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Open Journal of Anesthesiology 2020年第4期10卷 144-156页

作者： Blaise Adelin Tchaou Nvènonfon Charles Frédéric Tchégnonsi Hervé Philippe Minsili Bikolo Patrick Stéphane Kouomboua Mfin Martin Chobli Service d’Anesthésie-Réanimation et des Urgences Centre Hospitalier Universitaire et Départemental du Borgou/Alibori Parakou Benin

Introduction: The gravity of the clinical state of the patient of intensive care is linked to the existence of one or several lesions and visceral defaults putting its forecast into play. Objective: To determine the prognosis value of two general graveness’ scores of patients admitted to intensive care at University Hospital of Parakou in Benin. Patients and Methods: Descriptive and analytical observational study data were collected from March 1st to June 30th, 2017. The SAPS II and APACHE II were calculated during first 24 hours of hospitalization to assess the clinical graveness and predict patient’s mortality. Results: We enrolled 185 patients representing 89.37% of admissions, majority were men (63.78%). Mean age was 38.89 ± 17.92 years (16 to 99), mean of hospitalization duration was 4.36 ± 2.2 days. Neurological failure was the most common disorder observed (58.37%). Mean SAPS II and APACHE II were 29.54 ± 19.04 and 14.24 ± 10.49 respectively. Mean predicted mortality of SAPS II and APACHE II was 19.12 ± 5.05 and 25.69 ± 5.00 respectively. The mortality rate was 25.95% and increased with severity scores. The sensibility of APACHE II and SAPS II score was 72.90% and 66.70% respectively. SAPS II score was found to be more specific (85.40%) than APACHE II (80.03%). Conclusion: Those severity patient scores accurately predicted the prognosis of patients in intensive care unit and should be integrated into our practice.

关键词： Indications of Gravities Prognosis Mortality Intensive Care

Management of Two Cases of Spina Bifida and Neonatal Genital Prolapse at the University Hospital of Parakou and Review of the Literature

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Open Journal of Modern Neurosurgery 2022年第4期12卷 216-221页

作者： Kouassi Jean Marie Maurin Kisito Quenum Ayaovi Armel Hadonou Toyifia Eudoxie Bernice Quenum Hountondji Sophonie Dokpe Zachée Agbo Matine Balagoun Olatundji Holden Fatigba Service de Neurochirurgie du Centre hospitalo universitaire départemental/borgou Alibori (CHUD/BA) Parakou Benin Service de chirurgie du Centre hospitalo universitaire départemental/borgou Alibori (CHUD/BA) Parakou Benin Centre de prise en charge médicale intégrée des nourrissons et femmes enceintes atteints de la drépanocytose (CPMI-NFED) Parakou Benin

Spina bifida, or spinal dysraphism, is a malformative pathology related to an anomaly in the development of the nervous system, occurring during embryogenesis. The neural tube does not close properly around the 28th day of life and affects the development of the spinal column and spinal cord. Spina bifida is characterised by damage to the nervous system and will generate handicaps and damage of varying degrees: neurological motor, sensory, cognitive, genito-phincter (bladder and anorectal) deficits with consequences for the quality of life of these people. The literature describes the association between spinal dysraphism and genital prolapse. However, genital prolapse is an exceptional and rare entity in newborns. We report the observations of two newborns: the first case of a newborn born at term, at 7 days of age, who presented a prolapse of the uterine cervix in association with myelomeningocele, without any neuromuscular repercussions, and the second case of a newborn at 10 days of age, presenting with a lumbosacral spina bifida and a uterine prolapse. They benefited from conservative medical treatment characterised by manual reduction of the prolapse in both cases with a favourable evolution. In the case of spina bifida, a cure of myelomeningocele was performed surgically with simple postoperative course.

