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Prognostic Factors for diabetic Foot at CNHU-HKM

Journal of diabetes Mellitus 2024年第1期14卷 20-27页

作者： Annelie Kerekou Hode Alihonou Hubert dedjan déo-Gratias Gnaho centre National hospitalier universitaire Hubert Koutoukou Maga Cotonou Benin centre hospitalier universitaire départemental-Ouémé/Plateau Porto-Novo Porto-Novo Benin

Introduction: Predictions on the prevalence of diabetes mellitus, according to the International diabetes Federation, indicated 9.3% in 2019 and nearly 10.9% of the general population in 2045. In Benin, the increase in this prevalence, according to the World Health Organization (WHO), is constantly increasing. diabetic foot is one of its most common complications. The aim of this work was to study the prognostic factors of diabetic foot in the department of Endocrinology, Metabolism and Nutrition of the CNHU-HKM of Cotonou. Patients and method: This is a descriptive and analytical retrospective study of the prognostic factors of diabetic foot over a period of 3 years from January 2019 to december 2021 in patients who have been hospitalized or followed on an outpatient basis for diabetic foot in the Endocrinology, Metabolism and Nutrition department of the CNHU-HKM of Cotonou. Results: A total of 112 patients were included in this study. The average age of the patients was 59.70 ± 2.10 years. A male predominance was noted with a sex ratio (M/F) of 1.7. Mixed gangrene and phlegmons were the most common lesions. According to the classification of diabetic feet according to the University of Texas, 59.1% of patients had a 100% risk of amputation. Ten patients died from sepsis (8.9%). The average blood glucose on admission was 2.74 ± 0.23 g/l, reflecting the glycemic imbalance in these patients. There is a statistically significant association between the duration of progression of diabetes, the type of lesion and amputation. Patients whose diabetes has lasted more than 30 years and patients who are not monitored have a greater risk of death. Conclusion: diabetic patients most often consulted at a late stage, compromising conservative treatment. The duration of diabetes and the type of lesion on admission were the main factors leading to amputation, thus compromising the functional prognosis. As for death, it was mainly linked to irregular monitoring of diabetes and the

关键词： diabetes diabetic Foot Prognosis Blood Sugar Imbalence Benin

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Evaluation of the Strategy and Efficacy of Treatment of Chronic Viral Hepatitis C with the Sofosbuvir/daclatasvir Combination in a Resource-Limited Country

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Open Journal of Gastroenterology 2024年第7期14卷 233-240页

作者： Mayanna Habkreo Ali Mahamat Moussa Adama Ahmed Ngare Abdraman Kossou Tahir Mahamat Saleh Maire dehainsala Mahamat Ali Hachim Mahamat Ali Bolti Oumaima djarma Joseph Madtoingue Service de Gastroentrologie/Mdecine Interne du centre hospitalier universitaire la Rfrence Nationale NDjamena Chad Service de Gastroentrologie du centre hospitalier universitaire la Renaissance NDjamena Chad Service de Maladies Infectieuses du centre hospitalier universitaire la Renaissance NDjamena Chad Service de Maladies Infectieuses du centre hospitalier universitaire la Rfrence Nationale NDjamena Chad

Introduction: The treatment of viral hepatitis C (HCV), a major public health problem, has evolved considerably since the introduction of direct-acting anti-virals (dAAs). The aim of this study was to evaluate the strategy for initiating treatment with Sofosbuvir/daclatasvir, and also to assess its efficacy. Patients and Methods: Included were patients aged at least 15 years, with detectable hepatitis C viremia and treated with a pan-genotypic Sofosbuvir/daclatasvir regimen at the centre “hospitalier universitaire la Référence Nationale de N’djamena” between October 2019 and October 2023. The APRI score was used to assess fibrosis. Cure was defined by an undetectable viral load 12 weeks after the end of treatment. Results: A total of 835 patients were included (sex ratio 1.55, mean age 50.5 ± 13.73, extremes 20 and 84 years). The 60 - 69 age group was the most represented. The mean APRI score was 0.42 ± 0.29, with extremes of 0.019 and 1.84. The mean viral load was 2,316,193.086 IU/mL. All subjects had good renal function. Cytolysis was absent in 70% of cases. Without genotyping, a pan-genotypic regimen was used in all patients: Sofosbuvir (400 mg)/daclatasvir (60 mg). The cure rate was 99.4%, with good tolerability. However, four cases of failure were recorded out of the 668 patients who underwent follow-up HCV-PCR testing after 12 weeks of treatment. Conclusion: The Sofosbuvir/daclatasvir regimen is highly effective, with an excellent safety profile. However, the still high cost of these molecules limits their accessibility to a large proportion of patients.

