Ischemic strokes revealing neurosyphilis: Study of six (6) observations at the neurology Department of the University Hospital of Conakry.

Introduction: In sub-Saharan Africa (SSA), stroke is a major public health problem and the etiological aspects are poorly studied and documented because of under-medicalization; the syphilitic etiology is rarely mentioned. Patients and methods: We performed a retrospective study of 472 patients hospitalized for ischemic stroke between 2016 and 2021 in the Neurology Department of the University Hospital of Conakry, confirmed by neuroradiological explorations (brain CT, MRI-Angio) and a biological workup including VDRL-TPHA serological reactions in blood and CSF. Results: Syphilitic etiology was retained for six (6) patients (4 men and 2 women) with a mean age of 43 years (extremes 36 and 49 years). The clinical picture was dominated by carotid syndromes: superficial and deep sylvian syndrome, anterior cerebral artery syndrome and vertebro-basilar syndromes and one case of lacunar syndrome.The diagnosis was based on the positivity of serological reactions (VDRL-TPHA) in blood and cerebrospinal fluid (CSF) and the presence of a predominantly lymphocytic hypercellularity and a hyperproteinorachy in the CSF in the absence of any other etiology. Conclusion: These neurological vascular syndromes consecutive to a cerebral treponematous attack are often the result of a still poorly conducted management of primary and secondary syphilis in our country.

EPILEPTIC SEIZURES REVEALING STURGE WEBER'S DISEASE IN A TROPICAL ENVIRONMENT: STUDY OF EIGHT CASES.

In sub-Saharan Africa (SSA), the etiological factors of epilepsy are multiple and phacomatoses, in particular Sturge weber's disease, are rarely reported due to under-medicalization and insufficient multidisciplinary care. We carried out a retrospective study of 216 patients hospitalized for recurrent epileptic seizures between 2015 and 2022 in the neurology and pediatrics department of the University Hospital Center of Conakry, among whom eight (8) patients were identified for Sturge Weber's disease in order to reassess this pathology from a clinical and paraclinical point of view in a tropical environment. Sturge Weber's disease was retained in eight (8) on the presence of symptomatic partial epileptic seizures (age 6 months to 14 years) with frequency of status epilepticus, homonymous lateral hemiparesis linked to occipital involvement, piriform calcifications on imaging and ocular disorders. The delay in consultation and medical care revealed severe mental deterioration in our patients. This study shows a stereotyped clinical picture in a context of aggravation of signs related to a delay in multidisciplinary management. These results are important for the diagnostic, therapeutic and prognostic discussion.

GAYET WERNICKE'S ENCEPHALOPATHY AFTER COVID-19 IN ELDERLY SUBJECTS IN TROPICAL ENVIRONMENTS: STUDY OF SIX (6) OBSERVATIONS IN CONAKRY.

In sub-Saharan Africa, the COVID-19 pandemic has caused severe malnutrition in elderly populations with the appearance of vitamin deficiencies, in particular thiamine responsible for Gayet Wernicke's encephalopathy (EGW). We present a series of six (6) patients hospitalized in the Neurology Department of the CHU Ignace Deen for the management of a brain syndrome with vigilance disorders after recovery from COVID-19, including oculomotor disorders, motor incoordination on a course of severe weight loss. The six patients underwent an evaluation of malnutrition by determining the WHO body mass index, the Detsky index, the serum albumin assay, the thiamine assay and a neuroradiological assessment (MRI) and an electroencephalogram (EEG) examination although this does not seem necessary for diagnosis. Study of nutritional status: weight loss greater than 5%, patients in Desky group B and C, plasma albumin<30 g/l, lowered thiamine and MRI neuroradiological data: by the existence of hypersignals in certain regions of the neocortex, certain gray nuclei, the mammillary bodies the thalamic nuclei close to the wall of the 3rd ventricle and the regions bordering the 4th ventricle sign Gayet Wernicke's encephalopathy syndrome. This study shows a stereotyped clinical, biological, neuroradiological and evolutionary profile of Gayet Wernicke's encephalopathy in elderly subjects recovered from Covid-19 with proven malnutrition. These results are useful for the therapeutic and prognostic discussion.

[Contribution of the University Clinical Research Center's laboratoryin the diagnosis of SARS-CoV-2 in Mali]. / Contribution du laboratoire du Centre Universitaire de Recherche Clinique (UCRC) au diagnostic de SRAS-CoV-2 au Mali.

INTRODUCTION: The rapid diagnostic capacities of laboratories in Mali have been an essential element in the response to COVID-19. The University Clinical Research center (UCRC) diagnosed the first cases of Mali COVID-19. OBJECTIVE: The objective was to describe the contribution of the UCRC in the diagnosis of Covid-19 and to clinically and epidemiologically characterize the patients tested in the UCRC laboratory. MATERIALS AND METHODS: A cross-sectional study was conducted during eight months of intense activity. The samples were sent from the National Institute of Public Health (INSP) to the UCRC. RESULTS: The UCRC tested 12,406 contacts and suspected samples and confirmed the diagnosis in 1091 patients, or 9%. The most common symptoms were cough (48.78%), headache (34.14%), fatigue / weakness (34.14%), while (33.33%) of the patients were asymptomatic. The sample positivity rate among new cases decreased from May to September 2020, despite almost 230% of the number of samples tested. CONCLUSION: The laboratory played a major role in the response and there may be a low transmission of the virus in the Malian community.

