Radical Hysterectomy in Cervical Cancer: Patients’ Epidemiological and Clinical Profiles and Perioperative Outcome in Two Referral Hospitals in Cameroon

Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screening and awareness of early symptoms can reverse the situation.

Epidemiological and Clinical Profiles of Chronic Kidney Disease Patients Presenting for Emergency Hemodialysis: A Five-Year Retrospective Study in Two Dialysis Centres in Cameroon

Background: Late referral of Chronic Kidney Disease (CKD) patients requiring emergency hemodialysis (HD) for survival poses a serious threat to global health particularly in sub-Saharan Africa (SSA). Objective: Describe the epidemiological and clinical profiles of CKD patients starting HD in emergency. Methodology: This was a retrospective cross-sectional study. Files of patient files of CKD patients who underwent dialysis from January 1st, 2016 to December 31st, 2020 were reviewed at the HD centres of the two main hospitals of the Cameroon city capital, Yaoundé. We included all emergency HD for End Stage Renal Disease (ESRD). Socio-demographic and clinical data including past medical history, signs and symptoms at presentation and indications for emergency HD were recorded. Emergency HD was defined as a dialysis session performed in ESRD with a temporary vascular access. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 26 for Windows. Results: Out of 700 recorded CKD patients who started HD, 570 underwent an emergency HD, thus a prevalence of 81.43%. We included 311 patients, 63.7% were males. The mean age was 47.05 ± 15.60 years ranging from 8 to 83 years with a modal age group of 40 - 59 years. The most prevalent co morbidities were hypertension (66.2%), diabetes mellitus (28.6%) and HIV infection (10%). The commonest presenting symptoms were asthenia (68.2%), lower limbs swelling (52.1%) and anorexia (41.8%) and the main clinical signs were high blood pressure (74.92%), and pallor (60.5%) and altered general state (55%). The indications for emergency HD were dominated by uremic encephalopathy (33.4%) and pulmonary oedema (25.7%). Conclusion: More than eight out of ten CKD patients start emergency HD. Patients are mostly middle-aged adults with a male predominance. Hypertension and diabetes mellitus remain the most common co morbidities and uremic encephalopathy is by far the first indication for emergency HD.

Clinical Profiles at the Time of Diagnosis of SARS-CoV-2 Infection in Costa Rica During the Pre-vaccination Period Using a Machine Learning Approach

The clinical manifestations of COVID-19,caused by the SARS-CoV-2,define a large spectrum of symptoms that are mainly dependent on the human host conditions.In Costa Rica,more than 169,000 cases and 2185 deaths were reported during the year 2020,the pre-vaccination period.To describe the clinical presentations at the time of diagnosis of SARS-CoV-2 infection in Costa Rica during the pre-vaccination period,we implemented a symptom-based clustering using machine learning to identify clusters or clinical profiles at the population level among 18,974 records of positive cases.Profiles were compared based on symptoms,risk factors,viral load,and genomic features of the SARS-CoV-2 sequence.A total of 18 symptoms at time of diagnosis of SARS-CoV-2 infection were reported with a frequency>1%,and those were used to identify seven clinical profiles with a specific composition of clinical manifestations.In the comparison between clusters,a lower viral load was found for the asymptomatic group,while the risk factors and the SARS-CoV-2 genomic features were distributed among all the clusters.No other distribution patterns were found for age,sex,vital status,and hospitalization.In conclusion,during the pre-vaccination time in Costa Rica,the symptoms at the time of diagnosis of SARS-CoV-2 infection were described in clinical profiles.The host co-morbidities and the SARS-CoV-2 genotypes are not specific of a particular profile,rather they are present in all the groups,including asymptomatic cases.In addition,this information can be used for decision-making by the local healthcare institutions(first point of contact with health professionals,case definition,or infrastructure).In further analyses,these results will be compared against the profiles of cases during the vaccination period.

