[Predictors of success among first-year medical students at the University of Parakou]. / Facteurs prédictifs de succès des étudiants en première année de médecine à l'université de Parakou.

INTRODUCTION: Several factors including grades obtained in the Baccalaureate can influence academic performance of first year medical students. The aim of this study was to evaluate the relationship between results achieved by students taking Baccalaureate exam and student academic success during the first year of medical school. METHODS: We conducted an analytical study that included the whole number of students regularly enrolled in their first year of medical school at the university of Parakou in the academic year 2010-2011. Data for the scores for each academic discipline and distinction obtained in the Baccalaureate were collected. Multivariate analysis using logistic regression and multiple linear regression made it possible to determine the best predictors of success and grade point average obtained by students at the end of the year. SPSS Statistics 17.0 was used to analyse data and a p value p < 0.05 was considered significant. RESULTS: Among the 414 students regularly enrolled, we could exploit the data on 407 students. They were aged 15-31 years; 262 (64.4%) were male. 98 were enrolled with a success rate of 23.7%. Concerning men, the scores obtained in mathematics, in physical sciences, the grade point average obtained in the Baccalaureate and honors obtained in the Baccalaureate were associated with their success at the end of the year, but in multivariate analysis only a score in physical sciences > 15/20 was associated with success (OR: 2,8 [1,32-6,00]). Concerning the general average grade obtained at the end of the year, only an honor obtained in the Baccalaureate was associated (standard error of the correlation coefficient: 0,130 Beta =0,370 and p=0,00001). CONCLUSION: The best predictors of student academic success during the first year were a good grade point average in physical sciences during the Baccalaureate and an honor obtained in the Baccalaureate The inclusion of these elements in the enrollement of first-year students could improve academic performance.

The exploratory burr hole: indication and results at one departmental hospital of benin.

Objective. The aim of this study was to describe the indications and results of exploratory burr hole performed at the Departmental Teaching Hospital of Borgou (Benin). Methods. It was a retrospective study performed from January 2008 to February 2011. It concerned patients with a closed traumatic brain injury (TBI) in which an exploratory burr hole was performed. The selection criteria were unilateral mydriasis associated with neurological deficits on the opposite side or the occurrence of a decreased consciousness associated with the appearance of a motor deficit after a lucid interval. Results. Amongst the 74 patients operated, 23 (31%) underwent an exploratory burr hole for which the average age was 24.8 ± 17.3 years. Sex ratio male/female was 3.6. TBI was due to road traffic accident (56.5%), a fall (26.1%), and an assault (17.4%). It was severe (47.8%), moderate (39.1%), and mild (13.1%). Mydriasis was observed in 69.6% of cases as well as neurological deficit in all patients. A lesion was observed in 15 (65.2%) cases. Conclusion. The exploratory burr hole seemed as an old practice, still no longer performed in full practice in Benin, and is a diagnosis and therapeutic approach. Better technical conditions would allow more relevant therapeutic options.

Surgical management of head trauma: problems, results, and perspectives at the departmental teaching hospital of Borgou, Benin.

OBJECTIVE: The purpose of this study was to report our neurosurgical experience with traumatic brain injury (TBI) at a departmental teaching hospital in Benin. METHODS: This was a descriptive study performed from January 2008 to June 2010. It concerned patients who received surgical treatment after a brain trauma. Conditions for surgical care were based on imaging data or exclusively on clinical symptoms (disorders of consciousness associated with focal signs). RESULTS: Sixty-two patients underwent surgical management during the study period. They accounted for 5% of the TBI cases hospitalized. There were 56 (90.3%) men and 6 (9.7%) women. The average age of patients was 26.38 ± 14.76 years. The main cause of injury was road traffic accident (80.6%). The mean time of admission to the surgical room was 27.59 ± 20.71 hours. The indication for surgery was based on clinical data in 17 (27.4%) patients, clinical and x-ray data in 27 (43.6%) patients, and computed tomography scan data in 18 (29%) patients. A burr-hole exploration was performed in 17 (27.4%) patients. Repair of depressive fracture or cerebral wound and evacuation of hematoma were mainly performed (75.8%). Complete recovery was observed in 34 (54.9%) patients. Sequels were observed in 10 (16.1%) patients. The postoperative mortality was 29% (n = 18). This mortality was 76.5% among 17 patients for whom burr-hole exploration was performed (P = 0.00000). CONCLUSION: Surgical treatment of TBI is a common activity in our practice, despite the difficulties. Good imaging and enhanced prevention could improve care and reduce TBI severity.

