Enhanced biodegradation of crude oil in soil by a developed bacterial consortium and indigenous plant growth promoting bacteria.

AIMS: This study aimed to develop an efficient, cost-effective and eco-friendly bacterial consortium to degrade petroleum sludge. METHODS AND RESULTS: Four bacterial strains belonging to genera Acinetobacter and Pseudomonas were selected to constitute three different consortia based on their initial concentration. The highest degradation rate (78%) of 1% (v/v) crude oil after 4 weeks of incubation was recorded when the concentration of biosurfactant (BS) producing isolate was high. Genes, such as alkB, almA, cyp153, pah-rhdGN, nah, phnAC and cat23 were detected using the polymerase chain reaction method and their induction levels were optimal at pH 7·0. A crude oil sludge was artificially constituted, and its bacterial composition was investigated using 16S rRNA gene amplicon sequencing. The results showed that the soil bacterial community was dominated by plant growth-promoting bacteria (PGPB) after crude oil treatment. CONCLUSIONS: Our findings indicate the decontamination of the crude oil contaminated soil was more effective in the presence of both the constituted consortium and PGPB compared to the presence of PGPB alone. SIGNIFICANCE AND IMPACT OF THE STUDY: This study showed that the PGPB (Taibaiella) present in petroleum uncontaminated soil can promote the soil decontamination. The addition of both efficient hydrocarbon-degrading and BS producing bacteria is also necessary to improve the decontamination.

[Factors associated to loss of follow-up in patients underwent antiretroviral therapy in an ambulatory HIV treatment center at Conakry]. / Facteurs associés aux perdus de vue des patients sous traitement antirétroviral dans un centre de traitement ambulatoire du VIH à Conakry, Guinée.

BACKGROUND: Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry. METHODS: A retrospective cohort study was conducted in HIV patients aged over 15 years and who receiving antiretroviral therapy. Between August 1, 2008 and July 31, 2015, all patients managed by the ambulatory treatment center of the Guinean Women Association against AIDS and sexually and transmissible infection were included. Loss of follow-up was defined as no follow-up visit within 3 months. Kaplan-Meier curves and multivariate Cox regression models were used to analyze factors associated with loss of follow-up. Analyses were performed by using Stata 13 software. RESULTS: 614 patients aged 36.3±11.2 years, mainly females (68.4%) and living in Conakry (80.5%) were included. Among them, 104 were loss to follow-up, corresponding to a proportion rate of 16.9% (95% CI: 14.2-19.7%) or 5.79/100 person-years. The results of multivariate analyses showed that factors independently associated with loss of follow-up were malnutrition (AHR=7.05; 95% CI: 2.05-24.27; P=0.002) and CD4 cells account at the initiation of AHR (2.35; 95% CI: 1.61-6.39; P=0.016) in patients with 201-350 CD4/µL and 5.83 (95% CI: 2.85-11.90; P<0.001) in patients with less than 150CD4/µL. CONCLUSION: Despite efforts of health care workers and free antiretroviral therapy, many patients were loss to follow-up. Multivariate analysis showed that malnutrition and low CD4 account were independently associated with loss to follow-up.

Diabetes and impaired fasting glucose in rural and urban populations in Futa Jallon (Guinea): prevalence and associated risk factors.

AIM: The authors present the results of the first survey conducted among the population of the Futa Jallon province in Guinea on the prevalence of diabetes mellitus (DM) and impaired fasting glucose (IFG) and associated risk factors for diabetes. METHOD: A random sample of the study population selected by cluster house sampling method included 1537 Guineans (807 women and 730 men) aged 35 years and above in urban (Labé) and rural (Fellö Koundoua-Tougué) areas. Participants were examined and administered a capillary whole blood glycemia test. RESULTS: The mean age of subjects was 49.4 years. Participation rate was 77%. Overall crude diabetes and IFG prevalence were 6.1% and 13.4%, respectively. The age-adjusted prevalence of diabetes using the standardized age distribution of Segi was 6.7% (95% CI: 5.5-7.9%). Subjects in the urban area had twice as much DM as in the rural area (OR 2.0, 95% CI: 1.3-3.2). Out of the 94 subjects with DM, 66 had no prior history of disease. Urban location, age, waist to hip ratio, excess waist circumference, hypertension, raised systolic and diastolic blood pressures were significantly positively associated with DM. In multivariate analysis, only age (P=0.002) and waist circumference (P<0.05) remained independently associated with DM. CONCLUSION: The prevalence of DM was higher than expected in urban and rural areas. The data support the conclusion that prevalence of DM is expected to increase with the aging of the population. The factors associated with diabetes are potentially modifiable. Therefore, primary prevention through lifestyle modifications may play a critical role in the control of DM.