关键词： Efficacy Tolerance Sofosbuvir/daclatasvir HCV Chad

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Stepping up after spinal cord injury:negotiating an obstacle during walking

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Neural Regeneration Research 2025年第7期20卷 1919-1929页

作者： Alain Frigon Charly G.Lecomte department of Pharmacology-Physiology Faculty of Medicine and Health SciencesUniversitéde SherbrookeCentre de recherche du Centre Hospitalier Universitaire de SherbrookeSherbrookeQCCanada

Every day walking consists of frequent voluntary modifications in the gait pattern to negotiate *** spinal cord injury,stepping over an obstacle becomes *** over an obstacle requires sensorimotor transformations in several structures of the brain,including the parietal cortex,premotor cortex,and motor *** information and planning are transformed into motor commands,which are sent from the motor cortex to spinal neuronal circuits to alter limb trajectory,coordinate the limbs,and maintain *** spinal cord injury,bidirectional communication between the brain and spinal cord is disrupted and animals,including humans,fail to voluntarily modify limb trajectory to step over an ***,in this review,we discuss the neuromechanical control of stepping over an obstacle,why it fails after spinal cord injury,and how it recovers to a certain extent.

关键词： biomechanics locomotion neurophysiology obstacle negotiation spinal cord injury

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Eating disorders among Students in Northern Benin (2023)

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Open Journal of Psychiatry 2024年第1期14卷 11-28页

作者： Ireti Nethania Elie Ataigba Guy Gérard Aza-Gnandji david Sinet Koïvogui Wifrieda Aguidissou Eurydice Elvire djossou Anselme djidonou Francis Tognon Tchegnonsi Prosper Gandaho Josiane Ezin Houngbe Institut de Formation en Soins Infirmiers et Obstétricaux Faculté de Médecine Université de Parakou Parakou Bénin Service de Psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori Parakou Bénin Organisation Non Gouvernementale de Soutien Réhabilitation Insertion et Réinsertion (SouRIR ONG) Parakou Bénin Faculté des Sciences de la Santé Université d’Abomey-Calavi Cotonou Bénin Service de Psychiatrie Centre National Hospitalier Universitaire Hubert Koutoucou Maga de Cotonou Cotonou Bénin Faculty of Health Sciences and Techniques Université Gamal Abdel Nasser de Conakry Conakry Guinée

Introduction: From their earliest hours, human beings are able to identify a source of food and to feed themselves. Feeding is therefore one of the most instinctive human functions. It is regulated by several factors (physiological, psycho-affective and environmental) whose disruption can lead to eating disorders. Objective: The aim of this study was to investigate eating disorders among students in the town of Parakou in 2023. Method: descriptive cross-sectional study conducted from January to July 2023 in various universities in the city of Parakou, Benin. The study population consisted of all students in grades 1 to 7 at these universities. A two-stage non-proportional stratified sampling technique combined with a simple random draw was adopted. The Eating Attitude Test-26, Bulimia Inventory Test Edinburgh and a set of questions focusing on the diagnostic criteria for pica were used to screen for pica and other disorders such as anorexia, bulimia nervosa and binge eating disorder. data were analyzed using SPSS (Statistical Package for Social Sciences) version 25. Results: A total of 607 students were surveyed, 323 of whom had eating disorders. A prevalence of 53.21% of students at risk of eating disorders was found. In relation to the total population, the prevalences of anorexia, bulimia nervosa, binge eating disorder and pica were 45.96%, 0.82%, 15.48% and 12.68% respectively. In multivariate analysis, seven factors explained the risk to develop at least one eating disorder among the students surveyed. These were: urban area of residence (OR (95% CI) = 5.059 (1.75 - 14.65);p = 0.003);year of study (OR (95% CI) = 0.47 (0.28 - 0.79);p = 0.035);type of university attended (private university: OR (95% CI) = 1.63 (1.08 - 2.44);p = 0.019);parents’ marital status (couple or not) (OR (95% CI) = 1.50 (1.01 - 2.24);p = 0.046);father’s level of education: secondary (OR (CI 95%) = 3.85 (1.96 - 7.54);p 0.001)/higher (OR (CI 95%) = 2.83 (1.36 - 5.86);p = 0.005);mother’s one:

