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Multiple Antihypertensive Therapy in Nephrology Practice  [PDF]
Yao Kouame Hubert, Doro Arouna, Guehi Monlet Cyr, Konan Serge Didier, Gnionsahe Daze Appolinaire
Open Journal of Nephrology (OJNeph) , 2017, DOI: 10.4236/ojneph.2017.73010
Abstract: Introduction: Hypertension (HT) can be the cause or consequence of chronic kidney disease. Its management often requires a multiple therapy due to its severity. Objective: To describe the profile of patients receiving a multiple anti-hypertensive therapy in nephrology practice. Materials and Methods: This was a prospective, descriptive study conducted in the department of Nephrology, Yopougon Teaching Hospital, from January 1 to October 31, 2016. We included all patients admitted to this department who had received at least three anti-hypertensive drugs. Results: Out of a total of 625 hypertensive patients admitted over the study period, we included 120 patients on multiple therapy, i.e. a 19% prevalence. HT was essential in 60% of cases, secondary to chronic glomerulonephritis (CGN) in 25%, to diabetes in 13.3% and to polycystic kidney disease (PKD) in 1.7%. The therapy consisted of the combination of 3 antihy-pertensive drugs in 36.7% of cases, 4 drugs in 49.2% and 5 drugs in 4.2%. The antihypertensive classes used were Calcium channel blockers (CCB) in 99.2% of cases, Diuretics (D) in 87.5%, Angiotensin Converting Enzyme Inhibitors (ACEI) in 70%, Centrally acting medication (C) in 66.7%, Angiotensin Receptor Blockers (ARB) in 25.8% and Beta-blockers (β-) in 6.7%. The main combinations were CCB + D + ACEI + C in 34.2% of cases, CCB + D + ACEI in 23.3%, and CCB + D + ARB + C in 12.5%. The combinations of antihypertensive drugs varied according to the cause of HT with a non-significant difference. Patient outcome was characterized by normal blood pressure in 64.2% of cases and normal renal function in 13.3%. The mortality rate was 17.5%. In multivariate analysis, stage 5 renal disease (p = 0.001), hypertensive retinopathy (p = 0.04) and hemoglobin level < 8 g/dl (p = 0.039) were associated with mortality. Conclusion: Multiple antihypertensive therapy, which is common in nephrology, is related to the severity of HT and not to its cause. We still use centrally acting drugs in combination with the other recommended classes, so as to achieve the target blood pressure.
Adherence Factors Affecting Kidney Transplant Recipient among Patients on Maintenance Haemodialysis in C?te d’Ivoire  [PDF]
Delphine Amélie Lagou, Albert Pessa Coulibaly, Luc Nigue, Weu Mélanie Tia, Monlet Cyr Guei, Mohamed Ibrahim Alex Moudachirou, Kan Clément Ackoundou-N’Guessan, Daze Apollinaire Gnionsahe
Open Journal of Nephrology (OJNeph) , 2017, DOI: 10.4236/ojneph.2017.73009
Abstract: Background: Kidney Transplantation is the best treatment for patients in end stage renal disease. It’s a new therapeutic approach for such patients in Cote d’Ivoire which is expected to develop. Aim: Determine the adherence factors affecting kidney transplant recipient among patients on maintenance haemodialysis in Cote d’Ivoire and point out possible obstacles to the development of this new practice in the country. Patients and Methods: This was a cross-sectional study carried out from May to June 2016 in the Haemodialysis Centres of Abidjan. Any patient aged ≥18 years, on haemodialysis for at least 6 months, who signed the inform consent were subjected to a questionnaire. None of the respondents had been transplanted. The subjects addressed in the document were sociocultural status, opinion related to kidney transplantation and willingness to be transplanted or not and the reasons. A statistical analysis was performed to determine factors associated with kidney transplantation desire. Results: We included 295 (71.53% males) patients, with a mean age of 44.53 ± 12.09 years. Among this population, 36.61% had a higher level of education, 70.85% were Christians, 66.44% lived with partners, 56.61% had no income and 74.92% were treated in Public Health Centres. The median duration on dialysis was 34 months. A total of 287 (97.29%) patients had already heard of kidney transplantation among which 149 (51.94%) for the first time after initiation of haemodialysis. There was 231 (78.31%) patients willing to be transplanted with only 91 (39.39%) of them having a potential living donors. The main motivations were the desire to stop dialysis (52.38%) and the search for a better quality of life (41.13%). Among the 64 (21.69%) patients unfavourable to renal transplantation, 45.31% raised its higher cost compared to haemodialysis. Duration on haemodialysis (>34 months) was significantly higher in patients willing to be transplanted compare to non-applicants (51.95% versus 37.50%, p < 0.04). Factors associated with renal transplantation willingness were younger age (<45 years) (OR = 2.14 CI: 1.12 - 4.06 p = 0.02), longer median duration on dialysis (>34 months) (OR = 2.12 CI: 1.15 - 3.88 p = 0.01) and the Christian religion (OR = 0.43 CI: 0.20 - 0.92 p = 0.03). Conclusion: Almost all patients on maintenance haemodialysis were willing to be transplanted. However, the rate of living donor remains insufficient. For the non-seekers, the high cost of the process remains the main obstacle to kidney transplantation. Transplantation should be given more attention and political
