Cholécystectomie par Célioscopie d’une Lithiase Biliaire Symptomatique chez une Jeune Femme de 33 Ans et Revue de la Littérature (Un Cas Clinique)

Introduction : La lithiase biliaire est une pathologie d’une grande fréquence ; elle est le plus souvent asymptomatique, mais peux se compliquer en impactant négativement la qualité de vie. L’ablation de la vésicule sous endoscopie est prometteuse. Nous rapportons un cas clinique pour discuter des modalités thérapeutiques à travers une revue de la littérature. Observation médicale : Nous rapportons, l’observation d’une femme de 33 ans avec antécédent d’obésité morbide. Elle nous a consulté en juin 2020 pour des vomissements post prandiaux chroniques avec altération de l’état générale. Les examens paraclinques réalisés n’ont pas révélé une cause évidente. Evacuée à la polyclinique Hammamet à Tunis le diagnostic d’une lithiase vésiculaire a été posé et une ablation sous célioscopie était réalisée avec extraction de 12 gros calculs d’aspect cholestéroliques et la pièce opératoire a trouvé un aspect histologique d’une cholécystite chronique diverticulaire en poussée aigue modéré. La patiente est totalement guérie de sa maladie. Conclusion : L’intérêt de ce travail révèle dans le cas non typique d’une lithiase vésiculaire et les examens échographiques réalisés à Bangui avec nos appareils peu performants étaient normaux. Notre plateau technique doit être renforcé par les appareils performants et du personnel qualifié très spécialisé.   Introduction: Cholelithiasis is a very common pathology; it is most often asymptomatic, but can become complicated by negatively impacting quality of life. Removal of the gallbladder under endoscopy is promising. We report a clinical case to discuss therapeutic modalities through a review of the literature. Medical observation: We report the observation of a 33-year-old woman with a history of morbid obesity. She consulted us in June 2020 for chronic postprandial vomiting with deterioration in general condition. Paraclinical examinations carried out did not reveal an obvious cause. Evacuated to the Hammamet polyclinic in Tunis, the diagnosis of gallbladder lithiasis was made and ablation under laparoscopy was carried out with extraction of 12 large cholesterol-looking stones and the operating specimen found a histological appearance of chronic diverticular cholecystitis in moderate acute surge. The patient is completely cured of her illness. Conclusion: The interest of this work reveals in the non-typical case of gallbladder lithiasis and the ultrasound examinations carried out in Bangui with our poorly performing devices were normal. Our technical platform must be reinforced by high-performance devices and highly specialized qualified personnel

Profil Epidémiologique des Troubles Fonctionnels Intestinaux (TFI) Persistants au CHU de Conakry

