Prevalence of Refractive Errors among School Children Aged 5 to 15 Years Old at CHU-IOTA

Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school children aged 5 to 15 at CHU-IOTA. Patients and Method: This is a prospective, descriptive cross-sectional study carried out in the ophthalmic-pediatrics department of CHU-IOTA, from October to November 2023. Results: We received 340 school children aged 5 to 15, among whom 111 presented ametropia, i.e. a prevalence of 32.65%. The average age was 11.42 ± 2.75 years and a sex ratio of 0.59. The average visual acuity was 4/10 (range 1/10 and 10/10). We found refractive defects: astigmatism 73.87%, hyperopia 23.87% of cases and myopia 2.25%. The decline in distance visual acuity was the most common functional sign. Ocular abnormalities associated with ametropia were dominated by allergic conjunctivitis (26.13%) and papillary excavation (6.31%) in astigmatics;allergic conjunctivitis (9.01%) and papillary excavation (7.20%) in hyperopic patients;turbid vitreous (0.90%), myopic choroidosis (0.45%) and allergic conjunctivitis (0.45%) in myopes. Conclusion: Refractive errors constitute a reality and a major public health problem among school children.

Serological Profile of Hepatitis D Virus (Hepatitis Delta) in the Hepato-Gastro-Enterology Department of Chu Gabriel Toure

Infection with the defective hepatitis D virus (HDV) co-infects or superinfects a patient carrying hepatitis B virus (HBV). Delta virus infection is relatively common. The seriousness of infection with the hepatitis D virus (HDV), a virus defective in a patient carrying the hepatitis B virus (HBV), lies in its aggravating effect on the associated viral hepatitis B. Our aim was to study the serological profile of HDV in HBsAg-positive patients. As this study was fragmentary, we initiated this study with the aim of investigating the serological profile of HDV in HBsAg-positive patients. This was a descriptive and analytical cross-sectional study that ran from March 2019 to February 2020, a 12-month period. It focused on the population of patients seen and screened positive for HBsAg. We obtained a frequency of 10%. The mean age of our patients was 41.8 ± 13.09 years. The sex ratio was 4.5. VHD RNA was detected in 50% of patients. In 100% of cases, the presence of VHD RNA was associated with advanced fibrosis according to the APRI score, but without any statistically significant link. All HBV-infected patients should be screened for anti-HDV Ac. HDV infection leads to rapid progression to complications of liver disease.

Epidemiological Study of Ametropia at the CHU-BSS of Kati

Introduction: Ametropias or refractive errors are pathologies commonly encountered in ophthalmology characterized by the projection on the retina of a blurry image. There are several types of ametropia and each of them has a specific means of correction. In the literature, numerous data have been reported on the issue through studies that were mostly carried out on infant populations. To better treat ametropia in a more formal way, it is important to know their general characteristics within a larger population, hence the present investigation, the aim of which is to carry out an epidemiological study of ametropia at the Kati University Hospital-BSS. Materials and Methods: The study was carried out at Kati University Hospital-BSS between January 1 and December 31, 2022 and included 663 ametropic patients of all ages. Results: During the study period, 663 cases of ametropia were diagnosed out of 1678 new consultations, representing an incidence of 39.51%. Patients aged between 21 and 40 years were more affected. Depending on the type, these ametropias were dominated by compound astigmatism with 68.75% followed by isolated hyperopia and isolated astigmatism. Visual fatigue was the most mentioned reason for consultation. The female gender was in the majority with 70.9%. Low ametropia (Discussion: The growing visual needs of young people, especially with new information and communication technologies, would push them to consult the ophthalmologist more, and therefore to want optical correction in the event of a refractive anomaly, which would partly explain their high frequency in this age group. Conclusion: It is important to know the general characteristics of ametropia in the general population in order to improve the quality of life of patients affected by it through efficient therapeutic solutions.

