Objective: To contribute to the knowledge of the characteristics of teenage birth. Patients and Methods: Retrospective, descriptive and comparative studies, from February 1st 2014 to April 31st 2015, carried out in th...Objective: To contribute to the knowledge of the characteristics of teenage birth. Patients and Methods: Retrospective, descriptive and comparative studies, from February 1st 2014 to April 31st 2015, carried out in the Obstetrics and Gynecology Department General Hospital of Loandjili. Included were births of less than 18 years of age at the end of a pregnancy of at least 22 weeks of amenorrhea on the one hand, and adults aged 18 and over, who had given birth at the same end of the pregnancy immediately after the teenager. Thus two populations consisted of 170 cases each. The parameters studied were: Sociodemographic, clinical and prognostic characteristics. Results: During this period, 4190 patients had given birth to 4341 births. Among them, 170 teenage girls are 4%. The average age of teenagers in our study was 16.2 years with a 17-year-age, versus 28.2 years for adults. The average parity was 1.19. While in adults, multiparity was represented at 45.89% with an average parity of 3.19. The average number of prenatal consultations (ANC) was 2.89 for adolescent girls and 31.2% had not been performed. By cons in adults, it was 4.23. These ANCs were started in teenage girls with an average of 22 weeks at the first ANC, while adults started on average at 18 weeks. The average delivery time was 38 weeks of amenorrhea for both populations. Thirty-four cases of premature newborns from adolescent mothers were observed, compared with 14 in adult mothers (p 0.05). The delivery mode was low in 66% of adolescent girls versus 75% of adults. Indications for caesarean section in adolescents were represented by complications of arterial hypertension (38.59%), followed by mechanical dystocia. While in adults, cervical dystocia and scar uteri were the most represented. During this study period, no maternal deaths were recorded among adolescent girls. Characteristics of the newborn: the condition of the newborn at birth was good according to the rating of Apgar among teenagers in 91%, and in adults in 96.5% and, with a birth weight at teenage girls normal in 74% versus 88% in adults. Low birth weight and prematurity were reported with a statistically significant difference in adolescent girls.展开更多
Introduction: Breast phyllodes are rare. Histologically, it is a fibro-epithelial tumour that differs from the fibro-adenoma by a more abundant and more cellular stroma. Observation: We report a case of a large breast...Introduction: Breast phyllodes are rare. Histologically, it is a fibro-epithelial tumour that differs from the fibro-adenoma by a more abundant and more cellular stroma. Observation: We report a case of a large breast phyllode tumour in a 42-year-old woman in the Obstetric and Gynaecology Department of Loandjili General Hospital. This tumor has evolved for 3 years. It is by discomfort due to chest pain. The clinical examination showed a voluminous right breast in the form of a calabash that hung down the body with a large collateral circulation, associated with an appearance of “orange peel”, and an axillary lymph node. In addition, there were necrotic areas and retraction of the nipple. In addition to the clinical characteristics, the ultrasound images and the histological analyses following the biopsy made it possible to evoke the diagnosis of phyllode tumour of the breast. The treatment consisted of a full right simple mastectomy with a 50 cm breast with a major axis that weighed 9465 grams, supplemented by homolateral axillary lymph node dissection. At the section of the tumour measuring 40 cm long, the sectional sections alternately showed solid and cystic areas. The histological examination confirmed the phyllode nature of the tumour with intermediate grade 2 malignancy. The lymph nodes showed an inflammatory appearance, with no signs of malignancy. Early post operation period was uneventful. The patient’s follow-up was annual, and the last check dated 09/01/2017 proved to be normal. Conclusion: The phyllode tumor is a rare pathology. In our environment, it can be greatly increased by the lack of diagnosis and early management. In all cases, any tumour of the breast operated, must benefit from an anatomo-pathological analysis, to determine the benign or malignant character of it, allowing proposing a plan of management better adapted.展开更多
Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. Screening fo...Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. Screening for hepatitis viral-HIV coinfection before initiation of treatment for viral hepatitis or HIV is recommended. In this context, we report a case of possible cross-reaction between the serology of viral hepatitis C and HIV infection by rapid diagnostic orientation tests. Although these rapid tests are the main diagnostic tools in developing countries, their scientific validation must be required before they are made available to practitioners. The knowledge and the rigorous application of diagnostic algorithms of viral infections will make it possible to save money and to better organize the prevention and management strategies for patients as part of an integrated Hepatitis/HIV program.展开更多
