Postpartum Eclampsia in the Department of Obstetrics Gynecology and Reproductive Medicine of the Souro Sanou University Hospital;Burkina Faso: About 76 Cases

Background: Postpartum eclampsia is a life-threatening obstetric emergency. Its management is multidisciplinary. Despite measures taken to accelerate the reduction of maternal, fetal and infant mortality in Burkina Faso, maternal deaths related to postpartum eclampsia persist. The aim of the study was to investigate the epidemiological, clinical and prognostic aspects of postpartum eclampsia in the obstetrics department of the Sourô Sanou University Hospital in Bobo-Dioulasso. Method: This was a descriptive cross-sectional study with retrospective data collection covering the period from June 1, 2018 to May 31, 2019. We included 76 patients in the study;the variables studied were the epidemiological, clinical and prognostic aspects. The data collected were entered on a microcomputer and analyzed with the EPI info version 7.2 software. Results: The prevalence of postpartum eclampsia was 0.87% compared to admissions to the obstetrics department. The average age of the patients was 23 years old with the extremes of 15 and 39 years old. Primiparas accounted for 39.47%, housewives 53%, and home births accounted for 15.79%. Seizures accounted for 55% of the reasons for admission, the average time to onset of these seizures postpartum was 3.8 days with extremes of 1 and 30 days with 45% of seizures occurring postpartum immediately. Maternal complications were noted in 42.10% of cases with 5 cases of Hellp syndrome, 3 cases of renal failure, and 3 cases of acute pulmonary edema. We recorded 4 cases of maternal death, representing a case fatality rate of 5.2%. Conclusion: Postpartum eclampsia is common in the obstetrics department of the Souro Sanou University Hospital Center with a significant case fatality rate. Emphasis should be placed on monitoring and prevention, especially women at risk of developing postpartum eclampsia for better maternal prognosis.

Glucose-6-Phosphate Dehydrogenase Deficiency: Difficulties in Diagnosis at the Souro Sanou University Hospital, Burkina Faso

Glucose-6-phosphate dehydrogenase deficiency is the most common enzymopathy worldwide. The precise prevalence of G6PD is unknown in Burkina Faso. The objective of the study was to describe the difficulties to diagnose this disease at the Souro Sanou University hospital (CHUSS) in Bobo-Dioulasso. It involved five patients comprising one child with homozygous SS sickle cell disease, one adolescent screened following a family investigation, and three adults including a man and two women. Blood smear stained with May Grunwald Giemsa was performed to look for specific signs of G6PD-deficient red blood cell and brilliant cresyl Blue for Heinz Bodies. A microscope Olympus BX53 equipped with a Camera (XC10) and connected to a computer was used to read blood smears and capture images. Genes sequencing by Sanger method were performed in a specialized laboratory in molecular genetics. For each analysis, the protocol and instructions of the equipment and reagent manufacturer were applied. Of the five patients, three had anemia and only one had hyperreticulocytosis. Two patients had biological signs of hemolysis and one patient had an elevated CRP. Blood smear stained with MGG and cresyl blue showed specific signs of G6PD-deficient red blood cells and Heinz bodies in all patients. Biochemical analysis and molecular typing confirmed G6PD deficiency. The presence of G6PD-deficient red blood cells in the blood smear guides the diagnosis of G6PD deficiency. The diagnosis is biochemical and is based on the combined measurement of G6PD plus pyruvate kinase and/or hexokinase.

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.

Contribution of Computed Tomography to the Diagnosis of Urinary Lithiasis in a West African University Hospital

Introduction: Urinary lithiasis is defining as a condition characterized by the formation of concretions in the kidneys or urinary excretory tract. We aimed to study professional practice in CT urinary lithiasis at CHUYO. Materials and method: This was a descriptive cross-sectional study with retrospective data collection covering 3 years from January 2017 to December 2019. Results: In general, it was noted that CT scans in our environment provide all the elements needed by urologists to diagnose urinary lithiasis and its impact on the urinary system. However, there are shortcomings, particularly in terms of the accuracy of the shape and density of the stones in the CT scan reports, which does not make it easier for urologists to decide on treatment. Conclusion: Computed tomography plays a major role in the diagnosis and therapeutic management of urinary lithiasis, and its use needs to be improved in our context.

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.