Prevalence and Causes of Neonatal Mortality at Chu-Mel, Cotonou in 2023

Introduction: Neonatal mortality represents a global health problem that has been at the core of programs developed by the World Health Organization (WHO) for more than 30 years. In our country, it represents a real scourge and remains high despite the efforts made by the Ministry of Health. The goal of this study was to investigate the prevalence and causes of neonatal mortality at CHU-MEL of Cotonou in 2023. Material and Methods: This was a cross-sectional and descriptive study with retrospective data collection, carried out in the neonatology unit of the Mother and Child Teaching Hospital of Lagune (CHU-MEL) in Cotonou over a period of six months from January 1, 2023 to June 30, 2023. All neonates, premature or full-term, born alive and who died during hospitalization in the unit were included. Results: 211 cases of neonatal deaths were recorded among the 2884 neonates hospitalized in the unit during the study period, representing a hospital prevalence of 7.31%. Early neonatal mortality represented 81.5% of cases. The average age at admission was 4.6 days ± 5.3. The average weight of deceased neonates was 1609.08 ± 798.35 g. The most frequent reasons for hospitalization were represented by prematurity (60.66%) and respiratory distress (23.22%), respectively. Prematurity was the leading cause of neonatal mortality (41.7%), followed by neonatal infections (29.4%) and perinatal asphyxia (10.9%). Conclusion: The prevalence of neonatal mortality in the neonatology unit of CHU-MEL is high. Efforts to improve the quality of perinatal care departments must be intensified to reduce this prevalence.

Thyroidectomy: Frequency and Indications in the General Surgery Department of the Hôpital National Ignace Deen/CHU de Conakry

Introduction: Thyroidectomy is a surgical procedure to remove all or part of the thyroid gland. The aim of this study was to report the results of thyroidectomy in the general surgery department of the Hôpital national Ignace Deen/CHU de Conakry. Methodology: This was a retrospective study, of seven (07) years (January 1, 2016 - August 31, 2023), in the General Surgery Department of the Ignace Deen National Hospital-CHU in Conakry. We included all records of patients admitted and operated on for thyroidectomy and with up-to-date medical records. The variables were epidemiological, clinical and therapeutic. Results: During the study period, we recorded 3221 cases of surgery, including 40 thyroidectomies (1.24% of cases). The average age was 42.4 years. Women were the most represented, with a sex ratio of 0.16. The reason for consultation was anterior cervical swelling in 86% (n = 25) of cases, followed by signs of cervical compression 21% (n = 6) and signs of thyrotoxicosis 31% (n = 9). Indications for thyroidectomy were dominated by homogeneous goitres in 69% (n = 20) of cases, basedow’s disease in 20.7% (n = 6) and nodular goitres in 6.9% (n = 2) of cases. The surgical procedures were lobo-isthmectomies in 72.4% (n = 21), subtotal thyroidectomies 13.8% (n = 4), total thyroidectomies 10.3% (n = 3). Postoperative follow-up was straightforward in 69% (n = 20). Complications included haemorrhage in 20.7% (n = 6) and recurrence in 6.9% (n = 2). The average hospital stay was 7 days. Conclusion: Thyroidectomy is a relatively frequent surgical procedure in our department. Indications are dominated by homogeneous goitres. Morbidity is related to hemorrhage. Rigorous hemostasis could improve the quality of thyroidectomy.

