Frontal Sinus Fractures: Management at the Yalgado Ouedraogo University Hospital Centre (Burkina Faso)

Introduction: Frontal sinus fractures are potentially serious. They are defined as a solution of continuity, open or closed, of one or both bone tables of the frontal sinus. This study aims to report on the management of them at the Yalgado OUEDRAOGO University Hospital Centre. Methodology: It is a descriptive cross-sectional study with retrospective collection from January 01, 2016 to December 31, 2018. Patients with frontal sinus fractures were managed at the Yalgado OUEDRAOGO University Hospital Centre through CT-scan proof. Results: Over three years, a total of 102 cases of frontal sinus fractures were collected with 29.9 years as average age. There were 96 men. Workers in the informal sector and pupils/students represented 58.90% of patients. The residence of the patients was urban in 68.80% of cases and rural in 31.40%. Road traffic accidents (RTAs) happened in 90.20%, and involved 2-wheelers in 98.20%. None of these drivers was wearing a helmet. The type III frontal fracture of Ioannides et al. represented 51.9% of cases. In 89.21% of cases, other facial and/or cranioencephalic injuries were compounded to frontal sinus fractures. No surgical management was observed in 82 (80.39%) patients and surgical management in 20 (19.61%) patients. The outcome was favourable, but sequelae and/or complications were noted in 10 patients who had surgery and 30 patients who did not. Conclusion: These results enforce helmet wearing for all riders of two-wheeled machines. In addition, vaccinations to prevent meningitis in frontal sinus fractures with dural breach should be systematic.

Osteosynthesis Results of Tibia Plateau Fractures at the Yalgado Ouedraogo University Hospital Center

The sophistication of the implants allows the extension of the surgical indications for tibia plateau fractures. These fractures, which are often comminuted, are caused by a high velocity trauma, making treatment difficult. Objective: The aim of this study was to determine the indications for osteosynthesis of tibia plateau fractures in the orthopaedic-traumatology department of the Yalgado Ouédraogo University Hospital, in order to evaluate the results for their better management. Patients and Methods: it was a 5-year retrospective study of the records of patients with tibia plateau fracture operated and hospitalized in our department. The anatomical-clinical and therapeutic aspects collected from the complete files were analysed. A cortico-cancellous graft was performed in 67.4% of cases. The results were evaluated according to the criteria of Merle d’Aubigné and Mazas [1]. Road traffic accidents (97.4%) were the predominant etiology, involving mainly motorcycles (97.8%). Results: Spino-tuberository and uni-tuberository fractures were the most common. The average consolidation time was 12.5 weeks. One urinary infection, 3 superficial suppurations, 3 vicious calluses and 2 equipment dismantlings were the main complications. Our results were excellent and good in 91.3% and fair in 6.5%. Osteosynthesis of tibial plateau fractures provides excellent results and remains the most appropriate procedure to treat these fractures. Conclusion: reduce the operating time, modernize the technical platform, will allow stable osteosynthesis and early functional rehabilitation to optimize their results.

Mortality of Traumatic Injuries in Traumatological Emergencies of the Yalgado Ouedraogo University Hospital Center in Ouagadougou (Burkina Faso)

Background: Serious trauma is the main cause of death for people under 40 years old. According to the WHO, in 2002, nearly 1.2 million people died worldwide from road traffic injuries. The vast majority (90%) are from low and middle-income countries. The diagnostic performance, the quality of the treatments offered, and the optimization of trauma care channels, make it possible to improve the management of serious trauma. This is not always the case in our context of a country with limited resources. Objectives: The objective is o describe the epidemiological, diagnostic and therapeutic aspects of premortal death in patients with traumatic injuries. Methods: This was a descriptive study with retrospective collection in the trauma emergency department of Yalgado Ouedraogo Teaching Hospital (Ouagadougou, Burkina Faso). All patients who died on the ward while in the hospital or on arrival were included. Results: 192 deaths were listed. The annual mortality was 1.6%, the sex ratio was 6.1 and the average age was 36 years. Road traffic accidents were the main etiology: 163 deaths (85%). Head injuries were the most common injuries: 45.3% of deceased patients had a Glasgow score ≤ 8. There was no pre-hospital care in 63% of the patients who died. The first six hours, on-call periods and the weekend were correlated with the death rate. Discussion: the high mortality in road traffic accident injuries in Africa is due to the weakness of pre-hospital care, the non-medicalization of the transport of the injured and also the non-wearing of helmets by motorcyclists. The MGAP (Mechanism, Glasgow coma scale, Age, arterial Pressure) score is reliable in predicting the mortality of serious injuries.