Objectives: To determine the correlation between dermatosis papulosa nigra (DPN) and cardiovascular disease (CVD). Patients and Method: A retrospective study was conducted between April 2022 and March 2023 in cardiolo...Objectives: To determine the correlation between dermatosis papulosa nigra (DPN) and cardiovascular disease (CVD). Patients and Method: A retrospective study was conducted between April 2022 and March 2023 in cardiology at Loandjili General Hospital. Were included all adult patients older than 18 years of age presenting with DPN, and divided into two groups according to the presence of CVD. Hypertension (HT), endomyocardial fibrosis, dilated and restrictive cardiomyopathy, chronic pulmonary heart, ischemic heart disease, stroke, and valvular heart disease were retained as CVD. Pregnant women, Peutz Jeghers syndrome and all dermatosis with cardiovascular manifestations were excluded. Studied variables were clinico-demographic, hereditary and behavioral. Results: A total of 55 patients were selected. There were 40 patients with CVD, 15 patients without CVD, 43 women (78.1%) and 12 men (21.8%). Mean age was 52 ± 12.6 years (extremes: 22 - 85 years). There was a significant difference between age and sex (P 0.05). There were 34 hypertensive patients, 10 patients with diabetes mellitus, 7 strokes, 2 endomyocardial fibrosis and 2 ischemic heart diseases. Periorbital location was representative was frequently found in the group with CVD. Hereditary and behavioral factors were involved in the development of DPN and CVD. There was a significant correlation between DPN and onset in childhood (P 0.05), between hypertension and use of medication (P 0.05), and between onset in childhood (P 0.05) and use of mercury containing soap (P 0.05). Conclusion: DPN predominates in young women. The occurrence of CVD depends on DPN location. Hereditary and behavioral factors associated with development of DPN are CVD factor risks.展开更多
<strong>Background:</strong><span><span><span style="font-family:;" "=""> Post-stroke sequelae can have repercussions on the sexual life and relational life of pa...<strong>Background:</strong><span><span><span style="font-family:;" "=""> Post-stroke sequelae can have repercussions on the sexual life and relational life of patients and their partners. <b>Objectives:</b> To determine the frequencies of sexual disorders after a first stroke event;to identify the factors associated with sexual disorders;to explore the real-life experience of sexual disorders within couples. <b>Methods:</b> It was an analytical cross</span></span></span><span style="font-family:Verdana;"></span><span><span><span style="font-family:;" "="">-sectional study, conducted on patients followed up for a first stroke and their partners. It was carried out at public and private hospitals in Brazzaville, Congo, during the period of patient follow-up, from May to September 2019 (5 months). The Female Sexual Function Index, International Index of Erectile Function 5 <span>and</span> interviews were used to describe sexual aspects. The real-life experience of couples was explored using standardized and pre-established questionnaires. <b>Results:</b> Of the 36 patients who had taken up again sexual intercourse after stroke, 29 (80.6%) were men. Among the post-stroke sexual disorders, erectile dysfunction (53.2%) and ejaculatory dysfunction (40.4%) were the most frequent in men. <span>Decrease</span> <span>of</span> sexual desire was predominant in women (100%). Factors associated with erectile dysfunction were sleep disorder (p = 0.007) and mean sleep duration per night (p = 0.01). Lack of verbal and non-verbal communication of sexual problems and psychological effects was noted in 77.8% of patients and 60% of their partners. The most frequent psychological effects were: in patients, frustration (52.8%), <span>attitude</span> of person decreased (50%) and sadness (41.7%);in partners, <span>attitude</span> of carer (86.7%). <b>Conclusion:</b> Post-stroke sexual disorders are frequent in our context. Sleep disorders and mean sleep duration per night, psychological factors seem to <span>have a negative impact on</span> the sexual life and relational life of stroke patients and their partners. It is important to improve the sex management of couples.</span></span></span>展开更多
