Les occlusions neonatales au Centre National Hospitalier et Universitare (CNHU) de Cotonou : Aspects épidémiologiques, cliniques et thérapeutiques

Les occlusions nonatales (ONN), les plus frquentes des urgences chirurgicales nonatales, sont des affections graves, greves d.une forte mortalit dpassant encore 50% en Afrique tropicale. Ce travail avait pour objectifs d.tudier leurs aspects pidmiologiques, cliniques et volutifs et d.analyser les problmes poss par leur prise en charge au Centre National Hospitalier et Universitaire (CNHU) de Cotonou. Il s.agit d.une tude rtrospective vise descriptive portant sur les occlusions nonatales, l.exclusion des malformations ano-rectales. 62 dossiers d.occlusions nonatales ont t colligs reprsentant 41 % des syndromes occlusifs. L.incidence annuelle moyenne tait de 4. L.ge moyen d.admission tait de 14 ± 5 jours. La sex-ratio tait de 1,4. Le dlai d.admission tait en moyenne de 11 ± 4 jours. Aucune ONN n.a t diagnostique en priode antnatale. 50% des ONN taient des atrsies intestinales. Le dlai moyen d.intervention chirurgicale tait de 7 + 3 jours. Les complications post-opratoires, observes dans 75% des cas, taient domines par la dnutrition (55%) et les occlusions post-opratoires (22%). La mortalit globale tait de 44,2%. Elle tait plus importante chez les oprs (58,3%). Les ONN ont une frquence sous estime Cotonou. Elles sont caractrises par des retards considrables l.admission, au diagnostic et l.intervention, et de fortes, morbidit et mortalit. Cette situation est en rapport avec l.absence de diagnostic antnatal, l.inexistence de services spcialiss et performants d.Anesthsie-Ranimation et de Soins intensifs en Nonatologie et l.inexistence de couverture sociale universelle. Clinics in Mother and Child Health Vol. 3(1) 2006: 457-46

Le Traitement Medical De La Stenose Hypertrophique Du Pylore A Cotonou (Benin): A propos de deux cas.

La fréquence globale de la sténose hypertrophique du pylore se situe entre 1 et 3 pour 1000 naissances vivantes et concerne 5 fois plus le garçon que la fille. Son traitement, toujours chirurgical, était une pyloromyotomie extramuqueuse mise au point par Fredet en 1907 et Ramsted en 1911. La morbidité était de 1 à 16 % avec une mortalité inférieure à 0,4 % en Occident. La morbidité et la mortalité restent lourdes en Afrique car le traitement chirurgical de la sténose hypertrophique du pylore dans les paysdéfavorisés demeure hypothéqué par des conditions difficiles de prise en charge. A l’instar des études indiennes, serbes et japonaises, les auteurs rapportent 2 cas de sténose hypertrophique dupylore traités efficacement par l’atropine en intraveineuse à Cotonou

CT pelvimetry of variant pelvis and child birth prognosis

The aim of this study was to determine the threshold values of pelvimetry by scanning and to evaluate the ability of the pelvimetry alone to diagnose a fetal-pelvic disproportion. It was an observational retrospective study on 410 pregnant women who had a scanner pelvimetry for any reasons. Based on the fetal presentations, two subgroups (breech and cephalic -others) have been defined. Measurements of the main obstetric diameters (promonto-retropubic, median transverse and dual sciatica) were taken. The 5th and 10th percentile were calculated as well as the 90th and 95th to determine the threshold values of pelvimetry by scanner. The scanner values found on CT were compared with the standard X ray pelvimetry values. Referring to extreme values obtained by pelvimetry scanner, some pathological pelvic brim were reconstructed in 3D. Moreover, the delivery prognostic was analyzed by crossing the pelvic inlet dimensions (Magnin index) and pelvic outlet dimensions (bi-sciatic diameter) with the outcome of the delivery. The mean values of the scanno-pelvimetry measurement in our series were:m12,39 cm (± 1) for the promonto-retropubic diameter, 12.88 cm (± 1.01) for the transverse median diameter and 11 cm (± 1.32) for the bi-sciatic diameter. These measurements provided an accuracy less than 1 cm compared to the standard ray pelvimetry. Although Magnin index at 23 allows a vaginal delivery, 51% of oursample have failed. Moreover, for the Magnin index at 24 and 25, the vaginal delivery failure rate remains high:45.1% and 39.61% respectively. Compared to classical pelvimetry, pelvimetry by scanner provides additional precision and allows to study the geometry of the basin. However, the pelvimetry alone could not be effective to establish the prognosis of vaginal delivery.Keywords: scanno-pelvimetry, prognosis, deliver