Maternal Mortality in the Gynecology-Obstetric Department at the Yalgado Ouedraogo University Hospital Center (CHUYO), Burkina Faso: About 181 Cases Collected from January 1^stto December 31^st2016

Objective: To study maternal mortality in the obstetrics and gynecology department at Yalgado Ouedraogo teaching Hospital Center. Patients and Methods: We conducted a cross-sectional retrospective and descriptive study of 181 cases of maternal deaths during study period. The parameters studied were sociodemographic characteristics, the causes of death, the clinical data and the contributing factors. Results: The maternal mortality ratio was 2624 per 100,000 live births. The mean age of death was 26.79 with extremes of 15 years to 40 years. Direct obstetric causes accounted for 58% dominated by hypertension and complications, hemorrhage during pregnancy and postpartum, and obstetric infections. The indirect obstetric causes were 42% dominated by non-obstetric infections and chronic anemias. In addition to the delay in consultation and delay in care, the lack of antenatal care was the contributing factor to maternal deaths. Conclusion: Maternal mortality remains a public health problem in view of its high ratio. The reduction of this scourge will inevitably go through a health insurance that will allow the supply of quality care.

Management of Traumatic Injuries of Road Traffic Accident Victims in the City of Ouagadougou at the University Hospital Trauma Emergency Department-Yalgado Ouédraogo

Purpose: To evaluate the management of traumatic injuries of accident victims in the city of Ouagadougou admitted to the trauma emergencies of the University Hospital of Ouagadougou. Material and Method: This was a descriptive prospective study of road traffic accident victims in the city of Ouagadougou on their arrival at trauma emergencies and on the 7th and 30th day after their discharge. A total of 991 patients were identified. The sex ratio was 1.94 with a male predominance. The average age of the patients was 31.5 years. The ratio of caregivers to patients on a 24-hour shift was 7/47, excluding patients hospitalized in the corridors. Results: We note that 81.94% of patients were transported by the fire brigade. The average time to first contact with a caregiver was 11 minutes. Upon admission, accident victims were accompanied in 84% of cases. The combination of paracetamol and néfopam was the most prescribed analgesic (50.2%). The average time between admission and X-ray completion was 101 minutes. Benign skin lesions were the most frequent (48.82%), followed by osteoarticular lesions of the limbs (fractures and dislocations). Ceftriaxone, and the combination of Amoxicillin + Clavulanic Acid, were the most prescribed antibiotics. Dressings and sutures (44.63%) were the most commonly performed treatments, followed by orthopaedic restraints (37.88%) and open fracture areas in 14.34%. The average time between admission and orthopaedic and/or surgical treatment was 04 hours 25 minutes. Patients discharged against medical advice accounted for 10.80% of cases. In 95% of cases, patients were satisfied with their management. Conclusion: The management of patients admitted to trauma emergencies is satisfactory, but difficulties remain in terms of delays in management. It is imperative to take into account certain factors involving both staff and working conditions in order to reduce the time required to provide care and improve user satisfaction in this emergency unit.