Traditional birth attendant training for improving health behaviours and pregnancy outcomes.

BACKGROUND: Between the 1970s and 1990s, the World Health Organization promoted traditional birth attendant (TBA) training as one strategy to reduce maternal and neonatal mortality. To date, evidence in support of TBA training remains limited and conflicting. OBJECTIVES: To assess effects of TBA training on health behaviours and pregnancy outcomes. SEARCH STRATEGY: We searched the Trials Registers of the Cochrane Pregnancy and Childbirth Group and Cochrane Effective Practice and Organisation of Care Group (EPOC) (June 2006); electronic databases representing fields of education, social, and health sciences (inception to June 2006); the internet; and contacted experts. SELECTION CRITERIA: Published and unpublished randomized controlled trials (RCT), controlled before/after and interrupted time series studies comparing trained and untrained TBAs or women cared for/living in areas served by TBAs. DATA COLLECTION AND ANALYSIS: Three authors independently assessed study quality and extracted data. MAIN RESULTS: Four studies, involving over 2000 TBAs and nearly 27,000 women, are included. One cluster-randomized trial found significantly lower rates in the intervention group regarding stillbirths (adjusted OR 0.69, 95% confidence interval (CI) 0.57 to 0.83, P < 0.001), perinatal death rate (adjusted OR 0.70, 95% CI 0.59 to 0.83, P < 0.001) and neonatal death rate (adjusted OR 0.71, 95% CI 0.61 to 0.82, P < 0.001). Maternal death rate was lower but not significant (adjusted OR 0.74, 95% CI 0.45 to 1.22, P = 0.24) while referral rates were significantly higher (adjusted OR 1.50, 95% CI 1.18 to 1.90, P < 0.001). A controlled before/after study among women who were referred to a health service found perinatal deaths decreased in both intervention and control groups with no significant difference between groups (OR 1.02, 95% CI 0.59 to 1.76, P = 0.95). Similarly, the mean number of monthly referrals did not differ between groups (P = 0.321). One RCT found a significant difference in advice about introduction of complementary foods (OR 2.07, 95% CI 1.10 to 3.90, P = 0.02) but no significant difference for immediate feeding of colostrum (OR 1.37, 95% CI 0.62 to 3.03, P = 0.44). Another RCT found no significant differences in frequency of postpartum haemorrhage (OR 0.94, 95% CI 0.76 to 1.17, P = 0.60) among women cared for by trained versus TBAs. AUTHORS' CONCLUSIONS: The potential of TBA training to reduce peri-neonatal mortality is promising when combined with improved health services. However, the number of studies meeting the inclusion criteria is insufficient to provide the evidence base needed to establish training effectiveness.

[Long-term outcome of the adult onset craniopharyngiomas]. / Devenir à long-terme des craniopharyngiomes de l'adulte.

There is few published series dealing on the long-term outcome of the adult-onset craniopharyngiomas. We report the long term clinical, tomodensitometric and MRI data outcome of 35 (23 woman and 12 men) consecutive adult-onset cured for craniopharyngiomas between 1983 and 2002, and followed-up in Rennes University Hospital. The operation was performed via frontopterional approach in 59% and transphenoïdal approach in 41% of cases. Their age at the time of diagnosis was 44.7+/-15.1 years (21-74). The average postoperation follow-up was 7.4+/-7.0 years (0.1-19.1). Recurrence of tumour occurred in 8 patients (25.8%) and a tumor progression in 1 case. The delay of recurrence after initial surgery was 4.1+/-1.3 years (1.4-6.3). Two patients had 5 and 6 years treatment by growth hormone (GH), without tumor recurrence. The observed increase of weight after the surgical cure of craniopharyngiomas concerned 22 patients (63%). The average weight gain was 17.5+/-14.7 kg (1.5-58). In 7 cases (20%) neuropsychological disorders were noted, of which 2 with lost of professional activity. Three patients died. In conclusion the craniopharyngiomas recurrence is frequent and can appear in very prolonged deadlines after the initial surgery.