关键词： Spina Bifida Genital Prolapse Neonate Complications CHUD/BA

Impact and Factors Associated with Presbycusis among 50 Years Old People of Parakou and Over in 2021

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第1期11卷 56-73页

作者： Marius Claude Flatin Alexis AWC do Santos Zounon Cocouvi Bruno Ametonou Fatiou Alabi Bouraima Mé ré Roland Kimba Spé ro HR Hounkpatin Wassi Adjibabi Bernadette Vignikin-Yehouessi Faculté de Mé decine Universit&#233 de Parakou Parakou B&#233 nin Centre Hospitalier Universitaire et Dé partemental borgou Parakou B&#233 nin Faculté des Sciences de la Santé Universit&#233 d’Abomey Calavi Cotonou B&#233 nin

Introduction: Presbycusis or age-related hearing loss is a condition of in-sidious onset with significant socio-professional repercussions. The objec-tive of this study was to determine the impact and factors associated with presbycusis among 50 years aged people or older in Parakou commune during 2021. Methods: This was a cross-sectional, descriptive, analytical study with prospective data collection. The study has involved 541 50 years aged people or older, from February to May 2021. For each of them, a questionnaire was completed, otoscopy and tone audiometry performed. The ERSA questionnaire and the logistic regression model were used to determine the impact and factors associated with presbycusis. Results: The mean age was 59.48 ± 9.80 years and the sex ratio was 1.23. The prevalence of presbycusis was 50.28%. Age ≥ 80 years (p = 0.002), male sex (p = 0.016), low educational level (p = 0.001), family history of age-related hearing loss (p = 0.018) and presence of hearing loss (p = 0.001) were significantly associated with presbycusis in multivariate analysis. Of the life domains studied, personal life (mean score = 32.9 ± 10.52) was the most affected. Similarly, communication in a noisy environment (mean score = 4.39 ± 2.39) was the most affected aspect of personal life. Conclusion: Presbycusis leads to an impairment of personal life. A good knowledge of the associated factors and an early management could contribute to the improvement of the hearing health of the elderly.

关键词： Presbycusis Elderly Hearing Deafness

Factors Associated with Non-Compliance among Patients with Chronic Kidney Disease at the Departmental University Hospital of borgou and Alibori in Parakou (Benin)

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Open Journal of Nephrology 2023年第4期13卷 420-434页

作者： Coovi Nonwanou Ignace Tokpanoude Séraphin Ahoui Damien Barikissou Georgia Elvire S. E. Djossou Sayo Djibo Gottfried Agballa Ireti Nethania Elie Ataigba Ismaël Landry Paraiso Omer Adjibode Benoit S. Agossoukpe Rodrigue S. Kakpo-Zannou Badirou Aguemon Unité de Santé Publique de la Faculté des Sciences de la Santé (FSS) Université d’Abomey-Calavi (UAC) Cotonou Bénin Association des Médecins Communautaires du Bénin (AMCB) Parakou Bénin Service de Néphrologie Centre Hospitalier Universitaire Départemental du Borgou Alibori (CHUD/B-A) Parakou Bénin Faculté de Médecine (FMP) Institut de Formation en Soins Infirmiers et Obstétricaux (IFSIO) Parakou Bénin Service de Psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori (CHUD/B-A) Parakou Bénin

Introduction: Therapeutic compliance in chronic kidney disease (CKD) represents a major challenge for the prevention of this condition, which is both a non-communicable disease (NCD) and a complication of other NCDs. Non-adherence to treatment (NOT) is a factor in the poor prognosis of CKD in developing countries, particularly in Benin. The aim of this study was to evaluate therapeutic compliance (TC) and determine the factors associated with non-compliance in patients with chronic kidney disease undergoing treatment at the Departmental University Hospital of borgou and Alibori in Parakou (CHUD/B-A). Patients and Methods: This study was carried out in the Nephrology Department of CHUD/B-A. It was a cross-sectional, descriptive study with analytical aims that ran from December 25, 2022 to March 15, 2023 and covered data from 2017 to 2022. It involved 345 patient records meeting the diagnosis of CKD according to the KDIGO 2012 criteria. NOT was defined by a Girerd score evaluation greater than or equal to 3. Data processing and analysis were performed with R software version 4.3.0. Results: The mean age (SD) of patients was 50 years (±14.9). The prevalence of NOT was 57.1%. Potential predictors of non-adherence were: monthly revenue (p = 0.009), mode of admission (p = 0.001), phytotherapy (p = 0.040), traditional treatment (p = 0.049) and quantity of drugs (p = 0.042). Conclusion: Therapeutic compliance among chronic kidney patients still needs to be improved through awareness-raising sessions.

