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Isolated Caeco-Vesical Fistula: A Case Report

Open Journal of Urology 2020年第12期10卷 309-314页

作者： Lucienne Irène Patricia Ondima Melvin Ondongo Atipo Steve Aristide Ondziel Opara Didace Massamba-Miabaou Régis Moyikoua Peggy Dalhia Galou Mawandza Moï se Yanguedet service Caryne Mboutol-Mandavo Pierre Aymar Oko Jean-Claude Mieret Cardinale Princilia Okiemy Niendet Gracia Christelle Ossete Erica Nuptia Akobande Anani Wenceslas Séverin Odzébé Prosper Bouya Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo Pediatric Surgery Department University Hospital Center Brazzaville Republic of Congo Urology and Andrology Department University Hospital Center Brazzaville Republic of Congo Visceral Surgery Department University Hospital Center Brazzaville Republic of Congo Medical Imaging Department University Hospital Center Brazzaville Republic of Congo Multipurpose Resuscitation Department University Hospital Center Brazzaville Republic of Congo Pediatric Intensive Care Unit University Hospital Center Brazzaville Republic of Congo

Congenital uro or genito-digestive fistulas are frequently found in the context of caudal pole malformations. Isolated congenital forms without associated anorectal malformation have not been reported until now. We report the first case we know a 9 year old female child received in a pediatric surgery consultation for fecaluria evolving since birth with a permeable anus. She presented a good general condition, a good staturo-ponderal and psychomotor development, a vulva soiled by stool and a permeable anus with a tonic sphincter. A retrograde urethrocystography revealed a caeco-vesical fistula. Surgery consisted of ligation-section of the caeco-vesical septum. A follow-up urethrocystography at three months post-surgery no longer visualized the fistula. Our post-operative follow-up is 4 years. Isolated congenital caeco-vesical fistula is an unknown pathology whose late diagnosis can have serious repercussions.

关键词： Fistula Congenital Isolated Caecum Bladder Child Surgery

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Knowledge Attitude and Practice of Viral Hepatitis B and C Screening by General Practitioners in brazzaville

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Open Journal of Gastroenterology 2020年第12期10卷 311-316页

作者： Rody Stéphane Ngami Sonia Opomba Philestine Clausina Mikolele Ahoui Apendi Arnaud Mongo-Onkouo Jile Florient Mimiesse Ngala Akoa Itoua-Ngaporo Marlyse Ngalessami Céline Sandra Adoua Deby Gassaye Blaise Irénée Atipo Ibara Jean-Rosaire Ibara Department of Gastroenterology and Internal Medicine Brazzaville University Hospital Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo

The involvement of general practitioners in the early detection of viral hepatitis B and C must be paramount. The objectives of this work were to assess GPs’ knowledge, attitude and practice with regard to screening for viral hepatitis B and C. We carried out a cross-sectional analytical study among GPs recruited by simple random sampling from the list of GPs in the city of Brazzaville. The judgement criteria were knowledge and practice of screening for viral hepatitis B and C, assessed according to a Likert scale divided into 3 categories: very good, good and bad. One hundred and twenty-one general practitioners were included, including 48 women and 73 men, with a sex ratio of 1.52;the average age was 33 years;52.89% of them worked in the private sector with an average period of activity of 4 years. The majority of the doctors had a good knowledge (69.42%) and a bad practice (56.20%) of screening for viral hepatitis B and C. The duration of activity was the factor linked to knowledge of viral hepatitis B and C (p = 0.006) while age was the factor linked to the practice of screening for viral hepatitis B and C (p = 0.0366). In conclusion, in Brazzaville, general practitioners’ knowledge of screening for viral hepatitis B and C is good in general, but the practices are poor and require targeted in-service training.

