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Neurological Sequelae in Cranioencephalic Trauma Patients at the national hospital in zinder (Niger)

Open Journal of Modern Neurosurgery 2022年第2期12卷 104-115页

作者： Mahaman Sani Rabiou Abd-el Kader Moumouni Abiba Tamou Tabe Essosinam Kpelao Stackys Hounkpatin Moussa Taofik Abdoulaye Adamou Babana Dede Regine Diane Ajavon Aminata Kelani Soumaila Sanoussi Depetement of Neurosurgery Zinder Hospital Zinder Niger Department of Neurosurgery Kara University Hospital Center KaraTogo Depeartment of Radiology Kara Regional Hospital Center Kara Togo Department of Neurosurgery Syvanus Olympio University Hospital Center Lome Togo Depetement of Traumatology Zinder Hospital Zinder Niger Department of Neurosurgery Maradi Niger Reference Hospital Maradi Niger Faculty of Health Sciences University of Kara Kara Togo Depetement of Neurosurgery CHU Niamey Niamey Niger

Introduction: Cranioencephalic trauma is a frequent reason for admission to emergency departments and is a source of mild to severe neuropsychological defects that will persist over time. Their management remains difficult. Objectives: To evaluate the sequelae presented by patients suffering from cranioencephalic trauma. Methods: This was a retrospective, descriptive, cross-sectional study conducted at the national hospital of zinder. It will include all patients admitted and hospitalised in the emergency, intensive care and neurosurgery departments of zinder national hospital for head injury over a period of 28 months from 1 January 2016 to 30 April 2018. Brain scan, X-ray were the imaging tests used. Results: Out of a total of 974 admissions, 367 were retained, i.e. 37.6%, with a male predominance (82.6%). The average age was 26.5 years. MVAs were represented in 89.7% of cases. Moderate CTE accounted for 64% of cases. Altered consciousness was reported in 295 patients (80.38% of cases). Brain scans were used in 76.7% of cases and skull X-rays in 4.2% of cases. Medical management was performed in all patients. Treatment was operative in 78 patients (21.25%). Recovery without immediate sequelae was found in 187 patients (50.9%). Persistent headache represented 47.7% of the late sequelae observed in the patients, epileptic seizures represented 16.8% of the late sequelae, neurological deficit represented 14.7%. Conclusion: Cranioencephalic trauma represents a major public health issue. Although their in-hospital management remains a challenge, post-hospital management related to the appearance of sequelae remains another.

关键词： Cranioencephalic Trauma CT Scan X-Ray Sequelae Niger

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Adult Urological Cancers at zinder national hospital

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Open Journal of Urology 2024年第5期14卷 267-276页

作者： Halidou Maazou Manzo M. S. Ousmane Chaibou Soumana Abdoulaye Kodo Idrissa Seriba Abdoulrazak R. H. Zakou Soumana Amadou Department of Urology University of Zinder Zinder Niger Department of Urologie University of Niamey Niamey Niger Department of Mé dicale Oncology National H&#244pital of Zinder Zinder Niger Department of Anatomy Pathology Universit&#233 of Zinder Zinder Niger

