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Management of Breast Cancer in visceral surgery of cnhu-hkm of Cotonou in Benin

Surgical Science 2016年第3期7卷 170-176页

作者： Dansou Gaspard Gbessi Ismail Lawani Chrystelle Tawo-Nounagnon Francis Moïse Dossou Yacoubou Imorou Souaïbou Delphin Kuassi Mehinto Jean-Léon Olory-Togbe Kémoko Osséni Bagnan Nazaire Padonou visceral surgery a cnhu-hkm Cotonou Benin General surgery CHDU-OP of Porto-Novo Porto-Novo Benin visceral surgery B cnhu-hkm of Cotonou Cotonou Benin

Breast cancer affects more females than males. It occurs earlier with the black females and is often diagnosed at a stage of complication. This study aims to describe its epidemiological characteristics, the changing stages, and to analyze the treatment and means of interdisciplinary and international cooperation in its care and treatment. Our study was retrospective, descriptive and analytic on breast cancer patients received at cnhu-hkm of Cotonou between January 1, 2001 and December 31, 2013. Breast cancer accounts for 24.24% of mammary pathologies and most affects the left breast. Females aged from 40 to 59 years old are the most affected. For males, the average age was 47.5 years old. Patients mostly consult at a later stage where the tumor is already palpable with nodal metastasis. Breast echography and mammography had been done only for 23.85% of the cases. In an anatomical pathology perspective, the invasive ductal carcinoma was the most common type with 87.2%. For the therapeutical aspect, a radical mastectomy according to Patey was realized in 81.65% of the cases;48.65% underwent a chemotherapy and 14.7% were able to do a radiotherapy. The chance at life for patients was decreasing while the life time is increasing. Also, the average life span of patients was increased by the combination of diverse types of treatments notably when radiotherapy is done. The incidence of breast cancers in visceral surgery A and B department of cnhu-hkm-Cotonou is increasing over years.

关键词： Cancer Breast Epidemiology Stage Diagnosis Chemotherapy Radiotherapy

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Spontaneous Infection of Ascites Fluid at the National and University Hospital Hubert Koutoukou Maga in Cotonou: Prevalence and Associated Factors

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Open Journal of Gastroenterology 2024年第1期14卷 1-10页

作者： Aboudou Raïmi Kpossou Comlan N’dehougbèa Martin Sokpon Chloé Andréa Obekandon Opè Mahouton Jacques Tovizounkou Kadiatou Diallo Rodolph Koffi Vignon Jean Séhonou University Clinic of Hepato-Gastroenterology National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin University Clinic of Internal Medicine CNHU-HKM Cotonou Benin Department of Internal Medicine Donka National Hospital Conakry Guinea

Background: Spontaneous ascites fluid infection (SAFI) is an extremely serious and frequently encountered complication in cirrhotic patients. We aimed to determine the prevalence of SAFI and the factors associated with it in the largest hospital in Cotonou. Methods: This was a retrospective descriptive and analytical study conducted from January 2013 to July 2019, at the National and University Hospital Hubert Koutoukou Maga (cnhu-hkm) in Cotonou, Benin. All patients followed in the University Clinic of Hepato-Gastroenterology and diagnosed with SAFI were included. Results: Eighty-two patients were included, predominantly males (69.5%), with a mean age of 51.5 ± 14.5 years. Among them, 32 had SAFI, i.e., a prevalence of 39%. Of the 32 cases of SAFI, the culture of ascites fluid was positive in 6 cases (18.7%). The most frequent germ found in SAFI was Escherichia coli (5 patients, 83.3%). The factors associated with SAFI in this study were: abdominal pain (p = 0.004), increased bilirubinemia (p = 0.009), decreased prothrombin level 20 (p = 0.001). Conclusion: SAFI was common in cirrhotic patients in the department. Certain clinical and paraclinical factors were associated with it, as was the severity of cirrhosis. Early diagnosis and aetiological management of cirrhosis could reduce its frequency.