INTRODUCTION: Les capacités de diagnostic rapide des laboratoires au Mali ont été un élément essentiel dans la riposte contre la COVID-19. Le Centre Universitaire de Recherche Clinique (UCRC)a diagnostiqué les premiers cas du Mali. OBJECTIF: Etait de décrire l'apport de l'UCRC dans le diagnostic de la Covid-19 et de caractériser cliniquement et épidémiologiquement les patients testés au laboratoire de l'UCRC. MATÉRIELS ET MÉTHODES: Une étude transversale a été conduite pendant huit mois d'activité intense. Les échantillons ont été envoyés de l'Institut National de Santé Publique (INSP) à l'UCRC. RÉSULTATS: L'UCRC a testé 12 406 échantillons contacts et suspects et a confirmé le diagnostic chez 1091 patients soit 9%. Les symptômes les plus rencontrés ont été la toux (48,78%), les maux de tête (34,14%), la fatigue/faiblesse (34,14%), tandis que (33,33%) des patients étaient asymptomatiques. Le taux de positivité des échantillons a diminué entre mai et août et avec une légère diminution en septembre 2020,avec près de 230% du nombre d'échantillons testés. CONCLUSION: Le laboratoire a joué un grand rôle dans la riposte et il y'aurait une faible transmission du virus dans la communauté Malienne.

Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali.

BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RR-TB.METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RR-TB.RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7-3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDA-negative at 2M (P = 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%.CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.

Performance of Mali's biosafety level 3 laboratory in the external quality assessment in preparedness of laboratory accreditation and support to clinical trials.

Background: The external quality assessment (EQA) or external quality control is an evaluation conducted by a certified external organization to inquire about the quality of the results provided by a laboratory. The primary role of EQA is to verify the accuracy of laboratory results. This is essential in research because research data should be published in international peer-reviewed journals, and laboratory results must be repeatable. In 2007, the University Clinical Research Center (UCRC's) biosafety level 3 (BSL-3) laboratory joined the EQA program with the College of American Pathologists in acid-fast staining and culture and identification of mycobacteria as per laboratory accreditation preparedness. Thus, after 11 years of participation, the goal of our study was to evaluate the performance of our laboratory during the different interlaboratory surveys. Methods: We conducted a descriptive retrospective study to evaluate the results of UCRC mycobacteriology laboratory from surveys conducted during 2007 and 2017. Results: Of the 22 evaluations, the laboratory had satisfactory (100% of concordance results) in 18 (81.8%) and good (80% of concordance results) in 4 (18.2%). Overall, the laboratory was above the commended/accepted limits of 75%. Conclusion: So far, UCRC's BSL-3 performed well during the first 11 years of survey participation, and efforts should be deployed to maintain this high quality in the preparedness for laboratory accreditation and support to clinical trials.

[Foreskin Cyst After Circumcision At The Hospital Of Sikasso (MALI)]. / Kyste Du Moignon Preputial Post Circoncision Traditionnelle A L'Hopital De Sikasso (MALI).

Cyst scar post circumcision of the stump of the prepuce is pathology of which we have not found any cases in the literature. The circumcision traditional is still practiced in our regions with its attendant complications, in particular, the high section, the whole or part of the gland, infections. The case we report concerns a patient 24 years of age, having a large cyst of 8cm diameter, evolving for the past 17 years. The patient has not informed his parents that when the desire to marry has become very pressing. The consultation was motivated by the psychological trauma, the discomfort and the pain caused by the infection, and the fistulisation. The treatment was surgical with bedroom suites. This observation underscores the importance of the knowledge of good surgical technique in order to minimize complications; it also sheds light on the taboo side of the pathologies the sphere uro-genitale.

Le kyste cicatriciel post circoncision du moignon du prépuce est une pathologie dont nous n'avons pas trouvé de cas dans la littérature. La circoncision traditionnelle est toujours pratiquée dans nos régions, avec son cortège de complications, notamment l'hémorragie, la section partielle ou totale du gland, les infections. Le kyste cicatriciel post circoncision traditionnelle que nous rapportons concerne un patient de 24 ans présentant un volumineux kyste de 08cm de diamètre, évoluant depuis 17ans. Le patient n'a informé ses parents que lorsque le désir de se marier est devenu très pressant. La consultation fut motivée par le traumatisme psychologique, la gêne et la douleur provoquée par l'infection et la fistulisation. Le traitement a été chirurgical avec des suites simples. Cette observation souligne l'importance de la maitrise de la bonne technique opératoire afin de minimiser les complications de la circoncision traditionnelle, elle met aussi la lumière sur le côté tabou des pathologies touchant la sphère uro-génitale.

[Urethral Prolapse Of The Girl In The Service Of Pediatric Surgery Of The Teaching Hospital Gabriel Touré]. / Prolapsus Uretral Chez La Fille En Chirurgie Pediatrique Du CHU Gabriel Toure.