关键词： Viral Hepatitis B and C Screening General Practitioners brazzaville

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Working in Psychiatry: Staff Perception of the brazzaville hospital and university Center

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Open Journal of Psychiatry 2020年第2期10卷 39-44页

作者： Mbou Essie Darius Gandou Paul Mouanga Alain Matini Prefina Gontran Ondzotto Ntsiba Honoré Ibara Jean-Rosaire Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo General Management of Health Care services Ministry of Public Health Brazzaville Republic of the Congo Department of Psychiatry Brazzaville Hospital and University Centre Brazzaville Republic of the Congo

Background: In Congo-brazzaville, there is a lake of mental healthcare provider and facilities specialized on psychiatric care: only two psychiatrists and one psychiatric department around the country. Poor appreciation of their role and work environment can negatively impact the esteem of psychiatric staff and lead to stigma and discrimination towards patients. Aims: The study aimed to assess the perception of the staff of the only psychiatric service in Congo. Material and methods: We conducted a cross-sectional descriptive, prospective survey;conducted among the psychiatric staff of the brazzaville university hospital in September 2019. An anonymous individual questionnaire was administered to collect: 1) socio-professional data, 2) perceptions (assignment, role, workload and working conditions), and 3) identify the main problems of the service. Averages and frequencies were calculated on Epi info 7.***.2.6. Results: Thirty out of 42 staff had responded (71.4%);16 were male and at their first psychiatric assignment (28/30), with an average age of 44.7 ± 7 and seniority of 8.4 ± 8.3 years. Among them: one psychiatrist, two psychologists, and 19 nurses. Their assignment in psychiatry was well perceived in 93.3% (27/30), as well as their role (the importance of psychiatric care and psychiatry). Working conditions were perceived as poor: precarious hygiene (93.3%), cohabitation with dangerous patients (82.1%), heavy workload due to lack of staff (100%). Of their professional future, 23.3% (7/30) were considering leaving. Conclusion: Almost all psychiatric staff had a good perception of their role and psychiatry, but not of the working conditions. Local measures to improve working conditions must be carried out to improve the attractiveness of psychiatry and the quality of care.

关键词： Psychiatric Health Care Provider Working Conditions Perception brazzaville

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Intracranial Suppuration at the brazzaville Academic hospital

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Neuroscience & Medicine 2020年第1期11卷 36-44页

作者： L. Boukassa H. B. Ekouele-Mbaki O. B. Ngackosso S. B. Kinata Bambino Department of Surgery Division of Neurosurgery Brazzaville Academic Hospital Brazzaville Republic of Congo

Background: Intracranial suppurations (ICS) due to banal germs are medical-surgical emergencies, despite their little removed frequency. Represented by abscesses and empyemas, their management has been improved by the combined contributions of new diagnostic and therapeutic methods. Objective: Appreciate the management of intracranial suppurations banal germ in our service. Material and methods: A retrospective study of 41 cases of intra-cranial suppurations was conducted at brazzaville university hospital, from January 2007 to June 2019. Diagnostic, therapeutic and evolution aspects have been studied. Results: They are divided into 24 empyemas, 8 abscesses and 9 associations abscess-empyema. The average age was 20.2 years old in general. The male predominance is noted in all groups. The sex ratio is 3.1 for all of these intracranial suppurations (ICS). They frequently complicated Oto-Rhino-Laryngology (ORL) infections (41.4%). The clinic was mostly represented by the Bergman’s triad 51.2%, followed by headache 14.6% and seizures 12.2%. The lesions were predominant in supratentorial 97.5%. Frontal location was found in 67.4%. Germs were isolated in 29.4% of samples. There were 5 Streptococci, 3 Staphylococci and 2 Gram-negative Bacilli. The medico-surgical treatment indicated in 80.5% combined often probabilistic tri-antibiotherapy with the evacuation of the pus by the trepano-puncture. Evolution under this treatment was marked by healing in 90.2%. The lethality was 9.7%. Conclusion: The pursuit of the improvement of these infections requires the adequate treatment of their gateways, most of them loco-regional.