关键词： Ascites Infection Cirrhosis Cotonou

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Macroangiopathic Complications and Associated Factors in Type 2 Diabetics at cnhu-hkm

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Journal of Diabetes Mellitus 2024年第1期14卷 13-19页

作者： Annelie Kerekou Hode Hubert Dedjan Gaëtan Ayina Endocrinology Metabolism and Nutrition Department CNHU-HKM Cotonou Benin Department of Medicine and Medical Specialties CHUD-OP Porto-Novo Benin

Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descriptive cross-sectional study with an analytical aim covering the period from January 2019 to December 31, 2021 in the Endocrinology, Metabolism and Nutrition clinic of the National Teaching Hospital Hubert Koutoukou Maga (cnhu-hkm) We thus identified 150 type 2 diabetic patients. Results: The prevalence of macroangiopathy was 60% with 11.3% for stroke, 28.6% for acute coronary syndrom, 4% for cervical macroangiopathy, and 46.97% ± 25.36% for obliterating arteriopathy of the lower limbs (OALL). The mean age of the patients was 57.69 ± 1.77 years with a sex ratio 1. The duration of diabetes progression was greater than 10 years for more than half of the patients 52.6%. The main associated cardiovascular risk factors were arterial high blood pressure (64.7%), family history of diabetes (33.7%), obesity with 20.0%. The death rate was 7.3%. Conclusion: Macroangiopathy’s mortality rate of in type 2 diabetics is high. Prevention remains the best treatment and involves screening for factors associated with macroangiopathy.

关键词： Type 2 Diabetes Macroangiopathy Coronary Artery Disease Stroke Peripheral Arterial Disease

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Hypoglycaemiac Medicinal Plants Used by Diabetics at cnhu-hkm

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Journal of Diabetes Mellitus 2024年第1期14卷 41-48页

作者： Annelie Kerekou Hode Hubert Dedjan Léonce Gaba Department of Endocrinology Metabolism Nutrition of cnhu-hkm Cotonou Bénin Department of Medicine and Medical Specialties of the CHUD-OP Porto-Novo Benin

Introduction: Diabetes is a major public health problem. Medicinal plants are frequently used either combine with industrial treatment or exclusively, in Africa and particularly in Benin. Our study aims to identify the different medicinal plants used by diabetic patients at the cnhu-hkm. Method: we carried out a descriptive and analytical cross-sectional study. It took place at the University Clinic of Endocrinology, Metabolism and Nutrition of cnhu-hkm over a of 3 months period from 20th of June to 16th of September, 2022, over diabetic followed-up. Results: One hundred and seventy-three (173) patients were gathered using an anonymous inquiry form. In the study population, the age of the patients varied between 31 and 75 years with an average age of 59 +/− 1.43 years, women represented 59% with a sex ratio (male/female) of 0.69. Sixty-five (65) or 37.6% of the population had used medicinal plants. Among given reasons for using medicinal plants were, mainly the positiveness on a third party. Data analysis outcome twenty-nine species of plants belonging to twenty (20) botanical families, the most represented being the Annonaceae and Fabaceae. The most used species are Phyllanthus amarus (hlenwé in fon), Mangifera indica (mangatin in fon), Momordica charantia (gninsikin in fon), Combretum micranthum (kinkéliba in fon), and Picralima nitida (ayorkpè in fon). Most used parts of the plants are the leaves. The recipes are prepared mainly by infusion and are administered exclusively by mouth. Most of the patients who used the hypoglycaemic medicinal plants were satisfied and no adverse effects were reported by them. Conclusion: Hypoglycaemic medicinal plants could be subjected to pharmacognosy and marketed due to their richness in active components, after further toxicological studies.

