Évaluation du Risque Cardiovasculaire Absolu Chez les Patients Hémodialysés Diabétiques et Non diabétiques au Centre National d’Hémodialyse de Donka Conakry

Le risque cardiovasculaire chez les hémodialysés semble varier en fonction du statut diabétique ainsi que d’autres facteurs associés et constitue un problème de santé publique en Afrique en général et particulièrement en Guinée. Dans ce sens, l’objectif de cette étude était d’évaluer le risque de survenue d’une pathologie cardiovasculaire absolu chez les patients hémodialysés diabétiques, par rapport aux patients hémodialysés non diabétiques. La présente, étude transversale, descriptive et analytique a été réalisée entre le 1 ier avril et le 30 juin 2019 au Centre National d’Hémodialyse de Donka. L’étude a inclus les 140 patients hémodialysés durant la période. Le recrutement était exhaustif et concernait tous les patients hémodialysés répondant aux critères de sélection. Les données ont été recueillies prospectivement chez les patients hémodialysés puis compilées et traitées dans Epi info. 7.2.2.6. Un questionnaire semi-administré a été utilisé à ce fin. Pour évaluer le risque cardiovasculaire chez les patients le FRAMINGHAM RISK SCORE (FRS) a été aussi utilisé. L’enquête a concerné 140 individus dont 91 (65,00%) étaient des hommes, contre 49 (35,00%) de femmes, soit un sex- ratio de 1,86 soit 2 hommes pour une femme. L’âge moyen était de 41 ± 4,1 ans avec des extrêmes de (30 ; 74) ans. On notait une prédominance chez les hommes des facteurs de risque, pour le tabagisme. L’étude a trouvé 39 diabétiques contre 101 non diabétiques. Le risque était élevé chez 23 diabétiquessur 39 ; et 25 sur 101 des patients non diabétiques. L’étude montre qu’un patient sur quatre aurait un risque absolu élevé chez les patients non diabétiques et un patient sur deux chez les patients diabétiques. Ce risque est majoré par d’autres facteurs associés. Introduction: Cardiovascular risk in hemodialysis appears to vary depending on diabetic status and other associated factors and is a public health problem in Africa in general and particularly in Guinea. The objective of this study was to assess the risk of absolute cardiovascular disease in diabetic hemodialysis patients, compared to non-diabetic hemodialysis patients. Methods: Between April 1 and June 30, 2019, a descriptive and analytical cross-sectional study was conducted at the National Hemodialysis Centre in Donka. The study included 140 hemodialysis patients during the period. Recruitment was comprehensive and involved all hemodialysis patients meeting the selection criteria. The data were collected prospectively in hemodialysis patients and then compiled and processed in Epi info. 7.2.2.6. A semi-administered questionnaire had been used. To assess cardiovascular risk in patients, FRAMINGHAM RISK SCORE (FRS) was used. Results: The survey involved 140 individuals, 91 of whom (65.00%) 49 (35.00%) were men. sex ratio of 1.86 or 2 men per woman. The average age was 41-4.1 years with extremes of (30; 74) years. There was a predominance among men of risk factors for smoking. The study found 39 diabetics versus 101 non-diabetics. The risk was high in 23 out of 39 diabetics; and 25 out of 101 non-diabetic patients. Conclusion: The study shows that one in four patients would have a high absolute risk in diabetic and non-diabetic patients and also confirms the association of other factors that increase this risk. The survey involved 140 individuals, 91 of whom (65.00%) 49 (35.00%) were men. sex ratio of 1.86 or 2 men per woman. The average age was 41-4.1 years with extremes of (30; 74) years. There was a predominance among men of risk factors for smoking and diabetes. In our series, most of our patients had a low risk level of 56 (40%). Conclusion: This survey finds a low risk in this hemodialysis population. This should lead to strengthening strategies for preventing cardiovascular disease in this at-risk population

Traumatological emergencies: epidemiological and problematic aspects of care in the orthopedics traumatology department of the CHU Ignace Deen in Conakry

