Background: The ovarian reserve, which is an important marker in the management of couple infertility, undergoes depletion over time. This depletion could accelerate in the presence of certain circumstances, such as o...Background: The ovarian reserve, which is an important marker in the management of couple infertility, undergoes depletion over time. This depletion could accelerate in the presence of certain circumstances, such as obesity. The contradictory results of studies on the impact of obesity on the ovarian reserve throughout the world accelerated ovarian ageing in infertile women from Kinshasa, as well as the high rate of obese women in this population, seemed necessary to undertake this study to find out if this obesity impacted the ovarian reserve of Kinshasa women. The objective of this study was to identify the profile of markers of ovarian reserve in obese infertile patients according to certain characteristics. Method: A case-control study with retrospective data collection on 439 obese infertile patients (cases) and 439 normal-weight infertile patients (controls) who had consulted for the desire to conceive at the University Hospital of Kinshasa and the Edith Medical Center between January 2016 and December 2021. Results: The average age of the patients was 33.6 years ± 4.3 years, with 47.8% of patients aged at least 35 years. Menarche and menstrual duration were correlated with AMH in linear regression (p = 0.043 and 0.021, respectively). Late menarche and irregular cycle were risk factors for ovarian ageing [OR: 4.6;95% CI: (1.052 - 20.636);p = 0.043 and OR: 4.8;95% CI: (1.633 - 14.566);p = 0.005] while PCO was a protective factor for ovarian ageing [OR: 0.109;95% CI: (0.182 - 0.652);p = 0.015]. Conclusion: Within the limits of our study, we found that the more obese the patients were, the faster the ovaries aged.展开更多
Context and Objective: The practice of outpatient anaesthesia has many advantages over anesthesia with conventional hospitalisation, particularly in the reduction of post-operative complications and the faster resumpt...Context and Objective: The practice of outpatient anaesthesia has many advantages over anesthesia with conventional hospitalisation, particularly in the reduction of post-operative complications and the faster resumption of activity, etc. No study has been carried out on this subject in our community;this study was carried out in order to come up with a concrete state of play when it comes to outpatient anesthesia for medical and surgical procedures in the city of Kinshasa. Methodology: This was a cross-sectional study, which took place in seven hospitals in the city of Kinshasa from 1 November 2020 to 31 January 2021. The population consisted of all patients who received outpatient anesthesia and the included patients had signed an informed consent. The variables of the study were the general profile of patients, surgical procedures and indications, anesthetic data and patient evolution. Statistical analyses were performed with SPPS 21.0 with p Results: We collected data from 971 patients who had undergone anesthesia in the seven medical facilities in the city of Kinshasa. Among these patients, 394 had benefited from outpatient anesthesia, i.e. a frequency of outpatient anesthesia estimated at 40.5%. Three hundred and ninety-four (394) patients were selected. They were 58.6% women and 41.4% men i.e. a sex ratio M/F of 0.7. The mean age was 39.3 ± 18.7 years with the extremes of 1 and 82 years. Gastroscopy was the most performed (operative) procedure (21.6%). Patients were classified as ASA 1 in 75.1%, narcosis (80.7%) using propofol (80.2%) was the most used anesthetic technique and performed by a specialist doctor in Anesthesia in 65.5%. Suxamethonium was the most used curare in 13.2%. Fentanyl was the most used opioid in 14.5%. Bupivacaine (10.9%) was the most widely used local anesthetic. Eleven patients or 3.2% had complications and, i.e. (0.8%) were hospitalized, class ASA II appeared to be a factor associated with complications. Conclusion: Ambulatory anesthesia is a reality in the city of Kinshasa;however, it is still underdeveloped and mainly concerns explorations (gastroscopy, colonoscopy, laparoscopy…) and some minor procedures. This anesthesia mainly uses propofol and is done by the specialist doctor. A high-powered study and an evaluation of this practice in the light of international recommendations would be useful.展开更多
