bluuebunny/crossref_metadata_2025 huggingface dataset:
Tumeurs malignes de la cavité buccale et du pharynx : étude sur 11 ans au Centre Hospitalier de Soavinandriana, Antananarivo
Authors: Rakotoarivony AE , Rakotoarison RA , Razanakoto FA , Rakoto Alson S , Rakoto FA
Published: April 2024

The oral cavity and pharynx are the location of several diseases but cancer is the most redoutable. The objective of this work is to study the characteristics of malignant tumors of the oral cavity and pharynx. A retrospective study has been conducted during eleven years (January 2001-December 2011)at the “Hospital Center of Soavinandriana-Antananarivo”, from January 2001 to December 2011. We identified 28 cases with 12 men (42.9%) and 16 women (57.1%). Alcohol consumption and tobacco smoking were almost mentioned in males. The age group between 51 and 60 years was most involved (28.6%). The oral cavity was the main location (71.43%) compared to the pharynx (28.57%). Within the oral cavity, the tongue was the most affected site (17.8%) and oropharynx was the main location in the pharynx (14.3%). Carcinomas were the main histological type (82.1%). This pathology had poor prognosis. Delayed treatment significantly reduced patient survival. The management is multidisciplinary. In this study, the mortality rate was 10.7%, however this result is underestimated because of the existence of patients lost to follow up. According to this study, the typical case in our sample was a fifty years old woman, with carcinoma of the oral cavity and having had chronic consumption of alcohol and tobacco.
Facteurs de risque cardiovasculaire et données électro- cardiographiques à l’admission chez les patients victimes d’accident vasculaire cérébral à Brazzaville : à propos de 50 cas
Authors: Ondze-Kafata LI , Amounya-Zobo S , Amounya-Zobo M , Otiobanda GF , Ngolo K , Kimbally-Kaky G , Nkoua JL
Published: April 2024

Introduction. To evaluate the cardiovascular risk factors and the value of the resting electrocardiogram (ECG) in patients experiencing ischemic stroke. Methods and patients. This is a prospective and descriptive study in the Department of Neurology of the University Hospital Center in Braz- zaville, Congo between June 2011 and June 2012. Results. There were 33 men (66%) and 17 women (34%), mean age 60.6 ± 12.7 years (range = 20 to 85 years). There were 11 obese (22%) and 10 overweight patients (20%). Hypertension was found in 26 patients (52%), diabetes mellitus in 8 (16%), dyslipidemia in 4 (8%), and smoking in two patients. At the resting ECG, the rhythm was sinus in all cases. The mean heart rate was 78.7 ± 14.2 per minute (range 46 to 114). There was left ventricular hypertrophy in nine cases (18%), right ventricular hypertrophy in one patient, a left anterior hemi block in five cases (11.3%). Left bundle branch block, right bundle branch block, atrioventricular block and sinoatrial block were found in one case respectively. Left atrial hypertrophy was noticed in eight cases (16%), ventricular extrasystoles in three cases (6%), sequelae of infarction in three cases (6%) and electrical signs of myocardial ischemia in eight cases ( 16%). The location of this myocardial ischemia was anterior (n=2), inferolateral (n=2), inferior (n=1), anteroseptal (n=1) and anterolateral (n=2). The electrocardiogram was normal in 37 cases (74%). Conclusion. The ischemic stroke is life-threatening and could induce functional burden. Achieving a resting ECG is essential to find a cause for cardioembolic for adaptating the therapy.
Respect du calendrier vaccinal selon le programme élargi de vaccination au CSMIU de Moramanga
Authors: Randriatsarafara FM , Ralamboson S , Rakotonirina El-CJ , Rahoelison H , Ranjalahy RJ , Ratsimbazafimahefa RH
Published: April 2024

Introduction. Respecting vaccination according the expanded program of immunization is one of the most important in protecting children from target diseases. This study aims to describe this respect and to identify its determinants. Materials and methods. A cross- sectional and descriptive study was conducted in the CSMIU of Moramanga between the 10 of April and the 10 of May 2012 focuses on 366 children who have been to the vaccination service. Results. Three fourth (73.2%) has an immunization statute delayed. For the BCG 65% were lagging et 1,1% did not receive any dose of BCG ; non compliance of vaccination schedule increase about 10% passing from 32.8% to 43.2% between DTC Hep Hib P1 à DTC Hep Hib P3; For ATR, 7.5% of children are lagging . The most reported reasons for these delay are unavailability of the mother (28.9%) and the accessibility problem (22.9%). Factors associated significantly with non-compliance of the schedule are the single statut of the mother, low level of education of parents, low socio-economic level, home birth by traditional midwives and distance more than 5 kilometers between the place of residence and the health care facilities (p<10 ). Conclusion. To improve compliance, our suggestions include better sensitization for mother and a good quality of services.
Les carcinomes basocellulaires de la face : à propos de cinq cas malgaches
Authors: Razafindrakoto RMJ , Randrianandraina MP , Rakotoarisoa ANH , Razanakoto GFA , Rakoto FA
Published: April 2024