Management of Non-Traumatic Urological Emergencies at Souro Sanou University Teaching Hospital of Bobo-Dioulasso (Burkina Faso)

Background: Generally, urological emergencies are assumed not to be very common, however, recent reports showed that they constitute an important aspect of the day-to-day urological practice. If not well and promptly managed, they may lead to serious morbidity or mortality. Objectives: To study the pattern of presentation, diagnosis and outcome of management of non-traumatic urological emergencies seen at the Emergency Department of Souro Sanou University Hospital in Bobo-Dioulasso. Patients and Methods: This was a retrospective and descriptive study over four years. It included patients of all ages and both sexes, admitted for non-traumatic urological emergencies in the surgical emergency department of Souro Sanou University Hospital. It took place from January 1, 2017 to December 31, 2020. Results: A total of 584 patients were reviewed in our study. Non-traumatic urological emergencies account for 6.3% of all surgical emergencies seen during the study period. The male-to-female ratio was 9.2 to 1. The mean age of the patients was 51.9 ± 23.9 years. Forty-five per cent of the patients presented within 48 hours of symptoms. The vast majority of the patients presented with difficulties with passing urine (41.6%), followed by cases of hematuria (18.4%). On admission, 154 patients (26.4%) presented with severe conditions such as anemia as seen in 40.9% of the cases and deterioration in the general health condition as seen in 34.4% of the patients. Leukocytosis was noted in 18.7% of the patients and anemia in 17.9%. Urine culture was positive in 15.4% of the patients and Escherichia coli was the most common pathogen found (40.6%). Ultrasound was the most requested examination (81.2%), followed by a computerized tomography (CT) scan (22%). The most frequent diagnoses were urine retention (42.9%), hematuria (16.9%) and renal colic (10.1%). Emergency interventions were carried out in 525 patients (89.9%) who include bladder catheterization (46.1%), bladder lavage and/or bladder irrigation (20.9%) and suprapubic cystocatheterization (10.1%). Most of the patients (61.3%) were discharged after a mean stay in the hospital of about 5.1 ± 7.5 days. A mortality rate of 3.8% was also recorded among the patients studied. Conclusion: Non-traumatic urological emergencies are common and are an important aspect of daily urological practice. The majority of the patient presents late with usually a severe form of the disease, which adversely affects the outcome even after treatment.

Sexual Experience of Women after Gynecological Hysterectomy in the Department of Obstetrics and Gynecology of Yalgado Ouedraogo Teaching Hospital, Burkina Faso

Objective: To study the sexual experience of women after gynecological hysterectomy in the obstetrics and gynecology department of Yalgado Ouedraogo University Teaching Hospital in Burkina Faso. Patient and Method: We conducted a cross-sectional study from October 1, 2016 to March 30, 2017. It included any patient who had a gynecological indication for a hysterectomy in the Department of Obstetrics and Gynecology of Yalgado Ouedraogo University Teaching Hospital (CHU-YO) during the study period. A total of 85 patients were included. We collected information from the consultation records, clinical records, and operating room registries and by surveying the patients themselves. Result: The frequency of hysterectomy in the gynecological period was 3.9%. The mean age of the patients was 51.71 (extremes: 35 and 66 years) and the mean parity was 4.8. Married women were the majority. Fibromyoma and genital prolapse accounted for 56.47% and 23.53% respectively of operative indications. Regarding postintervention sexuality, 29.41% of women declared no longer having sexual desire. Also, they complained of vaginal dryness (31.8%), decreased frequency of orgasm (42.3%), dyspareunia (37.65). Sexual dysfunction was present in 82.35% of women. There was a statistically significant difference between global sexual functioning and geographic origin, educational attainment, socio-economic level, surgical approach, preintervention sexual counseling, women’s psychological profile and their emotional relationship with their spouses. Conclusion: The psychosexual soundness of hysterectomy is important. A diagnosis of sexual disorders prior to the intervention and psychological follow-up throughout the therapeutic process of the pathology indicative of a hysterectomy is necessary for successful postoperative sexuality.

