Introduction: Diabetes is a major public health problem. Medicinal plants are frequently used either combine with industrial treatment or exclusively, in Africa and particularly in Benin. Our study aims to identify th...Introduction: Diabetes is a major public health problem. Medicinal plants are frequently used either combine with industrial treatment or exclusively, in Africa and particularly in Benin. Our study aims to identify the different medicinal plants used by diabetic patients at the CNHU-HKM. Method: we carried out a descriptive and analytical cross-sectional study. It took place at the University Clinic of Endocrinology, Metabolism and Nutrition of CNHU-HKM over a of 3 months period from 20<sup>th</sup> of June to 16<sup>th</sup> of September, 2022, over diabetic followed-up. Results: One hundred and seventy-three (173) patients were gathered using an anonymous inquiry form. In the study population, the age of the patients varied between 31 and 75 years with an average age of 59 +/− 1.43 years, women represented 59% with a sex ratio (male/female) of 0.69. Sixty-five (65) or 37.6% of the population had used medicinal plants. Among given reasons for using medicinal plants were, mainly the positiveness on a third party. Data analysis outcome twenty-nine species of plants belonging to twenty (20) botanical families, the most represented being the Annonaceae and Fabaceae. The most used species are Phyllanthus amarus (hlenwé in fon), Mangifera indica (mangatin in fon), Momordica charantia (gninsikin in fon), Combretum micranthum (kinkéliba in fon), and Picralima nitida (ayorkpè in fon). Most used parts of the plants are the leaves. The recipes are prepared mainly by infusion and are administered exclusively by mouth. Most of the patients who used the hypoglycaemic medicinal plants were satisfied and no adverse effects were reported by them. Conclusion: Hypoglycaemic medicinal plants could be subjected to pharmacognosy and marketed due to their richness in active components, after further toxicological studies.展开更多
Introduction: Predictions on the prevalence of diabetes mellitus, according to the International Diabetes Federation, indicated 9.3% in 2019 and nearly 10.9% of the general population in 2045. In Benin, the increase i...Introduction: Predictions on the prevalence of diabetes mellitus, according to the International Diabetes Federation, indicated 9.3% in 2019 and nearly 10.9% of the general population in 2045. In Benin, the increase in this prevalence, according to the World Health Organization (WHO), is constantly increasing. Diabetic foot is one of its most common complications. The aim of this work was to study the prognostic factors of diabetic foot in the Department of Endocrinology, Metabolism and Nutrition of the CNHU-HKM of Cotonou. Patients and method: This is a descriptive and analytical retrospective study of the prognostic factors of diabetic foot over a period of 3 years from January 2019 to December 2021 in patients who have been hospitalized or followed on an outpatient basis for diabetic foot in the Endocrinology, Metabolism and Nutrition Department of the CNHU-HKM of Cotonou. Results: A total of 112 patients were included in this study. The average age of the patients was 59.70 ± 2.10 years. A male predominance was noted with a sex ratio (M/F) of 1.7. Mixed gangrene and phlegmons were the most common lesions. According to the classification of diabetic feet according to the University of Texas, 59.1% of patients had a 100% risk of amputation. Ten patients died from sepsis (8.9%). The average blood glucose on admission was 2.74 ± 0.23 g/l, reflecting the glycemic imbalance in these patients. There is a statistically significant association between the duration of progression of diabetes, the type of lesion and amputation. Patients whose diabetes has lasted more than 30 years and patients who are not monitored have a greater risk of death. Conclusion: Diabetic patients most often consulted at a late stage, compromising conservative treatment. The duration of diabetes and the type of lesion on admission were the main factors leading to amputation, thus compromising the functional prognosis. As for death, it was mainly linked to irregular monitoring of diabetes and the duration of diabetes. Effective prevention and management of diabetic feet requires patient education about the diabetic foot and systematic screening of at-risk feet in consultation.展开更多
Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descripti...Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descriptive cross-sectional study with an analytical aim covering the period from January 2019 to December 31, 2021 in the Endocrinology, Metabolism and Nutrition clinic of the National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) We thus identified 150 type 2 diabetic patients. Results: The prevalence of macroangiopathy was 60% with 11.3% for stroke, 28.6% for acute coronary syndrom, 4% for cervical macroangiopathy, and 46.97% ± 25.36% for obliterating arteriopathy of the lower limbs (OALL). The mean age of the patients was 57.69 ± 1.77 years with a sex ratio 1. The duration of diabetes progression was greater than 10 years for more than half of the patients 52.6%. The main associated cardiovascular risk factors were arterial high blood pressure (64.7%), family history of diabetes (33.7%), obesity with 20.0%. The death rate was 7.3%. Conclusion: Macroangiopathy’s mortality rate of in type 2 diabetics is high. Prevention remains the best treatment and involves screening for factors associated with macroangiopathy.展开更多
