Tolérance et efficacité de la ligature des varices œsophagiennes au Centre Hospitalier Universitaire Andrainjato, Fianarantsoa, Madagascar / Tolerance and efficacy of esophageal varices ligation at the Andrainjato teaching hospital, Fianarantsoa, Madagascar

Introduction: La ligature des varices œsophagiennes constitue un des piliers de la prise en charge de l'hémorragie digestive par rupture des varices œsophagiennes. Cette étude a pour objectif d'analyser la tolérance et l'efficacité de la ligature des varices œsophagiennes dans un échantillon de patients au Centre Hospitalier Universitaire Andrainjato Fianarantsoa, Madagascar. Méthodes: Une étude prospective, observationnelle longitudinale sur une période de 21 mois (mois de janvier 2018 au mois d'août 2019) a été réalisée. Le test de Khi carré a été utilisé pour déterminer les corrélations (SPSS® v22). Résultats : Trente-et-un patients à prédominance masculine (sex ratio 1,5), âgés de 43,0 ± 9,0 ans, ont été retenus et 67 séances de ligatures de varices œsophagiennes ont été effectuées. La prophylaxie secondaire était l'indication de la ligature dans 96,8 % (n = 30) des cas. Les varices œsophagiennes étaient de grade III dans 64,4 % (n = 20) des cas. Toutes les ligatures ont été réalisées sous anesthésie générale. Le nombre de bandes élastiques utilisées était de 3,4 ± 1,1. La bonne tolérance de la ligature élastique était de 97,0 % (n = 65) lors de la procédure et de 58,0 % (n = 39) en post-procédure. La douleur thoracique post-procédure était observée dans 65,7 % (n = 44) des cas. L'éradication était obtenue après 3 séances dans 6,45 % (n = 2) des cas et 58,1 % (n = 18) étaient en cours d'éradication après 1,7 ± 0,9 séances. Conclusion : Cette étude a pu déterminer que la ligature des varices œsophagiennes est une technique bien tolérée et efficace dans la prévention de l'hémorragie digestive par rupture des varices œsophagiennes malgré certains inconvénients postopératoires

Comparison between herbs used for the treatment of gastroesophageal reflux diseases (GERD)

Background:An abnormality that causes reflux is termed as Gastroesophageal reflux disease (GERD), which is symptomatic by nature and adds to the long-term effects.Objective:The aim of this study is to observe and monitor the effects of a herbal ttratment of GERD with SiniZuojin Decoction (SNZID)and to assess its mediation impacts regarding the use of the medication in patients with Gastrointestinal EBB ailment.Materials and Methods:The cohort research methodology was used inthe study.The research included 2581 individual patients who were older than 18 years of age and were suffering from Gastrointestinal ebbailment. The patients were selected from various government herbal clinics in eastern China, including the states of Anhui, Fujian, Jiangsu, Jiangxi, Shandong, and Zhejiangover, from 2008 to 2018. Results:The study was conducted with a total of 2581 patients. The thorough assessment indicated that Sini Zuojin Decoction (SZD)notwithstanding standard stomach remedies pack was more effective than the traditionalist stomach suppositories bundle (RR=1.34, with CI=95% [1.47, 1.38], and P-value = 0.008); Test packs including SZD was essentially better contrasted with traditional stomach medicines(TSM)gearshifts in developing dyspepsia, substernal chest plague, decreasing regurgitation, and vomiting (P < 0.0002); SNZJD plus traditional stomach medicines(SPTSM)could by and large lessen full-scale sign scores with liberal ampleness (P < 0.00002). The replication degree and antagonistic effects regarding Sacroiliac Joint Dysfunction(SJD)treatment were basic. As confirmed through the TSA regarding thorough assessment, the results were significant, yet repeat security consequences were uncertain. As shown by the computation of the Grading of Recommendations Assessment, Development and Evaluation(GRADE)strategy, the idea regarding verification was minimal. Moreover, Schizoaffective disorder(SZD)may treat Gastrointestinal ebb ailment by presenting the onsetof the infection and controlling factors that may contribute to Gastrointestinal ebb ailments.Conclusion:The research evaluated the efficiency of Sini Zuojin Decoction in treating patients suffering from Gastrointestinal Ebb Ailments. [Ethiop. J. Health Dev.2022: 36(2) (00-00)]Keywords:GERD, Esophagitis, Sini Zuojin Decoction(SZD), Gastrointestinal ebb ailment;

