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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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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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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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Profile of Autoantibodies and Clinical Symptoms in Guinean Patients with Connective Tissue Diseases

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Open Journal of Immunology 2024年第1期14卷 1-10页

作者： Mariama Sadjo Diallo Doufin Traore Adame Diouf Djiba Kaba Issiaga Diallo Doudou Georges Massar Niang Alimou Camara Oumar Mouctar Diallo Boh Fanta Diane Abdoulaye Barry Ouo-Ouo Yaramon Kolie Moustapha Mbow Aly Badra Kamissoko djibril sylla Babacar Mbengue Mohamed Cisse Faculté des Sciences et Techniques de la Santé Université Gamal Abdel Nasser de Conakry Conakry Guinée Laboratoire de Biologie Moléculaire Nestor BANGOURA/Helene LABROUSSE H&#244pital de jour Donka CHU Donka Conakry Guinée Centre d’Excellence Africain Pour la Prévention et le Contrô le des Maladies Transmissibles Conakry Guinée Laboratoire d’Immunologie Université Cheikh Anta Diop Dakar Sénégal Service de Dermatologie-Vénérologie CHU Donka Conakry Guinée Service de Rhumatologie H&#244pital National Ignace Deen Conakry Guinée Service de Médecine Interne CHU Donka Conakry Guinée

Connective tissue diseases (CTDs) are Autoimmune diseases (AIDs) characterized by the appearance of autoantibodies, which are diagnostic markers. Investigations of these autoantibodies play a major role in the management of several autoimmune diseases. The objective of this study was to describe the profile of anti-ENA antibodies according to the clinical symptoms of mixed CTDs in Conakry teaching Hospital. We performed a cross-sectional study during six months. A total of 20 patients was recruited and we measured antibodies using the ELISA technique. The mean age of our patients was 36.5 years, with a predominance of females. Cutaneous and rheumatological signs were the main clinical manifestations. SLP was the most frequent CTDs;the threshold of ENA antibodies positivity was higher in scleroderma with and SLP. Anti-ENA identification reveals the frequency of anti-SSA (83.33%), anti-U1RNP (66.66%) and anti-histone (50%) antibodies. Antinuclear antibodies (ANA) react with various components of the cell nucleus. Their detection is of major interest in the diagnosis of CTDs. Our results highlight the importance of determining the specificity of these antibodies to guide differential diagnosis.

关键词： Autoantibodies Extractible Nuclear Antigen (ENA) Connective Tissue Diseases ELISA

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Compliance with Hand Hygiene among Health Professionals in the Medical-Surgical Emergency Department of the Donka National Hospital

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Open Journal of Internal Medicine 2022年第1期12卷 29-37页

作者： sylla djibril Kaké Amadou Camara Toumin Diakhaby Mamadou Keita Mory Filany Sako Fodé Bangaly Medical and Surgical Emergency Department of the Donka National Hospital Conakry Guinea Internal Medicine Department of the Donka National Hospital Conakry Guinea Department of Infectious and Tropical Diseases of the Donka National Hospital Conakry Guinea

Introduction: The transmission of infectious agents through the hands of nursing staff during care is the main cause of nosocomial infections. Hand hygiene has been recognized for over a century as an effective measure to prevent healthcare associated infections in healthcare settings, the objective of this study was to appreciate the practice of hand hygiene during care by health professionals in the medical-surgical emergency department of the Donka National Hospital. Methods: It was a cross-sectional, analytical study. Data collection took place from March 1 to April 30, 2021. The study covered all health professionals, namely doctors, nurses, laboratory technicians, radiography technicians, pharmacists, students, stretcher bearers, surfactants who were present at the time of the study period. Results: During the study period, out of a total of 104 registered health professionals, we surveyed 99, which is a rate of 95%. The most represented age group was [30 - 39 years] with an average of 37.17 ± 10.34 years, and extremes of 22 years to 65 years. The male sex was the most dominant or 59.60% compared to the female sex or 40.40% with a sex ratio of 1.47. The hand hygiene compliance rate was low at 21%. The practice of hand hygiene during care for 100% of health professionals was very low, at 8.08%. No factors influence the observance of the practice of hand hygiene and the socio-professional characteristics of the conditions of provision of care activities. Conclusion: Hand hygiene during care is an essential aspect that must be considered as an essential measure in the prevention of infections in this period of the COVID-19 pandemic.

关键词： Hand Hygiene Compliance Health Professionals Donka Emergencies

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

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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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Dyspnea in a 26-Year-Old Woman with Fatal Left Atrial Myxoma

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World Journal of Cardiovascular Diseases 2023年第6期13卷 309-312页

作者： Ibrahima Sory sylla Mamadou Aliou Baldé Mamadou Bassirou Bah Sana Samoura Souleymane Diakité Alpha Koné Ibrahima Sory Barry Mariame Béavogui djibril sylla Elhadj Yaya Baldé Mamadi Condé Mamadou Dadhi Baldé Department of Cardiology Ignace Deen National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Cardiology Sino-Guinean Hospital Conakry Guinea Department of Internal Medicine CHU Conakry Guinea

Cardiac myxoma is one of the primary intracardiac tumours. We report the case of a left atrial myxoma in a 26-year-old female patient admitted for investigation of dyspnoea. Echocardiography led to the diagnosis of a giant hypermobile myxoma prolapsing into the left ventricle. The patient died before being evacuated for surgical treatment.