Factors for Postponement or Cancellation of Operating Programs Set in the Orthopedics-Traumatology Department of Yalgado Ouédraogo University Teaching Hospital in Ouagadougou (Burkina Faso)

Objective: The purpose of this work was to study the factors of cancellations or postponement of regulated operating programs of the Orthopedic-Traumatology unit of Yalgado Ouédraogo University Teaching Hospital. Materials and Methods: This was a prospective descriptive study over a period of six months. All interventions postponed or canceled during the study period were included. Patients who died or were lost to follow-up before surgery were not included. Results and Comments: the postponement/ cancellation rate was 24.5%. Out of 83 operations cancelled, 72.3% of patients were under 50 years old [extreme 15 and 88 years old]. ASA classes I and II were dominant with 57% and 37% of patients canceled, respectively. There were more postponed interventions (67.5%) than definitive cancellations (32.5%). The causes found were avoidable in 68.7% of cases. The most common was the unavailability of labile blood products (57%), the lack of financial means (36%) and the absence of the patient (28%). The results of our study show that 53% of the causes of cancellations were related to the organization of the hospital. Conclusion: the cancellation rate of orthopedic surgeries remains high at Yalgado Ouédraogo University Teaching Hospital. Most of the causes of cancellations are potentially preventable and the vast majority of them are related to the organization of the hospital. Financial accessibility to care plays an important role in cancellations.

Male Anterior Urethral Stricture: Epidemiological Profile and Management at Ouagadougou University Teaching Hospital (Burkina-Faso)

It was a retrospective and descriptive study conducted in the urology division of Yalgado Ouedraogo University Teaching Hospital from October 2009 to September 2014. Sixty three (63) male patients with anterior urethral stricture disease were included. All the patients have their diagnosis confirmed by voiding retrograde cystourethrogram (VCUG) or during surgical intervention. Anterior urethral stricture constitutes 41.1% of all urethral stricture. Hospital prevalence was 4.2%. Patient average age was 50.5 years. Dysuria and urinary retention were the major complaints representing respectively 66.7% and 33.3%. The infectious cause of urethral stricture was 71.1% of cases, followed by iatrogenic and traumatic causes with respectively 17.4% and 11.1% of cases. Voiding retrograde urethrocystogram (VCUG) was the only diagnostic procedure. Single urethral stenosis of the anterior urethra was about 88.8% while multiple stenosis constituted about 11.2%. Bulbar urethral stricture was the major location for the stenosis. Urine analysis was performed on 82.5% patients and ruled out urinary infections in 69.2% of cases with identification and isolation of Escherichia Coli in 77.7%. Majority of patients (61.9%) had open surgery of which 39.7% had end to end resection and anastomosis. Dilatation constituted 33.3% of treatment of the stricture of the anterior urethra. No endoscopic treatment was registered. At the removal of the catheter, all were successful but with time, the success rate was 87% at 6 months, 89.7% at 12 months, 85.2% at 18 months 63.1% at 24 months.

Isolated Rupture of Corpus Spongiosum Associated a Partial Rupture of the Urethra during a False Step of the Coitus: A Case Reported at the University Hospital Sanou Souro

Penile fracture is a rare urological emergency. It occurs mainly in young adults during sexual intercourse. In many instances, one of the corpora carvanosus is involved though bilateral injuries with or without corpus spongiosus involvement is not uncommon. However, isolated injury to corpus spongiosus is extremely rare. We report a case of isolated rupture of corpus spongiosum secondary to penile injury during coitus in a 43-year-old man that presented to University Hospital Souro Sanou of Bobo Dioulasso. He presented with history of persistence bleeding per urethra following penile injury during sexual intercourse. The Retrograde urethrography (RUG) showed a partial rupture of urethra, Moore type 3. Complementary penile ultrasound revealed extensive contusion of the urethra with circumferential hematoma and rupture of the distal 1/3 of the corpus spongiosus. He had gentle per urethral catheterization which was left for one month. Penile ultrasound sound done after removal of catheter showed residual injury and narrowing of the urethra.