Introduction. Basal cell carcinomas are one of the most prevalent cancer type among white-skinned populations worldwide. They are noted frequently at sun-exposed sites, like head areas. Intense exposition with solar ultraviolet radiations is condemned in their etiopathogeny. Metastases are exceptional. The aims of this study were to establish the existence of facial basal cell carcinomas in Madagascar and to evaluate their management. Patients and methods. This is a retrospective study of facial basal cell carcinomas seen at the Ear, Nose and Throat Department at the Joseph Ravoahangy Andrianavalona Hospital in Antananarivo. Results. Our patients were aged 46 à 70 years (mean age= 52). There were three male and two female patients. Four patients underwent a wide surgical excision, and one albinos patient received radiotherapy. All patients came from the Highlands of Madagascar. The carcinomas were localized in the facial areas, but also in thorax and hands with the albinos patients. Diagnosis was confirmed by histopathological examination underwent with all patients. Conclusion. There are basal cell carcinomas among Malagasy people whose origins are Arabian, African and Asiatic (Indonesia and Ma- laysia). However, more research is needed to establish epidemiology of basal cell carcinomas in Madagascar.
Aspects tomodensitométriques des céphalées de l’adulte vues au Centre Hospitalier Universitaire Campus de Lomé, Togo
Authors: Sonhaye L , Kolou B , Tchaou M , Amadou A , Gbande P , Assih K , N’timon B , Adambounou K , Adjénou K , N’Dakéna K
Published: April 2024

Introduction. The purpose of this work is to determine the causes of headache and their aspects in computed tomography (CT). Methods. We conducted a cross-sectional descriptive study over a period of one year from 1 January to 31 December 2011 in the Radiology Department of the University Hospital and Medical Imaging Campus of Lome. Included were patients aged at least 16 years and who received a CT scan for headache. Other indications of cerebral CT were excluded. Results. During the study period, 1,160 brain CT were performed including 78 (6.7%) for headache. Clinically, the recent brutal headaches were found in 48.7% of cases (n=38) and progressive new headache in 29.5% of cases (n=23). The CT scan was normal in 35.9% (n=28), or in 13.1% (n=5) recent brutal headache, 21.7% (n=8) Recent progressive headache, 85.7 % (n=12) of cases of non-usual chronic headaches and 100% (n=3) cases of usual chronic headaches. The CT findings were represented by the subarachnoid hemorrhage in 11.5% (n=9), parenchymal bleeding in 11.5% (n=9), meningo-encephalitis in 11.5% (n=9), the facial sinusitis in 10.3% (n=8), the macro-pituitary adenoma in 7.7% (n=6), subdural hematoma in 7.7% (n=6) and hydrocephalus in 3.8% (n=3). Conclusion. This study shows that CT is usually normal in chronic headaches. The lesions found by CT - scan in acute headaches are dominated by subarachnoid hemorrhage and/or parenchymal.
Myélopathies cervicarthrosiques : aspects épidémiologiques et cliniques au Centre Hospitalier Universitaire de Cocody à Abidjan, Côte d’Ivoire
Authors: Diomandé M , Tano M , Kouakou ESCL , Djaha KJM , Eti E , Kouakou MN
Published: April 2024

Objective. Describe the epidemiological and clinical characteristics of cervical myelopathy at the university hospital center of Cocody in Abid- jan, Côte d’Ivoire. Materials and methods. A retrospective descriptive study was conducted in the department of Rheumatology of University Hospital Center of Cocody over a period of 5 years between January 2007 and December 2012. Twenty eight patients with cervical myelopathy were included. A structured questionnaire was used to select epidemiological and clinical data. Results. Hospital prevalence of cervical myelopathy was 0.75% or 28 cases among 3698 rheumatological diseases. Men predominated (n=21; 75%) with a mean age of 61.67 years. The average duration of the disease was 18 months. The complaints were signs of cervical spine (n=7; 25%) with an isolated neck pain (n=3; 10.7%) and cervico-brachial neuralgia (n=3; 10.7%), non-cervical spinal signs (n=8; 28.6 %) dominated by sciatica associated with gait disturbance (n=7; 25%) and non-spinal symptoms (n=13; 46.4%)] where gait disturbance (n=11; 39.6%)] predominated. Clinical examination revealed a stiff cervical spine (n=7; 25%) and radicular syndrom (n=39.28%), movement disorders (n=21; 75%) dominated by paraplegia (n=6; 21.42%) and tetraparesis (n=5; 17.87%), the disorders of the deep sensitivity (n=3; 10.71%) and genital and sphincter troubles (n=12; 42.3%). CT-scan and MRI of cervical spine were performed respectively in 71.42% (n=20) and 39.28% (n=11) of cases. Conclusion. The cervical myelopathy seems very rare in Abidjan and affects the elderly. Neurological signs are prominent. CT-scan and/or MRI are the imaging modality of choice.
Prise en charge des môles hydatiformes à l’Hôpital Universitaire Gynécologie Obstétrique de Befelatanana, Antananarivo
Authors: Rajaonarison JJC , Rakotondraisoa JM , Andrianampy HA , Randriambelomanana JA , Andrianampanalinarivo HR
Published: April 2024

Introduction. The hydatidiform mole is a cystic transformation of chorionic villi. It is a rare and poorly known precancerous condition. The objectives of our study were to determine the epidemiological and evolutionary profile and analysis support. Patients and methods. This is a prospective descriptive and analytical study carried out Befelatanana Obstetrics Gynecology University Hospital between 1 January and 31 December 2011. We followed all patients supported for hydatidiform mole to the negativity of ChorioGonadotrophine plasma hormone (HCG). Results. We collected 46 cases of hydatidiform mole on 9975 pregnancies supported during this period, a rate to 4.61 / 1,000 pregnancies. The average age was 25.5 years. These are first pregnancies in 32.6% of cases. The 39.13% of the patients were low socio-economic levels. Blood group O + was the most common (43.47%). The average term of diagnosis was 15 weeks amenorrhea. Curettage was the primary means of evacuation of the uterus (89.13%). 8% of cases followed evolved into a trophoblastic tumor. The average time of HCG plasma negativity was 3.9 months. Conclusion. The molar pregnancy for young low-income women in Madagascar. The high cost of histological diagnosis and monitoring of HCG plasma leads to delayed diagnosis of degeneration alter the healing nature of this highly metastatic tumor. An investment on the part of the State's financial management of this disease is sought.
Syndrome de la main diabétique tropicale : cas observés à l’Hôpital Universitaire Joseph Raseta de Befelatanana d’Antananarivo, Madagascar
Authors: Raherison RE , Raharinavalona SA , Ravololomanana N , Rakotomalala ADP , Randria MJD
Published: April 2024