Introduction: Since its creation in 2017 by the European community, the EU-TIRADS classification has enjoyed an excellent reputation in several countries around the world. Indeed, several studies conducted in these co...Introduction: Since its creation in 2017 by the European community, the EU-TIRADS classification has enjoyed an excellent reputation in several countries around the world. Indeed, several studies conducted in these countries testify to the effectiveness of this tool for the management of nodular thyroid pathology. However, in Benin, the contribution of this classification has not yet been evaluated. It is therefore to overcome this inadequacy that we undertook this study. Objective: Participate in improving the diagnostic and therapeutic management of thyroid nodules at the CNHU HKM in Cotonou and at the CHUZ in Suru-Léré. Methods: This is a cross-sectional study with retrospective data collection spread over a period of 3 years 5 months, from January 2019 to May 2022 and carried out jointly in the Endocrinology Metabolism Nutrition and ORL-CCF departments of the CNHU HKM of Cotonou and in the ORL-CCF department of the CHUZ of Suru-Léré. The study population consisted of patients who consulted the University Clinic of Endocrinology Metabolism Nutrition, the University Clinic of ORL-CCF of the CNHU-HKM and the University Clinic of ORL-CCF of the CHUZ of Suru-Léré for thyroid nodule and who have had surgery. The study data was collected from patients hospitalization records using a survey form. Results: On ultrasound, according to the EU-TIRADS classification, 56.8% of nodules presented a low risk of malignancy (EU-TIRADS 3) compared to respectively 19.8%;23% and 2.5% of nodules with zero (EU-TIRADS 2), intermediate (EU-TIRADS 4) and high (EU-TIRADS 5) risk of malignancy. Regarding the performance of this classification, it is sensitive in 37.5% of cases and has a specificity of 78.5% with a PPV (Positive Predictive Value) and a NPV (Negative Predictive Value) respectively of 6.6 % and 91.6%. Furthermore, the bivariate correlations revealed that the size of the nodule was significantly associated with the malignancy of the nodule (p = 0.014) and the calculated value of the Yule’s Q coefficient (0.375) reflects a moderate intensity of the connection between the EU-TIRADS and histology. Conclusion: the EU-TIRADS classification, due to its excellent NPV, is of great interest for the management of thyroid nodules at the CNHU-HKM of Cotonou and at the CHUZ of Suru-Léré. In view of this, particular emphasis must be placed on its regular and rigorous use.展开更多
Diabetic peripheral neuropathy (DPN) is a common complication of diabetes. The main objective of the study was to determine the prevalence of diabetic peripheral neuropathy and associated factors in diabetics in the U...Diabetic peripheral neuropathy (DPN) is a common complication of diabetes. The main objective of the study was to determine the prevalence of diabetic peripheral neuropathy and associated factors in diabetics in the University Clinic of Endocrinology Metabolism Nutrition of the CNHU-HKM, Cotonou, Benin 2021. This was a cross-sectional, analytical study that ran from 23 September to 23 December 2021. Admitted diabetic patients seen in consultation during the study period were included. The DN4 tool was used as the basis for data collection. Data analysis was performed using R software version 3.6.1. Multivariate analysis was used to identify factors associated with DPN. Out of 155 diabetics, 54 patients had diabetic peripheral neuropathy, a prevalence of 34.8%. The average age of our patients was 56.8 years and 56.8% were female. Of the patients, 54.7% had unbalanced diabetes. An association between DPN and gender (p = 0.022), occupation (p = 0.004), education (p = 0.011), hypertension (p = 0.017), smoking (p = 0.031), diabetic imbalance (p = 0.001), diabetic retinopathy (p = 0.020) and dyslipidaemia (p = 0.015) was observed. DPN was also associated with erectile dysfunction in men (p = 0.001). Conclusion: Diabetic peripheral neuropathy is common (34.8). Its occurrence is indicative of the presence of associated factors.展开更多
Diabetes mellitus is a disease of great frequency and is a major public health problem. Several complications can occur during the course of diabetes such as diabetic nephropathy, which starts with microalbuminuria in...Diabetes mellitus is a disease of great frequency and is a major public health problem. Several complications can occur during the course of diabetes such as diabetic nephropathy, which starts with microalbuminuria in diabetic patients. This was a cross-sectional and analytical study which took place from 23 September to 23 December 2021 in the Endocrinology-Metabolism-Nutrition Department of the CNHU-HKM of Cotonou, Benin. We carried out an exhaustive census of the patients. Type 2 diabetic patients were included in the study, and 24-hour microalbumunuria, fundus examination and assessment of complications were performed. We identified 145 type 2 diabetic patients of whom 44 had positive microalbuminuria, i.e. a prevalence of 30.3%. There were 61 men and 84 women with a sex ratio of 0.72. The mean age was 59 years with extremes of 26 and 85 years. The complications identified in diabetics with positive microalbuminuria were Neuropathy (43.2%), Nephropathy (22.7%) and Retinopathy (20.5%). Factors associated with microalbuminuria in diabetics were: age, occupation, hypertension, diabetes imbalance, erectile dysfunction. Conclusion: Microalbuminuria is common in type 2 diabetes. It should be managed early to slow the progression of kidney disease to the end stage.展开更多