The aim of this study was to present the epidemiological, clinical and therapeutic aspects of adult urological cancers in the department of urology at zinder national hospital. Patients and Methods: This was a cross-sectional study of adult primary urologic cancers during the period of January 2019 to December 2023. Data were obtained from the record of patients admitted to urology, and the medical oncology department. The parameters studied were;frequency, age, sex, urogenital distribution, anatomopathological type, and therapeutic aspects. Data were recorded on Excel 2013 and analyzed with Epi-info version 7.2.5. Results: Epidemiology: About 289 cancers were diagnosed through 6017 consultations during the period, corresponding to 4.80% of urological pathologies: prostate cancer (n = 221;76.47%), bladder cancer (n = 46;15.92%), kidney cancer (n = 13;04.5%), testis cancer (n = 09;03.11%). Median age of patients was 50.42 years. Prostate cancer: was Adenocarcinoma in 100% (n = 221) with Gleason scores > 7 (77.83%) and prostatique specific antigen (PSA) > 20 ng/ml in 90.04%. Extension evaluation 134 cases (60.63%). Treatment was chirurgical castration in (62.44%) and resistance to castration appeared between 8 and 11 months. hospital mortality for prostate cancer was 16.29%. Bladder cancer was found in 46 cases with Sex ratio 7/1. Cystoscopy was performed for all. Histology revealed squamous cell carcinoma (n = 41;89.13%), and (n = 5;10.87%) urothelial. Endoscopic resection performed (n = 14;30.43%). Kidney cancers were 13 cases (10 men, 03 women). Nephrectomy was performed in (n = 8;61.54%) cases and Histology revealed renal cell cancer in 76.92%. Testicular cancers were diag 09 cases. History of cryptorchidism was found in 4 cases, 4-year infertility in 3 cases. Orchidectomy was done in all cases. Chemotherapy in 3 cases. Conclusion: urological cancers are frequent, dominated by prostate cancer. The endemicity of bilharziasis has increased squamous cell carcinoma. T

关键词： Urologic Cancers Epidemiology Histology zinder

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Alternative Phenotypic Profile for B-Cell Abnormality in a Case at zinder national hospital

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Open Journal of Blood Diseases 2024年第1期14卷 8-16页

作者： Brah Moustapha Maman Amadou Djibrilla-Almoustapha Moustapha Elhadji-Chefou Abdoul-Aziz Garba Badé Malam-Abdou Department of Medicine Université André Salifou de Zinder Zinder Niger Department of Medicine H&#244pital National de Zinder Zinder Niger Department of Medicine Université Abdou Moumouni de Niamey Niamey Niger Department of Medicine Université Dan Dicko Dan Koulodo de Maradi Maradi Niger

Introduction: Since it is impossible to establish a diagnosis in the presence of hyperlymphocytosis not secondary to lymphocytic hyperactivation, we considered a B-lymphoid hematopathy with a non-specific phenotypic profile. We report one case of this. Observation: This is a forty-eight (48) year old patient with hyperlymphocytosis at 139,000 elements per cubic millimeter, heterogeneous splenomegaly at 25.6 cm in diameter on abdominal ultrasound without detectable deep or peripheral lymphadenopathy. Peripheral blood cytology shows lymphocyte cell proliferation suggestive of the circulating phase of chronic lymphoproliferative B syndrome. The expression profile of cell membrane markers did not allow for the definition of a specific phenotypic profile. Faced with this immunophenotyping result, we considered a B-lymphoid hemopathy with a non-specific phenotypic profile. After three courses, the MINICHOP treatment was used to achieve partial remission with wasting of more than 80% of the evaluable masses. Conclusion: Despite the contribution of immunophenotyping in the diagnosis of lymphoproliferative syndromes, it is possible to consider the diagnosis of a B-lymphoid hemopathy with a phenotypic non-specific profile of CD45+, monotypic kappa, CD19+, FMC7+, CD22+, CD5−, CD79b−, CD23−, CD43−, CD38−, CD200−.

关键词： Hyperlymphocytosis CLL Immunophenotyping MINICHOP

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Prevalence of Extended-Spectrum Beta-Lactamase-Producing Strains Isolated at zinder national hospital (ZNH) in 2021 and Their Antibiotic Susceptibility Profile

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Open Journal of Medical Microbiology 2023年第1期13卷 43-51页