Introduction. The tropical diabetic hand syndrome is less reported in the literature. It corresponds to hand infections in diabetic patients. This complication is more frequent in tropical countries and in Africa. It can cause severe injury involving the functional prognosis of the hand and the vital prognosis of the patient. The aim of this article is to describe the etiology, the clinical manifestations and the management of the hand infection in our diabetic to improve the prognosis of its patients. Patients and methods. This is a retrospective descriptive study of infections of the hand in hospitalized diabetics in the Endocrinology Unity of the University Hospital of Antananarivo Befelatanana from 1rst of January 2011 to 31rst of December 2012. Results. Nine cases of tropical diabetic hand syndrome were observed among 1296 hospitalized diabetics during the study period. The sex ratio Male/Female was 0.28. The average age of patients was 50.22 years (42 - 62 years). Four patients were manual workers and four other housewives. Five lesions (55,6%) were caused by trauma. The average period of hospitalization was 17 days (6 - 30 days). Four patients presented hand cellulitis, 3 with wet gangrene of fingers and 2 presented with paronychia. The average initial blood glucose was 4.21 g/L. The amputation rate was 55.6%. The average length of stay was 13.22 days (5 - 22 days). Conclusion. The characteristics of tropical diabetic hand syndrome in Madagascar look like those of other African countries. Patient educa- tion remains a key-point to avoid the occurrence and improve the prognosis of this complication.
La corrélation entre la variation des paramètres biologiques prothrombotiques et le diabète et ses complications vasculaires
Authors: Diouf NN , Boye O , Soumboundou M , Sylla-Niang M , Diatta A
Published: April 2024

Introduction. To study the routine parameters of coagulation and assess their relationship with microvascular complications after 5 years of development of type 2 diabetes. Patients and methods. A prospective cross-sectional study consisted of 50 type 2 diabetics (T2D) with presence or absence of microvascu- lar complications, older than 40 years whose disease was confirmed for at least five years and recruited consultation of Internal Medicine Department of General Hospital of Grand-Yoff and a control population consisted of 50 subjects free of diabetes and glucose intolerance. Results. The study population consists of 50 type 2 diabetics with a sex ratio which is equal to 1.94 and a mean age of 62.08 ± 9.74 years. The frequency of microvascular complications was 53.85%, 30.77% and 15.38% for retinopathy, peripheral arterial disease and nephropathy. Blood glucose, HbA1c, the fibrinogenemia, platelet counts and TCA patient / TCA control ratio were significantly higher in T2D than in controls (p <0.01). Raising the fibrinogenemia in T2D with microvascular complications compared with T2D without microvascular complications was statistically significant (p = 0.02, p<0.01). The OR was equal to 2.83 between T2D microvascular complications and microvascular complica- tions T2D and 4.75 between type 2 diabetics and controls. Conclusion. Thrombosis present in type 2 diabetes is much more common when it is accompanied by microvascular complications.
Prise en charge thérapeutique et évolution de la maladie de Kaposi dans les formations sanitaires de Bangui, République Centrafricaine (2006-2010)
Authors: Kobangué L , Fikouma V , Dibéré Kamba GD , Guéréndo P , Ngoazou C , Lénguébanga F , Yapoumandji B , Wali Y , Namdito P , Koffi B
Published: April 2024

Introduction. The aim was to evaluate the quality assessment of the management of Kaposi's sarcoma in accredited centers in Bangui. Patients and methods. It was a cross retrospective, study covering the period January 1, 2006 to June 30, 2010. We collected the outcome of patients treated according to therapeutic modalities. Results. The patients were HIV-positive in 94% of cases. Kaposi's sarcoma associated with HIV was not observed in 26 patients (6%). All patients infected with HIV were receiving antiretroviral treatment. Most patients (86.4%) had received a combination including two NRTI and one NNRTI, but chemotherapy was applied in 72.8% of people living with HIV. Chemotherapy with bleomycin was used in all patients not infected with HIV. The evolution was marked by the survival of 180 patients (41.2%); mortality was 37.5%. Patients were lost to the number of 93 (21.3%). Factors associated with death were visceral and obvious T0S1 and T1S1 group classification TIS. Conclusion. Kaposi's sarcoma has a high risk of mortality in hospitals in Bangui. The prescription of triple therapy including a protease inhibitor, in combination with chemotherapy for aggressive forms and the proper management of opportunistic infections will help to improve prog- nosis.
Faisabilité et avantages du traitement médicamenteux par misoprostol des avortements incomplets de moins de 12 semaines d’aménorrhée
Authors: Rainibarijaona LN , Rajaonarison TJ , Rakotomboahangy TM , Andrianampanalinarivo HR
Published: April 2024

