Contribution to a better analysis of spermatic and ultrasound testicular parameters in the follow-up of male infertility at the Histology Embryology Cytogenetic Laboratory of Cheikh Anta Diop University (UCAD).

INTRODUCTION: In Senegal, marital infertility is a real problem for society. We undertook the study of this subject to make an analysis of the spermatic parameters of the infertile Senegalese man and to better understand the impact of testicular morphological anomalies on male fertility. PATIENTS AND METHODS: We conducted a cross-sectional, descriptive, retrospective study of 100 infertile patients followed at the Histology-Embryology-Cytogenetics laboratory of UCAD in Dakar, during the year 2020. Sperm parameters, presence of varicocele, and testicular volume were evaluated in our patients. RESULTS/DISCUSSION: The mean age of the patients was 35.17±8.7 years. A history of sexually transmitted infections was found in 57% of patients. The mean duration of infertility was 5.67±3.2 years. The mean sperm count was 14,871,230/ml±4,950,000. Necrospermia was the most frequent abnormality found (60%), followed by asthenospermia (51%). The high rate of necrospermia could be explained by the high frequency of sexually transmitted infections. Other abnormalities were oligospermia (48%, including 09% cryptospermia), azoospermia (19%), teratospermia (19%), and hypospermia (13%). The predominance of azoospermia and oligospermia should prompt a search for a genetic predisposition in these subjects. The mean testicular volume was 10.3±4.9 cc on the right and 9.5±4.8 cc on the left. A single or bilateral varicocele was found in 43% of subjects. Patients with azoospermia and teratospermia were associated with testicular hypotrophy with a significant value (p=0.04). CONCLUSION: Overall, the senegalese man consulting for infertility is a young adult, married for an average of 5 years. Necrospermia is the most frequently found anomaly. The severity of both qualitative and quantitative abnormalities should lead to a systematic search for a genetic origin. The etiological research of infertile patients must be done within a multidisciplinary framework to propose better management of these patients.

[Clinical manifestations related to kitchen biomass smoke in African women]. / Manifestations cliniques liées à la fumée de cuisine chez les femmes en milieu africain.

CONTEXT: Fires of wood and charcoal play an essential part in the cooking of food in Africa. These fires emit thick smoke that has definite health consequences. OBJECTIVES: To determine the clinical manifestations related to kitchen smoke and to identify the type of fire most often incriminated. METHODS: It was a transverse study comparing the clinical features in women using three types of fire: wood, charcoal and gas. We questioned 200 women in each group who used one type of fire exclusively for five days a week for at least five years. RESULTS: Clinical manifestations associated with the smoke were reported in all the women using wood as opposed to 98.5% using charcoal and 45.5% using gas. More than 80% had physical signs. These comprised 89.1% upper respiratory and 77% pulmonary signs. Upper respiratory signs were the most common, mainly sneezing and nasal obstruction. At the pulmonary level, a predominance of signs was found in women using wood fires (47.3%) and charcoal (36.2%), the difference being statistically significant. The signs included chronic cough, chest pain and dyspnoea. Wheezes were found in 15% of the women. CONCLUSION: Cooking smoke exposes women to complications which are most frequently associated with the use of wood or charcoal.

[Smoking in school: Cocody, Abidjan]. / Tabagisme en milieu scolaire dans la commune de Cocody à Abidjan.

MATERIAL AND METHODS: A cross-sectional study on smoking in school was conducted in public, private, and international secondary schools in Cocody, Abidjan, between March 18 and May 4, 2003. Data were collected with an anonymous individual questionnaire from 1000 pupils. RESULTS: Pupils smoked for the first time at an early age, 13.9 years on average. The prevalence of smoking was 15.9%, with a strong proportion of girls who smoked (10.6%). Smoking was particularly prevalent in private and international schools. Many pupils (37.7%) stated their teachers also smoked in the school and in their presence. Only 13.8% of parents knew their children smoked. Favoring factors observed were the influence of smoking parents (26.5%), influence of smoking peers (67.6%). Two motivations were predominant: curiosity and imitation. Most pupils bought their cigarettes with their pocket money (62.7%). Most smokers smoked in night clubs and bars (74.3%) and drank alcohol (69%). Less than two-thirds of the pupils were knowledgeable about the consequences of smoking: basically they knew about lung diseases (62.9%), and particularly lung cancer (63% of lung diseases). The majority of the pupils were aware of the nicotine content of cigarettes (52.8%).