Early Postoperative Deaths in the Surgical Intensive Care Unit of CHU-Kara

Aim: Review of early postoperative deaths in the surgical intensive care unit at CHU-Kara. Introduction: Surgery, one of the means of treatment of diseases, also presents risks for the patient, including early postoperative death linked to numerous risk factors. Methodology: This was a retrospective descriptive study conducted on the records of patients who died within 48 hours after surgery from November 1, 2019 to April 30, 2021. The study was conducted in the surgical intensive care unit and in the operating room. Results: Thirty-two early postoperative deaths or 2.22% out of 1442 operated with 30 deaths retained for the study. Male gender predominated (70%). The average age was 31.22 years. Farmers were more concerned (66.67%). The time to surgery was 1.6 days. ASA1 patients (40%) predominated followed by ASA IV (30%). 80% of patients were operated on as an emergency. Digestive pathologies 80% were more represented. General anaesthesia 86.66% was more practiced associating Propofol, Fentanyl, Ketamine and Atropine more frequently. The average duration of the procedures was 132.5 minutes. Intraoperative complications were associated with cardiac arrest and hemorrhage (33.34%). ASA class higher than 2, dirty surgery (46.67%), and delayed recovery (13.34%) were the incriminating risk factors. Death by hemodynamic shock and respiratory distress were the main causes 26.66%. Conclusion: Early postoperative mortality was high and involved all ages. Anesthesia and surgery, the low level of qualification of the intraoperative actors, the lesser intraoperative security;the association of anesthetic effects, the complexity of intraoperative lesions led to the increase of mortality. The combination of two or more factors was pejorative for the deaths.

Evaluation of the Effectiveness and Nature of Analgesia in the Medical-Surgical Emergency Department of CHU-Donka

Introduction: Pain assessment is an essential step towards pain relief. In our context, however, it is insufficient in emergency departments. The aim was to assess the nature and effectiveness of the analgesia used in the emergency department of the CHU-Donka. Method: This was a single-centre prospective observational study conducted over one month (November 2020) in the medical-surgical emergency department of CHU-Donka. All patients aged 18 or over admitted to the emergency department with moderate to severe acute pain were included. Results: We enrolled 880 patients, 615 of whom (69.88%) were in pain. Males predominated (65.2%), with a sex ratio of 1.87. The average age was 44.78 ± 16.41 years, with extremes ranging from 18 to 85 years. The most represented age group was 18 - 34 years, with 66.18%. Initial assessment of pain by nursing staff in 3 cases. Initial assessment of pain by the investigator was 100%, 74% moderate and 26% severe. No reassessment of pain by nursing staff. Reassessment by the interviewer was 100% and found 5% no pain, 61% mild pain, 24% moderate pain and 10% severe pain. With an average numerical scale of 3.77 ± 2.61 and extremes from 0 to 10. Average length of stay was 2.85 ± 1.48 hours, with extremes ranging from 45 minutes to 8 hours. Analgesia was administered with paracetamol alone (43.58%), combined with tramadol or nefopam. No patient received morphine. Conclusion: This study revealed a lack of pain assessment in our department.

Leontiasis Ossea about a Case Treated at Chu Owendo

Introduction: Leontiasis ossea is the most severe bone complication of the maxillae of chronic renal failure. The objective of this work is to determine the clinical, paraclinical and therapeutic aspects of this condition. Observation: A 42-year-old patient with chronic anuric terminal renal failure dialysis for 12 years had consulted for multiple maxillo-mandibular swelling evolving for 2 years deforming the face with discomfort to chewing. The biological assessment was: PTH: 5252 pg/mL, Ca2+: 2.86 mmol/L, free T3: 4.16 pmol/L, free T4: 6.55 pmol/L, TSH: 3.13 U/mL, serum protein: 61 g/L, Creatinine: 835 μmol/L. The maxillofacial CT noted heterogeneous diffuse thickening of the cranial vault and bones of the facial massif evoking leontiasis ossea with right mandibular brown tumor. The biopsy diagnosed fibrous gingival epulis. The patient had undergone modeling surgery, under general anesthesia after dialysis, of the right mandibular tumor whose histological result was Leontiasis ossea. Conclusion: Treatment is modeling surgery under hemostatic control.

Prevalence and Contributing Factors of Orthostatic Hypotension in the Cardiology Department of the CHU Ignace Deen in Conakry