Emphysematous Pyelonephritis in a Black African Woman Managed with Antibiotics Alone  [PDF]
Kossi Akomola Sabi, Béfa Noto Kadou Kaza, Eyram Yoan Amekoudi, Jacques Vigan, Vicko Manou, Dazé Apollinaire Gnionsahe
Open Journal of Nephrology (OJNeph) , 2016, DOI: 10.4236/ojneph.2016.64019
Abstract: Introduction: Emphysematous pyelonephritis (EPN) is a severe, life-threatening infection of the renal parenchyma. This condition is characterized by the production of intrarenal and perinephric gas. In the world, the EPN is currently limited to case series reported. No cases have been described in black Africa. Aims: Related a first case of EPN diagnosed and treated in the University Hospital Center Sylvanus Olympio of Lomé in Togo. Observation: A 40 years old woman, with antecedent of diabetes presented pyelonephritis emphysematous class 2. She was treated successfully with antibiotic alone without using percutaneous drainage or nephrectomy. Conclusion: As reported in every case series, it was a young diabetic patient with a clinical features of acute pyelonephritis which CT scan had helped lay the EPN class 2
Edible Ectomycorrhizal Mushrooms Russula spp. of C?te d’Ivoire: Total Phenolic Content, HPLC-Profiles of Phenolic Compounds and Organic Acids, Antioxidant Activities  [PDF]
Kouamé Appolinaire Kouassi, Eugène Jean Parfait Kouadio, Kouakou Martin Djè, Ahipo Edmond Dué, Lucien Patrice Kouamé
Journal of Agricultural Chemistry and Environment (JACEN) , 2016, DOI: 10.4236/jacen.2016.52008
Abstract: The aim of this study was to investigate the phenolic compounds content, HPLC-profiles of phenolic compounds and organic acids, and also antioxidant activities via the ability to scavenge DPPH radical of three wild edible mushrooms belonging to Russula genus and being collected in center of C?te d’Ivoire. Total phenolic compounds, flavonoids and tannins contents of methanolic extracts were assessed by colorimetric assays. So, the obtained values of these chemical parameters ranged from 394.05 to 513.50 mg/100 g DW, 94.50 to 139.95 mg/100 g DW and from 124.20 to 165 ± 0.54 mg/100 g DW, respectively. Otherwise, HPLC-profiles of the methanolic extracts revealed that quercetin, salicylic acid and tannin ol were the main phenolic compounds in R. delica whereas R. lepida contained gallic acid, catechin and protocatechuic acid as main phenolic compounds. Besides, it showed that the phenolic compounds such as salicylic acid, tannin ol and catechin were observed in R. mustelina. As for HPLC-profiles of organic acid, the fumaric and malic acid were recorded as the main organic acids in the three species of wild edible mushrooms. However, citric acid content was found to be highest in R. lepida. The methanolic extracts of the three mushrooms exhibited high DPPH radical scavenging activities ranging from 74.92% to 58.92%. These wild edible mushrooms could be considered a potential supply source of adequate natural antioxidant for local population.
Metagenomic Analysis of RNA Viruses in a Fresh Water Lake
Appolinaire Djikeng, Ryan Kuzmickas, Norman G. Anderson, David J. Spiro
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0007264
Abstract: Freshwater lakes and ponds present an ecological interface between humans and a variety of host organisms. They are a habitat for the larval stage of many insects and may serve as a medium for intraspecies and interspecies transmission of viruses such as avian influenza A virus. Furthermore, freshwater bodies are already known repositories for disease-causing viruses such as Norwalk Virus, Coxsackievirus, Echovirus, and Adenovirus. While RNA virus populations have been studied in marine environments, to this date there has been very limited analysis of the viral community in freshwater. Here we present a survey of RNA viruses in Lake Needwood, a freshwater lake in Maryland, USA. Our results indicate that just as in studies of other aquatic environments, the majority of nucleic acid sequences recovered did not show any significant similarity to known sequences. The remaining sequences are mainly from viral types with significant similarity to approximately 30 viral families. We speculate that these novel viruses may infect a variety of hosts including plants, insects, fish, domestic animals and humans. Among these viruses we have discovered a previously unknown dsRNA virus closely related to Banna Virus which is responsible for a febrile illness and is endemic to Southeast Asia. Moreover we found multiple viral sequences distantly related to Israeli Acute Paralysis virus which has been implicated in honeybee colony collapse disorder. Our data suggests that due to their direct contact with humans, domestic and wild animals, freshwater ecosystems might serve as repositories of a wide range of viruses (both pathogenic and non-pathogenic) and possibly be involved in the spread of emerging and pandemic diseases.