Context: Polycystic ovary syndrome (PCOS) is considered a syndrome related to the metabolic syndrome with a high risk for developing diabetes mellitus. The evaluation of the glycated hemoglobin (HbA1c) seems to be an ...Context: Polycystic ovary syndrome (PCOS) is considered a syndrome related to the metabolic syndrome with a high risk for developing diabetes mellitus. The evaluation of the glycated hemoglobin (HbA1c) seems to be an interesting tool to detect states of hyperglycemia that may be associated with this syndrome and to understand her pathophysiology. Aims: The purposes of this study are to determine the profile of HbA1c in Congolese women with PCOS, to determine the frequency of states of hyperglycemia and to assess the impact of this marker on clinical signs on this syndrome. Material and methods: This is a case-control study of 130 Congolese subfertile women;65 with a diagnosis of PCOS and 65 others without PCOS. This is conducted from June 2016 to June 2019 among Congolese women of childbearing age. All these women were recruited at the subfertility outpatient clinic of the University Hospital of UNIKIN as well of the YANGA medical centers in Kinshasa, Democratic Republic of Congo. Sickle cell disease was excluded as also the cases of anemia. HbA1c was assayed via the immunoturbidimetric method and the results interpreted according to the ADA recommendations with a pathological cut-off point ≥ 6.5%. Results: Mean hemoglobin was 11.6 ± 1.2 g/dl (11.5 ± 1.1 g/dl vs. 11.8 ± 1.4 g/dl, P = 0.568). The proportion of diabetics was 1.6% (1.6% vs. 1.5%, P = 0.74). Higher HbA1c values were noted in the PCOS group compared to the control group (7.3% ± 2.1% vs. 5.6% ± 0.6%, P 0.001). The multivariate analysis showed a strong correlation between elevated HbA1c levels and PCOS (OR 14.79 (CI 5.43 - 40.32), P 0.001). In the PCOS group, higher HbA1c values were significantly correlated with a higher socio-economic status (OR 3.38 (1.67 - 8.47), P = 0.018) and with obesity (OR 3.48 IC (1.31 - 7.13) P = 0.029). A perfect, positive and significant linear correlation was found between HbA1c and fasting blood glucose (r = 0.807). 60% of women in the PCOS group had pathological values of HbA1c (≥6.5%)展开更多
文摘Background: The ovarian reserve, which is an important marker in the management of couple infertility, undergoes depletion over time. This depletion could accelerate in the presence of certain circumstances, such as obesity. The contradictory results of studies on the impact of obesity on the ovarian reserve throughout the world accelerated ovarian ageing in infertile women from Kinshasa, as well as the high rate of obese women in this population, seemed necessary to undertake this study to find out if this obesity impacted the ovarian reserve of Kinshasa women. The objective of this study was to identify the profile of markers of ovarian reserve in obese infertile patients according to certain characteristics. Method: A case-control study with retrospective data collection on 439 obese infertile patients (cases) and 439 normal-weight infertile patients (controls) who had consulted for the desire to conceive at the University Hospital of Kinshasa and the Edith Medical Center between January 2016 and December 2021. Results: The average age of the patients was 33.6 years ± 4.3 years, with 47.8% of patients aged at least 35 years. Menarche and menstrual duration were correlated with AMH in linear regression (p = 0.043 and 0.021, respectively). Late menarche and irregular cycle were risk factors for ovarian ageing [OR: 4.6;95% CI: (1.052 - 20.636);p = 0.043 and OR: 4.8;95% CI: (1.633 - 14.566);p = 0.005] while PCO was a protective factor for ovarian ageing [OR: 0.109;95% CI: (0.182 - 0.652);p = 0.015]. Conclusion: Within the limits of our study, we found that the more obese the patients were, the faster the ovaries aged.