Comparison of the Clinical Profile and Severity Factors of COVID-19 during the First 4 Waves in a Paediatric Population of Yaounde

Introduction: COVID-19 is an infectious disease that has been causing a global pandemic since 2019. Although clinical forms are generally less severe in children than in adults, children nevertheless present polymorphous clinical forms and severe cases that can lead to death. Objective: To describe the clinical presentations found in the different waves of COVID-19, and to highlight the different factors of severity. Materials and Methods: We conducted a cross-sectional study with retrospective and prospective data collection which lasted 7 months (from November 2021 to June 2022) and covered a study period from 6 March 2020 to 22 June 2022, i.e. 27 months. All patients aged 0 to 18 years, suspected of having COVID-19, confirmed by real-time RT-PCR or an antigenic Rapid Diagnostic Test or antibody were included. These patients were to be managed in the Mother and Child Centre of the Chantal Biya Foundation, as well as in the Specialised Centre for the Management of COVID patients, annex number II of the Yaoundé Central Hospital. The results were analysed using IBM SPSS.23 software. Results: We included 163 patients in our study. No paediatric patients were registered during the 3rd wave. The mean age of the patients in the study population was 13 ± 5 years with extremes from 15 days to 18 years. We had a female predominance with a sex ratio of 0.83. The most common comorbidity was asthma. The first wave presented mainly with respiratory symptoms such as dry cough and signs of respiratory distress. The second wave presented mainly with digestive symptoms such as diarrhoea, abdominal pain and vomiting. The fourth wave presented with ENT signs such as sore throat, and rhinorrhea. Factors associated with severity were mainly age less than five years (OR = 17.69), vomiting (OR = 6.50), presence of comorbidities (OR = 3.39), and alteration of vital parameters such as bradypnoea (OR = 19.68), bradycardia (OR = 6.34), tachycardia (OR = 3.73), oxygen saturation Conclusion: Clinical presentations varied between waves and the main risk factor was age under 5 years. The fourth wave was less severe than the second wave, which in turn was less severe than the first. (4th nd st) which allows us to humbly recommend more screening for patients under 18 years of age with respiratory, ENT and digestive signs and special attention for those under 5 years of age.

Clinical Profile of Women with Mental Disorders in Dakar Hospitals

Introduction: In Senegal, knowledge of the clinical profile of mental disorders in women has not been the subject of many studies, even though it is of vital importance to those involved in mental health. Thus, the aim of our study was to describe the clinical aspects of psychiatric disorders in women hospitalized at Fann. Methodology: This was a cross-sectional, retrospective, and descriptive study over a five-year period. We identified 402 cases that met the selection criteria. The data collection form provided information on aspects of the clinical profile of mental disorders, such as medical, surgical, gynecological, obstetrical and psychiatric history, instigator of the request for care, diagnosis, duration and number of hospitalizations. ICD-10 was used for the various pathologies identified. Results: Asthma was noted in 7% of patients, as was hypertension. Gynecological surgery was found in 43 patients (11%). Eight patients were menopausal (2%). The mean number of gestations was 2.09, with a standard deviation of 2.257 and extremes between 0 and 10 gestations. Patients with a history of abortion numbered 58 (14%). The decision to hospitalize the patients was made by 96% (384 patients) of those around them. Hetero aggression was the most recurrent reason for hospitalization (19%). Pathology group F20-29 (schizophrenia, schizotypal disorder, and delusional disorders) was the majority group. Conclusion: The clinical profile of the mentally ill woman in Dakar is a woman in her mid-forties who most often presents with a personal psychiatric history, and her hospitalization is prompted by hetero-aggression and/or logorrhea. She usually suffers from schizophrenia and related disorders. Hospitalization usually lasts between 11 and 20 days.