[Epidemiological, clinical and biological profile of resistant or recurrent pulmonary tuberculosis in Abidjan]. / Profil épidémiologique et microbiologique des malades tuberculeux en situation d'échec ou de rechute à Abidjan.

From August to December 1998, over a period of 5 months, a cross-sectional study had been carried out in Abidjan in order to analyze the epidemiological and microbiological features of BAAR+ TB patients in situation of failure or relapse after specific treatment. We investigated 79 patients enrolled in the departments of pulmonary disease of two general hospitals in Abidjan (CHU of Cocody and Treichville) and a TB outpatients' clinic. From 45 strains of Mycobacterium obtained by culture, 33 antibiograms were performed. The rate of multi-drug-resistance (MDR-TB) was 79%. Among MDR--TB patients, those aged of 20-40 years were the most concerned age group (72%) with a clear male predominant rate (sex ratio: 3). Among them 49/79 (62%) had an educational level lower or equal to primary school standarts and most of them lived in dwellings with common yard (67%). In their medical history only 40% had tuberculosis and 2 cases of self-medication were reported. MDR--TB prevailed among patients having at first a positive bacilloscopy. No link between HIV infection and MDR--TB was found.

On the number of multilinear partitions and the computing capacity of multiple-valued multiple-threshold perceptrons.

We introduce the concept of multilinear partition of a point set V/spl sub/R/sup n/ and the concept of multilinear separability of a function f:Vtwo head right arrowK={0,...,k-1}. Based on well-known relationships between linear partitions and minimal pairs, we derive formulae for the number of multilinear partitions of a point set in general position and of the set K(2). The (n,k,s)-perceptrons partition the input space V into s+1 regions with s parallel hyperplanes. We obtain results on the capacity of a single (n,k,s)-perceptron, respectively, for V subset R(n) in general position and for V=K(2). Finally, we describe a fast polynomial-time algorithm for counting the multilinear partitions of K(2).

Benign mediastinal lymphadenopathy in congestive heart failure.

We report three cases of benign mediastinal lymphadenopathy revealed by chest radiography in patients ranging in age from 61 to 75 years. All three patients had severe coronary heart disease and a history of several episodes of acute cardiac decompensation. Chest CT scanning contributed to the diagnosis by revealing the existence of multiple enlarged lymph nodes, mostly 10 to 17 mm in short-axis diameter. CT scanning also confirmed the disappearance of the mediastinal lymph nodes in one patient on follow-up after treatment with diuretics and digitalis. Histopathology investigations of biopsy samples obtained by mediastinoscopy consistently revealed noninflammatory, benign lesions that did not affect the node structure. Our report draws attention to the particular nosology of left heart disease represented by benign enlarged lymph nodes of the mediastinum and pulmonary edema. The diagnostic approach to such lymphadenopathy should be guided by the radiologic regression seen on follow-up CT scanning while the patient was undergoing appropriate therapy for congestive heart failure, which constitutes a decisive argument for the congestive heart failure origin.

STRIP--a strip-based neural-network growth algorithm for learning multiple-valued functions.

We consider the problem of synthesizing multiple-valued logic functions by neural networks. A genetic algorithm (GA) which finds the longest strip in V is a subset of K(n) is described. A strip contains points located between two parallel hyperplanes. Repeated application of GA partitions the space V into certain number of strips, each of them corresponding to a hidden unit. We construct two neural networks based on these hidden units and show that they correctly compute the given but arbitrary multiple-valued function. Preliminary experimental results are presented and discussed.

[Evaluation of likely antibiotherapy in bacterial-like acute pneumopathies in patients hospitalized in Africa]. / Evaluation de l'antibiothérapie probabiliste dans les pneumopathies aiguës d'allure bactérienne hospitalisées en milieu africain.