Five-year Prevalence of Gastrointestinal Diseases and Disorders in Akure South, Nigeria

The burden of gastrointestinal diseases and disorders (GIDD) remains high in Nigeria and varies across regions. This study wa s therefore designed to examine the prevalence of gastrointestinal diseases and disorders over a period of 5-years from January 2014 to December 2018 in Akure South of Ondo state, Nigeria. Descriptive retrospective study was employed and the medical records of all patients diagnosed for GIDD in the two selected health facilities were reviewed within the study period. In total, 12,323 medical records of patients with GIDD were included in this study. The prevalence of GIDD were 44.9% in the year 2014 with the lowest prevalence of 6.7% occurring in the year 2018. Over the 5-years period, lower GIDD cases were 91% compared to upper GIDD that was 9%. Peptic ulcer had the highest prevalence (55%) of lower GIDD followed by gastroenteritis (30%). Hiatal hernia had the highest prevalence (84%) for upper GIDD followed by dyspepsia (11%) and Gastroesophageal reflux disease (5%). Over a 5-year period, the prevalence of gastrointestinal disease and disorders in Akure south in this study shows that lower GIDD is more prevalent in the study area with peptic ulcer as the most predominant GIDD among the study population.

Abdominal Masses in Children: A 10-Year Review

Background: Some childhood diseases present with abdominal masses alone or with other constitutional symptoms. The knowledge of the common causes of abdominal masses in children can assist in developing a protocol of management by clinicians.Objective: To describe the aetiology and presentation of abdominal masses in children.Methods: The hospital records of all cases of intra-abdominal masses in children managed between May 1998 and April 2008 were retrieved for analysis. Socio-demographic and clinical data were obtained and analysed using simple descriptive statistics.Results: A total of 93 children were included while those without clinical, radiological and intra-operative evidence of intra-abdominal masses were excluded from the study. There were 49 males (52.7%) and 44 (47.3%) females with male-to-female ratio of 1.1:1. The children were aged 1 day to 14 years; 15 (16.1%) were aged <3 years while 23 (24.7%), 27 (29%) and 14 (15.1%) each were aged 3-6 years, >6-9 years, >9-12 years and >12-14 years. The most common cause of abdominal masses was appendiceal mass/abscess in 29%, followed by hydronephrosis in 22.6% and nephroblastoma in 16.11%. The most common symptoms included abdominal pain (86.0%), fever (46.2%), vomiting (40.9%) and abdominal distension (32.2%). The mortality rate was 13%.Conclusion: Non-malignant conditions were mostly responsible for abdominal masses in children while abdominal pain, fever and vomiting were the leading presentations of abdominal masses in children

Prevalence of Helicobacter Pylori Caga and Vaca Allelic Variants and Associated Disease Outcomes in Kenyan Patients with Dyspepsia

Although Helicobacter pylori has been linked to various gastric disorders in Western countries and Asia; its aetiopathological role in African populations is controversial. The aim of this study was to investigate the role of H. pylori and its virulence genotypes in gastrointestinal diseases in Kenyan patients with dyspepsia. Gastric biopsy specimens were obtained for DNA isolation and histopathological analysis. Amplification was performed using specific oligonucleotide primers. H. pylori positivity was determined by H. pylori stool antigen test; rapid urease test; and histology and molecular diagnostic tools. H. pylori was detected with high frequency in patients with gastritis; peptic ulcer disease (PUD) and gastro-oesophageal reflux disease. This implies a significant risk of the development of these pathologies (p-value = 0.0000 in all cases). H. pylori strains with cagA occurred more frequently in PUD (65.2). vacA s1a genotype appeared to play a more significant pathological role (82.6 PUD) than the other variants (p-value = 0.0142). The prevalence of vacA m1 was significantly higher in gastritis cases (p-value = 0.0253). vacA m2 was found to be significantly associated with gastritis (p-value = 0.0253). This finding may point to the fact that H. pylori vacA m1 and vacA m2 are independently associated with an increased risk for gastritis. Indications are that H. pylori prevalence in Kenya may be declining. The independently occurring H. pylori genotypes; as opposed to simultaneous carriage; could be the reason for the low distribution of H. pylori pathologies