Adult Kidney Cancer in Mauritania: Clinical and Therapeutic Aspects

Introduction: since its creation, our urology department has taken care of tumor pathologies in particular kidney cancer in adults;our goal is to study the clinical and therapeutic epidemiological profiles of adult kidney cancer in Mauritania. Materials and Methods: We carried out a retrospective study over a period of six years, from January 1, 2012 to December 31, 2017, including all cases of adult kidney cancer registered in the urology-andrology departments of the Cheikh Zayed Hospital and Pathological Anatomy of the National Hospital of Nouakchott (Mauritania). Results: we collected 50 cases of kidney cancer. The average annual incidence was 8.3 cases. The average age of the patients was 52.98 years with extremes of 18 and 84 years. There was a female predominance (52%) or 29 women for 21 men. Lumbar pain was the most frequent clinical expression, more than half of the patients had symptoms over a period of at least 12 months before the first consultation. The left kidney was the most frequently affected. The right localization was demonstrated in 23 patients, the extension assessment was made with thoraco-abdomino-pelvic CT in 40 patients. Twelve patients had a tumor localized in the kidney. The extension assessment had made it possible to objectify the existence of metastases in 17 of our patients (37%). The preferred locations of these metastases were pulmonary and hepatic. Surgical intervention was performed in 44 patients (88%), of whom 36 underwent radical nephrectomy (72%), and two patients underwent partial nephrectomy (4.5%). Surgical abstention was decided from the outset in 6 patients (13.6%). None of our patients had received treatment with anti-angiogenics. The histological type most observed in our patients was renal cell carcinoma, observed in 34 patients, or 77.72%. At the time of the study, more than a third of the patients had died. The mortality rate in our series had reached 24%. A specific survival rate could not be assessed due to lack of information in the files and significant numbers of patients lost to follow-up at the time of the study. Conclusion: adult kidney cancer in Mauritania is characterized by its low incidence, its occurrence in a relatively young population, its female predominance, its often late diagnosis at locally advanced and metastatic stages, and the treatment is the most often surgical.

Philippine retinoblastoma initiative multi-eye center study 2010-2020

AIM:To provide a comprehensive and more representative national data on the disease,especially on treatment options and outcomes,and to determine access of retinoblastoma patients from Luzon,Visayas and Mindanao to eye care,and determine if access is associated with delay in consultation,staging and outcomes.METHODS:Cohort study of retinoblastoma patients seen in eleven institutions located in the three major areas of the Philippines namely Luzon,Vizayas and Mindanao from 2010-2020.RESULTS:Totally 636 patients,involving 821 eyes,were included.Majority(57%)were from Luzon and were seen in institutions in Luzon(72%).Annually,58±10 new cases were seen with 71%having unilateral disease.Median delay of consultation remained long at 9(3,17)mo,longest in patients with unilateral disease(P<0.02)and those from the Visayas(P<0.003).Based on the International Retinoblastoma Staging System,only 35%of patients had Stage 1 while 47%already had extraocular disease.Enucleation was the most common treatment received by 484 patients while intravenous chemotherapy was received by 469.There were 250(39%)patients alive,195(31%)dead,85(13%)abandoned,17(3%)refused and 89(14%)with no data.CONCLUSION:This study presents the largest cohort of retinoblastoma patients in the Philippines in terms of patients’and participating institutions’number and geographical location and type of institution(private and public).It also presents more comprehensive data on the treatments used and outcomes(survival,globe salvage,and vision retention rates).Delay in consultation was still long among patients leading to advanced disease stage and lower survival rate.Despite increasing capacity to diagnose and manage retinoblastoma in the country,the delay of consultation remains long primarily due to accessibility issues to eye care institutions especially in the Visayas and financial concerns.The delay was still significant that overall survival rate remain low.