关键词： Diabetes Hypoglycaemic Medicinal Plants Glycemic Imbalance Chronic Complications Benin

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Factors Associated with High Blood Pressure and Diabetes Cormobidity in Littoral Department of Benin, in 2023

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Open Journal of Internal Medicine 2024年第2期14卷 188-212页

作者： Rodrigue Sèmèvo Kakpo Zannou Georgia Barikissou Damien Léopold Codjo Coovi Nonwanou Ignace Tokpanoude Elvire Sègnon Eurydice Djossou Folabi Femi Teddy Attonde Lorens Sènan Zinsalo Mondoukpe Mouinatou Tao Marius Esse Badirou Aguemon Public Health Unit Faculty of Health Sciences University of Abomey-Calavi (UAC) Cotonou Bnin Cardiology Service National Hospital and University Center Hubert Koutoukou Maga de Cotonou (CNHU-HKM) University of Abomey-Calavi (UAC) Cotonou Bnin

Introduction: The number of people suffering from diabetes and hypertension (HBP) is increasing worldwide and particularly in sub-Saharan Africa, despite the fact that they are preventable. The aim of our study is to determine the factors associated with hypertension and diabetes comorbidity in the Department of Littoral in 2023. Study Setting and Methods: Our study took place in the Department of Littoral in Benin. It was a cross-sectional general population study conducted over a three-month period from April 10 to July 10, 2023. It included subjects aged 18 and over with or without a history of hypertension and/or diabetes. The sampling method was probabilistic and the technique used was a WHO three-stage cluster survey. The dependent variable is comorbidity of hypertension and diabetes. A logistic regression model was used to identify factors associated with hypertension-diabetes comorbidity. Results: The study population was predominantly female (59.9%). The mean age was 44 ± 17. A total of 48 (8.8%) of the subjects in the study suffered from both diabetes and hypertension. Factors associated with comorbidity of hypertension and diabetes were age ≥ 50 years (OR: 5.48;95% CI: 2.69 - 12.20;p = 0.001);male sex (OR: 2.98;95% CI: 1.39 - 6.46;p = 0.005);too much salt or salty sauce consumed (OR: 6.06;95% CI: 1.56 - 22.20;p = 0.034);abdominal obesity (OR: 6.12;95% CI: 2.79 - 14.3;p = 0.001). Conclusion: Hypertension and diabetes are emerging as major public health problems in Benin. The main associated factors were age, gender, the amount of salt or salty sauce consumed and abdominal obesity. A response is urgently needed to act on the factors identified in order to avoid possible complications and an increase in prevalence.

关键词： Comorbidity Hypertension-Diabetes Associated Factors Littoral Department Benin

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Epidemiological Aspects and Results of the Management of Polycystic Ovary Syndrome at the cnhu-hkm of Cotonou

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Open Journal of Endocrine and Metabolic Diseases 2022年第12期12卷 266-282页

作者： Annelie Kerekou Hode Justin Lewis Denakpo Dedjan A. Hubert Mohamed Dakin Esther Techeme Department of Endocrinology Metabolism and Nutrition-CNHU-HKM Cotonou Benin Department of Gynecology and Obstetric-cnhu-hkm Cotonou Benin

Introduction: Polycystic Ovarian Syndrome (PCOS), also known as Stein Leventhal Syndrome, is one of the common endocrine diseases affecting women of childbearing age and the leading cause of anovulatory infertility worldwide. The aim of this study was to describe the clinical, paraclinical and therapeutic aspects of PCOS at the University Clinic of Obstetrics and Gynaecology of the National Hospital and University Centre Hubert Koutoukou MAGA of Cotonou (cnhu). Patients and Method: The study was doing in the University Clinic of Gynecology and Obstetrics of the cnhu-hkm. This was a descriptive and analytical longitudinal study with retrospective and prospective data collection over a period of 7 years from January 2015 to December 2021. It focused on women of childbearing age seen in gynecological consultation. Results: The frequency of PCOS was 2.53%. The mean age of the patients was 27.28 ± 6.55 years. They were educated for the most part with a university level in 43.8% of cases. Obstetrically they were nulligest (45.63%) and nulliparous in 60% of cases. The history of spontaneous miscarriages was found in 61.11%. The main reasons for consultation were menstrual disorders (51%) followed by the desire for pregnancy (40.6%). Clinically, obesity (30%), overweight (33.1%), high blood pressure (20.63%), hirsutism (24%) and acne (27%) were noted. All the women had micropolycystic ovaries in ultrasound. Testosterone was elevated in 61% of cases. Phenotype D was found in 45.63% of patients. All these patients were put under lifestyle and dietary measures, Metformin (13.80%) and estrogen-progestogen (18.80%). The outcome of the treatment was assessed by cycle regularity, regression of hirsutism, weight loss, fertility and fertility. The cycle was normalised in most cases with notable regression of physical signs of hyperandrogenism. The cycle was normalized in most cases with the notable regression of physical signs of hyperandrogenism. We had recorded 25 pregnancies incl

