Ischemic strokes revealing neurosyphilis: Study of six (6) observations at the neurology Department of the University Hospital of Conakry.

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.

[Gunshot wounds of low urinary tract in period of security crisis at the Sominé Dolo Hospital of Mopti (Mali): Epidemiological and diagnostic aspects]. / Blessures par arme à feu du bas appareil urinaire en période de crise sécuritaire à l'hôpital Sominé Dolo de Mopti (Mali) : aspects épidémiologiques et diagnostiques.

INTRODUCTION: Firearm injuries to the lower urinary tract are injuries resulting from an energy transfer from a projectile fired by a firearm or a blast from a firearm, to the bladder, prostate, urethra and terminal ureter. Our objective was to describe the epidemiological and diagnostic aspects in the context of a security crisis. PATIENTS AND METHOD: This was a descriptive cross-sectional study of lower urinary tract firearm injuries at Sominé Dolo Hospital in Mopti from January 2017 to December 2021. RESULTS: In five years, 29 traumas of the lower urinary tract have been collected, about 6 cases per year. The mean age of patients was 27.48 years, the sex ratio was 13.5/1. The main circumstances of occurrence were intercommunal violence 51.72 %, war wounds 31.03 %. Injuries were inflicted by rifles in 62.1 % and improvised explosive devices in 37.9 %. The main modes of discovery were acute urine retention, hematuria and penoscrotal wounds respectively in 31.03 %, 20.69 %, 17.24 %. The organs affected were the urethra in 58.62 %, the bladder, 37.93 %, the prostate 3.45 %. Associated non-urological lesions present in 68.96 % (n=20) were dominated by intestinal lesions and pelvic fractures. CONCLUSION: Firearm injuries to the lower urinary tract are rare despite the context of the security crisis. They affect young men, are mostly linked to intercommunal violence, and are dominated by urethral and bladder injuries.

GAYET WERNICKE'S ENCEPHALOPATHY AFTER COVID-19 IN ELDERLY SUBJECTS IN TROPICAL ENVIRONMENTS: STUDY OF SIX (6) OBSERVATIONS IN CONAKRY.

In sub-Saharan Africa, the COVID-19 pandemic has caused severe malnutrition in elderly populations with the appearance of vitamin deficiencies, in particular thiamine responsible for Gayet Wernicke's encephalopathy (EGW). We present a series of six (6) patients hospitalized in the Neurology Department of the CHU Ignace Deen for the management of a brain syndrome with vigilance disorders after recovery from COVID-19, including oculomotor disorders, motor incoordination on a course of severe weight loss. The six patients underwent an evaluation of malnutrition by determining the WHO body mass index, the Detsky index, the serum albumin assay, the thiamine assay and a neuroradiological assessment (MRI) and an electroencephalogram (EEG) examination although this does not seem necessary for diagnosis. Study of nutritional status: weight loss greater than 5%, patients in Desky group B and C, plasma albumin<30 g/l, lowered thiamine and MRI neuroradiological data: by the existence of hypersignals in certain regions of the neocortex, certain gray nuclei, the mammillary bodies the thalamic nuclei close to the wall of the 3rd ventricle and the regions bordering the 4th ventricle sign Gayet Wernicke's encephalopathy syndrome. This study shows a stereotyped clinical, biological, neuroradiological and evolutionary profile of Gayet Wernicke's encephalopathy in elderly subjects recovered from Covid-19 with proven malnutrition. These results are useful for the therapeutic and prognostic discussion.

[The Ileal Neobladder With The Hautmann Technic At The Urology Depatment Of University Hospital Pr. Bocar S. SALL Of Kati]. / Le Remplacement De Vessie Selon La Technique De Hautmann Au Service D'Urologie Du Chu Pr. Bocar S. SALL De Kati.

Radical cystectomy is the standard treatment for bladder tumors infiltrating the bladder muscle, for patients who have tumors without invasion of neighboring organs and without metastasis. After radical cystectomy, the urinary diversion is a challenge for any urologist. Ileal neo bladder is a rare surgery in our country. The ileal neo bladder is recommended in these patients. We report a case of ileal neo bladder in a 42-year-old woman with a bladder tumor. We discuss the clinical, diagnostic and therapeutic aspects.