Introduction: One of the biological markers for monitoring glycaemic control in diabetic patients is glycated protein. The definition of a reference method to improve the accuracy of measurement tools is necessary. Th...Introduction: One of the biological markers for monitoring glycaemic control in diabetic patients is glycated protein. The definition of a reference method to improve the accuracy of measurement tools is necessary. The aim of our study was to assess the glycemic control of diabetic patients based on glycated hemoglobin. Patients and Method: This is a descriptive cross-sectional study conducted in April 2021 at the national university hospital center (CNHU-HKM) of Cotonou. All patients who consulted during the period and who gave their consent were included. After collecting the blood samples according to the classical standards of the pre-analytical phase, we measured the blood glucose level and the HbA1c. Results: The mean blood glucose level of the patients was 1.52 ± 0.16 g/L with extremes of 0.80 g/L and 3.5 g/L. The mean HbA1c proportion was 8.39% ± 0.60% with a minimum and maximum value of 5.40% and 16% respectively. We also noted that the mean body mass index (BMI) of the patients was 28.61 ± 1.46 Kg/m<sup>2</sup> with extremes of 17.50 Kg/m<sup>2</sup> and 46.02 Kg/m<sup>2</sup>. Oral anti diabetic and hygienic-dietary measures were used by 44 patients (80%) and hygienic-dietary measures (HDM) only used by 9.09%. A frequency of 87.53% of patients had at least one degenerative complication. Retinopathy was the most observed degenerative disease (36.36%) followed by cardiovascular disease (25.45%). Conclusion: This study showed that there is a poor correlation between fasting blood glucose and glycated haemoglobin levels, which could be due to several biological and clinical reasons. It also showed that despite the respect of hygienic dietary measures and a well conducted treatment, it is difficult to obtain a satisfactory glycemic balance in obese patients.展开更多
Diabetic retinopathy (DR) is one of the microvascular complications of diabetes. The aim of this study was to analyze the risk factors associated with the occurrence of diabetic retinopathy (DR) at the National Univer...Diabetic retinopathy (DR) is one of the microvascular complications of diabetes. The aim of this study was to analyze the risk factors associated with the occurrence of diabetic retinopathy (DR) at the National University Hospital Center-Hubert Koutoukou MAGA (CNHU-HKM). Patients and method: this was a descriptive and analytical cross-sectional study with prospective data collection. It was carried out over a three-month period from July 10 to October 10, 2019. It concerned all patients suffering from diabetes mellitus and who consulted in the Endocrinology department during the study period. Results: the frequency of diabetic retinopathy was 30.46% (53/174 patients). A female predominance was observed with a sex ratio (M/F) of 0.57. The main modifiable risk factors were represented by occupation and those that were not modifiable were represented by the presence of old nephropathy, glycated hemoglobin, age of discovery of diabetes and its length of service. Diabetic retinopathy is a serious condition that can ultimately lead to blindness. The frequency of DR remains high in our study.展开更多
Erectile dysfunction was one of the most common complications in diabetic patients. According to several studies, its prevalence was two to three times higher in diabetics than in the general population. But it has of...Erectile dysfunction was one of the most common complications in diabetic patients. According to several studies, its prevalence was two to three times higher in diabetics than in the general population. But it has often been overlooked despite the fact that it seriously affects the quality of life. The aim of this study was to determine the prevalence of erectile dysfunction and its associated factors in diabetics’ patients. This was a cross-sectional analysis study of 76 male diabetic patients who consulted by the Department of Endocrinology from June 22, 2019 to September 25, 2019. Erectile dysfunction was diagnosed by calculating the IIEF score. Statistical comparisons were made between patients without and with Erectile dysfunction chi-square test with a significance level p Conclusion: This study showed a high prevalence of erectile dysfunction in diabetics. Significant concomitant factors were hypertension, diabetes imbalance and the duration of diabetes. It was, therefore, important to include systematic screening for erectile dysfunction at least annually, as well as other complications of diabetes.展开更多
Introduction: Polycystic Ovarian Syndrome (PCOS), also known as Stein Leventhal Syndrome, is one of the common endocrine diseases affecting women of childbearing age and the leading cause of anovulatory infertility wo...Introduction: Polycystic Ovarian Syndrome (PCOS), also known as Stein Leventhal Syndrome, is one of the common endocrine diseases affecting women of childbearing age and the leading cause of anovulatory infertility worldwide. The aim of this study was to describe the clinical, paraclinical and therapeutic aspects of PCOS at the University Clinic of Obstetrics and Gynaecology of the National Hospital and University Centre Hubert Koutoukou MAGA of Cotonou (CNHU). Patients and Method: The study was doing in the University Clinic of Gynecology and Obstetrics of the CNHU-HKM. This was a descriptive and analytical longitudinal study with retrospective and prospective data collection over a period of 7 years from January 2015 to December 2021. It focused on women of childbearing age seen in gynecological consultation. Results: The frequency of PCOS was 2.53%. The mean age of the patients was 27.28 ± 6.55 years. They were educated for the most part with a university level in 43.8% of cases. Obstetrically they were nulligest (45.63%) and nulliparous in 60% of cases. The history of spontaneous miscarriages was found in 61.11%. The main reasons for consultation were menstrual disorders (51%) followed by the desire for pregnancy (40.6%). Clinically, obesity (30%), overweight (33.1%), high blood pressure (20.63%), hirsutism (24%) and acne (27%) were noted. All the women had micropolycystic ovaries in ultrasound. Testosterone was elevated