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cost of Medical Treatment for Primary Open-Angle Glaucoma in Relation to Patients’ Income and Its Impact on the Prognosis of the Disease, in bouaké University Hospital

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Open Journal of Ophthalmology 2024年第1期14卷 8-17页

作者： Yves Ouattara Liliane Ella Godé Zana Diabaté Franck Hermann Koffi Mamadou Korka Diallo Philippe Emile France Koffi Bilé Diomandé François Gossé Ibrahim Abib Diomandé Ophthalmology Department of bouaké University Hospital (chu de bouaké) Bouaké C&#244te d’Ivoire

Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 cFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .

关键词： Primary Open-Angle Glaucoma Treatment cost Medical Treatment Income Blindness

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Results of Trans-Urethral Resection of Bladder (TURB) for the Treatment of Non-Infiltrating Bladder Tumors (NMIBT) in Musk in bouake

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Open Journal of Urology 2024年第2期14卷 39-49页

作者： Kouassi Patrice Avion N’diamoi Akassimadou Venance Alloka Sadia Kamara Koffi Dje Urology Department Bouaké University Hospital (CHU) Bouaké Ivory Coast

Background: bladder tumors rank 2nd among urological tumors in sub-Saharan Africa, particularly in côte d’Ivoire. Objective: to report the results of transurethral resection of the bladder (TURB) for the treatment of non-muscle-infiltrating bladder tumors (NMIBT) in bouaké. Patients and methods: we conducted a cross-sectional, descriptive study of transurethral resection of the bladder (TURB) for the treatment of non-muscle-infiltrating bladder tumors (NMIBT) between January 2022 and April 2023. All patients and their families were informed in advance and had signed an informed consent form. All patients with a non-muscle-invasive bladder tumor confirmed by an initial TURB were included, and patients with a bladder tumor infiltrating the bladder muscle were excluded. Diagnosis was based on cystoscopy and anatomopathological examination of resection shavings. Parameters studied were: age, sex, risk factors, reason for consultation, clinical signs, cystoscopy findings, stage, grade, Evolution. Results: 17 patients with a mean age of 53.7 years (22-73 years) underwent trans-ureteral bladder resection to treat a non-muscle-infiltrating bladder tumor (NMIBT). Male gender predominated with 88.23% (n = 15), the majority of patients came from the ME region with 47.05% (n = 8), farmers were the most numerous (52.94%;n = 9). The most frequent reason for consultation was macroscopic hematuria with 64.1% (n = 11), risk factors were dominated by urinary bilharziasis with 70.58% (n = 12), physical examination was normal in 47.05% (n = 8). Hemoglobin (HB) levels were between 7.5 and 8.5 g/dl in 52.94% (n = 9). On cystoscopy, the tumor was budding in 76.45% (n = 13), the localization was trigonal in 52.9% (n = 9) and the base of implantation was sessile in 70.52% (n = 12). On ultrasound, the tumor was 3 cm or larger in 70.52% (n = 12). Therapeutically, 82.35% (n = 14) of patients received a blood transfusion. TURB was complete in the majority of cases 88.23% (n = 15). Squamous cell

关键词： Bladder Tumor NMIBT TURB Squamous cell carcinoma

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Molecular Detection of Resistance and Virulence Genes in coagulase Negative Staphylococci Isolated from Blood cultures at the University Teaching Hospital of bouake

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Journal of Biosciences and Medicines 2024年第6期12卷 52-63页

作者： Oby Zéphirin Wayoro Ahou Micheline N’Guessan Adjaratou Traore Akissi christine Houssou Etilé Augustin Anoh Abdoulaye Diarrassouba Safiatou Karidioula Juste Olivier Tadet Pacôme Monemo chantal Akoua-Koffi centre Hospitalier et Universitaire (chu) de bouak Laboratoire de Bactriologie-Virologie Bouak Cte dIvoire Departement des Sciences Fondamentales et Bioclinique UFR des Sciences Mdicales Universit Alassane Ouattara (UAO) de Bouak Bouak Cte dIvoire

Introduction: coagulase-negative staphylococci (coNS) are currently recognized as genuine pathogens. However, little is known about the resistance and virulence genes that explain their pathogenicity in hospitals in cte d'Ivoire. The aim of this study was to contribute to the genotypic identification of resistance and virulence genes in coNS isolated from blood cultures at the University Teaching Hospital (chu) of bouak, in order to improve patient management. Material and Methods: This was a descriptive study conducted from September to December 2023. The coNS isolates studied came from the collection of strains isolated from blood cultures of febrile patients hospitalized or attending consultations at the chu of bouak. The strains were analyzed using conventional simplex PcR. Results: Of the 45 isolates analyzed, 46.7% carried both the aacA-aphD and tetK genes and 40% carried the mecA gene. With regard to virulence genes, only the LukS-PV gene was observed in S. epidermidis and S. haemolyticus isolates. conclusion: The high prevalence of coNS isolates carrying the mecA gene and the presence of virulence genes observed in this study give cause for concern in hospitals. It is important to develop comprehensive surveillance strategies against nosocomial and multi-resistant infections at the chu of bouak.