La cystectomie totale constitue le traitement de référence des tumeurs de vessie infiltrant le muscle vésical, pour les patients qui ont une tumeur sans envahissement des organes voisins et sans métastase. Après la cystectomie, la dérivation des urines est un challenge pour tout urologue. Le remplacement de vessie est un geste rarement réalisé dans notre pays. Un remplacement de vessie par l'intestin est recommandé chez ces patients. Nous rapportons un cas de remplacement de vessie chez une femme de 42 ans ayant une tumeur de vessie. Nous discutons les aspects cliniques, diagnostiques et thérapeutiques.

Prevalence, management and ethnobotanical investigation of hypertension in two Guinean urban districts.

ETHNOPHARMACOLOGICAL RELEVANCE: Hypertension is an important public health challenge in low- and middle-income countries, and in many African countries including Guinea medicinal plants are still widely used for its treatment. MATERIALS AND METHODS: The objective of this study was to determine the prevalence of hypertension in two Guinean urban districts (Pounthioun and Dowsare), to describe its management and to collect information on traditional herbal remedies. A total of 316 participants entered the study, 28.2% (89/316) men and 71.8% (227/316) women. Of these, 181 were from Dowsare (50 men and 131 women) and 135 from Pounthioun (39 men and 96 women). The mean age of subjects was 40.8 ±â€¯14.0 years (range18 - 88years), while the majority of subjects (63.3% or 200/316) were 45-74 years old. RESULTS: The overall prevalence of hypertension was 44.9% (142/316): 46.4% (84/181) from Dowsare and 43.0% (58/135) from Pounthioun. Ethnobotanical investigations among hypertensive patients led to the collection of 15 plant species, among which Hymenocardia acida leaves and Uapaca togoensis stem bark were the most cited. Phytochemical investigation of these two plant species led to the isolation and identification of isovitexin and isoorientin from H. acida, and betulinic acid and lupeol from U. togoensis. CONCLUSION: The presence of these constituents in Hymenocardia acida leaves and Uapaca togoensis stem bark may at least in part support their traditional use against hypertension in Guinea.

Le remplacement de vessie selon la technique de hautmann au service D'urologie du CHU pr. Bocar s. Sall de kati

La cystectomie totale constitue le traitement de référence des tumeurs de vessie infiltrant le muscle vésical, pour les patients qui ont une tumeur sans envahissement des organes voisins et sans métastase. Après la cystectomie, la dérivation des urines est un challenge pour tout urologue. Le remplacement de vessie est un geste rarement réalisé dans notre pays. Un remplacement de vessie par l'intestin est recommandé chez ces patients. Nous rapportons un cas de remplacement de vessie chez une femme de 42 ans ayant une tumeur de vessie. Nous discutons les aspects cliniques, diagnostiques et thérapeutiques

[Urological Complications of Pelvic Surgery at Point-G Hospital, About 23 Cases]. / Les Complications Urologiques Liees a la Chirurgie Pelvienne au CHU du Point-G, a Proposde 23 cas.

INTRODUCTION: Bladder and ureteral lesions are the most common urologic complications occurring during pelvic surgery with 1% and 0.5% to 3%, respectively. These lesions are rarely recognized intraoperatively and pose a major problem to urologists, gynecologists, and general surgeons. OBJECTIVE: To study the factors favoring urologic complications following pelvic surgery at the University Hospital Point-G. PATIENTS AND METHOD: We conducted a retrospective study at the University Hospital Point-G between 2006 and 2015. It involved 23 patients with a whole urological lesion following pelvic surgery. These patients underwent a clinical and para-clinical examination (intravenous urography, methylene blue test) to confirm the urological lesion and to determine its management. RESULTS: The average age of our patients was 32.00 years with extremes of 18 and 40 years old. The leakage of urine was found in 82.6% (19/23). Interventions that caused urologic injury were: caesarean section 52.2% (12/23), hysterectomy 30.4% (7/23), as well as a caesarean section and hysterectomy 17.4% (4/23). Methylene blue was performed in 19 patients, it was positive in 52.2% (12/23) and intravenous urography (IVU) in 7 patients. The lesions encountered were: retrotrigonal fistula vesico-vaginal 10 cases, vesico-vaginal fistula under trigonal 2 cases, uretero-vaginal fistula 7 cases, and bilateral ureteral ligation 4 cases. Fistulorraphy was performed in 52.2% followed by direct ureterovesical reimplantation. The postoperative outcome was satisfactory in 100% of cases with obtaining a good bladder tightness. The average duration of hospitalization was 12 days (+/- 4 days). CONCLUSION: Pelvic surgery results in urological injuries. Caesarean section and hysterectomy are contributing factors. Vesico-vaginal fistula or ureteral lesions are common.