in 61% of cases. Phenotype D was found in 45.63% of patients. All these patients were put under lifestyle and dietary measures, Metformin (13.80%) and estrogen-progestogen (18.80%). The outcome of the treatment was assessed by cycle regularity, regression of hirsutism, weight loss, fertility and fertility. The cycle was normalised in most cases with notable regression of physical signs of hyperandrogenism. The cycle was normalized in most cases with the notable regression of physical signs of hyperandrogenism. We had recorded 25 pregnancies including one miscarriage. The occurrence of pregnancy was obtained in 50% of these women after 12 months and in less than 20% after 24 months. Conclusion: PCOS was common in the CUGO of the CNHU-HKM. A population-based epidemiological study seems necessary to better appreciate the risk factors of this endocrine syndrome and its repercussions on fertility and metabolic diseases such as type 2 diabetes, obesity and hypertension.展开更多
Introduction: The pathologies associated with excessive weight gain during pregnancy are numerous and frequent. They are the cause of significant maternal and perinatal morbidity and mortality and thus pose a real pub...Introduction: The pathologies associated with excessive weight gain during pregnancy are numerous and frequent. They are the cause of significant maternal and perinatal morbidity and mortality and thus pose a real public health problem. Patients and method: The main objective of our work was to study the influence of excessive weight gain on maternal and perinatal morbidity and mortality in a university hospital in Cotonou. Study method: The study took place at the CUGO. This was a descriptive and analytical study with retrospective data collection over a period of 10 years from January 1, 2012 to December 31, 2021. The analysis focused on the description of pregnant women and the search for factors associated with an excessive weight gain during pregnancy and which influence maternal and perinatal prognosis. The different odds ratios and their confidence intervals were calculated. The significance level was 5%. Results: A total of 690 pregnant women were included and divided into four sub-populations according to their pre-gestational or first trimester BMI: 05.94% underweight pregnant women, 41.74% normal BMI pregnant women, 28.55% of overweight pregnant women and 23.77% obese pregnant women. The average age of pregnant women was 30.41 years ± 5.40 years. They were civil servants (35.80%) and resided in Cotonou in 93.91% of cases. Pregnant women had a history of hypertension in nearly 3% of cases. Pregnancy hypertension (07.97%) was the main pathology associated with pregnancy in our study. Weight gain was excessive in overweight pregnant women and obese pregnant women in the same proportion 41.12%. The average weight gain was 9.42 kg for underweight pregnant women, 8.35 kg for pregnant women with a normal BMI, 8.46 kg for overweight pregnant women and 7.45 kg for obese pregnant women. Pregnant women who had gained excessive weight during pregnancy had a 9 times higher risk of having pregnancy-induced hypertension (OR = 9.5 and p ≤ 0.0001). They also presented a 6 times higher risk of having pre-eclampsia (OR = 6.6;p ≤ 0.0001). The risk of gestational diabetes is also high (OR = 3.82;p ≤ 0.0001). There is also a risk of macrosomia (OR = 3.33 and p = 0.007) and the risk of cesarean delivery 2 times higher: OR = 2.15 and p = 0.0004. There was no statistically significant link between excessive weight gain and term at delivery, the condition of the newborn at birth, and neonatal mortality. Conclusion: Excessive weight gain during pregnancy in our study was assessed in several pregnant women with a high prevalence. It is the source of several maternal and fetal complications.展开更多
This survey had the objective to determine the frequency of the obesity at the parturient, to value the impact of the obesity on the childbirth by Caesarean and the complications postoperative immediate in the teachin...This survey had the objective to determine the frequency of the obesity at the parturient, to value the impact of the obesity on the childbirth by Caesarean and the complications postoperative immediate in the teaching hospitals of Cotonou. Patients and Method: We did a prospective, comparative and analytic survey from January 13 to April 13, 2012. Eight hundred ninety-one consecutive parturients having had a Caesarean were included. We studied the anesthetic techniques, the techniques of control of the aerial ways, the number of necessary tests for the tracheal intubation, the complications and aftercare of the first 48 hours. A comparison has been made according to the BMI. The obesity has been defined by a BMI ≥ 30 kg/m2. The parturient has been classified in two groups: Non-obese: BMI ≤ 30 kg/m2, obese: BMI ≥ 30. Results: There were 703 (78.90%) Caesareans in emergency and 188 (21.09%) programmed Caesareans. The obesity which has been recovered at 286 parturient is 32.10%. The obese parturient also required more frequently several lumbar punctures (p Conclusion: Many changes led by pregnancy are added to those of the obesity to drive to functional changes, a reduction of the physiological reserve and finally to an increased anesthetic and obstetric risk. The obesity is frequent at the parturient in Benin. The post-operative complications are more frequent after the Caesarean at the obese parturient.展开更多