关键词： coagulase-Negative Staphylococcus Gene Multiresistance Virulence bouaké

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Epidemiological, Diagnostic, Therapeutic, and Prognostic Profile of Non-Tuberculous community-Acquired Purulent Pleurisy in children at the bouaké University Hospital center, 2017-2021

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Advances in Infectious Diseases 2024年第1期14卷 220-232页

作者： Yapo Thomas Aba christian Yao Pacôme Monemo Richard Azagoh-Kouadio Iburaima Akandji Noelle Gonné Jean-Marie Karidioula Vincent Achi Vincent Kouadio Asse Department of Infectious and Tropical Diseases University Hospital of Bouaké Bouaké Ivory Coast University Alassane Ouattara of bouake Bouake Ivory Coast Department of Pediatrics University Hospital of Bouaké Bouaké Ivory Coast Department of Bacteriology & Virology University Hospital of Bouake Bouaké Ivory Coast Department of Pediatrics University Hospital of Angré Abidjan Ivory Coast Department of Pneumology University Hospital of Bouake Bouaké Ivory Coast

Introduction: In côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at bouaké University Hospital center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the chu of bouaké, marked by high mortality rates.

关键词： community-Acquired Purulent Pleurisies children Mortality bouaké

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Neonatal Intestinal Obstruction in Acute Renal Failure in Premature Infant: A case Report

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Open Journal of Pediatrics 2024年第2期14卷 338-343页

作者： Ondima Lucienne Irène Patricia Okiemy Niendet cardinale Princilia Gandzali-Ngabe Pierre Eric caryne Mboutol-Mandavo Bosseba Missengui Rhodia Hélène Akobande Nuptia Erica Department of paediatric surgery CHU Brazzaville Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Department of Nephrology and Dialysis Brazzaville University Hospital Brazzaville Congo

Introduction: Intestinal obstruction is a common cause of abdominal surgery in the neonate. Diagnosis is straightforward using standard radiology, and surgical technique depends on the underlying anatomical lesion. Peritoneal dialysis (PD) is an effective, albeit invasive, therapy for neonatal renal failure. We report a case of neonatal obstruction with severe renal failure treated by PD to highlight our hospital practice and possible remedies in a context of limited resources. case Presentation: This was a female neonate of moderate prematurity admitted on day 4 of life for management of a flat neonatal obstruction. Radiological diagnosis suggested small bowel atresia. Biological tests revealed severe renal failure with creatinine levels of 416 micromoles per liter and blood urea of 27.1 micromoles per liter. Management consisted of preoperative peritoneal dialysis for 48 hours followed by laparotomy. The intraoperative diagnosis was GROSFELD type IIIa digestive atresia. The postoperative course was favourable, transit was resumed on day 5 and the patient returned home on day 12. Progress at 3 months was satisfactory. conclusion: Neonatal intestinal obstruction with renal failure in premature infants is associated with a poor prognosis, even more so if there is a delay in treatment. Peritoneal dialysis seems to be a suitable alternative for this management in our working conditions with limited resources.

关键词： Neonate Occlusion Peritoneal Dialysis case Report

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Severe Musculoskeletal Injuries in children during Play

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Open Journal of Orthopedics 2022年第11期12卷 393-399页

作者： Soumahoro Ibrahim Akobé Achié Jean Régis Krah Koffi Léopold Kouassi Kouamé Jean-Eric Bénié Adoubs célestin Kouassi Aya Adelaïde Natacha Ochou Jr Pierre Germain Digbeu Ogou Kevin Elie Traoré Ibrahim Traoré Abdoul Massandjé Norah Soro Zolopégué Marcel Blé Gbalé Yannick Akpro Sédy Louess De Randolphe Kodo Michel Orthopaedics-Traumatology Department of the University Hospital of bouaké (cô te d’Ivoire)/Alassane Ouattara University Bouake Ivoiry Coast paediatric surgery unit of the chu of bouaké (cô te d’Ivoire)/Alassane Ouattara University Bouake Ivoiry Coast