文摘Context and Objective: The practice of outpatient anaesthesia has many advantages over anesthesia with conventional hospitalisation, particularly in the reduction of post-operative complications and the faster resumption of activity, etc. No study has been carried out on this subject in our community;this study was carried out in order to come up with a concrete state of play when it comes to outpatient anesthesia for medical and surgical procedures in the city of Kinshasa. Methodology: This was a cross-sectional study, which took place in seven hospitals in the city of Kinshasa from 1 November 2020 to 31 January 2021. The population consisted of all patients who received outpatient anesthesia and the included patients had signed an informed consent. The variables of the study were the general profile of patients, surgical procedures and indications, anesthetic data and patient evolution. Statistical analyses were performed with SPPS 21.0 with p Results: We collected data from 971 patients who had undergone anesthesia in the seven medical facilities in the city of Kinshasa. Among these patients, 394 had benefited from outpatient anesthesia, i.e. a frequency of outpatient anesthesia estimated at 40.5%. Three hundred and ninety-four (394) patients were selected. They were 58.6% women and 41.4% men i.e. a sex ratio M/F of 0.7. The mean age was 39.3 ± 18.7 years with the extremes of 1 and 82 years. Gastroscopy was the most performed (operative) procedure (21.6%). Patients were classified as ASA 1 in 75.1%, narcosis (80.7%) using propofol (80.2%) was the most used anesthetic technique and performed by a specialist doctor in Anesthesia in 65.5%. Suxamethonium was the most used curare in 13.2%. Fentanyl was the most used opioid in 14.5%. Bupivacaine (10.9%) was the most widely used local anesthetic. Eleven patients or 3.2% had complications and, i.e. (0.8%) were hospitalized, class ASA II appeared to be a factor associated with complications. Conclusion: Ambulatory anesthesia is a reality in the city of Kinshasa;however, it is still underdeveloped and mainly concerns explorations (gastroscopy, colonoscopy, laparoscopy…) and some minor procedures. This anesthesia mainly uses propofol and is done by the specialist doctor. A high-powered study and an evaluation of this practice in the light of international recommendations would be useful.
文摘Context: Polycystic ovary syndrome (PCOS) is considered a syndrome related to the metabolic syndrome with a high risk for developing diabetes mellitus. The evaluation of the glycated hemoglobin (HbA1c) seems to be an interesting tool to detect states of hyperglycemia that may be associated with this syndrome and to understand her pathophysiology. Aims: The purposes of this study are to determine the profile of HbA1c in Congolese women with PCOS, to determine the frequency of states of hyperglycemia and to assess the impact of this marker on clinical signs on this syndrome. Material and methods: This is a case-control study of 130 Congolese subfertile women;65 with a diagnosis of PCOS and 65 others without PCOS. This is conducted from June 2016 to June 2019 among Congolese women of childbearing age. All these women were recruited at the subfertility outpatient clinic of the University Hospital of UNIKIN as well of the YANGA medical centers in Kinshasa, Democratic Republic of Congo. Sickle cell disease was excluded as also the cases of anemia. HbA1c was assayed via the immunoturbidimetric method and the results interpreted according to the ADA recommendations with a pathological cut-off point ≥ 6.5%. Results: Mean hemoglobin was 11.6 ± 1.2 g/dl (11.5 ± 1.1 g/dl vs. 11.8 ± 1.4 g/dl, P = 0.568). The proportion of diabetics was 1.6% (1.6% vs. 1.5%, P = 0.74). Higher HbA1c values were noted in the PCOS group compared to the control group (7.3% ± 2.1% vs. 5.6% ± 0.6%, P 0.001). The multivariate analysis showed a strong correlation between elevated HbA1c levels and PCOS (OR 14.79 (CI 5.43 - 40.32), P 0.001). In the PCOS group, higher HbA1c values were significantly correlated with a higher socio-economic status (OR 3.38 (1.67 - 8.47), P = 0.018) and with obesity (OR 3.48 IC (1.31 - 7.13) P = 0.029). A perfect, positive and significant linear correlation was found between HbA1c and fasting blood glucose (r = 0.807). 60% of women in the PCOS group had pathological values of HbA1c (≥6.5%)