Clinical profile of patients with advanced age and inflammatoric dilated cardiomyopathy on endomyocardial biopsy

Background Endomyocardial biopsy （EMB） is an important tool when patients with inflammatoric cardiomyopathy （DCMi） are evaluated. We aimed to assess the clinical profile of elderly patients with DCMi on EMB. Methods Retrospective study of all consecutive patients hospitalized from January 2007 to December 2011 with clinical suspicion of DCMi undergoing EMB. Patients with evidence of DCMi on EMB （Group 1 〉 70 years, n = 85; Group 3 〈 70 years; n = 418） were compared to patients of the same age group without evi- dence of DCMi on EMB （Group 2 〉 70 years, n = 45; Group 4 〈 70 years; n = 147）. Results Among 24,275 patients treated at our institu- tion during the study period, 695 had clinical suspicion of DCMi and underwent EMB; 503 （2.1%） patients had DCMi on EMB. There were more male patients in Group 1, mean age was 74 ~ 2.8 years, mean ejection fraction was 38% q- 14%. On presentation, signs of hemody- namic compromise （NYHA functional class IIUIV, low cardiac output/index, and low cardiac power index） were more frequent in Group 1. EMB revealed viral genome in 78% of the patients, parvovirus B 19 （PVB） was frequently encountered in both age groups （Group 1： 69.4% vs. Group 2： 59.6%）; detection of more than one viral genome was more frequent in Group 1 （21.2% vs. 11.2%; P = 0.02） whereas the extent of immune response was significantly lower in individuals with advanced age. Conclusions In patients 〉 70 years with DCMi on EMB signs of hemodynamic compromise, detection of multiple viral genomes together with an overall lower extent of immune response were more frequently observed.

Variance in Clinical Profile and Use of Anticoagulants in Valvular and Non Valvular Atrial Fibrillation

Introduction: Atrial fibrillation is the most common cardiac arrhythmia encountered in clinical practice that affects morbidity and mortality to a large extent. This study was intended to determine various clinical profile and etiological factors in valvular and non-valvular atrial fibrillation and evaluate the usage of anticoagulants in them in the settings of developing nation like ours. Methods: A hospital based cross-sectional observational prospective study was conducted at Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Nepal for a period of sixteen months. All the patients with atrial fibrillation who were admitted in the cardiology department were included. The demographic profile, etiology, clinical features and the usage of anticoagulants were recorded. Results: A total of 175 patients with atrial fibrillation were enrolled in the study with 62% nonvalvular and 38% valvular cases. The overall mean age was 60 ± 16.79 years but among valvular atrial fibrillation, it was 47.9 ± 14.013 and among nonvalvular atrial fibrillation, it was 67.85 ± 13.507 years. Majority of patients were female (56%). Sixty percent were from outside Kathmandu valley. Rheumatic heart disease was the most common cause (38.9%) followed by dilated cardiomyopathy, systemic hypertension, degenerative valvular heart disease, coronary artery disease, etc. The most common presentation was dyspnea. About 79% of valvular and 17% of nonvalvular atrial fibrillation patients were using anticoagulants. Conclusion: Atrial fibrillation was common in young females and rheumatic heart disease was the leading cause. There was inadequate use of anticoagulants in both valvular and nonvalvular atrial fibrillation probably due to the economic constraints and geographical hurdles.

Clinical, Biological, Immunological and Therapeutic Profile of Patients Co-Infected with HIV-HBV and/or HCV in Kinshasa, in the Democratic Republic of the Congo: Multicenter Cross-Sectional Study

Background and Objective: HIV infection is often associated with HBV and HCV infection, together leading to high morbidity and mortality in developing countries. The objective of this study is to describe the clinical, biological, immunological and therapeutic profile of patients co-infected with HIV-HBV and/or HCV. Methods: A cross-sectional and descriptive study including 180 people living with HIV (PLWHIV) in the city of Kinshasa province was conducted. Socio-demographic, clinical, biological and serological characteristics were analyzed. Results: The frequency of HIV-HBV/HCV co-infection was 23.9%. The distribution of age and sex of patients did not differ significantly according to co-infection status. The notion of pedicure and manicure was significantly more observed in patients free from viral hepatitis (51.1% versus 32.6%, p = 0.034). The median duration of knowledge of the HIV status which was longer in the co-infected (4 years versus 2 years, p = 0.022). A lower median level of GPT was observed in co-infected compared to other patients (14 IU/L versus 20 IU/L, p = 0.041). Serum albumin (3.1 g/L versus 3.3 g/L, p = 0.034) and prothrombin (58.3% versus 65.6%, p = 0.045) were lower in HIV co-infected-VHB and/or VHC. The median INR was higher in co-infected than in other patients (1.6 versus 1.4;p = 0.009). Patients without therapy Antiretroviral (TARV) medication were more numerous in co-infected (20.9% versus 8.0%, p = 0.025). Conclusions: The profile of PLWHIV was dominated by the presence of pedicures and manicures with high transaminases and without anti-viral treatment.