Introduction. A complication of spontaneous abortion or termination of pregnancy, incomplete abortion remains a big problem for Malagasy women. The aim was to demonstrate the feasibility and benefits of drug therapy of the incomplete abortion under 12 weeks by using miso- prostol. Patients and methods. This is a retrospective descriptive transversal study from January 2007 to July 2007. During this period, we were able to identify 48 cases of which 41 were treated with misoprostol. Treatment consists of oral administration of 2 tablets of 200μg of misoprostol, sublingual, as a single dose with clinical and ultrasound control seven days after treatment. Results. In our study, 75.6% of patients were under 29 years and they are paucipares. They had an incomplete abortion under 9 weeks in 65.85% of cases. The reasons for consultation were dominated by bleeding. Ultrasound examination was revealed image of retention under 30 mm in 7.61% of cases and images of gestational sac were visualized in 7.31%. The control at the seventh day of treatment showed 97.56% of success. Conclusion. The use of misoprostol in the medical treatment of incomplete abortions is an alternative to surgical method. In equal effectivity with another method, it has the advantage of being easy to use, accessible and acceptable.
Profil de la variation de l’Albuminémie et de l’Albuminurie chez les diabétiques de type 2 en République Démocratique du Congo
Authors: Kabamba A , Kyandabike RK , Mulubwa J-JM , Kalubandika GM , Kalonda DM , Otshudi AL , Kalala ZL
Published: April 2024

Introduction. Kidney failure is a serious complication of diabetes type 2. The presence of albumin in urine is an important marker that should alert on kidney disease. The first detectable manifestation of diabetic nephropathy is the increase of albumin in urine. Our objective was to determine the profile of the serum albumin and albuminuria in patients with diabetes type 2 in a Congolese population. Patients and methods. This is a case-control study conducted from March 10 to June 8, 2015 in Lubumbashi ( DR Congo ) where assays of serum and urinary albumin were performed in cases consist of 30 type 2 diabetics older than 30 years ( group I) and in controls consist of 30 non- diabetic patients ( group II). The results obtained were compared in the two groups and the level of significance was set at p <0.05. Results. The average age of 30 diabetic patients (55 ± 6 years) was comparable to that of 30 controls (56 ± 3 years). The mean serum albu- min was 33.8 ± 3.66 g / L in group I against 38.12 ± 2.16 g / L in group II. A decrease in albumin in the blood was found in 53% of cases and no controls (p ≤ 0.05). The average of albuminuria was 36.7 ± 7.8 mg / 24 hours in group I while it was 32.2 ± 5.1 mg / 24 hours in group II. An increase in albuminuria was found in 23 % of diabetics against 7 % of controls (p ≤ 0.05). Conclusion. A decrease in serum albumin and a significant albuminuria have characterized diabetics patients with type 2 Congolese.
Évaluation de deux tests rapides de détection de l’antigène Hbs à Bangui
Authors: Mossoro-Kpindé CD , Camengo Police SM , Gbangba-Ngai E , Mossoro-Kpinde HD , Kamalo CG , Nembi G , Kamandji LF , Koffi B , Komas NP
Published: April 2024

Viral hepatitis B is a widespread disease in the world. The reference method for diagnostic is not available in all laboratories. The objective of this study was to assess two rapid tests for HBsAg detection: MINITEST® and ACUMEN®. It appears from this study that the two tests have 100% of sensitivity, 100% of specificity, 100% of predictive positive value and 100% of negative predictive value. The 2 tests respond well to all 6 criteria for evaluation released by the WHO: the quick results that appear within 5 minutes; the validity and accuracy with the sensitivity and specificity that are 100%; the minimum volume of sample required is 50 μl; the nature of the sample which can be serum, plasma or whole blood; tests are easy to use in one step without the need for specialized equipment; reagents are stable, can be stored at + 2° to + 30° C. The two tests are reliable, easy to use but a study with a large number of samples is needed.
Que dire du pneumothorax tuberculeux au CHU de Toamasina ?
Authors: Razafindrakoto L , Razafindrafara HE , Ratobimanankasina HH , Rakoto Sedson RO , Valisoa Andrianjafimamy T , Razafinjato R , Andriamihaja R , Andrianarisoa ACF
Published: April 2024

Introduction. The goal of our study is to determine the clinico-biological, treatment and evolving aspect of the secondary spontaneous pneumothorax of pulmonary tuberculosis at the CHU Toamasina. Patients and methods. We conducted a retrospective study from October 1st 2012 to October 30th 2014 in the Pneumo-Phtisiology service of CHU Toamasina. Results. We collected 13 cases (3,06%) of pulmonary tuberculosis complicated of peumothorax on 424 cases treated during this period. Sex ratio was 3,33 in favor of men, the mean age is 32,9 years. The brutal chest pain and dyspnea were the most frequently found. A severe clinical symptom with respiratory distress was found in 30,76% of cases; active smoking in 46,15%. The radiography showed hydro- pneumothorax image in 38,46% of cases, a partial pneumothorx in 46,1%. A unilateral localisation was in all cases.The evolution under treatement by exsufflation was favorable in the majority of cases. We deplored two cases of death by suffocant pneumothorax in the midst of the evolution. Conclusion. The risk of secondary spontaneous pneumothorax during the evolution of pulmonary tuberculosis is real. The needle exsuffla- tion's technic is an emergency simple gesture that deserves to be known by any doctor, to prevent death by pneumothorax complications. The early treatment of pulmonary tuberculosis cases would prevent the occurence of secondary pneumothorax related on the importance of pulmonary parenchymal lesions.
Profil bactériologique de l’infection urinaire gravidique (Cas de l’hôpital Bonzola à Mbujimayi en RD Congo)
Authors: Kadima Mutombo C , Mumba Mukandila A , Biayi Mikenji J , Ntambwe Katumbayi G , Mulowayi Kashi F
Published: April 2024