We conducted a retrospective analysis of 100 records of adult African patients hospitalised for bacterial-like acute pneumonia. The objective of the study was to evaluate the use and efficacy of probabilist antibiotherapy. The study population was made up of 57% men and 43% women. Serious clinical symptoms were found in 31% of the patients, with serious x-ray and biological anomalies for respectively 67% and 51% cases. Secondary morbidity was associated with pneumonia in 30% cases. In the first intention, the three (3) most prescribed antibiotics are beta-lactamins (84%), fluoroquinolons (25%), and aminosids (25%). Sulfamids, macrolids and imidazols were prescribed together in 18% cases. Monotherapy was prescribed in 53% cases and concerned especially amoxicillin (39/53) and fluoroquinolons (5/53). Double therapy was used in 42% of cases and consisted of amoxicillin + aminosid (21/42) and amoxicillin + fluoroquinolon (17/42). Three antibiotics were noted for 5 cases. The intravenous administration was frequently used (68%), either alone (27%), either associated with other modes of drug administration (41%). Mean duration of antibiotherapy was 12.71 days. 73% of patients improved, 22% failed to improve and 5% died. Antibiotherapy was influenced by the seriousness biological signs and by the mode of administration of antibiotherapy in monotherapy. Deaths occurred precociously and concerned HIV positive (4/5) patients presenting at least 2 factors of co-morbidity and having received beta-lactamin in monotherapy.

[Role of pharmacists in the management of asthma in Africa. Survey among pharmacists from the city of Abidjan]. / Rôle du pharmacien dans la prise en charge de l'asthme en Afrique. Une enquête auprès des pharmaciens d'officine de la ville d'Abidjan.

This questionnaire survey was conducted to assess delivery of asthma drugs in community pharmacies in Abidjan, Ivory Coast. Participation rate was 88.69%. All participants stated they provide care for asthma patients either during acute episodes or between acute episodes. It was found that a considerable number of patients come to community pharmacies for care without prior medical prescription. In case of acute episodes, care is provided by the pharmacist in 59.80% of the cases. Aerosol devices are the most widely used although the technical procedures required for correct inhalation were found to be poorly understood by pharmacists. Slow-release corticosteroids are widely delivered for chronic care. Pharmacists also provide information and advice on drug compliance and concerning the importance of regular medical care and eviction of allergens.

[Evaluation of management of asthma African adults. National survey among general physicians from Ivory Coast]. / Evaluation de la prise en charge de l'asthme de l'adulte en Afrique. Une enquête nationale réalisée auprès des médecins généralistes ivoiriens.

A cross sectional study of asthma management of adults in Africa based on an anonymous questionnaire was conducted among 149 general practitioners working in the principal 18 cities in the Ivory Coast located in 6 geographical regions drawn for the purpose of this study. Data collected included: complementary tests prescribed at first diagnosis, typical prescriptions for acute asthma and for long-term control, knowledge of metered-dose inhalation techniques, regular measurement of FEV1 and prescription of sports activities. Forty-one percent of the physicians were unaware of the usefulness of expiration volume measurements and FEV1 measurements were prescribed by only 8%. The most widely prescribed tests were chest x-ray, blood cell counts, and ENT consultation. Lung function tests were requested by 12.75% of the physicians and skin allergy tests by 10.74%. Beta 2 agonists were prescribed for acute asthma, basically by inhalation or subcutaneous administration and were generally combined with corticosteroid therapy. Nebulization was rarely prescribed. Aberrant prescriptions (delayed release tablets, corticosteroid sprays, delayed release corticoidsteriods) were also given. For long term management, delay release beta 2-agonists were most widely used. Delayed release corticosteroid injections were prescribed by 18.5% of the physicians and metered dosers by 14%. Dry powders were rarely used. These findings emphasize the poor management of asthma in Africa. Directives taking into account the social and economic setting in the Ivory Coast should be initiated.

[Epidemiology of tuberculosis in Abidjan, Ivory Coast: effects of HIV infection]. / Epidémiologie de la tuberculose à Abidjan, Côte d'Ivoire: évolution sous la poussée de l'infection à VIH.