Clinical and Histological Profile of Breast Cancer at University Clinics of Kinshasa, Democratic Republic of Congo

Context: Breast cancer represents a significant public health problem concern the world, given its frequency (20% to 25% of female cancers) and diagnosis clinical stage with a particular frequency of locally advanced cancers and inflammatory forms. Objectives: To describe the socio-demographic, clinical and histological characteristics of breast cancer at the University Clinics of Kinshasa. Methods: A descriptive and retrospective study was completed at University Clinics of Kinshasa from 1 January 2003 to 30 July 2018, including 300 cases of breast cancer diagnosed and treated. Results: The mean age of women at diagnosis was 47.5 ± 10.8 years. Most of the patients were married, multipara with an average parity of 3.7 ± 2.5 and non-menopausal. Breast mass was the main reason for medical visit (47.5%) and the majority of patients consulted 12 months after the onset of the disease (36.3%) at stage 3 (56%) and node extension was observed in 61.3%. The average size of the breast mass was 8.02 ± 3.7 cm. The infiltrating ductal carcinoma was the most common histological type in 82.5% of cases;the majority of tumors were histo-pronostic II in 47.5% of cases. 83% of the tumors were hormonal-dependent. Only 35.9% of the tumors over-expressed the HER 2/Neu receptor. Conclusion: Most patients consulted more than 12 months after the onset of the disease and the diagnosis was made at advanced stages. The tumor was large at diagnosis. The left breast was the most affected. The majority of tumors are of high histopronostic grade and are hormonal-dependent.

Clinical-Pathological Features and Treatment Modalities of Primary Brain Tumors in Tanzania—4 Years of Institutional Experience

Background: The profile of primary brain tumors and treatment modalities employed in Tanzania remains largely unknown. The study aimed to describe the baseline clinical-pathological profile and treatment modalities for primary brain tumors in adults treated at the Ocean Road Cancer Institute (ORCI) from 2017 to 2020. Materials and Methods: This was a retrospective study conducted at ORCI by reviewing 61 medical records of patients with primary brain tumors over the age of 15 from January 2017 to December 2020. A structured questionnaire was used to retrieve information on sociodemographic, clinical-pathological characteristics, and treatment modalities. The 2007 WHO classification system and the International Classification of Cancer Diseases (ICD-0-3) were used for classification and diagnosis. The X2 test and Fisher’s exact test were used to compare the proportions and an independent t-test was used to compare the means. A P-value less than 0.05 was deemed statistically significant. The Results: The mean age of the females was 41.8 years and the mean age of males was 42.9 years. Overall M: F ratio was 1:1.2. Meningioma was the only tumor that was more commonly found in women with M:F of 1:2.1. The most prevalent symptom was headache (57.4%). Glioblastoma (GBM) was the most common tumor among adults (38%), followed by astrocytomas (23%) and meningioma (18%). Approximately 91.8% of all tumors occurred in the supratentorial region. The Frontal lobe was the most common site (29.5%). Approximately 81.9% of patients received surgery. The gross tumor resection (GTR) rate was 26.2%, and the subtotal tumor resection (STR) rate was 55.7%. Roughly 18% of the tumors were inoperable. An estimated 80.3% of respondents received radiation therapy. The radiotherapy technique was 3DCRT in two-thirds of the patients and the rest received conventional 2D radiotherapy. The mean equivalent dose in the 2 Gy fractions (EQD2) was 43.9 Gy. Respondents with low-grade intracranial tumors were treated with a mean EQD2 of 47.3 Gy, while those with high-grade intracranial tumors were treated with a mean EQD2 of 44.3 Gy and the difference was statistically significant. Only half of the patients who received adjuvant radiotherapy received it concurrently with chemotherapy. Temozolomide was the most widely used cytotoxic medication. Conclusion: Mean age of the patients was 41 years old. Most tumors were in the supratentorial area and GBM was the most common tumor. Only meningioma was a bit more common amongst females. Overall, radiotherapy doses and the gross tumor resection rates were low. Concurrent chemotherapy with radiotherapy was given to a few patients.