Introduction: Orthostatic Hypotension (OH) is a frequent situation during consultation in hypertensive patients. The prevalence in the general population increases with age and it is recommended to systematically search for it in patients with multiple comorbidities. The objective of this study was to determine the prevalence of orthostatic hypotension;describe their socio- demographic profile, the various clinical and paraclinical aspects and the predisposing factors of orthostatic hypotension in treated hypertensives, controlled or not. Method: This was a descriptive cross-sectional study, from January 2 to June 30, 2022 in the cardiology department of the Ignace Deen National Hospital. Included in this study were all patients who presented with orthostatic hypotension under antihypertensive treatment, regardless of age and sex, and who agreed to participate in the study. The non-inclusion criteria were hypertensive patients without OH and those who had not agreed to participate in the study. Each patient had blood pressure and heart rate measured in the supine position at room temperature and with an empty bladder. Then the measurement is taken again three (3) minutes after the switch to orthostatism. We retained the diagnosis of OH if the SBP drops by at least 20 mmHg and/or the PAD by at least 10 mmHg three (3) min after the transition to orthostatism. Our data obtained were analyzed in the Epi-info 7.4.0 software. Results: During our study period, we investigated 385 presented with OH, 12.2%. The mean age of the patients was 60.83 years ± 10.01 years and hypertensive patients, 47 of whom the M/F sex ratio was 0.81. In our study, blood pressure was not controlled in 36.2% of our patients with a predominance of grade 3 hypertension, a rate of 55.32%. Renal failure, anemia, heart failure and stroke were the main comorbidities associated with the occurrence of HO. The most incriminated factors were age with a frequency of 74.47%, followed by obesity at 44.68% and diabetes at 27.66%. BP was normally controlled with a rate of 68.8% in treated hypertensive patients with OH. It is found much more in patients using triple therapy, a rate of 61.71%. Conclusion: The prevalence of OH is high in our department. It is found much more in patients using triple therapy. The most incriminated factors were age followed by obesity and diabetes.

Cardio-Renal Syndrome: Epidemiological, Clinical, Paraclinical, Etiological Aspects and Prognostic Factors in the Cardiology Department of the CHU Ignace Deen in Conakry

Introduction: Heart and kidney diseases are common among patients admitted to hospital and they coexist in a significant number of cases. The interactions between the cardiovascular system and the kidney have been known and described for many years and have led to the description of cardio-renal syndrome. The objective of this study was to determine the frequency;to describe the clinical, etiological and prognostic aspects of acute renal failure in patients hospitalized for chronic congestive heart failure. Method: This was a descriptive retrospective study from January 2, 2018 to December 31, 2022. Included in this study were all the complete records of patients hospitalized for chronic congestive heart failure with serum creatinine ≥120 μmol/I. We’re not included in this study, incomplete files, records of patients hospitalized for other pathologies, records of patients hospitalized for chronic congestive heart failure with normal renal function. Our study variables were qualitative and quantitative divided into clinical, paraclinical and prognostic data. Our data were analyzed using the EPI-info 7.2.2.6 software. Data entry and presentation were carried out using Word, Excel and PowerPoint from the 2016 Office Pack. Results: We collected 830 files of which 114 met our selection criteria, a frequency of 13.73%. The mean age of the patients was 47 ± 19 years. The F/M sex ratio was 1.23. The dominant etiologies were hypertension followed by diabetes with respectively 60.5% and 23.7%. Toxic factors including tobacco accounted for 7.9% of cases. Dyspnea accounted for 86.8%. Most of our patients were grade 3 or 36% based on systolic blood pressure on admission with an average of 164.16 ± 33.95 mmHg and an average diastolic blood pressure of 93.24 ± 20.40 mmHg. Biologically, the serum creatinine revealed a high frequency of 201 - 400 μmol/l (33% of cases) with an average value of 586.49 ± 631.44 μmol/l with the extremes 2.960 and 2448.68 μmol/I. Anemia was moderate in 34.2% of cases. Cardiac ultrasound was performed on 81 patients, the results of which showed dilated cardiomyopathy in 48.2% of cases. Renal ultrasound was performed only by 18 patients, renal suffering was found with 8.8%. Almost all (92.11%) of the patients had an acute renal failure of functional origin. More than half (65.80%) of our patients were at risk. Diuretics were the most prescribed antihypertensives with 87.71% followed by ACE inhibitors 78.94%. The average length of hospitalization was 13.81 ± 7.66 days with extremes of 24 hours and 41 days. Conclusion:The association of acute renal failure and chronic congestive heart failure is a frequent situation. The diagnostic approach must be guided by the context and the data of a meticulous examination supplemented by an appropriate paraclinical assessment. Kidney renal failure is mostly functional.

