[Biological insulin resistance in Congolese woman with polycystic ovary syndrome (PCOS)]. / L'insulinorésistance biologique chez la femme congolaise avec syndrome des ovaires polymicrokystiques (SOPK).

OBJECTIVES: Metabolic features of polycystic ovary syndrome (PCOS) have been poorly investigated in African women where environmental factors are different from those occurring in developed countries. This study aimed to determine the frequency and features of insulin resistance (IR) in Congolese women affected by polycystic ovary syndrome (PCOS). PATIENTS AND METHODS: This was a case-control study conducted in women received in three hospital institutions in Kinshasa from 2006-2007. Blood samples were taken to measure HDL and LDL cholesterol, triglycerides, fasting insulin and glucose levels, and the homeostatic model (HOMA-IR) was used to assess IR under basal conditions. RESULTS: Fifty-five Congolese women with PCOS and forty-four normal women (mean age 24 ± 6.8 years) were included in the study. Although body mass index was not statistically different between PCOS and control women, IR evaluated by the HOMA-IR was detected in 39.3% of PCOS women. Fasting insulin level was the most significant determinant of IR in the Congolese women with PCOS (OR 2.134 [1.360-3.348]; P<0.001). CONCLUSIONS: Nearly one in two women from Congo affected by PCOS is IR and this feature is independent of overweight and central fat distribution. HOMA-IR is the most suitable index than the clinical parameters for detecting IR in these women.

Les lesions tubaires et peritoneales a la coelioscopie chez les femmes steriles aux Cliniques Universitaires de Kinshasa

Les 434 cas de coelioscopie diagnostique pour sterilite pratiquee aux Cliniques Universitaires de Kinshasa du 1er Aout 1988 au 31 juillet 1992 font l'objet d'une etude retrospective pour apprecier l'importance des differentes lesions tubo-peritoneales et leurs etiologies. Les obstructions tubaires distales sont deux fois et demi plus frequentes que les obstructions tubaires (OT) proximales; qui predominent chez les epouses des polygames. Les Obstructions tubaires distales et les adherences pelviennes sont plus frequentes chez les femmes avec antecedents de chirurgie gynecologique pelvienne. La frequence des cas d'endometriose pelvienne est de 6;4 pour cent. A part les maladies sexuellement transmissibles qui sont souvent evoquees comme cause; la chirurgie pelvienne semble etre egalement a la base de ces lesions

Treatment of multibacillary leprosy with a regimen of 13 weeks duration.

In a prospective study 559 multibacillary patients in Zaire were treated for 13 weeks with twice weekly rifampicin (600 mg) and daily ethionamide (500 mg) and dapsone (100 mg), 13-RED, or clofazimine (100 mg), 13-REC. The patients were followed for a total of 1418 person years, mean 3.2 years. The incidence of hepatitis was 3.3%. The incidence of relapses was 0.28 per 100 person years. Relapses were due to drug-sensitive organisms. In patients who received the same drug regimens but with a reduced dosage of ethionamide to 5 mg/k bodyweight, the incidence of hepatitis was significantly lower but the relapse rate was 7.8 per 100 person years of follow-up in the RED group, no relapses were diagnosed in the REC group. It is concluded that by the use of potent antileprosy drugs in suitable combinations and dosages, it will be possible to shorten the duration of antibacterial treatment in multibacillary leprosy to 3 months.

A controlled therapeutic trial in paucibacillary leprosy comparing a single dose of rifampicin with a single dose of rifampicin followed by one year of daily dapsone. The Collaborative Study Group for the Treatment of Leprosy in Zaire.

The cure rates of two treatment regimens in PB leprosy were compared in a prospective randomized trial: treatment U consisting of a single dose of rifampicin 40 mg/K bodyweight, and treatment A of rifampicin 1500 mg in a single dose, followed by one year of daily dapsone 100 mg. In patients with a BI = 0, the cure rates evaluated on the basis of histopathology of skin biopsies, were identical for the two regimens but in patients with a BI = 1, cure and relapse rates were unacceptable. For this reason and particularly the need to separate patients on the basis of the BI in skin biopsies, the single dose regimen does not appear to be suited for wide-scale application.

