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Knowledge and Attitudes of nursing Staff towards Obstetric Fistula at the Abeche university hospital, Chad

Open Journal of Urology 2024年第5期14卷 277-281页

作者： Vadandi Valentin Mahamat Ali Mahamat Temga Ouang Michael Vounouzia Barthelemy Minguemadji Allah Siyangar ndormadjita Allah Siyangar Abdelmahamoud Chene Konan Paul Gerard Rimtebaye Kimassoum department of Urology University Hospital Center Abeche Chad department of Urology University Hospital of National Reference N&#8217Djamena Chad department of Urology University Hospital of Renaissance N&#8217Djamena Chad department of Urology University Hospital Center Abidjan Cote d&#8217Ivoire

Introduction: Prevention of obstetric fistula (OF) remains a challenge in Chad where its incidence is 464 cases/year. The present study aims to determine the knowledge and attitudes of nursing staff towards obstetric fistula. Patients and Method: This was a cross-sectional, descriptive and analytical study including nursing staff at the Abéché university hospital. The survey took place from March to May 2023 and the sampling was exhaustive. data collection was done using a form including a questionnaire on sociodemographic parameters, knowledge and attitudes. Participation in the study was voluntary and individual. Results: Participation in the study was 76.11%. Emergency department staff were the most represented, followed by gynecology-obstetrics staff with 34.4% and 20.91% of cases respectively. nurses represented 53.17% of participants followed by doctors (23.52%). An exact definition of obstetric fistula was reported by 7.84% of participants and it was partial in 80.39%. The level of knowledge of risk factors was considered good in 12.41%. Exact knowledge of clinical signs was reported by 74.5% of cases. Among the participants, 1.96% reported that the treatment of obstetric fistula is traditional. Knowledge about means of prevention was considered good by 13.72% (n = 21), and attitudes by 26.79%? Obstetric fistula knowledge was influenced by profession (doctor, p = 0.011) and attitudes by service (p = 0.004) and profession (doctor, p = 0.001). Conclusion: Obstetric fistula is a curable disease whose prevention remains possible and requires good knowledge of the disease and the promotion of safe motherhood. This study should serve as a basis for the establishment of the obstetric fistula module in the curriculum of healthcare personnel and the promotion of continuing training for its eradication.

关键词： Obstetric Fistula Knowledge Attitudes CHU-A Abeche Chad

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Toxoplasmic Chorioretinitis: About a Case in an Immunocompetent Adult at the Renaissance university hospital Centre (UHC) in n’djamena (Chad) and Review of the Literature

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World Journal of neuroscience 2024年第1期14卷 1-5页

作者： Mahamat Ali Bolti M. Lobe Régis Oumaima djarma Siddick Oumar Koyo Yusra Aboulbachar Alain Hernandez department of Internal Medicine Renaissance University Hospital N’Djamena Chad Ophthalmology department Renaissance University Hospital N’Djamena Chad Research Laboratory of the Faculty of Human Health Sciences in n’djamena Farcha Provincial Hospital N’Djamena Chad Emergency department N’Djamena Renaissance University Hospital N’Djamena Chad

Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.

关键词： Chorioretinitis Toxoplasmosis n’djamena Chad

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delay for Performing Laparotomy for Extra Uterine Pregnancy in n’djamena Mother and Child university hospital

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 520-527页

作者： Gabkika Bray Madoué Saleh Abdelsalam Khadidja Mahayadine Salah Serfeurbe Pefah Foumsou Lhagadang Faculty of Human Health Sciences of n’ Djamena N&#8217Djamena Chad n’ Djamena Mother and Child University Hospital N&#8217Djamena Chad