Giant Hydronephrosis in Sourou Sanou University Teaching Hospital of Bobo-Dioulasso (Burkina-Faso). Two Cases Reports and Literature Review

Giant Hydronephrosis (GH) is a rare condition in urology literature and defined as a pelvicalyceal system of kidney containing more of 1000 ml of urine. This condition is not so rare in our setting. We herein, reported two cases of giant hydronephrosis, seen in two young patients respectively with 5 and 9 years old and their collecting system containing 4000 ml and 5000 ml of urines respectively. Only simple nephrectomy was performed for the two cases with renal function impairment and the post operative course was uneventful. Our purpose through these cases reports is to discuss diagnosis features and management of such condition in our setting, a context of low income countries as Burkina-Faso where diagnosis tool and further investigation are not always available.

Results of the Traditional Treatment of Fractures of Patients Discharged against Medical Advice from the Orthopedics Department of the Ouahigouya Regional University Hospital (Burkina Faso)

Introduction: Binding retains an important place in Africa. Leaving a health facility to see a bonesetter is common there, but a source of complications. The purpose of this work was to analyze the results obtained by bonesetter after discharge against medical advice. Methodology: Analytical cross-sectional study over a period of one year, including all patients admitted for limb fracture, discharged against medical advice for treatment with a bonesetter. Results: Thirty-nine patients were selected. The average age was 36.9 years, and the sex ratio was 5.50. The fractures were open in 35.9%. At a mean follow-up of 19 months, the course was marked by pain in 34.4% and inequality in limb length in 62.5%. Thirteen fractures (40.6%) were consolidated with axis defect, and 11 were without axis defect (34.4%). There were eight non-union (25%), and eleven patients (34.4%) presented with stiffness in one or more joints. Seven patients had died. Discussion: The problem of discharge against medical advice is found in all hospitals but is particularly marked for fractures in our context. The absence of an X-ray and ignorance of the rules of asepsis lead to complications. Only the fractures of the two bones of the leg had progressed well (5/8 good results). The rate of vicious calluses (40.6%) and non-union (25%) is high. Conclusion: Although a few cases have progressed favorably, the results of patients traditionally treated after discharge against medical advice are generally poor.

Assessment of Liver Fibrosis in HBsAg-Negative and Anti HBc Positive Patients

Background: Surface antigen (HBsAg) is the mean marker of hepatitis B virus infection. During the course of the infection, some patients lose the HBsAg and only the presence of anti-HBc antibody indicates previous contact with the virus. Among these patients, some have detectable viral load (occult infection) but most without viral replication. There is no guideline regarding these patients. The aim of this study was to assess hepatic fibrosis in patients with only the hepatitis B virus contact marker “total anti-HBc”. Patients and methods: it was a descriptive and analytical cross-sectional study, conducted in three private hospitals from January to August 2022. Were included HBsAg-negative and HBc-positive patients, consulting in Gastroenterology departments. Noninvasive methods (APRI, FIB-4 and FIBROSCAN) were used to evaluate liver stiffness because of their easy accessibility and low-cost. The hepatic fibrosis was considered significant when the score determined by APRI, FIB-4 and FIBROSCAN® tests was respectively greater than 1.5;2.67 and 8 kPa corresponding to fibrosis level 2 (F2). Results: A total of 63 HBsAg-negative/total HBcAg-positive patients were included. The mean age was 49.9 ± 13.4 years. The male/female sex ratio was 1.78. Of the 63 patients, 19 had significant liver fibrosis (30.1%) among which 9 patients had HCC. The FIB-4 score outperformed the APRI score in assessing liver fibrosis, with a sensitivity of 84.2%, a specificity of 100% and a negative predictive value of 93.6%. In univariate analysis, there was a significant association between the occurrence of significant liver fibrosis and age over 40 years, dyslipidaemia, obesity, alcohol consumption, smoking, herbal medicine, negative anti-HBs immunological status and detectable viral load. Conclusion: Our study revealed a high prevalence of significant to severe hepatic fibrosis in anti-HBc positive patients. In most of the cases, the fibrosis was severe. Progression to HCC has also been possible. There is no consensus on the follow-up strategy for those patients. However, screening for hepatic fibrosis using noninvasive methods should be recommended for patients aged over 40 years, alcohol or herbal medicine users, patients with metabolic syndrome or occult hepatitis B. In HBsAg-negative/anti-HBc-positive patients, liver stiffness should be evaluated and if it is greater than F2, HCC screening should be started.

