>Objective: To investigate the compliance of computed tomography (CT) scan requests in the X-ray units of Sub-Saharan Africa. Methods: Multi-centric, exhaustive, descriptive and cross-sectional study (Burkina Faso ...>Objective: To investigate the compliance of computed tomography (CT) scan requests in the X-ray units of Sub-Saharan Africa. Methods: Multi-centric, exhaustive, descriptive and cross-sectional study (Burkina Faso and Benin) focused on CT scan requests implemented and interpreted from May 1 to July 31, 2014. Request compliance was assessed according to the criteria of the French High Authority for Health to which was added a criterion for fulfillment of description of patient clinical information. An exam was deemed compliant when all criteria were met. Ratios were compared by means of Chi<sup>2</sup> test at 0.05% significance level. Results: Among the 426 colligated computed tomography prescriptions, the least filled fields were allergy concept (0%), creatinine-mia (0.3%), examination purpose (50.2%). The overall compliance rate was 35%. The requests made by medical specialists were more compliant than those made by general practitioners and students (p = 0.003). Fulfillment of clinical information description was also better among medical specialists compared to the other prescribers (p = 0.002). Conclusion: It is important to improve the quality of computed tomography (CT) scan requests in the hospitals of Bobo-Dioulasso (Bur-kina Faso) and Parakou (Benin).展开更多
<strong>Background:</strong> Measuring optic nerve sheath diameter (ONSD), a relatively re-cent technique, allows an indirect and non-invasive diagnosis of intracranial hypertension. The ONSD ratio to eyeb...<strong>Background:</strong> Measuring optic nerve sheath diameter (ONSD), a relatively re-cent technique, allows an indirect and non-invasive diagnosis of intracranial hypertension. The ONSD ratio to eyeball transverse diameter (ETD) increases this reliability of the technique. The objective of this study was to determine the normal ONSD and its ratio with ETD in black African adults in Benin. <strong>Methods:</strong> A descriptive cross-sectional study was conducted between May 2019 and August 2019. Ultrasound ONSD and ONSD/ETD ratio were meas-ured in 210 healthy adults received in the medical imaging department of the Borgou and Alibori University Hospital Center in Benin. The ONSD corre-sponded to the average of 12 measurements (03 horizontal and 03 vertical for each eye) taken 3 mm behind the papilla. The transverse ETD corresponded to the average of 03 measurements. <strong>Results:</strong> The mean ONSD was 4.20 ± 0.28 mm (95% CI = [4.17;4.24] mm and 95th percentile = 4.70 mm). The mean ETD was 24.25 ± 1.10 mm. The ONSD/ETD ratio was 0.17 ± 0.01 (95% CI = [0.17;0.17] and 95th percentile = 0.19). There was no difference between ver-tical and horizontal ONSD and between right and left ONSD. The ONSD and the ONSD/ETD ratio were not correlated with any of the socio-demographic and anthropometric characteristics studied (sex, age, ethnicity, weight, height, body mass index, head circumference and waist circumference). The ONSD was associated with ETD (p < 0.001 and r = 0.55). <strong>Conclusion:</strong> An ONSD and an ONSD/ETD ratio respectively greater than 4.70 mm and 0.19 should sus-pect intracranial hypertension. The ONSD/ETD ratio may be a better indicator of HICT because of its small variation.展开更多
Introduction: Viral hepatitis B is a public health problem worldwide. The objective of this study was to determine the epidemiological and diagnostic profile of chronic carriers of hepatitis B virus seen for gastroent...Introduction: Viral hepatitis B is a public health problem worldwide. The objective of this study was to determine the epidemiological and diagnostic profile of chronic carriers of hepatitis B virus seen for gastroenterology consultations in Parakou, Republic of Benin. Patients and Methods: This was a cross-sectional and descriptive study with retrospective data collection. Patients seen for gastroenterology consultations from January 1, 2017 to June 30, 2021 at the Regional Teaching Hospital of Borgou/Alibori (CHUD-B/A) and having been diagnosed as chronic carriers of hepatitis B virus were included. A minimum initial assessment was required to be included. The minimum sample size was calculated with Schwartz formula. The variable of interest was the detection of HBsAg twice and at least 6 months apart. The other variables studied were sociodemographic, clinical and paraclinical data. The data collected were analyzed using SPSS 17 software. Results: A total of 2786 patients were seen for gastroenterology consultations, including 