作者： Maman Sani Falissou Saïdou Abdoulaye Ousmane Abdoulaye Inoussa Abdoulaye Maman Bachir Hassane Boureima Lo Gora Alhousseini Maiga Daouda Doutchi Mahamadou Bako Saley Mahaman Laouali Sidi Maman Bacha Boukar Mamadou Saidou Faculté des Sciences de la Santé Université Dan Dicko Dankoulodo de Maradi Maradi Niger Hôpital national de zinder Zinder Niger Centre de Recherche Médicale et Sanitaire Niamey Niger Faculté de Médecine de Pharmacie et d’odontostomatologie Université Cheikh Anta Diop de Dakar Dakar Sénégal Faculté des Sciences de la Santé Université Abdou Moumouni Niamey Niger Faculté des Sciences de la Santé Université de Zinder Zinder Niger

Purpose: Bacterial resistance to antibiotics has become a global public health problem. Enterobacteriaceae ESBL is among the most incriminated in this emergence which reduces the therapeutic possibilities. Thus, the objective of this study is to determine the prevalence of the extended-spectrum beta- lactamase (ESBL) producing Enterobacteriaceae at ZNH and their antibiotic susceptibility profile. Materials and Methods: This is a prospective study carried out over 5 months in all hospitalized and non-hospitalized patients in whom a culture was taken for the diagnosis of an infection. The search for ESBL is done by the double disc diffusion method. Results: In total, 21 out of 45 of our strains are ESBL-producing, i.e. a frequency of 46.7%. The mean age is 41.62 (±22.90) with extremes of 2.6 - 78 years. The distribution of ESBL producing species showed a predominance of E. coli with 66.7% followed by K. pneumoniae and K. oxytoca each 9.5%. All ESBL strains were resistant to Amoxicillin, Cefalotin, Pipiracillin, Piperacillin + tazobactam, Ticarcillin, Ticarcillin + clavulanic acid. Resistance to C3G and Aztreonam was each 95.5%, to Amoxicillin/clavulanic acid 9.1%. All strains were sensitive to imipenem. E. coli strains showed resistance: 85.7% to ciprofloxacin, 50% to Amikacin, 57.1% to Gentamicin. For K. pneumoniae, it is 66.7% for Gentamicin and Ciprofloxacin. Conclusion: Our study reports a high prevalence of ESBL at the HNZ. This must be taken into account in order to monitor this phenomenon which constitutes a public health problem. The study also reports sensitivity to Amoxicillin/clavulanic acid and Aminoside which can be an alternative.

关键词： Bacterial Resistance ESBL Enterobacteriaceae zinder Niger

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Hepatic Elastometry in the Management of Hepatitis B at national hospital of Niamey

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Open Journal of Gastroenterology 2024年第9期14卷 313-321页

作者： Ousseini Fanta Hamidine Illa Moussa Saley Sahada Abdourahamane Idrissa Fatouma Abdou Nafissatou Ali Cheik Rakia Abdou Boubé Abdou Djibo Ben Moctar Ky Lawagoulé Joseph Emile Daou Mamane Faculty of Health Sciences Abdou Moumouni University Niamey Niger Department of Hepato-Gastroenterology National Hospital of Niamey Niamey Niger Laboratoire de Recherche Clinique et Systme de Sant Niger Universit Andr Salifou of Zinder Zinder Niger Department of Hepato-Gastroenterology Zinder National Hospital Zinder Niger Department of Infectiology National Hospital of Niamey Niamey Niger Regional hospital Centre of Niamey Niamey Niger Department of Hepato-Gastroenterology General Reference Hospital of Niamey Niamey Niger Department of Hepato-Gastroenterology The University Hospital Ouagadougou Burkina Faso Department of Internal Medicine General Reference Hospital of Niamey Niamey Niger

