Hepatic Metastatic GIST:Diagnostic and Therapeutic Difficulties in Souro Sanou Teaching Hospital in Bobo Dioulasso,Burkina Faso

Introduction: Gastrointestinal stromal tumor (GIST) is the most common non-epithelial, mesenchymal tumor of the digestive tract. Targeted therapy has improved the prognosis but the diagnosis must be accurate before using the existing drugs. Aim: To report the diagnostic difficulty in our context through the clinical polymorphism and define the position of targeted therapy in the management of GIST metastatic stomach. Casuistry: We report 3 cases of gastric GIST with liver metastasis in different circumstances of discovery. Patients were 21, 45, and 73 years old. Discovery circumstances were respectively digestive hemorrhage, severe clinical anemia, abdominal tumor and gastric tumor. There was hepatic metastasis in the three cases. The three patients received Imatinib treatment, adjuvant treatment for the first two cases, and neo-adjuvant treatment for the third case, with a very good clinical response and CT response on metastases. Conclusion: Because of their rarity, GISTs are often difficult to diagnose, and necessarily require immunohistochemistry which is not available in our work context. The effectiveness of targeted therapy even on metastasis needs a rigorous diagnostic approach to improve patient survival.

Drivers of the Chemical Quality of Market Gardening Soils in the Urban and Peri-Urban Environment of Bobo-Dioulasso (Burkina Faso): Impact of Fertilizers Sources and Sites Location

Urban and peri-urban agriculture plays a key role by providing many goods and services. In particular, it provides diversified food and employment for vulnerable groups (youth and women). However, it often involves negative externalities due to non-conventional soils fertility management practices. This study aimed to investigate the chemical quality of soils over six (06) sites of the market gardening area of Bobo-Dioulasso (Burkina Faso) as affected by fertilizers uses and sites location. Thirty (30) representative market gardening farms, located in urban, semi-urban and rural areas, were randomly selected from a baseline survey database. Within each farm, composite soil samples made up of 3 individual cores were taken over the 0 - 15 cm soil depth for determining soils carbon, total nitrogen, available phosphorus contents and pH-water. These data were normalized and summarized to compute a synthetic Soil Fertility Index (SFI). The data processing was focused on a Principal Component Analysis and an Ascendant Hierarchical Classification in order to make a typology of the vegetable farms. Fertilizers management effects on soils quality were compared through Variance Analysis (ANOVA) following a GLM procedure in Rstudio software. As main results, soils chemical parameters, except for available K, were affected by the location of the sites. Soils in urban farms are less acidic (on average pH = 6.9), while semi-urban and rural sites (Samadeni, Nakaguana) have more acidic soils. However, the latter site had the highest values of C and N. Moreover, the long-term application of organic matter sources results in improving of the chemical quality of the market garden soil. The SFI is positively correlated with the rate of applied organic fertilizers, and the cultivation duration. On the other hand, soil quality tends to decrease with the expansion of the area, due to a dilution effect of the organic fertilizer doses. All these results suggest that there is a real scope to reinforce the position of the market garden as an opportunity for recycling organic wastes and sequestration of carbon by promoting relevant fertilization packages that strongly rely on organic matters sources (Compost, Biochar, etc.).

Upper Gastrointestinal Endoscopy at University Hospital Souro Sanou Bobo-Dioulasso (Burkina Faso), about 1022 Cases: Signs and Lesions Observed

