Button Cell Ingestion in Infants: A Report of Five Cases

Button cell ingestion is a common household accident among infants, often leading to serious complications that require immediate diagnosis and urgent removal. We report five cases of button cell ingestion involving infants aged between 9 and 32 months, including four boys and one girl. The ingestion was accidentally discovered in two infants, while in the other three, it was suspected during play. In three cases, mothers attempted to induce vomiting by giving fluids, but the batteries remained in the digestive tract for 38 hours to 5 days. After confirming the diagnosis, the batteries were removed within 4 to 36 hours. The locations of the cells were the esophagus in two cases, the cardia in one, the stomach in one, and the bowel in one. One case involved a large cell in the esophagus, while the others involved smaller cells. Complications occurred in four cases, including esotracheal fistula, esophageal ulceration, and perforation of the jejunum and caecum. In one case, the digestive mucosa appeared normal upon endoscopy. One patient died.

Progressive Characteristics of HIV Infection in the Elderly in the Cohort of the Internal Medicine Department of the Points G University Hospital, Bamako. Mali

Few data are available on HIV infection in the elderly and they are an important population in our different cohorts in view of the improvement in the quality of care over the last ten years. Objective: to determine the clinical and immunovirological characteristics as well as the acceptance of antiretroviral drugs in this patient population. This is a cohort study of the files of PLHIV (People living with HIV) aged 50 years or more, followed in the Internal Medicine Department of the Point G University Hospital between January 2007 and December 2012. Results: Out of 161 HIV-infected patients in the cohort, 38 were aged 50 years or older, of whom 11 met the criteria and were included. The median age was 55 years, 90.9% of whom were in the [50 - 59 years] age group, with 63.6% being women (sex ratio = 0.57). At admission, 3 patients (27.3%) had prurigo and 2 (18.2%) had oral-pharyngeal candidiasis. At inclusion, 45.5% of patients were classified as WHO stage 2 and one as WHO stage 4. All were on ARVs, including 10 on 1st line HIV-1 and 1 on HIV-2. On triple therapy, the average weight gain was 5.1 kg at D15 and 6.84 kg at M6. However, at M12 there was a weight loss of 1.04 kg. The mean CD4 T cell gain was +102/mm3 at M6 and +188/mm3 at 12 months. At D0, mean viral load = 565024.75 copies/mm3 [99 - 1100000] in 4/11. At M12, two patients had undetectable viral loads. Conclusion: The prevalence of HIV in elderly subjects is certainly underestimated. Thanks to triple antiretroviral therapy, PLHIV are aging with HIV but screening is not systematically proposed during consultations in elderly subjects. It is necessary to reinforce communication about HIV at all ages.

Phenotypic Characterization of Carbapenemase-Producing Enterobacteriaceae Strains in a Referral Teaching Hospital in Yaoundé, Cameroon

Background: Carbapenemase-producing Enterobacteriaceae (CPE) are an important and increasing threat to global health. They are nowadays more encountered routinely in hospitals and cause high morbidity and mortality due to limited therapeutic alternatives. This study sought to determine the prevalence of CPE in Yaoundé teaching hospital, Cameroon, and the associated risk factors. Materials and Method: To achieve this goal, a descriptive cross-sectional study coupled to an analytical component with consecutive collection of Enterobacteria strains was carried out during a three-month period (from 27th July to 24th October 2018) in the University Teaching Hospital of Yaoundé, Cameroon. The oxidase and biochemical identification tests using a miniaturized Api 20 E system were performed on colonies grown on Eosin Methylene Blue (EMB) medium and subcultured on nutrient agar. Drug susceptibility testing was carried out according to the Antibiogram Committee of the French Society of Microbiology (CA-SFM 2018.V.2.0). The detection of carbapenemase production was performed by the CA-SFM 2018 algorithm for the screening of carbapenemase-producing enterobacteriaceae and its classification by inhibitory synergy tests. Results: Out of the 104 isolates, Escherichia coli (50%) was the most prevalent species, followed by Klebsiella pneumoniae (37.5%) and Citrobacter frendii (12.5%). Drugs susceptibility patterns showed a high resistance to penicillins group (97.4% to amoxicillin), cephalosporins (68.4% to cefotaxim, 58.1% to cefixim, 60.7% to ceftazidim, 57.1% of cefoxitin) and aztreonam (55.7%). However, 11.9% carbapenems related resistance was noticed: 14.4% to imipenem, 13.8% to ertapenem and 7.5% to meropenem. Numerous co-resistance to quinolones (65.8%), fluoroquinolones (49.6%), aminoglycosides (49.6%) and cotrimoxazole (71.8%) were also observed. From 104 isolates, AmpC production represented 23.08% (25/104) and 36.54% (38/104) were ESBL-isolates. The overall prevalence of CPE was 25% (26/104) with K.pneumoniae predominant (61.53%). Besides, Class A and class B carbapenemase were mainly produced with respectively 20% (21/104) and 5% (5/104). Univariate analysis revealed a significant association of carbapenemase production to Klebsiella pneumoniae (p = 0.01), ESBL and AmpC production ((P = 0.01 and P = 0.001 respectively) while that association was only significant to Klebsiella spp (p = 0.04) and AmpC production (p = 0.02) in multivariate analysis. Conclusion: The multi-resistance of Enterobacteriaceae to antibiotics in Cameroon has considerably increased. More attention should be paid to those bacteria to stall antimicrobial resistance spread.