1126 (40.4%) HBsAg-positive patients. Among them, 417 patients met the inclusion criteria and were the subject of the present study. The average age of the patients was 34.8 ± 10.5 years. Two hundred and forty-seven patients (65.7%) were male, representing a sex ratio of 1.9. The discovery of positive HBsAg status was made during systematic screening in 231 patients (55.4%). Scarifications were noted in 373 patients (89.4%). Asthenia was reported in 184 patients (44.1%). Co-infections with human immunodeficiency virus, hepatitis C and D viruses were 0% (0 in 92), 2.8% (4 in 146) and 14.3% (2 in 146), respectively. During the initial assessment, 274 patients (65.7%) were sero-negative for chronic HBeAg infection, 21 (5%) had clinically significant fibrosis including 16 (3.8%) at the stage of cirrhosis and 7 patients (5.4%) had hepatocellular carcinoma. Conclusion: In Parakou, chronic hepatitis B virus infection is common and affects young people with a male predominance. Asthenia is a no展开更多
Introduction: Irritable bowel syndrome is the most common functional gastrointestinal disorder. The objective of this work is to contribute to improving the medical follow-up of medical students at the University of P...Introduction: Irritable bowel syndrome is the most common functional gastrointestinal disorder. The objective of this work is to contribute to improving the medical follow-up of medical students at the University of Parakou through a study of irritable bowel syndrome. Study Methods: This was a descriptive and analytical cross-sectional study with prospective data collection. Data were collected from medical students from May 2018 to July 2018 using a pre-established questionnaire. Sampling was probabilistic using a two-stage survey. The diagnostic tools were: Rome IV criteria, Bristol scale and HAD (hospital anxiety and depression) scale. Data analysis was performed using Epi Info 7.1.3.14 software. CDC. Results: Thirty-two (7.55%) of the 424 students included had irritable bowel syndrome. Out of the 32 students with IBS, 24 (75%) were female. Their average age was 21.38 ± 2.39 years. For 24 students (75%), the symptoms occurred at the same time as exam preparation or the intense course period. Of the 32 students with IBS, 1 (3.12%) was regularly physically active. In this series, 8 students (28%) consulted a doctor for their symptoms. The factors associated with this syndrome were female sex (p = 0.022), sleep disorders (p = 0.008) and the presence of a doubtful depression (p = 0.021). Absenteeism due to irritable bowel syndrome was noted in 18 (56.25%) students. Conclusion: Irritable bowel syndrome is a common condition among medical students in Parakou. Support for better management of psychological disorders could improve the quality of life of these students.展开更多
<strong>Background:</strong> Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imag...<strong>Background:</strong> Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imaging (MRI) plays an important role in the early detection of lesions. This work aimed to describe the MRI aspects of different brain lesions occurred in HIV positive patients in our practice. <strong>Methods:</strong> This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. <strong>Results:</strong> Among the 39 patients included, 19 (48.7%) had a previous brain CT scan, 11 of which were normal (28.2%). Thirty-five (89.74%) patients had a pathological MRI. The main etiologies found were toxoplasmosis (37.14%), tuberculosis (17.14%), cerebral atrophy (17.14%) and HIV encephalitis (14.28%). Among the eleven patients with a normal Computer Tomography scan, the MRI found 7 abnormalities including 1 case of toxoplasmosis, 3 cases of HIV encephalitis and 3 cases of Progressive Multifocal Leukoencephalopathy (PML). <strong>Conclusion:</strong> MRI played an important role in the diagnosis of CNS disorders in HIV-infected individuals. It can be used to differentiate and characterize various brain lesions. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV.展开更多