关键词： Myxoma Left Atrium Echocardiography

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Prevalence of Metabolic Syndrome in the Medical-Surgical Emergency Department of the Donka National Hospital

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Open Journal of Internal Medicine 2023年第2期13卷 85-94页

作者： djibril sylla Amadou Kake Thierno Amadou Wann Mohamed Lamine Yaya Bah Mhamed Ciré Keita Alhassane Barry Mamadou Diakhaby Lansana Diaby Internal Medicine Department of the Donka National Hospital Conakry Guinea Medical and Surgical Emergency Department of the Donka National Hospital Conakry Guinea

Introduction: The metabolic syndrome (MS) corresponds to the coexistence of several metabolic disorders including three (3) factors out of five (5) in the same individual. These five (5) major criteria are central or abdominal obesity, hypertriglyceridemia, low High-Density Lipoprotein cholesterol (HDLc), hyperglycemia, and elevated blood pressure. It has been the subject of various definitions over the past 10 years. It is a clinical-biological entity recognized by the World Health Organization (WHO) in 1998, the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) in 2001, the International Diabetes Federation (IDF) in 2005, then the IDF Harmonization Consensus in 2009. The objective of this study was to determine the prevalence of metabolic syndrome in the medico-surgical emergency department of the Donka national hospital. Methods: This was a descriptive study, data collection took place from February 5 to July 5, 2022 and, covering all patients aged 16 and over, without distinction of sex, origin received in consultation in the medical unit in the emergency department of Donka and having agreed to participate in the study. Anthropometric, clinical and biological data were recorded. Results: We recruited 107 patients whose age ranged from 20 to 94 years with a mean age of 58.92 ± 13.78 years. The prevalence of metabolic syndrome in our study population was 6.30% with a female predominance of 73.83%. The most frequent components of the metabolic syndrome were abdominal obesity (100%) followed by hyperglycemia (85.98%) and hypertension (85.05%). Among the complications related to the metabolic syndrome, diabetes was found with (46.73%), hypertension (43.93%) and stroke (16.93%). Conclusion: Our results show a significant prevalence of the metabolic syndrome and its main complications, which were diabetes, hypertension and stroke. These data justify early detection and treatment strategies.

关键词： Prevalence Metabolic Syndrome Medicine Unit Donka National Hospital

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Epidemiology and Clinical Profile of Behcet’s Disease in a Sub-Saharan Country: About Five Observations

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Open Journal of Internal Medicine 2023年第2期13卷 120-125页

作者： Thierno Amadou Wann Mamadou Lamine Yaya Bah Mamadou Saliou Baldé Abdoul Karim Baldé Toumin Camara Ibrahima Kalil Shiaman Barro Amadou Kaké djibril sylla Internal Medicine Teaching Hospital of Conakry Conakry Guinea Nephrology-Hemodialysis Department Teaching Hospital of Donka Donka Guinea Ophtalmology Department CADES/O CHU de Conakry Conakry Guinea

Behçet’s disease (BD) is a multi-systemic vasculitis characterized by a triad made up of oral aphthosis, genital aphthosis and uveitis which may or may not be associated with visceral involvement. Other times described in the ancient silk road, BD is increasingly found in countries south of the Sahara with the mixing of populations. Our objective was to describe the epidemiology and clinical characteristics of BD in an African country. Methodology: This was a five-year retrospective study in the internal medicine department of Donka National Hospital. We used international criteria finding BD. Urinary dipstick was use for finding kidney disease. Result: During the period, five cases of Behçet’s disease were collected. The average age was 35 years old. The male sex was more represented with 3 out of 5 cases. The most common clinical manifestation was oral aphthosis in all patients (100%), followed by genital aphthosis in 4 cases (80%). The other clinical manifestations observed were uveitis in 3 cases (60%), joint manifestations such as arthralgia in 3 cases (60%) and neurological manifestations such as chronic headache in one case (20%). HLA-B51 was found in two cases. The pattergic test done in two patients came back positive (100%). The patients received colchicine and oral corticosteroid therapy. Two patients were lost to sight. We deplored a death probably in a neuro-Behçet table before the rebellious headaches. Conclusion: Behçet’s disease is a multi-systemic vasculitis that must be evoked and managed quickly in a tropical environment, especially since the prognosis, vital and functional prognosis can be engaged.

关键词： Profile Epidemiological Clinical Behçet Sub-Saharan

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Biermer’s Disease at the Donka National Hospital in Guinea—Epidemio-Clinical, Therapeutic and Evolutionary Aspect in the Internal Medicine Department

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Open Journal of Internal Medicine 2023年第3期13卷 218-224页

作者： Thierno Amadou Wann Mamadou Sarifou Diallo Djenabou Diallo Kadiatou Diallo Mamadou Lamine Yaya Bah Mamadou Diakhaby Mohamed Cissoko Amadou Kaké djibril sylla Department of Internal Medicine Teaching Hospital of Conakry Conakry Guinea Department of Hepato-Gastroenterology University Hospital of Conakry Conakry Guinea

Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal medicine department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.

关键词： Biermer’s Disease Donka Aspects Epidemiological-Clinical Therapeutics

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