[Peripheral facial paralysis revealing HIV infection in black African populations]. / Paralysie faciale peripherique revelatrice d'une infection par le VIH chez le noir Africain.

INTRODUCTION: Peripheral facial paralysis (PFP), a frequent complication during infection with the human immunodeficiency virus (HIV), is a major cause of morbidity for these patients. The aim of this study was to show the place of unilateral PFP in the discovery of HIV infection in tropical areas. MATERIAL AND METHODS: This is a descriptive cross-sectional study with prospective data collection over a 12-month period, in the ENT departments of the Ignace Deen National Hospital and Neurology Hospital of the Sino-Guinean Friendship Hospital (CHU de Conakry). RESULTS: Of the 2517 patients received during the study period, 64 had PFP, a prevalence of 2.54%. HIV serology was performed in 56 patients, 24 of whom had a positive serological reaction, a prevalence of 42.86%. The young adult population was the most exposed, with an average age of 34.5 years. There were 9 men and 15 women, or a sex ratio of 0.6. In 70.83% of cases, the consultation period occurred between the 1st and 3rd week. Unilateral facial asymmetry and persistent opening of the palpebral fissure were the main clinical signs. A total of 75% of our patients were infected with HIV1. CD4 levels ranged from 175 to 400/mm3. All our patients had received PFP and HIV treatments. The evolution was marked by a complete recovery with no sequelae of PFP in 62.5% of cases. CONCLUSION: The occurrence of isolated PFP in apparently healthy adults should suggest seroconversion to HIV. The prognosis of these PFPs is often good despite the delay in diagnosis.

INTRODUCTION: La paralysie faciale périphérique (PFP), complication fréquente au cours de l'infection par le virus de l'immunodéficience humaine (VIH), constitue une cause importante de morbidité chez ces patients. Le but de cette étude était de montrer la place de la PFP unilatérale dans la découverte de l'infection par le VIH en zone tropicale. MATÉRIEL ET MÉTHODES: Il s'agit d'une étude transversale descriptive avec collecte des données prospective, sur une période de 12 mois, réalisée dans les services d'ORL de l'Hôpital National Ignace Deen et de Neurologie de l'hôpital de l'amitié Sino-Guinéenne (CHU de Conakry). RÉSULTATS: Sur les 2517 patients reçus en consultation durant notre période d'étude, 64 présentaient une PFP soit une prévalence de 2,54%. La sérologie VIH avait été réalisée chez 56 patients, dont 24 avaient eu une réaction sérologique positive, soit une prévalence 42,86 %. La population adulte jeune était la plus exposée, avec un âge moyen de 34,5 ans. Il s'agissait de 9 hommes et 15 femmes, soit un sex-ratio de 0,6. Le délai de consultation était, dans 70,83% des cas, situé entre la 1ère et 3ème semaine. L'asymétrie faciale unilatérale et la persistance d'ouverture de la fente palpébrale étaient les principaux signes cliniques. Au total 75 % de nos patients étaient porteurs du VIH1. Le taux de CD4 variait entre 175 et 400/mm3. Tous nos patients avaient bénéficié d'un traitement de la PFP et du VIH. L'évolution avait été marquée par la récupération totale et sans séquelle la PFP dans 62,5% des cas. CONCLUSION: La survenue d'une PFP isolée chez l'adulte apparemment en bonne santé, doit faire évoquer une séroconversion au VIH. Le pronostic de ces PFP est souvent bon malgré le retard diagnostic.

Associated tuberculosis and diabetes in Conakry, Guinea: prevalence and clinical characteristics.