Introduction. Determine the bacteriological profile of urinary infection during pregnancy in our midst. Patients and methods. This descriptive and cross-sectional study was conducted at the maternity Bonzola from 13 March to 31 May 2015. Prevalence and bacterial susceptibility parameters were studied using the software Epi Atlanta7.1.1.14 (CDC, USA, 2013). L'association be- tween parameters studied was made using the chi square test and Pearson failing Yates corrected and the difference was considered significant for p <0.05. Results. The prevalence of urinary tract infection during pregnancy was 66.36% with a predominance of cystitis (43.66%) followed by asymp- tomatic bacteriuria (36.62%). Escherichia coli (53.5%) and Staphylococcus (30.98%) alone or in combination with Candida albicans were the main isolates proved very resistant to penicillins and certain third generation cephalosporins (Cefotaxine). Conclusion. The frequency of urinary tract infection during pregnancy that remains the highest in our midst and bacterial epidemiology re- mains dominanated by enterobactereriaceae. Antibiotic resistance is high especialy for penicillin G and cephalosporins of the third generation.
Prise en charge chirurgicale de la grossesse extra utérine au Centre de Maternité et de Néonatologie de Tunis (CMNT)
Authors: Achour A , Gabkika BM , Boudeya F , Gharsa A , Chelli D , Sfar E
Published: April 2024

Introduction. Much progress has been made in recent years to improve the management and prognosis of ectopic pregnancy. Surgical management techniques are still subject of interrogation about surgical approach, and conservative or radical attitude for uterine tube. The goal of our study was to describe the surgical management of ectopic pregnancy. Patients and methods. This was a prospective and descriptive survey of seven-month period (January 1st, 2015 to July 31st, 2015) achieved at the service A of Tunis center of Maternity and Neonatology (CMNT). We included in our study all patients admitted for ectopic pregnancy and treated surgically. Were excluded those treated medically. The studied variables were: incidence, clinical and para clinical data surgical approach, conservative or radical attitude, and post operative issue. Data analysis was performed using the SPSS17.0. Results. Forty among 58 patients admitted for ectopic pregnancy were treated surgically (68.9%). Thirty-three patients (82.5%) received laparoscopic surgery. Four patients (10%) were treated by laparotomy. The radical treatment represented 87.5% of cases (n=35). Twenty-four patients (60%) had left hospital during the first two postoperative days. The outcome was favorable for all patients, no maternal death was recorded. Conclusion. The surgical management of ectopic pregnancy is still dominated by laparoscopic surgery. Radical treatment is often performed. Maternal prognosis is good with a short hospital stay for numerous patients.
Carcinome hépatocellulaire dans l’Ouest Algérien : profil épidémiologiques et clinico-pathologiques
Authors: Harir N , Zeggai S , Tou A , Yekoru Dj
Published: April 2024

Hepatocellular carcinoma is the most frequent primary liver cancer. Its prognosis is very severe. The objectives of this study were to establish the epidemiological profile, clinico-pathological for hepatocellular carcinoma in the region of Sidi Bel Abbes (west of Algeria). To do so, we conducted a retrospective epidemiological study of 2005 to 2014 including 56 cases of hepatocellular carcinoma diagnosed and monitored in gastroenterology and oncology services of the university hospital Abdelkader Hassani Sidi Bel Abbes. The average age of our patients was 62.35 years, the maximum frequency is represented with 32.14% (n= 18/56) in the age group [61-70 years] and a male predominance was observed (sex-ratio: 1, 32). The liver was cirrhotic (62.5%) (n=35/56) and most often the role of hepatitis B and C, and alcohol were predomi- nant (37.50% (n=12/32); 18.75%(n=6/32)). The hepatomegaly, ascites and right upper quadrant pain were the most frequent clinical represent 87.50% (n=49/56); 67.85% (n=38/56); 78.57% (n=44/56) respectively and tumor location was most often bilobiale. For a better under- standing of hepatocellular carcinogenesis mechanisms, further studies are needed.
Indications de l’amygdalectomie chez l’enfant au Centre Hospitalier de Soavianandriana, Antananarivo
Authors: Razanakoto GFA , Tsifiregna RL , Fare ATS , Andriamampionona GB , Rakotoarison RA , Rakotoarisoa AHN , Rakoto FA
Published: April 2024

Introduction. A tonsillectomy is the surgical removal of the palatine tonsils. This is a surgical procedure well known to the general public. The age of intervention is often delayed because of the reluctance of pediatricians and parents. The aim of our study is to educate practitioners on relevant indications for tonsillectomy in children. Patients and methods. This is a retrospective and descriptive study conducted in the department of otolaryngology Soavinandriana Hospital Centre for tonsillectomies performed from January 2009 until December 2013. Were included children up to 14 years and whose files were complete and usable. Results. We retained 95 files in 5 years. The mean age was 8.65 years. There was no gender predominance. The main indication was recurrent angina (n = 56 or 58.94% of cases), followed by difficulty in breathing tonsillar hypertrophy (n = 28 or 29.47% of cases). Conclusion. In the literature, the main indication was obstructive hypertrophic and tonsils, which includes obstructive sleep apnea syndrome. In this study, the indications were dominated by recurrent tonsillitis. The age of intervention was delayed relative to that of literature. Tonsillectomy is possible from the age of nine months according to the ANAES. The result is spectacular on the breath, sleep, food and school attendance. Large national multicenter scale studies are needed to know the reality of the indication of tonsillectomy in Madagascar.
Un régime hygiéno-diététique simplifié associé à la metformine améliore le syndrome métabo
Authors: Razafimahefa SH , Rabenjanahary TH , Rakoto Sedson R , Rivo Andriantahina JE , Rakotondravoavy LE , Ramanampamonjy RM , Rabearivony N
Published: April 2024