INTRODUCTION: Les lésions vésicale et urétérale constituent les complications urologiques les plus fréquentes survenant au décours d'une chirurgie pelvienne soit respectivement 1 à 4% et 0,5 à 3% [6,7]. Ces lésions sont rarement reconnues en peropératoire et posent un problème important auquel sont confrontés les urologues, les gynécologues, les chirurgiens généralistes. OBJECTIF: Etudier les facteurs favorisants les complications urologiques consécutives à la chirurgie pelvienne au CHU du Point-G. PATIENTES ET MÉTHODE: Il s'agissait d'une étude rétrospective réalisée au CHU du Point-G entre 2006 et 2015. Elle a concerné 23 patientes présentant toute une lésion urologique au décours d'une chirurgie pelvienne. Ces patientes ont subi un examen clinique et para cliniques (Urographie intra veineuse; le test au bleu de méthylène) dans le but de confirmer la lésion urologique et d'en déterminer la prise en charge. RÉSULTATS: l'âge moyen de nos patientes était de 32,00 ans avec des extrêmes allant de 18 à 40 ans. La fuite d'urine était retrouvée chez 82,6% (19/23). Les interventions pourvoyeuses de lésions urologique étaient : la césarienne 52, 2% (12/23), l'hystérectomie 30, 4% (7/23), une association césarienne et hystérectomie 17,4 % (4/23). Le test au bleu de méthylène a été réalisé chez 19 patientes, il a été positif dans 12 cas soit 52,2 % et l'UIV chez 7 patientes. Les lésions rencontrées étaient : la fistule vésico-vaginale retro trigonale 10 cas, la fistule vésico-vaginale sous trigonale 2 cas, la fistule urétéro-vaginale 7 cas, et la ligature urétérale bilatérale 4 cas. La fistulorraphie a été effectuée dans 52,2 % suivie de la réimplantation urétéro-vésicale directe. Les suites opératoires étaient satisfaisantes dans 100% des cas avec l'obtention d'une bonne étanchéité vésicale. La durée moyenne d'hospitalisation était de 12 jours (+/− 4 jours). CONCLUSION: La chirurgie pelvienne est pourvoyeuse de lésions urologiques. La césarienne et l'hystérectomie sont des facteurs favorisants. Les fistules vésico-vaginales ou des lésions urétérales sont fréquentes.

[Patients' satisfaction survey after tranvesical prostatectomy in the urology department of Gabriel Touré University Hospital]. / Evaluation de la Satisfaction des Patients Apres Adenomectomie Transvesicale de la Prosate dans le Service D'Urologie du Chugabriel Toure.

AIM: This study was aimed to evaluate patients' satisfaction with tranvesical prostatectomy in the Urology department of University Hospital Gabriel Touré according to the (International Prostate Symptoms Score (IPSS) and the quality of life scores. PATIENTS AND METHODS: We conducted a prospective descriptive study over a 12-month period including a consecutive cohort of patients who had transvesical prostatectomy. Each patient was evaluated before and six weeks after the surgery. We used the IPSS as an assessment tool, supplemented by the Quality of Life (SQ) questionnaire. RESULTS: One hundred and thirteen (113) patients aged 71 ± 8 years old on average were evaluated. The mean duration of symptoms associated with benign prostatic hyperplasia was 19 months and 17% of patients had a mechanical complication. All patients had either moderate or severe lower urinary tract symptoms preoperatively, while 99% of them had an IPSS score <8 postoperatively. CONCLUSION: Transvesical prostatectomy allows an important improvement of the IPSS score of the patients and their satisfaction about their quality of life.

