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Search Results: 1 - 10 of 1684 matches for " Dossou Gilbert Avode "
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Factors associated with stroke direct cost in francophone West Africa, Benin example  [PDF]
Dieu Donné Gnonlonfoun, Thierry Adoukonou, Constant Adjien, Emma Nkouei, Dismand Houinato, Dossou Gilbert Avode, Pierre Marie Preux
World Journal of Neuroscience (WJNS) , 2013, DOI: 10.4236/wjns.2013.34039

Background: In sub-Saharan Africa, stroke constitutes a public health issue. Few studies were conducted to assess the cost involved in its treatment. Objective: To determine the factors involved in direct cost of stroke in Cotonou-Benin. Method: It consists in a transversal and prospective research of economic type with analytical and descriptive aim. It was conducted from 20thFebruary 2011 to 30thSeptember 2011. The research dealt with 122 stroke patients. With regard to the economic approach, bottom-up was the data collection technique which was adopted. Cost was estimated not only based on the patient himself/herself but considering societal aspect. Cost estimation period was hospitalization period. Data analysis was conducted via software such as Epi info and SPSS. Results: Overall expenses in terms of direct cost varied from $144.9 to $9393.9; average expenses were $1030.1 ± $101.7. Patients aged 50 and above had higher stroke hospitalization cost ($1277.4) than those aged below 50 ($857.4) p = 0.001; male patients made more expenses than females (FCFA 1157.5 against $831.8) p = 0.01; direct cost of stroke was increased in proportion to neurological deficit (score NIHSS) p = 0.043. This cost was higher in cases of hemorrhagic stroke than ischemic stroke (FCFA $1375 against $1098) p = 0.002. Stroke direct cost was also increased in proportion to severance of disability level of patients. Stroke type (hemorrhagic) and RANKIN score were firmly correlated to stroke hospitalization cost. Conclusion: Stroke is very expensive for patientsin Benin and they constitute a burden for both patients and their family. There is a great need to increase awareness regarding risk factor control in order to reduce the cost involved in treating this malady.

Post-Stroke Cognitive Disorders and Associated Factors in French Speaking West Africa, Benin Case  [PDF]
Dieu Donné Gnonlonfoun, Paul Macaire Ossou-Nguiet, Lansana Laho Diallo, Constant Adjien, Isaac Avlessi, Gérard Goudjinou, Octave Houannou, Dismand Houinato, Gilbert Dossou Avode
Neuroscience & Medicine (NM) , 2014, DOI: 10.4236/nm.2014.51006

Introduction: Cognitive disorders frequency arising after a cardio-cerebral vascular disease (stroke) is currently on the rise due to the ageing population and the increase in the number of survivors after stroke occurrence. Objective: Determining post-stroke cognitive decline and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study which was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. The study involved 100 patients who have known stroke for at least the past 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. The cognitive decline (CD) was estimated by using a modified and adapted MMSE to suit our cultural era. Results: All patients were aged 58.9 years ± 13.6 years. Sex-ratio was 1.4. Cognitive decline frequency was 20%. Post-stroke cognitive decline frequency per sex was 11.6% and 8.4% respectively for females and males. Ischemia stroke patients had a higher cognitive decline (22.5%). 58.3% had severe CD. Moreover the CD frequency increased with time, from 16.7% in a year to 50% in 3 years. Total MMSE varied from 6 to 23 with 21 as median. From the unvaried analysis, the presence of sphincter disorders (1.26 [0.35-4.59], p = 0.004), consciousness disorders (15.67 [1.46-168], p

Stroke after Hospitalization: Assessment of Functional Prognosis through Disability and Dependency in CNHU-HKM, Cotonou, Benin  [PDF]
Dieu Donné Gnonlonfoun, Paul Macaire Ossou-Nguiet, Lansana Laho Diallo, Constant Adjien, Isaac Avlessi, Octave Houannou, Gérald Goudjinou, Jocelyn Acakpo, Dismand Houinato, Dossou Gilbert Avode
Neuroscience & Medicine (NM) , 2014, DOI: 10.4236/nm.2014.53017