Current antiretroviral therapy has reduced morbidity and mortality of HIV patients. However, their induced hepatotoxicity constitutes a risk. In this issue, we report a clinical case of fulminant hepatitis, observed i...Current antiretroviral therapy has reduced morbidity and mortality of HIV patients. However, their induced hepatotoxicity constitutes a risk. In this issue, we report a clinical case of fulminant hepatitis, observed in the HIV unit of the hepatogastroenterology department of the General hospital of Loandjili in Pointe-Noire. The patient is a 36-year-old female HIV treated with triple-dug combination antiretroviral therapies (ART) including one antiprotease (ritonavir) and two non-nucleoside reverse transcriptase inhibitors (nevirapine and efavirenz). He developed fulminant hepatitis five years after treatment initiation. He succumbed to the side effects. Although antiretroviral combination therapies are the standard of care for HIV infection, increased vigilance is warranted to early identify this side effect and adjust treatment in order to prevent fatal consequences.展开更多
Congenital Adrenal Hyperplasia(CAH)is an autosomal recessive condition that results from the deficiency of one of the steroidogenesis enzymes responsible for cortisol biosynthesis.In the majority of cases,CAH is cause...Congenital Adrenal Hyperplasia(CAH)is an autosomal recessive condition that results from the deficiency of one of the steroidogenesis enzymes responsible for cortisol biosynthesis.In the majority of cases,CAH is caused by 21-hydroxylase deficiency.More rarely,the deficiency concerns 11b-hydroxylase,3b-hydroxysteroid dehydrogenase,17hydroxylase,or exceptionally StAR and P450 oxydoreductase.Here,we report the case of a 3 year and 4 months old male child,born from a consanguineous marriage who presented at 15 months old with the salt-loss syndrome.Physical examination found generalized melanoderma,micropenis and bilateral cryptorchidism.Biological assessment at the time of diagnosis revealed hyponatremia,hyperkalemia,functional renal failure,hypoglycemia,low blood cortisol level,and high blood level of ACTH,suggesting primary adrenal insufficiency.The patient presented also with the abnormality of sexual differentiation with a 46 XY karyotype,testosteronemia level was low at the baseline and after HCG stimulation,pelvic ultrasound and Magnetic Raisonance Imaging(MRI)showed bilateral testicular atrophy in the inguinal position.The genetic study revealed a likely pathogenic homozygous variant in the StAR(steroidogenic acute regulatory)gene.Therapeutically,our patient was hydrated by saline solution and treated with hydrocortisone and fludrocortisone,then benefited from a surgical testicular correction marked by a favorable evolution.Although mutations in StAR gene are rare,they can be responsible for the defect in the early stage of steroidogenesis and therefore cause a deficiency in adrenal and sexual hormones biosynthesis.展开更多
文摘Objective: To contribute to the knowledge of the characteristics of teenage birth. Patients and Methods: Retrospective, descriptive and comparative studies, from February 1st 2014 to April 31st 2015, carried out in the Obstetrics and Gynecology Department General Hospital of Loandjili. Included were births of less than 18 years of age at the end of a pregnancy of at least 22 weeks of amenorrhea on the one hand, and adults aged 18 and over, who had given birth at the same end of the pregnancy immediately after the teenager. Thus two populations consisted of 170 cases each. The parameters studied were: Sociodemographic, clinical and prognostic characteristics. Results: During this period, 4190 patients had given birth to 4341 births. Among them, 170 teenage girls are 4%. The average age of teenagers in our study was 16.2 years with a 17-year-age, versus 28.2 years for adults. The average parity was 1.19. While in adults, multiparity was represented at 45.89% with an average parity of 3.19. The average number of prenatal consultations (ANC) was 2.89 for adolescent girls and 31.2% had not been performed. By cons in adults, it was 4.23. These ANCs were started in teenage girls with an average of 22 weeks at the first ANC, while adults started on average at 18 weeks. The average delivery time was 38 weeks of amenorrhea for both populations. Thirty-four cases of premature newborns from adolescent mothers were observed, compared with 14 in adult mothers (p 0.05). The delivery mode was low in 66% of adolescent girls versus 75% of adults. Indications for caesarean section in adolescents were represented by complications of arterial hypertension (38.59%), followed by mechanical dystocia. While in adults, cervical dystocia and scar uteri were the most represented. During this study period, no maternal deaths were recorded among adolescent girls. Characteristics of the newborn: the condition of the newborn at birth was good according to the rating of Apgar among teenagers in 91%, and in adults in 96.5% and, with a birth weight at teenage girls normal in 74% versus 88% in adults. Low birth weight and prematurity were reported with a statistically significant difference in adolescent girls.