Intestinal Parasitosis in Children among Internally Displaced Persons in the Hauts-Bassins Region of Burkina Faso

Introduction: The setting up of camps for internally displaced persons in Burkina Faso as a result of terrorism creates favorable conditions for the emergence of digestive parasitosis in these displaced populations. The objective of this study was to evaluate the prevalence of digestive parasitosis in children of this population in the Hauts-Bassins region. Material and methods: This was a prospective cross-sectional study from November to December 2020, in which stool samples were collected from internally displaced children from the Sinfra reception site in Banzon and from Poya in Karangasso Vigué. The stool samples were stored at room temperature, protected from dust and insects, in a cooler and then sent to the laboratory of the CHUSS in Bobo-Dioulasso where the parasitological analyses were performed. Results: The mean age was 5.8 ± 2.4 years. The most represented age group was 5 to 10 years (75.31%). The sex ratio is 1.61. The overall prevalence of intestinal parasite infection was 53.09%. The prevalence was statistically higher among those who consumed well water than those consuming tap water (p = 0.01). Monoparasitism by protozoa and helminths represented 74.42% and 6.68% respectively. The polyparasitism rate was 9.31%. The species identified in monoparasite patients were protozoa with Entamoeba coli (37.21%), Giardia lamblia (25.58%), Endolimax nanus (6.98%) and Entamoeba histolytica/dispar (4.65%). Biparasitism was identified with combinations, such as E. coli + E. histolytica/dispar (11.63%). Conclusion: There is a high prevalence of digestive parasitosis among IDPs in the Sinfra and Poya reception site. Educational sessions on hand washing before meals, use of drinking water, etc. should emphasize preventive measures in these IDP camps.

Ambulatory Radio Iodine Therapy in the Management of Hyperthyroidism in Africa: African Systematic Review and Perspectives in Burkina Faso

Introduction: In hyperthyroidism, selective irradiation of the thyroid gland with radioactive iodine is a radical treatment and an alternative to surgery. The aim of this review is to assess the medium-term efficacy of outpatient treatment of hyperthyroidism with iodine-131 in Africa. Methods: We identified the studies carried out in Africa on outpatient radiation therapy between 2016 and 2020. For each article included, we noted the country concerned and the year of publication, the numbers studied, the socio-demographic characteristics of the patients, the indications for radio iodine therapy, the dose administered, the results of the hormonal dosage 6 months after radiation. Results: 13 retrospective studies were included to constitute a total population of 925 patients. The average age was 40.77 years, the sex ratio of 1/5.4 with a clear female predominance. The 3 main etiologies of hyperthyroidism justifying outpatient radio iodine therapy were Graves’ disease (55.89%), toxic multinodular goiter (22.70%) and toxic adenoma (21.40%). The average dose of iodine 131 administered per course is 13.7 mCi. No short-and medium-term complications were reported. The radio iodine therapy was effective in 86.08% (n = 796) of the patients with extremes of 72% and 100%. Conclusion: Radio iodine therapy is effective in Africa. It is simple, inexpensive on an outpatient basis and well tolerated. The introduction of outpatient radio iodine therapy could improve the management of patients with hyperthyroidism in Burkina Faso.

Is There Still a Place for the Staca Nail Plate in the Osteosynthesis of Trochanteric Fractures? Results from 52 Cases in a Regional Hospital in a Developing Country