Background: Ectopic pregnancy is defined as any pregnancy developed outside the uterine cavity. Objective: to study the relationship between the duration of laparotomy for EP and maternal prognosis. Patients and method. This was a prospective analytical study performed during a period of six (06) months, from May 1st to October 30, 2023, on delay time to perform laparotomy for EP in n’djamena Mother and child university hospital (nMCUH). We included in this series all patients admitted for EP managed by laparotomy. data were collected using Word software and analyzed using SPSS 18.0 version 2018. The p value statistical test was used to compare variables (p significant if ≤5%). Results: We recorded 92 cases of EP out of 5751 pregnancies, giving a frequency of 1.6%. Among patients diagnosed with EP, 76/92 (82.6%) had an indication of laparotomy. In 90.8%, the EP was ruptured. On admission, the diagnosis of EP was made within 1 hour in 15.8% of cases. The time to sign the consent allowing doctor to operate was >1 hour in 14.5% of cases. The operating room was unavailable in 34.2% of cases, with an unavailability of >1 hour in 17.1% of cases. Total salpingectomy was performed in 93.4%. Salpingotomy was performed in 6.6%. The lethality rate was 3.9% with significant value when the delay after indication and admission in the operating room is >1 (p value = 0.03). Conclusion: Various factors, such as the search for blood products, the time loss to sign the consent form and the unavailability of the operating room, delay the laparotomy, influence maternal prognosis. Anticipation on these factors is necessary in order to limit the proportion of delays.

关键词： delay Laparotomy nMCUH Chad

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Epidemiological, Clinical and Paraclinical Profile of Osteoarthritis of the Lower Limbs in Obese Patients at the Cocody university Teaching hospital

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Open Journal of Rheumatology and Autoimmune diseases 2024年第2期14卷 69-76页

作者： nzima Brice Kollo Aboubakar Bamba¹ Aboubacar Sidiki Condé nzima Hilary ngon Kanbaye Medom Ada nina Kpami Yaya Coulibaly Kan Joseph Enoch Koffi Ehaulier Soh Christian Louis Kouakou Mohamed diomandé¹ Edmond Eti Rheumatology department Cocody University Hospital Abidjan C&#244te d&#8217Ivoire Internal Medicine department Yaounde University Hospital Yaounde Cameroon Rheumatology department Bouake University Hospital Bouake C&#244te d&#8217Ivoire

Objective: To describe the epidemiological, clinical and paraclinical characteristics of osteoarthritis of the lower limbs in obese patients at the Cocody university Teaching hospital. Methodology: This was an analytical cross-sectional study carried out in the rheumatology department of the Cocody UTH in Abidjan (Ivory Coast) from March 1 to April 30 2023. Patients who came for rheumatology consultation presenting with mechanical arthralgia of the lower limbs, who were obese, had radiographic images were included. All patients without radiographic images were excluded. Obesity was defined as a body mass index (BMI) greater than or equal to 30 kg/m. The Chi2 test was used to compare proportions and determine the existence of associations between osteoarthristis and obesity, obesity severity and radiographic stage of osteoarthritis as well as the functional impact. A p-value below a predefined threshold (p = 0,05) indicates a significant relationship between the variables. Result: Out of 185 patients received for osteoarthritis of the lower limbs during the study period, 136 were obese (74%). There were 115 women (84.6%) with an average age of 56.03 with a standard deviation of 12.72 years (extremes: 22 and 84 years). The main socio-professional category was the informal sector (30%). The majority of patients had a low socio-economic level (80.2%) and lived in urban areas (92.6%). The most common past medical history was hypertension (33.08%) followed by peptic ulcer disease (16.91%). Patients had a body mass index class 1 (81.6%), class 2 (15.40%) and class 3 (2.90%). The average duration of symptom progression until diagnosis was 11 months. Genu varum was the main static disorder (56.10%) and the knee joint was the dominant topography (90.4%) with a bilateral localization (80%). The average Lequesne index was greater than 8 (59.5%). The Kellgren and Lawrence radiographic stages were stage 1 (9.20%), stage 2 (46.90%), stage 3 (29.20%) and stage 4 (6.90%).

关键词： Osteoarthritis Lower Limbs Obesity Abidjan

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Psychological Experience of Mothers of Children with Sickle Cell disease Followed at the Pediatric department of Bouaké university Teaching hospital

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Open Journal of Pediatrics 2024年第1期14卷 149-163页

作者： Akanji Iburaima Alamun Aka-Tanoh Koko Aude Hélène Yao Kouassi Christian Adou Leioh Romeo Sahi Gnantin Josette Landryse Amani Ehi Alexise Eleonore Boune Aboulaye Asse Kouadio Vincent Paediatrics department Bouaké University Teaching Hospital Bouaké C&#244te d’Ivoire

Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké university Teaching hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké university Teaching hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.