Diagnosis of Helicobacter pylori Infection in Low Out-Outcome Country: Rapid Urease Test, Serological Test, versus Direct Microbiological Examination with Gram Stain

Introduction: Helicobacter pylori is a gram-negative bacillus responsible for numerous gastroduodenal pathologies, and this infection is a public health problem. The prevalence of infection with this bacterium remains high in countries with limited resources. Diagnosis relies mainly on numerous invasive and noninvasive methods. The aim of this work was to evaluate the different indirect diagnostic methods using bacterial cultures. Methods: We conducted a cross-sectional and analytical study from January to May 2022 in the gastroenterology departments of Douala General Hospital and Douala Military Hospital. All patients aged 18 years and older who were in the gastroenterology consultation and agreed to participate were included in our study. Sociodemographic, clinical, and paraclinical data were collected. Urease, liquid urea, and culture tests were performed from the specimens obtained by fibroscopy. Serological tests were performed on the blood sample. Results: 101 patients were included, 58 were female and 43 were male, for a sex ratio of 1.3. The mean age was 44.2 ± 16 years. The prevalence of infection was 90.5%, 44.1%, 40.6% and 21.8% for serology, direct microbiological examination, RUT (rapid urea test) and culture, respectively. Comparison of the different tests showed sensitivity and specificity of 67.1% and 64%, respectively, for RUT, 100% and 73.7%, respectively, for direct microbiological examination, and 100% and 14.8%, respectively, for serology. The positive and negative predictive values were 39.5% and 100% for serology, 39% and 85% for RUT, and 55.6% and 100% for direct microbiological examination, respectively. Conclusion: The prevalence of Helicobacter pylori infection depends on the type of test used. Direct examination is more reliable than RUT and serology.

Epidemiological and Clinical Profile of Hypertensive Patients with Obstructive Sleep Apnea at CHU-B

Objectives: To detect obstructive sleep apnea syndrome (OSAS) in a population of hypertensive patients, using the Berlin questionnaire and to establish the epidemiological and clinical profile of patients. Patients and Method: This was a cross-sectional and analytical study, carried out from March to August 2019 at the CHU Brazzaville. Included are hypertensive patients followed as outpatients. The diagnosis of the OSAS was based on the answers to the Berlin questionnaire. Results: A total of 315 patients were included, including 210 women (64.9%). Prevalence of OSAS was 75.8% (n = 239). The average age of patients with sleep apnea was 58.5 ± 12.4 years with female predominance (64.9%). In the mixed analysis, the factors associated with (OSAS) were: occupation OR (2.56) 95% CI (1.15 - 5.69), obesity OR 7.50 (1.60 - 35.1) and abdominal obesity OR 2.36 CI 95% (1.36 - 4.08). Living standards were high in 59 cases (18.7 per cent). The medical history of previous hospitalization was present in 209 cases (66.3%), diabetes 95 (30.2%), and heart failure 57 cases (18.1%). Lifestyle patterns were: sedentary (n = 181;57.5%) alcohol consumption (n = 97;30.8%). On physical examination, overweight was noted in 96 cases (30.5%) and obesity in 91 cases (28.8%). The anomalies in the Berlin questionnaire were: snoring (n = 197;62.5%), waking fatigue (n = 127;40.3%), fatigue during the day (n = 97;30.8%). Conclusion: The prevalence of obstructive sleep apnea syndrome is high during arterial hypertension in our setting. Hence the need for sleep exploration through polysomnography, and prevention through the fight against the associated risk factors.