Indications and Indings at Colonoscopy in Ilorin; Nigeria

Colonoscopy is a safe and effective means of visual inspection of the large bowel from the distal rectum to the caecum. It may be carried out for diagnostic and or therapeutic reasons. There is a paucity of data on this procedure in Nigeria. We; therefore; determined the indications; findings; and diagnostic yield in Nigerians at colonoscopy. Materials and Methods: This was a hospital-based cross-sectional study carried out at the Endoscopy unit of Crescent hospital; Ilorin from January 2010 to May; 2012. The endoscopy register was reviewed; and the biodata; indications and colonoscopic findings were recorded on a pro forma. Results: A total of 103 patients had colonoscopy. Seventy (68.0) were males while 33 (32.0) were females. The indications for colonoscopy were rectal bleeding 41 (39.8); suspected colon cancer 32 (31.1); chronic constipation and chronic diarrhoea nine each (8.7); abdominal/anal pain five (4.9); suspected anorectal cancer and enterocutaneous fistula two each (1.9); faecal incontinence; occult gastrointestinal bleeding; post-colostomy for Hirschsprung disease one each (1.0). Endoscopic findings were normal findings 21 (20.4); diverticulosis 17 (16.5); polyps 16 (15.5); haemorrhoids 16 (15.5); anorectal cancer 13 (12.6); angiodysplasia 12 (11.7); colon cancer eight (7.8); colitis 7 (6.8); anorectal ulcer 4 (3.9); anal warts two (1.9); anal fissure; caecal tumour; faecal impaction and proctitis one each (1.0). The diagnostic yield was 79.6. Conclusions: The commonest indication for colonoscopy was rectal bleeding; while the most frequent pathology was diverticulosis. The diagnostic yield was high

Understanding Lactose Intolerance and the Dietary Management Thereof

Diets that exclude dairy may decrease gastrointestinal symptoms in symptomatic individuals who have lactose malabsorption or lactose intolerance. However; most lactose-intolerant adults can consume some lactose without experiencing major symptoms; thereby reducing the need for strict elimination of dairy products from the diet

Prevalence of Gastrointestinal Pathogens in Sub-Saharan Africa: Systematic Review and Meta-Analysis

A significant proportion of vulnerable people in sub-Saharan Africa (SSA) remain at risk for contracting diarrhoeal diseases due to the presence of many risk factors facilitating their transmission. A systematic review of published articles from the SSA region was done to determine the prevalence and types of diarrhoeal pathogens in circulation; based on a search of databases; including EBSCO host; PubMed; Scopus; Science Direct; Google scholar and Web of Science was done between September 2009 and December 2010. Data were summarized from 27 studies; with pooled data analysed and reported. Pathogens were isolated from between 26.8-65.6of cases; with an overall isolation rate of 55.7(95CI; 48.2-62.9). Isolation rates were highest amongst adult cases followed by children; and the odds of isolating a pathogen was greater in diarrhoeal cases (Odds Ratio 4.93 (95CI; 1.99 to 12.23); than in asymptomatic controls. Overall isolation ranged from 8to 99; and heterogeneity testing suggests differences between age groups (Q=5.806; df=2; P=0. 055). Mixed E. coli spp.; (29.95); Cryptosporidium (21.52); Cyclospora (18); Entamoeba; (13.8); Shigella spp. (10.49); Salmonella spp. (8.36); and Campylobacter spp. (8.33); were most commonly reported; and rotavirus was the most common virus isolated. This is the first review to look at the range of enteric pathogens circulating in SSA; and has confirmed high rates of isolation of pathogens from diarrhoeal cases. Public health practitioners can use this information to understanding the challenges related to diarrhoeal illness and set priorities for their prevention and control

Prevalence of Gastrointestinal Pathogens in Sub-Saharan Africa: Systematic Review and Meta-Analysis