SETTING: Anti-tuberculosis centres in Conakry. OBJECTIVES: To determine the prevalence of diabetes mellitus in patients with tuberculosis (TB), identify the associated risk factors and describe the clinical signs of the association of TB and diabetes. METHOD: A total of 388 patients with TB selected by simple random sampling from the register of cases diagnosed in Conakry were examined and administered a capillary blood glycaemia test to detect diabetes. RESULTS: Thirteen cases of diabetes were identified, giving a prevalence rate of 3.35% (95%CI 1.35-5.35). Four (31%) had not been diagnosed before the survey. The diagnosis of diabetes preceded that of TB by an average of 5 years (range 1-9 years). The clinical characteristics of TB (frequent exposure to infection, site and proportion of new and retreated cases) did not differ from one group to another. Increased age (P < 0.0001), obesity (P < 0.005), sedentary lifestyle (P < 0.0004), and previous family history of diabetes (P = 0.04) or obesity (P = 0.04) were significantly associated with diabetes. CONCLUSION: The prevalence of diabetes among TB patients is higher than previously estimated for Guinea. Because of frequent co-morbidity, systematic testing for diabetes among TB patients may be recommended, particularly if risk factors are present.

Herbal medicine and treatment of diabetes in Africa: an example from Guinea.

AIM: Use of medicinal plants is widespread in Africa, particularly in Guinea where oral transmission of practices is part of the social ritual. The purpose of this study was to determine the proportion of diabetic patients who use herbal medicine and identify the types of plants in use. Reasons for using herbal medicine and the formulations employed were also noted. METHODS: A questionnaire on use of herbal medicine was proposed to all diabetic patients hospitalized or consulting the Endocrinology Unit of the Conakry University Hospital between April 1 and June 30, 2003. RESULTS: A total of 397 patients responded; 33% declared they used herbal medicine. They proposed many motivations, sometimes in association: belief in its efficacy (74%), easy access to medicinal plants (70%), lower cost (48%), and search for complete cure of diabetes (37%). Hearing about a positive experience had convinced 78% of the users to use herbal medicine. The majority of the users were satisfied (85%). One or more clinical manifestations occurring concomitantly with use of herbs was observed in 23 patients (18%), particularly gastrointestinal disorders (n = 10) and skin problems (n = 8). Two cases of hypoglycaemia were noted. CONCLUSION: Herbal medicine plays an important role in anti-diabetes treatment in Guinea. This type of treatment should be based on scientific evidence but very few studies have been conducted. Conditions of use should be better defined and patients should be informed of potential adverse effects.

[Erectile dysfunction and diabetes in Conakry (Guinea): frequency and clinical characteristics from 187 diabetic patients]. / Dysfonction érectile et diabète à Conakry (Guinée): fréquence et profil clinique à partir de 187 observations.

Sexual dysfunction is frequent in the diabetic population. In Africa, medical care for erectile dysfunction is underprovided, profoundly altering the quality of life of the patients. We report the prevalence of erectile dysfunction in 187 diabetic patients followed in the department of Endocrinology of the Conakry teaching hospital. Prevalence was estimated from the French version of the International Index of Erectile Function (IIEF). Erectile dysfunction concerned 90 patients (48%) of whom a severe form was observed in 54%, a moderate form in 35% and a mild form in 12%. The patients who presented erectile dysfunction were significantly older, displayed longer duration of diabetes with more complications (sensorial neuropathy and macroangiopathy) and often took drugs for associated cardiovascular diseases. In 28% of the cases, erectile dysfunction was associated with a decline in libido and in 26% with ejaculation disorders. In conclusion, erectile dysfunction is frequent and severe among diabetic patients in Guinea. The medical staff plays an essential role to initiate early diagnosis, promote psychological support and provide medication, if possible.

[Floating elbows: anatomo-clinical aspect and review of treatment method]. / Coudes flottants: aspects anatomocliniques et l'analyse du traitement.

INTRODUCTION: Floating elbows are rare pathologies that cause a number of problems to manage. The current treatment tendency is surgical. The orthopedic treatment is a good management option when the technical plateau is limited. METHODS: We performed an 18-month prospective study that included patients with floating elbows. Two treatment methods were used and chosen following predefined indication criteria. The final evaluation was made on average 10 months (minimum 6 and maximum 18 months) according to the functional classification of the mayo clinic. RESULTS: In 18 months, we treated 8 patients with floating elbow, who were all victims of traffic accidents. On an anatomo-clinical level, real floating elbows accounted for 37.5% of all cases, the rest were derived pathologies. Among these derived pathologies, the association of diaphyseal fracture of the humerus with a lesion of one or both forearm bones represented 50% of the cases. Regarding skin condition, open fractures were present in 37.5% of all patients. At the final evaluation we obtained two unsatisfactory results in patient treated surgically. No orthopedic treatment achieved an excellent final result, but they ranged between good and fair. CONCLUSION: This study shows that the orthopedic treatment maintains its position as valid treatment for floating elbows. Nevertheless it is important to master the technique and recognize its limits.

