ABSTRACT
OBJECTIVE: To determine the prognosis value of two generalgraveness' scores in patients admitted to intensive care at University Hospital of Parakou in Northern Benin. PATIENTS AND METHODS: Descriptive and analytical observational study data were collected from March 1st to June 30th, 2017. The SAPS II and APACHE II were calculated during first 24 hours of hospitalization to assess the clinical graveness and predict patient's mortality. RESULTS: We enrolled 185 patients representing 89.37% of admissions, majority were men (63.78%). Mean age was 38.89 ± 17.92 years (16 to 99), mean of hospitalization duration were 4.36 ± 2.2 days. Neurological failure was the most common disorder observed (58.37%). Mean SAPS II and APACHE II was 29.54 ± 19.04 and 14.24 ± 10.49 respectively. Mean predicted mortality of SAPS II and APACHE II was 19.12 ± 5.05 and 25.69 ± 5.00 respectively. The mortality rate was 25.95% and increased with severity scores. The sensibility of APACHE II and SAPS II score was72.90% and 66.70% respectively. SAPS II score was found to be most specific (85.40%) than APACHE II (80.03%). CONCLUSION: Those severity patient scores accurately predicted the prognosis of patients in intensive unit and should be integrated in our practice.
OBJECTIF: Déterminer la valeur pronostique de deux scores de gravité généralistes chez les patients admis en réanimation à l'hôpital universitaire de Parakou (Bénin). PATIENTS ET MÉTHODES: Il s'agissait d'une étude observationnelle descriptive et analytique. Les données ont été collectées du 1er mars au 30 juin 2017. Les scores de gravité généralistes IGS II et APACHE II avaient été calculés dans les 24 premières heures d'hospitalisation afin d'évaluer la gravité de l'état clinique des patients et prédire leur mortalité. RÉSULTATS: Cent quatre-vingt-cinq patients ont été colligés représentant 89,37% des admissions. Une prédominance masculine (63,78%) avait été notée (sex-ratio de 1,76). L'âge moyen était de 38,89 ans ± 17,92 (16 à 99 ans). La durée moyenne de séjour était de 4,36 ± 2,2 jours. La défaillance neurologique était la plus fréquente à l'admission (58,37%).Les valeurs moyennes des scores IGS II et APACHE II étaient respectivement de29,54 ± 19,04 et 14,24 ± 10,49. La mortalité prédite moyenne des scores IGS II et APACHE II étaient de 19,12 ± 5,05 et 25,69 ± 5,00 respectivement. La mortalité globale était de 25,95% et augmentait avec les valeurs des scores de gravité. Le score APACHE II s'était révélé le plus sensible à 72,90%contre66,70% pour IGS II. Le score IGS II s'était révélé spécifique à 85,40% contre 80,03% pour APACHE II. CONCLUSION: Ces scores de gravité prédisent avec précision le pronostic des patients en unité de réanimation et devrait être intégré dans notre pratique.
ABSTRACT
Les auteurs rapportent un cas de grossesse abdominale à 31 semaines d'aménorrhée chez une patiente de 32 ans à l'hôpital de zone de Dassa. Diagnostic fait, la patiente refuse l'hospitalisation et sort contre avis médical. Revue deux semaines plus tard pour douleurs abdominales, l'échographie de contrôle révèle une mort fÅtale à 33 semaines d'aménorrhée + 3 jours. Une laparotomie a été réalisée suivie d'une extraction de la cavité abdominale d'un fÅtus mort-né macéré 3ème degré. L'évolution post-opératoire était simple et la patiente était sortie au 6ème jour post-opératoire
Subject(s)
Benin , Case Reports , Fetal Death , LaparotomyABSTRACT
The burden of chronic and neuropathic pain is high making it an important public health problem. The epidemiology is not well known in the general population in sub-Saharan Africa. We aimed to determine the prevalence of chronic pain with a neuropathic component at Tititou in Parakou in northeastern Benin. A cross-sectional study was conducted from 1st April to 31 May 2012 and included 2314 people in a door-to-door survey. Chronic pain was defined as pain occurring for more than three months. Neuropathic pain was assessed with the DN4 score. A neurological exam was performed by a young physician for all people with chronic pain. During the interview, sociodemographic data, past medical history, weight and height were recorded. Multivariate logistic regression was performed to analyze the main associated factors. Among the 2314 people included in this survey, 49.7% were male. The mean age was 32.3 ± 13.1 years. Nine hundred seven reported pain occurring for more than 3 months. The prevalence of chronic pain was 39.2% (CI95%: 29.3-34.7). It was more frequent in females, older people, among diabetics, people with a history of any surgery, stroke, brain trauma, and alcoholism. The prevalence of chronic pain with a neuropathic component was 6.3% (CI95%: 5.0-7.9). The main associated factors were age, matrimonial status, professional occupation, body mass index, diabetes, history of zoster, history of any surgery, brain trauma. People with neuropathic pain often reported pain with burning (87.6%), prickling (82.8%), numbness (66.9%), tingling (63.4%), and lightning pain (48.3%). The main locations were the lower limbs and low back pain. This study suggested the high frequency of chronic neuropathic pain in the general population in Parakou compared with rates reported in western countries.