关键词： Chronic Kidney Disease Therapeutic Non-Adherence Girerd Assessment Chronic Renal Failure Benin

Bilateral Iris Coloboma Revealed by a Decreased Vision: About the First Case in Togo Observed in Kara University Teaching Hospital

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Open Journal of Ophthalmology 2021年第4期11卷 249-252页

作者： Kokou Messan Amedome Codjo Rodrigue Abel Assavédo Yao Ako Patrick Mensah Kossi Dzidzinyo Kokou Vonor Koffi Didier Ayéna Komi Balo Centre Hospitalier Universitaire de Kara Kara Togo Centre hospitalier départemental borgou-Alibori Parakou Benin Centre Hospitalier Universitaire Sylvanus Olympio Lomé Togo Centre Hospitalier Régional de Kara Tomdè Kara Togo Hô pital Secondaire de Bè Lomé Togo

Background: Ocular coloboma is the product of an error in the fetal fissure closure, normally occurring between the fifth and sixth weeks of gestation [1]. It may involve the cornea, iris, zonula, ciliary body, choroid, retina and optic nerve. The incidence of this syndrome is 0.7 per 10,000 live-births [1]. The aim of this observation is to present the first case of bilateral coloboma of the iris [1]. This case was associated with an ametropia causing a decrease in visual acuity. Case Presentation: This was a clinical observation concerning a young 12-year-old patient who consulted for blurring of vision which had progressed for approximately 2 years. The ophthalmologic examination revealed an ametropia with a bilateral notch of the pupillary rim suggesting a bilateral coloboma. There was no association with another coloboma such as chorioretinal coloboma which is quite common and is accompanied frequently by visual symptoms. Conclusion: A visual impairment of the child can indicate ametropia. However, other congenital anomalies can be discovered as was the case in this clinical observation.

关键词： Coloboma Iris Decreased Vision Kara Togo

Pediatric Hypertension in Two University Hospitals in Cotonou, Benin: Presentation, Etiology, Management and Outcome

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Open Journal of Pediatrics 2018年第1期8卷 74-85页

作者： Francis Lalya Didier Adedemy Yevedo Tohodjede Marcelline d’Almeida Linda Ayedadjou Maroufou Jules Alao Pediatrics Unit Centre National Hospitalier Universitaire Hubert K. Maga (CNHU-HKM) Cotonou Benin Pediatrics Unit Centre Hospitalier Universitaire Départemental Borgou-Alibori Parakou Benin Pediatrics Unit Centre Hospitalier Universitaire de la Mère et de l’Enfant Lagune (CHU-MEL) Cotonou Benin

Background: Hypertension (HPT) is a major public health problem. Many studies have attempted to investigate HPT in school children. Few, however, have targeted hospital HPT. We conducted this study to describe the epidemiologic characteristics, etiologies, management, and outcome of hospital HPT in our setting. Methods: This was a prospective and descriptive study carried out from March 01 through June 30, 2017 in the pediatric departments of two university hospitals: Centre National Hospitalier Universitaire Hubert K. Maga and Centre Hospitalier Universitaire de la Mère et de L’Enfant Lagune of Cotonou, Benin. Every consecutive patient aged 3 to 18 years who was admitted to the two hospitals for any reason had his (her) BP measured. Every patient with HPT was reviewed for demographics, history and clinical examination, and laboratory investigations as appropriate. Management was done accordingly. Outcome was also recorded. Results: The hospital frequency of HPT was 1.98% (31 cases/1565 admissions). The male/female ratio was 1.06 (16 males, 15 females). Mean age was 8.5 years ± 4.39 (range, 3 to 16 years). 74.19% patients had Body mass index within -2SD and +2SD. Only one patient had BMI above +3SD. The main etiologies found were renal: acute tubular necrosis (45.16%), acute glomerulonephritis (16.13%), and acute pyelonephritis (12.90%). Diuretics (64.5%), were the main antihypertensive drugs used. A single drug therapy was used in 35.4%, a two-drug therapy in 32.2% and a three-drug therapy in 9.6% of cases. Length of hospital stay was more than one week in 70.97% of cases. Hospital death rate for HPT was 19.35%. The outcome was not known in one patient due to exit from hospital against medical advice. All the other patients fully recovered at one month post-discharge follow-up. Conclusion: HPT presents as a symptomatic disease in our hospitals;it has a renal etiology in most cases and has significant death rate despite treatment. Advocacy with health authorities mu