OBJECTIVES: To describe the diagnostic and therapeutic aspects of urethral prolapse in girls in pediatric surgery. PATIENTS AND METHOD: This was a 9-year retrospective study (January 2007 to December 2015) of girls aged 0-15 years with urethral prolapse and management in the department during the study period. RESULTS: In 9 years, 18 cases of prolapsewerediagnosed, or 2 cases / year. The averageagewas 8.9 ± 3.4 yearswithextremes of 6 years and 15 years. Of the 18 cases identified, 10 werereferred. Femalegenital mutilation wasfoundin 15 (83.3%) patients, rectal prolapsewasassociatedin 2 cases (11.1%) and a cough concept in 5 (27.8%) patients. The average consultation time was 11.6 ± 7.9 dayswithextremes of 1 and 21 days. Eleven (61.1%) patients werereceivedurgently, including 2 cases (11.1%) of strangulation. Prolapsewas in the form of a roundedswelling, centered by the urethralmeatus. The mass wasblackishin 2 cases (11.1%). Shewasbleeding and painfulin 11 (61.1%) cases. Thesesignswere absent in 5 cases (27.8%). Swellingwasassociatedwithsigns of urinarydysuria and / or urinaryblightin 10 (55.5%) girls. The diagnosiswasclinical in all patients. Treatmentconsisted of excision and suturing of the prolapsedmucosa in all patients with placement of an indwellingurinarycatheter. Immediatefollow-up was simple in 16 (88.9%) patients and 2 cases (11.1%) of surgical site infection.

OBJECTIFS: décrire les aspects diagnostiques et thérapeutiques du prolapsus urétral chez la fille en chirurgie pédiatrique. PATIENTS ET MÉTHODE: il s'agissait d'une étude rétrospective de 9 ans (janvier 2007 à décembre 2015) portant sur les filles de 0-15ans présentant un prolapsus urétral et prises en charge dans le service pendant la période d'étude. RÉSULTATS: en9 ans, 18 cas de prolapsus ont été diagnostiqués soit 2 cas/an. L'âge moyen était de 8,9±3,4 ans avec des extrêmes de 6 ans et 15ans. Parmi les 18 cas recensés, 10 ont été référés. Une mutilation génitale a été retrouvée chez 15 (83,3%) patientes, un prolapsus rectal était associé dans 2 cas (11,1%) et une notion de toux chez 5 (27,8%) patientes. Le délai moyen de consultation a été 11,6± 7,9 jours avec des extrêmes de 1 et 21 jours. Onze (61,1%) patientes ont été reçues en urgence parmi lesquelles 2 cas (11,1%) d'étranglement. Le prolapsus se présentait sous la forme d'une tuméfaction arrondie, centrée par le méat urétral. La masse était noirâtre dans 2 cas (11,1%). Elle était saignante et douloureuse dans 11 (61,1%) cas. Ces signes étaient absents dans 5 cas (27,8%). La tuméfaction était associée à des signes d'infections urinaire à type de dysurie et ou de brûlure mictionnelle chez 10 (55,5%) filles. Le diagnostic était clinique chez toutes les patientes. Le traitement a consisté à l'excision puis suture de la muqueuse prolabée chez toutes les patientes avec mise en place d'une sonde urinaire à demeure. Les suites immédiates ont été simples chez 16 (88,9%) patientes et 2 cas (11,1%) d'infection du site opératoire.

[Urological Complications of Pelvic Surgery at Point-G Hospital, About 23 Cases]. / Les Complications Urologiques Liees a la Chirurgie Pelvienne au CHU du Point-G, a Proposde 23 cas.

INTRODUCTION: Bladder and ureteral lesions are the most common urologic complications occurring during pelvic surgery with 1% and 0.5% to 3%, respectively. These lesions are rarely recognized intraoperatively and pose a major problem to urologists, gynecologists, and general surgeons. OBJECTIVE: To study the factors favoring urologic complications following pelvic surgery at the University Hospital Point-G. PATIENTS AND METHOD: We conducted a retrospective study at the University Hospital Point-G between 2006 and 2015. It involved 23 patients with a whole urological lesion following pelvic surgery. These patients underwent a clinical and para-clinical examination (intravenous urography, methylene blue test) to confirm the urological lesion and to determine its management. RESULTS: The average age of our patients was 32.00 years with extremes of 18 and 40 years old. The leakage of urine was found in 82.6% (19/23). Interventions that caused urologic injury were: caesarean section 52.2% (12/23), hysterectomy 30.4% (7/23), as well as a caesarean section and hysterectomy 17.4% (4/23). Methylene blue was performed in 19 patients, it was positive in 52.2% (12/23) and intravenous urography (IVU) in 7 patients. The lesions encountered were: retrotrigonal fistula vesico-vaginal 10 cases, vesico-vaginal fistula under trigonal 2 cases, uretero-vaginal fistula 7 cases, and bilateral ureteral ligation 4 cases. Fistulorraphy was performed in 52.2% followed by direct ureterovesical reimplantation. The postoperative outcome was satisfactory in 100% of cases with obtaining a good bladder tightness. The average duration of hospitalization was 12 days (+/- 4 days). CONCLUSION: Pelvic surgery results in urological injuries. Caesarean section and hysterectomy are contributing factors. Vesico-vaginal fistula or ureteral lesions are common.

