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Study of Vision Problems in Schools in libreville and Owendo, Gabon

Open Journal of Pediatrics 2014年第4期4卷 300-306页

作者： Simon Ategbo Jean Koko Edgar Brice Ngoungou Eliane Kuissi Christelle Moyou Tchapbou Steeve Minto’o Emmanuel Mve Mengome André Moussavou Pediatrics Department Faculty of Medecine Health Sciences University Libreville Gabon Department of Epidemiology and Biostatistics Faculty of Medecine Health Sciences University Libreville Gabon Ophtalmology Department Omar Bongo Ondimba Army Instruction Hospital Libreville Gabon

The purpose of this work is to evaluate the epidemiological aspects of vision problems and their repercussions in the schooling of children in libreville and Owendo. Methodology: This transversal and descriptive study was carried out in May and June 2011. Included in the study were children in the 7th and 8th grades of the primary schools in libreville and Owendo. For each child, an eye exam, including the subjective measure of visual acuity, was carried out using the Monoyer scale, and the color vision assessment was carried out with the Ishihara test. Any visual capacity under or equal to 7/10th in at least one eye was considered to be pathological. We gathered information about demographic characteristics, any preceding vision issues on the record, data on other medical problems on the record and the eye examination on computer cards. Results: Nine hundred and sixty-three children (416 boys and 517 girls, with a gender ratio of 0.86) were examined. The average age was 12 ± 1.7 years old. The prevalence of the drop in visual acuity was 16.2%. The prevalence of color vision anomalies was 15.5%. Complaints concerning vision problems were significantly more present from children with a drop in visual acuity (p 0.01). Visual anomalies had an impact on the children’s schoolwork, and yet, visits to the ophthalmologist’s office were few. Conclusion: The frequency of anomalies in vision justifies systematic screening in schools and organization of an appropriate treatment.

关键词： Visual Acuity Children Schools Color Vision

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LARCs after unsafe abortion in libreville (Gabon): Women accept quickly but the time interval for the insertion is longer than that of injectable contraceptives

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Open Journal of Obstetrics and Gynecology 2014年第1期4卷 23-27页

作者： Sosthène Mayi-Tsonga Jacques Bang Ntamack Boniface Sima-Ole Pamphile Assoumou Obiang Ulysse Minkobame Doris Ngouafo Department of Obstetrics and Gynecology of University Hospital of libreville Gabon Africa Faculty of Health Sciences of Libreville Gabon Africa

Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.

关键词： Unsafe Abortion Contraception LARC Period for the Insertion of LARCs Gabon

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Conservative Treatment of Breast Cancer and Oncoplasty at the Teaching Hospital Mother and Child of Jeanne Ebori Foundation in libreville (Gabon)

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妇产科期刊(英文) 2023年第10期13卷 1747-1758页

作者： Assoumou Obiang Pamphile Minkobame Ulysse Makoyo Opheelia Eya’Ama Robert Dikongo Wilson Mewie Anouchka Ntsame Elsy Juvette Minto’o Junior Bang Jacques Albert Meye Jean François Department of Obstetrics Gynecology Faculty of Medicine of Libreville University of Health Sciences (USS) Libreville Gabon

Introduction: Breast cancer is currently the most common malignant tumour in women worldwide. Objective: To evaluate conservative treatment of breast cancer and oncoplasty at the teaching hospital Mother and Child of Jeanne Ebori Foundation (CHUMEFJE). Patients and methods: This is an observational, descriptive study, which took place from August 2019 to December 2021 at CHUMEFJE. Data were collected using patients’ medical records, and operative and pathological anatomy reports. Results: Conservative treatment and oncoplasty were performed in 12 (34.2%) patients. Of these patients, 8 (66.7%) benefited from an external technique and 2 (16.7%) from a pamectomy. Post-operative complications were dominated by lymphocele in 5 (41.6%) patients. Ten (83.3%) patients were satisfied with the post-operative aesthetic result. At the time of updating the records, 1 (8.3%) patient had died and 11 (91.7%) were alive. Conclusion: Conservative treatment and oncoplasty are giving satisfactory results at the CHUMEFJE in libreville.