Introduction: Musculoskeletal injuries are common in children but rarely severe. Their treatment varies according to the type of injury observed. The aim was to describe the epidemiological and therapeutic aspects of severe musculoskeletal injuries in children during play. Patients and Methods: This was a retrospective descriptive study conducted in the Orthopaedic-Traumatology Department and the paediatric surgery unit of the University Hospital of bouaké between January 2018 and December 2020. It concerned patients less than 16 years of age hospitalised for more than 24 hours for a musculoskeletal trauma following a gambling accident. The variables studied were epidemiological and therapeutic. Results: A total of 53 patients were collected. The frequency was 2.9%. The mean age was 9 ± 3.99 years. There were 38 (71.7%) boys and 15 (28.3%) girls. The sex ratio was 2.5. The patients were attending school in 79.3% (n = 42). The circumstances of occurrence were dominated by falls during play accidents (n = 35;66%). Football was observed in 93.5% (n = 49). The thoracic limb (n = 35;66%) was the preferred site of these injuries. The injuries were closed (86.7%) with a predominance of forearm fractures (n = 22;41.6%). The average hospital stay was 2.8 ± 1.4 days. Most of the patients were treated orthopedically (n = 37;69.9%). The evolution was favourable without complications. conclusion: Musculoskeletal injuries during play were infrequent (2.9%). The circumstances were dominated by falls during play. The injuries were mainly closed fractures, most of which were treated orthopedically.

关键词： children Fractures Musculoskeletal Trauma Orthopaedic Treatment

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craniofacial Horn Injuries: Rares Lesional Entities at the University Hospital of bouaké(côte d’Ivoire)

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Open Journal of Stomatology 2018年第7期8卷 250-257页

作者： Eric Kouassi Zegbeh-N’Guessan Adoubs célestin Benie Gohi Serge Irie Bi Rokiatou Kone-Kamate Serge Yao Konan Grébéret Emmanuel crezoit Department of Odontostomatology and Maxillofacial surgery of the University Hospital of bouaké C&ocirc te d’Ivoire Department of Pediatric surgery chu Bouaké C&ocirc te d’Ivoire Resuscitation and Anesthesiology Department of the University Hospital of bouaké C&ocirc te d’Ivoire Department of Neurosurgery of the University Hospital of bouaké C&ocirc te d’Ivoire

Aim: Describe the epidemiological, clinical and therapeutic particularities of craniofacial trauma by encornment. Type of study: This was a retrospective and descriptive study. Material and methods: It took place in the surgical emergency departments of bouaké (côte d’Ivoire) University Hospital from January 2013 to December 2017, for a period of 5 years. It focused on patients of 0 to 5 years old admitted for craniofacial trauma involving the horn of a bovine. Results: Of the 26 cases of traumatic encornment, 11 were craniofacial location (42%). There were 9 male and 2 female victims. The average age was 10.54 years with extremes of 6 months and 24 years. Patients came from rural areas of côte d’Ivoire. Bovids were responsible for all causal encornements. The lesions involved the scalp (3 cases) and the face (8 cases). The lesions were cutaneous-musculo skeletal in 7 cases. The surgical treatment included debridement associated to a suture in all cases and associated with maxillo mandibular blockage in 3 cases and duro-cranioplasty in one case. conclusion: In the local context, facial cranio traumatism by encornement is rare and seems to be essentially infantile, masculine and rural problem.

关键词： cranio Facial Trauma Encornement cow

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An Inahbitual Etiology of Acute Intestinal Obstruction: The Giant Fecalome

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Surgical Science 2023年第3期14卷 225-230页

作者： Leh Bi Kalou Ismaèl Traoré Mamadou N’Dri Ahou Bernadette Ekra Amos Serge Akowendo Ezéchiel Kouakou Blaise Amos Bamba Inza Kouakou Kouamé Bernadin Anzoua Kouakou Ibrahim Lebeau Roger Diané Bamourou Department of General and Digestive surgery chu of bouaké Bouake Ivory Coast

The authors report an observation of a 20-year-old patient, who was referred by the medical emergency department for abdominal distention. The disease would have started with the appearance of abdominal pain, a stop of materials without stopping gases appeared gradually and evolving for 4 months. The patient was chronically constipated. She administered daily enemas with homemade products to have a bowel movement. She never had rectal bleeding, there was no alteration diarrhea—constipation. Mother of 3 children alive and apparently healthy. On clinical examination the abdomen was enlarged in size, painless but of firm consistency. The hernial orifices were free. Hard and abundant stools were noted on digital rectal examination. The abdominal cT scan revealed a large endorectal fecal impaction going up into the left colon, an absence of abdominal mass. We retained the diagnosis of giant fecal impaction. The patient was hospitalized and we instituted paraffin oil therapy combined with an evacuator enema with glycerin. The evolution was marked by a resumption of transit in the form of stool and gas (3 to 4 stools per day). At Day 8 of hospitalization the abdomen had decreased in volume the transit was regular and the patient was discharged on Day 10. Reviewed 3 months later, she maintained a regular transit made of one bowel movement a day. After a setback of 3 years the transit is still preserved. The authors discuss the etiologies of fecal impaction and their respective treatments.