Introduction. The complications of metabolic syndrome are preventable. The aim of this study was to assess the effect of a non-standardized regimen and metformin on the metabolic syndrome and the risk of coronary artery disease. Patients and methods. Forty patients with metabolic syndrome were followed for 6 months while following a simplified regimen made up of a low-calorie, high-fiber diet, daily physical exercise and 850 mg of metformin. Results. After 6 months, metabolic syndrome was corrected in 29 patients out of 40. Each sign of the syndrome was improved : body mass index ≥ 25 kg/m2 (22/40), hypertension (10/18), hypertriglyceridemia (21/36), hypo-HDL cholesterolemia (27/36), hyper-LDL cholesterolemia (12/24), hyperglycemia (14/17), hyperuricemia (13/28) and abnormal C-reactive protein (17/20). Conclusion. This study showed a significant improvement in metabolic syndrome and a reduction in the risk for coronary artery disease after a simplified regimen and metformin.
Déterminants de l’allaitement maternel exclusif au CSBII d’Ambohitsoa, Antananarivo : étude cas-témoins
Authors: Andriamifidison NZR , Ravaoarisoa L , Randriatsarafara FM , Razafintsoa AM , Rakotonirina EJ , Ramangasoavina L , Andrianasolo R
Published: April 2024

Introduction. This study aims to identify the determinants of the choice of exclusive breastfeeding at CSBII Ambohitsoa. Patients and methods. This is a case-control study in which cases are defined as breastfeeding women practicing exclusive breastfeeding, and witnesses are made by breastfeeding women not practicing exclusive breastfeeding, two witnesses for a case. Results. The practice of exclusive breastfeeding practice is significantly determined by the male sex of the baby (OR = 2.9 [1.01 to 4.76]), higher of education (OR = 3.68 [1.14 to 11.86]), awareness of the exclusive breastfeeding (OR = 8.31 [2.33 to 29.63]), knowledge in the field of exclusive breastfeeding (OR = 26.46 [3.43 to 203.88]) and the right attitude on the exclusive breastfeeding (OR = 46 [14.36 to 150.06]). Conclusion. Indeed, if the relevant authorities and health workers take into account these variables, improving the practice of exclusive breastfeeding by all Malagasy women seems possible.
Evaluation de la bonne pratique des médecins sur la prescription des analyses dans le suivi du diabète
Authors: Ranaivosoa KM , Randriamanantany ZA , Raherinaivo A , Rasamindrakotroka A
Published: April 2024

Introduction. Data about clinical practice are rare in Madagascar. This study aimed to assess the physician’s practice about biological survey of diabetes mellitus. Patients and methods. This was a prospective and descriptive study during six months, from May 2011 to november 2011. We randomly chose 40 physicians from 400 who worked in private practice in Antananarivo. We did an interview among them in order to evaluate their habits of prescription about biological survey of diabetes mellitus. Results. We have excluded 5 physicians. The response rate was 87.5%. Among the 35 physicians, 12 have received less than 1 diabetic patient per month, 13 of them followed diabetic patients. Three of 13 physicians have treated their patients all the time; but 10 of them have refered their patients to specialists for particular reasons. Glycemia and creatininemia were the most prescribed parameters (84.61%), followed by cholesterolemia (61.54%) and glycated hemoglobin (46.15%). Conclusion. We found lack of knowledge concerning the international recommendations about biological survey of diabetes mellitus. Physicians need an update of their knowledge, and they have to follow postgraduate course in order to improve their practice.
Étude préliminaire épidémio-clinique des carcinomes hépatocellulaires observes au Centre Hospitalier Universitaire Tambohobe, Fianarantsoa
Authors: Ranaivomanana M , Rakotovao A , Fanantenantsoa R , Randrianiaina D , Razafimahefa HS , Rafaramino F
Published: April 2024

Introduction. Hepatocellular carcinoma is the most common cancer of the liver in adults. Often, it follows a cirrhosis caused by viral hepatitis B and C. Its management is difficult especially in sub-Saharan Africa. Our aim is to describe the epidemioclinical aspect of hepatocellular carcinomas at the University Hospital of Tambohobe, Fianarantsoa. Patients and methods. It is a retrospective descriptive study from january 2015 to may 2017 at the University Hospital of Tambohobe, Fiana- rantsoa. It included all patients over 15 years -old with a diagnosis of hepatocellular carcinoma. Results. Six patients were included. The sex ratio was 2 and the mean age at diagnosis was 49 years-old. All patients had serologic hepatitis B and C negative, one patient had a chronic alcoholism and one patient had consumed frequently groundnut. In 5 patients, serology of Schis- tosomiasis was positive. Abdominal pain was present for all patients. Conclusion. During our study, the presence of Schistosomiasis was noticed frequently in patients with hepatocellular carcinoma; non-viral causes of hepatic carcinoma would require more investigation in our region.
Les facteurs associés à une altération de la qualité de vie des patients atteints de pelade à Antananarivo, Madagascar
Authors: Ranaivo IM , Sendrasoa FA , Andrianarison M , Raharolahy O , Razanakoto NH , Rakotoarisaona MF , Ramarozatovo LS , Rapelanoro Rabenja F
Published: April 2024

Introduction. Alopecia areata (AA) is associated with psychological distress and poor health-related quality of life (QL). We aim to identify the factors associated with the deterioration of QL in AA patients seen in the University Hospital, Joseph Raseta Befelatanana. Patients and methods. A cross-sectional study was performed in the department of Dermatology in the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, between january 2013 and may 2015. It included 35 AA patients that were classified in 3 groups (G) according to the severity of hair loss: group 1 <25% hair loss (n=17); G2: 25-75% hair loss (n=9) and G3>75% hair loss (n=9). Results. The 35 AA patients (24 females and 11 males) had a mean age of 29.2 years-old. Seventeen patients (48.6%) reported stressful events 2 to 4 months before the onset of alopecia. Our patients had a mean Dermatology Life Quality Index (DLQI) of 9.11 with worse QL in daily activities. Our results showed that women have a more significantly altered quality of life than men (score DLQI 10.1 vs 6.9). No correla- tion was found between patient’s QL and marital status, occupation and the duration of AA progression. However, patients with alopecia universalis had the highest DLQI (DLQI=14), the difference was statistically significant compared to the other clinical forms (p=0.001). Conclusion. This study demonstrated that AA has a negative impact on mental and physical well-being, as well as on the interpersonal relationship. The impairment of patients' QL was mainly influenced by gender, age and clinical presentation of the alopecia areata.
Les réunions de concertation pluridisciplinaire d’oncologie dans les centres hospitaliers universitaires d’Antananarivo, Madagascar
Authors: Refeno V , Hasiniatsy NRE , Ramahandrisoa AVN , Ramanampamonjy RM , Rakotovao HJL , Rafaramino F
Published: April 2024