A significant proportion of vulnerable people in sub-Saharan Africa (SSA) remain at risk for contracting diarrhoeal diseases due to the presence of many risk factors facilitating their transmission. A systematic review of published articles from the SSA region was done to determine the prevalence and types of diarrhoeal pathogens in circulation; based on a search of databases; including EBSCO host; PubMed; Scopus; Science Direct; Google scholar and Web of Science was done between September 2009 and December 2010. Data were summarized from 27 studies; with pooled data analysed and reported. Pathogens were isolated from between 26.8-65.6of cases; with an overall isolation rate of 55.7(95CI; 48.2-62.9). Isolation rates were highest amongst adult cases followed by children; and the odds of isolating a pathogen was greater in diarrhoeal cases (Odds Ratio 4.93 (95CI; 1.99 to 12.23); than in asymptomatic controls. Overall isolation ranged from 8to 99; and heterogeneity testing suggests differences between age groups (Q=5.806; df=2; P=0. 055). Mixed E. coli spp.; (29.95); Cryptosporidium (21.52); Cyclospora (18); Entamoeba; (13.8); Shigella spp. (10.49); Salmonella spp. (8.36); and Campylobacter spp. (8.33); were most commonly reported; and rotavirus was the most common virus isolated. This is the first review to look at the range of enteric pathogens circulating in SSA; and has confirmed high rates of isolation of pathogens from diarrhoeal cases. Public health practitioners can use this information to understanding the challenges related to diarrhoeal illness and set priorities for their prevention and control

Malnutrition in Support Groups of People Living with HIV/AIDS (PLWHA): a Case in Botswana

Objectives: The objectives of this study were 1) to determine the proportion of people living with HIV/AIDS (PLWHA) at risk of developing malnutrition; 2) to determine the prevalence of malnutrition (BMI 18.5 kg/m2); and 3) to describe the dietary intake and other nutrition parameters of PLWHA with membership in support groups. Design: Descriptive cross-sectional study. Setting: Six support groups in Gaborone and neighbouring locations. Subjects: Consenting; free-living HIV-positive adults 20 to 50 years of age with membership in support groups for PLWHA. Outcome measures: The subjects' risk of developing malnutrition was established using a modified subjective global assessment (SGA) screening tool. Subjects with an SGA score (n = 69) were found to be at high risk of developing malnutrition (SGA score = 4) and 28.5(n = 41) were malnourished (BMI 18.5 kg/m2). In the sample with SGA scores (n = 35) presented with a BMI 18.5 kg/ m2. These two groups also reported more unintentional weight loss; gastrointestinal symptoms; and other conditions commonly associated with a high risk of developing malnutrition. PLWHA with membership in support groups also had low educational attainment and high unemployment rates. A total of 47of subjects with an SGA score = 4 needed food assistance. Conclusions: Almost 50of PLWHA with membership in support groups for PLWHA are at risk of developing malnutrition; while about 30have a BMI 18.5kg/m2. Nutrition screening can also help to identify those PLWHA with a BMI 18.5 kg/m2 who are still at high risk of developing malnutrition. Timely nutrition interventions can therefore be instituted in order to prevent deterioration in nutritional status

Helicobacter pylori et pathologie gastrique au Benin

Une etude prospective conduite du 2/01/1994 au 31/08/1994 au Centre National Hospitalier et Universitaire et au Centre Medical Saint Luc de Cotonou a determine la prevalence de l'infection a Helicobacter pylori (HP) chez 202 patients atteints de differentes affections gastriques. Le diagnostic des lesions gastriques a ete histologique. HP a ete identifie dans la muqueuse gastrique par le test a l'uree et la culture. La combinaison des 2 methodes montre que l'infection a HP est associee a la gastrite chronique dans 66;5 pour cent; a l'ulcere gatrique dans 64;7 pour cent et a la dyspepsie non ulcereuse dans 9 pour cent des cas. La pathologie gastrique et duodenale en Afrique est largement dominee par les gastrites; les duodenites et ulceres. Dans l'ethiopathogenie de ces lesions; de nombreux facteurs sont incrimines dont le plus recent est Helicobacter pylori decouvert en 1983. Si en France et aux U.S.A; ce microorganisme a fait l'objet de nombreuses etudes; en Afrique; par contre; le caractere assez recent de cette decouverte; l'absence d'Unite d'Endoscopie Digestive et de laboratoires equipes pour les recherches sur HP dans bon nonmbre d'hopitaux africains expliquent le nombre reduit des travaux qui lui sont consacres. Les travaux liminaires de HOOUNGBE et KODJOH au Benin; DIOMANDE en Cote d'Ivoire; LACHLAM au Kenya; HOLCOMBE au Nigeria et ROUVROY au Rwanda donnent une idee de l'ampleur du probleme. Le present travail se propose de determiner la place de HP dans la survenue des affections gastriques en s'aidant au mieux des techniques modernes de diagnostic