Gallbladder Carcinoma of the Thyroid Revealed by an Acute Festered Thyroiditis: A Literature Study about a Case

The cutaneous extension of gallbladder thyroid carcinoma is uncommon and is among the aggressive forms of the disease. We are reporting the case of a woman of 54 that shows acute festered thyroiditis worsened by a necrotic ulcer wound on the skin lasting 3 weeks amid a big neglected hetero-multinodular goitre, evolving since 20 years. The anatomopathological test showed a gallbladder thyroid carcinoma of the thyroid with severe inflammation. The treatment consisted of a complete thyroidectomy with recurrent bilateral dredging. There was a favourable evolution. Gallbladder carcinoma, in its aggressive aspect, may be linked to the occurrence of acute festered thyroiditis. Therefore, the prognosis of our patient was favourable.

Hormonal Contraception and Hypertension at the Department of Obstetrics and Gynecology, Yalgado Ouédraogo Teaching Hospital: Epidemiological, Clinical and Therapeutic Patterns

Context: The use of hormonal contraceptives could lead to a rise in blood pressure with an onset of hypertension. The objective of the study was to describe the epidemiological, clinical and therapeutic patterns of hypertension occurring in women on hormonal contraception. Patients and Methods: A retrospective study was carried out over a period of 5 years. It involved clients on hormonal contraception who developed hypertension during follow-up at the Family Planning Unit of the Yalgado Ouedraogo Teaching Hospital in Burkina Faso. Results: The global frequency of hypertension in clients on hormonal contraception was 1.8%;it varied depending on the type of methods of contraception used;it was 4.2% for clients on oral combined pills, 1% for implant users and 0.97% for women on injectable. The mean age of patients was 35.6 ± 8.4 years. Sixty-seven patients (84.8%) had mild to moderate hypertension. The mean time to onset of hypertension was respectively seventeen (17), thirty six (36) and thirty eight (38) months for patients on OCPs, CIP, and implants. After the discovery of hypertension, the contraception methods have been changed in 75.9% of cases, stopped in 5.2% of cases and the same contraception method was continued in 8.9% of cases. None of the patients who continued the same contraceptive method had obtained a normalization of blood pressure. Blood pressure was normalized in 48.6% of patients who have changed contraceptive methods. The average time of normalization of the blood pressure varied from three to five months, depending on the method that induces the hypertension. Conclusion: Hypertension on hormonal contraception is not uncommon. It is important to assess the risk factors for its occurrence at the initiation of contraception.

Papulosa Nigra Dermatosis Another Factor Associated with Cardio-Vascular Diseases?

Objectives: To determine the correlation between dermatosis papulosa nigra (DPN) and cardiovascular disease (CVD). Patients and Method: A retrospective study was conducted between April 2022 and March 2023 in cardiology at Loandjili General Hospital. Were included all adult patients older than 18 years of age presenting with DPN, and divided into two groups according to the presence of CVD. Hypertension (HT), endomyocardial fibrosis, dilated and restrictive cardiomyopathy, chronic pulmonary heart, ischemic heart disease, stroke, and valvular heart disease were retained as CVD. Pregnant women, Peutz Jeghers syndrome and all dermatosis with cardiovascular manifestations were excluded. Studied variables were clinico-demographic, hereditary and behavioral. Results: A total of 55 patients were selected. There were 40 patients with CVD, 15 patients without CVD, 43 women (78.1%) and 12 men (21.8%). Mean age was 52 ± 12.6 years (extremes: 22 - 85 years). There was a significant difference between age and sex (P 0.05). There were 34 hypertensive patients, 10 patients with diabetes mellitus, 7 strokes, 2 endomyocardial fibrosis and 2 ischemic heart diseases. Periorbital location was representative was frequently found in the group with CVD. Hereditary and behavioral factors were involved in the development of DPN and CVD. There was a significant correlation between DPN and onset in childhood (P 0.05), between hypertension and use of medication (P 0.05), and between onset in childhood (P 0.05) and use of mercury containing soap (P 0.05). Conclusion: DPN predominates in young women. The occurrence of CVD depends on DPN location. Hereditary and behavioral factors associated with development of DPN are CVD factor risks.