关键词： Breast Cancer Conservative Treatment Oncoplasty Aesthetics Satisfaction

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Factors Determining the Postponement of Schedule Gyneaco-Obstetric Surgery at CHUMEFJE in libreville (Gabon)

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Open Journal of Obstetrics and Gynecology 2023年第10期13卷 1699-1710页

作者： Pamphile Assoumou Obiang Jacques Albert Bang Ntamack Ophélia Makoyo Ulysse Minkobame Jean Pierre Malanda Anouchka Mewie Juvette Elsy Ntsame Robert Eya’ama Ernest Junior Minto’o Jean François Meye Department of Obstetrics and Gynaecology Faculty of Medicine Libreville University of Health Sciences (USS) Libreville Gabon

The study aimed to identify factors causing delays in scheduled gynaeco-obstetric surgeries at CHUMEFJE in libreville from January 2019 to July 2020. Through a 16-month observational survey, it was found that out of 346 scheduled procedures, 128 (36.4%) were postponed. Organizational issues in the operating theatre were responsible for 80.3% of these delays, with 95.3% being preventable. To enhance efficiency, improvements in operating theatre organization are recommended.

关键词： Scheduled Gynaeco Obstetric Surgery Postponement Determining Factors

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Diabetic Retinopathy: Diagnostic Challenges and Impact of Physical Activity

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Open Journal of Ophthalmology 2024年第2期14卷 136-142页

作者： Prudence Ada Assoumou Davy Alex Mouinga Abayi Daniella Nsame Annick Kougou Ntoutoume Hélène Nyinko Aboughe Olive Matsanga Tatiana Harly Mba Aki Emmanuel Mve Mengome Owendo University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Omar Bongo Ondimba Military Instructions Hospital Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Endocrinology Department at the libreville Hospital Center Department of Internal Medicine at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Jeanne Ebori Foundation Mother and Child University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon

Introduction: Diabetes represents a major public health challenge, affecting over 463 million people according to the World health Organization (WHO). Among its complications, diabetic retinopathy stands out as the leading cause of blindness in industrialized countries. Physical activity is now recognized as a cornerstone of diabetes management, and its impact on diabetic retinopathy is of growing interest. Observation: Mr. A.E, a 54-year-old man, presents with progressive deterioration of his vision. Family history of diabetes and hypertension is noted. He engages in one hour of physical activity daily, including treadmill running and indoor cycling. Despite recent optical correction, his visual acuity remains at 3/10 unimproved. Ocular imaging, notably fluorescein retinal angiography and optical coherence tomography, reveals proliferative diabetic retinopathy with bilateral macular edema. Blood tests, performed after physical activity, show normal values of blood glucose and HbA1c, delaying the initiation of treatment and promoting the progression of retinopathy. Despite appropriate management, no significant improvement in visual function is observed during follow-up. Conclusion: The management of diabetic retinopathy requires an approach integrating physical activity. A better understanding of the interaction between physical activity and diabetic retinopathy is needed to optimize prevention and treatment strategies.

关键词： Diabetes Retina Blood Glucose HbA1c Physical Activity

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Ocular Complications in Diabetic Patients: Prevalence, Impact on Quality of Life, and Implications for healthcare

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Open Journal of Ophthalmology 2024年第2期14卷 149-158页

Introduction: Diabetes, a chronic disease characterized by persistent hyperglycemia, poses a major global health challenge. In Gabon, 10% of the population is affected by this condition, highlighting the need to actively understand and manage it. Ocular complications of diabetes, including diabetic retinopathy, glaucoma, and cataracts, have a devastating impact on patients quality of life and represent a crucial issue for healthcare systems. Methodology: This study conducted in libreville from February 9, 2022, to April 15, 2022, was cross-sectional, longitudinal, and descriptive, with prospective data collection. Participants were diabetic patients regularly followed in the endocrinology department of CHUL, who were referred for a comprehensive ophthalmological examination at CHUO. Sampling was exhaustive, with strict inclusion criteria aimed at ensuring the representativeness of the study population. Results: The mean age of participants was 57.5 ± 13.2 years with a male-to-female ratio of 0.8. Personal histories were dominated by hypertension, while family histories were dominated by diabetes. Ocular complications of diabetes included refractive disorders (78.9%), cataracts (31.7%), glaucoma (78.9%), and diabetic retinopathy (13.7%). These ocular complications had a significant impact on participants’ quality of life, leading to impaired vision (78.9%), difficulties in carrying out daily activities (62.2%), the need for caregiver assistance (50.3%), high levels of stress and anxiety (68.9%), regular medication intake (71.4%), adherence to a specific diet (55.9%), and frequent blood glucose monitoring (74.5%). Conclusion: This study highlights the major impact of diabetic ocular complications on patients’ quality of life.