关键词： Hirsutism Spaniomenorrhea Hyperandrogenism Insulin Resistance Metformin

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Prevalence and Factors Associated with Erectile Dysfunction in Diabetic Patients at the National University Hospital Center Hubert Koutoukou Maga in Cotonou

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Journal of Diabetes Mellitus 2023年第3期13卷 239-247页

作者： Annelie Kerekou Hode Hubert Alihonou Dedjan Aurel Mazaman-Esso Lantokpode Department of Endocrinology Metabolism Nutrition CNHU-HKM Cotonou Bénin Department of Internal Medicine CNHU-HKM Cotonou Bénin

Erectile dysfunction was one of the most common complications in diabetic patients. According to several studies, its prevalence was two to three times higher in diabetics than in the general population. But it has often been overlooked despite the fact that it seriously affects the quality of life. The aim of this study was to determine the prevalence of erectile dysfunction and its associated factors in diabetics’ patients. This was a cross-sectional analysis study of 76 male diabetic patients who consulted by the Department of Endocrinology from June 22, 2019 to September 25, 2019. Erectile dysfunction was diagnosed by calculating the IIEF score. Statistical comparisons were made between patients without and with Erectile dysfunction chi-square test with a significance level p Conclusion: This study showed a high prevalence of erectile dysfunction in diabetics. Significant concomitant factors were hypertension, diabetes imbalance and the duration of diabetes. It was, therefore, important to include systematic screening for erectile dysfunction at least annually, as well as other complications of diabetes.

关键词： Erectile Dysfunction Diabetes Diabetes Imbalance High Blood Pressure Bénin

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Glycated Haemoglobin Determination in the Biological Follow-Up of Diabetic Subjects Admitted to the Endocrinology Department of the cnhu-hkm of Cotonou

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Journal of Diabetes Mellitus 2023年第1期13卷 36-44页

作者： Annelie Kerekou Hode Hubert Dedjan Nesme Aboudou Department of Endocrinology Metabolism and Nutrition CNHU-HKM Cotonou Benin

Introduction: One of the biological markers for monitoring glycaemic control in diabetic patients is glycated protein. The definition of a reference method to improve the accuracy of measurement tools is necessary. The aim of our study was to assess the glycemic control of diabetic patients based on glycated hemoglobin. Patients and Method: This is a descriptive cross-sectional study conducted in April 2021 at the national university hospital center (cnhu-hkm) of Cotonou. All patients who consulted during the period and who gave their consent were included. After collecting the blood samples according to the classical standards of the pre-analytical phase, we measured the blood glucose level and the HbA1c. Results: The mean blood glucose level of the patients was 1.52 ± 0.16 g/L with extremes of 0.80 g/L and 3.5 g/L. The mean HbA1c proportion was 8.39% ± 0.60% with a minimum and maximum value of 5.40% and 16% respectively. We also noted that the mean body mass index (BMI) of the patients was 28.61 ± 1.46 Kg/m2 with extremes of 17.50 Kg/m2 and 46.02 Kg/m2. Oral anti diabetic and hygienic-dietary measures were used by 44 patients (80%) and hygienic-dietary measures (HDM) only used by 9.09%. A frequency of 87.53% of patients had at least one degenerative complication. Retinopathy was the most observed degenerative disease (36.36%) followed by cardiovascular disease (25.45%). Conclusion: This study showed that there is a poor correlation between fasting blood glucose and glycated haemoglobin levels, which could be due to several biological and clinical reasons. It also showed that despite the respect of hygienic dietary measures and a well conducted treatment, it is difficult to obtain a satisfactory glycemic balance in obese patients.

