Prognosis of Pregnancy in Epileptics in Benin: A Case-Control Study.

Objective The main purpose of this article is to define prognosis of pregnancies in epileptic women in Benin. Methods This was a case-control study that included 54 epileptic women who had at least one pregnancy matched to 162 controls on age, pregnancy term, and monitoring center. Information about epilepsy, treatment, pregnancy, and childbirth were collected. A logistic regression with odds ratio (OR) calculation was used to study the association. Results During pregnancy 22.22% of epileptic women experienced an increase in seizure frequency. Epileptics had more frequent miscarriages (OR: 1.84 [1.01-3.51]), more incidents during pregnancy (OR: 4.03 [1.04-15.60]), and were more often hospitalized (OR: 3.35 [1.46-7.69]) than women without epilepsy. They, more often, had premature children before 37 weeks of amenorrhea (OR: 2.10 [1.12-3.91]) and gave birth to low-birth-weight children (OR = 2.17 [1.00-4.76]). Conclusion Occurrence of a pregnancy in an epileptic woman in Benin is at risk and requires multidisciplinary monitoring by both neurologist and obstetrician to reduce complications.

[Incidence of post-stroke depression in Parakou in 2014]. / Incidence de la dépression après un accident vasculaire cérébral à Parakou en 2014.

Depression is a frequent psychiatric complication after a stroke. In a Sub-Saharan Africa, the majority of the studies are about their prevalence, but the incidence of post-stroke depression was rarely estimated. We aimed to estimate this incidence in Parakou, Benin. We had conducted a dynamic cohort study with 203 stroke patients in the department of neurology of the university hospital in Parakou. Patients with a history of depression were excluded. Patients were followed during a period of 21 months from January 1, 2013 to September 30, 2014. Depression was defined according to the criteria of DSM-IV. They were 18 to 99 years old with an average age of 58.4±14.2 years. In average, consultation was made 54.3h±112.9h after onset symptoms. Concerning the type of stroke, 45.8% were ischemic, 31% hemorrhagic and 23.2% were indeterminate. The cumulative incidence of depression was 30%. The incidence rate of depression was 18.5 per 100 person-years. The factors associated with the occurrence of depression were initial coma, initial severity of stroke, disability and history of diabetes. The incidence of depression remains very high and must be evaluated. Considering the associated factors of depression in post-stroke and including them among the management strategies could reduce overall burden.

Evaluation de la qualité de la prise en charge de la douleur chez les patients en milieu hospitalier à Cotonou

Objectifs : La douleur est l'un des motifs les plus fréquents de demande de soins. L'objectif de notre étude était d'évaluer la qualité de sa prise en charge chez les patients adultes hospitalisés au CNHUHKM de Cotonou. Méthodes d'etude : Il s'agissait d'une étude transversale, descriptive conduite sur une période de 09 mois allant de Janvier à Septembre 2016 au CNHU-HKM. Un recrutement exhaustif a été fait pendant la période d'étude et a inclus les sujets adultes hospitalisés depuis au moins 24 heures. L'APS-POQR (American Pain Society- Patient Outcome Questionnaire- Revised) a été modifié et intégré dans l'outil de collecte des données. Résultats : Des 408 patients recrutés, 76,7% avaient ressenti une douleur au cours des 24 premières heures d'hospitalisation. La douleur était sévère chez 72,5% de ces patients. On notait une prédominance masculine et une fréquence de la douleur plus importante en chirurgie. En dépit de la forte prévalence et de la sévérité de la douleur, près de 2 sur 3 patients (70,1%) d'entre eux étaient au moins modérément satisfaits du traitement antalgique. Conclusion : La douleur est fréquente, sévère et sous traitée au CNHU-HKM. L'étude suggère l'instauration d'une véritable « culture de lutte contre la douleur » qui commence dès la formation théorique des soignants dans les universités et qui continue dans les différents services à l'hôpital

Cerebral Hydatid Cyst in a Young Immunocompromised Patient in Parakou.

We report the case of a 30-year-old human immunodeficiency virus (HIV)-positive HIV patient who was poorly followed. She was admitted on November 30, 2017, for the management of febrile encephalitis syndrome with motor deficit of the left hemicorps and generalized seizures. In biology, we found a nonspecific inflammatory syndrome. The cerebral imaging without and with injection found a cystic formation multilobed right fronto-parietal of approximately 83 mm × 62 mm, the presence of an annular calcification of approximately 8 mm with a commitment under falcator, and a contralateral ventricle dilation. Treatment with antiepileptic, antibiotic, antiparasitic, and corticosteroid therapy was marked by death the day before the neurosurgical procedure after initial improvement.