关键词： Ocular Complications Diabetes Quality of Life Prevalence Gabon

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A Rare Cause of Leukocoria in Children: Persistent Hyperplastic Primary Vitreous

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Open Journal of Ophthalmology 2024年第1期14卷 63-68页

作者： Prudence Ada Assoumou Davy Alex Mouinga Abayi Yoan Mboussou Annick Kougou Ntoutoume Helene Nyinko Aboughe Olive Matsanga Tatiana Harly Mba Aki Emmanuel Mve Mengome Owendo University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Omar Bongo Ondimba Military Instructions Hospital Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Médivision Clinic Libreville Gabon Jeanne Ebori Foundation Mother and Child University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon

Introduction: Leukocoria, a whitish pupillary reflection, is a common warning sign of various pediatric ocular pathologies, including Persistent hyperplastic primary vitreous (PHVP). This case report describes the observation of a 3-year-old child with melanoderma, presenting with a white spot in the left eye since birth. Observation: Uncorrected distance visual acuity was 2/10 in the right eye and hand movements were perceived at 2 meters in the left eye. Examination of the anterior segment in the left eye revealed leukocoria and microphthalmia. The fundus examination was normal in the right eye but revealed a white mass extending from the center of the optic disc towards the temporal region in the left eye. Ocular imaging, including ocular ultrasound and optical coherence tomography, confirmed the diagnosis of PHVP, illustrated by a residual white mass at the center of the optic disc in the left eye. Conclusion: PHVP should be considered in the presence of leukocoria in a child, with urgent exclusion of retinoblastoma. This observation underscores the importance of early diagnosis for appropriate management. .

关键词： PHVP Leukocoria Amblyopia Ocular Imaging Childhood

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Birth Defects of the Child Optic Disc: Diagnostic Challenges and Prospects for Care

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Open Journal of Ophthalmology 2024年第2期14卷 128-135页

作者： Prudence Ada Assoumou Davy Alex Mouinga Abayi Annick Kougou Ntoutoume Hélène Nyinko Aboughe Olive Matsanga Tatiana Harly Mba Aki Emmanuel Mve Mengome Owendo University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Omar Bongo Ondimba Military Instructions Hospital Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon Jeanne Ebori Foundation Mother and Child University Hospital Center Department of Surgery at the Faculty of Medicine of the University of Health Sciences Libreville Gabon

Introduction: Congenital optic disc anomalies in children refer to structural variations of the optic nerve head present from birth. These deformations involve the size, shape, color, and vessels of the optic disc. Although often asymptomatic, these anomalies can impact the visual development of the child, underscoring the importance of a thorough fundus examination for early detection and appropriate medical follow-up. We present two cases of congenital optic disc anomalies in children, illustrating the diagnostic challenges and complexity of their management. Case 1: A 3-year-old girl presented with a white spot in her left eye present since birth. Uncorrected distance visual acuity was 2/10 in the right eye, while she could perceive hand movements at 2 meters with the left eye. Normal examination in the right eye showed leukocoria, microphthalmia, and a white mass at the center of the optic disc on fundus examination in the left eye. Ocular imaging, including ultrasound and optical coherence tomography (OCT), confirmed the diagnosis of persistent hyperplastic primary vitreous (PHPV) in its mixed form in the left eye. Management included prescribing full optical correction and functional rehabilitation, without resorting to surgery. The course was marked by persistent amblyopia leading to a poor prognosis. Case 2: A 7-year-old girl consulted for vision disturbance in her right eye. Visual acuity was finger counting at 2 meters in the right eye and 10/10 in the left eye. Anterior segment examination revealed no abnormalities in both eyes. However, fundus examination highlighted a large funnel-shaped excavation associated with central glial proliferation, wheel spoke vessels, and neuroretinal ring atrophy in the right eye. Optical coherence tomography (OCT) of the right eye confirmed the diagnosis of isolated unilateral Morning Glory syndrome. Management included full optical correction and orthoptic rehabilitation. The course was marked by the absence of ocular complication and maintenance of visual stability in