<strong>Introduction:</strong> Damage to the nasal cavities and sinuses of the face concern many disciplines, especially the specialist in Otorhinolaryngology and Cervi-cal-Facial Surgery (ENT-CFS), since ...<strong>Introduction:</strong> Damage to the nasal cavities and sinuses of the face concern many disciplines, especially the specialist in Otorhinolaryngology and Cervi-cal-Facial Surgery (ENT-CFS), since most symptoms have little value to direct the patient towards a precise diagnosis, radiological exploration, including three-dimensional imaging, provides diagnostic, therapeutic and follow-up support. The aim is to study the clinical and computed tomography scan as-pects of non-traumatic chronic nasosinusitis disorders at the Teaching Univer-sity Hospital of Hubert Koutoukou Maga (CNHU/HKM) in Cotonou. Materi-al and <strong>Method:</strong> It was a descriptive and analytical study with retrospective collection, carried out over a period of 36 months from January 1st, 2014 to December 31st, 2016;on 261 files of patients seen in Otorhinolaryngology (ENT) and Cervico Facial Surgery (CFS) consultating for a chronic nasosinusi-tis disorder with no trauma notion and having performed a CT scan. <strong>Results:</strong> Chronic lesions of the nasal sinus cavities accounted for 13.42% of ENT con-sultations. There was female predominance with a sex ratio of 0.85. The clinic varied, the most common signs were rhinorrhea (74%), headache (73.6%) and sneezing (38.3%). On computed tomography scan, 225 results were pathologi-cal. Sinus backfilling was in the lead with 66.7% followed by mucous thicken-ing with 60.44%, and by bone involvement in 28%. Inflammatory pathologies (82.22%) were on top of the list, followed by pseudo-tumoral pathologies (20.9%). The anterior sinus complex was the most affected (56%) with predominance of the maxillary sinuses. <strong>Conclusion:</strong> chronic nasosinusitis dis-orders are frequent in daily practice, with a varied clinic. Computed tomogra-phy scan is a major diagnostic tool that should be favored.展开更多
<strong>Introduction</strong>: Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatism. The increasing use of bone and joint ultrasound as a tool to aid in the detection of unrefined s...<strong>Introduction</strong>: Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatism. The increasing use of bone and joint ultrasound as a tool to aid in the detection of unrefined synovitis in developed countries, has led us to study the performance of ultrasound in the diagnosis of RA in subjects consulting in rheumatology at Cotonou. <strong>Study Method:</strong> Descriptive cross-sectional study of patients with RA, selected on the basis of ACR/ EULAR 2010 criteria. A complete clinical examination with imaging including X-rays and ultrasounds of the hands and feet were performed in all patients who have given their consent. The data collected was analyzed using EPI data 3.1 and SPSS 24.0 software. The significance rate was defined with a p-value < 5%. Cohen’s Kappa (k) test was used to assess agreement. <strong>Results:</strong> All 53 patients included had lesions on ultrasound. Synovitis was found in 98.1% and bone erosions in 88.7%. There was no agreement in the wrists between clinical examination and ultrasound (k = <span style="white-space:nowrap;">-</span>0.116), MCP (k = <span style="white-space:nowrap;">-</span>0.097) and MTP (k = <span style="white-space:nowrap;">-</span>0.031). Agreement was very low at the PPI level (k = 0.03). It was low at the different sites, between ultrasound and radiographic detection of lesions (k between 0.022 - 0.22). Age, positive immunologic RA factor and biological inflammatory syndrome were associated with ultrasound erosions (p = 0.0001) and only age was associated with active synovitis (p = 0.022). <strong>Conclusion:</strong> Bone and articular ultrasound is a good complementary alternative to clinical examination and radiography diagnostic in early diagnosis of RA in our developing countries, in the absence of MRI which remains a luxury.展开更多
文摘>Objective: To investigate the compliance of computed tomography (CT) scan requests in the X-ray units of Sub-Saharan Africa. Methods: Multi-centric, exhaustive, descriptive and cross-sectional study (Burkina Faso and Benin) focused on CT scan requests implemented and interpreted from May 1 to July 31, 2014. Request compliance was assessed according to the criteria of the French High Authority for Health to which was added a criterion for fulfillment of description of patient clinical information. An exam was deemed compliant when all criteria were met. Ratios were compared by means of Chi<sup>2</sup> test at 0.05% significance level. Results: Among the 426 colligated computed tomography prescriptions, the least filled fields were allergy concept (0%), creatinine-mia (0.3%), examination purpose (50.2%). The overall compliance rate was 35%. The requests made by medical specialists were more compliant than those made by general practitioners and students (p = 0.003). Fulfillment of clinical information description was also better among medical specialists compared to the other prescribers (p = 0.002). Conclusion: It is important to improve the quality of computed tomography (CT) scan requests in the hospitals of Bobo-Dioulasso (Bur-kina Faso) and Parakou (Benin).