关键词： Eating disorders Benin 2023

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Maternal Burnout: Prevalence and Associated Factors in Northern Benin (2023)

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Open Journal of Psychiatry 2024年第1期14卷 29-44页

作者： Ireti Nethania Elie Ataigba Guy Gérard Aza Gnandji david Sinet Koivogui Owèrè Charlotte dagan Coovi Ignace Tokpanoude Kwamé Abdias Adoufou Anselme djidonou Francis Tognon Tchegnonsi Prosper Gandaho Institut de Formation en Soins Infirmiers et Obstétricaux Faculté de Médecine Université de Parakou Parakou Bénin Service de Psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori Parakou Bénin Organisation Non Gouvernementale de Soutien Réhabilitation Insertion et Réinsertion (SouRIR ONG) Parakou Bénin Faculté des Sciences de la Santé Université d’Abomey-Calavi Cotonou Bénin Service de Psychiatrie Centre National Hospitalier Universitaire Hubert Koutoucou Maga de Cotonou Cotonou Bénin Faculté des Sciences et Techniques de la Santé Université Gamal Abdel Nasser de Conakry Conakry Guinée

Introduction: Also known as maternal burnout syndrome, maternal burnout is a state of physical, emotional and mental exhaustion generated by prolonged stress in the family environment. It is experienced by women in their role as mothers. Those affected can develop psychological disorders, sleep disturbances, etc., all of which impair their day-to-day lives, and thus their maternal role. The repercussions affect both the child and other family members. Objective: The aim of the present study was to investigate maternal burnout among female users of public and private health facilities in the commune of Parakou in 2023. Methods: descriptive cross-sectional study was conducted from december 2022 to July 2023 among all mothers using public and private health facilities in the commune of Parakou. All healthy mothers with at least one biological or adoptive child fully dependent on them and living at home, who came for a consultation in one of the health facilities or for an appointment at the Expanded Program on Immunization (EPI) and gave their free and informed consent. Sampling was done for non-exhaustive convenience were included in the study. Burnout was assessed using the Parental Burnout Assessment (PBA) scale. Results: A total of 888 mothers meeting the inclusion criteria were surveyed. The prevalence of burnout calculated using the Parental Burnout Assessment (PBA) scale was 6.19%. The risk factors for maternal burnout were poor relationships with family and friends (OR = 8.90;p = 0.045), moderate (OR = 11.71;p = 0.020) and severe depression (OR = 40.85;p = 0.001), followed by the presence of repeated nocturnal awakening (OR = 5.14;p = 0.014). Conclusion: This is a subject that is almost never discussed in African society, but whose reality is revealed by the present study, which provided statistical data on maternal burnout. From now on, the risk of burnout will no longer be discussed solely in the family context. It will also need to be explored within the fam

关键词： Burnout Maternal Benin 2023

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Post-Traumatic Stress disorder among defence and Security Forces in Northern Benin (2023)

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Open Journal of Psychiatry 2024年第2期14卷 142-161页

作者： Ireti Nethania Elie Ataigba Guy Gérard Aza Gnandji david Sinet Koivogui dalmace Fauste Adjaho Eurydice Elvire djossou Anselme djidonou Francis Tognon Tchegnonsi Prosper Gandaho Josiane Ezin Houngbe Faculté de Médecine & Institut de Formation en Soins Infirmiers et Obstétricaux Université de Parakou Parakou Bénin Service de Psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori Parakou Bénin Organisation Non Gouvernementale de Soutien Réhabilitation Insertion et Réinsertion (SouRIR ONG) Parakou Bénin Faculté des Sciences de la Santé Université d’Abomey-Calavi Cotonou Bénin centre Nationale hospitalier universitaire Hubert Koutoucou Maga de Cotonou Cotonou Bénin Faculté des Sciences et Techniques de Santé Université Gamal Abdel Nasser de Conakry Conakry Guinée