The synthesis of trochanteric fractures has evolved considerably since the use of the Staca nail-plate in 1964. This implant, despite its age, remains a solid and reliable material for the synthesis of this type of fracture. Objective: To evaluate the anatomo-clinical and functional results of Staca nail-plate osteosynthesis of trochanteric fractures at the Regional University Hospital of Ouahigouya in Burkina Faso. Methods: We performed a retrospective study of 52 trochanteric fractures treated by Staca nail-plate in the regional university hospital of Ouahigouya between June 2007 and June 2017. There were 10 women and 42 men with a mean age of 61 years (range 17 years to 89 years). Ten stable type I and II of Ender classification fractures and 42 unstable fractures were recorded, including four pseudarthrosis and six vicious calluses. The anterolateral approach was used in all cases. In the absence of an image intensifier, we performed an arthrotomy to identify the femoral neck and set up a guide pin. Results: The reduction was satisfactory with stable synthesis in 39 cases. At last follow-up, consolidation was effective in all patients, except one. Two cases of acetabular protrusion were noted, requiring early removal of equipment. Fifty-one patients were autonomous. The overall results were considered satisfactory. Conclusion: The Staca nail-plate remains a means of solid osteosynthesis. Although it is no longer relevant in industrialized countries, it provides comparable results to new implants for the osteosynthesis of trochanteric fractures. Because of its low cost, its abandonment is not justified in low-income countries.

Frequency, Risk Factors and Clinical Forms of Neuropathies in Diabetics in Hospitals in Burkina Faso

Introduction: Diabetic neuropathy is one of the most common chronic complications of diabetes. Most of the studies on the subject in the sub region, particularly in Burkina Faso, dealt it with the study of the complications of diabetes, or one of its components. Our study was designed to study in particular in all its aspects, by searching for its peculiarities in our context, for improvement of its support. Methodology: This is a cross-sectional descriptive study carried out in 150 diabetic patients aged at least 15 years followed in the Department of Internal Medicine at Yalgado Ouedraogo University Teaching Hospital. All patients included had agreed to participate in our survey after informed consent. We collected the data during the period from 2015 November to 2016 June. Each patient was evaluated by the DN4 questionnaire and clinically by a neurological examination. We determinated the frequency, the sociodemographic, clinical and therapeutic characteristics of diabetes neuropathy and its related factors. Results: The frequency of diabetic neuropathy was 80.7%. Peripheral neuropathies were seen in 81.8% of cases and autonomic neuropathies in 72.7% of cases. Autonomic neuropathy was dominated by the DAN (59.1%), and erectile dysfunction (44%). There was a high comorbidity with physical inactivity (66.9%), obesity (49.4%) and hypertension (38.8%). There were poorly controlled patients in 38.8%. A link was found between T2DM and neuropathy (p = 0.014). Painful diabetes was related to the quality of glycemic control (p = 0.007), and hypertension (p = 0.021). A link was also found between tobacco consumption (p < 0.001), male (p < 0.001), and urogenital autonomic neuropathy. Conclusion: Diabetic neuropathies are very common in our context and could be a haunting to the practitioner with the progression of diabetes and its corollary of degenerative complications. There was a significant association between Type 2 Diabetes mellitus and the presence of peripheral diabetic neuropathy.

Clinical, Prognostic and Socio-Economic Aspects of T4 Breast Cancers in Ouagadougou, Burkina Faso: A Retrospective Study

Breast cancers classified T4 according to the TNM code are frequent in Burkina Faso. A better knowledge of these cancers would help to better organize the fight against breast cancer in general. We conducted this study to present the clinical and prognostic aspects of T4 breast cancer in Ouagadougou. It was a descriptive retrospective study based on the medical record of patients received from January 1, 2017 to December 31, 2021 in the cancer department of Yalgado Ouedraogo University Hospital. Patients followed for histologically confirmed breast cancer who were classified in the cT4 category of the TNM code 8e edition were included. We collected a total of 286 patients. Non-salaried patients accounted for 90.56%. In this study, 53.3% of patients lived in urban area and 36.7% in rural area. Menopausal patients accounted for 56.8% of cases. One hundred and thirty-three (46.5%) patients were overweight or obese and 121 (42.3%) patients had a normal weight. The average consultation time, which is the time between the first signs and consultation in a specialized center, was 12 months, with a median of 11 months. According to category T of the TNM code, 19 patients (6.6%) were classified T4d, 176 (61.5%) were classified T4c, 69 (24.1%) were classified T4b and 22 (7.7%) T4a. One hundred and twenty patients (42%) were metastatic. The median overall survival of all patients in our sample was 20 months. In univariate analysis, metastatic status was risk factor for death, while obesity and surgery were protective factors. In multivariate analysis, obesity, surgery and metastatic status were independently associated with survival;obesity and surgery were protective factors. Survival is poor due to advanced stages and difficulties in the management of these cancers. Measures to facilitate access to care would improve the prognosis of these cancers.