文摘<strong>Background:</strong> Measuring optic nerve sheath diameter (ONSD), a relatively re-cent technique, allows an indirect and non-invasive diagnosis of intracranial hypertension. The ONSD ratio to eyeball transverse diameter (ETD) increases this reliability of the technique. The objective of this study was to determine the normal ONSD and its ratio with ETD in black African adults in Benin. <strong>Methods:</strong> A descriptive cross-sectional study was conducted between May 2019 and August 2019. Ultrasound ONSD and ONSD/ETD ratio were meas-ured in 210 healthy adults received in the medical imaging department of the Borgou and Alibori University Hospital Center in Benin. The ONSD corre-sponded to the average of 12 measurements (03 horizontal and 03 vertical for each eye) taken 3 mm behind the papilla. The transverse ETD corresponded to the average of 03 measurements. <strong>Results:</strong> The mean ONSD was 4.20 ± 0.28 mm (95% CI = [4.17;4.24] mm and 95th percentile = 4.70 mm). The mean ETD was 24.25 ± 1.10 mm. The ONSD/ETD ratio was 0.17 ± 0.01 (95% CI = [0.17;0.17] and 95th percentile = 0.19). There was no difference between ver-tical and horizontal ONSD and between right and left ONSD. The ONSD and the ONSD/ETD ratio were not correlated with any of the socio-demographic and anthropometric characteristics studied (sex, age, ethnicity, weight, height, body mass index, head circumference and waist circumference). The ONSD was associated with ETD (p < 0.001 and r = 0.55). <strong>Conclusion:</strong> An ONSD and an ONSD/ETD ratio respectively greater than 4.70 mm and 0.19 should sus-pect intracranial hypertension. The ONSD/ETD ratio may be a better indicator of HICT because of its small variation.
文摘Introduction: Viral hepatitis B is a public health problem worldwide. The objective of this study was to determine the epidemiological and diagnostic profile of chronic carriers of hepatitis B virus seen for gastroenterology consultations in Parakou, Republic of Benin. Patients and Methods: This was a cross-sectional and descriptive study with retrospective data collection. Patients seen for gastroenterology consultations from January 1, 2017 to June 30, 2021 at the Regional Teaching Hospital of Borgou/Alibori (CHUD-B/A) and having been diagnosed as chronic carriers of hepatitis B virus were included. A minimum initial assessment was required to be included. The minimum sample size was calculated with Schwartz formula. The variable of interest was the detection of HBsAg twice and at least 6 months apart. The other variables studied were sociodemographic, clinical and paraclinical data. The data collected were analyzed using SPSS 17 software. Results: A total of 2786 patients were seen for gastroenterology consultations, including 1126 (40.4%) HBsAg-positive patients. Among them, 417 patients met the inclusion criteria and were the subject of the present study. The average age of the patients was 34.8 ± 10.5 years. Two hundred and forty-seven patients (65.7%) were male, representing a sex ratio of 1.9. The discovery of positive HBsAg status was made during systematic screening in 231 patients (55.4%). Scarifications were noted in 373 patients (89.4%). Asthenia was reported in 184 patients (44.1%). Co-infections with human immunodeficiency virus, hepatitis C and D viruses were 0% (0 in 92), 2.8% (4 in 146) and 14.3% (2 in 146), respectively. During the initial assessment, 274 patients (65.7%) were sero-negative for chronic HBeAg infection, 21 (5%) had clinically significant fibrosis including 16 (3.8%) at the stage of cirrhosis and 7 patients (5.4%) had hepatocellular carcinoma. Conclusion: In Parakou, chronic hepatitis B virus infection is common and affects young people with a male predominance. Asthenia is a no
文摘Introduction: Irritable bowel syndrome is the most common functional gastrointestinal disorder. The objective of this work is to contribute to improving the medical follow-up of medical students at the University of Parakou through a study of irritable bowel syndrome. Study Methods: This was a descriptive and analytical cross-sectional study with prospective data collection. Data were collected from medical students from May 2018 to July 2018 using a pre-established questionnaire. Sampling was probabilistic using a two-stage survey. The diagnostic tools were: Rome IV criteria, Bristol scale and HAD (hospital anxiety and depression) scale. Data analysis was performed using Epi Info 7.1.3.14 software. CDC. Results: Thirty-two (7.55%) of the 424 students included had irritable bowel syndrome. Out of the 32 students with IBS, 24 (75%) were female. Their average age was 21.38 ± 2.39 years. For 24 students (75%), the symptoms occurred at the same time as exam preparation or the intense course period. Of the 32 students with IBS, 1 (3.12%) was regularly physically active. In this series, 8 students (28%) consulted a doctor for their symptoms. The factors associated with this syndrome were female sex (p = 0.022), sleep disorders (p = 0.008) and the presence of a doubtful depression (p = 0.021). Absenteeism due to irritable bowel syndrome was noted in 18 (56.25%) students. Conclusion: Irritable bowel syndrome is a common condition among medical students in Parakou. Support for better management of psychological disorders could improve the quality of life of these students.