Introduction: Post-traumatic stress disorder (PTSd) is defined as “actual exposure to death or the threat of death, serious injury or sexual violence”, either directly or indirectly, resulting in a symptomatic procession of repetition, avoidance, neurovegetative hyperactivity and individualized symptoms, with or without negative cognitive and mood changes. It therefore goes without saying that the defence and security forces constitute a high-risk population in need of attention. Objective: To study post-traumatic stress disorder in defence and security forces in the city of Parakou in 2023. Methods: descriptive cross-sectional study conducted from december 2022 to July 2023. The study population consisted of active military, republican police and firefighters in the city of Parakou in 2023. Non-proportional stratified sampling was used, given the inaccessibility of the source population size for national security reasons. Post-traumatic stress disorder was assessed using the “post-traumatic stress disorder checklist-5 (PCLS-5) scale. Results: A total of 305 subjects participated in the survey. Males dominated 90.2%. The most represented corps was the Republican Police (41.6%), most of whom were non-commissioned officers (46.6%). The majority count between 11 and 20 years of service (48.9%), with 2 to 5 missions completed (67.5%). The calculated prevalence of post-traumatic stress disorder was 11.8%, based on the post-traumatic stress disorder checklist-5 (PCL-5). Of the 36 respondents with post-traumatic stress disorder, 20 (55.6%) had experienced an armed attack, 25 (69.4%) had witnessed a violent death, 18 (50.0%) had witnessed the agony of a colleague, 15 (41.7%) had been exposed to a fire or explosion, while 26 (72.2%) had been traumatized by physical and/or verbal aggression. 5 (13.9%) had consulted a specialist psychiatrist, while 6 (16.7%) were on medication and 26 (72.2%) used sport as a means of maintaining physical and mental health. Respectively 22 (61.1

关键词： Post-Traumatic Stress disorder Forces defence Security Benin 2023

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Problematic Use of Video Games in Schools in Northern Benin (2023)

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Open Journal of Psychiatry 2024年第2期14卷 120-141页

作者： Ireti Nethania Elie Ataigba david Sinet Koivogui damega Wenkourama Marcos Tohou Eurydice Elvire djossou Anselme djidonou Francis Tognon Tchegnonsi Prosper Gandaho Josiane Ezin Houngbe Faculté de Médecine & Institut de Formation en Soins Infirmiers et Obstétricaux Université de Parakou Parakou Bénin Service de Psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori Parakou Bénin Organisation Non Gouvernementale de Soutien Réhabilitation Insertion et Réinsertion (SouRIR ONG) Parakou Bénin Faculté des Sciences et Techniques de Santé Université Gamal Abder Nasser de Conakry Conakry Guinée Faculté des Sciences de la Santé Université de Kara Kara Togo Service de Psychiatrie Centre Hospitalier Universitaire de Kara Kara Togo Facultés des Sciences de la Santé Université d’Abomey-Calavi Cotonou Bénin centre Nationale hospitalier universitaire Hubert Koutoucou Maga de Cotonou Cotonou Bénin

Objective: To study the problematic use of video games among secondary school students in the city of Parakou in 2023. Methods: descriptive cross-sectional study conducted in the commune of Parakou from december 2022 to July 2023. The study population consisted of students regularly enrolled in public and private secondary schools in the city of Parakou for the 2022-2023 academic year. A two-stage non-proportional stratified sampling technique combined with simple random sampling was adopted. The Problem Video Game Playing (PVP) scale was used to assess problem gambling in the study population, while anxiety and depression were assessed using the Hospital Anxiety and depression Scale (HAdS). Results: A total of 1030 students were included. The mean age of the pupils surveyed was 15.06 ± 2.68 years, with extremes of 10 and 28 years. The [13 - 18] age group was the most represented, with a proportion of 59.6% (614) in the general population. Females predominated, at 52.8% (544), with a sex ratio of 0.89. The prevalence of problematic video game use was 24.9%, measured using the Video Game Playing scale. Associated factors were male gender (p = 0.005), pocket money under 10,000 cfa (p = 0.001) and between 20,000 - 90,000 cfa (p = 0.030), addictive family behavior (p d relationship with father (p = 0.020), organization of video game competitions (p = 0.001) and definite anxiety (p Conclusion: Substance-free addiction is struggling to attract the attention it deserves, as it did in its infancy everywhere else. This study complements existing data and serves as a reminder of the need to focus on this group of addictions, whose problematic use of video games remains the most frequent due to its accessibility and social tolerance. Preventive action combined with curative measures remains the most effective means of combating the problem at national level.