关键词： Intracranial Suppuration Abscess Empyema

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Histopathologic Profile of Miscarriages during First Trimester of Pregnancy in Teaching hospital of Grand Yoff in Dakar (Senegal)

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Open Journal of Pathology 2020年第1期10卷 56-65页

作者： Mama Sy Diallo Chérif Mohamed Dial Henriette Poaty Oumar Faye Histology-Embryology and Cytogenetics Laboratory Faculty of Medicine Cheikh Anta Diop University Dakar Senegal service of Pathology Teaching Universitary Hospital of Grand Yoff Dakar Senegal Histology-Embryology and Genetics Unit Faculty of Health Sciences of Brazzaville Brazzaville Congo National Research Institute on Health Sciences Brazzaville Congo

Background: Mainly for economic reasons, histopathologic analysis is not a systematic practice in medical structures in Senegal, and the utility of this exam is being questioned by many authors. The purpose of this paper is to report the results of this exam, in our medical practice and try to determine if this exam should be systematic of kept only for individualized cases. Material and Methods: It was a retrospective study from January 2010 to December 2018, carried out in the Laboratory of Pathology of the Teaching hospital of Grand Yoff in Dakar. The data were collected from the register of pathologic examinations of the laboratory. Results: We registered 543 results of histopathologic examination of products of conception from the first trimester abortion. The women mean age was 22.4 years ± 6.2 with extremes of 17 and 46 years. The routine histopathologic assessment of products of first- trimester miscarriages highlighted in our study three pathologies: hydatidiform mole (24.7%), infection (4.6%) and ectopic pregnancy (0.09%). Only 11.7% of cases of Hydatidiform mole (HM) were suspected before the histopathologic assessment. In our sample, molar pregnancy seems to be higher in anembryonic conception with a prevalence of 45%. The prevalence of Complete Hydatidiform Mole (CHM) was higher than the one of Partial Hydatidiform Mole (PHM) (14.8% vs. 9.9% of miscarriages). Indeed, both require follow up to prevent or manage at time the occurrence of choriocarcinoma. Conclusion: The results of the histologic analysis after abortion in the first trimester of pregnancy show that this exam should be practiced systematically in routine in our context because of high prevalence of hydatidiform mole.

关键词： Histopathologic Miscarriage Hydatidiform Mole Ectopic Pregnancy

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Sexual Assault: Epidemiological Profile and Clinical Aspects at the brazzaville university hospital Center

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Open Journal of Obstetrics and Gynecology 2020年第2期10卷 326-332页

作者： L. M. E. Eouani J. C. Mokoko C. Itoua N. S. Sekangue Potokouen Mpia L. H. Iloki service de Gynécologie Obstétrique Hopital Général de Loandjili de Pointe-Noire Pointe-Noire Congo UniversitéMarien NGOUABI de brazzaville Brazzaville Congo service de Gynécologie Obstétrique Centre Hospitalier Universitaire de Brazzaville Brazzaville Congo

Objective: to identify the socio-demographic profile of the alleged victims of sexual assault, to define the characteristics of the aggressors, to describe the types of clinical lesions, and to analyze the link between these different parameters.?During the study period, 5620 clients were admitted to gynecological emergencies, including 150 for sexual assault (2.6%). The alleged victims of aggression were 14 years old on average [range: 2?-?49 years]. Among these clients, there were 147 (98%) women and 3 (2%) men [sex ratio: 0.02]. They had a primary education level of 38%, secondary to 42.7%, and single in 87.2% of cases. Clients came from home (69.3%) or police station (24.7%). The perpetrator was male, with an average age of 25.5 years [range: 16 to 35 years]. Regarding the relationship with the victim, the neighborhood accounted for 83%. The perpetrator was alone in 76.7% of cases, two (14%) or more (16.7%), up to 18.?The aggressor’s home was the place of aggression (39.3%). The threats were made using knives (49.3%) and firearms (8.5%). The perpetrator used either his sex (79.9%), his fingers (34.2%) or an object (2.7%). The route of entry was vaginal (94.6%), anal (21.7%) and oral (10%). The abuser used the condom in 74.7% of cases.?Customers had viewed within 24 hours (40.7%). The general state and hemodynamics at admission was normal for all clients. Physical injuries were injuries (23%) and scrapes (34.5%). External genitalia included perineal tears (28%), vaginal tears (8.6%), hymenal tears (7.3%), and old deflowering (72.7%). The hymen was intact in 20%.?The bi-varied analysis found a correlation with a statistically significant difference in the age range of the alleged victims with the number of aggressors, the time of aggression, the path and type of penetration, and the weapon used for the threat.