CCNO mutation as a cause of primary ciliary dyskinesia:A case report

BACKGROUND Primary ciliary dyskinesia(PCD)is an uncommon and genetically diverse condition.According to reports,most patients had more than 50 visits before being diagnosed with PCD,and the age at diagnosis was mostly in preschool,with an average age of about(10.9±14.4)years old.CCNO is a pathogenic gene that regulates the cell cycle,and its mutation is linked to the uncommon human genetic disorder PCD.Although the prevalence of the CCNO mutation is regarded to be exceptionally low,new reports of this mutation have increased in comparison to prior ones.PCD patients with CCNO are rare,and the incidence rate is no more than 2%in whole PCD patients.CASE SUMMARY Here,we report a case of a young Chinese woman diagnosed with PCD,who was found to carry the CCNO gene by whole exon gene sequencing.In this case,a young non-smoking Chinese female exhibiting recurrent cough and sputum at birth.Chest computed tomography(CT)showed bronchiectasis with infection,and sinus CT showed chronic sinusitis.However,the patient had no visceral transposition and no history of infertility.Under electron microscope,it was found that cilia were short and reduced in number,and no power arm of cilia was observed.Whole exon sequencing analysis of the genome of the patient showed that the patient carried CCNO pathogenic gene,exon c.303C>A nonsense mutation and c.248_252dup frameshift mutation.Her clinical symptoms and CT images were improved after two months of treatment with aerosol inhalation and oral azithromycin.CONCLUSION The results showed that CCNO is an important cause of PCD.More mutant genes that may contribute to genetically diverse disorders like PCD have been discovered as sequencing technology has advanced.Furthermore,the increase of genetic information makes it easier to diagnose uncommon diseases in clinical practice.

Bio-characteristic profiling related to clinic:A new technology platform for quality evaluation of Chinese materia medica

Quality evaluation is a bottleneck restricting the modernization and internationalization of Chinese materia medica (CMM). Due to characteristics of multi-component, multi-efficacy, multi-target, the existing quality evaluation system still cannot fully meet quality control needs of CMM. Hence, the author put forward “Bio-characteristic profiling related to clinic, BPRC” academic concept, meanwhile, fully take the advantage of analysis method with clinical monitoring superiority or profiling characteristics, build up “BPRC” new technology platform, in order to realize “real-time, dynamic and full-range monitoring” new technologies of CMM quality evaluation system and promote the further development of CMM industry.

Epidemiological Aspects of Cervicofacial Cellulitis Due to Dental Origin in the City of Ouagadougou (Burkina Faso)

Background: Head and neck cellulitis of dental origin are polymicrobial bacterial infections involving the cellulo-adipose spaces of the face and neck. The objective of this work was to describe the epidemiological and clinical profile of patients with head and neck cellulitis. Methods: This was a cross-sectional study conducted from 1 January to 30 June 2020. All patients consulting for cervico-facial cellulitis of dental origin in 2 university hospitals in Ouagadougou were included in the study. The usual parameters of descriptive statistics were estimated for each variable. Results: Two hundred and ninety-two cases (184 men and 108 women), aged 3 to 85 years were collected. The 25 - 35 years old were the most affected (33%). Decay was the leading dental cause (95.6%). The delay in consultation was included within 7 days in 74.66% of cases. Ninety-one-point forty-four percent of patients had poor oral hygiene. Diffuse cellulitis was the most common (64.04%) and peri-mandibular regions were the most invaded (42.81%). Conclusion: The frequencies observed in our study allow us to conclude that cervicofacial cellulitis of dental origin is still frequent and affects a young and disadvantaged population.