INTRODUCTION: Les coudes flottants sont des pathologies rares qui posent assez de problèmes de prise en charge. La tendance actuelle du traitement est celle de la chirurgie mais le traitement orthopédique est un bon moyen quand on a un plateau technique limité. MATÉRIEL ET MÉTHODE: Nous avons fait une étude prospective de 18 mois qui consistait à faire la prise en charge des patients présentant des coudes flottants. Deux méthodes de traitement ont été utilisées avec des critères d'indication préalablement définis. L'évaluation définitive s'est faite en moyenne en 10 mois avec des extrêmes de 6 et 18 mois et selon la classification fonctionnelle de mayo clinic. RÉSULTATS: En 18 mois, nous avons traité 8 patients présentant des coudes flottants qui étaient tous des victimes d'accidents de circulation. Sur le plan anatomopathologique, les coudes flottants vrais représentaient 37,50% les autres étaient des dérivées. Parmi ces dérivées, l'association de la diaphyse humérale à l'un ou les deux os de l'avant bras représentait 50%. Par rapport à l'état cutané, 37,50% des patients avaient de fractures ouvertes au niveau de l'avant bras. A l'évaluation finale nous avons obtenu 2 mauvais résultats issus du traitement chirurgical, les autres étant des bons et moyens résultats. CONCLUSION: Cette étude montre à suffisance que le traitement orthopédique garde sa place dans le traitement des coudes flottants, mais il faut avoir la maitrise de la technique et connaître ses limites.

Les corps étrangers en otorhinolaryngologie : analyse de 192 cas au centre hospitalier universitaire de Conakry

Introduction. La survenue d'un corps étranger (CE) est un motif fréquent de consultation en ORL. Le but de notre étude était d'analyser les données épidémiologiques, cliniques et thérapeutiques des sujets porteurs de corps étrangers à l'Hôpital National Ignace Deen (CHU de Conakry). Matériels et méthodes. Il s'agit d'une étude prospective de type descriptif, étalée de Janvier ­à décembre 2015 (un an), portant sur tous les cas de corps étrangers des conduits auditifs externes et des voies aérodigestives supérieures colligés au service d'ORL de l'Hôpital National Ignace Deen. Nos variables d'intérêt étaient les données épidémiologiques, cliniques et thérapeutiques Résultats. Durant la période d'étude, 192 cas de CE ont été colligés parmi les 2177 consultations, soit une fréquence de 8,82%. L'âge des patients variait de 2 à 60 ans avec une prédominance des enfants de moins de 10 ans (42,71%). Le sex-ratio homme/femme était de deux. Le délai moyen d'admission était de 48h avec des extrêmes de 0 à 30 jours. Les circonstances de survenue des CE étaient représentées par les jeux dans 54,17 % des cas. Le conduit auditif externe était la localisation la plus fréquente (64,58%). La nature des CE était inorganique dans 76,56 % des cas et organique dans 23,44 % des cas. Tous les CE ont été extraits par la voie d'introduction, le plus souvent au fauteuil de consultation (90,10 % des cas). L'évolution a été favorable chez tous les patients. Conclusion. Les corps étrangers ORL constituent un motif fréquent de consultation et affectent surtout les enfants de sexe masculin.ils sont habituellement inorganiques et affectent surtout le conduit auditif externe. L'évolution est en règle favorable après extraction

Les pathologies ORL chez les sujets diabétiques : une étude de 281 patients à l'hôpital national Donka