Upper gastrointestinal endoscopy is an excellent way for the diagnosis of high digestive pathology. We report the results of 1022 upper gastrointestinal endoscopy performed at Bobo-Dioulasso CHU-SS, in western Burkina Faso (West Africa). The aim of this study was to document the indications and lesions found in high endoscopy at the CHUSS. Patients and Methods: It was a cross-sectional study, prospective to describe the results of gastroscopy performed from 1st January 2015 to 30th June 2016 at the digestive endoscopy unit CHU-Souro Sanou Bobo-Dioulasso. Results: In the study period, 1022 upper gastrointestinal endoscopies were performed. The main indications were: The epigastric pain (48.6%), portal hypertension (10.7%) and gastroesophageal reflux disease (9.9%). The pathologies observed were dominated by gastropathies (48.11%), peptic ulcer (27%) and oesophageal varices (9.68%). Epigastralgias were the main circumstance for the discovery of: 52.3% of esophagitis, 49.17% of gastropathies and 46.12% of peptic ulcers. Histopathologically, the results of the 236 biopsies were dominated by gastritis (88.56%), stomach cancers (7.63%) and esophagus (3.81%). Conclusion: The main indication of the UGIE at the CHU-Souro Sanou in Bobo-Dioulasso was epigastralgia. The pathologies observed were dominated by gastropathy, esophagitis and PUD.

Situation of Artificial Depigmentation among Women in 2016 to Bobo-Dioulasso, Burkina Faso

INTRODUCTION: The artificial depigmentation (DA) is a practice that aims to reduce the natural pigmentation of the skin by the use of depigmenting products (DP). In Burkina Faso, few studies have been made on the issue and the last date of 2003. The objective of the study is to realize an overview of the DA phenomenon in women population in Bobo-Dioulasso City. METHODS: This is a descriptive cross-sectional study held from April 16th to April 30th 2016 including 437 women aged from 13 to 55 years old. A multi-stage random sampling was realized A chi-square test was used to compare groups with significant threshold of 5%. RESULTS: The prevalence of the use of DP (67.28% with IC95 = [63.52 - 71.03]). The mean age of users was 27.5 years old;the typical profile was women from 30 to 35 years old (85.7%), with elementary study level, (73.47%), housewife’s (75.19%) and monogamous (71.98%). the products used was those made of hydroquinone (81.6%), EDTA (8.33%), kojic acid (4.86%), mixtures (11.12%) or unknown products (14.58%). The origin of the product was doubtful for almost all the cases (98.96%). The monthly mean cost of this practice for a single user is 1710 CFA. Complications were reported in 62.5% of users, and the most found was dyschromia (85.87%), acne (17.39%) and burns (10.32%). DISCUSSION: The DA is in great progress in Bobo-Dioulasso (2 out of 3 women) compared to half, thirteen years ago. The hydroquinone was markedly the most frequent DP while there was an apparent lack of corticosteroids and mercuries replaced by the new depigmenting agent such as EDTA and kojic acid. This result contrasted with the classic combination hydroquinone-dermocorticoid-mercuries reported by previous studies. CONCLUSION: The low-cost of DP could explain the magnitude of the artificial depigmentation phenomenon. Other studies should be conducted in order to establish with precision the composition of these products and their causality in the occurrence of common complications. Research in cosmetology should make it possible to provide women with safe products that respect their deep needs.

Knowledge, Attitudes and Contraceptive Practices among Young People from the Youth Listening Center of the Burkinabè’s Family Well-Being Association in Bobo-Dioulasso City

Objective: To study the knowledge, attitudes and practices regarding contraception among young people in the Burkinabè’s family well-being association for youth listening center in Bobo-Dioulasso city. Methods: This was a survey of 635 clients in the youth listening’s center of Bobo-Dioulasso city, Burkina Faso. These clients were gradually included by random choice from January 15 to April 15, 2018. The data were collected by self-administered written questionnaire under the supervision of an investigator and after a free and informed verbal agreement of the participant. The analysis was done using the software Epi info version 7.1.1.0. Results: The average age of the respondents was 20.62 years. Female respondents were more numerous, 508 (80%). Contraceptive methods were known by 98.12% of respondents and 61.42% said they were always using them. Two-thirds of clients (67%) cited at least two benefits of contraceptive methods which were correct. Condoms were the best-known method (92.60%) and also the most used (92.56%). But emergency contraception was known by 30.71% of participants. Young people who were already sexually active accounted for 73.54% of the sample with a mean age at their first sexual intercourse of 18.42 years. Conclusion: The majority of respondents knew contraceptive methods. However, risky sexual behaviors and misconceptions about contraception remain. The setting up of family planning services within schools and the teaching of a reproductive health module in all secondary schools will contribute to improve their sexual and reproductive health.