文摘<strong>Background:</strong> Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imaging (MRI) plays an important role in the early detection of lesions. This work aimed to describe the MRI aspects of different brain lesions occurred in HIV positive patients in our practice. <strong>Methods:</strong> This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. <strong>Results:</strong> Among the 39 patients included, 19 (48.7%) had a previous brain CT scan, 11 of which were normal (28.2%). Thirty-five (89.74%) patients had a pathological MRI. The main etiologies found were toxoplasmosis (37.14%), tuberculosis (17.14%), cerebral atrophy (17.14%) and HIV encephalitis (14.28%). Among the eleven patients with a normal Computer Tomography scan, the MRI found 7 abnormalities including 1 case of toxoplasmosis, 3 cases of HIV encephalitis and 3 cases of Progressive Multifocal Leukoencephalopathy (PML). <strong>Conclusion:</strong> MRI played an important role in the diagnosis of CNS disorders in HIV-infected individuals. It can be used to differentiate and characterize various brain lesions. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV.
文摘<strong>Introduction:</strong> Damage to the nasal cavities and sinuses of the face concern many disciplines, especially the specialist in Otorhinolaryngology and Cervi-cal-Facial Surgery (ENT-CFS), since most symptoms have little value to direct the patient towards a precise diagnosis, radiological exploration, including three-dimensional imaging, provides diagnostic, therapeutic and follow-up support. The aim is to study the clinical and computed tomography scan as-pects of non-traumatic chronic nasosinusitis disorders at the Teaching Univer-sity Hospital of Hubert Koutoukou Maga (CNHU/HKM) in Cotonou. Materi-al and <strong>Method:</strong> It was a descriptive and analytical study with retrospective collection, carried out over a period of 36 months from January 1st, 2014 to December 31st, 2016;on 261 files of patients seen in Otorhinolaryngology (ENT) and Cervico Facial Surgery (CFS) consultating for a chronic nasosinusi-tis disorder with no trauma notion and having performed a CT scan. <strong>Results:</strong> Chronic lesions of the nasal sinus cavities accounted for 13.42% of ENT con-sultations. There was female predominance with a sex ratio of 0.85. The clinic varied, the most common signs were rhinorrhea (74%), headache (73.6%) and sneezing (38.3%). On computed tomography scan, 225 results were pathologi-cal. Sinus backfilling was in the lead with 66.7% followed by mucous thicken-ing with 60.44%, and by bone involvement in 28%. Inflammatory pathologies (82.22%) were on top of the list, followed by pseudo-tumoral pathologies (20.9%). The anterior sinus complex was the most affected (56%) with predominance of the maxillary sinuses. <strong>Conclusion:</strong> chronic nasosinusitis dis-orders are frequent in daily practice, with a varied clinic. Computed tomogra-phy scan is a major diagnostic tool that should be favored.
文摘<strong>Introduction</strong>: Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatism. The increasing use of bone and joint ultrasound as a tool to aid in the detection of unrefined synovitis in developed countries, has led us to study the performance of ultrasound in the diagnosis of RA in subjects consulting in rheumatology at Cotonou. <strong>Study Method:</strong> Descriptive cross-sectional study of patients with RA, selected on the basis of ACR/ EULAR 2010 criteria. A complete clinical examination with imaging including X-rays and ultrasounds of the hands and feet were performed in all patients who have given their consent. The data collected was analyzed using EPI data 3.1 and SPSS 24.0 software. The significance rate was defined with a p-value < 5%. Cohen’s Kappa (k) test was used to assess agreement. <strong>Results:</strong> All 53 patients included had lesions on ultrasound. Synovitis was found in 98.1% and bone erosions in 88.7%. There was no agreement in the wrists between clinical examination and ultrasound (k = <span style="white-space:nowrap;">-</span>0.116), MCP (k = <span style="white-space:nowrap;">-</span>0.097) and MTP (k = <span style="white-space:nowrap;">-</span>0.031). Agreement was very low at the PPI level (k = 0.03). It was low at the different sites, between ultrasound and radiographic detection of lesions (k between 0.022 - 0.22). Age, positive immunologic RA factor and biological inflammatory syndrome were associated with ultrasound erosions (p = 0.0001) and only age was associated with active synovitis (p = 0.022). <strong>Conclusion:</strong> Bone and articular ultrasound is a good complementary alternative to clinical examination and radiography diagnostic in early diagnosis of RA in our developing countries, in the absence of MRI which remains a luxury.