Hydranencephalie a Cotonou (Benin) a propos de 3 cas cliniques

L’hydranencéphalie est une malformation rare du système cérébral. Elle est caractérisée par une disparition des hémisphères cérébraux bilatéraux qui sont remplacés par le liquide céphalorachidien. Nous rapportons 3 cas cliniques. Le diagnostic repose sur le scanner cérébral et l’IRM et pose un problème thérapeutique et éthique car aucun traitement n’améliore le développement neurologique.Mots-clés: hydranencéphalie, hydrocéphalie, malformation, système nerveux central, BéninEnglish Title: Hydranencephaly at Cotonou (Benin): 3 cases reportsEnglish AbstractHydranencephaly is a rare malformation of the brain system. It is characterized by the absence of bilateral cerebral hemispheres which are replaced by cerebrospinal fluid. We present three clinical cases. Brain CTscan was performes for diagnosis. Therapeutic and ethic problems are discussed.Keywords: hydranencephaly, hydrocephalus, malformation, central nervous system, Beni

Facteurs déterminants de la volonté des pêcheurs artisanaux d'adopter la cogestion des droits de propriété dans le complexe lac Nokoué et lagune de Porto-Novo au Bénin : Approche par une expérience de choix discret

The estuarian and lagoon areas of southern Benin are an atypical lake territory where private property rights are inherited from endogenous law. In this area, people live in stilt dwellings and exclusively for free-to-access fishing. Consequently, an increasing number of fishers with low respect for the State’ general rules for fishing sustainability contribute to the tragedy of commons. Co-management of small-scale fisheries has been advocated to offer various benefits, including improved socio-ecological integration, shared sustainable livelihoods and adherence to biodiversity objectives. This study aims to assess the factors that influence the willingness of small-scale fishers to adopt property rights co-management options in southern Benin. We interviewed a random sample of 277 small-scale fishers. The data collected using the Discrete Choice Experiment were analysed using mixed and latent class logit models. The results show that only 44% of fishers are willing to adopt property rights co-management options. This willingness to adopt is determined by their involvement in the co-management committee, access to a subsidy and livelihood diversification options. However, they would prefer to keep the area of water granted as small as possible, even if they are motivated to contribute to more open space on the water bodies. These fishers are primarily owners of Acadja, members of fishers’ associations, and are the oldest in the sample. Institutional agreements for co-management establishment, subsidies to support small-scale fishers’ livelihood diversification and capacity-building must be set up to reduce their fishing time and ensure fishery viability.6. Clean water and sanitatio

Facteurs déterminants de la volonté des petits pêcheurs d'adopter la cogestion des droits de propriété dans le complexe lagunaire du lac Nokoué et de Porto-Novo au sud-est du Bénin.

peer reviewedThe estuarian and lagoon areas of southeast Benin are atypical lake territories where private property rights are hereditary from endogenous legal tradition. People live in stilt dwellings and are exclusively dedicated to free-to-access fishing. Consequently, an increasing number of fishers with low respect for the State’s general rules for sustainable fishing contribute to legal pluralism and the tragedy of the commons. Co-management of small-scale fisheries has been advocated to offer various benefits, including improved socio-ecological integration, shared sustainable livelihoods, and adherence to biodiversity objectives. This study aims to assess the factors that influence the willingness of small-scale fishers to adopt property rights co-management options in southeast Benin. The data were collected using the discrete choice experiment method. The results show that 44% of fishers are willing to adopt property rights co-management options. This willingness is determined by their involvement in the co-management committee, access to a subsidy and livelihood diversification options. These fishers are the oldest in the sample and primarily owners of Acadja, a traditional fishing tool made of bush and tree branches planted in the lake. Institutional agreements for co-management establishment, such as subsidies to support small-scale fishers’ livelihood diversification and capacity-building, must be set up to achieve co-management goals.14. Life below wate