Despite the rising morbidity and mortality of tuberculosis in patients with HIV infection, epidemiology of tuberculosis in the Ivory Coast remains under-documented. The aim of this retrospective study of 1638 cases of tuberculosis diagnosed in the Pneumology Department of the Abidjan University Hospital was to collect current epidemiological data. From 1986 to 1992, a total of 4631 patients were hospitalized at University Hospital-Abidjan. Clinical and serological tests to detect HIV infection were performed in 982 patients. During hospitalization all patients received the same treatment for tuberculosis (2RHZ/4RH). Tuberculosis accounted for 42 p. 100 of diagnoses with a prevalence of 234 patients per year and a rate of increase was 4.5 p. 100 per year. Most patients were between the ages of 20 and 40 years (59 p. 100) and of male sex (72 p. 100). Overall HIV seroprevalence was 44.5 p. 100 with a rate of increase of 4.4 p. 100 per year. The proportion of patients tested for HIV grew from 11 p. 100 to 98 p. 100 over the seven-year study period and infection rates were consistently higher in men than in women (sex ratio: 3 to 1). The mean percentage of extrapulmonary or disseminated tuberculosis was sharply higher in the last three years of study (from 23.5 p. 100 to 46 p. 100 after 1989). This study demonstrates that seroprevalence rate has increased and that this increase has been correlated with a rising incidence of lethal and extrapulmonary tuberculosis.

[Prevalence of allergy to cockroaches in the African intertropical zone. Review of the literature]. / Prévalence de l'allergie aux blattes en zone intertropicale Africaine. Revue de la littérature.

The epidemiology of environmental allergens and their role in respiratory pathology remains poorly understood in sub-Sahara Africa. The aim of this work was to measure the frequency of sensitivity to cockroach allergens of subjects with chronic respiratory affections in the Ivory Coast. We recruited consecutively 140 patients, adults and infants, who had asthma, rhinitis or sinusitis over a period of 20 months, in a hospital environment. The patients were prepared by a clinical questionnaire on atopy (personal and familial antecedents), systemic prick tests for common environmental allergens (cockroaches, mites, moulds). Our results indicated that the mean age of the children was 8 years and that of the adults 26 years (with extremes of 3 and 53 years). The proportion of patients with positive prick tests to cockroaches was 30.7% (43 cases). In asthmatics it was 16.5%. When asthma was associated with an ORL focus, 41.9% was found and in isolated ORL pathology 19.5%. Existence of familial atopy was found in 72% of cases. Discomfort from domestic dust was shown on questioning by 88.4% of cases. In 81.4% of cases positivity of the prick test to cockroaches was accompanied by a positive reaction to mites. Those who were only sensitive to cockroaches were less than 10%. Types II and III asthma were 2/3 in the asthmatic patients. In conclusion, the cockroaches were in the second rank of pneumoallergens that are implicated in sensitization and in the perpetuation of allergic respiratory symptoms, after the mites. These two factors were often associated in our patients and are consequently seen with a strong allergenic potential that is exercised by the interior environment.

[Prevalence of nocardiosis in an area of endemic tuberculosis]. / Prévalence de la nocardiose pulmonaire en zone d'endémie tuberculeuse.

This is a prospective study recruiting 120 patients successively who were admitted to the chest department in hospital for respiratory infections irrespective of their aetiology. The aim of the study was to assess the frequency of nocardiosis in respiratory pathology in the era of AIDS and in an area where tuberculosis is endemic. The HIV serology was carried out on all 120 patients. A systemic search was made for nocardiosis and Koch's bacillus in the sputum and also in the broncho-alveolar lavage liquid obtained by endoscopy. The HIV serology was positive in 74 patients (61.7%). Pulmonary nocardiosis was diagnosed in five patients (4.2%), of whom four patients were HIV positive (80%). Tuberculosis was diagnosed in 58 cases (48.3%) of whom 40 were HIV positive (70%). The association of nocardiosis and tuberculosis was present in only one patient. The radioclinical aspect of nocardiosis in our service was suggestive of tuberculosis. The prevalence of nocardiosis in our series at 4.2% is in agreement with that obtained in autopsy studies in the Ivory Coast. The similarity of the radioclinical appearance between tuberculosis and nocardiosis demands that a search is made for the latter on all HIV positive patients and in negative cases a search for Koch's bacillus and empirical antibiotic therapy ought to have a spectrum of activity that would include nocardia.