关键词： Psychosocial Experience Sickle Cell disease Côte d’Ivoire

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detection of KRAS G12d in colorectal cancer stool by droplet digital PCR

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World Journal of Gastroenterology 2017年第39期23卷 7087-7097页

作者： Susana Olmedillas-López dennis César Lévano-Linares Carmen Laura Aúz Alexandre Luz Vega-Clemente Edurne León Sánchez Alejandro Villagrasa Jaime Ruíz-Tovar Mariano García-Arranz damián García-Olmo Foundation Health Research Institute-fundación jiménez díaz university hospital department of Surgery School of Medicine Universidad Autónoma de Madrid department of Surgery Rey Juan Carlos University Hospital department of Pathology Fundación Jiménez Díaz University Hospital department of Biomedicine and Biotechnology Universidad de Alcalá department of Surgery Fundación Jiménez Díaz University Hospital

AIMTo assess KRAS G12d mutation detection by droplet digital PCR (ddPCR) in stool-derived dnA from colorectal cancer (CRC) *** this study, tumor tissue and stool samples were collected from 70 patients with stage I-IV CRC diagnosed by preoperative biopsy. KRAS mutational status was determined by pyrosequencing analysis of dnA obtained from formalin-fixed paraffin-embedded (FFPE) tumor tissues. The KRAS G12d mutation was then analyzed by ddPCR in FFPE tumors and stool-derived dnA from patients with this point mutation. Wild-type (WT) tumors, as determined by pyrosequencing, were included as controls; analysis of FFPE tissue and stool-derived dnA by ddPCR was performed for these patients as *** the total 70 patients included, KRAS mutations were detected by pyrosequencing in 32 (45.71%), whereas 38 (54.29%) had WT tumors. The frequency of KRAS mutations was higher in left-sided tumors (11 located in the right colon, 15 in the left, and 6 in the rectum). The predominant point mutation was KRAS G12d (14.29%, n = 10), which was more frequent in early-stage tumors (I-IIA, n = 7). In agreement with pyrosequencing results, the KRAS G12d mutation was detected by ddPCR in FFPE tumor-derived dnA, and only a residual number of mutated copies was found in WT controls. The KRAS G12d mutation was also detected in stool-derived dnA in 80% of all fecal samples from CRC patients with this point *** is a reliable and sensitive method to analyze KRAS G12d mutation in stool-derived dnA from CRC patients, especially at early stages. This non-invasive approach is potentially applicable to other relevant biomarkers for CRC management.

关键词： droplet digital PCR KRAS Stool Formalin-fixed paraffin-embedded Pyrosequencing Colorectal cancer

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Epidemio-Clinical-Histopathological Aspects and Therapeutics of Squamous Cell Carcinoma of the Conjunctival at the university hospital Center of Bouake

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Open Journal of Ophthalmology 2024年第2期14卷 159-167页

作者： Philippe Emile France Koffi Bile Pierre Windinmanegde djiguimde Gossé François diomandé Zana diabate Kouassi Franck-Hermann Koffi Liliale Ella Godé Ange Mickael Goule Opeyemi Babayeju Yves Ouattara Ibrahim Abib diomande Ophthalmology department University Hospital Center Bouake C&#244te d&#8217Ivoire Ophthalmology department University Hospital Center Bogodogo Ouagadougou Burkina Faso

Introduction: Squamous cell carcinoma of the conjunctiva is one of the most common malignancies in the elderly. Purpose: To describe the specific aspects of squamous cell carcinoma of the conjunctiva and to determine the therapeutic modalities. Materials and Methods: descriptive cross-sectional retrospective study carried out at the university hospital Center of Bouake over a period of 9 years (From January 2015 to december 2023). We identified all malignant oculo-adnexal and orbital tumors whose histopathological diagnosis was confirmed;monitoring the sorting of squamous cell carcinomas of the conjunctiva among these cancers and studying the different parameters linked to them. Results: The average age of patients is 44.3 years. Male predominance with a sex ratio of 1.12. HIV was the majority ATCd with 64.7%. The main reason for consultation was exophthalmos (36.11%). The average consultation time was 10 months 13 days. Invasive differentiated conjunctival squamous cell carcinoma was predominant at 55.56%. Enucleation was the most performed surgical method. Conclusion: Squamous cell carcinoma of the conjunctiva is a malignant ocular tumor of the elderly whose frequency increases in young adults infected with HIV-AIdS. Invasive differentiated forms are increasingly encountered, limiting treatment to mutilating surgery.