INTRODUCTION: Les lésions vésicale et urétérale constituent les complications urologiques les plus fréquentes survenant au décours d'une chirurgie pelvienne soit respectivement 1 à 4% et 0,5 à 3% [6,7]. Ces lésions sont rarement reconnues en peropératoire et posent un problème important auquel sont confrontés les urologues, les gynécologues, les chirurgiens généralistes. OBJECTIF: Etudier les facteurs favorisants les complications urologiques consécutives à la chirurgie pelvienne au CHU du Point-G. PATIENTES ET MÉTHODE: Il s'agissait d'une étude rétrospective réalisée au CHU du Point-G entre 2006 et 2015. Elle a concerné 23 patientes présentant toute une lésion urologique au décours d'une chirurgie pelvienne. Ces patientes ont subi un examen clinique et para cliniques (Urographie intra veineuse; le test au bleu de méthylène) dans le but de confirmer la lésion urologique et d'en déterminer la prise en charge. RÉSULTATS: l'âge moyen de nos patientes était de 32,00 ans avec des extrêmes allant de 18 à 40 ans. La fuite d'urine était retrouvée chez 82,6% (19/23). Les interventions pourvoyeuses de lésions urologique étaient : la césarienne 52, 2% (12/23), l'hystérectomie 30, 4% (7/23), une association césarienne et hystérectomie 17,4 % (4/23). Le test au bleu de méthylène a été réalisé chez 19 patientes, il a été positif dans 12 cas soit 52,2 % et l'UIV chez 7 patientes. Les lésions rencontrées étaient : la fistule vésico-vaginale retro trigonale 10 cas, la fistule vésico-vaginale sous trigonale 2 cas, la fistule urétéro-vaginale 7 cas, et la ligature urétérale bilatérale 4 cas. La fistulorraphie a été effectuée dans 52,2 % suivie de la réimplantation urétéro-vésicale directe. Les suites opératoires étaient satisfaisantes dans 100% des cas avec l'obtention d'une bonne étanchéité vésicale. La durée moyenne d'hospitalisation était de 12 jours (+/− 4 jours). CONCLUSION: La chirurgie pelvienne est pourvoyeuse de lésions urologiques. La césarienne et l'hystérectomie sont des facteurs favorisants. Les fistules vésico-vaginales ou des lésions urétérales sont fréquentes.

[Patients' satisfaction survey after tranvesical prostatectomy in the urology department of Gabriel Touré University Hospital]. / Evaluation de la Satisfaction des Patients Apres Adenomectomie Transvesicale de la Prosate dans le Service D'Urologie du Chugabriel Toure.

AIM: This study was aimed to evaluate patients' satisfaction with tranvesical prostatectomy in the Urology department of University Hospital Gabriel Touré according to the (International Prostate Symptoms Score (IPSS) and the quality of life scores. PATIENTS AND METHODS: We conducted a prospective descriptive study over a 12-month period including a consecutive cohort of patients who had transvesical prostatectomy. Each patient was evaluated before and six weeks after the surgery. We used the IPSS as an assessment tool, supplemented by the Quality of Life (SQ) questionnaire. RESULTS: One hundred and thirteen (113) patients aged 71 ± 8 years old on average were evaluated. The mean duration of symptoms associated with benign prostatic hyperplasia was 19 months and 17% of patients had a mechanical complication. All patients had either moderate or severe lower urinary tract symptoms preoperatively, while 99% of them had an IPSS score <8 postoperatively. CONCLUSION: Transvesical prostatectomy allows an important improvement of the IPSS score of the patients and their satisfaction about their quality of life.

BUT: Evaluer la satisfaction des patients après adénomectomie transvésicale de la prostate dans le service d'urologie du CHU Gabriel Touré selon l'International Prostate Symptoms Score (IPSS) et le score de qualité de vie. PATIENTS ET MÉTHODES: il s'agissait d'une étude prospective et descriptive d'une cohorte consécutive de patients opérés pour adénomectomie transvésicale de la prostate réalisée sur une période de 12 mois. Les patients étaient tous évalués avant l'intervention chirurgicale et 6 semaines après. Nous avons utilisé l'IPSS comme outil d'évaluation, complété par la question sur la qualité de vie. RÉSULTATS: Cent treize patients d'âge moyen de 71 ± 8ans ont été évalués. La durée moyenne d'évolution des symptômes liés à l'hypertrophie bénigne de la prostate était de 19 mois et 17 % des patients présentaient une complication mécanique. Tous les patients présentaient des symptômes modérés ou sévères du bas appareil urinaire en préopératoire tandis qu'en postopératoire 99% des patients avaient un score IPSS inférieur à 8. CONCLUSION: l'adénomectomie transvésicale de la prostate permet une amélioration du score IPSS et celui de la qualité de vie des patients avec une importante satisfaction des patients.

Benefit of direct-acting antiviral therapy for hepatitis C virus (HCV) in monoinfected and HIV-HCV-coinfected patients with mixed cryoglobulinaemia.