关键词： Sexual Assault Firearm Stab Perineal Tear Vaginal Tear Hymenal Tear

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Immunoscreening of Alpha-Tocopherol in Breast, Prostate Cancers and in Gestational Choriocarcinoma Tissues

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CellBio 2021年第2期10卷 11-21页

作者： Henriette Poaty Franck Arnaud Moukobolo Kinsangou Alexis F. Bolenga Liboko Judith Nsonde Malanda Michel Geffard Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo National Research Institute on Health Sciences (IRSSA) Brazzaville Congo Oncology service Teaching hospital Brazzaville Congo Institut pour le Développement de la Recherche en Pathologie Humaine et Thérapeutique Talence France

Background: Many literature reviews report vitamin E supplementation as a benefit chemopreventive and adjuvant therapy in breast and prostate cancers. We investigated in the present work, alpha-tocopherol (α-T) expression (the current active form of vitamin E) from tissues of Congolese patients neither smokers nor alcohol drinkers and without intake antioxidant vitamins supplement. Methods: α-T was analysed in one normal placenta of nine weeks of gestation and in nineteen cancerous tissues, including seven breast cancers, six prostate cancers, and six gestational choriocarcinomas. The study was performed by immunohistochemistry method after diagnosis confirmation by histological analysis. Results: α-T staining in membrane cells and collagen fibers presented a moderate expression in healthy sections of tissues (positive control), but the labelling was strong in breast, prostate adenocarcinomas, and in choriocarcinomas. Conclusion: Tumors immunohistochemistry of α-tocopherol in breast, prostate cancers and in choriocarcinoma show elevated immunostaining suggesting a probable oncogenic effect of the micronutrient.

关键词： Vitamin E Alpha-Tocopherol Immunohistochemistry Breast Cancer Prostate Cancer Choriocarcinoma

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Epidemiology of Cardiovascular Diseases in Children at the Teaching hospital of brazzaville, Congo

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World Journal of Cardiovascular Diseases 2016年第11期6卷 410-424页

作者： Anne Berthe M’pemba Loufoua-Lemay Alphonse Massamba Department of Pediatrics University of Brazzaville Hospital Brazzaville Congo Laboratory of Health Exercise Physiology and Biomechanics Superior Institute of Physical Education University Marien Ngouabi Braz-zaville Congo

Context: Several studies were conducted throughout the world on heart diseases in children;no data is available in Congolese child. Objective: To evaluate epidemiological profile of Congolese children and teenager carrying cardiovascular diseases. Methods: A descriptive and prospective study was carried out during 4 years in the pediatric department of teaching hospital of brazzaville, near the children received in consultation of pediatric cardiology. Results: On 41,472 patients admitted in pediatric service, 526 patients were received in consultation for suspicion of heart diseases. Among them, 444 had cardiopathy (incidence of 10.7‰). It was about a congenital heart disease to 316 (60%) incidence of 7.6‰;Acquired heart disease to 128 (24.4%) incidence of 3.1‰. Among congenital heart defects observed frequency of patients with ASD was 20.3%, isolated in 10.1% of cases, and associated with ECD (11.8%). The VSD was observed in 30.1% of cases, and the Tetralogy of Fallot in 10.1% of cases. Among the acquired heart diseases, severe hypo kinetic dilated cardiomyopathy (DCM) was noted in 24.4% of cases. The rheumatic heart diseases accounted for 41.4% of cases. It was mitral regurgitation (33.6%), a mitral stenosis (1.6%). Pericarditis was objectified at 10.1% of the patients. The evolution was favorable for 43.3% of patients. An aggravation of symptoms was observed to 2.7% of patients. Mortality was 11.9% and 71.9% of deaths were observed to not operate carriers of congenital heart disease. 69.9% of dead patients were carrying a cyanogen heart disease. Left to right shunt represented 21.7% of the deaths. Conclusion: Heart diseases are real problem of public health for Congolese children.