Introduction: Viral hepatitis B is a public health problem in Niger which is classified as a high endemicity area with a prevalence ranging from 8 to 17% depending on the studies [1] and that of HBV-related cirrhosis is about 40.26% in 2024. The decision to treat is based on a combination of three parameters: viral load, ALT values and the degree of hepatic fibrosis [2]. The latter is assessed by hepatic elastography (Fibroscan), which is a decisive factor in treatment. In Niger, until 2024, the decision to treat or not to treat a patient with HBV was based on the determination of viral load B and transaminases, and no work evaluating the contribution of this third element, liver elasticity, has been done, hence the interest of our study. Objective: To study the contribution of Fibroscan in measuring hepatic elasticity in the management of patients with HBV. Methodology: This was a prospective descriptive study conducted from January 05 to November 30, i.e. a period of 11 months, on clinically asymptomatic HBsAg-positive patients who had undergone FibroScan liver elasticity measurement. The examination was carried out by a hepatogastroenterologist who had received training in the Fibroscan. The median of ten measures of liver elasticity at the same point with an IQR of less than 30% was considered the valid measure and no or minimal fibrosis was defined as a value ˂7 Kpa, moderate fibrosis as a value between 7 and 10 kpa, severe fibrosis as a value greater than 10 Kpa, and the existence of cirrhosis as a value greater than 14 Kpa were analyzed using SPSS version 20 software. Results: Out of 398 patients monitored for HBV, 60 cases met the inclusion criteria, i.e., a frequency of 15.07%. The mean age of the patients was 35.63 years, with extremes of 18 and 70 years. They were predominantly male, with a sex ratio of 3.2. Married patients accounted for 61.67% (n = 37). Jaundice was absent in 91.67% (n = 55). The circumstances of discovery of HBV were the routine health

关键词： Hepatic Elasticity Fibroscan Fibrosis Hepatitis B Niger

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Sickle Cell Disease in the zinder Region in 2023: Prevalence and Sociodemographic Factors

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Open Journal of Blood Diseases 2024年第1期14卷 1-7页

作者： Brah Moustapha Maman Amadou Djibrilla-Almoustapha Moustapha Elhadji-Chefou Illa Hamidine Moussa Diongolé Hassane Badé Malam-Abdou Department of Medicine Université André Salifou de Zinder Zinder Niger Department of Medicine H&#244pital National de Zinder Zinder Niger Department of Medicine Université Abdou Moumouni de Niamey Niamey Niger Department of Medicine Université Dan Dicko Dan Koulodo de Maradi Maradi Niger

Introduction: In view of the number of sickle cell patients and due to a low production of descriptive studies, we decided to determine the prevalence of genes S and C of the disease in the zinder region. The objective was to contribute to improving the management of sickle cell disease in zinder. Methodology: This was a systematic screening by the “Sickle Scan” test of any blood donor admitted to the zinder Regional Blood Transfusion Center during the 6-month study period, from January to June 2023. The Sickle Scan is a qualitative lateral flow chromatography immunoassay using whole blood samples that aid in the rapid diagnosis of sickle cell disease. Results: The study was carried out on 613 samples during the period concerned. The frequency of sickle cell genes was 26.9% (n = 165) in all samples collected, with 23.1% (n = 142) and 3.8% (n = 23) for the S gene and the C gene, respectively. The 18 - 30 age group was the most represented with 64.4% (n = 395) cases. The median age of blood donors was 26 years ± 10 years (min = 18 years/max = 60 years). The sex ratio was 2.5. Donors of Nigerien nationality accounted for 84.1% (n = 516). There is a predominance of blood donors with an average monthly income between 34,000 and 70,000 CFA francs in 44.3% (n = 272), lived in permanent housing with drinking water supply. Sickle cell trait (SMA) was found in 22.5% (n = 138). Conclusion: The analysis of these results highlights a high frequency of the S gene for sickle cell disease. The population with an average monthly income is the most affected, with a male predominance.