Arterial Hypertension and Pregnancy about 72 Cases

Background: Hypertension is the leading cause of cardiovascular disease worldwide. Hypertensive disorders in pregnancy also constitute a major global health threat. There are different types of hypertension that can occur during pregnancy;with different mechanisms and consequences for mother and fetus. Objectives: To determine the frequency of hypertension (hypertension) during pregnancy. Document the risk factors for pregnancy-related hypertension. Review the material and fetal complications which determine the prognosis. Methods and Patients: This was a retrospective cross-sectional study from January 1 to June 30, 2022 in the Obstetrics and Gynecology Department of the Brazzaville Hospital and University Center. We noted 72 cases of hypertension among 1188 births admitted during the reference period. Hypertension was defined as blood pressure 40/90mmHg. Results: Hypertension was observed in 6% of those giving birth. The average age of the patients was 28 ± 8 years (range 15 to 39 years). The age group of 15 to 34 years was the most affected, 56 cases (778%). The risk factors were young age (15 - 34 years), late transfer of women in labor, 49 cases (68%). Primiparity, 33 cases (45.8%), absence of prenatal consultation, 7 cases (9.7%), hypertension, 8 cases (11%), twinning, 4 cases (5%), fetal macrosomia, one case (1.3%). Maternal complications recorded were: 21 cases of eclampsia (29%), 6 cases of left ventricular failure (8.3%), 5 cases of anemia (6.9%), 2 cases of retroplacental hematoma (2.8%), 1 case of HELLP syndrome, as much renal failure. Fetal and neonatal complications were 23 cases of prematurity (32%), 10 cases of acute fetal distress (14%), 4 cases of hypotrophy (5.6%). Eleven cases of death (15.3%) were: 3 in utero. B in the neonatal period.

A Chronic Dysphony Caused by a Bifocal and Pulmonary Laryngeal Tuberculosis

Laryngeal tuberculosis is a rare entity. We consider the case of a woman of 62 who presented a one-year evolving chronic dysphonia chart associated with cough, febricula and general health damage. The nasofibroscopy showed a budding ulcerous lesion of the larynx a priori evoking a granulomatous lesion or cancer. The BAAR spits were strongly positive and the radiographic pictures of the thorax, typically evoked a pulmonary tuberculosis. Seeing the excellent therapeutic response to TB treatment in 4 months period, the bifocal tuberculosis diagnostic was confirmed.

Factors associated with stroke direct cost in francophone West Africa, Benin example

Background: In sub-Saharan Africa, stroke constitutes a public health issue. Few studies were conducted to assess the cost involved in its treatment. Objective: To determine the factors involved in direct cost of stroke in Cotonou-Benin. Method: It consists in a transversal and prospective research of economic type with analytical and descriptive aim. It was conducted from 20thFebruary 2011 to 30thSeptember 2011. The research dealt with 122 stroke patients. With regard to the economic approach, bottom-up was the data collection technique which was adopted. Cost was estimated not only based on the patient himself/herself but considering societal aspect. Cost estimation period was hospitalization period. Data analysis was conducted via software such as Epi info and SPSS. Results: Overall expenses in terms of direct cost varied from $144.9 to $9393.9;average expenses were $1030.1 ± $101.7. Patients aged 50 and above had higher stroke hospitalization cost ($1277.4) than those aged below 50 ($857.4) p = 0.001;male patients made more expenses than females (FCFA 1157.5 against $831.8) p = 0.01;direct cost of stroke was increased in proportion to neurological deficit (score NIHSS) p = 0.043. This cost was higher in cases of hemorrhagic stroke than ischemic stroke (FCFA $1375 against $1098) p = 0.002. Stroke direct cost was also increased in proportion to severance of disability level of patients. Stroke type (hemorrhagic) and RANKIN score were firmly correlated to stroke hospitalization cost. Conclusion: Stroke is very expensive for patientsin Benin and they constitute a burden for both patients and their family. There is a great need to increase awareness regarding risk factor control in order to reduce the cost involved in treating this malady.