OBJECTIVES: Mixed cryoglobulinaemia (MC) is found in 40-60% of patients with chronic hepatitis C virus (HCV) infection. Direct-acting antiviral (DAA) regimens considerably improve clinical outcome of HCV infection with sustained virological response rates (SVR) above 90%. We aimed to evaluate the impact of DAA therapy on cryoglobulin clearance and on MC-related symptoms in patients with HCV-associated MC. METHODS: Thirty-five HCV-monoinfected and 12 HIV-HCV-coinfected patients with symptomatic or asymptomatic MC treated with DAA regimen were analysed. Cryoglobulin levels were assessed at DAA initiation, at different time points during treatment and after treatment and until cryoglobulin clearance if any. RESULTS: Median age was 61 years and 51% (24/47) were males. HIV patients had all undetectable HIV RNA with combined antiretroviral therapy. MC was symptomatic in 77% (27/35) of HCV-monoinfected patients and in 8% (1/12) of HIV-HCV-coinfected patients (p < 0.001). Fifty-one per cent (24/47) of patients were previous non-responders to pegylated-interferon/ribavirin (PEG-IFN/RBV) therapy and 32% (15/47) were cirrhotics. One patient received DAA + PEG-IFN/RBV and all others received an IFN-free DAA regimen. The overall SVR12 rate was 100%. Cryoglobulinaemia persisted in 34% (n = 16/47) of patients at the end of follow-up: 17% (2/12) of HIV-HCV-coinfected and 40% (14/35) of HCV-monoinfected patients. Among these patients, median cryoglobulin level decreased from 101.4 mg/L at DAA treatment initiation to 51.7 mg/L at the end of follow-up. CONCLUSIONS: DAA-induced SVR allows cryoglobulin clearance in two-thirds of patients.

[Appendiceal Duplication In A Patient Operated For Chilled Appendix Breastplate At Gao Regional Hospital]. / Duplication Appendiculaire Chez Une Patiente Operee Pour Plastron Appendiculaire Refroidi A L'Hopital Regional De Gao, A Propos D'Un Cas.

Appendiceal duplication is the very rare malformation. It was first described by Picoli in 1892. It is a condition that is most often seen in the first years of life, sometimes some forms may remain asymptomatic and only occur in adulthood. We report the case of appendiceal duplication in a patient operated for chilled appendix breastplate at Gao Regional Hospital. CONCLUSION: appendiceal duplication is a rare abnormal abnormality of intraoperative discovery in general. Each surgeon must think about it during an appendectomy.

La duplication appendiculaire est une malformation très rare. Elle a été décrite pour la première fois par Picoli en 1892. C'est une affection qui se manifeste le plus souvent dans les premières années de vie, parfois certaines formes peuvent rester asymptomatiques et ne s'expriment qu'à l'âge adulte. Nous rapportons le cas de duplication appendiculaire chez une patiente opérée pour plastron appendiculaire refroidi à l'hôpital régional de Gao. CONCLUSION: la duplication appendiculaire est une anomalie malformative rare de découverte per opératoire en général. Chaque chirurgien doit y penser au cours d'une appendicectomie.

On-chip conductometric detection of short DNA sequences via electro-hydrodynamic aggregation.

Fluorescence measurement is the main technology for post-amplification DNA detection in automated systems. Direct electrical reading of DNA concentration in solution could be an interesting alternative to go toward more miniaturized or less expensive devices, in particular in the pathogen detection field. Here we present the detection of short bacterial biomarkers with a direct impedancemetric measurement, within solutions of amplified and elongated DNA sequences in a microchannel. This technology relies on the electrohydrodynamic instability occurring in solutions of long charged macromolecules in a strong electric field. This instability specifically induces the aggregation of long DNAs and triggers conductivity variations that can be monitored by on-contact conductometry. An innovative isothermal amplification and elongation strategy was developed, combining SDA and HRCA reactions, in order to yield long DNAs suitable to be detected by the above principle, from a dilute initial DNA target. In contrast with previous label-free detection methods, this new strategy is very robust to matrix effects, thanks to the unique molecular weight dependence of the instability, coupled with this specific DNA amplification strategy. We demonstrate the detection of a 1 pM gene sequence specific to Staphylococcus aureus, in a portable system.

The predictor of mortality outcome in adult patients with Ebola virus disease during the 2014-2015 outbreak in Guinea.

The purpose of this study was to examine the association of any demographic and clinical factors with mortality outcome among adult patients with Ebola virus disease (EVD) in Guinea. This retrospective observational study analyzed medical records of laboratory confirmed EVD adult patients during the 2014-2015 EVD outbreak in Guinea. The associations between any demographic or clinical variables and mortality outcome of EVD were assessed using univariate and multivariate logistic regression analyses. Of 2,310 EVD adult patients included for analysis, the overall case fatality rate was 68.1%. Univariate analyses identified factors possibly associated with mortality outcome, including patient age (p < 0.001), history of visiting or close contact with a suspected or confirmed EVD patient (p = 0.035), and seven clinical symptoms on admission, i.e., fever (p = 0.003), hiccups (p < 0.001), vomiting (p = 0.003), diarrhea (p < 0.001), cough (p = 0.001), sore throat (p = 0.016), and unexplained bleeding (p = 0.021). The multivariate analysis showed that patient age was independently associated with mortality outcome of EVD (OR = 1.06; 95%CI = 1.03-1.09; p < 0.001), while none the of clinical symptoms on admission were significantly associated with the mortality outcome. Our analysis indicates that older age was the only independent factor associated with death among EVD adult patients in Guinea. This suggests that older EVD patients should receive intensive medical care and be carefully monitored.