BUT: Evaluer la satisfaction des patients après adénomectomie transvésicale de la prostate dans le service d'urologie du CHU Gabriel Touré selon l'International Prostate Symptoms Score (IPSS) et le score de qualité de vie. PATIENTS ET MÉTHODES: il s'agissait d'une étude prospective et descriptive d'une cohorte consécutive de patients opérés pour adénomectomie transvésicale de la prostate réalisée sur une période de 12 mois. Les patients étaient tous évalués avant l'intervention chirurgicale et 6 semaines après. Nous avons utilisé l'IPSS comme outil d'évaluation, complété par la question sur la qualité de vie. RÉSULTATS: Cent treize patients d'âge moyen de 71 ± 8ans ont été évalués. La durée moyenne d'évolution des symptômes liés à l'hypertrophie bénigne de la prostate était de 19 mois et 17 % des patients présentaient une complication mécanique. Tous les patients présentaient des symptômes modérés ou sévères du bas appareil urinaire en préopératoire tandis qu'en postopératoire 99% des patients avaient un score IPSS inférieur à 8. CONCLUSION: l'adénomectomie transvésicale de la prostate permet une amélioration du score IPSS et celui de la qualité de vie des patients avec une importante satisfaction des patients.

[Treatment outcome, survival and their risk factors among new tuberculosis patients co-infected with HIV during the Ebola outbreak in Conakry]. / L'issue du traitement, la survie et ses facteurs de risque chez les nouveaux tuberculeux co-infectés par le VIH pendant l'épidémie d'Ebola à Conakry.

BACKGROUND: Mortality among TB/HIV co-infected patients remains high in Africa. The study aimed to estimate survival and associated factors in a cohort of TB/HIV co-infected patients who started tuberculosis treatment during the Ebola outbreak in Conakry, Guinea. METHODS: A prospective cohort study was conducted from April 2014 to December 2015. TB patients with HIV co-infection were enrolled at the University Hospital of Conakry. Survival and risk factors were analyzed according to Kaplan-Meier's method, log-rank test and Cox's regression. RESULTS: Data from 573 patients were analyzed. From these, 86 (15.0%) died before the end of treatment, 52% occurring within eight weeks of treatment onset. Survival at 4, 12 and 24 weeks after the beginning of the TB treatment was 92%, 86% and 83%, respectively. Independent risk factors associated with death were in the cell CD4 <200 cells/mm3 [adjusted hazard ratio (AHR): 2.25; 95% CI (confidence intervals): 1.16-4.37], opportunistic infections other than TB [AHR: 2.89; 95% CI: 1.39-6.02], and comorbidities [AHR: 4.12; 95% CI: 2.10-8.10]. An increase of one unit in hemoglobin [AHR: 0.81; 95% CI: 0.75-0.91] was protective of death. CONCLUSION: TB/HIV co-infected patients had a higher fatality rate during treatment of tuberculosis. Prevention of opportunistic infections, anemia and proper management of tuberculosis treatment in early comorbidities may improve survival for TB/HIV co-infected patients in restoring immune function.

Ethnomedical and ethnobotanical investigations on the response capacities of Guinean traditional health practioners in the management of outbreaks of infectious diseases: The case of the Ebola virus epidemic.

ETHNOPHARMACOLOGICAL RELEVANCE: The recent outbreak of Ebola virus infections has mostly remained confined to the West African countries Guinea-Conakry, Sierra-Leone and Liberia. Due to intense national and international mobilizations, a significant reduction in Ebola virus transmission has been recorded. While international efforts focus on new vaccines, medicines and diagnostics, no coherent national or international approach exists to integrate the potential of the traditional health practitioners (THPs) in the management of infectious diseases epidemics. Nevertheless, the first contact of most of the Ebola infected patients is with the THPs since the symptoms are similar to those of common traditionally treated diseases or symptoms such as malaria, hemorrhagic syndrome, typhoid or other gastrointestinal diseases, fever and vomiting. MATERIALS AND METHODS: In an ethnomedical survey conducted in the 4 main Guinean regions contacts were established with a total of 113 THPs. The socio-demographic characteristics, the professional status and the traditional perception of Ebola Virus Disease (EVD) were recorded. RESULTS: The traditional treatment of the main symptoms was based on 47 vegetal recipes which were focused on the treatment of diarrhea (22 recipes), fever (22 recipes), vomiting (2 recipes), external antiseptic (2 recipes), hemorrhagic syndrome (2 recipes), convulsion and dysentery (one recipe each). An ethnobotanical survey led to the collection of 54 plant species from which 44 identified belonging to 26 families. The most represented families were Euphorbiaceae, Caesalpiniaceae and Rubiaceae. Literature data on the twelve most cited plant species tends to corroborate their traditional use and to highlight their pharmacological potential. CONCLUSIONS: It is worth to document all available knowledge on the traditional management of EVD-like symptoms in order to evaluate systematically the anti-Ebola potential of Guinean plant species.