Introduction : Les troubles fonctionnels Intestinaux (TFI) ou syndrome de l’intestin irritable représentent un véritable problème de santé publique. Si cette affection n’engage pas le pronostic vital, elle altère significativement et de façon chronique la qualité de vie des malades. L’étiologie est mal connue et de nombreux facteurs sont impliqués. Méthodes : Il s’agissait d’une étude transversale descriptive à recueil prospectif de données réalisée en consultation externe du service d’hépato-gastroentérologie de l’hôpital national Donka du CHU de Conakry pour une durée de 2 ans. Résultats : Trois cent quatre-vingt-dix-huit cas de TFI sur 1309 patients avaient été recensé soit une prévalence de 30,40%. On notait une prédominance féminine avec un sex ratio de 0,92. L’âge moyen de nos patients était de 49 ans avec des extrêmes de 10 et 88 ans. Les tranches d’âge de 25-34 ans et 35-44 ans étaient les plus représentées avec des fréquences respectives de 24,52% et 22,07%. Les principaux signes cliniques étaient des douleurs abdominales (92,28%), de la constipation dans 84,41%, ballonnement abdominal 28,39% et diverses manifestations extradigestives : insomnie dans 32,08%, de céphalées dans 30,55% des cas, de la fibromyalgie 22,91%. Les principaux facteurs déclenchants étaient : les facteurs psychologiques 32,08% et alimentaires (tubercules 14,13%, haricot 6,11%, le dîner tardif et ou copieux 4,2% et les boissons gazeuses 3,44%). Le retentissement socioprofessionnel des TFI était dominé par l’absentéisme dans 82,78% des cas, le retard au travail dans 20%. Les comorbidités digestives les plus fréquentes étaient : le reflux gastro œsophagien (RGO), la dyspepsie, le dolichocôlon ainsi que leur association. Les examens  complémentaires morphologiques étaient représentés par (une échographie abdominale et pelvienne a été réalisée chez 50,11% de nos patients et elle objectivait une aérocolie dans 45% des cas ;un scanner abdominopelvien  fait dans 3,56% des cas, examen sans anomalie ; une ano-recto-sigmoïdoscopie dans 17,80% des cas et une ; coloscopie dans 4,98% des cas, toutes normales ; une fibroscopie oeso-gastroduodénale chez  25% de nos patients et était normale ;un lavement baryté double contraste 11,20%. Conclusion : Le TFI est un problème de santé publique qui altère la qualité de vie des personnes atteintes. Les douleurs abdominales, la constipation et le ballonnement abdominal en constituent la triade symptomatique. Le stress est un facteur déclenchant de la symptomatologie. L’association du SII avec des comorbidités digestives et extra-digestives est fréquente. Les examens complémentaires morphologique ont des conséquences financières difficiles dans la majorité des cas chez nos patients.   Introduction : Functional digestive disorders (TFI) or irritable bowel syndrome represent a real public health problem. Although this condition is not life-threatening, it significantly and chronically alters the quality of life of patients. The etiology is poorly understood and many factors are involved. Methods : This was a descriptive cross-sectional study with prospective data collection carried out in the outpatient clinic of the hepato-gastroenterology department of the Donka National Hospital of the Conakry University Hospital for a period of 2 years. Results : Three hundred and ninety-eight cases of TFI out of 1309 patients were identified, representing a prevalence of 30.40%. There was a female predominance with a sex ratio of 0.92. The average age of our patients was 49 years with extremes of 10 and 88 years. The age groups of 25-34 and 35-44 were the most represented with respective frequencies of 24.52% and 22.07%. The main clinical signs were abdominal pain (92.28%), constipation in 84.41%, abdominal bloating in 28.39%, and various extra digestive manifestations: insomnia in 32.08%, headache in 30.55% of cases. cases, fibromyalgia 22.91%. The main triggering factors were: psychological factors 32.08% and dietary factors (tubers 14.13%, beans 6.11%, late or heavy dinner 4.2% and soft drinks 3.44%). The socio-professional impact of TFIs was dominated by absenteeism in 82.78% of cases, and lateness for work in 20%. The most frequent digestive comorbidities were: gastroesophageal reflux disease (GERD), dyspepsia, dolichocolon and their association. Additional morphological examinations were represented by (an abdominal and pelvic ultrasound was carried out in 50.11% of our patients and it revealed aerocolia in 45% of cases; an abdominopelvic scan was performed in 3.56% of cases, examination without abnormality; an anorecto-sigmoidoscopy in 17.80% of cases and the colonoscopy in 4.98% of cases, all normal; an esophagogastroduodenal fibroscopy in 25% of our patients and was normal; a double contrast barium enema 11 .20%. Conclusion: TFI is a public health problem that impairs the quality of life of those affected. Abdominal pain, constipation, and abdominal bloating constitute the symptomatic triad. Stress is a triggering factor for the symptoms. The association of IBS with digestive and extra-digestive comorbidities is common. Additional morphological examinations have difficult financial consequences in the majority of cases among our patients

Prévalence Et Diversité De Salmonella En Afrique : Analyse Qualitative Et Quantitative

International trade, new agricultural, animal production and food practices have facilitated the spread and transmission of food-borne pathogens; including Salmonella. Salmonella is a ubiquitous bacterium responsible for a variety of diseases in humans, animals. It has a large diversity and contains more than 2579 serotypes. However, very little work describing the diversity, structure and populations dynamics of Salmonella in different hosts is available in Niger. In order to describe the general context of Salmonella diversity in Africa, an analysis of the available literature on this subject was carried out. A total of 131 publications were identified. From those publications, twenty five (25) were eligible. The LOGIT estimation model was used for serotype analysis to standardize the distribution of data and minimize sample sizes. It appears from our analysis that the prevalence of Salmonella is high regardless of the host and host germ. The major serotypes found in humans in Africa are S. Typhimurium, S. Enteritidis and S. Typhi. In poultry, the predominant serotype is S. Hadar on the other side S. Typhimurium predominates in North Africa. Thus, the results of these review analyzes constitute one of the steps in the process of understanding trends in the distribution of Salmonella in Africa. These results are presented as an outline of the implementation of a successful 251 model for the continuation of our studies on the diversity of Salmonella in Niger

Cholécystectomie par Célioscopie de Lithiases Biliaires Symptomatiques chez une Jeune Femme de 34 Ans et Revue de la Littérature (Un Cas Clinique)