Ultrasound of the Rotator Cuff in Non-Fractured Shoulder Trauma: 30 Cases at the Yalgado Ouedraogo University Hospital of Ouagadougou (Burkina Faso)

Introduction: Ultrasound is the imaging technique of choice for the study of rotator cuff lesions. However, in the case of shoulder trauma, it is rarely requested in our context. This study aimed to show ultrasound lesions of the rotator cuff in cases of non-fracture shoulder trauma at the CHUYO in Ouagadougou. Methodology: This was a prospective descriptive cross-sectional study running from August 1 to November 30, 2017, in the medical imaging department of CHUYO. The study population consisted of patients received in the department for ultrasound in the context of non-fracture shoulder trauma. Results: We collected 20 cases (66.67%) of rotator cuff lesions out of 30 non-fracture shoulder injuries. The mean age of the patients was 27.6 years. Road traffic accidents accounted for 60% of injuries, sports accidents for 30%, and domestic accidents for 10%. Ultrasound lesions were mainly tendon ruptures (36.67%) and tendinitis (23.33%). Ruptures were non-transfixing in 90.90% of cases. The supraspinatus was the most affected (81.81%). Conclusion: Ultrasound can help diagnose rotator cuff injuries, particularly in non-fractured shoulder trauma.

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.

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.

Atlas of Elbow Soft Tissue Pathologies Using Magnetic Resonance Imaging at the Saint Camille Hospital in Ouagadougou and the Polyclinique Notre Dame de la Paix (Burkina Faso)

Introduction: The elbow is a superficial joint, particularly exposed to direct impact, forced movement, and overstrain. Our work aimed to study magnetic resonance imaging (MRI) pathologies of the soft tissues of the elbow through illustrative cases. Methodology: This was a retrospective and prospective cross-sectional study covering a period of one year, from June 2020 to June 2021, at the Saint Camille Hospital in Ouagadougou and the Polyclinique Notre Dame de la Paix. Results: In general, this study found that the pathologies diagnosed on MRI were lateral epicondylitis, subcutaneous type V elbow lipoma and liposarcoma, anteromedial cortical fracture of the radial cup, cortical detachment fracture of the lateral epicondylitis, medial epicondylitis, villonodular articular synovitis, simple dermo-hypodermatitis, sequellar fibrosis of the ulnar nerve, Workman's syndrome (median and ulnar nerves) and osteoarthritis of the elbow. Lateral epicondylitis was the most frequent pathology, and most patients consulted for elbow pain predominantly associated with pressure on the epicondyle, with relative functional impotence and, occasionally, elbow swelling. Conclusion: MRI, as a complement to ultrasound and radiography, remains the most informative examination for exploring soft-tissue pathologies of the elbow.

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.

Contribution of Ambulatory Blood Pressure Monitoring to the Management of Arterial Hypertension at Blaise CompaoréUniversity Hospital

Background: Hypertension is a major public health concern in Burkina Faso. Its management relies on in-office medical setting blood pressure monitoring which is known to be an imperfect diagnosis tool. Objective: This study aims to assess the contribution of ambulatory blood pressure monitoring in the management of hypertension at Blaise Compaoré University Hospital. Methods: A monocentric descriptive retrospective study was conducted in the cardiology outpatient unit of Blaise Compaoré University Hospital. Patients aged at least 18 years who underwent ambulatory blood pressure monitoring between March 2013 and June 2015 were enrolled. Hypertension was defined as follows: average blood pressure over 24 hours > 130/80 mmHg, or diurnal blood pressure > 135/85 mmHg, or nocturnal blood pressure >120/70 mmHg. Data were analyzed using the SPSS 20.0 software. The threshold for significance was set at 5% for a validity interval at 95%. Chi square test was used for?the statistical analysis. Results: A total of 122 patients were enrolled. The main reasons for ambulatory monitoring were the evaluation of hypertensive therapy (51.6%) and the diagnosis confirmation (39.3%). The results of the ambulatory monitoring found 61.4% of the patients with hypertension and 37.7% with normal blood pressure. A treatment adjustment was made for 36.1% of the patients;an initiation of antihypertensive therapy was undertaken for 24.6%, an abstention from drug therapy was recommended?for 23.8%,?and the pursuit of previous treatment for 13.1% of the patients. Conclusion: Ambulatory blood pressure monitoring should be used more often in order to optimize the management of hypertension in our current practice.