Introduction et objectifs. L'association du diabète aux pathologies oto-rhino-laryngologiques est un fait classique. Cette association constitue par la difficulté thérapeutique et la gravité de ses complications, un problème clinique et thérapeutique. Notre étude avait pour but de décrire la prise en charge des pathologies ORL chez les diabétiques à l'Hôpital National Donka. Méthodologie. Il s'agit d'une étude transversale descriptive effectuée au mois de mai 2015. Elle a concerné tous les patients diabétiques vus en ambulatoires ou hospitalisés aux services ORL-CCF et d'Endocrinologie-Diabétologie de l'Hôpital National Donka, présentant un signe ORL et ayant accepté de participer à l'étude. Résultat. La prévalence des pathologies ORL chez les diabétiques était de 33%. Les sujets âgés d'au moins 56 ans étaient les plus représentés (75%) avec un écart type de 15 et des extrêmes de 2 et 90 ans. Les patients sans revenu étaient les plus atteints (58,6%). 78,9% des patients vivaient en zone urbaine. La quasi- totalité des patients ont été examiné en ambulatoire (92,9 %). Le diabète de type II a dominé la série (94,6%). L'hypertension artérielle représentait 51,6% des pathologies associées. L'hyperglycémie à jeun a été retrouvée chez 84,6% des patients (P=0,01). La rhino sinusite était la pathologie la plus fréquente (72,3%). Les antibiotiques, l'antalgique, la corticothérapie ont été les plus utilisés. Conclusion. Chez le sujet diabétique avec affection ORL, le diabète est le plus souvent mal contrôlé. La rhinosinusite est la pathologie la plus fréquente

[Hypertension: epidemiology and metabolic abnormalities in Foutah-Djallon in Guinea]. / Hypertension arterielle: epidemiologie et anomalies metaboliques au Foutah-Djallon en Guinée.

The objectives of this transverse study were to clarify the prevalence of the hypertension in Foutah-Djallon in Guinea, the influence of the environment (rural or urban areas) and to identify the associated metabolic abnormalities (AMA) (hyperglycaemia, weighty excess). 1537 subjects of 35 and more years old living in urban zones (Labé, n=886) and in rural areas (Fellö-Koundoua in Tougué, n=651), were selected by a cluster sampling, and examined between February 1st and March 31st, 2003.The prevalence of the hypertension (blood pressure: BP > or = 140/90 mm of Hg) was 43.6% in urban areas, 14.9% in rural areas (p < 0.001). The subjects living in urban areas had more often a weighty excess and were more sedentary. Among them, 3.6% presented an AMA (waist measurement > or = 95 cms in the man and > or = 88 cms in the woman, BP > or = 130/85 mm of Hg, and fasting capillary blood glycaemia > or = 1.10 g/l) against 0.3% in the subjects living in rural areas. These results confirm the important role of the changes of way of life (urbanization and sedentary) in the increase of the prevalence of the hypertension and the AMA in Africa. Appropriate programs educational sanitary in wide scale are indispensable.

Conditions d'utilisation et contrôle de qualité des lecteurs de glycémie capillaire au chu de conakry avec l'hemocue b glucose

Les objectifs de l'étude étaient de préciser les conditions d'utilisation et la fiabilité des résultats des lecteurs de glycémie utilisés par le personnel soignant au Centre Hospitalier et Universitaire (CHU) de Conakry. Chaque lecteur en utilisation (n=21) a été testé sur les mêmes prélèvements capillaires, en normoglycémie et en hyperglycémie par rapport à la valeur cible de référence : l'analyseur HemoCue B glucose®. Des données complémentaires ont été recueillies au près de chaque utilisateur qui a été ensuite soumis à une observation directe pendant qu'il effectuait une glycémie. Les appareils recensés étaient de la marque Life scan® (n=17) et Roche® (n=4). Le modèle le plus utilisé était le One Touch Basic® (n=7). En moyenne, les résultats rendus par les différents lecteurs de glycémies s'écartaient de la référence de 0,09 g/L (soit 9,7% de la valeur de référence) en normoglycémie et de 1,40g/l (soit 26%) en hyperglycémie. Les valeurs obtenues par 81% des lecteurs de glycémie étaient à plus de 15% de la valeur cible de référence. Aucun utilisateur n'employait les bandelettes de contrôle. Deux lecteurs étaient souillés de sang et aucun port de gants lors de la réalisation des glycémies n'a été observé. La formation des utilisateurs et un contrôle de qualité régulier des lecteurs de glycémies pourraient prévenir le risque induit de traitement inadapté ou de transmission nosocomiale d'infection