Post-stroke Chorea in the Neurology Department of Ignace Deen Hospital of Conakry, Guinea.

INTRODUCTION: Chorea is an uncommon complication of stroke. The pathophysiology, the exact location of the lesions, and the evolution of this type of chorea are still poorly understood. The objective was to describe the epidemiological, clinical, and imaging profile of post-stroke chorea in a tropical environment in the context of a stroke epidemic. MATERIAL AND METHODS: We conducted a five-year retrospective observational study from 2015 to 2020 on stroke patients who presented with chorea in our department. Epidemiological, clinical, and imaging data were registered. RESULTS: Fourteen patients presented with chorea after their stroke, a frequency of 0.6%. The average age was 57.1 years with a male predominance. Hypertension was the cardiovascular risk factor in half of the patients; three patients (21.4) were diabetic. Chorea was the initial manifestation of the stroke in eight patients (57.1%). Thirteen patients (92.9%) had an ischaemic stroke and one had a cerebral haemorrhage. The middle cerebral artery (MCA) was involved in nine patients (64.3%), the anterior cerebral artery (ACA) in three patients (21.4%), and two patients (14.3%) had posterior cerebral artery (PCA) involvement. The lesions were cortical in five patients (35.7%), five other patients (35.7%) had a deep location, and four patients (28.6%) had both deep and cortical locations of their lesions. The structures affected were the lentiform nucleus (50%), the insula (35.7%), the caudate nucleus (14.3%), and the thalamus (14.3%). CONCLUSION: Post-stroke chorea is poorly studied in the tropics. In the presence of any acute abnormal movement associated with cardiovascular risk factors, post-stroke chorea should be considered. Recovery is rapid when treated early.

Mortalité maternelle chez les adolescentes au service de Gynécologie-Obstétrique de l'Hôpital National Ignace Deen / Maternal mortality among adolescents in the Gynecology-Obstetrics department of Ignace Deen National Hospital

Introduction. L'objectif de cette étude était de contribuer à l'étude de la mortalité maternelle chez les adolescentes. Méthodes. Il s'agissait d'une étude retro-prospective descriptive et analytique cas témoin, d'une durée de trois ans. La collecte rétrospective avait porté sur deux (2) ans allant du 1er Janvier 2018 au 31 Décembre 2019 et celle prospective sur un (1) an allant du 1er Janvier 2020 au 31 Décembre 2020. Résultats. Durant la période d'étude nous avons enregistré 38 cas de décès maternels sur 16175 naissances vivantes soit un ratio de 235 décès pour 100000 naissances vivantes. Le décès concerne l'adolescente de 18-19 ans (65,8%), mariée (63,2%), non scolarisé (42,1%), et nullipare (65,8%). La majorité des adolescentes avait effectué 1-3 CPN (44,7%), et provenait d'une maternité périphérique (84,2%) et avait accouché par voie basse (78,4%). Le moyen de transport le plus utilisé était le transport en commun (63,2%). La cause de décès était dominée par l'hémorragie (44,7%). Le post-partum a été la période la plus pourvoyeuse de décès (52,6%). Conclusion. La mortalité maternelle constitue un problème de santé majeure dans notre pays, sa réduction nécessite la mobilisation de tous les acteurs de la société et implique une bonne éducation pour la santé, l'amélioration de la qualité du suivi prénatal et celle des soins obstétricaux d'urgence.

Introduction. The objective of this study was to contribute to the study of adolescent maternal mortality. Methods. This was a retrospective descriptive and analytical case-control study, lasting three years. The retrospective data collection covered two (2) years from January 1, 2018 to December 31, 2019 and the prospective one over one (1) year from January 1, 2020 to December 31, 2020. Results. During the study period we recorded 38 cases of maternal deaths out of 16,175 live births, ie a ratio of 235 deaths per 100,000 live births. The death concerns an adolescent girl aged 18-19 (65.8%), married (63.2%), out of school (42.1%), and nulliparous (65.8%). The majority of adolescent girls had performed 1-3 ANC (44.7%), and had come from a peripheral maternity hospital (84.2%) and had given birth vaginally (78.4%). The most used mode of transportation was public transit (63.2%) The cause of death was dominated by hemorrhage (44.7%). The postpartum period was the most significant period of death (52.6%). Conclusion: Maternal mortality is a major health problem in our country, its reduction requires the mobilization of all actors in society and involves good health education, improving the quality of prenatal care and that of obstetric care emergency

Violences sexuelles à l'hôpital Donka (Guinée)

Introduction. L'objectif de ce travail était de déterminer la prévalence, le profi l épidémiologique et clinique des victimes de violences sexuelles prises en charge au Centre Hospitalo-universitaire de Donka. Méthodes. Il s'agissait d'une étude rétrospective de type descriptif qui s'est déroulée du 01 Janvier2015 au 31 Décembre 2017à l'unité de médecine légale. Résultats. Sur un total de 1937 cas constituant l'ensemble des consultations en victimologie, 16% étaient descas de violence sexuelle.L'âge moyen des victimes était de 8 ansavec des extrêmes de 5 et 56ans et un écart type de 10,79.Dans la majorité des cas, l'agresseur était connu de la victime mais ne faisait pas partie de l'entourage familial direct (52,6%). Les victimes ont consulté majoritairement au cours des 5 premiers jours (55,8%) avec des extrêmes de 8heures et 30jours.Il s'agissait dans la majorité des cas des défl orations anciennes (54,2%). Conclusion : Nos résultats ne sauraient refl éter exactement l'ampleur du phénomène car la majorité des victimes préfère pour une raison ou une autre taire leur drame

Cerebrovascular accidents indicative of COVID-19 infection: about 4 observations in Guinea.

INTRODUCTION: Coronavirus is a virus with potential to target the nervous and respiratory systems. The aim of this work is to establish the prevalence of strokes in COVID19 positive patients in Guinea. METHODS: All patients with stroke confirmed by brain imaging and COVID-positive PCR were included in this study. Retrospective patient data were obtained from medical records. Informed consent was obtained. RESULTS: The RT-PCR confirmed the initial diagnosis and the chest CT scan provided a good diagnostic orientation. Brain imaging identified ischemic brain lesions. We report the case of four patients with stroke and a COVID-19 incidental finding in Guinea. CONCLUSION: This work shows that the onset of ischemic stroke associated with COVID-19 is generally delayed, but can occur both early and late in the course of the disease. More attention is needed because the early symptoms of viral attack are not just pulmonary.