A simple algebraic cancer equation: calculating how cancers may arise with normal mutation rates

<p>Abstract</p> <p>Background</p> <p>The purpose of this article is to present a relatively easy to understand cancer model where transformation occurs when the first cell, among many at risk within a colon, accumulates a set of driver mutations. The analysis of this model yields a simple algebraic equation, which takes as inputs the number of stem cells, mutation and division rates, and the number of driver mutations, and makes predictions about cancer epidemiology.</p> <p>Methods</p> <p>The equation [<it>p </it>= 1 - (1 - (1 - (1 - <it>u</it>)^<it>d</it>)^<it>k</it>)^{<it>Nm </it>}] calculates the probability of cancer (<it>p</it>) and contains five parameters: the number of divisions (<it>d</it>), the number of stem cells (<it>N </it>× <it>m</it>), the number of critical rate-limiting pathway driver mutations (<it>k</it>), and the mutation rate (<it>u</it>). In this model progression to cancer "starts" at conception and mutations accumulate with cell division. Transformation occurs when a critical number of rate-limiting pathway mutations first accumulates within a single stem cell.</p> <p>Results</p> <p>When applied to several colorectal cancer data sets, parameter values consistent with crypt stem cell biology and normal mutation rates were able to match the increase in cancer with aging, and the mutation frequencies found in cancer genomes. The equation can help explain how cancer risks may vary with age, height, germline mutations, and aspirin use. APC mutations may shorten pathways to cancer by effectively increasing the numbers of stem cells at risk.</p> <p>Conclusions</p> <p>The equation illustrates that age-related increases in cancer frequencies may result from relatively normal division and mutation rates. Although this equation does not encompass all of the known complexity of cancer, it may be useful, especially in a teaching setting, to help illustrate relationships between small and large cancer features.</p

Facteurs influençant l’intensité de l’utilisation des semences améliorées de maïs au Bénin

Au Bénin, des nouvelles semences améliorées de maïs ont été introduites dans diverses localités du pays pour contribuer à l’amélioration de la productivité du maïs. Le présent article a pour objectif d’évaluer les déterminants de l’intensité de l’utilisation des semences améliorées de maïs dans les zones favorables à cette culture au Bénin. L’étude contribue à l’amélioration de l'efficacité des services de recherche et de vulgarisation et de politique agricole, pour accroître la productivité des agriculteurs. Cette étude a été réalisée dans les zones agro-écologiques de production du maïs au Bénin. Les données ont été collectées sur un échantillon de 490 producteurs. Il ressort des résultats que les variables "quantité de semence utilisée", "formation particulière reçue sur l’utilisation des semences améliorées", "nombre d’années d’expérience dans la production" et "part sur 10 du revenu agricole annuel qui provient de la production de maïs" sont celles qui influencent l’intensité de l’utilisation des semences améliorées de maïs.Mots clés: Semence améliorée de maïs, adoption, intensité d’utilisation, modèle Tobit, BéninEnglish Title: Factors affecting the intensity of the use of improved maize seeds in BeninEnglish AbstractIn Benin, new improved maize seeds were introduced to improve maize productivity in various places. This paper aims to evaluate the determinants of the intensity of the use of the improved maize seeds in areas favorable maize crop in the country. The research contributes to the improvement of the effectiveness of the agricultural policy and agricultures services of research centers to increase the productivity of the farmers. The study was conducted in the agro-ecological zones of maize production in Benin, where data were collected on a sample of 490 producers. The results reveal that the variables “quantity of seed used”, “training received on the use of the improved seeds”, the “number of year of experiment in the production” and “the part on 10 of annual farm income comes from production of maize”influence significantly the intensity of the use of improved maize seeds.Keywords: Improved maize seeds varieties, adoption, utilization intensity, Tobit model, Beni