Introduction: Stroke results in severe disability, with impacts that are sometimes socially, emotionally or professionally dramatic and also dramatic for the cost involved in care and treatment. Objective: Assessing the functional prognosis after hospitalization and identifying associated factors. Method: It consisted in a cross-sectional, prospective, descriptive and analytical study that was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. It involved 100 patients who have known stroke for at least 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. Disability and dependency were then measured respectively with the Rankin score and Barthel index. The STATA/IC11.0 statistical software was used as the basis for data analysis. Unvaried and multi-varied analyzes helped to identify associated factors. Results: The overall disability and dependency rates were respectively 69% and 57.7%. And the highest rate of disability (38.8%) was observed between 50 and 60 years old. However, dependency prevalence was higher in subjects above 70 years old (37.3%). Regarding gender, the prevalence of disability was 59.2% in men and rather 41.5% in women. Predictors of disability and dependency were paralysis on admission (IC95% = 0.26 [0.77 - 0.92]; p = 0.036), obesity (IC95% = 0.26 [0.77 - 0.92]; p = 0.012) and monthly income lower than 70$US (IC95% = 0.05 [0.01 - 0.56]; p = 0.015). Conclusion: This study enabled us to assess the functional outcome of patients once discharged. The significance of motor deficit on stroke occurrence, obesity and the low monthly income were factors of poor functional prognosis.

Prevalence of Dementia and Its Associated Factors in Cotonou Teaching Hospital, Benin  [PDF]
Dieu Donné Gnonlonfoun, Constant Adjien, Paul Macaire Ossou-Nguiet, Lansana Laho Diallo, Octave Houannou, Jocelyn Acakpo, Gérard Goudjinou, Dismand Houinato, Dossou Gilbert Avode
Advances in Alzheimer's Disease (AAD) , 2014, DOI: 10.4236/aad.2014.32010
Abstract: Introduction: Dementia constitutes a public health hazard in developing countries. There is little data in the sub-Saharan region of African especially in Benin. Objective: Determining dementia hospitalization prevalence and identifying its associated factors in CNHU-HKM, Cotonou. Method: It was a cross-sectional, prospective, descriptive and analytical research conducted from October 2012 to July 2013 in the neurology department; it involved 251 patients aged 50 and above. Dementia screening was conducted using a modified and adapted Mini Mental Scale Examination (MMSE). Dementia clinical and etiological diagnoses were respectively conducted based on DMS-IV and HACHINSKI criteria. Results: Patients were averagely aged 60.9 ± 8.1. Sex ratio (Male/Female) was 1.07. Dementia prevalence was 8.8%. This rate increased proportionally with age, from 5.3% with patients aged below 60 to 12.7% with patients aged above 60. Degenerative dementia was the most predominant type (50%). Following multi-varied analysis, smoking (RC = 6.05 [IC 95% = 1.26 - 29.38] p = 0.0001) and stroke past records (RC = 6.05 [IC 95% = 1.26 - 29.38] p = 0.001) revealed to be the factors associated with dementia. Conclusion: This research showed that dementia affects a significant part of the aging population in CNHU-HKM. It is imperative to combat its associated factors so as to defuse its prevalence.
Stroke: Medium and long-term mortality and associated factors in French-speaking West Africa, case of Benin  [PDF]
Dieu Donné Gnonlonfoun, Constant Adjien, Paul Macaire Ossou-Nguiet, Isaac Avlessi, Gérald Goudjinou, Octave Houannou, Jocelyn Acakpo, Dismand Houinato, Gilbert Dossou Avode
World Journal of Neuroscience (WJNS) , 2014, DOI: 10.4236/wjns.2014.41008