Background: A trauma emergency is any aggression (direct or indirect) external to the body for which no therapeutic delay is allowed at the risk of endangering the patient's life or the functional prognosis of his limbs. The objective of this study was to report the results of the management of traumatological emergencies. Methods: This was a descriptive cross-sectional study from 11 January 2021, to 11 July 2021. It focused on patients seen for traumatological emergencies in the CHU Ignace Deen Orthopaedics-Traumatology department. Results: Trauma emergencies constitute 75.2% of admissions to the emergency department. The average age of the patients was 32.2 years, with extremes of 1 and 91 years. There was a predominance of 76.3% males with a ratio (M/F) of 3.2. Road traffic accidents were the most found aetiology in 82.9%, and motorcycles were involved in 68.7%. Limb fractures were found in 34.7%. The treatment time was ≤6 hours in 67.5%, and 203 patients received drug treatment, i.e., 49.7%. Conclusions: Trauma emergencies constitute, by their frequency and seriousness, a real public health problem in Africa in general and in Guinea in particular

Kidney failure screening in the general population of rural Africa

Kidney failure is a silently progressive disease too often unknown to the patients. The objective of this study was to assess the impact of kidney disease in Conakry so as to develop strategies for early detection and prevention.This was a descriptive-type prospective study carried out over six months, from January 31 to July 31, 2012. The study was carried out in two areas: In health facilities where the population were at a higher risk of developing kidney disease (diabetes, uropathies, infectious diseases and HIV, hypertension and cardiovascular disease), and in an apparently healthy population. In the study we included black subjects hospitalised in different targeted wards, as well as fully active apparently healthy subjects of the general population. Renal function was assessed with the simplified MDRD formula. Data collection included clinical parameters: Blood pressure, weight, height and blood laboratory parameters (creatinine, glucose) and urine (urine dipstick, 24h quantitative proteinuria).One hundred and ninety-nine patients were selected for the study: 117 men and 82 women ageing from 20 to 90 years. The prevalence of renal failure was 59% in the population at risk, with 53.3% of men and 16% in apparently healthy population with 60% of men with a statistically significant difference: p = 0.00000001. Proteinuria was observed in 86 patients in the population at risk against 19 in the healthy population

Importance of screening for urinary tract infection in African Black diabetics

Urinary tract infections are common and often latent in diabetic patients. The objective of this study was to determinethe frequency of urinary tract infections and the organisms responsible.This is a descriptive type prospective study conducted in the Endocrinology and Diabetology ward of Donka UniversityHospital. All diabetic patients hospitalised from January 3rd to April 4th 2013 were included in the study.Two hundred and sixty-two diabetics had been screened, 64 (24.42%) had a urinary tract infection 41 women (64%)and 23 men (36%). The average age was 56.48 16.3 years with a range of 20-90 years. Urinary tract infections weremore frequent between the ages of 45 and 74 (67.20%). Sixty patients were married, four were single. Fifty-six patientswere type 2 diabetes against eight type I diabetes. Urine test strips showed 60 cases of pyuria, 36 cases of nitruria, 21cases of proteinuria and three cases of hematuria. Organisms identified were: Escherichia coli in 31 cases (48.43%): 25women and six men; Klebsiella pneumoniae in 14 cases (21.87%): nine women and five men; Staphylococcus aureusin 11 cases (17.18%): six women and five men; and Proteus mirabilis in eight cases (12.51%): two women and six men.The clinical manifestations were: asymptomatic bacteriuria in 57 cases (89.06%); acute cystitis in five cases (7.81%); andacute urethritis in two cases (3.13%).Urinary infection in African diabetics is very common. It requires a systematic screening with urine test strips becauseasymptomatic types are by far the most common. This would allow early treatment and avoid serious complications

Fréquence des néphropathies congénitales au Centre hospitalier universitaire de Donka à Conakry: Frequency of congenital nephropathies in the University Hospital of Donka in Conakry