Introduction. The Multidisciplinary Meeting (MM) is an alliance between physicians and other healthcare professionals due to the existence of a medical record for a specific tumor in purpose to combine their individual abilities to give the best chances to the patient to treat. In Madagascar, there is no legal text about the MM in the management of cancer. With the initiative of the first participants, the oncology MM has started at Antananarivo in 1998. There is no previous study of this MM. The aim of our study was to report the activities of MM concerning the oncology in Antananarivo. Patients and methods. It was a retrospective, descriptive study, at 3 teaching hospitals of Antananarivo owning oncology department, from 1st january to 30th april 2014, including all cases presented in the MM concerning the oncology. Results. One hundred and seven cases were presented within 4 months, mainly divided between the weekly MM of thoracic oncology (n=24) and digestive oncology (n=16) and the daily MM of general oncology (n=62). The quorum was respected for 51 cases of 107 (47.66%). The most frequent cancer were digestive cancer (n=24), pleuro-pulmonary cancer (n=18) and breast cancer (n=16). The decision of the MM was specific treatment (n=58), more diagnostic investigations (n=28) and exclusive symptomatic treatment (n=14). The effectiveness of the deci- sion was unknown. Conclusion. The MM concerning oncology has started at Antananarivo, not mandatory, since 20 years, but many specialties did not partici- pate. This study is an initial picture which will serve us as reference for future studies assessing the evolution of our MM concerning the oncology.
Aspects épidémio-cliniques et étiologiques de l’insuffisance cardiaque du sujet jeune vue aux services de cardiologie du CHU Befelatanana d’Antananarivo
Authors: Ramiandrisoa LR , Randriamihangy NA , Ramilitiana B , Rakotoniaina DM , Rakotoarimanana S , Rabearivony N
Published: April 2024

Introduction. Heart failure is a public health problem that particularly affects older people in developed countries, contrasting with what happens in developing countries where the young population would be the most concerned. Aims. The aim of the study was to describe the epidemiologic, clinical and etiological aspects of heart failures in the young age from 18 to 45 years. Patients and methods. It was a cross-sectional descriptive study in the department of Cardiology and Intensive Care Unit of Cardiology at Befelatanana hospital in Antananarivo over a 18 months-period (from february 2014 to july 2015). Echocardiography was the essential criterion to enroll the patient in the study. Results. We enrolled 77 patients. It was 14.86% of all hospitalized heart failure patients. The mean age was 33.83 years. Heart failure wa congestive in 67 patients (87%). Echocardiography found dilation of the left ventricle in 57 patients (74%) and left ventricu lar systolic dysfunction in 58 patients (75.32%). The causes were: hypertension in 21 cases (27.3%), peripartum cardiomyopathy in 19 cases (24.6% ), valvular heart disease in 16 cases (20.2%), ethylic cardiopathy in 9 cases (11.7%), dilated cardiomyopathy with no cause found in 6 ca ses (7.8%), ischemic heart disease in 4 cases (5.2%), and congenital heart disease in 2 cases (2.6%). The hospital mortality was 19.4% (1 5 patients). Conclusion. Heart failure is a serious disease. It affects young and active population. So hypertension is one of the main diseases to manage in the public health.
Maladie de Wegener : difficulté diagnostique et gravité
Authors: Andrianasolo RL , Sendrasoa FA , Randremandranto RNS , Ramilitiana B , Razanaparany MMO , Rakotoarivelo RA , Randriamarotia WF , Randria MJD
Published: April 2024

Wegener’s granulomatosis is a systemic granulomatous vasculitis rare, particulary among black race. We report one case of Wegener’s granulomatosis revealed by chronic fever and rapidly progressive renal failure. There was no Ear-Nose-Throat (ENT) and pulmonary symp- toms. c-ANCA (specificity anti proteinase3) was strongly positive. In spite of high dose corticosteroids combined with a bolus of cyclophos- phamide, the outcome was fatal. Without the classic ENT and pulmonary manifestations, the diagnosis of Wegener’s granulomatosis is diffi- cult. The prognosis is unfavorable when there is a serious renal failure or a high rate of c-ANCA
Quid du cancer de primitif inconnu dans un pays en voie de développement ?
Authors: Razafimahefa SH , Rabenjanahary TH , Raberahona M , Rakotozafindrabe R , Ramanampamonjy RM
Published: April 2024

Carcinoma of unknown primary site constitutes 3-5% of all malignant tumors. Our aim is to report a case compatible with a cancer of unknown primary site and to discuss management of such tumors. A 40 years old female patient was admitted at gastroenterology ward with abdominal pain. She had no medical history. Abdominal ultrasonography showed multinodular liver and partial portal thrombosis. A peritoneal effusion and alteration of her general condition occurred rapidly. Research of primary site was negative. The patient died 5 months after the onset of the symptoms. Carcinoma of unknown primary site with liver metastasis has a poor prognosis. In Madagascar, where therapeutic resources are limited, the necessity of extensive work-up to identify the primary site is debatable in case of presumed liver metastatic localization of cancer.
Localisation et complication rare d’une infection à Streptococcus milleri
Authors: Rakotoarivelo RA , Razanaparany MMO , Rakotonirainy OH , Andrianasolo RL , Sendrasoa FA , Rakotoharivelo H , Randria MJD , Rapelanoro Rabenja F
Published: April 2024