[Delivery of pregnant women in Zaire who have previously had cesareans. An analysis of 145 cases]. / Accouchement chez la gestante zaïroise antérieurement césarisée. Analyse de 145 cas.

A retrospective study was carried out to survey 145 women who gave birth who previously had caesarean operations, delivered in the Department of Gynecology and obstetrics of the University Clinic in Kinshasa between 1st January and 31st December 1981. The authors have analysed the obstetric outcome of these pregnant women. Their study gives rise to the following results: The incidence of women who had previously had caesarean operations was 2.4%. 92 women (63.4%) delivered normally and 53 (36.6%) had another Caesarean operation. Favourable factors leading to a normal delivery were previous vaginal delivery, particularly after a caesarean operation, and a vertex cephalic presentation. The growing number of Caesarean operations had led to many repeat operations. Long labour is one of the principal factors leading to ruptured uterus which did not seem to make the prognosis for the mother any worse. On the other hand fetal prognosis was saddled with an increased mortality rate (37.5%). Even this high figure is better than the prognosis in previous series: 50% in 1975 [24], and 46% in 1983 [26].

[Malaria and pregnancy. Epidemiological situation in Kinshasa (Zaïre)]. / Paludisme et grossesse. Situation épidémiologique à Kinshasa (Zaïre).

By regular blood smears to 730 women (430 pregnant women and 250 non pregnant) authors state precisely epidemiologic situation of malaria to women at Kinshasa. The prevalence of malaria of pregnant women is 22 per cent against 6.1 per cent for non pregnant adult women. Malarial infestation in gravido-puerperal period is : mother : 23.7 per cent ; umbilical cord : 3.1 per cent ; newborn : 5.4 per cent ; placenta : 10.1 per cent. Plasmodium falciparum is the principal agent of malaria at Kinshasa. Neither age, nor parity constitute risk factors of malaria. Many cases of malaria without fever exist at Kinshasa. Newborn with malaria and from pregnancies with infected placentas present at the birth a small weight. Placentas of pregnancies with malaria and infected have invariably the same weight.

Sperm characteristics of infertile and fertile Zairian men at the University Clinic of Mont Amba (Kinshasa).

The best interpretation of different sperm characteristics of zairian men consulting for infertility results from comparative studies with the sperm characteristics of fecund men. In this study four sperm variables permitted us to distinguish infecund from fecund men: sperm count, total sperm count, morphology and motility at the 24th-26th hour. No differences have been observed about aspect, odor, pH and volume of ejaculate.

[Epidemiological study of eclampsia at Mont Amba (Zaire) University Hospitals. Apropos of 28 case reports from 1981 to 1982]. / Etude épidémiologique de l'éclampsie aux Cliniques Universitaires du Mont Amba (Zaïre). A propos de 28 observations de 1981 à 1982.

The authors report the results of a retrospective epidemiological study of 28 cases of eclampsia observed from 1981 to 1982 in the maternity ward of the University Clinic of Mont Amba (Zaire). Three essential points are revealed by the analysis: the incidence of the disease is 1 case in 417 confinements, that is 0.24 per cent; the pregnant women at high risk are primiparae, those with a twin pregnancy and those of the A and B blood groups, the mean age being 22.7 +/- 2.9 years (S.D.); the disorder is particularly frequent in the dry season and does not seem to be affected by prenatal consultations. The morbidity and mortality rates among the mothers and children are low.

[Contribution of the male component to the infertility of couples in Kinshasa (Zaïre)]. / La contribution de la composante masculine dans l'infertilité du couple à Kinshasa (Zaïre).