[Quantitative And Morphological Abnormalities Of Blood Cells Counts Among Customers Received VCT Unit Of The Central Laboratory Of The CHU Of Yopougon]. / Anomalies Quantitatives Et Morphologiques De L'Hemogramme Chez Les Clients Reçus A L'Unite De CDV Du Laboratoire Central Du CHU De Yopougon.

INTRODUCTION: The hematologic abnormalities constitute a reccuring problem in the general population. The HIV infection is a favourable situation for the potentiation of these various hematologic disorders. The aim of the study was to describe the quantitative and qualitative aspects of the three blood lines of our population of study. MATERIAL AND METHOD: It was a prospective cross-sectional study of descriptive type having concerned the people received at the central laboratory of CHU de Yopougon for voluntary tracking from September 1st to September 30th, 2015. RESULTS: We colliged 154 people among whom, a female prevalence was noted with a sex ratio M/F of 0.64. The age bracket from 18 to 29 years was represented (50%) with a 32.94 years median age ± 10 with the 18 and 75 years extremes represented by 50% of single people. The HIV infection prevalence was 20.37%. Anaemia was the most frequent hematologic abnormality (44.44%) its hypochromic microcitic form microcytic (50%) especially. The HIV positive patients had primarily a normochromic normocytic non regenerative anaemia (27.27%). Among HIV positive patients, 23 (65.22%) had a leuconeutropenia combined with lymphopenia at 23 (65.22%) and 12 had bicytopenia which consisted of thrombocytopenia and anaemia. A morphological abnormality of the three blood lines (red blood cells, white blood cells and platelets) was found in 57.41% of our subjects. CONCLUSION: To be in apparent good health, does not exclude the hematologic abnormalities presence. But an HIV infection presence, even in the absence of specific treatment, increases the risk or the degree of severity of these different qualitative and quantitative abnormalities.

INTRODUCTION: Les anomalies hématologiques constituent un problème récurrent dans la population générale. L'infection par le VIH est une situation propice pour la potentialisation de ces différents désordres hématologiques. L'objectif de l'étude était de décrire les aspects quantitatifs et qualitatifs des trois lignées sanguines de notre population d'étude. MATÉRIEL ET MÉTHODE: Etude transversale prospective de type descriptif ayant concerné les personnes reçues au laboratoire central du CHU de Yopougon pour le dépistage volontaire du 1er septembre au 30 septembre 2015. RÉSULTATS: Nous avons colligé 154 personnes parmi lesquelles, une prédominance féminine a été notée avec un sex ratio H/F de 0,64. La tranche d'âge de 18 à 29 ans était la plus représentée (50%) avec un âge moyen de 32,94 ans ± 10 avec les extrêmes de 18 et 75 ans représentée par 50% de célibataires. La prévalence de la séropositivité au VIH était de 20,37%. L'anémie était l'anomalie hématologique la plus fréquente (44,44%) surtout la forme hypochrome microcytaire (50%). Les personnes vivant avec le VIH avaient essentiellement une anémie normochrome normocytaire (27,27%) arégénérative. Une leucopénie avec lymphopénie avait été observée chez 23 (65,22%) tous infectés par le VIH et 12 cas de bicytopénie faite de thrombopénie et d'anémie avaient été observés. Des anomalies morphologiques portant sur les trois lignées sanguines (globules rouges, globules blancs et plaquettes) ont été retrouvées chez 57,41% de nos sujets. CONCLUSION: Etre en bonne santé apparente, n'exclut pas la présence d'anomalies hématologiques. Mais l'association d'une infection par le VIH, même en l'absence de traitement spécifique, augmente le risque ou le degré de sévérité de ces différentes anomalies qualitatives et quantitatives.

Morphology and ultrastructure of the antennal sensilla of Sitophilus granarius (Coleoptera: Curculionidae).

Sensilla are sense organs in insects, typically consisting of a group of cuticle or epidermal cells that appear as hairs or rod-shaped structures. Sensilla serve as the functional elements of sensory systems. The goal of this study was to determine the type and distribution of sensilla in the antennae of Sitophilus granarius (L.) using light microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). This is one of the first studies in which the morphology and distribution patterns of sensilla on antennal segments of male and female S. granarius have been investigated using SEM, followed by TEM. Different morphological sensilla types, including two sensilla basiconica (SB) types, with two subtypes, four sensilla coeloconica (SC) types and five sensilla chaetica (SCH) types, with one subtype, have been identified on S. granarius antennae, whose external structure and shape are peculiar. TEM micrographs of SB on the antennae of S. granarius are characterized by strongly corrugated pores around the cuticle, while micrographs of SC longitudinal sections showed flat-tipped and smooth-surfaced pegs bearing an apical pore that is suggestive of a gustatory function. TEM micrographs of SCH longitudinal sections showed dendrite branches and cuticular pore arrow heads that may be involved in the perception of humidity, temperature, heat and CO2. Because SCH of different sizes were distributed around the head and rostrum, these may function as contact-chemoreceptors .These results are discussed in relation to the possible roles of the sensilla types in the host location behavior of S. granarius.

