Knowledge of Patients and Their Accompanying Persons about Obliterative Arteriopathy of the Lower Limbs at Conakry University Hospital in 2022

Introduction: Obliterative arterial disease of the lower limbs is a marker of advanced atherosclerosis. It is one of the world’s most common cardiovascular diseases, present in one in five people over the age of 60, and carries an increased risk of morbidity and mortality. The aim of this study was to assess the knowledge of patients and their carers about obliterative arteriopathy of the lower limbs at Conakry University Hospital. Material and Methods: We conducted a descriptive cross-sectional study lasting 3 months, from March 12 to June 12, 2022 in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). Following free and informed consent, they were interviewed on the basis of a pre-established questionnaire. Socio-demographic data (age, gender, level of education) were collected, and knowledge of obliterative arterial disease of the lower limbs. Results: The study involved 159 people, comprising 106 patients (66.66%) and 53 accompanying persons (33.34%) in the hospitals of the University Hospital of Conakry (Donka and Ignace Deen). The 60 to 79 age group was the most represented (44.7%), with an average age of 55.4 ± 15.9 years and extremes of 20 to 84 years. Half (47.8%) had not attended school, and almost all (96.4%) of those who had attended school had a low level of education (primary and secondary). Almost all of them (91.2%) had never heard of AOMI. Only 5% identified at least one risk factor, diabetes, hypertension and smoking. Amputation was the most frequently identified complication. About 98% did not know that AOMI is associated with myocardial infarction and stroke, and 93.7% did not know of any complications. Almost all the participants (99.4%) had poor knowledge of the following complications. Conclusion: Obliterative arterial disease of the lower limbs could be prevented or delayed by screening and controlling risk factors. Our results show a huge deficit in knowledge of this pathology, including risk factors, preventive measures, clinical signs and complications among patients and their relatives. A study conducted outside the hospital environment would provide a better understanding of the extent to which the general population is unaware of this disease.

Clinical and Therapeutic Evaluation of Hypertensives According to the Practice of Ambulatory Blood Pressure Measurement (ABPM) at the Bel Air International Clinic in Conakry from January 1, 2019 to November 30, 2022

Introduction: Ambulatory Blood Pressure Measurement (ABPM) is a non- invasive examination recommended for subjects at high cardiovascular risk, and those requiring a nocturnal drop in BP such as elderly and obese subjects, those with secondary hypertension or resistant, diabetics, subjects with metabolic syndrome or sleep apnea syndrome. The objective of this study was to evaluate the contribution of ABPM in the diagnosis and evaluation of the level of control of hypertension under treatment at the Bel Air international clinic. Materials and Methods: This is a retrospective, cross-sectional and descriptive study, carried out at the Bel Air International Clinic in Conakry (Guinea) between January 2019 and November 30, 2022. It included a consecutive series of 180 consenting patients recruited through an ambulatory measurement of 24-hour blood pressure from a FUGADA brand device. Results: We collected 180 patients, with a male predominance (sex-ratio M/F = 2.46). The mean age of the patients was 48.48 ± 14.23 years. The most represented age group was that of 32 to 42 years with 50 cases (27.8%) followed by that of 43 to 52 years with 42 cases or 23.3%. The indication was for diagnostic purposes in 106 cases 58.9%, the therapeutic evaluation in 58 patients (32.2%). The examination was prescribed by a cardiologist in 98 cases (54.4%), a general practitioner in 71 cases (39.4%), a neurologist in 11 cases (6.1%). In the therapeutic evaluation, high blood pressure was controlled in 24 patients (13.3%) and uncontrolled in 34 cases (18.9%). In the diagnostic indication, high blood pressure was confirmed in 79 cases (43.9%) with a statistically significant link (Chi2 = 4.57 and p-value = 0.032). The nycthemeral mean was 187.27 ± 26.22 mmHg for systolic blood pressure (SBP) and 110.37 ± 19.06 mmHg for diastolic blood pressure (DBP), during the day, 151.64 ± 21.45 mmHg for SBP and 71.59 ± 8.67 mmHg for diastolic blood pressure. During the study 65 patients (36.1%) were identified as dippers and 115 patients (63.9%) were no-dipping. The antihypertensive protocol used was monotherapy in 68 cases (37.8%), dual therapy in 46 cases (25.6%), triple therapy in 17 cases (9.4%). However 39 patients or 21.7% were not taking any antihypertensive. Conclusion: This preliminary study, despite the modest sample size, showed the importance of ABPM as a tool for diagnosis, monitoring of hypertensive patients and therapeutic adaptation. A large-scale national study would be necessary for the rational use of ambulatory blood pressure measurement in our context in order to improve the management of hypertensive patients.

Cardiac Amyloidosis: A Case Report of Seven Patients

Introduction: Cardiac amyloidosis is a rare and under-diagnosed disease. The objective of this study was to collect cases of cardiac amyloidosis in patients hospitalized in the cardiology department of the Centre Hospitalier Intercommunal Alençon-Mamers (CHICAM). Patients and Methods: This was a retrospective descriptive study of the records of patients diagnosed with cardiac amyloidosis. The study took place in the cardiology department of the CHICAM over 12 months (from January 1, 2020 to December 31, 2020). We included the files of patients in whom the diagnosis of cardiac amyloidosis was confirmed on the basis of clinical, echocardiographic, biological, scintigraphic and cardiac MRI evidence. Results: Seven patients were included. The mean age was 86.71 years. Six men for one woman. Most of the patients were in heart failure. There was one case of periorbital ecchymosis. Troponinemia was increased in three patients, NTproBNP was always high with a mean of 1000 ng/L. Cardiac echography showed a hyperbright septum in four cases, concentric hypertrophy of the left ventricle with a mean interventricular septum in diastole of 13.85 mm. Six cases were senile transthyretin amyloidosis (TTR), one case was mutated transthyretin amyloidosis (TTRm). Two cases of death were noted. Conclusion: Cardiac amyloidosis has a poor prognosis due to delayed diagnosis.

Deep Vein Thrombosis in HIV and Tuberculosis Treatment in a Case of a 19-Year-Old Guinean Student

The objective of this study was to describe Thrombotic manifestations and therapeutic management during HIV infection and tuberculosis in a 19-year-old male student. The objective of this study was to describe Thrombotic manifestations and therapeutic management during HIV infection and tuberculosis in a 19-year-old student. Observation: It is Mr. S. C., aged 19, admitted for pain and swelling of the right lower limb, physical asthenia and notion of fever. Evolution 5 days, with no particular history of cardiovascular disease, anti-retroviral treatment for 1 year and anti-tuberculosis treatment for 3 months. On clinical examination heart sounds are irregular with a heart rate at 115 bpm, blood pressure at 110/70 mmhg. A febrile red painful swelling at right lower limb with positive Homans sign. 0°C (Temperature 37.7°C), Weight at 58 Kg. The rest of the clinical examination is without particularity. Venous Doppler echo of the lower limbs: shows the presence of acute deep vein thrombosis of the right lateral vein. Mr. S. C. to benefit the following Medical Treatment: lovenox 0.6 UI subcutaneously morning and evening, Sintrom 4 mg 1 comprimed at night, Tramadol 50 mg morning and evening;with a good clinical evolution. CONCLUSION: TB and HIV are chronic infections that result in widespread inflammation predisposing patients to a MTVE (Venous thromboembolic disease) table as well as rifampicin and anti-proteases.