[Study of factors influencing clinical outcomes of obstetric urogenital fistula surgery at the Point G University Hospital of Bamako, Mali]. / Etude des facteurs influençant les resultats clinique de la chirurgie de la fistule uro-genitale obstetricale au CHU de l'Hopital du point G Bamako Mali.

The aim of this study was to identify factors influencing the clinical outcomes of surgery of obstetric urogenital genital fistula. This was a cross sectional study, which focused on factors influencing results in the treatment of urogenital fistula, from January 2011 to January 2012 at the urology department of the Point-G University Hospital. This study involved 115 patients suffering from urogenital fistula. Cure of urogenital fistula accounted for 17% of the bloc's activities. Closure of the fistula was achieved in 68.7% of cases. This result was influenced by certain factors. Including factors related to condition of the tissue peri-fistula (good trophic tissue, or fibrosis peri-fistula). Fistulas operated primarily peri-sinus tissue remodeling were closed in 71.42% of cases. Factors related to the patient and care: those carried out for the first time have a success rate of 68.42%, only 47.62% of success in patients who presented after five years. Factors related to clinicopathological seat: fistula vesicovaginal septum and cervical-vaginal urethrovaginal reported a success rate of 76.92%. Care-related factors include: the experience of the surgeon, surgeons of the urology service have a 76.19% success rate against 25% from other surgeons. The incision fistula was related to the clinicopathological seat, so the trigonal-vaginal fistulas and uretero addressed by the upper route have been successful in 85%. In addition to these factors the postoperative follow-up, the instruments, the suture thread, the operating table, and the lighting in the room have also improved the results.

Le but de cette étude était d'identifier les facteurs influençant les résultats cliniques de la chirurgie de la fistule uro- génitale obstétricale. Il s'agissait d'une étude transversale, qui a porté sur les facteurs influençant les résultats dans la prise en charge de fistule uro-génitale, allant du janvier 2011 au janvier 2012 au service d'urologie du CHU du Point-G. Cette étude a concerné 115 patientes souffrantes de fistule uro-génitale. La cure de la fistule uro-génitale a représenté 17 % des activités du bloc. La fermeture de la fistule a été obtenue dans 68,7% des cas. Ce résultat a été influencé par certains facteurs, dont les facteurs liés à l'état du tissu péri-fistuleux (bonne trophicité du tissu, ou fibrose péri-fistuleux). Les fistules opérées avant tout remaniement tissulaire péri-fistuleux ont été fermées dans 71,42 % des cas. Les facteurs liés à la patiente et aux soins : celles opérées pour la première fois ont un taux de réussite de 68,42 %, seulement 47,62 % de succès chez les patientes qui se sont présentées après cinq ans. Les facteurs liés au siège anatomo-clinique : les fistules de la cloison vésico-vaginale et cervico-urétro-vaginale ont occupé un taux de succès de 76,92 %. Les facteurs liés aux soins regroupent : l'expérience du chirurgien, les chirurgiens du service d'urologie contrairement aux autres chirurgiens ont 76,19 % de réussite contre 25%. La voie d'abord de la fistule était en rapport avec le siège anatomo-clinique, ainsi les fistules trigonales et urétéro-vaginales abordées par la voie haute ont été réussies dans 85 %. En plus de ces facteurs le suivi post-opératoire, les instruments, les fils de suture, la table opératoire, l'éclairage de la salle ont améliorée aussi les résultats.

Etude des facteurs influencant les resultats cliniques de la chirurgie de la fistule uro-genitale obstetricale au CHU de l'hopital du Point G Bamako Mali