Epidemiological, Etiological, Therapeutic and Evolutionary Aspects of Acute Surgical Abdomens Operated at the University Hospital of Bobo-Dioulasso

Surgical acute abdomens represent a significant proportion of surgical emergencies in terms of frequency, morbidity and mortality. The aim of our study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of acute surgical abdomens operated in the surgical emergency department of the Centre Hospitalier Universitaire Souro Sanou (CHUSS). This was a retrospective descriptive study of 426 cases of surgical acute abdomens operated in the CHUSS surgical emergency department from 1 January to 31 December 2015. These 426 cases accounted for 24.14% of the emergency interventions carried out in the CHUSS surgical emergency department. These were 314 (73.7%) men and 112 (26.3%) women with an average age of 30 years. Among the causes, there were 187 (43.9%) cases of acute generalized peritonitis, 71 (16.7%) cases of acute intestinal occlusions, 49 (11.5%) cases of acute appendicitis, 38 (9.4%) cases of strangulated parietal hernias, 16 (3.8%) cases of abdominal contusions, and 15 (3.5%) cases of penetrating wounds of the abdomen. The appendectomy was the most performed gesture with 112 (26.3%) cases. The time to surgery was greater than 48 hours in 29 (6.8%) cases. Complications were observed in 68 (16%) cases with 35 (8.2%) cases of parietal infections, 18 (4.2%) cases of postoperative peritonitis. The death occurred in 37 (8.7%) patients. The average hospital stay was 8.7 days. Improving the prognosis of acute surgical abdomens requires early diagnosis and treatment, as well as better postoperative follow-up.

Molecular Epidemiology of High-Risk Human Papilloma Virus Infection in Sexually Active Women at Bobo-Dioulasso University Teaching Hospital

The objective of this study was to determine the prevalence of HPV-HR genotypes in the population of sexually active women in Bobo-Dioulasso, Burkina Faso. Methods: This study took place at Souro Sanou Teaching Hospital in Bobo-Dioulasso from September to June 2017. A total of 234 women in the gynecological period and also sexually active were enrolled after they gave an individual consent. Swabbing of the endocervical canal was done. From the sample stored at -20°C, the viral DNA was extracted using the “DNA-Sorb-A” kit from SACACE biotechnologies&reg. Amplification of the PCR of the extracted DNA was made, using the “HPV Genotypes 14 Real-TM Quant” V67-100 FRT kit. Data were analyzed with SPSS software version 17.0 and Epi Info 6. Chi-square and Fisher’s tests were used to compare proportions and averages;a link was significant when p 0.05. Results: The mean age was 30.7 ± 7.3 years (median: 30 years);84.5% of them were married, 43.5% had a socio-professional activity and 61% were schooled. A total of 20.6% of women were positive for at least one of the following HPV-HR genotypes: HPV 18, 31, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68. Genotypes the most frequently found were HPV 52 with 11 cases (17.2%) and 66 with 10 cases (15.6%). Conclusion: Our results show a predominance of HPV-HR genotypes not covered by available vaccines. Mapping genotypes are needed to fully understand viral ecology at the national level. But for instance, the nonavalent vaccine, which has a better coverage of the predominant genotypes, is to be promoted.

Delivery on Scarred Uterus at Souro Sanou Teaching Hospital, Burkina Faso (about 531 Cases)

