ABSTRACT
Introduction: In sub-Saharan Africa (SSA), stroke is a major public health problem and the etiological aspects are poorly studied and documented because of under-medicalization; the syphilitic etiology is rarely mentioned. Patients and methods: We performed a retrospective study of 472 patients hospitalized for ischemic stroke between 2016 and 2021 in the Neurology Department of the University Hospital of Conakry, confirmed by neuroradiological explorations (brain CT, MRI-Angio) and a biological workup including VDRL-TPHA serological reactions in blood and CSF. Results: Syphilitic etiology was retained for six (6) patients (4 men and 2 women) with a mean age of 43 years (extremes 36 and 49 years). The clinical picture was dominated by carotid syndromes: superficial and deep sylvian syndrome, anterior cerebral artery syndrome and vertebro-basilar syndromes and one case of lacunar syndrome.The diagnosis was based on the positivity of serological reactions (VDRL-TPHA) in blood and cerebrospinal fluid (CSF) and the presence of a predominantly lymphocytic hypercellularity and a hyperproteinorachy in the CSF in the absence of any other etiology. Conclusion: These neurological vascular syndromes consecutive to a cerebral treponematous attack are often the result of a still poorly conducted management of primary and secondary syphilis in our country.
ABSTRACT
In sub-Saharan Africa (SSA), the etiological factors of epilepsy are multiple and phacomatoses, in particular Sturge weber's disease, are rarely reported due to under-medicalization and insufficient multidisciplinary care. We carried out a retrospective study of 216 patients hospitalized for recurrent epileptic seizures between 2015 and 2022 in the neurology and pediatrics department of the University Hospital Center of Conakry, among whom eight (8) patients were identified for Sturge Weber's disease in order to reassess this pathology from a clinical and paraclinical point of view in a tropical environment. Sturge Weber's disease was retained in eight (8) on the presence of symptomatic partial epileptic seizures (age 6 months to 14 years) with frequency of status epilepticus, homonymous lateral hemiparesis linked to occipital involvement, piriform calcifications on imaging and ocular disorders. The delay in consultation and medical care revealed severe mental deterioration in our patients. This study shows a stereotyped clinical picture in a context of aggravation of signs related to a delay in multidisciplinary management. These results are important for the diagnostic, therapeutic and prognostic discussion.
Subject(s)
Cognitive Dysfunction , Epilepsy , Child , Humans , Retrospective Studies , Guinea , Epilepsy/complications , Epilepsy/diagnosis , Seizures/diagnosis , Seizures/etiologyABSTRACT
In order to evaluate the evolution and the issue of pregnancies among women who are less than 20 years old, a retrospective inquiry has been made in the gynecological and obstetrical service at the regional hospital center of Ziguinchor, in Senegal. It covered a period of three years from January 1st 1997 to December 31st 1999. It concerned 477 cases of patients received at the end of their pregnancy. The risks of morbidity and mortality were globally higher in the group of 13-17 than that of 18-19. The Khi2 test has confirmed a statistically significant difference (p < 0.05) for evacuation, hospitalizations, abortions and dead-born frequencies. For the study of the other parameters (causes of evacuations, length of stay in hospital, evolutive term, way of delivery, maternal death frequency and theircauses, and the types of dead-born), the frequencies haven't been significantly different. So, the risk of morbidity and mortality is higher with the pregnancy of adolescents who are less than 18 years old. Hence the interest of doing every thing to prevent pregnancies among adolescents by an appropriate contraceptive method and to look with priority after any pregnancy occurring among this age group.
Subject(s)
Pregnancy in Adolescence , Adolescent , Adult , Age Factors , Female , Hospitals , Humans , Pregnancy , Pregnancy Outcome , Retrospective Studies , SenegalABSTRACT
This study evaluated the attitudes and practices of the personnel with respect to the prevention of nosocomial infections in a hospital environment. We carried out a qualitative survey of all categories of personnel between July 1998 and March 1999, at the five regional hospitals in Senegal (Thiés, Kaolack, Saint-Louis, Diourbel, and Louga). Data were collected in two ways: using a questionnaire to evaluate knowledge and by observing the attitudes and practices of the personnel. Hands were rarely washed before and after each procedure and surgical washing was often performed in poor conditions. The decontamination of soiled equipment was ineffective. Reusable instruments were washed directly with bare hands or by individuals wearing used surgical gloves. The equipment used for sterilization was dilapidated and unsuitable and the norms for sterilization were seldom respected. Circulation in the region of the operating theatre was disorganized, if not anarchic. The personnel had a high risk of contamination from blood. Biomedical waste was not decontaminated: it was collected poorly and disposed of directly into the environment. None of the sites visited had a program of waste incineration. In conclusion, at the sites visited, there is a high risk of nosocomial contamination during care and the reuse of equipment, for both the staff and the patients treated.
Subject(s)
Cross Infection/prevention & control , Hospitals, District/standards , Attitude of Health Personnel , Decontamination , Female , Hand Disinfection , Humans , Male , Medical Waste Disposal/standards , Obstetrics and Gynecology Department, Hospital/standards , Operating Rooms/standards , Senegal , Sterilization/standards , Surgery Department, Hospital/standards , Surveys and QuestionnairesABSTRACT
The left paraduodenal hernia obtains when the small intestine goes through the left paraduodenal fosset. It (the hernia) develops on the left, at the back of the descending mesocolon. The present authors study one case looking at its pathogeny and the clinical and therapeutic problems posed by such a variety of congenital internal hernia. The authors emphasize, in particular, its morbid associations with the volvulus of the pelvic colon. Finally they highlight the importance of a through and careful exploration of the abdominal cavity during any laparatomy following an occlusive syndrome.