Context and objective. The real extent of congenital nephropathies is little known in Africa and in particular in Guinea. The objective of this study was to determine the prevalence of congenital nephropathies in the University Hospital of Donka. Methods. This was a descriptive retrospective study enrolling patients admitted for congenital nephropathy at both pediatric and pediatric surgery departments of Donka, between January 1st, 2007 and June 30th, 2012. The parameters of the study were epidemiological, clinical and paraclinical data.  Results. Of 34,448 patients recorded during the period studied, 26 had congenital nephropathies. They encompassed nephroblastoma (n=17), SJPU (n=6), hydronephrosis on left multikystic kidney (n=1), multikystic kidney in ptosis (n=1) and renal ectopia (n=1). Male sex was preponderant (21/26) with a sex ratio of 4.2/1. The 29 day-old to 2 year-old children were more affected. Conclusion. Congenital nephropathies appear less frequently in this hospital probably due to the absence of optimal facilities. The early diagnosis of congenital nephropathies should be made during the antenatal time, which would be a key to a better management of these conditions in affected children. Contexte et objectif. L’ampleur réelle des néphropathies congénitales est peu connue en Afrique et notamment en Guinée. L’objectif de cette étude était de déterminer la fréquence des néphropathies congénitales rencontrées. Méthodes. Cette étude documentaire de type descriptif sur la néphropathie congénitale, a été conduite entre les 1er janvier 2007 et 30 juin 2012, dans les services de pédiatrie et de chirurgie pédiatrique de Donka. Les paramètres d’interet englobaient les données épidémiologiques, cliniques et paracliniques.  Résultats. Parmi les 34.448 dossiers colligés, 26 présentaient une néphropathie congénitale. Il s’agissait des néphroblastomes (n=17), des syndromes de jonction pyélo-urétérale (n=6), d’une hydronéphrose sur rein multikystique gauche (n=1), d’un rein multikystique en ptose (n=1) et d’une ectopie rénale (n=1). Le sexe masculin était prépondérant (21/26) avec un sexe ratio de 4,2/1. Les enfants de 29 jours à 2 ans étaient les plus touchés. Conclusion. Les néphropathies congénitales sont paraissent moins fréquentes dans cette institution hospitalière, à cause du manque d’un plateau technique diagnostique optimal. Le diagnostic précoce des néphropathies congénitales devrait être fait dans la période prénatale ce qui permettrait une meilleure prise en charge des enfants affectés

An Update on the Surveillance of Livestock Diseases and Antimicrobial Use in Sierra Leone in 2021-An Operational Research Study.

In Sierra Leone, in 2020, a study by the Livestock and Veterinary Services Division (Ministry of Agriculture and Forestry) on the surveillance system of animal diseases and antimicrobial use found poor reporting. Of the expected weekly districts reports, <1% were received and only three of the 15 districts had submitted reports occasionally between 2016 and 2019. Following this, staff-capacity-building on reporting was undertaken. In 2021, we reassessed the improvement in reporting and used the reports to describe livestock diseases and antimicrobials utilized in their treatment. Between March and October 2021, 88% of expected weekly reports from all 15 districts were received. There were minor deficiencies in completeness and consistency in the terminology used for reporting animal disease and antimicrobials. Available reports showed that 25% of the livestock had an infectious disease, and a quarter of the sick animals had received an antimicrobial drug. Most animals received antimicrobials belonging to World Organization for Animal Health's "veterinary critically important" category (77%) and World Health Organization's "critically" (17%) and "highly important" (60%) categories for human health. These indicate a significant improvement in the animal health surveillance system and highlight the need for enhanced antimicrobial stewardship to prevent misuse of antimicrobials that are significant in animal and human health

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Coercivity and Exchange Bias Study of Polycrystalline Hollow Nanoparticles