关键词： Glycemia Glycated Haemoglobin Diabetes Benin

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Panorama, Reasons for Seeking Care and Evolution of Systemic Autoimmune Diseases in Benin Hospitals in 2021

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Open Journal of Internal Medicine 2023年第1期13卷 76-84页

作者： Agbodandé Kouessi Anthelme Wanvoégbè Finangnon Armand Dossa Marie Flora Falade Ange Assogba Mickael Dansou Eugénie Azon Kouanou Angèle Department of Internal Medicine National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin

Introduction: Systemic autoimmune diseases have been poorly studied in sub-Saharan Africa and their frequency is not well known. This study provided an overview of the main reasons for the use of care and their evolution in the main hospitals in Benin. Methods: This was a multi-centric descriptive cross-sectional study conducted in the internal medicine, rheumatology, dermatology and nephrology departments of nine (09) public and private hospital centers in Benin over a 57-month period, from January 1st, 2017 to September 30th, 2021. It involved patients followed for a systemic autoimmune disease. The data was collected with a digital survey sheet and then processed and analyzed with the R software (version 3.4). Results: Two hundred and three (203) patients were recorded, which represents a hospital frequency of 0.13%. The mean age was 44 years and the sex ratio (M/F) was 0.29. Connective tissue disease accounted for 95.07% of systemic autoimmune diseases which were dominated by rheumatoid arthritis (40.9%) and systemic lupus (37.4%). Ten cases of vasculitis have been reported and dominated by Behçet’s disease (40%). The main reasons for seeking care were asthenia, weight loss and fever. Arthralgia and skin lesions are the main guiding signs. Six deaths (3.1%) were recorded among connective tissue disease and 1 death (10%) among vasculitis. Conclusion: In spite of being rare, systemic autoimmune diseases are a reality in Benin. A general population study would provide a better understanding of clinical characteristics and identify prognostic factors.

关键词： Systemic Autoimmune Diseases Connectivitis Vasculitis Benin

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Clinical Presentation and Evolution of Systemic Lupus at the cnhu-hkm of Cotonou (Benin)

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Open Journal of Internal Medicine 2023年第4期13卷 447-460页

作者： Agbodandé Kouessi Anthelme Wanvoegbè Finangnon Armand Adelakoun Babatundé Abdul-Farid Akogbeto Dieu-Donné Dansou Eugénie Assogba Mickael Azon Kouanou Angèle Department of Internal Medicine National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin

Introduction: Systemic lupus erythematosus (SLE) is a non-organ-specific autoimmune disease with an unknown origin. The unchanged trend of premature mortality in systemic lupus erythematosus shows the critical unmet need for improved and optimized management of systemic lupus erythematosus. Objectives: To analyze the clinical features and the prognostic factors of death in SLE at the cnhu-hkm of Cotonou. Patients and Methods: This was a retrospective cohort study. It was conducted over the period from January 1st 2010 to December 31st 2021. The study population consisted of all patients followed for SLE in the internal medicine, rheumatology, nephrology and dermatology wards at the cnhu-hkm of Cotonou. Results: 88 cases were recorded in 12 years, i.e. an incidence of 7 cases per year. There were 80 women and 8 men with a mean age of 36.4 ± 13.1 years. The clinical picture was dominated by mucocutaneous (86.3%) and osteoarticular (71.5%) disorders. The biological abnormalities observed were anemia (78.8%), lymphopenia (43.1%) and thrombocytopenia (17.7%). 39 patients had renal damage (44.3%). The incidence of death was 17%. Factors associated with death were renal involvement, infectious complications, high initial SLEDAI score, flare, thrombocytopenia and lymphopenia. Conclusion: Mortality related to SLE remains high at the cnhu-hkm of Cotonou. Renal involvement, infectious complications, high initial SLEDAI score, flare, lymphopenia and thrombocytopenia were the factors associated with death. The presence of these factors should lead to an evaluation of the treatment.

关键词： Systemic Lupus Erythematosus Death Prognosis cnhu-hkm

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