关键词： Gaming Problem Video Games Benin 2023

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Epdemiology and Treatment of Pseudarthrosis of Long Bones in the Servce d Orthopedics-Traumatology of the University Hospital of donka

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Open Journal of Orthopedics 2024年第3期14卷 133-138页

作者： Camara Nouhou Mangué diallo Mamadou Moustapha Moustapha Alhassane diallo Alpha Mamadou Fela Sidimé Sory Camara Abdoulaye Kolié Germain Lamah Léopold Service d’Orthopédie-Traumatologie Centre Hospitalier Universitaire de Donka Conakry Republic of Guinea

Introduction: Pseudarthrosis (PSA) of the diaphysis of long bones still remains a current problem, despite improvements in the treatment of these fractures. Our study aims to study the epidemiological and therapeutic aspects of PSA of the diaphysis of long bones. Method: This retrospective work concerns 30 cases of non-union of the diaphysis of long bones treated in the orthopedic and trauma surgery department at donka National Hospital, during a period of 18 months from January 1, 2019 to June 30, 2020. Results: We recruited 30 patients, 80% of whom were male, with an average age of 39.9 years. Public road accidents (AVP) represented the main cause of fractures of the diaphysis of long bones 87%, they were open in 25 cases or 83%. The fractures were located in the middle 1/3 of the diaphysis of the long bones in 50% of cases. Treatment of initial fractures was traditional in 21 cases, orthopedic in 2 cases and surgical in 7 cases. It was aseptic nonunion in 28 cases (93%) and septic nonunion in 2 cases. They were hypertrophic in 7 cases, slightly hypertrophic in 5 cases, oligotrophic in 11 cases, atrophic in 6 cases and with bone defect in 1 case. The treatment was based on osteosynthesis including 16 cases of screwed “PV” plate: 7 cases of centromedullary “ECM” nailing, 2 cases of external fixator, 1 case of broaching and 4 cases of Plastering. The results according to ASAMI criteria on an anatomical level were excellent in 19 cases, good in 3 cases and poor in 3 cases, with a union rate of 76%. And 5 patients undergoing consolidation. Conclusion: Based on the literature data and the experience of our department, the true treatment of PSA requires correct management of the initial fracture without forgetting the interest in preventing AVP which appears to be an element essential, making it possible to reduce the incidence of fractures of the diaphysis.

关键词： Pseudarthrosis Aseptic-Septic-diaphysis Long Bones Screwed Plate Intramedullary Nailing Bone Graft Osteo-Muscular decortication

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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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Results of an Eight Year Long Practice of Saline Bipolar Transurethral Resection of Prostate

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Open Journal of Urology 2024年第4期14卷 189-196页

作者： Sossa Jean Mangoue Moube Ariane Landry Yevi dodji Inès Magloire Hodonou Fred Avakoudjo déjinnin Josué Georges centre National hospitalier universitaire Hubert Koutoucou Maga Cotonou Benin

Background: Open prostatectomy has long been the only prostatic bladder outlet obstruction’s surgery available in Benin. It is prone to postoperative bleeding and infections and is not suitable for prostate cancer-induced bladder outlet obstruction. Objective: To evaluate the first results of endoscopic surgery of prostatic bladder outlet obstruction in our environment. Patients and Method: We conducted an observational study of saline bipolar transurethral resection of prostate (B-TURP) at the former Military Teaching Hospital of Cotonou. We retrospectively collected the data from patients’ medical records from November 17, 2014, to September 7, 2022. We used Excel 2019 to make a descriptive analysis of the data. Results: Saline B-TURP was performed in 60 consecutive patients. Their mean age was 69.1 years (range: 48-85). The procedure was indicated in 22 (36.7%), 32 (53.3%), 3 (5%), and 3 (5%) patients, respectively for acute urinary retention, chronic urinary retention, obstructive renal failure, and unresponsiveness to alpha-blockers. 35 patients (58.3%) had prostate cancer (PCa). 25 patients (41.7) had benign prostate hyperplasia (BPH). No patient got a blood transfusion. The duration of postoperative hospitalization was 3 days (88.3%) to 5 days (11.7%). 5 patients (8.3%), i.e., 3 BPH and 2 prostate cancer patients got preoperative urinary tract infection. The causative bacteria were Escherichia coli in 3 patients (60%), Klebsiella pneumoniae in 2 patients (40%), and multi-resistant Acinetobacter as a metachronous infection to Escherichia coli in 1 patient (20%). All the infections were associated with indwelling Foley catheter. 7 patients (11.7%), i.e., 3 BPH and 4 prostate cancer patients, got a second resection to recover full spontaneous micturition. Prostate size was available in the medical record of 21 BPH patients and 15 prostate cancer patients. Prostate size ranged from 22 to 123 g with a mean value of 61.1 g in BPH patients, and from 34 to 180 g with

关键词： Saline B-TURP BPH Prostate Cancer

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