Simultaneous gastric band removal and sleeve gastrectomy: a comparison with front-line sleeve gastrectomy.

The placement of a gastric band (GB) prior to a sleeve gastrectomy (LSG) would increase postoperative complications, whether it is withdrawn or not at the time of the LSG. The purpose of this retrospective study was to evaluate and compare postoperative morbidity and outcome weight for simultaneous GB removal (RGB) and LSG (the RGB + LSG group) and front-line LSG only (the LSG group) after unsuccessful GB. From May 2005 to May 2009, 305 patients underwent first- or second-line LSG at Amiens University Hospital. The primary endpoint was the postoperative complication rate (according to the Clavien classification) in the RGB + LSG and LSG groups. The secondary endpoints were intra-operative data, postoperative data, and weight loss over a period of 2 years (body mass index, percentage of excess weight loss, and percentage of excess body mass index (BMI) loss). Univariate and multivariate propensity score analyses were used to search for independent risk factors for postoperative complications. The RGB + LSG group (n = 46) had a mean age of 42 and a mean BMI of 44 kg/m(2). The indication for surgery was renewed weight gain or insufficient weight loss in 68 % of these cases. The LSG group (n = 259) had a mean age of 41 and a mean BMI of 49.2 kg/m(2). All procedures were performed laparoscopically. The complication rate was 8.6 % in the RGB + LSG group and 8 % in the SG group (p = 0.42). The fistula rates in the two groups were 4.3 and 3.4 %, respectively (p = 0.56), and the mean BMI at 2 years was 33.4 kg/m(2) (RGB + LSG group) and 34.4 kg/m(2), respectively (p = 0.83). The operating time for LSG (after subtracting the time associated with RGB for a combined procedure) averaged 107 min, whereas the operating time for front-line LSG was 89 min (p = 0.011). The propensity score analysis failed to find independent risk factors for postoperative complications. The performance of RGB + LSG is feasible and does not increase the postoperative morbidity rate. Weight loss after RGB + LSG validates the concept of "restrictive surgery after restrictive surgery". We did not find any independent risk factors that would have justified the avoidance of RGB + SG.

[Clinical and radio-anatomical aspects of traumatic brain injuries after road crash at one hospital, Benin]. / Aspects cliniques et radio-anatomiques des traumatismes crânio-encéphaliques par accident de la circulation dans un centre hospitalier au Bénin.

BACKGROUND: Traumatic brain injuries (TBI) represent one major cause of death worldwide. The young people are most concerned and road crash is the first etiology. AIM: To establish the frequency, clinical, and radio-anatomical sides of TBI after road crash. METHODS: It was descriptive study performed from January 1, 2008 to June 30, 2009 in Borgou Departmental Hospital, Benin. It concerned patients admitted in ours unit four traumatic brain injuries after road crash. RESULTS: 274 patients answered the criteria of inclusion. They was 22, 2% of the hospitalizations in surgery unit. The mean age was 29.56 years. The age bracket most concerned was the 21- 30 years [35.8%]. The sex ratio M/F was 5.85. The initial loss of consciousness was the clinical sign more observed [89.8%]. The neurological deficits were observed in 9.8% of the cases. The severe TBI (GCS ² 8) accounted for 27.7% of the patients. Among the 110 patients [41.1%] received skull X-ray, 66 patients [50.9%] presented a vault's lesion. The cerebral scanner produced among 38 patients [13.9%] objectified lesions of the vault in 21 [55.3%] patients. The intracranial injuries were dominated by the cerebral contusions [31.6%]. Mortality was 17.5%. Among death, the 21-30 years old was 37.5%. CONCLUSION: TBI admitted in CHD-Borgou are major problem. Preventives measure concerning all users may be applied.