High prevalence, low awareness, treatment and control rates of hypertension in Guinea: results from a population-based STEPS survey.

Hypertension is a major and fast-growing public health problem in Africa. We determined the prevalence of hypertension and assessed the levels of awareness, treatment and control in Guinea. A cross-sectional study based on a stratified cluster random sampling was conducted. In all, 2491 adults (1351 women) aged 15-64 years were selected and screened during September-December 2009. Hypertension (systolic (and/or diastolic) blood pressure ⩾140 (90) mm Hg or use of antihypertensive medications) and diabetes mellitus (fasting capillary glucose ⩾110 mg dl(-1) or use of antidiabetic medications) were determined. Logistic regressions were used to investigate the determinants of hypertension. The mean body mass index was 22.4 kg m(-2) (s.d.=4.5). The prevalence of hypertension and diabetes was, respectively, 29.9% (95% confidence interval (CI) 29.8-30.0) and 3.5% (95%CI 3.4-3.5). The prevalence of hypertension was 29.4% (29.3-29.5) in men and 30.4% (30.4-30.6) in women. The prevalence was 62.5% in the 44-64 years age group. Overall, 75.8% of hypertensive participants were undetected before the survey and 34.9% of those aware of their hypertensive status were receiving treatment, of whom 16.3% were at target control levels. Age, education, diabetes and obesity were the main factors associated with hypertension. There was a high prevalence of hypertension among the adults in Guinea, but with low awareness, treatment and control rates. Urgent response is needed in the form of integrated and comprehensive action targeting major non-communicable diseases in the country.

[Clinical, paraclinical and epidemiological profile of erectile dysfunction in consultation at the urology department of the Point G University Hospital]. / Profil epidemiologique clinique et paraclinique de la dysfonction erectile en consultation dans le service d'urologie du CHU du Point G.

OBJECTIVE: To study the epidemiological, clinical and paraclinical profile of erectile dysfunction in outpatient urology. MATERIAL AND METHODS: It was a prospective longitudinal study from January to August 2012 (8 months) in the urology department of the Point G University Hospital. 72 patients were involved, and were consulting for erectile dysfunction. These patients underwent clinical and laboratory examinations. Erectile dysfunction was evaluated by the Massachusetts Male Aging Study self-assessment (Single question of Self report of Erectile Dysfunction Massachusetts Male Aging Scale). RESULTS: Frequency of erectile dysfunction was estimated at 9.6%, average age was 45 years, 71% of patients were polygamous, and 18% were monogamous. Most patients (82%) resided in Bamako; traders were most represented (34%). The deficit was moderate in 48.61% of patients. The average time of consultation was 2.5 years. Co-morbidity factors were found in 54.16% of patients, the most frequent risk factors were physical inactivity (34.72%). Blood glucose was elevated in 27.78% patients, cholesterol and triglycerides were elevated in 13.15% of patients, testosterone was low in three patients, prolactin was high in six patients. A Doppler ultrasound of the penis revealed a low perfusion of corpus cavernosum in six cases, and three cases of Peyronie's disease. CONCLUSION: At the end of the study the epidemiological, clinical and paraclinical profile is identical to that found in other countries. But a more serious study with specific evaluation scores will help to identify this profile.

OBJECTIF: Etudier le profil épidémiologique, clinique et paraclinique des patients présentant une dysfonction érectile reçus en consultation externe dans le service d'urologie. MATÉRIEL ET MÉTHODES: il s'agissait d'une étude longitudinale prospective réalisée de Janvier 2012 à Aout 2012 (8 mois) dans le service d'urologie du Centre Hospitalier Universitaire du Point G. Elle a porté sur tous les patients qui ont consulté pour dysfonction érectile. Ces patients ont bénéficié d'examens cliniques et paracliniques. La dysfonction érectile a été évaluée par l'échelle de l'unique question d'auto-évaluation de la dysfonction érectile du Massachusetts Male Aging Study. (Single question of Self report of erectile dysfonction Massachusetts Aging Study). RÉSULTATS: La fréquence de la dysfonction érectile a été estimée à 9,6 %, l'âge moyen était de 45 ans; 71% des patients étaient polygames, 18% étaient monogames.La plupart des patients (82%) résidait à Bamako, les commerçants étaient les plus représentés (34%). Le déficit était modéré chez 48,61% des patients. Le délai moyen de consultation était de 2,5 ans. Des facteurs de Co-morbidités ont été retrouvés chez 54,16% des patients, le facteur de risque le plus fréquent a été la sédentarité (34,72%). La glycémie était élevée chez 27,78% patients, les cholestérols et les triglycérides étaient élevés chez 13,15% des patients, la testostérone était basse chez trois patients, la prolactine était élevée chez six patients. L'écho-doppler de la verge a révélé une faible perfusion des corps caverneux dans six cas, trois cas de Maladie de Lapeyronie. CONCLUSION: Au terme de notre étude le profil épidémio-clinique et paraclinique retrouvé reste identique à celui d'autres pays. D'autres études plus détaillées avec des scores d'évaluation précis permettront de mieux cerner ce profil.