This was a retrospective and descriptive study conducted from 1 July 2006 to 31 July 2011 and carried on 122 cases of diabetic foot collected a total of 706 diabetic patients hospitalized over a period of 5 years. Obj...This was a retrospective and descriptive study conducted from 1 July 2006 to 31 July 2011 and carried on 122 cases of diabetic foot collected a total of 706 diabetic patients hospitalized over a period of 5 years. Objective: To study the characteristics of diabetic feet in Cotonou. Results: The mean age of patients was 58.05 years ± 10.65 years, ranging from 35 years to 70 years. The sex ratio was 1.5. Duration of diabetes before the onset of diabetic foot was 11 years. The overall prevalence of diabetic foot was 21.53%. Of these, 95% had neuropathy, 70.40% had arterial disease and all had a foot infection. The amputation rate was 31.96% and the mortality rate was 17.21%. Conclusion: The occurrence of diabetic foot is earlier than in the West, and hence there is a need for early treatment of diabetes.展开更多
文摘Introduction: Diabetes is a major public health problem. Medicinal plants are frequently used either combine with industrial treatment or exclusively, in Africa and particularly in Benin. Our study aims to identify the different medicinal plants used by diabetic patients at the CNHU-HKM. Method: we carried out a descriptive and analytical cross-sectional study. It took place at the University Clinic of Endocrinology, Metabolism and Nutrition of CNHU-HKM over a of 3 months period from 20<sup>th</sup> of June to 16<sup>th</sup> of September, 2022, over diabetic followed-up. Results: One hundred and seventy-three (173) patients were gathered using an anonymous inquiry form. In the study population, the age of the patients varied between 31 and 75 years with an average age of 59 +/− 1.43 years, women represented 59% with a sex ratio (male/female) of 0.69. Sixty-five (65) or 37.6% of the population had used medicinal plants. Among given reasons for using medicinal plants were, mainly the positiveness on a third party. Data analysis outcome twenty-nine species of plants belonging to twenty (20) botanical families, the most represented being the Annonaceae and Fabaceae. The most used species are Phyllanthus amarus (hlenwé in fon), Mangifera indica (mangatin in fon), Momordica charantia (gninsikin in fon), Combretum micranthum (kinkéliba in fon), and Picralima nitida (ayorkpè in fon). Most used parts of the plants are the leaves. The recipes are prepared mainly by infusion and are administered exclusively by mouth. Most of the patients who used the hypoglycaemic medicinal plants were satisfied and no adverse effects were reported by them. Conclusion: Hypoglycaemic medicinal plants could be subjected to pharmacognosy and marketed due to their richness in active components, after further toxicological studies.
文摘Introduction: Predictions on the prevalence of diabetes mellitus, according to the International Diabetes Federation, indicated 9.3% in 2019 and nearly 10.9% of the general population in 2045. In Benin, the increase in this prevalence, according to the World Health Organization (WHO), is constantly increasing. Diabetic foot is one of its most common complications. The aim of this work was to study the prognostic factors of diabetic foot in the Department of Endocrinology, Metabolism and Nutrition of the CNHU-HKM of Cotonou. Patients and method: This is a descriptive and analytical retrospective study of the prognostic factors of diabetic foot over a period of 3 years from January 2019 to December 2021 in patients who have been hospitalized or followed on an outpatient basis for diabetic foot in the Endocrinology, Metabolism and Nutrition Department of the CNHU-HKM of Cotonou. Results: A total of 112 patients were included in this study. The average age of the patients was 59.70 ± 2.10 years. A male predominance was noted with a sex ratio (M/F) of 1.7. Mixed gangrene and phlegmons were the most common lesions. According to the classification of diabetic feet according to the University of Texas, 59.1% of patients had a 100% risk of amputation. Ten patients died from sepsis (8.9%). The average blood glucose on admission was 2.74 ± 0.23 g/l, reflecting the glycemic imbalance in these patients. There is a statistically significant association between the duration of progression of diabetes, the type of lesion and amputation. Patients whose diabetes has lasted more than 30 years and patients who are not monitored have a greater risk of death. Conclusion: Diabetic patients most often consulted at a late stage, compromising conservative treatment. The duration of diabetes and the type of lesion on admission were the main factors leading to amputation, thus compromising the functional prognosis. As for death, it was mainly linked to irregular monitoring of diabetes and the duration of diabetes. Effective prevention and management of diabetic feet requires patient education about the diabetic foot and systematic screening of at-risk feet in consultation.
文摘Nowadays, chronic clinical manifestations of diabetemellitus constitute an important disease and a huge public health issue. Aim: Study the macroangiopathic complications in type 2 diabetics. Method: It is a descriptive cross-sectional study with an analytical aim covering the period from January 2019 to December 31, 2021 in the Endocrinology, Metabolism and Nutrition clinic of the National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) We thus identified 150 type 2 diabetic patients. Results: The prevalence of macroangiopathy was 60% with 11.3% for stroke, 28.6% for acute coronary syndrom, 4% for cervical macroangiopathy, and 46.97% ± 25.36% for obliterating arteriopathy of the lower limbs (OALL). The mean age of the patients was 57.69 ± 1.77 years with a sex ratio 1. The duration of diabetes progression was greater than 10 years for more than half of the patients 52.6%. The main associated cardiovascular risk factors were arterial high blood pressure (64.7%), family history of diabetes (33.7%), obesity with 20.0%. The death rate was 7.3%. Conclusion: Macroangiopathy’s mortality rate of in type 2 diabetics is high. Prevention remains the best treatment and involves screening for factors associated with macroangiopathy.