Subject(s)
Chronic Pain/epidemiology , Neuralgia/epidemiology , Adult , Age Factors , Aged , Benin/epidemiology , Body Height , Body Mass Index , Body Weight , Cross-Sectional Studies , Diabetic Neuropathies/epidemiology , Female , Humans , Male , Middle Aged , Neurologic Examination , Prevalence , Sex Factors , Socioeconomic Factors , Young AdultABSTRACT
OBJECTIVE: To study the preoperative psychological experience and beliefs in adult patients scheduled for surgery at the University Hospital of Parakou. PATIENTS AND METHODS: A descriptive and analytical study with prospective data collection conducted over three months (June 1st to August 30, 2012) and involved 75 patients. RESULTS: Of the 108 patients scheduled for surgery, 75 patients (69.44%) had been chosen. The average age was 44.11±16.24 years with a male predominance (56%). Fifty-five patients (73.3%) were anxious and 32 patients (46.7%) were afraid of dying. Forty-five patients (60%) had not received any information about the procedure they should undergo and 60 patients (80%) were not informed of the possible complications of surgery. Fifty-eight patients (77.3%) were aware of the anesthetic technique and 5.2% of patients were aware of the possible complications of anesthesia. In 56 patients (74.7%), the disease was of natural origin, in 18.6% of cases there was an enchantment and 5 patients (6.7%) the disease is due to a deity. In the context of spiritual care, 15 patients (20%) had consulted a marabout, 11 patients (14.7%) a healer and 10 patients (13.3) a fetish. CONCLUSION: The preoperative period induces a significant burden of anxiety among patients and their families. In Benin, the announcement of surgery is an opportunity for confrontation of the patient to an obsession with death which he manages to escape despite the countless sacrifices of traditional conjuring.
Subject(s)
Culture , Preoperative Period , Surgical Procedures, Operative/psychology , Adult , Aged , Aged, 80 and over , Anesthesia/psychology , Anxiety/epidemiology , Anxiety/psychology , Attitude , Benin , Fear/psychology , Female , Humans , Male , Middle Aged , Patient Education as Topic , Prospective Studies , Religion , Young AdultABSTRACT
OBJECTIVE: The purpose of this study was to compare the effects of early resumption of solid versus liquid food intake after emergency cesarean section in black African women, in terms of gastrointestinal complications and maternal satisfaction. PATIENTS AND METHOD: A total of 120 patients were randomly distributed into two groups of 60 each. In group L, liquid food intake in the form of sweetened citronella drink was allowed at will starting 6 six hours after the procedure but no solid food was allowed for 24 hours. In group S, normal solid food intake was resumed six hours after the procedure. The two study groups were not significantly different with regard to age, medical history, ASA class, obstetrical status, indications for cesarean section, anesthetic protocol, mean procedural duration, and postoperative analgesia. Study variables included tolerance of food intake, gastro-intestinal complications, time necessary to resume full activity and patient satisfaction. RESULTS: Overall, 6% of patients reported complications involving nausea, vomiting and bloating. There was no statistical difference between the two groups. Normal intestinal transit resumed earlier in group S but the difference was not significant. Auscultation of the abdomen at 16 hours after the procedure demonstrated presence of peristalsis in 59 patients in group S and 51 in group L (p = 0.008). The maternal satisfaction rate was 92% in group S and 43% in group L (p <0.01). All dissatisfied patients said that they would opt for solid food in case of future cesarean. CONCLUSION: Early solid food intake after cesarean in black African women is as well tolerated as early liquid feeding. Resumption of solid food intake allows earlier rehabilitation and improves patient satisfaction.