Evaluation of Medical Prescribers’ Theoretical Knowledge on Medical Imaging in the Northern Region of Burkina Faso

Introduction: Medical imaging is a medical specialty that involves producing images of the human body and interpreting them for diagnostic, therapeutic purposes, and for monitoring the progress of pathologies. We aimed to assess the theoretical knowledge of doctors and interns in medical imaging in the northern region of Burkina Faso. Methodology: This was a descriptive cross-sectional survey based on a self-administered questionnaire. Prescribers knowledge was estimated based on scores derived from questionnaire responses. Results: We collected 106 questionnaires out of 163, i.e. a participation rate of 65.03%. The average knowledge score was 81.71% for the contribution of medical imaging to patient management. It was 60.02% for the indications/counter-indications of radiological examinations and 72.56% for the risks associated with exposure to radiation during these examinations. The score was 59.83% for the methods used to select the appropriate radiological examination. As regards the completeness of the clinical and biological information on the forms requesting imaging examinations, the score was 96.65%. Specialist doctors had the highest overall level of knowledge (74.68%). Conclusion: Improved technical facilities, good initial and in-service training, and interdisciplinary collaboration will help to ensure that imaging tests are properly prescribed, leading to better patient care.

Chest Radiography: General Practitioners’ Compliance with Recommendations

Introduction: Chest radiography is the most frequently prescribed imaging test in general practice in France. We aimed to assess the extent to which general practitioners follow the recommendations of the French National Authority for Health in prescribing chest radiography. Methodology: We conducted a retrospective analysis study, in two radiology centers belonging to the same group in Saint-Omer and Aire-sur-la-Lys, of requests for chest radiography sent by general practitioners over the winter period between December 22, 2013, and March 21, 2014, for patients aged over 18 years. Results: One hundred and seventy-seven requests for chest X-rays were analyzed, 71.75% of which complied with recommendations. The most frequent reason was the search for bronchopulmonary infection, accounting for 70.08% of prescriptions, followed by 11.2% for requests to rule out pulmonary neoplasia, whereas the latter reason did not comply with recommendations. Chest X-rays contributed to a positive diagnosis in 28.81% of cases. The positive diagnosis was given by 36.22% of the recommended chest X-rays, versus 10% for those not recommended. Conclusion: In most cases, general practitioners follow HAS recommendations for prescribing chest X-rays. Non-recommended chest X-rays do not appear to make a major contribution to diagnosis or patient management, confirming the value of following the recommendations of the French National Authority for Health.

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.

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.

Elderly Men Sexuality in Ouagadougou (Burkina Faso)

Background: In general, sexuality is a taboo subject. It is more so in elderly people, as it is believed that they do not complain about sexual disorder. Objective: To analyse the sexual activity of elderly men in Ouagadougou, Burkina Faso. Methods: This is a descriptive cross-sectional study on the sexual activity of men aged at least 60 years old. The study was carried out in Ouagadougou, Burkina Faso, from 1st June to 31st August 2014. All consenting males who were aged 60 and above at the time of the study were included. Results: We contacted 652 men, but only 200 responded i.e. a response rate of 30.67%. The age of the respondents was between 60 years and 89 years with a mean age of 66.38 ± 5.72 years. 80.15% of the respondents had at least one sexual intercourse in a month. Erection was considered satisfactory or very satisfactory in 45.8% (60/131) of respondents and 63.36% of them always had orgasm during sexual intercourse. Premature ejaculation was noted in 23.66% of respondents, while a decline in libido was noted in 82.44% of them. Conclusion: This study which is the first of its kind in Burkina Faso has helped reveal the importance of sexuality in the lives of elderly men.

Hemostasis Hysterectomies in a Low Resources Country: Epidemiological, Clinical, and Therapeutic Aspects