Acute Alithiasis Cholecystitis in Children: Diagnostic and Therapeutic Approach in the Pediatric Surgery Department of the CHU of Conakry

Acute alithiasic cholecystitis (AAC) is the inflammatory disease of the gallbladder in the absence of gallstones. It is a rare pathology in children. The aim was to describe the clinical, diagnostic and therapeutic characteristics of this disease. Materials and Method: This was a 3-year retrospective study (January 2008 to December 2010) including 66 patient records collected for CAA. Results: The frequency of AAC was 3.57%, the mean age of the patients was 8 ± 3.52 years, and there were 36 boys and 30 girls. The main clinical features were right hypochondrial pain (66 cases), positive Murphy’s (66 cases), fever (53 cases) and jaundice or sub-jaundice (51 cases). The main ultrasound signs were thickened vesicular wall 50 cas (75.76%), vesicular distension 50cas (75.76%) and positive ultrasound Murphy 47 cas (71.21%). Medical treatment was exclusive in 64 patients (96.97%) and surgical treatment in 2 patients (3.03%). Conclusion: Acute alithiasic cholecystitis is a rare pathology in children, the clinical picture is not very specific and abdominal ultrasound is the key to early diagnosis. Conservative treatment is the first choice in the absence of any complications.

Septic Hip Arthritis at CHU Gabriel TOURE: Therapeutic and Evolutionary Aspects

Introduction: Septic hip arthritis involves the functional prognosis of the hip in case of joint destruction. The aim of this work was to evaluate the hospital frequency, to determine the therapeutic and evolutionary aspects of septic arthritis of the hip at the trauma orthopedic department of CHU Gabriel TOURE Bamako. Methods: This was a descriptive, monocentric, cross-sectional study of patients with septic hip arthritis, managed from January 2010 to December 2019. Results: We collected 48 patients. Gender male was represented 58.3% with a sex ratio of 1.4. The average age of our patients was 17.02, with extremes of 7 and 80. Septic hip arthritis was observed in a chronic mode in 87.5% (more than 3 weeks). Diagnosis was based on clinical, bacteriological and imaging. Trauma was incriminated in 5 cases (10.4%). The radiographic assessment at the time of the consultation was normal in 66.7% of cases. Staphylococcus aureus was the most common germ with 47.9%, and the culture was sterile in 10.4%. Septic hip arthritis was complicated in 18.75% of cases. Antibiotic therapy was probabilistic with the combination of ciprofloxacin and metronidazole in 24 cases (50%). Watson Jones antero-lateral arthrotomy was performed in 35.71%. We observed 66.6% complications. After an average decrease of 41.6 months, functional results were good in 58.3%. Conclusion: Septic hip arthritis is a serious condition of the child and adolescent. Diagnosis must be early;management must also be early, multidisciplinary and adapted to minimize sequelae.

Acute Renal Failure in COVID-19 Patients in Intensive Care at the CHU du Point G in Mali

Introduction: SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona-virus 2) causes an acute respiratory disease with interstitial and alveolar pneumonia, which can affect several organs including the kidneys [1] [2] [3]. As Mali is no stranger to this pandemic, we report our experience of the management of cases of kidney failure observed in the COVID-19 intensive care unit at the Point G University Hospital Centre (CHU). The aim of this work was to characterise acute renal failure in COVID-19 patients in intensive care, describing the management methods used and determining the vital prognosis. Materials and Methods: This was a retrospective descriptive study, covering an 18-month period from April 2020 to September 2021. We included all patients admitted to the COVID-19 intensive care unit on the basis of a positive RT-PCR and/or the presence of ground-glass images on thoracic computed tomography. Results: We selected 232 patients admitted for COVID-19. Acute Renal Failure (ARF) developed in 71 patients (30.6%). The stages of AKI according to KDIGO were Stage 1 in 28.2%, Stage 2 in 18.3% and Stage 3 in 53.5%. The mean age was 63.96 years, with a standard deviation of 16.6, and males accounted for the majority (71.8%). Organic ARF was found in 80.3% of cases. Risk factors and comorbidities for ARF included advanced age (60.6%), male sex (71.8%), hypertension (52.1%), diabetes (21.1%), invasive mechanical ventilation (71.8%) and septic shock (56.3%). Extra renal purification (haemodialysis) was used in 29.6% of patients. Admission to intensive care ranged from 7 days to 14 days in 43.7% of cases. More than half the patients (52.1%) were in critical condition on admission. Death occurred in 76.1% of patients. Conclusion: ARF appears to occur more frequently in patients with severe COVID-19. It is associated with a poor prognosis.