Introduction: Stroke is the leading cause of mortality and physical disability in sub-Saharan Africa. Objective: Determining medium-term and long-term mortality for stroke and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study that was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. It involved patients who have known stroke for at least 6 months, and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. Then, the number of deceased was systematically recorded with precision of death time-limit. Results: The overall mortality rate was 29%. Mortality was higher with patients over 70 years with a frequency of 57.1%. The medium-term mortality rate was 25% against 4% for long-term. The average time-limit for death occurrence after the vascular incident was 7 months ± 6.4 months. Prognostic factors of mortality were: the age of the patient (IC95% = 7.73 [1.49 - 39.99], p = 0.015 ), marital status (IC95% = 0.27 [0.08 to 0.94], p = 0.039 ) and the presence of aphasia (IC95% = 5.52 [1.45 to 20.94 ], p = 0.012). Conclusion: Stroke mortality still remains significant, even after the patients have been discharged from hospital. A good psychological family support and efficient aphasia coverage are essential for its reduction.

Doppler shift generated by diffraction gratings under time-dependent incidence angle near a Wood anomaly
Kokou B. Dossou
Physics , 2015,
Abstract: Diffraction gratings are famous for their ability to exhibit, near a Wood anomaly, an arbitrarily large angular dispersion, e.g., with respect to the incidence angle or wavelength. For a diffraction grating under incidence by a plane wave at a fixed frequency, by rotating the incidence angle at a given angular velocity, the field propagated by a nonzero diffraction order will rotate at increasingly fast angular velocity as the incidence angle approaches the angle where Wood anomaly occurs. Such a fast rotating diffracted field has the potential to generate a substantial Doppler shift. Indeed, under the assumption of a grating with infinite extent, the expression for the instantaneous frequency shift perceived by an observer, who is looking into the light radiated by the diffraction order, is derived and it is in full agreement with the prediction from an interpretation based on the Doppler shift generated by a rotation of light sources. In particular the classical (non-relativistic) Doppler shift can take arbitrarily high values as the incidence angle approaches a Wood anomaly. It is also found that gratings of a finite size can have a similar property. In order to have a physically detectable frequency shift, it is important to use a grating which can maintain a significant reflectance into higher diffraction orders near their Wood anomaly cut-off. Interestingly, we have found that the geometry of the nanostructures of a \emph{Morpho} butterfly wing scale is aptly suited for such a function because it can strongly reflect into higher diffraction orders while minimising the reflection into the specular order.
Modeling Time in Medical Education Research: The Potential of New Flexible Parametric Methods of Survival Analysis  [PDF]
Gilbert Reibnegger
Creative Education (CE) , 2012, DOI: 10.4236/ce.2012.326139
Abstract: Time – the duration of a certain process or the timing of a specified event – plays a central role in many situations in medical research. Waiting time analysis (“survival analysis”) is a field of statistics providing the tools for solving the unique problems of such studies. In particular, waiting time analysis correctly handles the typical positively skewed distributions of waiting times as well as censored observations on study subjects for whom the target event does not occur before data collection ends. For decades, non-parametric Kaplan-Meier analysis and semiparametric Cox regression despite some inherent limitations have dominated waiting time analysis in medical contexts, while parametric models, although in principle offering important theoretical advantages, were scarcely applied in practice because of lacking flexibility. Recently, however, new flexible parametric methods (Royston-Parmar models) became available offering exciting new research potential. Surprisingly, although medical education research deals with a range of typical problems suited for waiting time analysis, the methods were rarely used in the past. By re-analyzing data from a previous investigation on study dropout of medical students, this is the first study demonstrating the usefulness and practical applications of waiting time analysis with special emphasis on Royston-Parmar models in a medical education research environment.