文摘Introduction: Breast phyllodes are rare. Histologically, it is a fibro-epithelial tumour that differs from the fibro-adenoma by a more abundant and more cellular stroma. Observation: We report a case of a large breast phyllode tumour in a 42-year-old woman in the Obstetric and Gynaecology Department of Loandjili General Hospital. This tumor has evolved for 3 years. It is by discomfort due to chest pain. The clinical examination showed a voluminous right breast in the form of a calabash that hung down the body with a large collateral circulation, associated with an appearance of “orange peel”, and an axillary lymph node. In addition, there were necrotic areas and retraction of the nipple. In addition to the clinical characteristics, the ultrasound images and the histological analyses following the biopsy made it possible to evoke the diagnosis of phyllode tumour of the breast. The treatment consisted of a full right simple mastectomy with a 50 cm breast with a major axis that weighed 9465 grams, supplemented by homolateral axillary lymph node dissection. At the section of the tumour measuring 40 cm long, the sectional sections alternately showed solid and cystic areas. The histological examination confirmed the phyllode nature of the tumour with intermediate grade 2 malignancy. The lymph nodes showed an inflammatory appearance, with no signs of malignancy. Early post operation period was uneventful. The patient’s follow-up was annual, and the last check dated 09/01/2017 proved to be normal. Conclusion: The phyllode tumor is a rare pathology. In our environment, it can be greatly increased by the lack of diagnosis and early management. In all cases, any tumour of the breast operated, must benefit from an anatomo-pathological analysis, to determine the benign or malignant character of it, allowing proposing a plan of management better adapted.
文摘Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. Screening for hepatitis viral-HIV coinfection before initiation of treatment for viral hepatitis or HIV is recommended. In this context, we report a case of possible cross-reaction between the serology of viral hepatitis C and HIV infection by rapid diagnostic orientation tests. Although these rapid tests are the main diagnostic tools in developing countries, their scientific validation must be required before they are made available to practitioners. The knowledge and the rigorous application of diagnostic algorithms of viral infections will make it possible to save money and to better organize the prevention and management strategies for patients as part of an integrated Hepatitis/HIV program.
文摘Objectives: To determine the correlation between dermatosis papulosa nigra (DPN) and cardiovascular disease (CVD). Patients and Method: A retrospective study was conducted between April 2022 and March 2023 in cardiology at Loandjili General Hospital. Were included all adult patients older than 18 years of age presenting with DPN, and divided into two groups according to the presence of CVD. Hypertension (HT), endomyocardial fibrosis, dilated and restrictive cardiomyopathy, chronic pulmonary heart, ischemic heart disease, stroke, and valvular heart disease were retained as CVD. Pregnant women, Peutz Jeghers syndrome and all dermatosis with cardiovascular manifestations were excluded. Studied variables were clinico-demographic, hereditary and behavioral. Results: A total of 55 patients were selected. There were 40 patients with CVD, 15 patients without CVD, 43 women (78.1%) and 12 men (21.8%). Mean age was 52 ± 12.6 years (extremes: 22 - 85 years). There was a significant difference between age and sex (P 0.05). There were 34 hypertensive patients, 10 patients with diabetes mellitus, 7 strokes, 2 endomyocardial fibrosis and 2 ischemic heart diseases. Periorbital location was representative was frequently found in the group with CVD. Hereditary and behavioral factors were involved in the development of DPN and CVD. There was a significant correlation between DPN and onset in childhood (P 0.05), between hypertension and use of medication (P 0.05), and between onset in childhood (P 0.05) and use of mercury containing soap (P 0.05). Conclusion: DPN predominates in young women. The occurrence of CVD depends on DPN location. Hereditary and behavioral factors associated with development of DPN are CVD factor risks.