Subject(s)
Beverages , Black People , Cesarean Section , Eating , Food , Postoperative Care , Adult , Benin , Emergencies , Female , Humans , Patient Satisfaction , Pregnancy , Risk Assessment , Risk Factors , Time FactorsSubject(s)
Blood Vessels/pathology , Stevens-Johnson Syndrome/pathology , Adult , Critical Care , Fatal Outcome , Female , Humans , Prognosis , Young AdultABSTRACT
OBJECTIVE: The purpose of this report was to describe early outcome of surgical management of digestive disease in a tropical setting. Study design. This retrospective, descriptive study was carried out in Benin over the three-year period from January 1, 2002 to December 31, 2004. PATIENTS AND METHODS: A total of 613 patients admitted to the intensive care unit (ICU) following surgical treatment for digestive disease were studied. Data were collected on cards from ICU patient admission records, duty register, and patient charts. The data obtained by exact transcription from cards was entered into the Epidata 3.02 software package and analyzed using the Stata 8.0 software package. RESULTS: Patients undergoing surgery for digestive disease accounted for 32% of admissions to the ICU during the study period. Mean patient age was 30 years (range, 1 day to 85 years). Surgery was carried out under emergency conditions in 510 patients and elective conditions in 103. The most common surgical indications were peritonitis, acute bowel occlusion, and malignant tumors. Overall postoperative morbidity was 25.8% with a strong male prevalence (27.6% after emergency procedures and 16.5% after elective procedures). Most complications (74.7%) occurred within 4 days after the procedure. Complications rare occurred after the 6th post-operative day. Overall mortality was 13% (13.3% after emergency procedures and 11.6% after elective surgery). The most frequent cause of death was sepsis. In the vast majority of the cases (78.7%) death occurred in the first 72 hours. CONCLUSION: Post-operative morbidity and mortality remain high in our ICU especially after surgical management of digestive disease. Although this finding is correlated with inadequate technical and human resources, it is mainly due to delayed treatment or slow evacuation time with most patients being admitted in extremely critical condition. Elective surgery was usually performed on patients presenting advanced-stage malignancy. Delayed management with subsequent deterioration of the patient's clinical state was frequently due to prior treatment by practitioners of traditional medicine.
Subject(s)
Digestive System Diseases/surgery , Outcome Assessment, Health Care , Adolescent , Adult , Aged , Aged, 80 and over , Benin , Child , Child, Preschool , Female , Hospital Mortality , Humans , Infant , Infant, Newborn , Intensive Care Units , Male , Middle Aged , Postoperative Complications , Retrospective Studies , Young AdultABSTRACT
INTRODUCTION: Toxic epidermal necrolysis (TEN) is usually a drug-induced disease, involving vital or functional prognosis with 20 to 30% mortality rates. OBJECTIVES: The aim was to collect cases of TEN in an intensive care unit in Cotonou National University and Teaching Hospital, and describe epidemiologic, clinical, therapeutic and evolutive patterns. STUDY DESIGN: Retrospective and descriptive study over five years. PATIENTS AND METHODS: The medical report-forms of patients admitted between January 1998 and December 2002, for toxic dermatitis with total skin injury area more than 10% were reviewed. RESULTS: Fourteen patients with TEN were identified. The average incidence was three cases per year, accounting for 0.25% of the admissions in the unit. Sulphonamides (n=4), antituberculous drugs (n=2), penicillin (n=3) were the main cause of TEN. In five patients, the cause was not found. Self-medication was found in 7 patients. Total skin injury area reached from 26 to 87%. Mucosal and viscera injury occurred in respectively 11 and 9 patients. The treatment was usual as in extended burns. Four patients died (28.5%). The average time before hospitalisation was 11.4 days. CONCLUSION: The growing-awareness of people can prevent/reduce the morbidity and improve the prognosis of TEN.
Subject(s)
Hospitals, University/statistics & numerical data , Stevens-Johnson Syndrome/epidemiology , Adolescent , Adult , Antitubercular Agents/adverse effects , Case Management , Child , Child, Preschool , Female , France/epidemiology , Hospital Mortality , Humans , Incidence , Infant , Infant, Newborn , Length of Stay/statistics & numerical data , Male , Penicillins/adverse effects , Retrospective Studies , Self Medication , Stevens-Johnson Syndrome/etiology , Stevens-Johnson Syndrome/pathology , Stevens-Johnson Syndrome/therapy , Sulfonamides/adverse effectsABSTRACT
Les malformations digestives de l'enfant sont souvent des urgences chirugicales a la naissance avec une gravite preoccupante dans les suites operatoires. Dans le but d'evaluer la frequence et le pronostic de ces malformations; les auteurs analysent les observations de 38 enfants recus en 5 ans dans le service polyvalent d'anesthesie reanimation du Centre National Hospitalier et Universitaire de Cotonou. Les malformations congenitales sont essentiellement des imperforations anales; des atresies et stenoses digestives; des omphaloceles et des maladies de Hirshprung. Elles representent 1;8 pour cent des admissions du service et 5 pour cent des urgences chirurgicales digestives. Excepte; tous les enfants sont operes le jour de leur admission. Les suites operatoires ent ete marquees par: 22 cas de deces soit 57;9 pour cent et 7 cas de complications a type de peritonites; fistules et occlusions. Le pronostic est lie a la specificite du terrain du nouveau-ne et au retard de diagnostic
