Prognosis of Pregnancy in Epileptics in Benin: A Case-Control Study.

Objective The main purpose of this article is to define prognosis of pregnancies in epileptic women in Benin. Methods This was a case-control study that included 54 epileptic women who had at least one pregnancy matched to 162 controls on age, pregnancy term, and monitoring center. Information about epilepsy, treatment, pregnancy, and childbirth were collected. A logistic regression with odds ratio (OR) calculation was used to study the association. Results During pregnancy 22.22% of epileptic women experienced an increase in seizure frequency. Epileptics had more frequent miscarriages (OR: 1.84 [1.01-3.51]), more incidents during pregnancy (OR: 4.03 [1.04-15.60]), and were more often hospitalized (OR: 3.35 [1.46-7.69]) than women without epilepsy. They, more often, had premature children before 37 weeks of amenorrhea (OR: 2.10 [1.12-3.91]) and gave birth to low-birth-weight children (OR = 2.17 [1.00-4.76]). Conclusion Occurrence of a pregnancy in an epileptic woman in Benin is at risk and requires multidisciplinary monitoring by both neurologist and obstetrician to reduce complications.

[Medication-overuse and chronic headaches in Brazzaville: patients' profile and therapeutic approach]. / Abus médicamenteux et céphalées chroniques à Brazzaville: profil et parcours thérapeutique des patients.

INTRODUCTION: Medication-overuse headaches (MOHs) are the least studied of all headaches in Africa. METHODS: We conducted a longitudinal study in order to describe our experience with patients placed in Neurology Outpatient observation in Brazzaville over a period of 4 years, from September 2010 to August 2014. All patients with chronic primary headaches, according to the International Classification of Headache Disorders (ICHD) (2nd edition), were included in the study. All patient with secondary headaches or who hadn't given consent were excluded. The patients were divided into two groups: those who had progressed to medication-overuse and those who didn't meet the criteria for medication-overuse (without-MOH). The variables used were the sociodemographic characteristics of patients, the clinical features of primary headaches and MOH treatment. RESULTS: The study population was constituted by 193 patients out of 212. The average age of patients was 42 ± 14 years, of whom 66.32% were women. MOH rate was 35.75%. The associated factors were: early age (p=0.003), concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol (p=0.0001) as well as self-medication (p<0.0001). By contrast, higher education (p<0.0001) and the use of NSAID alone (0.002) were protective factors against the onset of MOH. Ambulatory withdrawal was the most practiced treatment and amitriptyline was the most commonly used medication. CONCLUSION: Medication-overuse headaches are frequent in patients placed in Neurology Outpatient observation in Africa and deserve identification for a better management.

Knowledge, attitudes, and practices of health sciences students regarding epilepsy at the end of their curriculum in Benin.

OBJECTIVE: The main objective of this study was to evaluate the knowledge, attitudes, and practices (KAP) of health sciences students regarding epilepsy at the end of their curriculum in Benin. METHODS: We conducted a cross-sectional survey among medical, pharmacy, nursing, and midwife students in their last year of health sciences training in the University of Abomey-Calavi in Benin. Students completed a self-administered questionnaire, containing items addressing demographics, epilepsy treatment, diagnosis, clinical practice, and social tolerance regarding a person with epilepsy (PWE). RESULTS: The response rate to our survey was 87.7% (n = 164). The sample consisted of 64 medical students, 22 pharmacy students, 43 nursing students, and 35 midwife students. They were divided into 95 female subjects and 69 males; sex ratio was 0.7. The mean age of participants was 23.6 ±â€¯1.8 years. The mean scores for epilepsy knowledge, practices, and attitudes were respectively 7.6 ±â€¯1.7 out of a maximum score of 11, 3.9 ±â€¯1.8 out of 8, and 9.6 ±â€¯0.8 out of 10. The KAP overall score was 21.1 ±â€¯3.4 out of a maximum score of 29.0. The variables associated with the overall KAP score were training school, gender, having heard about epilepsy before health sciences studies (p = 0.017), and having a relative with epilepsy (p = 0.001). Male students and medical school students had significantly better overall KAP score than female students or the other training schools respectively (p < 0.001). SIGNIFICANCE: These findings support the need to improve the health sciences students' knowledge of epilepsy, in particular, during their training.

Ischemic stroke due to embolic heart diseases and associated factors in Benin hospital setting.

INTRODUCTION: Poor access to cardiovascular checkups is a major cause of ignorance of embolic heart diseases as the etiology for ischemic stroke. OBJECTIVE: Study ischemic strokes due to embolic heart diseases and their associated factors. METHOD: It was a cross-sectional, prospective, descriptive and analytical study conducted from November 1, 2014 to August 31, 2015 on 104 patients with ischemic stroke confirmed through brain imaging. Embolic heart diseases included arrhythmia due to atrial fibrillation (AF), atrial flutter, myocardial infarction (MI), heart valve diseases and atrial septal aneurysm (ASA). The dependent variable was embolic heart disease while independent variables encompassed socio-demographic factors, patients' history, and lifestyle. Data analysis was carried out through SAS 9.3. RESULTS: The rate of embolic heart diseases (EHD) as etiology for ischemic stroke was 26% (28/104). AF accounted for 69% of embolic heart diseases and 22.8% of etiologies for ischemic stroke. Ischemic strokes prevalence was 3.5%, 2.5% and 1.2% respectively for heart valve diseases, MI and ASA. The associated factor was age (p=0.000). CONCLUSION: The diagnosis of a potential cardiac source of embolism is essential because of therapeutic and prognostic implications. Wherefore, there is need for cardiovascular examination particularly Holter ECG and cardiac ultrasound examination which are not always accessible to our populations.