关键词： Malignant Tumor Ocular Carcinoma Conjunctiva

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Surgical Treatment of Osteonecrosis of the Femoral Head Using Minimally Invasive Surgical drilling and Cancellous Grafting at Brazzaville university hospital

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Open Journal of Orthopedics 2024年第2期14卷 122-132页

作者： Kevin Parfait Bienvenu Bouhelo-Pam Marius Monka Arnauld Sledje Wilfrid Bilongo Bouyou Regis Perry Massouama Paul Yèlai Ikounga Roger Bertrand Sah Mbou Armand Moyikoua department of Orthopaedic surgery and Traumatology University Hospital of Brazzaville Brazzaville Republic of the Congo Faculty of Health Sciences Marien N’GOUABI University Brazzaville Republic of the Congo

Introduction: Osteonecrosis of the femoral head (OnTF) is a debilitating condition. Several treatments have been proposed with controversial results. The aim of our study was to evaluate treatment by surgical drilling coupled with in situ cancellous grafting. Materials and methods: Our study was a case-control study conducted at Brazzaville university hospital from 1st January 2018 to 31 december 2023. It compared two groups of patients with OnTF: non-operated (13 patients, 20 hips) and operated (22 patients, 35 hips). We used the visual digital scale (VdS) for pain assessment, the Merle d’Aubigne-Postel (MdP) scoring system for clinical and functional assessment, and the evolution of necrosis. Results: The group of non-operated patients had a mean age of 35.69 ± 3.4 years, no improvement in pain with an EVn above seven at the last recoil and a mean global MdP score falling from 12.7 before offloading to 10.13 at one year. The group of patients operated on had a mean age of 37.86 ± 7.02 years, a significant reduction in pain (p = 0.00004) and a significantly increased MdP score (p = 0.0034). A comparison of the two groups of patients showed significant stabilization of the necrotic lesions in the operated patients (p = 0.00067), with better satisfaction in the same group. Conclusion: Surgical drilling combined with grafting in the treatment of early-stage OnTF has improved progress in our series. The technique is reproducible and less invasive. It has made it possible to delay unfavorable progression and, consequently, hip replacement surgery.

关键词： Hip Osteonecrosis of the Femoral Head Conservative Treatment Surgical drilling Bone Grafting

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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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Stereotactic body radiotherapy in pancreatic adenocarcinoma

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Hepatobiliary & Pancreatic diseases International 2024年第1期23卷 14-19页

作者： Carolina de la Pinta Radiation Oncology department Ramón y Cajal University HospitalIRYCISAlcaláUniversity28034 MadridSpain

Background:Stereotactic body radiotherapy(SBRT)in pancreatic cancer allows high delivery of radiation doses on tumors without affecting surrounding *** review aimed at the SBRT application in the treatment of pancreatic *** sources:We retrieved articles published in MEdLInE/PubMed from January 2017 to december *** used in the search included:“pancreatic adenocarcinoma”OR“pancreatic cancer”And“stereotactic ablative radiotherapy(SABR)”OR“stereotactic body radiotherapy(SBRT)”OR“chemoradiotherapy(CRT)”.English language articles with information on technical characteristics,doses and fractionation,indications,recurrence patterns,local control and toxicities of SBRT in pancreatic tumors were *** articles were assessed for validity and relevant ***:Optimal doses and fractionation have not yet been ***,SBRT could be the standard treatment in patients with pancreatic adenocarcinoma in addition to ***,the combination of SBRT with chemotherapy may have additive or synergic effect on pancreatic ***:SBRT is an effective modality for patients with pancreatic cancer,supported by clinical practice guidelines as it has demonstrated good tolerance and good disease *** opens a possibility of improving outcomes for these patients,both in neoadjuvant treatment and with radical intent.

关键词： Chemoradiotherapy Pancreatic adenocarcinoma Radiotherapy Stereotactic body radiotherapy Stereotactic ablative radiotherapy

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