关键词： Sickle Cell Anemia Blood Donors Sickle Scan

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Obstetric Fistula: Epidemiological, Social and Therapeutic Aspects: Prospective Study of 196 Patients Admitted to the zinder Mother and Child Health Centre (CSME)

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Open Journal of Urology 2024年第2期14卷 95-103页

作者： Maazou Halidou Ousmane Manzo Zalika Lankoande Abdoulaye Kodo Harissou Adamou Oumarou Habou Abdoulaye Idrissa Tassiou Ibrahim Nafiou Idi Soumana Amadou Department of Surgery University André Salifou Zinder Niger national Reference Center for Genital Fistulas Care Niamey Niger

Introduction: Obstetric fistula (OF) is an abnormal communication between the genital and urinary tracts and/or associated with a recto-vaginal communication resulting from prolonged dystocic delivery. It is a frequent pathology in underdeveloped countries. In zinder no study has been carried out on obstetric fistula. The aim of this study was to evaluate the epidemiological, social impact and therapeutic aspects of obstetric fistula at the CSME of zinder. Patient and Method: This was a descriptive cross-sectional study of obstetric fistula care at CSME during the period of (January 2018 to June 2020). Results: A total of 196 cases were collected over 30 months. This represents an annual incidence of 78.4 fistulas. The median age of the patients was 18.63 years, and more than 65% were over 20 years old. One hundred and ninety-one patients (97.45%) did not attend school, and 56.12% (n = 110) lived in polygamous households. One hundred and fifty-one women (n = 151), 77.04% had full assistance from their husband during the first four (4) months of the pathology. Twenty-four (12.24%) had been notified of repudiation. Obstetrical risk of dystocia was found in 39.79% (n = 78) of the patients, of whom 24.49% (n = 48) had a focused antenatal consultation (CPNR). The labour lasted more than 24 hours in 100%. The majority of women are multiparous and 60% had at least 2 pregnancies. vesicovaginal fistula is the main pathological type with 86.23%. Fistulas were closed in 83.16% and 68.87% exited without urine loss. Conclusion: Obstetric fistula is a devastating disease affecting girls and young women in Niger, as in other countries in Africa and Asia. It is a major concern worldwide and is a social tragedy because it is disabling and depressing.

关键词： Obstetric Fistula Epidemiology CSME zinder

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Challenges and Opportunities in the Practice of Chinese Medicine in Singapore

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Chinese Journal of Integrative Medicine 2024年第6期30卷 483-488页

作者： CHEW Sin Yee national University hospital Singapore119074Singapore

According to the World Health Oranization(WHO)Traditional Medicine Strategy 2014-2023,traditional medicine is defined as"the sum total of the knowledge,skill and practices based on the theories,beliefs,and experiences indigenous to different cultures,whether explicable or not,used in the maintenance of health as well as in the prevention,diagnosis,improvement or treatment of physical and mental illness.

关键词： theories prevention diagnosis

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Acute Leukemia in Niger: Epidemiological, Diagnostic and Therapeutic Aspects

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Open Journal of Blood Diseases 2024年第3期14卷 81-90页

作者： Amadou Djibrilla-Almoustapha Badé Malam-Abdou Abdourahamane Yacouba Moussa Souley Moustapha Maman Brah Moustapha Elhadji-Chefou Boubacar Marou-Soumana Samaila Aboubacar Ousseini Fanta Maman Rabiou Badé Oumarou Adamou-Chaibou Department of Hematology-Oncology National Hospital of Niamey Niamey Niger Faculty of Health Sciences University of Abdou Moumouni Niamey Niger Department of Medicine Zinder Hospital Regional Niger Departtment of Biology Amirou Boubacar Diallo National Hospital Niamey Niger Faculty of Health Sciences University of Dan Dicko Dankouloudo of Maradi Maradi Niger Laboratory of Biology National Hospital of Niamey Niamey Niger