Periodontal Diseases in Pregnant Women in Prenatal Consultation

Background: The relationship between pregnancy and periodontal health had well documented in the literature. Of many studies of periodontal diseases in the Democratic Republic of Congo, no study had evaluated these diseases in pregnant women during Prenatal Consultation (PC). This study aimed to describe the occurrence and clinical profile of periodontal diseases in pregnant women admitted to the PC at the General Military Hospital of BOBILA. Materials and Methods: It is a cross-sectional and analytical study of pregnant women admitted to the PC from August to December 31, 2018, at the General Reference Military Hospital of BOBILA/Kinshasa City. The data were collected through a survey combined with the stomatological interview. Sociodemographic data, clinical and periodontal indices included Oral Hygiene Index Simplified (OHI-S), Bleeding on Probing (BOP), and Periodontal Disease Index (PDI) were assessed. The statistical analyses were carried out using the SPSS version 20.0 software. The Chi-square tests, Student t-test were used to determine differences in the distribution of variables, and the odd Ratio with a confidence interval (IC) at 95% was used to estimate the degree of association. The results were significant at p < 0.05. Results: Of the 105 pregnant women received at the PC, 83 were included in this study. The age group between 20 - 29 was the most represented, with a predominance of stay-at-home mothers (75.9%) and married cases (73.4%), they had an average economic status (56.6%) and a secondary education level (63.8%). Gingival bleeding (44.6%) was the main complaint of the pregnant. Gestational age was a significant factor associated with gum bleeding (p < 0.005). Most of the pregnant had poor oral hygiene, localized gravidities (69.6%) during the third semester. Conclusion: A significant proportion of women had experienced periodontal diseases during the pregnancy period, mostly in the third trimester, and was associated with a gestational age of pregnant women.

Profile of Newborns Hospitalized for Maternal Fetal Infection and Having a Positive CRP in the Pediatric Department of the Gabriel TouréCHU in Bamako, Mali

Objective: Early bacterial neonatal infection (INBP) or maternofetal infection (early neonatal sepsis) remains a concern of the pediatrician due to diagnostic difficulties and its increased morbidity and mortality. No study has been done in Mali on the profile of newborns admitted for INBP with positive CRP, hence the initiation of this work with the aim of studying the epidemiological, biological and bacteriological profile of newborns with a bacterial maternal-fetal infection. Method: Longitudinal study descriptive (from 27 June to 3 September 2016) which concerned all newborns aged from 0 to 72 hours of life hospitalized for confirmed early bacterial neonatal infection with a positive C-reactive protein (CRP) in the neonatal department of the CHU Gabriel Touré. INBP was defined by the presence of maternal and neonatal infectious risk factors, positivity of CRP with a germ in the blood culture. Results: During the study period we included 244 newborns for probable maternofetal infection and who benefited from the CRP assay, 43 had a positive CRP, i.e. a frequency of 17.62%. The sex ratio was 2.30. The majority had a low birth weight (<2500 g) in 69.8% of cases. Mothers were aged 18 to 35 in 93%. The majority were out of school (43.8%) and housewives in 74.4%. The main reasons for consultations were prematurity and/or low birth weight, respiratory distress and neonatal distress, i.e. 46.5%, 25.6% and 11.6% respectively. Among the 43 newborns with a positive CRP, the blood culture returned positive in 79.1% (n = 34). We deplore 2 deaths (4.7%). The main bacteria were gram-positive cocci (Staphylococcus aureus 53.01% and Streptococccus agalactiae 4.10%), gram-negative bacilli (GNB) type Enterobacteriaceae (Klebsiella pneumoniae 11.25% and E. coli at 5.70%) and non-fermentative GNBs (Pseudomonas aeruginosa 2.80% and Acinetobacter baumannii complex 2.24%). Conclusion: Maternal-fetal infection is a hospital pathology frequently encountered in the neonatal period. Its clinical presentation is dominated by respiratory distress, neurological disorders and low birth weight.

