 mg, Amlodipine 10 mg and Perindopril 10 mg. He is awaiting interventional treatment. His blood pressure is stable at around 140/90 mmHg.

关键词： Abdominal Aortic Coarctation Arterial Hypertension Young Subject Congenital Malformation

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Contribution of Cardiac MRI in the Diagnosis of Acute Myocarditis

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Open Journal of Radiology 2023年第1期13卷 17-25页

作者： Aboubacar Sidiki Keita Mamoudou Camara mamadou diallo Adama Dembele mamadou Cisse Medical Imaging Department North Franche-Comte Hospital Trevenans France Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Medical Imaging Department Elbeuf Louviers Intercommunal Hospital Center Elbeuf France Medical Imaging Department Blois Hospital Center Blois France

Objective: To describe the MRI abnormalities observed in acute myocarditis. Materials and Methods: Retrospective cross-sectional study with a descriptive aim, carried out at the North Franche-Comte Hospital, over a period of 12 months, from January 2021 to December 2021. It covered all patients who received an MRI of heart disease and were diagnosed with myocarditis. The diagnosis of myocarditis was retained in all patients on the basis of two arguments: a T2 PSIR hyper signal and a late enhancement at 15 min in T1 PSIR with gadolinium. Results: Myocarditis was diagnosed in 20 patients out of a total of 214 who performed cardiac MRI, i.e. 10.30% of cases. The average age was 33.7 ± 14.3 with extremes of 17 and 69 years. We observed a male predominance with 11 men (55%) for 9 women (45%) or a sex ratio of 1.2. Clinical suspicion of myocarditis and acute coronary syndrome were the main indications for MRI. The lesion sites were subepicardial (95%) and/or intramural (30%), respecting the subendocardium, interesting for the majority, segments 12 (anterolateral) in 50% and/or 11 (inferolateral) in 43% of cases. Global hypokinesia was observed in 30% of patients associated with a decrease in LVEF. There was no cardiac volume abnormality or valvular abnormality. Conclusion: Cardiac MRI is nowadays the most efficient non-invasive imaging in the diagnosis of acute myocarditis. The diagnosis of myocarditis was made on 2 pathognomonic signs, namely a T2 STIR hyper signal and late enhancement at 15 min in T1 PSIR after injection of gadolinium. The morphology and lesion locations were in agreement with those described in previous studies. Global hypokinesia and pericardial effusion were observed in some patients. On the other hand, there was neither valvular anomaly, nor cardiac volume anomaly.

关键词： Cardiac MRI Acute Myocarditis Acute Coronary Syndrome

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