关键词： Congenital Heart Diseases Acquired Heart Diseases Children brazzaville Sub-Saharan Africa

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Results of Femoral Neck Fractures Screwing in Adults at university hospital of brazzaville

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Open Journal of Orthopedics 2018年第6期8卷 227-234页

作者： Marius Monka Carine Mboutol Mandavo Kevin Bouhélo-Pam Albert Ngatsé-Oko Patrick W. H. Dakouré Armand Moyikoua service d’Orthopédie Traumatologie CHU de Brazzaville République du Congo service de Chirurgie Pédiatrique CHU de Brazzaville République du Congo service d’Orthopédie Traumatologie CHU Sour&ocirc Sanou Bobo-Dioulassou Burkina Faso

Purpose: The good of this survey was to analyze the epidemiological aspects and evaluate anatomical and functional results of the treatment by screwing of femoral neck fracture in adulthood at the Teaching hospital of an underequipped country. Material and Methods: This is a retrospective study from January 1, 2011 to December 31, 2015, concerning patients hospitalized for fractures of femoral neck and having been operated by screwing. The variables studied were epidemiological and therapeutic aspects. Anatomical results were examined on standard x rays of the pelvis in front and the hip in profil, based on the consolidation of the bony axis. Functional results were analyzed according to the quotation of Postel Merle D’Aubigné. Results: Eleven screwings of femoral neck have been done to 11 patients (9 men and 2 women), average age was 47 years (29 and 60 years) from January 2011 to December 2015, at the mean recoil of 19 months (12 and 24 months). Amongst consolidated patients (n = 7), one patient presented a necrosis of femoral head at two years hindsight. Four patients presented an aseptic pseudarthrosis of femoral neck, or a bad anatomical result. Amidst this group of patients, one underwent a joint replacement type Moore and suggestion of intermediary prothesis was recommended to three patients. According to the quotation of Postel Merle D’Aubigné, results were very satisfactory to 5 patients, good to 2 patients and bad to 4 patients. According to the score of Parker, 7 patients presented a score of 9 and 4 patients a score of 7. Conclusion: The treatment of femoral neck fractures in adulthood requires a surgical approach by osteosynthesis and must be precocious before 24 hours in order to reduce risks of pseudarthrosis of femoral neck and necrosis of femoral head.

关键词： Screwing Fracture Femoral Neck

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Associations of High Density Lipoprotein Cholesterol and Framingham Cardiovascular Risk with Diabetic Retinopathy in African Type 2 Diabetics

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World Journal of Cardiovascular Diseases 2014年第4期4卷 179-188页

作者： Benjamin Longo-Mbenza Moise Mvitu Muaka Thierry Gombet Igor Longo Phemba Stephen Cook Emmanuel Mve Mengome Department of Ophthalmology University of Kinshasa Kinshasa Congo Emergency service University Hospital Centre Brazzaville Congo Faculty of Health Sciences Walter Sisulu University Mthatha South Africa Faculty of Medicine University of Health Sciences Libreville Gabon School of International Studies Wenzhou Medical College Wenzhou China The Eye Centre East London South Africa

Objectives: To assess the associations of high density lipoprotein cholesterol (HDL-C) and Framingham cardiovascular (CVD) with diabetic retinopathy (DR). Methods: A cross-sectional study of random sample of 200 T2DM Central Africans. Sociobiographical, laboratory and eye examination main outcome measures were investigated using Tertiles of HDL-C (stratification = lowest 10% were the significant independent determinants for DR. In the highest HDL-C group, smoking status and 10-year Framingham risk ≥ 10% were the significantly independent determinants for DR. In 10-year Framingham risk ≥ 10% group, smoking status, insulin resistance and increasing levels of HDL-C were the significantly independent determinants for DR. Conclusion: DR and VD remain a public health problem in T2DM Central Africans. Some Central Africans with DR and VD appear to have higher HDL-C than T2DM Central Africans without DR and VD. HDL-C in T2DM patients with DR, may be tightly controlled by genetic factors (black Bantu ethnicity) than the other lipoproteins as reported among Indians, African-Americans, and Japanese individuals. The most preventable environmental risk factors for DR were smoking status, global cardiovascular disease risk, insulin resistance and oxidative stress.

关键词： Diabetic Retinopathy Visual Disability Higher High Density Lipoprotein Smoking Insulin Resistance Oxidative Stress Africans

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