关键词： Hypertension Hospital Children Benin

Place of Ocular Ultrasound in the Diagnosis of Optic Disc Druses in Developing Countries: About a Case and Review of the Literature

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Open Journal of Ophthalmology 2021年第4期11卷 325-331页

作者： Kokou Messan Amedome Kokou Vonor Codjo Rodrigue Abel Assavédo Nidain Maneh Massaga Dagbe Kossi Dzidzinyo Koffi Didier Ayéna Komi Balo Centre Hospitalier Universitaire de Kara Kara Togo Centre Hospitalier Régional de Kara Tomdè Kara Togo Centre Hospitalier Départemental borgou-Alibori Parakou Benin Centre Hospitalier Universitaire Campus de Lomé Lomé Togo Centre Hospitalier Universitaire Sylvanus Olympio de Lomé Lomé Togo Hô pital Secondaire de Bè Lomé Togo

Background: Druses of the papilla constitute abnormal deposits of calcified hyaline material at the level of the head of the optic nerve. They can be superficial or deep. Aim: The aim of this study is to show the utility of ocular ultrasound in ophthalmology in underdeveloped countries for the characterization of optic disc druse. Case Presentation: Our study relates to a clinical observation of buried papillary druses diagnosed by ocular ultrasound. The ophthalmologic examination revealed an aspect of false papillary edema in the fundus. The ocular ultrasound revealed hyperechogenic deposits buried in the papillary margins, which suggests the deep papillary druses. Conclusion: Ocular ultrasound still has a prominent place in the diagnosis of certain eye conditions despite the new sophisticated means available to ophthalmology to date.

关键词： Ultrasound Druses Hyperechoic Globe

Prognostic Factors for Diabetic Foot at CNHU-HKM

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Journal of Diabetes Mellitus 2024年第1期14卷 20-27页

作者： Annelie Kerekou Hode Alihonou Hubert Dedjan Déo-Gratias Gnaho Centre National Hospitalier Universitaire Hubert Koutoukou Maga Cotonou Benin Centre Hospitalier Universitaire Départemental-Ouémé/Plateau Porto-Novo Porto-Novo Benin

Introduction: Predictions on the prevalence of diabetes mellitus, according to the International Diabetes Federation, indicated 9.3% in 2019 and nearly 10.9% of the general population in 2045. In Benin, the increase in this prevalence, according to the World Health Organization (WHO), is constantly increasing. Diabetic foot is one of its most common complications. The aim of this work was to study the prognostic factors of diabetic foot in the Department of Endocrinology, Metabolism and Nutrition of the CNHU-HKM of Cotonou. Patients and method: This is a descriptive and analytical retrospective study of the prognostic factors of diabetic foot over a period of 3 years from January 2019 to December 2021 in patients who have been hospitalized or followed on an outpatient basis for diabetic foot in the Endocrinology, Metabolism and Nutrition Department of the CNHU-HKM of Cotonou. Results: A total of 112 patients were included in this study. The average age of the patients was 59.70 ± 2.10 years. A male predominance was noted with a sex ratio (M/F) of 1.7. Mixed gangrene and phlegmons were the most common lesions. According to the classification of diabetic feet according to the University of Texas, 59.1% of patients had a 100% risk of amputation. Ten patients died from sepsis (8.9%). The average blood glucose on admission was 2.74 ± 0.23 g/l, reflecting the glycemic imbalance in these patients. There is a statistically significant association between the duration of progression of diabetes, the type of lesion and amputation. Patients whose diabetes has lasted more than 30 years and patients who are not monitored have a greater risk of death. Conclusion: Diabetic patients most often consulted at a late stage, compromising conservative treatment. The duration of diabetes and the type of lesion on admission were the main factors leading to amputation, thus compromising the functional prognosis. As for death, it was mainly linked to irregular monitoring of diabetes and the