Le but de cette etude etait d'identifier les facteurs influencant les resultats cliniques de la chirurgie de la fistule uro- genitale obstetricale. Il s'agissait d'une etude transversale; qui a porte sur les facteurs influencant les resultats dans la prise en charge de fistule uro-genitale; allant du janvier 2011 au janvier 2012 au service d'urologie du CHU du Point-G. Cette etude a concerne 115 patientes souffrantes de fistule uro-genitale. La cure de la fistule uro-genitale a represente 17 % des activites du bloc. La fermeture de la fistule a ete obtenue dans 68;7% des cas. Ce resultat a ete influence par certains facteurs; dont les facteurs lies a l'etat du tissu peri-fistuleux (bonne trophicite du tissu; ou fibrose peri-fistuleux). Les fistules operees avant tout remaniement tissulaire peri-fistuleux ont ete fermees dans 71;42 % des cas. Les facteurs lies a la patiente et aux soins : celles operees pour la premiere fois ont un taux de reussite de 68;42 %; seulement 47;62 % de succes chez les patientes qui se sont presentees apres cinq ans. Les facteurs lies au siege anatomo-clinique : les fistules de la cloison vesico-vaginale et cervico-uretro-vaginale ont occupe un taux de succes de 76;92 %. Les facteurs lies aux soins regroupent : l'experience du chirurgien; les chirurgiens du service d'urologie contrairement aux autres chirurgiens ont 76;19 % de reussite contre 25%. La voie d'abord de la fistule etait en rapport avec le siege anatomo-clinique; ainsi les fistules trigonales et uretero-vaginales abordees par la voie haute ont ete reussies dans 85 %. En plus de ces facteurs le suivi post-operatoire; les instruments; les fils de suture; la table operatoire; l'eclairage de la salle ont amelioree aussi les resultats

Etude du codon 72 du gene p53 dans la predisposition au cancer du col de l'uterus au Senegal

Introduction: En dehors de l'infection par le Virus du Papillome Humain (HPV); des facteurs genetiques ont ete impliques dans la predisposition au cancer du col de l'uterus. L'allele Arginine du codon 72 du gene suppresseur de tumeur p53 (GC; Arg/Pro); a ete associe a une predisposition au cancer du col de l'uterus chez differentes populations. Notre objectif etait d'etudier l'effet de ce polymorphisme chez une population senegalaise atteinte de cancer du col de l'uterus. Patientes et Methodes: 30 patientes atteintes de cancer du col de l'uterus ont ete recrutees et suivies a l'Institut Curie de l'Hopital Aristide Le Dantec de Dakar et 93 femmes temoins bien portantes sans cancer du col diagnostique. Pour chaque individu; l'ADN a ete extrait a partir de sang total preleve sur tube EDTA. Le genotypage du codon 72 du gene p53 a ete realise par PCR-RFLP. Resultats et Discussion: Il n'a pas ete retrouve une association significative entre l'allele Arginine du codon 72 de p53 et la predisposition au cancer du col de l'uterus (p=0;354) de meme qu'il n'a pas ete retrouve de correlation entre l'allele Arginine et les types de lesions histologiques observees au niveau du col de l'uterus. Malgre l'absence d'association du codon 72 avec la survenue du cancer du col de l'uterus; le gene p53 reste toujours d'actualite dans ce cancer de par son role suppresseur de tumeur

Ethnobotanical survey on medicinal plants used by Guinean traditional healers in the treatment of malaria.

ETHNOPHARMACOLOGICAL RELEVANCE: The objective of the present study was to collect and document information on herbal remedies traditionally used for the treatment of malaria in Guinea. MATERIALS AND METHODS: The survey was carried out from May 2008 to September 2010 and targeted traditional medical practitioners and herbalists. The questionnaire and oral interviews were based on the standardized model which was prepared by the "Centre de Recherche et de Valorisation des Plantes Médicinales (CRVPM) - Dubréka". RESULTS AND DISCUSSION: A total of 258 people (141 males and 117 females) from which 150 traditional healers and 108 herbalists were interviewed. The age of informants ranged from 28 to 82 years old. 57% (149/258) of the interviewees were more than 50 years old. The respondents had good knowledge of the symptoms of malaria, and a fairly good understanding of the causes. One hundred thirteen plant species were recorded, out of which 109 were identified. They belonged to 84 genera and 46 families. The most frequently cited plants were Vismia guineensis, Parkia biglobosa, Nauclea latifolia, Harungana madagascariensis, Terminalia macroptera, Crossopteryx febrifuga, Terminalia albida, Annona senegalensis, and Nauclea pobeguinii. The leaves were most frequently used (80/113 species), followed by stem bark (38/113 species) and roots (4/113 species). The remedies were mostly prepared by decoction (111 species), followed by maceration (seven species). Only one species was prepared by infusion. CONCLUSION: The present study showed that traditional healers in Guinea have a consistent knowledge of antimalarial plants. Further research should be carried out to compare the anti-malarial activity of the different species, and to check if their use against malaria can be scientifically validated.