Magnetic nanoparticles (NPs) have the potential to be useful in a variety of applications such as biomedical instruments, catalysis, sensing, recording information, etc. These nanoparticles exhibit remarkably different properties compared to their bulk counter parts. Synthesis of magnetic NPs with the right morphology, phase, size and surface functionality, as well as their usage for specific applications are challenging in terms of efficiency and safety. Morphology wise, there have been numerous reports on magnetic nanoparticles where morphologies such as core/shell, hollow, solid, etc., have been explored. It has been shown that morphology affects the magnetic response. Achieving the right crystal structure with required morphology and the magnetic behavior of the nanoparticle phases determines the magnetic response of the structure. For example, in the case of core/shell NPs various ferromagnetic (FM), ferrimagnetic (FiM), and antiferromagnetic (AFM) core and shell combinations have been reported. In these cases, interesting and strikingly different features, such as unusually high spin glass transition temperature, large exchange bias, finite size effects, magnetic proximity effects, unusual trend of blocking temperature as function of average crystal size, etc., have been reported. More specifically, the morphology of core/shell nanoparticles provides added degrees of freedom compared to conventional solid magnetic nanoparticles, including variations in the size, phase and material of the core and shell of the particle, etc. which helps enhance their magnetic properties. Similar to traditional core/shell nanoparticles, inverted core/shell having a FiM or FM order above the Curie temperature (TC) of the shell has been reported where the Néel temperature (TN) is comparable with the bulk value and there is nonmonotonic dependence of the coercive field (HC) and exchange bias (HEB) on the core diameter. In addition to the core/shell morphology, nanoparticles with hollow morphology are also of interest to the scientific community. For such cases, surface spin glass transition enhancements have been reported due to the presence of the additional inner surface. CoFe2O4, NiFe 2O4 and γ-Fe2O3 hollow nanoparticles exhibit strikingly contrasting magnetic behavior compared to bulk and conventional solid particles; similar behavior was also observed in core/shell nanoparticles. Structurally, hollow polycrystalline nanoparticles are composed of multiple crystallographic domains. This random orientation of the crystallographic domains also causes randomization of the local anisotropy axes. Hence the overall effect of this morphology on the magnetic properties is exhibited through the high coercivity, relatively high temperature magnetic irreversibility, lack of magnetic saturation, high blocking temperature, etc. Over the years, extensive work on core/shell nanoparticles have been carried out to understand their exchange bias phenomenon and the effect on coercivity. Recently, focus has been given to hollow polycrystalline nanoparticles for the reason mentioned above. This thesis investigates the root cause for the above-mentioned effects on the coercivity and exchange bias. Since hollow nanoparticles with polycrystalline structure have shown to exhibit different and improved magnetic behavior compared to bulk and other conventional solid particles, they will be the focus of our investigation. First, extensive field and temperature dependent magnetic study on polycrystalline hollow nickel ferrite (NiFe2O4) have revealed the effect of the presence of inner surface in a single oxide nanoparticle. Second, the effect of having multiple oxides with different magnetic properties (i.e. FM and AFM) in a single nanoparticle, while maintaining a hollow morphology was investigated by studying polycrystalline hollow γ-Mn2O3 and MnO nanoparticles. Studies on various conventional solid manganese oxide nanoparticles have already been reported. Therefore, focus was only made on the fabrication and magnetic study of hollow polycrystalline manganese oxide, with a comparison of the results to those from solid nanoparticles already available in literature. A conclusion was drawn to the importance of the coupling of different magnetic phases (i.e. FM and AFM, FiM and AFM, or SG and AFM), in contrast to just having one single oxide in the hollow nanoparticles. Finally, the importance of this coupling as compared to the increase of surface-to-volume ratio was evaluated in CoO/Co3O4/CoFe2O4 polycrystalline hollow nanoparticles by varying the AFM phase (CoO/Co 3O4) in the nanoparticles and observing how the magnetic properties varied. This system helped address the effect of the coupling between different magnetic phases, super-exchange interaction, and proximity effect