Direct Visual Internal Urethrotomy (DVIU) in the Management of Male Urethral Strictures. A Single Center Experience about 44 Patients

Introduction: Male urethral stricture is one of the oldest urological disorders. Many techniques have been proposed to treat them, including endoscopic internal urethrotomy (DVIU). Material and Methods: To evaluate the contribution of this technique in the treatment of urethra narrowing, a retrospective study on the records of patients with urethral stricture treated with endoscopic internal urethrotomy between January 2014 and December 2021 in the urology division of the Souro Sanou University Teaching Hospital. Results: A total of 44 male patients with urethral stricture were treated with this technique and 48 procedures were performed. The average age of the patients was 53.2 ± 18.2 years. The etiology of the stricture was dominated by iatrogenic, infectious, traumatic and idiopathic causes in 43.2% (n = 19), 27.3% (n = 12), 20.4 % (n = 9), and 9.1% (n = 4) respectively. The location of the stricture was bulbar in 72.7%, and the anterior penile urethra in 15.9%. The overall success rate was 72.7% with satisfactory urination without dysuria, evaluated after removal of the urinary catheter, at three months this rate fell to 69.1%, and at 6 months this rate was 67.5%. Five cases (5) of extravasation of blood or irrigation fluid into the scrotum were reported and managed conservatively as well as two (2) cases of false routes with postoperative oedema of the penis were observed. Conclusion: DVIU is a simple technique, free of major morbidity and requiring only short-term hospitalization. It can be proposed as a first-line treatment for urethral stricture.

Can the Urine Dipstick Test Be an Alternative in the Screening of Urinary Tract Infections for Inpatients in the Context of a Low-Income Country?

Background: Urinary Tract Infection (UTI), a prevalent bacterial infection in adults, heavily relies on cytobacteriological examination of urine (CBEU) for diagnosis. However, in resource-limited countries, accessibility to CBEU remains hindered by cost and availability. This study aims to assess the utility of the Urinary Dipstick Test (UDT) in diagnosing UTIs among hospitalized patients in the context of limited resources. Methods: A cross-sectional study was conducted from February to May 2019, encompassing hospitalized patients who underwent CBEU at the bacteriology unit of Sour? Sanou University Hospital. UDT and CBEU were concurrently performed, and UDT’s analytical and diagnostic performance was evaluated against CBEU, considered the gold standard. Results: A total of 274 CBEU requests were registered, involving 274 patients (159 males) with a mean age of 45.8 ± 21.3 years (ranging from 1 to 90 years). UTI was confirmed in 90 patients, yielding a frequency of 32.85%. The UTI bacteriological profile was dominated by Enterobacteriaceae (75.23%), primarily Escherichia coli (60.55%). Nitrite and Leukocytes were positive in 54 (19.8%) and 157 (53.6%) of the samples tested. Among patients with confirmed UTI, Nitrite, and Leukocytes were positive in 30 (33%) and 71 (79%) patients respectively. UDT demonstrated variable performance based on nitrite and leukocyte combination: Sensitivity (57%-82%), Specificity (7%-98%), Positive Predictive Value (PPV) (43%-57%), Negative Predictive Value (NPV) (43%-67%). UDT performed slightly better in women (NPV = 88%) and inpatients without urinary catheters (NPV = 75% and PPV = 80%). Conclusion: This study underscores UDT’s potential utility in excluding UTIs among women, younger patients, and inpatients without urinary catheters, albeit with limited confidence. The UDT emerges as a complementary tool for UTI screening, particularly in resource-limited settings.