[Some reflections on the classification of African obstetric fistulas]. / Quelques réflexions sur la classification de la fistule obstétricale africaine.

UNLABELLED: While the English-speaking world may have reached a consensus about Kees Waaldjik's classification of obstetric fistulas, no unanimity around this classification exists among French-speaking medical workers. The objective of this review is to propose a classification, based on long experience in the care of these women, by setting up a comparison with Waaldjik's. Our classification takes two criteria into account: (1) the environment of the fistula, that is: (a) fistula with a soft (relatively unscarred) vagina, b) fistula with vaginal sclerosis (bands or adhesions, vaginal stenosis or atresia), (c) vesicovaginal fistula associated with a (high or low) rectovaginal fistula or perineal lacerations (first, second or third degree); (2) the anatomical site of fistula, of which there are five types: (a) type I: fistula of the vesicovaginal wall, (b) type II: vesico-cervico-urethral fistula, with two major subgroups: type IIA (without destruction of the urethra) and type IIB (with destruction of the urethra), type IIA being subdivided in three subgroups: IIAa, IIAB and cIAI, (c) type III fistulae trigono-Neck utero-vaginal, (d) type IV: complex mixed fistula, (e) type V, high fistulas: the vesico-cervical-uterine fistula and classical vesicouterine. CONCLUSION: Our classification is simple, not simplistic, with some resemblance to that of Waaldjjik.

[Study of factors influencing clinical outcomes of obstetric urogenital fistula surgery at the Point G University Hospital of Bamako, Mali]. / Etude des facteurs influençant les resultats clinique de la chirurgie de la fistule uro-genitale obstetricale au CHU de l'Hopital du point G Bamako Mali.

The aim of this study was to identify factors influencing the clinical outcomes of surgery of obstetric urogenital genital fistula. This was a cross sectional study, which focused on factors influencing results in the treatment of urogenital fistula, from January 2011 to January 2012 at the urology department of the Point-G University Hospital. This study involved 115 patients suffering from urogenital fistula. Cure of urogenital fistula accounted for 17% of the bloc's activities. Closure of the fistula was achieved in 68.7% of cases. This result was influenced by certain factors. Including factors related to condition of the tissue peri-fistula (good trophic tissue, or fibrosis peri-fistula). Fistulas operated primarily peri-sinus tissue remodeling were closed in 71.42% of cases. Factors related to the patient and care: those carried out for the first time have a success rate of 68.42%, only 47.62% of success in patients who presented after five years. Factors related to clinicopathological seat: fistula vesicovaginal septum and cervical-vaginal urethrovaginal reported a success rate of 76.92%. Care-related factors include: the experience of the surgeon, surgeons of the urology service have a 76.19% success rate against 25% from other surgeons. The incision fistula was related to the clinicopathological seat, so the trigonal-vaginal fistulas and uretero addressed by the upper route have been successful in 85%. In addition to these factors the postoperative follow-up, the instruments, the suture thread, the operating table, and the lighting in the room have also improved the results.

Le but de cette étude était d'identifier les facteurs influençant les résultats cliniques de la chirurgie de la fistule uro- génitale obstétricale. Il s'agissait d'une étude transversale, qui a porté sur les facteurs influençant les résultats dans la prise en charge de fistule uro-génitale, allant du janvier 2011 au janvier 2012 au service d'urologie du CHU du Point-G. Cette étude a concerné 115 patientes souffrantes de fistule uro-génitale. La cure de la fistule uro-génitale a représenté 17 % des activités du bloc. La fermeture de la fistule a été obtenue dans 68,7% des cas. Ce résultat a été influencé par certains facteurs, dont les facteurs liés à l'état du tissu péri-fistuleux (bonne trophicité du tissu, ou fibrose péri-fistuleux). Les fistules opérées avant tout remaniement tissulaire péri-fistuleux ont été fermées dans 71,42 % des cas. Les facteurs liés à la patiente et aux soins : celles opérées pour la première fois ont un taux de réussite de 68,42 %, seulement 47,62 % de succès chez les patientes qui se sont présentées après cinq ans. Les facteurs liés au siège anatomo-clinique : les fistules de la cloison vésico-vaginale et cervico-urétro-vaginale ont occupé un taux de succès de 76,92 %. Les facteurs liés aux soins regroupent : l'expérience du chirurgien, les chirurgiens du service d'urologie contrairement aux autres chirurgiens ont 76,19 % de réussite contre 25%. La voie d'abord de la fistule était en rapport avec le siège anatomo-clinique, ainsi les fistules trigonales et urétéro-vaginales abordées par la voie haute ont été réussies dans 85 %. En plus de ces facteurs le suivi post-opératoire, les instruments, les fils de suture, la table opératoire, l'éclairage de la salle ont améliorée aussi les résultats.