文摘Introduction: Since its creation in 2017 by the European community, the EU-TIRADS classification has enjoyed an excellent reputation in several countries around the world. Indeed, several studies conducted in these countries testify to the effectiveness of this tool for the management of nodular thyroid pathology. However, in Benin, the contribution of this classification has not yet been evaluated. It is therefore to overcome this inadequacy that we undertook this study. Objective: Participate in improving the diagnostic and therapeutic management of thyroid nodules at the CNHU HKM in Cotonou and at the CHUZ in Suru-Léré. Methods: This is a cross-sectional study with retrospective data collection spread over a period of 3 years 5 months, from January 2019 to May 2022 and carried out jointly in the Endocrinology Metabolism Nutrition and ORL-CCF departments of the CNHU HKM of Cotonou and in the ORL-CCF department of the CHUZ of Suru-Léré. The study population consisted of patients who consulted the University Clinic of Endocrinology Metabolism Nutrition, the University Clinic of ORL-CCF of the CNHU-HKM and the University Clinic of ORL-CCF of the CHUZ of Suru-Léré for thyroid nodule and who have had surgery. The study data was collected from patients hospitalization records using a survey form. Results: On ultrasound, according to the EU-TIRADS classification, 56.8% of nodules presented a low risk of malignancy (EU-TIRADS 3) compared to respectively 19.8%;23% and 2.5% of nodules with zero (EU-TIRADS 2), intermediate (EU-TIRADS 4) and high (EU-TIRADS 5) risk of malignancy. Regarding the performance of this classification, it is sensitive in 37.5% of cases and has a specificity of 78.5% with a PPV (Positive Predictive Value) and a NPV (Negative Predictive Value) respectively of 6.6 % and 91.6%. Furthermore, the bivariate correlations revealed that the size of the nodule was significantly associated with the malignancy of the nodule (p = 0.014) and the calculated value of the Yule’s Q coefficient (0.375) reflects a moderate intensity of the connection between the EU-TIRADS and histology. Conclusion: the EU-TIRADS classification, due to its excellent NPV, is of great interest for the management of thyroid nodules at the CNHU-HKM of Cotonou and at the CHUZ of Suru-Léré. In view of this, particular emphasis must be placed on its regular and rigorous use.
文摘Diabetic peripheral neuropathy (DPN) is a common complication of diabetes. The main objective of the study was to determine the prevalence of diabetic peripheral neuropathy and associated factors in diabetics in the University Clinic of Endocrinology Metabolism Nutrition of the CNHU-HKM, Cotonou, Benin 2021. This was a cross-sectional, analytical study that ran from 23 September to 23 December 2021. Admitted diabetic patients seen in consultation during the study period were included. The DN4 tool was used as the basis for data collection. Data analysis was performed using R software version 3.6.1. Multivariate analysis was used to identify factors associated with DPN. Out of 155 diabetics, 54 patients had diabetic peripheral neuropathy, a prevalence of 34.8%. The average age of our patients was 56.8 years and 56.8% were female. Of the patients, 54.7% had unbalanced diabetes. An association between DPN and gender (p = 0.022), occupation (p = 0.004), education (p = 0.011), hypertension (p = 0.017), smoking (p = 0.031), diabetic imbalance (p = 0.001), diabetic retinopathy (p = 0.020) and dyslipidaemia (p = 0.015) was observed. DPN was also associated with erectile dysfunction in men (p = 0.001). Conclusion: Diabetic peripheral neuropathy is common (34.8). Its occurrence is indicative of the presence of associated factors.
文摘Diabetes mellitus is a disease of great frequency and is a major public health problem. Several complications can occur during the course of diabetes such as diabetic nephropathy, which starts with microalbuminuria in diabetic patients. This was a cross-sectional and analytical study which took place from 23 September to 23 December 2021 in the Endocrinology-Metabolism-Nutrition Department of the CNHU-HKM of Cotonou, Benin. We carried out an exhaustive census of the patients. Type 2 diabetic patients were included in the study, and 24-hour microalbumunuria, fundus examination and assessment of complications were performed. We identified 145 type 2 diabetic patients of whom 44 had positive microalbuminuria, i.e. a prevalence of 30.3%. There were 61 men and 84 women with a sex ratio of 0.72. The mean age was 59 years with extremes of 26 and 85 years. The complications identified in diabetics with positive microalbuminuria were Neuropathy (43.2%), Nephropathy (22.7%) and Retinopathy (20.5%). Factors associated with microalbuminuria in diabetics were: age, occupation, hypertension, diabetes imbalance, erectile dysfunction. Conclusion: Microalbuminuria is common in type 2 diabetes. It should be managed early to slow the progression of kidney disease to the end stage.