[Epidemiological, clinical and therapeutics' data of HIV-infected patients placed on ART in the Segou hospital in Mali (2004-2011)]. / Données épidémiologiques, cliniques et thérapeutiques des patients infectés par le VIH sous traitement antirétroviral à l'hôpital de Ségou au Mali (2004-2011).

This is a retrospective study on a cohort of 811 adult patients placed on ART between January 2004 and December 2011 at the hospital Nianankoro Fomba Segou in Mali, to describe their epidemiological, clinical and developmental profile for 48 months. The average age of patients was 35.2±9.4 years. The sex-ratio was 0.6. Approximately 58.3% of the patients were from rural areas. HIV1 represented 95.8%. Prolonged fever, weight loss and chronic diarrhea were the main reasons for testing. The majority of patients (64.5%) had stage III WHO. The mean CD4 cell count was 144±135.8/mm³ at screening. The evolution was favorable under immunological antiretroviral therapy. The survival rate at 48 months follow-up was 78% [64.1%-81.3%]. Patients followed in the structure are predominantly rural, female and young aged. They are diagnosed with advanced HIV infection. Antiretroviral therapy has led to the strengthening of the immune system and improved the clinical outcomes with a survival rate of 78%.

[Investigation of epidemiology of neurotrauma in the Republic of Guinea].

The paper focuses on analysis of incidence of neurotrauma in economically underdeveloped country such as Republic of Guinea. It is found that leading etiology of central nervous system injuries are road accidents and indoor traumatism. Investigation of system of medical care revealed its poor condition and severe defects which prevent practical application of evidence-based recommendations for management of traumatic brain injury in underdeveloped countries including Republic of Guinea. Development of multiplanar strategy of control of neurotrauma is required which can be achieved only in case of massive governmental and international aid.

[Breech presentation: mode of delivery and maternal and fetal outcomes at the Ignace Deen Clinic of Gynecology and Obstetrics, Conakry University Hospital]. / Presentation de siege: mode d'accouchement et pronostic maternal-foetal a la Clinique de Gynecologie Obstetrique Ignace Deen du CHU de Conakry.

The authors in a prospective, analytical study of 8 months from January 1st to August 31st performed at the Ignace Deen Clinic of Gynecology and Obstetrics, Conakry University Hospital; assessed the impact of the mode of delivery in breech presentation on maternal and fetal outcome in the African context of Guinea. Breech presentation in mono fetal pregnancy of at least 28 weeks of amenorrhea was the inclusion criterion in this study. Among 1490 deliveries, 144 breech presentations were reviewed, representing a frequency of 9.66%. Half of breech deliveries (49.99%) were premature against only 11.85% in cephalic presentations. The breech was incomplete in 57.64% cases and complete in 42.35%. Caesarean section was performed in 40.97% of cases against 39.54% in cephalic presentation. The indications were often primiparity (30.50%), acute fetal distress (28.81%) and macrosomia (23.72%). Deliveries through the lower route frequently used the maneuver of Bracht (52.50%). 54.16% of the new-born babies had a fetal weight lower than 2500 g at born. Morbid Apgar score at the 1st minute after delivery through the lower route was found in 69.40% of the breech presentation born babies; however, this rate was 32.70% in cephalic presentation (p=0.000). The maternal morbidity concerned essentially perineal lesions (26.53%). The outcome is largely better in case of delivery through the upper route. The caesarean section is an alternative for the improvement of fetal outcome in countries with low resources.

[Intrapartum obstetrical transfers: sociodemographic, clinical and prognosistic aspects in Conakry, Guinea]. / Evacuations obstétricales intrapartum: aspects sociodémographique, clinique et pronostique à Conakry, Guinée.