Streptococcus milleri meningitis is relatively rare. Sinusitis complicated with isolated superior ophthalmic vein thrombophlebitis is uncommon. We report a case of S. milleri infection, with meningitis and sphenoid sinusitis complicated with right superior ophthalmic vein thrombophlebitis. S. milleri may be responsible of a serious infection, even for an unusual location.
Cancer du sein et maladie de Von Recklinghausen
Authors: Mseddi M , Abdelmaksoud W , Hariz W , Marrekchi S , Masmoudi A , Meziou TH , Boudaya S , Turki H
Published: April 2024

The association of neurofibromatosis type 1 (NF1) and breast cancer is rarely reported in the literature. Breast cancer can be attributed to NF1 (both BRCA1 and NF1 genes are located on the long arm of chromosome 17 and the highly risk of two linked mutations at the NF1 and BRCA1 loci). Breast cancer can be also fortuitous in NF1. We report the case of 36 year-old Tunisian woman, affected by both NF1 and breast cancer. The stage of cancer was T3N1M1. The patient was treated surgically (Patey’s intervention) followed by adjuvant chemotherapy. She had no other associated neoplasia.
Deux cas de loase importés à Madagascar
Authors: Rakotoniaina AI , Rabezanahary HM , Andrianarivelo AM , Razanakolona ML , Rasamindrakotroka A
Published: April 2024

Loiasis is a disease strictly African with limited distribution in the Western and Central African forest. To the best of our knowledge, no other cases of imported loiasis had been reported in Madagascar. We describe two cases of imported loiasis. Both cases had presented the subcu- taneous and conjunctival underpass of adult filaria. Calabar edema was present for the first patient and microscopy testing was positive for the second. Through the clinical signs and immigrant patients status or traveler, loiasis can be discussed.
Infarctus du myocarde inaugural d’une maladie de Horton
Authors: Rakoto Sedson RO , Randriamihangy NA , Raveloson HRF , Lagrange D , Aubin B , Rabearivony N
Published: April 2024

We reported a case of myocardial infarction revealing a temporal arteritis. A 78-year-old male presented with anterior myocardial infarction and fever. All the diagnostic criteria for temporal arteritis described by American College of Rheumatology were fulfilled. Treated initially with steroids associated with basic treatment of myocardial infarction, the management led to favorable clinical and biological outcomes. Rarely, temporal arteritis involves coronary artery. Corticosteroids therapy limits cardiovascular complications of myocardial infarction.
Allergies: la patate douce aussi...
Authors: Randriamanantany ZA , Randriantsara IJ , Rasamindrakotroka A
Published: April 2024

The prevalence of food allergies are increasing worldwide and the type of sensitization depends on the food ingested in each country. Here we report a rare case of allergy to sweet potato (Ipomoea batatas) in 9 years old boy, which consisted in an occurrence of severe asthma non -induced by effort, and of conjunctivitis. The diagnosis was made with a meticulous questioning, and by performing prick test with the native food. We could not perform a food challenge due to severity of symptoms occurring after ingesting sweet potato. Exclusion of sweet potatoes from his food leaded to a complete disappearance of symptoms.
Une observation d’un mésothéliome pleural malin sans notion d’exposition à l’amiante
Authors: Ndiaye El HM , Touré NO , Dia A , Ndiaye A , Diatta A , Thiam K , Ndiaye M
Published: April 2024

Malignant pleural mesothelioma (MPM) is a primary cancer of the pleura which is rare without exposure to asbestos. We report a case of MPM. Through this case the radiological and pathological progressive clinical features of this disease have been studied. A 58-year female patient without exposure to asbestos, presented with right chest pain, dyspnea, and cough. Examination revealed a pleural effusion syndrome. Puncture brought a sero-hematic liquid with leucocytes /mm3 1240 and 1010000 hematies /mm3. CT scan showed an irregular pleural thickening 12 cm on average. Thoracoscopy had revealed a mass of the cerebral basal parietal pleura and nodular and ne- crotic lesions on the visceral pleural. Histology and immunohistochemistry confirmed MPM, expressing AE1 / AE3 and cytokeratin 5/6. The staging showed no abdominal and brain secondary location. She received pleurodesis followed by chemotherapy. The evolution was marked by the death after 18 months of palliative care. MPM is a primary tumor of the pleura, very aggressive; the prognosis remains poor despite recent advances in the management. Our case illustrates the diagnostic difficulties and delay in the absence of the notion of exposure to asbestos.
Succession des complications graves chez un enfant traité pour un lymphome malin non hodgkinien
Authors: Rafaravavy NE , Rakotondrainibe T , Rakotomahefa ML , Raobijaona SH
Published: April 2024

The survival of children treated for cancers is improving. This requires a rigorous medical supervision of the side-effects of radiotherapy and chemotherapy. These side-effects can occur early or late even ten of years afterwards. Our aim was to report occurrence of two serious com- plications after chemotherapy for a malignant non Hodgkin’s lymphoma. A 6 years-old female patient has received chemotherapy for a non-hodgkin’s lymphoma. At the end of the treatment with anthracycline, she developed toxic cardiomyopathy. She recovered well under diuretic and angiotensin converting enzyme-inhibitor. Two years later, peritoneal tuberculosis occurred. Antituberculosis treatment was successful. An early management will improve certainly the future and survival.