Coercivity and exchange bias study of polycrystalline hollow nanoparticles

Shah, Syed IsmatMagnetic nanoparticles (NPs) have the potential to be useful in a variety of applications such as biomedical instruments, catalysis, sensing, recording information, etc. These nanoparticles exhibit remarkably different properties compared to their bulk counter parts. Synthesis of magnetic NPs with the right morphology, phase, size and surface functionality, as well as their usage for specific applications are challenging in terms of efficiency and safety. Morphology wise, there have been numerous reports on magnetic nanoparticles where morphologies such as core/shell, hollow, solid, etc., have been explored. It has been shown that morphology affects the magnetic response. Achieving the right crystal structure with required morphology and the magnetic behavior of the nanoparticle phases determines the magnetic response of the structure. For example, in the case of core/shell NPs various ferromagnetic (FM), ferrimagnetic (FiM), and antiferromagnetic (AFM) core and shell combinations have been reported. In these cases, interesting and strikingly different features, such as unusually high spin glass transition temperature, large exchange bias, finite size effects, magnetic proximity effects, unusual trend of blocking temperature as function of average crystal size, etc., have been reported. ☐ More specifically, the morphology of core/shell nanoparticles provides added degrees of freedom compared to conventional solid magnetic nanoparticles, including variations in the size, phase and material of the core and shell of the particle, etc. which helps enhance their magnetic properties. Similar to traditional core/shell nanoparticles, inverted core/shell having a FiM or FM order above the Curie temperature (TC) of the shell has been reported where the Néel temperature (TN) is comparable with the bulk value and there is nonmonotonic dependence of the coercive field (HC) and exchange bias (HEB) on the core diameter. ☐ In addition to the core/shell morphology, nanoparticles with hollow morphology are also of interest to the scientific community. For such cases, surface spin glass transition enhancements have been reported due to the presence of the additional inner surface. CoFe2O4, NiFe2O4 and γ-Fe2O3 hollow nanoparticles exhibit strikingly contrasting magnetic behavior compared to bulk and conventional solid particles; similar behavior was also observed in core/shell nanoparticles. Structurally, hollow polycrystalline nanoparticles are composed of multiple crystallographic domains. This random orientation of the crystallographic domains also causes randomization of the local anisotropy axes. Hence the overall effect of this morphology on the magnetic properties is exhibited through the high coercivity, relatively high temperature magnetic irreversibility, lack of magnetic saturation, high blocking temperature, etc. ☐ Over the years, extensive work on core/shell nanoparticles have been carried out to understand their exchange bias phenomenon and the effect on coercivity. Recently, focus has been given to hollow polycrystalline nanoparticles for the reason mentioned above. This thesis investigates the root cause for the above-mentioned effects on the coercivity and exchange bias. Since hollow nanoparticles with polycrystalline structure have shown to exhibit different and improved magnetic behavior compared to bulk and other conventional solid particles, they will be the focus of our investigation. First, extensive field and temperature dependent magnetic study on polycrystalline hollow nickel ferrite (NiFe2O4) have revealed the effect of the presence of inner surface in a single oxide nanoparticle. Second, the effect of having multiple oxides with different magnetic properties (i.e. FM and AFM) in a single nanoparticle, while maintaining a hollow morphology was investigated by studying polycrystalline hollow γ-Mn2O3 and MnO nanoparticles. Studies on various conventional solid manganese oxide nanoparticles have already been reported. Therefore, focus was only made on the fabrication and magnetic study of hollow polycrystalline manganese oxide, with a comparison of the results to those from solid nanoparticles already available in literature. A conclusion was drawn to the importance of the coupling of different magnetic phases (i.e. FM and AFM, FiM and AFM, or SG and AFM), in contrast to just having one single oxide in the hollow nanoparticles. Finally, the importance of this coupling as compared to the increase of surface-to-volume ratio was evaluated in CoO/Co3O4/CoFe2O4 polycrystalline hollow nanoparticles by varying the AFM phase (CoO/Co3O4) in the nanoparticles and observing how the magnetic properties varied. This system helped address the effect of the coupling between different magnetic phases, super-exchange interaction, and proximity effect.University of Delaware, Department of Materials Science and EngineeringPh.D

Quality of life of patients with end-stage renal disease in Guinea

This questionnaire-based study included 69 patients from the Republic of Guinea with end-stage renal disease (ESRD) and was conducted over 12 months. The factors that affected their quality of life (QoL) were determined. The included ESRD patients had an estimated creatinine clearance (CCr) of <15 mL/minute using MDRD formula. We used the SF36 question-naire and classified the results into two groups: Scores <50/100 as poor QoL and scores 50/100 as good QoL. Factors that determined the QoL were cessation of all activities and additional effort required, severe or mild pain, good or bad health, and reduced or not reduced social and physical activities. Of the 69 patients, 32 (46.3%) had a good QoL and 37 (53.7%) had a poor QoL. The estimated CCr was similar in both groups. The average age of the poor QoL group was 54 ± 4 years, the good-QoL group′s average age was of 47.6 ± 4 years (P = 0.01). Patients with a good QoL had better overall health, but this was not statistically significant [OR = 0.42 (0.14-1.28); P = 0.14]. Patients with a poor QoL had more severe pain (P = 0.002); however, good QoL did not protect against mental problems [OR = 46.67 (8.18-351.97); P = 0.0001]. Mental status (P = 0.01) and social activities (P = 0.001) were reduced, and there were more comorbidities in the poor-QoL group (29.7%, with >4, P = 0.01). Good QoL was associated with younger age, fewer comorbidities, less severe physical pain, and fewer physical or social limitations. QoL could be increased by improving comorbidity treatments, giving more effective pain control, and providing more assistance for social and physical limitations