The Canadian Policy on the Protection of Foreign Investment and the Canada-China Bilateral Investment Treaty  [PDF]
Gilbert Gagné
Beijing Law Review (BLR) , 2019, DOI: 10.4236/blr.2019.103021
Abstract: For a trading nation such as Canada, access to foreign markets has long been a key concern. In 2012, the Canadian government concluded a bilateral investment treaty (BIT) with China, so as to better protect Canada’s investments in this big expanding market. China’s communist regime, coupled with the importance of the country, has seemingly caused the Canada-China BIT to differ from the Canadian BIT model, both in terms of substantive provisions and the investor-state dispute settlement mechanism. Drawing on a legal-political analytical approach, the article: 1) looks at some key provisions on investment protection in the Canada-China BIT and 2) discusses the ways in which this BIT marks a departure in Canadian foreign investment policy. It also considers disagreements among legal scholars and commentators as to the implications of these differences, particularly with respect to the non-reciprocal character of the BIT to China’s advantage.
Frequency and Risk Factors of Complex Regional Pain Syndrome in Cotonou (Benin)  [PDF]
Martin Avimadje, Zavier Zomalheto, Hilaire Dossou-Yovo, Marcelle Gounongbe
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2014, DOI: 10.4236/ojra.2014.42014
Abstract: Aim: To determine the frequency and the risk factors of Complex Regional Pain syndrome (CRPS) in Cotonou (Benin). Patients and Méthod: This has been a transversal study carried out over 22 years on files of CRPS infected patients and submitted to rheumatologic consultation in the National Hospital University of Cotonou. Results: 73 out of 17,342 patients examined (0.42%) were suffering from CRPS. Those 73 patients (40 women, 54.8% and 33 men, 45.2%) were in average 54.66 years old and enjoyed an average duration of evolution of 5.79 months. The trauma (41 cases, 56.1%), the stroke (19 cases, 25%), the diabetes (8 cases, 11.3), were the main risk factors that were observed. CRPS was preferably located at the shoulder-hand (34.2%), shoulder (28.8%), wrist-hand (16.4%) and knee (11%). Inflammatory pain was observed in 55 cases. The treatment was dominated by griseofulvina (41 cases, 56.1%), antiinflammatory drugs (38 cases, 52%), analgesic (20 cases, 27, 3%), joint injection by betamethasone (17 cases, 27%). Conclusion: CRPS is not rare in our country. The first risk factor remains the trauma in rheumatologic consultation in Cotonou.
Influence of Metabolic Syndrome in Low Back Pain in Benin People  [PDF]
Zomalheto Zavier, Gounongbe Marcelle, Dossou-Yovo Hilaire
Open Journal of Rheumatology and Autoimmune Diseases (OJRA) , 2017, DOI: 10.4236/ojra.2017.73015
Abstract: Objective: To determine the frequency and impact of metabolic syndrome (MS) in patients with low back pain in rheumatology unit in Benin. Patients and Methods: Analytic cross-sectional study conducted between June and December 2016 in the rheumatology hospital unit of National Hospital University Hubert Koutoukou Maga of Cotonou. 82 patients with mechanical low back pain were selected. The prevalence of MS was defined using the criteria of the International Diabetes Federation 2005. The data were analyzed using epi data and SPSS17.0 software. Results: The mean age was 50.4 ± 14.9 [12 - 90] years. The sex ratio was 0.82. 29.3% patients have met diagnostic criteria for MS. The mean duration of back pain was 40 ± 17.2 [3 - 120] days. Diseases associated with low back pain were as follow: lumbar intervertebral disk degeneration (34.1%), disk herniation (13.4%), facet joint arthrosis (18.3%), degenerative spondylolisthesis (11%), degenerative lumbar spinal stenosis (6.1%) and related forms (17.1%). MS observed in 24 patients was characterized by the frequent association of abdominal obesity (24 cases), arterial hypertension (22 cases), HDL hypocholesterolemia (8 cases), hyperglycemia (12 cases) or hypertriglyceridemia (7 cases). The presence of the MS was associated with a decreased response to the medical treatment (p < 0.01). Conclusion: The MS is frequent in patients with low back pain in rheumatology unit at Cotonou and influence the treatment response. The management of these patients must be integrated into a multidisciplinary approach
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