Vaginal Cystocele Cure at Bouake University Hospital (Chu): Anatomical and Functional Results

Background: Cystocele is an anatomical form of pelvic organ prolapse. It involves herniation of the bladder through the anterior wall of the vagina. Objectives: To report the anatomical and functional results of vaginal cure of cystocele in five cases. Patients and methods: A cross-sectional descriptive study of five patients presenting with a cystocele between January 2021 and December 2022 at the Urology Department of the Bouaké University Hospital (Côte d’Ivoire). All patients underwent vaginal cure of cystocele. The results of the operation were assessed on the basis of judgment criteria. The parameters studied were: age, marital status, profession, history, reason for consultation and outcome of the operation. Results: During the study period, five patients underwent vaginal cystocele surgery. The mean age was 46.6 years with extremes of 32 and 63 years. Three patients were married. All patients had a history of obstructed labour due to fetal macrosomia. 4 patients had grade II cystocele and one patient had grade III cystocele. All patients underwent anterior colpo-perineorrhaphy. The average operating time was 56 minutes (45 - 65 minutes). There was no morbidity. The average hospital stay was 3.6 days. The average duration of the urinary catheter was 2.2 days. At three months post-op, 4 patients had a good anatomical and functional result with a very good degree of satisfaction, compared with one patient who was moderately satisfied and had an average anatomical and functional result. At six months, all five patients had a good anatomical and functional result with a very good degree of satisfaction. Conclusion: Cure of cystoceles by the vaginal route is a technique that offers several advantages, especially the significant reduction in patient morbidity. Its anatomical and functional results demonstrate its reliability.

Epidemiological, Clinical and Angiographic Profile of Chronic Coronary Syndromes in the Catheterization Room. Single-Centre Study Carried Out in the Cardiology Department of the Chu Aristide Le Dantec in Dakar (Senegal)

Background: Ischaemic heart disease is the cause of 7.4 million deaths per year. Their prevention is based on the management of cardiovascular risk factors, but also on the early detection and management of chronic coronary syndromes (CCS), for which few data are available in Africa. The main objective of our study was to determine the factors related to significative coronary artery disease in patients undergoing coronarography for suspected chronic coronary syndrome (CCS). Methodology: We conducted a retrospective descriptive and analytical study over 2 years (from January, 1st, 2018 to December 31st, 2019) in the Cardiology Department of the University Hospital Aristide Le DANTEC in Dakar. All patients admitted for coronary angiography for suspected chronic coronary syndrome were included. Results: One hundred and fifty-two patients were included with a mean age of 60.79 ± 9.73 years, the most represented age group was 60 - 69 years. Advanced age was the most frequent risk factor (77.63%) followed by sedentary lifestyle (56.58%) and hypertension (41.45%). Diabetes was present in 17.1% of cases. A history of angioplasty was found in 1.97% of patients. Typical pain was found in 71.05% of cases, atypical pain in 19.74% and exertional dyspnoea in 2.63%. The pre-test probability was intermediate in 67.1% of cases, low in 25% and high in 7.9%. Significative coronary lesion was found in 52.63% of the patients, while coronary angiography was normal in the remaining cases. Tritroncular status was observed in 37.50%, it was bitroncular in 26.25% and monotroncular in 36.25% of cases. Factors associated with significative coronary artery disease were age (p = 0.0001), diabetes (p = 0.006), previous angioplasty (p = 0.023), previous myocardial infarction (p = 0.018), typical angina (p = 0.001), intermediate pretest probability (p = 0.001). Low pretest probability was significantly correlated with the absence of a coronary lesion with a p = 0.001. Conclusion: Our study shows that screening for chronic coronary disease should be done especially in diabetics, elderly subjects and those with previous angioplasty taking into account symptoms and pretest probability to avoid unnecessary invasive procedures.