关键词： Diabetes Diabetic Foot Prognosis Blood Sugar Imbalence Benin

Evaluation of Suicidal Risk in Sickle Cell Patients Monitored at the Hubert Koutoukou Maga National University Hospital Center in Cotonou in 2022

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Open Journal of Psychiatry 2023年第S2期13卷 479-491页

作者： Guy-Gérard Aza-Gnandji Ireti Nethania Elie Ataïgba Sènan Gratias Koukoubou Kokou Messanh Agbémèlé Soedje Tchedié Etdéchié Elvyre Klikpo Josiane Ezin Houngbe Département de santé Mentale Faculté des Sciences de la santé de l’Université d’Abomey-Calavi Cotonou Bénin Centre National Hospitalier Universitaire Hubert Koutoukou Maga Cotonou Bénin Faculté de Médecine Université de Parakou Parakou Bénin Centre Hospitalier Universitaire Départemental du borgou Alibori Parakou Bénin Département de santé Mentale Faculté des Sciences de la santé de l’Université de Lomé Lomé Togo Centre Hospitalier Universitaire Sylvanus Olympio de Lomé Lomé Togo

Introduction: According to the WHO, suicide is a real public health problem worldwide, and several risk factors have been identified, including pain and chronic illness. Objective: The aim of this study was to assess the suicidal risk in sickle-cell patients. Method: This was a descriptive and analytical cross-sectional study of sickle-cell patients followed up at the University Clinic of Blood Diseases of Hubert Koutoukou Maga National University Hospital Center from August 2022 to November 2022. The instrument used was the Ducher suicide risk self-assessment scale. Results: A total of 65 patients were included. Mean age was 27.04 ± 1.95 years, with extremes of 16 and 50 years, and a peak of 47.69% in the 20 - 30 age group. Women predominated (58.46%), with a sex ratio of 0.71. Somatic complaints accounted for 41.54% of patients’ visits, including 21.54% for pain. Suicidal risk was positive in 44.62%, including 13.85% for severe suicidal risk, and 20% attributed their desire to die to pain. The factor associated with positive suicidal risk was single parenthood (p = 0.02). Of those with a positive suicidal risk, 46% had shared the intention with close relatives (family and friends), but none had used medical services. Conclusion: These data demonstrate the high prevalence of suicidal risk among people with sickle cell disease, and therefore the need for psychosocial intervention in this specific population in Benin.

关键词： Suicidal Risk Sickle Cell Disease Chronic Disease

Posttraumatic Stress Disorder Mediated by Exposure Level in French Civil Firefighters Following a Terrorist Attack: Some Hypotheses towards a Structural Model

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World Journal of Neuroscience 2020年第3期10卷 121-134页

作者： Angelika Wolman Jean-Marie Stève Marion Samor Evelyne Bouteyre Themistoklis Apostolidis Abdessadek El Ahmadi Aix-Marseille University CNRS LNSC UMR7260 Marseille France Service Départemental d’Incendie et de Secours (SDIS 06) Nice France Ecole Nationale Supérieure des Officiers de Sapeurs-Pompiers (ENSOSP) Aix-en-Provence France Service Départemental d’Incendie et de Secours (SDIS 11) Carcassonne France Aix-Marseille University LPCPP Aix-en-Provence France Aix-Marseille University LPS Aix-en-Provence France

To date, few studies have investigated the impact of organizational factors such as organizational status or the rank of firefighters on the development of posttraumatic stress disorder (PTSD) following a terrorist attack. To fill this gap in the scientific literature, this field study aimed to investigate the consequences of terrorist attacks on firefighters’ psychological health in terms of PTSD. Data were collected in France following two terrorist attacks. PTSD was assessed with the PCL-S (DSM-IV) 3 to 6 months after the events. Confirmatory factor analyses (CFAs) with existing PTSD models were inconclusive, leading us to find a two-factor model via an exploratory factor analysis (EFA). A cluster analysis showed different symptom profiles that were influenced by the exposure level. Elements for a structural model explaining PTSD symptoms are proposed and suggest a central role of the exposure level. Firefighters I/II represented an at-risk sub-population, suggesting that PTSD was mainly experienced among those who performed tasks not common to their occupation.

关键词： PTSD Firefighters Terrorist Attack Rank SEM