The objectives of this descriptive prospective study were to determine the frequency of intrapartum obstetrical transfers, assess the sociodemographic profile of parturients requiring transfer, describe transfer modalities, and assess maternal and newborn outcomes. Study included all patients requiring intrepartum obstetrical transfer to the Ignace Deen University Hospital Gynecology Obstetrics Clinic in Conakry, Guinea from August 1st, 2009 to July 31st, 2010. Out of 3122 deliveries during the study period, intrapartum transfer was required in 220 cases, i.e. 7.05%. Mean patient age was 23.2 years (range, 14 to 44). The risk for intrapartum transfer was higher among multiparous or nulliparous women (incidence, 8.79%) and adolescents (incidence, 10%). Patients requiring transfer were mainly housewives (60%) and uneducated women (57.27%). Most had had an insufficient number (<4) of antenatal examinations (76.36%) and had been examined at peripheral maternity units (62.73%). In 175 cases (79.54%), patients were transferred by taxi. In 191 patients, treatment required surgery including 130 caesarian sections. There were 12 maternal deaths (5.45%) and 45 neonatal deaths out of 242 newborns including 22 twin deliveries (18.59%). Further work is necessary to improve referral and transfer at all levels of the health pyramid.

Presentation de siege : mode d'accouchement et pronostic materno-feotal a la clinique de gynecologie obstetrique Ignace Deen du CHU de Conakry

Les auteurs dans une etude prospective de type analytique de 8 mois; allant du 1er janvier au 31 aout 2006; realisee a la clinique de gynecologie obstetrique de l'hopital Ignace Deen du CHU de Conakry; ont evalue l'impact du mode d'accouchement dans la presentation du siege sur le pronostic materno-foetal dans le contexte africain guineen. La grossesse mono foetale en siege d'au moins 28 semaines d'amenorrhee a ete le critere d'inclusion.Sur 1490 accouchements; 144 presentations de siege ont ete colliges; soit une frequence de 9;66. La moitie des accouchements en siege (49;99) etait prematuree contre seulement 11;85en sommet. Le siege etait decomplete dans 57;64des cas et complet dans 42;35. La cesarienne a ete realisee dans 40;97des cas; contre 39;54dans la presentation du sommet. Les indications etaient le plus souvent la primiparite (30;50); la souffrance foetale aigue (28;81) et la macrosomie (23;72).Les accouchements par voie basse avaient recours plus frequemment a la manoeuvre de Bracht (52;50). 54;16des nouveaux nes avaient un poids foetal inferieur a 2500 g a la naissance. L'Apgar morbide a la 1ere minute; apres accouchement par voie basse; a ete retrouve chez 69;40des nouveaux nes en siege ; alors que ce taux en sommet etait de 32;70(p=0;000). La morbidite maternelle concernait essentiellement les lesions perineales (26;53).Le pronostic est largement meilleur lors de l'accouchement par voie haute. La cesarienne est une alternative pour l'amelioration du pronostic foetal dans les pays a ressources limitees

[Management of pre-term labor: use of nifedipine in Conakry, Guinea]. / Menaces d'accouchement prématuré: utilisation de la nifédipine à Conakry, Guinée.

This purpose of this prospective and descriptive study was to evaluate the utility of a calcium-channel inhibitor, i.e. nifedipine, for management of preterm labor in our work setting in terms of safety and cost-effectiveness in comparison with betamimetics classically used for this indication. Study was carried out over a six-month period in the department of Gynecology-Obstetrics Department of Ignace Deen National Hospital in Conakry, Guinea. Pregnant women meeting the following criteria were included: 28 to 33 weeks of amenorrhea, six days of hospitalization either for preterm labor or for another diagnosis that was associated with the occurrence of preterm labor during hospitalization, and absence of contraindications for tocolysis using nifedipine. A total of 42 women were included. Pregnancy was extended for more than 48 hours after the first dose of nifedipine in 86.8% of cases. Administration of nifedipine failed in 5 cases including one case in which it was necessary to change the tocolytic and 4 cases in which delivery occurred less than 48 hours after the first dose of nifedipine. In 68% of cases, 90 mg of nifedipine were sufficient to stop uterine contractions within 48 hours. In 39.5% of cases, no side effects were observed. Adverse effects in the other cases were dizziness (39.5%) and headache (18.4%). The mean term of delivery was 36 weeks +/- 5 days of amenorrhea with a mean extension of 6.2 weeks. Apgar score was low in 30.5% of the newborns and normal in 69.5%. One newborn (2.8%) died. The results of this study indicate that nifedipine is an effective, economical and safe drug for tocolysis and that it can be used as an alternative to betamimetis in countries with limited resources. An information campaign is needed to promote use of nifedipine as a tocolytic in obstetrical facilities of our country.