Objective: Improve the care of patients followed for acute leukemia in the Oncohematology department of the national hospital of Niamey. Methods: This was a prospective study, over a period of 2 years from January 1, 2018 to December 31, 2019, in patients with acute leukemia in the Oncohematology department of the national hospital of Niamey (HNN), whose diagnosis was made on a blood smear associated with a myelogram and immunophenotyping and who were consenting. Results: We collected 25 cases of acute leukemia confirmed by myelogram and immunophenotyping. The mean age of the patients was 31.32 years, with a predominance of women, a sex ratio of 0.92. Pupils and students were in the majority with 40% and most came from the Niamey region, i.e. 68%. Anemic syndrome was the most common clinical sign in 96%. ALL predominated in 64% of cases. On the blood count, the hyperleukocytosis was more marked in AML (mean white count: 197256.6 elts/mm3) than in ALL (137891.6 elts/mm3), it was the same for thrombocytopenia which is more marked in AML (75588.89/mm3) than in ALL (52156.25/mm3). Therapeutically, 52% of patients received chemotherapy. The mean overall survival was 16.223 ± 3.191 months, including a mean survival for AML of 6.853 ± 1200 months compared to 21.720 ± 5.920 months for ALL. Conclusion: Acute leukemia still remains a major problem in our context, due to the precariousness of limited financial, diagnostic and therapeutic resources. Thus reflecting in our results, the increasing number of cases, the diagnostic delay and the guarded prognosis. This is the reality in several other countries in the sub-region and even in certain developed countries.

关键词： Acute Leukemia ALL AML Hematology-Niamey national hospital (HNN) Niger

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The evolution of cancer genomic medicine in Japan and the role of the national Cancer Center Japan

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Cancer Biology & Medicine 2024年第1期21卷 29-44页

作者： Teruhiko Yoshida Yasushi Yatabe Ken Kato Genichiro Ishii Akinobu Hamada Hiroyuki Mano Kuniko Sunami Noboru Yamamoto Takashi Kohno Department of Genetic Medicine and Services National Cancer Center HospitalTokyo 104-0045Japan Department of Diagnostic Pathology National Cancer Center HospitalTokyo 104-0045Japan Clinical Research Support Offce Clinical Research Coordinating SectionBiobank Translational Research Support SectionNational Cancer Center HospitalTokyo 104-0045Japan Department of Pathology and Clinical Laboratories National Cancer Center Hospital EastChiba 277-8577Japan Division of Molecular Pharmacology National Cancer Center Research InstituteTokyo 104-0045Japan national Cancer Center Research Institute Tokyo 104-0045Japan Department of Laboratory Medicine National Cancer Center HospitalTokyo 104-0045Japan Department of Experimental Therapeutics National Cancer Center HospitalTokyo 104-0045Japan Division of Genome Biology National Cancer Center Research InstituteTokyo 104-0045Japan

The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer *** the time,a variety of activating oncogenic alterations and their functional significance were unveiled in cancer cells,which led to the development of molecular targeted therapies in the 2000s and *** CGM is still a relatively new discipline and it is difficult to predict to what extent CGM will benefit the diverse pool of cancer patients,the national Cancer Center(NCC)of Japan has already contributed considerably to CGM advancement for the conquest of *** back at these past achievements of the NCC,we predict that the future of CGM will involve the following:1)A biobank of paired cancerous and non-cancerous tissues and cells from various cancer types and stages will be *** quantity and quality of these samples will be compatible with omics *** biobank samples will be linked to longitudinal clinical information.2)New technologies,such as whole-genome sequencing and artificial intelligence,will be introduced and new bioresources for functional and pharmacologic analyses(e.g.,a patient-derived xenograft library)will be systematically deployed.3)Fast and bidirectional translational research(bench-to-bedside and bedside-to-bench)performed by basic researchers and clinical investigators,preferably working alongside each other at the same institution,will be implemented;4)Close collaborations between academia,industry,regulatory bodies,and funding agencies will be established.5)There will be an investment in the other branch of CGM,personalized preventive medicine,based on the individual's genetic predisposition to cancer.

关键词： Cancer genomic medicine biobank patient-derived xenograft multi-gene panel test whole genome sequencing

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