A prospective study was carried out on infertility of the couple in Kinshasa by analysing the male component as derived from 278 sperm counts carried out on 95 patients. In 36.8% of couples the man was responsible. The mean age was 32.42 years of age +/- 4.89 (Standard Deviation). Previous gonorrhoea was responsible for this state of affairs in 47.3% of cases. The physical examination was marked by a large percentage of abnormal testes (36.8%) and of varicoceles in 18.9% of cases. The parameters that were most changed in the sperm counts were the total number in 72.6%, the distribution of the types of sperm in 51.7% and the pH of the seminal plasma in 40%.

[Epidemiologic study of visible congenital malformations in Zaire]. / Etude épidémiologique des malformations congénitales visibles en milieu zaïrois.

This retrospective study over an 11-year period revealed 79 cases of visible congenital malformations in a total of 64,777 deliveries (prevalence 1.2%). No aetiological feature was demonstrated. In contrast to data from the literature, the maternal age most involved was between 20 and 35 years and the pregnancy affected most often appeared to be the first. A past history of malformations and miscarriage was rare and difficult to assess because of the retrospective nature of the study. The commonest special features of the pregnancy were breech presentation (present in almost all cases of cranial abnormalities), foetal distress, dysgravidism and prematurity. The child with an external malformation is often born dead or dying and the organs most affected are the nervous and locomotor systems.

[Obstetrical profile of early maternity in Kinshasa (Zaire)]. / Profil obstétrical de la maternité précoce à Kinshasa (Zaïre).

A prospective study was carried out on the circumstances in youthful pregnancy in 377 primapara aged less than 16 years of age in Kinshasa as compared with 805 mothers between 20 and 24 years of age. The incidence of such youthful pregnancy is 3% with a mean age of 14.67 years. The psycho-social circumstances are dominated by the unmarried state of the patient, the low level of schooling and the fact that the pregnancy was usually unwanted. The antenatal time was usually marked by insufficient supervision, but no special complications of pregnancy could be put down to youth. Delivery was usually normal. The Apgar of the newborns from these young mothers was usually lower than in the control group but most did well because the perinatal mortality was not statistically higher. The mean weight was lower than in the control group but higher than the classical definition of small-for-dates babies.

Demonstration of plasma human chorionic gonadotropin beta-subunit during pregnancy using LH-hCG receptors from immature porcine testis.

In an attempt to provide better assessment of human chorionic gonadotropin beta-subunit (hCG-beta) secretion in pregnant women, a method was developed for complete removal of hCG by porcine-purified receptors before measurement of the free hCG-beta subunit by radioimmunoassay. Blood samples of 111 pregnant women were collected and the following results were obtained: (1) Extensive removal (over 96%) of hCG allows quantitative determination of the free hCG-beta subunit by a specific radioimmunoassay. Our data demonstrate the presence of circulating hCG-beta subunit during pregnancy, a fact that was still under controversy until now. (2) In contrast with the hCG profile drug during pregnancy the free hCG-beta subunit exhibits a plasma concentration peak (400 +/- 132 ng/ml; mean +/- 1 SD) at the 12th-13th week, indicating that the changes in plasma levels of intact hCG and free hCG-beta subunit are unrelated.

[Radioimmunoassay of HCG and HCG beta in blood during pregnancy and trophoblastomas]. / Dosage radioimmunologique de l'hCG-hCGbeta dans le plasma pendant la grossesse et les trophoblastomes.

This work was carried out on 151 estimations of the radioimmune levels of hCG-hCG beta in the first half of normal pregnancy and 390 levels estimated in 10 molar pregnancies, in 4 choriocarcinomata following moles and 1 primary choriocarcinoma of the ovary using homologous hCG beta. In normal pregnancy the level of hCG-hCG beta rises rapidly. The levels are highest between the 8th and 9th weeks of pregnancy, and then gradually decrease. In active molar pregnancies the levels of hCG-hCG beta in the plasma are significantly higher than those found in normal pregnancies of the same gestational age. When the outcome is going to be favourable the levels drop progressively. Complete absence in peripheral blood is usually found about 14 weeks after a mole has been expelled or evacuated. In choriocarcinomata, if the level of hCG-hCG beta rises it is a certain sign of reactivation of the tumour.