Background: The perilous path of the African woman’s pregnancy often ends in difficult situations putting her life in danger. One of the solutions to save her is often to “remove” her uterus, in a hemorrhage and emergency context. It is the hemostasis hysterectomy. It’s generally practiced in difficult conditions with complicated operative follow-ups. The tragedy is that finally the patient will die (almost 1 time out of 2 in our study). This is the sad reality of resource-limited countries. How many women will continue to die under these conditions? This study attempts to explore the different aspects of this reality. Objective: To study the epidemiological, clinical, and therapeutic aspects of hemostasis hysterectomies at the Teaching Hospital of Souro Sanou University Hospital in Burkina Faso. Methodology: This was a prospective cross-sectional descriptive study conducted over 12 months from January 1 to December 31, 2015. Included in our study were all patients received in our department and who required a total or subtotal hysterectomy in the management of a severe postpartum hemorrhage, during the study period. Results: The frequency of hemostasis hysterectomies was 0.4% compared to all deliveries. The average age was 29.65 years old. The average parity was 4.3. Multiparas and large multiparas accounted for 65%. The main indications were uterine rupture (40%) and uterine inertia (60%). Hysterectomy was subtotal in 95% of cases. Maternal morbidity was dominated in 90% of cases by hemorrhagic shock, hemostatic disorders, and obstetrical fistulas. The prognosis was poor, with 8 deaths or 40% of cases. Conclusion: Better management of pregnancy and childbirth would reduce cases of hemostasis hysterectomies. The availability of blood products would improve the maternal prognosis.

Compliance of Computed Tomography Scan Requests in Sub-Saharan Africa

>Objective: To investigate the compliance of computed tomography (CT) scan requests in the X-ray units of Sub-Saharan Africa. Methods: Multi-centric, exhaustive, descriptive and cross-sectional study (Burkina Faso and Benin) focused on CT scan requests implemented and interpreted from May 1 to July 31, 2014. Request compliance was assessed according to the criteria of the French High Authority for Health to which was added a criterion for fulfillment of description of patient clinical information. An exam was deemed compliant when all criteria were met. Ratios were compared by means of Chi2 test at 0.05% significance level. Results: Among the 426 colligated computed tomography prescriptions, the least filled fields were allergy concept (0%), creatinine-mia (0.3%), examination purpose (50.2%). The overall compliance rate was 35%. The requests made by medical specialists were more compliant than those made by general practitioners and students (p = 0.003). Fulfillment of clinical information description was also better among medical specialists compared to the other prescribers (p = 0.002). Conclusion: It is important to improve the quality of computed tomography (CT) scan requests in the hospitals of Bobo-Dioulasso (Bur-kina Faso) and Parakou (Benin).

Proteus Syndrome: About Two Paediatrics Cases

Proteus syndrome (PS) is a rare pathology characterized by mosaic and progressive hypertrophies, that can affect any organ or tissue of the body. A genetic mutation in the embryo is at the origin of the disease. Bones, fat, skin and connective tissue are the tissues most typically involved. The extent and severity of the abnormalities vary, giving different clinical presentations. The authors report two cases in two boys aged three and eight years respectively. In both, segmental and organ growth abnormalities, skin abnormalities and lipomas were present. The youngest patient was admitted for the management of severe malnutrition. He presented a major excrescence in the gluteal region, which required surgical management mainly because of its functional impact. In the second patient who was hospitalized following a viral meningoencephalitis, important vascular abnormalities were demonstrated, particularly at the cerebral and abdominal level. The clinical presentation was more severe in the latter, with the installation of an extended coma and a comitial state. PS is a pathology which could be incapacitating. It exposes to a high risk of benign tumours and deep venous thrombosis. The variability of abnormalities and the risks incurred required multidisciplinary management.

Knowledge,attitudes and practices concerning epilepsy among nurses and midwives working in primary health care settings in Ouagadougou of Burkina Faso

Background In developing countries,there is a lack of epilepsy knowledge among health workers.The objective of this study was to assess the knowledge,attitude and practice concerning epilepsy among nurses and midwives working in primary health care settings in Ouagadougou.Methods We carried out a cross-sectional study in the health districts of Ouagadougou from August 1st to September 15th,2017.All nurses and midwives working in three health districts were included in this study.Results A total of 213 participants with a mean age of 39.5 years were included in the survey;79.81%of them had a general certification in secondary education and 62%had a professional experience of more than 10 years.About 99%of the participants had not received training on epilepsy-related care during the last six months.In addition,74.5%of the participants had a good knowledge on epilepsy and 65%had a good practice toward epilepsy.The level of knowledge was associated with the workplace,years of training,and the professional experience.The level of knowledge about epilepsy was also associated with the level of education,while there was a significant link between professional status and nurses’level of practice in the management of seizures.Conclusions Efforts must be made to provide continuing education for nurses in order to improve their knowledge on epilepsy.