Urethral mucosal prolapse in young girls: A report of nine cases in Cotonou

Background: Urethral mucosal prolapse is rare. This condition may be confused with tumour or sexual abuse in girls. This study aims at reportingthe pathology presentation and therapeutic options of urethral prolapse in girls. Materials and Methods: A retrospective study was undertaken from January2000 to December 2008. Authors analysed the clinical features and the treatment options. Results: There were nine cases of urethral prolapse. The ages ranged from 2.5 to 10 years (mean age: 5.08 years). The mainpresentation was vaginal bleeding (five cases). Physical examination revealed a soft, non-tender mass that bleeds on touch (six cases), with a length ranging from 0.75 to 1 cm. Urine culture in four patients revealedurinary infection that yielded Escherichia coli in three cases and the Staphylococcus aureus in one case. Six patients had surgical treatment while three had medical treatment. In those who had surgery, one hadacute urine retention and one had recurrence that was treated successfully without operation. All the nine girls are cured.Conclusion: Urethral prolapse is a disease of the prepubertal girls of low socio-economic group. Diagnosis is clinical. The treatment of choice is surgical

Dimensionnement technico-économique de conduite forcee pour microcentrale hydroelectrique en utilisant les algorithmes genetiques

La conduite forcée est l’un des principaux éléments à considérer dans les projets d’aménagement de microcentrale hydroélectrique. Ainsi, son dimensionnement porte un intérêt scientifique élevé et fait l’objet de diverses méthodes. Ces méthodes sont basées sur des relations empiriques ou analytiques permettant d’optimiser les pertes de charge. Dans cet article, un nouveau concept de dimensionnement est développé en utilisant l’optimisation bi-objective avec les algorithmes génétiques NSGA II. Les deux fonctions objectives considérées sont le coût d’investissement et le rendement de la conduite forcée. Le diamètre et la longueur de la conduite forcée sont considérés comme variables d’optimisation. La méthode de dimensionnement est appliquée à trois sites potentiels en aménagement hydroélectrique du Bénin. Pour chaque site, les résultats de simulation présentent des courbes de front de Pareto qui représentent l’ensemble des solutions non dominées. Nous avons noté que le diamètre est un paramètre déterminant dans l’optimisation bi-objectif du coût d’investissement et du rendement de la conduite forcée. La longueur ne constitue pas un paramètre d’optimisation mais est plutôt est un paramètre spécifique à définir en tenant compte des contraintes environnementales du site. Cette étude présente aussi l’avantage qu’elle peut permettre de dimensionner la conduite forcée pour un site quelconque.Mots clés: Algorithmes génétiques ; Conduite forcée ; Coût ; Dimensionnement ;RendementEnglish Title: Techno-economic sizing of penstock for micro-hydropower using genetic algorithmsEnglish AbstractPenstock is one of the most important components to consider in micro hydropower projects. Thus, Penstock sizing has an interest and is subject of various methods. These methods either based on empirical or analytical relations, allowed to optimize friction Loss. In this paper, a new sizing concept is developed using bi-objective optimization with genetic algorithms NSGA II. Investment cost and efficiency of the penstock constitute the both objective functions of the optimization process. The decision variables considered are the diameter and the length of the penstock. The case study is applied to the three potential hydro sites (Affon, Beterou and Vossa) in Benin. For each potential hydro site, the simulation results give Pareto front curves which show nondominated solutions sets. We noted that diameter is a decisive parameter for optimization of investment cost and efficiency of Penstock, simultaneously. The length  of the penstock is not an optimization parameter but is a specific parameter to define considering the environmental constraints of the site. This study has the advantage to be applied to any site for sizing Penstock.Keywords: Genetic Algorithms; Penstock; Cost; sizing; Efficienc