Introduction : La lithiase biliaire est une pathologie d’une grande fréquence ; elle est le plus souvent asymptomatique, mais peut se compliquer en impactant négativement la qualité de vie. L’ablation de la vésicule sous endoscopie est prometteuse. Nous rapportons un cas clinique pour discuter des modalités thérapeutiques à travers une revue de la littérature. Nous rapportons, l’observation d’une femme de 34 ans avec antécédent obese  Elle nous a consulté en juin 2020 pour des vomissements post prandiaux chroniques avec altération de l’état générale. Les examens paraclinques réalisés n’ont pas révélé une cause évidente. Evacuée à la polyclinique Hammamet à Tunis le diagnostic d’une lithiase vésiculaire a été posé et une ablation sous célioscopie était réalisée avec extraction de 13 gros calculs d’aspect cholestéroliques dont le diamètre moyen de 3 cm, et la pièce opératoire a trouvé un aspect histologique d’une cholécystite chronique diverticulaire en poussée aiguë modérée. La patiente est totalement guérie de sa maladie.   Cholelithiasis is a very common pathology; it is most often asymptomatic, but can become complicated by negatively impacting quality of life. Removal of the gallbladder under endoscopy is promising. We report a clinical case to discuss therapeutic modalities through a review of the literature. We report the observation of a 34-year-old woman with a history of obesity. She consulted us in June 2020 for chronic postprandial vomiting with deterioration in general condition. Paraclinical examinations carried out did not reveal an obvious cause. Evacuated to the Hammamet polyclinic in Tunis, the diagnosis of gallbladder lithiasis was made and an ablation under laparoscopy was carried out with extraction of 13 large cholesterol-looking stones with an average diameter of 3 cm, and the operating specimen found an appearance histology of chronic diverticular cholecystitis in moderate acute attack. The patient is completely cured of her illness. Conclusion: The interest of the work lies in the atypical case of symptomatic cholelithiasis which our technical platform did not allow to easily treat in our country

Exome Sequencing Identifies a Novel TRPV4 Mutation in a CMT2C Family

Molecular and Cellular Biolog

Correction: A Seroepidemiological Study of Serogroup A Meningococcal Infection in the African Meningitis Belt.

[This corrects the article DOI: 10.1371/journal.pone.0147928.]

Peoples’ attitude toward COVID-19 vaccine, acceptance, and social trust among African and Middle East countries

Background: To end the COVID-19 pandemic, a large part of the world must be immune to the virus by vaccination. Therefore, this study aimed to gauge intent to be vaccinated against COVID-19 among ordinary people and to identify attitudes towards vaccines and barriers for vaccine acceptance. Methods: The study population comprises 1880 people residing in different countries that answer a prepared questionnaire. The questionnaire topics are demographics, historical issues, participants’ attitudes and beliefs regarding vaccines, concerns, and vaccine hesitancy. Results: Attitudes and beliefs relating to vaccines in general, and the COVID-19 vaccine, were ascertained. Overall, 66.81% of the contributors would like to be vaccinated against COVID-19, while %33.19 did not intend to be vaccinated. Reasons for COVID-19 vaccine hesitancy included concern regarding vaccine side effects, fear of getting sick from the uptake of the vaccine, and the absence of accurate vaccine promotion news. Individuals with higher education believe that India (68.6%) produces the best vaccine (P<0.001), while healthcare workers think the Chinese vaccine (44.2%) is the best (P=0.020). Individuals with higher education have not been vaccinated, not be healthcare workers, and females were the most contributors to effective of the vaccine in reducing mortality from COVID-19 disease. Conclusion: Given the degree of hesitancy against COVID-19 vaccination, a multifaceted approach to facilitate vaccine uptake that includes vaccine education, behavioral change strategies, and health promotion, is paramount

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Fighting COVID-19 in the West Africa after experiencing the Ebola epidemic

Coronavirus disease 2019 (COVID-19) dissemination occurred from December 2019 and quickly spread to all countries. Infected patients with COVID-19 have had a wide range of symptoms, ranging from mild to severe illness. The most mortality was observed in patients with underlying disease and over 45 years. World statistics have shown that the COVID-19 outbreak is most expanded in Middle Eastern, West Asian, European, North, and South American countries, and is least expanded in African countries. Therefore, the aim of the paper was the evaluation of six African countries including Mali, Mauritania, Niger, Guinea, Togo, and Djibouti to find why this disease is least expanded in African countries. Study was conducted by Questioner for countries health organizers to define their different aspect exposure and fight with COVID-19 including epidemiology, clinical aspects of the disease, case definitions, diagnosis laboratory confirmation, and referral of cases by the portal of entry, ease management, and disease prevention in these countries. According to this opinion review, due to the low international flights and low domestic travel, the spread, and prevalence of COVID-19 was low and the return of the immigrants of these countries has caused the spread of COVID-19 among these countries. Experience, preparation, and impact of previous infections epidemic such as the Ebola virus epidemic would have beneficial, which have promoted certain reflexes among people that cause low dissemination in these countries