关键词： Intestinal Obstruction Giant Fecal Impaction

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Hydatid cyst of the Liver: About a case at the Digestive and General surgery Department of the University Hospital of bouaké(côte d’Ivoire)

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Surgical Science 2023年第1期14卷 10-16页

作者： Leh Bi Kalou Ismaèl N’Dri Ahou Bernadette Ekra Amos Serge Kouakou Blaise Amos Bamba Inza Kouakou Kouamé Bernardin Anzoua Kouakou Ibrahim Traore Mamadou Lebeau Roger Diané Bamourou Department of General and Digestive surgery chu of bouaké Bouake Ivory Coast

Hydatid cyst of the liver (KHF) is a parasitic condition caused by the development of the larval form of the dog tapenia Echinococcus granulosus. In sub-Saharan Africa, few writings are interested in this pathology, which remains common and constitutes a public health problem in highly endemic countries [1] [2]. We report the observation of a 61-year-old hypertensive patient owner of a dog admitted for abdominal pain without abdominal mass. In whom ultrasound and computed tomography have made it possible to make the diagnosis of hydatid cyst of the liver (KHF). The patient underwent surgery. We performed an associated conservative treatment post-operative albendazole. The post-operative follow-up was simple. In our patient the evolution was good after a setback of more than 2 months. Through this observation and a review of the literature, we insist on the contribution of imaging in diagnosis and treatment, which is essentially surgical.

关键词： Liver Hydatid cyst Diagnosis Treatment

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childhood Heart Disease in côte d’Ivoire: Retrospective Multicentric Study about 228 cases

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Open Journal of Pediatrics 2018年第4期8卷 375-388页

作者： Richard Azagoh-Kouadio Kouakou Florent Diby Kouadio Vincent Asse Loa Gnaba Koko Aude Aka-Tanoh Kossonou Roland Yeboua Kouassi christian Yao christelle Avi Soumahoro Oulai paediatric Ward of University Teaching Hospital of Treichville Abidjan Cote d’Ivoire Department of cardiovascular and Thoracic Diseases CHU de Bouaké Bouaké Cote d’Ivoire paediatric Ward of University Teaching Hospital of Bouake Bouaké Cote d’Ivoire

Introduction: In cote d’Ivoire, the paediatrician has to face a diagnosis and management problem in front of pediatric heart disease, with consequent a high lethality. Objective: To describe the epidemiological, diagnostic, therapeutic and progressive aspects of childhood cardiopathy for the improvement of prognosis and professional practice. Materials and methods: This was a multicenter retrospective and descriptive study conducted from January 2011 to March 2016 in two main hospitals universities, one located in Abidjan and the other in bouaké. It concerned children aged 0 to 15 admitted for cardiac disease diagnosed on clinical and/or echocardiographic arguments. The variables studied were the epidemiological, diagnostic, therapeutic and evolutionary aspects. Results: A total of 49.760 admissions including 228 infantile heart disease cases (congenital 113, acquired 51, indeterminate 64) are overall prevalence of 4.6‰. They involved 106 boys and 122 girls. In 74.6% of cases, the age was between 0 and 2 years. Respiratory distress 73.7% was the main reason for consultation. The main congenital heart diseases (cHD) are ventricular septal defect (VSD) (31%), atrial septal defect (ASD) (20.4%), atrioventricular canal (AVSD) (12.4%) and tetralogy of Fallot (TOF) (11.5%). As for acquired forms (AHD), rheumatic mitral insufficiency (41.2%) and tuberculous pericarditis (15.7%) were the two main causes. Treatment progress is marked by stabilization (71.1%) and death (14%). Death was significantly associated with low socioeconomic status (p = 0.01) and with complication (p 0.001). conclusion: Infantile heart diseases are relatively less frequent and serious in cote d’Ivoire. To improve the prognosis, close collaboration between the pediatrician and the cardiologist is required for early diagnosis and management.

关键词： child congenital Heart Disease Acquired Heart Disease Ivory coast

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