关键词： Optic Disc PHPV Morning Glory Diagnosis Treatment

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Relationship between the rs2241766 ADIPOQ Polymorphism in a Black African Population and the Occurrence of Type 2 Diabetes

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American Journal of Molecular Biology 2024年第2期14卷 97-106页

作者： Aude Syntia Mbang Bengone Rosalie Nikiema-Ndong Elisabeth Lendoye Alvine Sibylle Batou Edwige Nnegue Edzo Serge Bekale Daniela Nsame Frédéric Da Dari Félix Ovono Abessolo Department of Chemistry-Biochemistry Faculty of Medicine University of Health Sciences Libreville Gabon Laboratory of Research in Biochemistry (LAREBIO) University of Sciences and Technology of Masuku Franceville Gabon Endocrinology Department University Hospital of Libreville Libreville Gabon Research Institute of health sciences Bobodioulasso Burkina Faso

Background: Type 2 diabetes mellitus (T2DM) is a metabolic disease, characterized by chronic hyperglycemia. This pathology is linked to various genes whose interaction with the environment promotes its development. The aim of this work was to determine the relationship between the rs2241766 (T/G) polymorphism of the ADIPOQ gene with type 2 diabetes in the black population. Material and Methods: This work was a case-control study, involving type 2 diabetics subjects (n = 94) and controls (n = 82). The study took place from September 2022 to September 2023. Patients were recruited in the Endocrinology Department of the libreville University Hospital Center. Analysis was performed in the Biochemistry laboratory of the University of health sciences in libreville and at the Research Institute of health sciences of Bobodioulasso. Genomic DNA was extracted using the protocol Qiagen kit and the PCR-RFLP method was used to determine the rs2241766 (T/G) polymorphism of the ADIPOQ gene. Results: Only 2 genotypes were found in this population, the TT genotype and the GT genotype. The proportions were not different between the two groups (p = 0.1095) neither the distribution of G and T alleles (p = 0.1095). On the other hand, the HDL hypocholesterolemia was frequent in subjects with the GT genotype compared to TT heterozygous (51.1% vs 48.9%, p = 0.0280;OR = 0.55 [0.30 - 1.01]). Conclusion: There was no association between the rs2241766 (T/G) variant of the ADIPOQ gene and the occurrence of type 2 diabetes in this population. On the other hand, a relationship between HDL hypocholesterolemia and the GT genotype has been established.

关键词： Type 2 Diabetes Mellitus Polymorphism rs2241766 ADIPOQ PCR-RFLP

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Fever among Children with Sickle-Cell Disease: Findings from the General Pediatric Ward of the Owendo Pediatric Hospital in libreville, Gabon

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Open Journal of Pediatrics 2014年第4期4卷 262-268页

作者： Jean Koko Daniel Gahouma Simon Ategbo Cathérine Seilhan Armelle Pambou André Moussavou General Pediatrics Service Owendo Peditric Hospital (OPH) Libreville Gabon Laboratory of Medical Biology Owendo Pediatric Hospital (OPH) Libreville Gabon Pediatrics Department Faculty of Medicine Health Sciences University (USS) Libreville Gabon

Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clinical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5°C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Complete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and headache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infections (22.4%). The white blood cell count was >20,000/mm3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels were <5g/dl for 52.2% of the cases involving malaria and 22.6% for those of unknown origin. For four patients, all less than 10 years of age, the disease was fatal. Conclusion: For the majority of fever episode

关键词： Sickle-Cell Disease Fever Malaria Acute Lower Respiratory Infections (ALRI) Gabon

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