[Fatal asthma. Seven case reports observed in Black Africans and review of the literature]. / Asthme mortel. A propos de 7 cas observés chez le Noir africain et revue de la littérature.

This is a retrospective study based on a descriptive analysis of the case notes of seven asthmatics who died during hospitalisation over a period of eleven years. Our objective was to underline the potentially fatal character of asthma and to review the characteristics of asthma on the Ivory Coast. The seven cases of fatal asthma (five men and two women) representing 7 out of 1291 of the causes of death in the period under consideration (< 0.5%). The mean age was 32 years. Basic treatment was non-existent in 5 out of 7 cases (71.4%) and relied on only a Salbutamol aerosol in two cases (28.6%). In four cases the individuals were without jobs (57.13%), retired in two cases (28.6%) and a child in one case (14.27%). The death occurred on admission in three cases (42.8%). The asthma was type III as described by Marsac with the two clinical forms. The immediate cause of death was delayed treatment for the crisis (3 out of 7), acute cardiorespiratory decompensation (2 out of 7) and sudden death (2 out of seven). Fatal asthma is a reality on the Ivory Coast and the risk factors seem to particularly related to the precarious conditions of life there.

Smear positive pulmonary tuberculosis in a prison setting: experience in the penal camp of Bouaké, Ivory Coast.

SETTING: Bouaké prison camp, Ivory Coast. OBJECTIVE: To determine the clinical, radiographic and therapeutic characteristics of smear-positive pulmonary tuberculosis in the prison camp of Bouaké. METHODS: The study included 108 cases of smear positive pulmonary tuberculosis who had never been treated previously. Triple chemotherapy of 6 months' duration was recommended for all of the patients. RESULTS: The incidence of smear positive tuberculosis in the prison population under study was very high (5.8%). In the majority of cases tuberculosis infection is associated with other conditions: here they were malnutrition (75%), anaemia (70%) and dermatoses (64%). Human immunodeficiency virus (HIV) infection was observed in 30% of the cases, and alcohol and tobacco dependence in 50%. Radiographic lesions were extensive in 70% of the cases. The 6-month treatment regimen is still effective: 80 of the 108 (74.1%) were cured, i.e. 97.6% of those who completed their treatment. The death rate, however, was alarming at 24% (one patient in four). The main reason for incarceration was theft (73%). CONCLUSION: Other epidemiological studies are needed urgently in order to pin-point those factors that favour the progression from tuberculous infection to disease in this very specific setting, and to improve socio-sanitary conditions for prison inmates.

[Bacterial lung diseases from common bacteria during HIV infection in African adults hospitalized in Abidjan, Côte d'Ivoire]. / Les pneumopathies bactériennes à germes banals au cours de l'infection par le VIH chez l'adulte africain hospitalisé à Abidjan, Côte d'Ivoire.

In this retrospective study, authors compare radiographic and clinical aspects in two groups of patients. They are hospitalized for bacterial pneumonia and distinguished by HIV serological profile (HIV+ or HIV-). Positif HIV serologic is observed in 60% among 96 patients included in this study. An african adult infected by HIV shows not much particularity. We notice however that dyspnoea is observed more frequently in the subject infected by HIV+: 74% against 26% of the groups HIV-. Reoccurring pneumoniae are only observed in the subject infected with HIV+: 12%. Extensive and bilateral radiographic lesions were more observed in HIV+ patients. Causative agent has been isolated in 11 cases (9 pneumococcus: 81%). The antibiotic treatment has a same result in two groups (HIV- and HIV+). Thus it is necessary to undertake research for further information concerning etiologies of bacterial pneumonia in HIV+ subjects in African countries.