Cardiopulmonary changes in patients with sickle cell anemia:A systematic review

BACKGROUND Given the high prevalence of cardiovascular and pulmonary abnormalities associated with sickle cell anemia(SCA),the clinical impact caused in addition to compromising the quality of life of patients and the overcharge that it represents to the public health system,this study systematized and evaluated scientific publications on pulmonary complications and cardiovascular diseases in sickle cell patients from 1920 to 2020.This compilation aims to provide knowledge for health professionals and managers in order to draw attention to the importance of chronic diseases in SCA patients and in addition to providing elements that provide improvements in management of useful resources that contribute to improve the quality and increase the life expectancy of these patients.AIM To systematically compile information about cardiopulmonary changes in patients with SCA.METHODS A systematic literature review was performed based on the PRISMA recommendation including scientific articles indexed in the Scientific Electronic Library Online databases of the United States National Library of Medicine and Biblioteca Virtual de Saúde.The search period was delimited between 1990 and 2020 and selected in Portuguese,English and Spanish.Three sets of descriptors were used for each database including research carried out with human beings.After reading the articles,those useful for this review were extracted using a collection instrument designed for this purpose.RESULTS The final selection included 27 studies.The year with the highest number of publications was 2016 with 5 studies(18.51%),followed by 2017 with 4(14.81%).The type of study most carried out in the period was cohort 10(37.03%)followed by cross-sectional and case-control with 8 studies in each(29.62%).Regarding the language of publication,the distribution was as follows:25(92.59%)in English,1(3.70%)in Spanish and 1(3.70%)in Portuguese.CONCLUSION The findings of the present study suggest that cardiopulmonary alterations represent a serious clinical repercussion of SCA.Of the analyzed studies,the high occurrence of pulmonary hypertension,ventricular hypertrophy and diastolic dysfunction stands out as the main cardiopulmonary complications.In view of the increased survival in SCA,there is a need for surveillance and the development of strategies aimed at preserving the cardiopulmonary function and consequently improving the quality of life of these patients.

Associations of autoantibodies and clinical profile of the patients with systemic sclerosis

Background:Systemic sclerosis is characterized by the involvement of organs and the presence of specific antibodies.The objectives of this study were to identify the autoantibodies and to determine their association with the selected clinical features of the disease among Bangladeshi systemic sclerosis patients.Methods:This cross-sectional study was performed at the rheumatology outpatient clinic of Bangabandhu Sheikh Mujib Medical University.Autoantibodies against nine systemic sclerosis-specific antigens were tested using an enzyme-linked immunoassay immunoblot kit.Several clinical features of patients with positive and negative autoantibody were examined by χ^(2) or Fisher's exact tests.Results:A total of 71 patients with systemic sclerosis(66;93.0%female)were included.Their mean age at disease onset was 33.2 years.Fifty-seven(80.3%)patients had diffuse cutaneous subtype.Out of nine autoantibodies,four were positive,anti-topoisomerase-I(57.7%),anti-U1 ribonucleic protein(21.1%),anti-RNA polymerase Ⅲ(18.3%),and anticentromere antibodies(4.2%).Eleven(15.5%)patients were negative for any antibodies and 11 patients were positive for at least two autoantibodies.Anti-U3-RNP,anti-PMScl,anti-Ku,and anti-Th/To auto antibodies were absent in all patients.Anti-RNA polymerase III was associated with raised pulmonary arterial systolic pressure(PASP)and anti-U1-RNP with decreased forced vital capacity(FVC).Conclusions:Anti-topoisomerase-I was the commonest autoantibody in patients with systemic sclerosis in Bangladesh.Anti-RNA polymerase III antibody had significant association with raised PASP and anti-U1-RNP with decreased FVC.