文摘<strong>Background:</strong><span><span><span style="font-family:;" "=""> Post-stroke sequelae can have repercussions on the sexual life and relational life of patients and their partners. <b>Objectives:</b> To determine the frequencies of sexual disorders after a first stroke event;to identify the factors associated with sexual disorders;to explore the real-life experience of sexual disorders within couples. <b>Methods:</b> It was an analytical cross</span></span></span><span style="font-family:Verdana;"></span><span><span><span style="font-family:;" "="">-sectional study, conducted on patients followed up for a first stroke and their partners. It was carried out at public and private hospitals in Brazzaville, Congo, during the period of patient follow-up, from May to September 2019 (5 months). The Female Sexual Function Index, International Index of Erectile Function 5 <span>and</span> interviews were used to describe sexual aspects. The real-life experience of couples was explored using standardized and pre-established questionnaires. <b>Results:</b> Of the 36 patients who had taken up again sexual intercourse after stroke, 29 (80.6%) were men. Among the post-stroke sexual disorders, erectile dysfunction (53.2%) and ejaculatory dysfunction (40.4%) were the most frequent in men. <span>Decrease</span> <span>of</span> sexual desire was predominant in women (100%). Factors associated with erectile dysfunction were sleep disorder (p = 0.007) and mean sleep duration per night (p = 0.01). Lack of verbal and non-verbal communication of sexual problems and psychological effects was noted in 77.8% of patients and 60% of their partners. The most frequent psychological effects were: in patients, frustration (52.8%), <span>attitude</span> of person decreased (50%) and sadness (41.7%);in partners, <span>attitude</span> of carer (86.7%). <b>Conclusion:</b> Post-stroke sexual disorders are frequent in our context. Sleep disorders and mean sleep duration per night, psychological factors seem to <span>have a negative impact on</span> the sexual life and relational life of stroke patients and their partners. It is important to improve the sex management of couples.</span></span></span>
文摘Current antiretroviral therapy has reduced morbidity and mortality of HIV patients. However, their induced hepatotoxicity constitutes a risk. In this issue, we report a clinical case of fulminant hepatitis, observed in the HIV unit of the hepatogastroenterology department of the General hospital of Loandjili in Pointe-Noire. The patient is a 36-year-old female HIV treated with triple-dug combination antiretroviral therapies (ART) including one antiprotease (ritonavir) and two non-nucleoside reverse transcriptase inhibitors (nevirapine and efavirenz). He developed fulminant hepatitis five years after treatment initiation. He succumbed to the side effects. Although antiretroviral combination therapies are the standard of care for HIV infection, increased vigilance is warranted to early identify this side effect and adjust treatment in order to prevent fatal consequences.
文摘Congenital Adrenal Hyperplasia(CAH)is an autosomal recessive condition that results from the deficiency of one of the steroidogenesis enzymes responsible for cortisol biosynthesis.In the majority of cases,CAH is caused by 21-hydroxylase deficiency.More rarely,the deficiency concerns 11b-hydroxylase,3b-hydroxysteroid dehydrogenase,17hydroxylase,or exceptionally StAR and P450 oxydoreductase.Here,we report the case of a 3 year and 4 months old male child,born from a consanguineous marriage who presented at 15 months old with the salt-loss syndrome.Physical examination found generalized melanoderma,micropenis and bilateral cryptorchidism.Biological assessment at the time of diagnosis revealed hyponatremia,hyperkalemia,functional renal failure,hypoglycemia,low blood cortisol level,and high blood level of ACTH,suggesting primary adrenal insufficiency.The patient presented also with the abnormality of sexual differentiation with a 46 XY karyotype,testosteronemia level was low at the baseline and after HCG stimulation,pelvic ultrasound and Magnetic Raisonance Imaging(MRI)showed bilateral testicular atrophy in the inguinal position.The genetic study revealed a likely pathogenic homozygous variant in the StAR(steroidogenic acute regulatory)gene.Therapeutically,our patient was hydrated by saline solution and treated with hydrocortisone and fludrocortisone,then benefited from a surgical testicular correction marked by a favorable evolution.Although mutations in StAR gene are rare,they can be responsible for the defect in the early stage of steroidogenesis and therefore cause a deficiency in adrenal and sexual hormones biosynthesis.