文摘Introduction: One of the biological markers for monitoring glycaemic control in diabetic patients is glycated protein. The definition of a reference method to improve the accuracy of measurement tools is necessary. The aim of our study was to assess the glycemic control of diabetic patients based on glycated hemoglobin. Patients and Method: This is a descriptive cross-sectional study conducted in April 2021 at the national university hospital center (CNHU-HKM) of Cotonou. All patients who consulted during the period and who gave their consent were included. After collecting the blood samples according to the classical standards of the pre-analytical phase, we measured the blood glucose level and the HbA1c. Results: The mean blood glucose level of the patients was 1.52 ± 0.16 g/L with extremes of 0.80 g/L and 3.5 g/L. The mean HbA1c proportion was 8.39% ± 0.60% with a minimum and maximum value of 5.40% and 16% respectively. We also noted that the mean body mass index (BMI) of the patients was 28.61 ± 1.46 Kg/m<sup>2</sup> with extremes of 17.50 Kg/m<sup>2</sup> and 46.02 Kg/m<sup>2</sup>. Oral anti diabetic and hygienic-dietary measures were used by 44 patients (80%) and hygienic-dietary measures (HDM) only used by 9.09%. A frequency of 87.53% of patients had at least one degenerative complication. Retinopathy was the most observed degenerative disease (36.36%) followed by cardiovascular disease (25.45%). Conclusion: This study showed that there is a poor correlation between fasting blood glucose and glycated haemoglobin levels, which could be due to several biological and clinical reasons. It also showed that despite the respect of hygienic dietary measures and a well conducted treatment, it is difficult to obtain a satisfactory glycemic balance in obese patients.
文摘Diabetic retinopathy (DR) is one of the microvascular complications of diabetes. The aim of this study was to analyze the risk factors associated with the occurrence of diabetic retinopathy (DR) at the National University Hospital Center-Hubert Koutoukou MAGA (CNHU-HKM). Patients and method: this was a descriptive and analytical cross-sectional study with prospective data collection. It was carried out over a three-month period from July 10 to October 10, 2019. It concerned all patients suffering from diabetes mellitus and who consulted in the Endocrinology department during the study period. Results: the frequency of diabetic retinopathy was 30.46% (53/174 patients). A female predominance was observed with a sex ratio (M/F) of 0.57. The main modifiable risk factors were represented by occupation and those that were not modifiable were represented by the presence of old nephropathy, glycated hemoglobin, age of discovery of diabetes and its length of service. Diabetic retinopathy is a serious condition that can ultimately lead to blindness. The frequency of DR remains high in our study.
文摘Erectile dysfunction was one of the most common complications in diabetic patients. According to several studies, its prevalence was two to three times higher in diabetics than in the general population. But it has often been overlooked despite the fact that it seriously affects the quality of life. The aim of this study was to determine the prevalence of erectile dysfunction and its associated factors in diabetics’ patients. This was a cross-sectional analysis study of 76 male diabetic patients who consulted by the Department of Endocrinology from June 22, 2019 to September 25, 2019. Erectile dysfunction was diagnosed by calculating the IIEF score. Statistical comparisons were made between patients without and with Erectile dysfunction chi-square test with a significance level p Conclusion: This study showed a high prevalence of erectile dysfunction in diabetics. Significant concomitant factors were hypertension, diabetes imbalance and the duration of diabetes. It was, therefore, important to include systematic screening for erectile dysfunction at least annually, as well as other complications of diabetes.
文摘Introduction: Polycystic Ovarian Syndrome (PCOS), also known as Stein Leventhal Syndrome, is one of the common endocrine diseases affecting women of childbearing age and the leading cause of anovulatory infertility worldwide. The aim of this study was to describe the clinical, paraclinical and therapeutic aspects of PCOS at the University Clinic of Obstetrics and Gynaecology of the National Hospital and University Centre Hubert Koutoukou MAGA of Cotonou (CNHU). Patients and Method: The study was doing in the University Clinic of Gynecology and Obstetrics of the CNHU-HKM. This was a descriptive and analytical longitudinal study with retrospective and prospective data collection over a period of 7 years from January 2015 to December 2021. It focused on women of childbearing age seen in gynecological consultation. Results: The frequency of PCOS was 2.53%. The mean age of the patients was 27.28 ± 6.55 years. They were educated for the most part with a university level in 43.8% of cases. Obstetrically they were nulligest (45.63%) and nulliparous in 60% of cases. The history of spontaneous miscarriages was found in 61.11%. The main reasons for consultation were menstrual disorders (51%) followed by the desire for pregnancy (40.6%). Clinically, obesity (30%), overweight (33.1%), high blood pressure (20.63%), hirsutism (24%) and acne (27%) were noted. All the women had micropolycystic ovaries in ultrasound. Testosterone was elevated in 61% of cases. Phenotype D was found in 45.63% of patients. All these patients were put under lifestyle and dietary measures, Metformin (13.80%) and estrogen-progestogen (18.80%). The outcome of the treatment was assessed by cycle regularity, regression of hirsutism, weight loss, fertility and fertility. The cycle was normalised in most cases with notable regression of physical signs of hyperandrogenism. The cycle was normalized in most cases with the notable regression of physical signs of hyperandrogenism. We had recorded 25 pregnancies including one miscarriage. The occurrence of pregnancy was obtained in 50% of these women after 12 months and in less than 20% after 24 months. Conclusion: PCOS was common in the CUGO of the CNHU-HKM. A population-based epidemiological study seems necessary to better appreciate the risk factors of this endocrine syndrome and its repercussions on fertility and metabolic diseases such as type 2 diabetes, obesity and hypertension.