State of Knowledge on the Metabolic Syndrome and NASH in the Ivorian Population: Case of People Attending the Diabetology Endocrinology Service of the University Hospital Center (CHU) of Yopougon (Abidjan, Côte d’Ivoire)

Non-alcoholic hepatic steatosis (NASH), characterized by an excessive accumulation of lipids in the liver, is strongly associated with Metabolic Syndrome, which groups together a constellation of cardiovascular risk factors that make it an emerging public health problem on a global scale. The objective of this study was to review the state of knowledge on Metabolic Syndrome and NASH in the Ivorian population. It was a retrospective study conducted over a period of 2 months at the Diabetes Endocrinology Department of the University Hospital Centre (CHU) of Yopougon. It included all patients of any age and sex who were hospitalized or received consultation. The criteria of the Metabolic Syndrome defined by the International Diabetes Federation (IDF) were used to define and calculate the prevalence of the Metabolic Syndrome. Our study found a prevalence of 18.66% of Metabolic Syndrome according to the IDF criteria and a prevalence of 3.33% of NASH in a population of 150 patients hospitalized or received in consultation. There was a predominance of women and older subjects, so the current level of knowledge about Metabolic Syndrome and NASH was low in our study population with only 12%. Indeed, patients over 50 years of age were at higher risk of developing Metabolic Syndrome and NASH. Apart from hyperglycemia, abdominal obesity and arterial hypertension were the most common criteria. Finally, age and body mass index (BMI) were significantly associated with the presence of metabolic syndrome and non-alcoholic fatty liver disease (NASH). However, the awareness of the population, the respect of food hygiene and the implementation of recommended strategies are essential elements in the eradication of these different pathologies.

Review of Laparoscopic Activities at the University Hospital Center (CHU) “Mère-Enfant Luxembourg” in 100 Cases

Introduction: Laparoscopic surgery is a surgical technique that allows to intervene under the control of an endoscope, introduced into the abdominal cavity previously distended by an artificial pneumoperitoneum. We propose in this study to bring the assessment of the laparoscopic activities in the department of general surgery at the CHU MERE-ENFANT “Luxembourg”. Methodology: This was a descriptive cross-sectional study from September 2019 to September 2020 including 100 cases of laparoscopic procedures at the University Hospital Mother and Child “Luxembourg”. All patients regardless of pathology, who underwent laparoscopic surgery with or without conversion to conventional surgery were included in the study. The data were collected from routine media such as the consultation register and the operative report register. Data analysis was performed using SPSS 21 software. Informed consent was obtained from the patients before their inclusion in the study, and each patient was assigned an anonymity number. Results: In our study, the female sex represented of the patients, i.e. 76% with a sex ratio of 3.2. Housewives were 53% of the cases. The majority of patients were in the age range of 16 - 30 in 44% of cases and 75% were married. Overweight/obesity, hypertension and peptic ulcer were the main medical histories with 22%, 12% and 10% respectively. All patients presented with abdominal pain. Cholecystectomy was the main activity during the study with a frequency of 43%, followed by tube surgery and appendectomy. The average duration was 53 minutes for digestive pathologies 48 minutes with extremes of 22 and 66 minutes for gynecological pathologies. One case of injury to the cystic artery was recorded. The conversion rate was 6% of cases. We recorded 5 cases of suppuration as a postoperative complication. The length of stay was 2 - 3 days in 96% of patients. Conclusion: In view of this study, the feasibility of laparoscopic surgery at the CHU Mère Enfant “Luxembourg” is no longer in question. Actions must be taken to reinforce the practice of laparoscopic surgery.