Introduction: Therapeutic conduct for delivery via a scarred uterus is controversial in modern obstetrics. Some authors recommend a ceasarean section. The purpose of this study was to analyse the conduct and prognosis of delivery via scarred uterus at Souro Sanou Teaching Hospital in Bobo-Dioulasso. Methods: We conducted a descriptive cross-sectional study from January 1 to December 31, 2017. Data were collected from medical, birth, and operating room records. Result: In total, 531 scared uterus deliveries and 5293 deliveries have been recorded in our study;the frequency of deliveries via a scarred uterus was 9.96%. The average age of the patients was 28.02 years old, with extremes of 17 and 44 years. The average parity was 2.34, with extremes of 1 and 8. Patients with a spacing interval between births of at least 24 months accounted for 86.6% of observed patients. Patients with a single scar uterus made up 70.6% of the population. There were 349 (65.73%) patients who had an emergency caesarean section during a previous delivery. The trial of vaginal delivery via a scarred uterus was conducted on 182 patients with a success rate of 89.56%. There was no maternal death. However, we noted 23 foetal deaths (4.33%). Conclusion: More than 50% of parturient women with a single caesarean uterine scar who underwent the uterine test gave birth vaginally in our department. However, like most previous studies on the subject, we recommend vaginal delivery in the presence of a prior caesarean-scarred uterus whenever possible.

Erectile Dysfunction among Diabetic Men in Two Medical Centers in Burkina Faso: Epidemiological, Diagnosis and Therapeutic Aspects

Objective: To study erectile dysfunction in diabetic patients seen in two clinics in the city of Bobo-Dioulasso, Burkina Faso. Materials and Methods: A prospective cross-sectional descriptive study was conducted at the Souro Sanou Teaching Hospital (CHUSS) and the Saint Leopold clinic in Bobo-Dioulasso, from March 1 to September 1, 2012. A total of 107 patients data were collated and analysed, which was then grouped into two: the ED group, designating patients with erectile dysfunction and the NED group consisting of those patients without. The sample comprised of 61 patients with types 1 and 2 diabetesand were aged between 25-70 years. The IIEF-5 was used to evaluate erectile dysfunction. Results: The prevalence of erectile dysfunction was 57%. The average age of patients was 54.4 ± 8.3 years. All patients with ED had type 2 diabetes. The mean disease duration of diabetes was 7.2 ± 6 years. Erectile dysfunction was severe in 32.8% of cases, moderate in 31.1% of cases and mild in 36.1%. Its severity was significantly associated with glycated hemoglobin, triglycerides and BMI. Phosphodiesterase types 5 (PDE5) inhibitors were found to be effective in the treatment of erectile dysfunction with a satisfactory therapeutic response in 77.4% of users. Conclusion: Erectile dysfunction is a common complication in diabetic patients. Its occurrence and severity are influenced by several factors. The potential presence of this disorder should be assessed due to its negative impact on quality of life. Phosphodiesterase type 5 inhibitors are an effective treatment modality in diabetic patients.

Placenta Previa at Souro Sanou Teaching Hospital, Burkina Faso (About 142 Cases)

Introduction: Placenta previa is an obstetric emergency that can be life-threatening for both mother and foetus. Despite the progress made in diagnosis and treatment, it continues to be feared by obstetricians because of high maternal and perinatal mortality and increased morbidity. This study aims to investigate the diagnostic, therapeutic and prognostic aspects of placenta previa at the Sourô Sanou University Hospital in Bobo-Dioulasso. Method: This was a descriptive cross-sectional study with retrospective data collection from January 1, 2016 to December 31, 2018. Included were 142 pregnant women admitted to the maternity ward of the Sourô Sanou University Hospital (CHUSS) and diagnosed with placenta previa during pregnancy, labor, or in the postpartum period. Result: The frequency of placenta previa was 0.89%;the average age of patients was 28.51 years with extremes of 16 and 44 years. The multigestations represented 28.17% and the pauciparous 31.69%. Patients with a uterine scar represented 15.49%. Ultrasound diagnosis was made in 38 patients (26.76%). Placenta previa was recovered in 56.34% of cases. Patients with severe anaemia were 28.87%, and 57.04% of the anaemic cases received blood transfusion. Caesarean section was performed in 93.66% of patients. Four maternal deaths (2.81%) and 30 stillbirths (27.02%) were reported. Conclusion: Placenta previa remains a fairly frequent pathology with a non-negligible lethality rate and perinatal mortality in the maternity ward of the Sourô Sanou University Hospital.