文摘Introduction: The pathologies associated with excessive weight gain during pregnancy are numerous and frequent. They are the cause of significant maternal and perinatal morbidity and mortality and thus pose a real public health problem. Patients and method: The main objective of our work was to study the influence of excessive weight gain on maternal and perinatal morbidity and mortality in a university hospital in Cotonou. Study method: The study took place at the CUGO. This was a descriptive and analytical study with retrospective data collection over a period of 10 years from January 1, 2012 to December 31, 2021. The analysis focused on the description of pregnant women and the search for factors associated with an excessive weight gain during pregnancy and which influence maternal and perinatal prognosis. The different odds ratios and their confidence intervals were calculated. The significance level was 5%. Results: A total of 690 pregnant women were included and divided into four sub-populations according to their pre-gestational or first trimester BMI: 05.94% underweight pregnant women, 41.74% normal BMI pregnant women, 28.55% of overweight pregnant women and 23.77% obese pregnant women. The average age of pregnant women was 30.41 years ± 5.40 years. They were civil servants (35.80%) and resided in Cotonou in 93.91% of cases. Pregnant women had a history of hypertension in nearly 3% of cases. Pregnancy hypertension (07.97%) was the main pathology associated with pregnancy in our study. Weight gain was excessive in overweight pregnant women and obese pregnant women in the same proportion 41.12%. The average weight gain was 9.42 kg for underweight pregnant women, 8.35 kg for pregnant women with a normal BMI, 8.46 kg for overweight pregnant women and 7.45 kg for obese pregnant women. Pregnant women who had gained excessive weight during pregnancy had a 9 times higher risk of having pregnancy-induced hypertension (OR = 9.5 and p ≤ 0.0001). They also presented a 6 times higher risk of having pre-eclampsia (OR = 6.6;p ≤ 0.0001). The risk of gestational diabetes is also high (OR = 3.82;p ≤ 0.0001). There is also a risk of macrosomia (OR = 3.33 and p = 0.007) and the risk of cesarean delivery 2 times higher: OR = 2.15 and p = 0.0004. There was no statistically significant link between excessive weight gain and term at delivery, the condition of the newborn at birth, and neonatal mortality. Conclusion: Excessive weight gain during pregnancy in our study was assessed in several pregnant women with a high prevalence. It is the source of several maternal and fetal complications.
文摘This survey had the objective to determine the frequency of the obesity at the parturient, to value the impact of the obesity on the childbirth by Caesarean and the complications postoperative immediate in the teaching hospitals of Cotonou. Patients and Method: We did a prospective, comparative and analytic survey from January 13 to April 13, 2012. Eight hundred ninety-one consecutive parturients having had a Caesarean were included. We studied the anesthetic techniques, the techniques of control of the aerial ways, the number of necessary tests for the tracheal intubation, the complications and aftercare of the first 48 hours. A comparison has been made according to the BMI. The obesity has been defined by a BMI ≥ 30 kg/m2. The parturient has been classified in two groups: Non-obese: BMI ≤ 30 kg/m2, obese: BMI ≥ 30. Results: There were 703 (78.90%) Caesareans in emergency and 188 (21.09%) programmed Caesareans. The obesity which has been recovered at 286 parturient is 32.10%. The obese parturient also required more frequently several lumbar punctures (p Conclusion: Many changes led by pregnancy are added to those of the obesity to drive to functional changes, a reduction of the physiological reserve and finally to an increased anesthetic and obstetric risk. The obesity is frequent at the parturient in Benin. The post-operative complications are more frequent after the Caesarean at the obese parturient.
文摘This was a retrospective and descriptive study conducted from 1 July 2006 to 31 July 2011 and carried on 122 cases of diabetic foot collected a total of 706 diabetic patients hospitalized over a period of 5 years. Objective: To study the characteristics of diabetic feet in Cotonou. Results: The mean age of patients was 58.05 years ± 10.65 years, ranging from 35 years to 70 years. The sex ratio was 1.5. Duration of diabetes before the onset of diabetic foot was 11 years. The overall prevalence of diabetic foot was 21.53%. Of these, 95% had neuropathy, 70.40% had arterial disease and all had a foot infection. The amputation rate was 31.96% and the mortality rate was 17.21%. Conclusion: The occurrence of diabetic foot is earlier than in the West, and hence there is a need for early treatment of diabetes.