Endometrial Cancer: Epidemiological, Histological and Therapeutic Aspects in the Gynecology-Obstetrics Department of the Donka National Hospital, CHU of Conakry

Objective: To study the epidemiological, histological and therapeutic characteristics of endometrial cancer in the Gynecology-Obstetrics department of the Donka National Hospital, CHU of Conakry. Methods: We conducted a retrospective descriptive study of 86 patients with endometrial cancer treated in the Gynecology-Obstetrics department of the Donka National Hospital from January 1, 2011, to December 31, 2021, based on their medical records. We analysed the epidemiological, histological and therapeutic aspects of the disease. Results: Endometrial cancer accounted for 3.1% of the 2793 gynecological pathology cases registered in the department during the study period, ranking third. The mean age of the patients was 63 ± 5 years. Most of them were uneducated (59.3%), postmenopausal (91.9%), nulliparous (30.2%), obese (65.1%) and hypertensive (77.1%). More than half of the patients (53.4%) were diagnosed at stage I. Endometrioid adenocarcinoma was the predominant histological type (68.6%). Surgery was performed in 96.6% of the patients, and chemotherapy in 14.0%. After a mean follow-up of 15 months, 84.5% of the patients were alive. Conclusion: Endometrial cancer is a common gynecological malignancy in our department. Endometrioid adenocarcinoma is the most frequent histological subtype. Surgery is the main treatment modality.

Surgical Treatment of Recent Traumatic Epiphyseal Detachments of the Distal Femur in the Orthopedic and Traumatological Surgery Department of the CHU Bocar Sidy Sall de Kati: About 20 Cases

Introduction: To our knowledge, no scientific study has been conducted at the university hospital of Kati on recent traumatic epiphyseal detachment fractures of the distal femur. However, every day, children present in consultation for knee trauma. Conjugal plate fractures are by definition single to children. Any break in any solution of continuity of this plate is called an epiphyseal fracture or detachment. Objectives: To evaluate the results of surgical treatment of traumatic epiphyseal in detachments of the distal femur recent in children and adolescents. Patients and Method: This was a 13-month prospectively collected longitudinal descriptive study from September 1, 2016 to September 30, 2017. We identified and reviewed 20 medical records of recent traumatic epiphyseal detachments of the distal femur. The parameters studied were sociodemographic, lesion, surgical technique and evolutionary. Results: During the study period, the most affected group age was 12 to 17 years (85%) with an average of 14.65 ± 1.61 years (6 and 20 years). The victims were male (95%). The most frequent etiology was road traffic accident (95%), with a mean time to care of 26.42 ± 10.21 hours and Type II was frequently encountered (85%) with 35% of immediate complications. Cross-bracketing was the most commonly used surgical technique (85%). The result was good (65%). Conclusion: This study allowed us to observe a significant hospital incidence of epiphyseal detachment fractures of the distal femur. Cross pinning was the most commonly used surgical technique with fewer complications (35%) and a satisfactory result in 90% of cases.

Bilateral Ovarian Fibroma: About a Case Seen at Chu Anosiala, Antananarivo

Ovarian fibroma is a tumor of the stroma and sex cords of the ovary. It is rare and represents 1% to 4% of benign ovarian tumors. It is sometimes associated with Demons-Meigs syndrome, raising suspicion of malignancy at the clinical and paraclinical stages. We report a case of bilateral ovarian fibroma diagnosed in the Pathological Anatomy Department of CHU Anosiala. A 46-year-old woman presented with abdominal pain and pollakiuria. Clinical examination revealed a palpable abdominopelvic mass lateralized to the right. Ultrasound suspected leiomyoma. Foci of microcalcifications were observed. The patient underwent bilateral adnexectomy. The histological study confirmed the diagnosis of bilateral ovarian fibroma. This is the first case of ovarian fibroma reported at the CHU Anosiala.