Etude epidemiologique des affections oeso-gastro-duodenales au Mali au moyen de la fibroscopie digestive haute

L'objectif principal a ete d'evaluer au moyen de la fibroscopie digestive haute la frequence des affections oeso-gastro-duodenales au Mali. Sur 2864 examens pratiques; 1963 (68;54 pour cent) ont permis la decouverte de 2386 lesions (associations frequentes de differentes lesions). L'estomac a ete le plus frequemment touche (54;27 pour cent). Les gastrites ont domine la pathologie (46;19 pour cent). L'homme jeune de 21 a 40 ans a ete le plus affecte. Le symptome le plus frequent a ete l'epigastralgie. Il n'a ete constate aucune particularite quant a l'ncidence des anomalies constatees; selon la profession; la residence et l'ethnie

Inhibition des contractions intestinales du rat par l'extrait acqueux (macerations) des ecorces de tronc de Khaya senegalensis (desr.) A. Juss (maliaceae)

"Khaya senegalensis ou cailcedrat est une des nombreuses plantes utilisees au Burkina Faso en traditherapie dans le traitement des pathologies gastro-enterologiques. Une etude ""in vitro"" sur l'intestin isole de rat a permis de mettre en evidence une activite spamolytique et antispasmodique vis-a-vis des contractions provoquees par l'acetylcholine et le chlorure de baryum. Ces actions antispasmodique et spasmolytique peuvent constituer un support pharmacodynamique explicatif de l'utilisation traditherapeutique de cette plante alors medicinale"

Endoscopy versus radiology in African AIDS patients with oesophageal disorders

Upper gastrointestinal endoscopy and double contrast barium radiology were compared prospectively in 45 Ugandan patients with AIDS and upper gastrointestinal oesophageal symptoms. Both investigating techniques were normal as was the histopathology in 5 patients. In 40 cases a definite pathological diagnosis (candidiasis; non-specific inflammation; malignancy) was made. Endoscopic examination provided a correct disgnosis in 38 cases; while only 15 cases were diagnosised from barium studies. Radiology was normal in 2 cases later proved to have definite pathology on endoscopy and histopathologic examination (oesophageal candidiasis). Endoscopy in this series was found to have 95sensitivity in diagnosing oesophageal disorders in AIDS patients; compared to a sensitivty of 37.5for radiology. The difference between the two procedures regarding sensitivity was statistically significant (p0.005). A combination of oral thrush and dysphagia was strongly associated with oesophageal candidiasis (positive predictive value 95; p0.0025). Endoscopy would be the ideal diagnostic procedure for oesophageal candidiasis. The above finding; however; provide a basis for empirical antifungal theraphy especially in places where diagnostic facilities are limited

Value of fibreoptic oesophago-gastro-duodenoscopy : experience at Hoima Hospital; Uganda

This paper presents the result of a retrospective study and the experience with 223 fibreoptic oesophago-gastro-duodenoscopies; which were performed at Hoima Hospital between January 1991 and January 1992 in an open access service. Almost fifty-three per cent of all patients examined had abnormal findings with gastris as the most frequent diagnosis. Because of its high diagnostic yield; its use in referral centres in developing countries is advocated

Diagnostic management of epigastric pain in Uganda

180 patients who attended the out patient of Hoima Hospital (Uganda) complaining of epigastric pain were studied in order to verify the cause of it and to assess the most effective diagnostic iter. All the patients underwent the following examinations : stool examination for parasites; upper digestive tract endoscopy; ultra sound scan of liver; spleen; pancreas and kidneys. The results suggest that being the main causes of epigastric pain in Uganda intestinal parasitosis (21 per cent); gastro-enteric upper tract lesions with endoscopic signs of disease and functional dyspepsia the best approach of assessment of epigastric pain is first of all to rule out the presence of parasites in the stool