Case Study of Pollutants Concentration Sensitivity to Meteorological Fields and Land Use Parameters over Douala (Cameroon) Using AERMOD Dispersion Model
Pascal Moudi Igri,Derbetini Appolinaire Vondou,Fran?ois Mkankam Kamga
Atmosphere , 2011, DOI: 10.3390/atmos2040715
Abstract: This paper deals with the simulation of the NOx concentration over Douala for the period 2002–2006 by means of the American Meteorological Society (AMS)/Environmental Protection Agency (EPA) Regulatory Model (AERMOD) model, version 07026. Its sensitivity to local meteorological fields and land use parameters are investigated by selecting different buildings (receptors) specific direction and distance from the source and by making changes in land use parameters. Results reveal variations in concentration patterns depending on the roughness length, albedo and the Bowen ratio. Changes in the albedo as well as the Bowen ratio only alter the concentration patterns during convective conditions. For a short averaging time, changes in albedo and Bowen ratio have the same effects on the concentration patterns. These results not only help to accurately choose the indicated areas for implanting industrial sites, to manage risk assessment exposure to pollutants in Douala city and addressing recommendations to policies makers.
Carcinomes hépatocellulaires en milieu africain burkinabè: Contribution de l’échographie à propos de 58 cas
N Zakari, S Appolinaire, KC Gilberte, C Rabiou
Pan African Medical Journal , 2010,
Abstract: Introduction : Décrire les différents aspects échographiques de carcinome hépatocellulaire (CHC) et préciser l’apport de l’échographie dans le diagnostic des CHC dans le contexte burkinabè. Méthodes : étude prospective descriptive de 12 mois, réalisée dans les services de médecine interne et d’imagerie médicale du CHU Souro Sanou de Bobo Dioulasso, portant sur 58 patients ayant un CHC. Tous les patients ont bénéficié d’une exploration échographique abdominale et dans certains cas d’un dosage du taux d’alpha-foetoprotéine et d’un examen histologique hépatique. Les caractères échographiques des tumeurs et les signes extra tumoraux associés ont été notés. Résultats : Cinquante huit patients d’age moyen de 45,6 ±12,5 ans (extrêmes 22-77 ans), avec une nette prédominance masculine (n=44) étaient inclus dans l’étude. Le retard diagnostic était de plus de 3 mois dans 50,7%. L’échographie décrivait des grosses tumeurs (69% des cas), multinodulaires (67,2%), à majorité hyperéchogènes (70,7%). Cinq formes pseudo suppuratives étaient notées (8,7%). L’ascite (60,3% des cas) et la thrombose portale (56,8%) étaient les signes extra-tumoraux les plus fréquents. La thrombose cave inférieure (n=1) était rare. L’alpha-foetoprotéine était significativement élevée chez 10 patients (43,5%). L’examen histologique (n=20) décrivait un CHC chez 18 patients (90%). Conclusion : Au Burkina Faso, le CHC est multinodulaire, hyperéchogène et de grosse taille avec une forme particulière pseudo abcédée. L’imagerie échographique est un examen complémentaire indispensable décrivant des aspects presque pathognomoniques du CHC. Toutefois, son association à l’histologie est plus utile que le dosage de l’alpha-foetoprotéine dans le diagnostic des CHC.
Erectile Dysfunction in Hemodialysis in Togo  [PDF]
Kossi Akomola Sabi, Béfa Noto Kadou Kaza, Eyram Yoan Amekoudi, Jacques Vigan, Souleymane Pessinaba, Kafui Avouwadan, Kodjo Tengue, Tchilabalo Matchona Kpatcha, Dazé Apollinaire Gnionsahe
Open Journal of Nephrology (OJNeph) , 2016, DOI: 10.4236/ojneph.2016.64018
Abstract: Objectives: To determine the prevalence and risk factors of erectile dysfunction (ED) in men on hemodialysis in Togo. Methods: Prospective cross-sectional study, descriptive and analytical ranging from December 2015 to February 2016 in the hemodialysis unit of CHU SO, only dialysis center in the country. The evaluation of the ED was made through IIEF-5 questionnaire. Results: 39 men (67.2%) of 58 hemodialysis is a sex ratio M/F of 2.05. The average age was 43.5 years with extremes of 25 and 59 years. The majority of men had a profession in 19 cases (48.7%). The mean duration of dialysis was 30 months with a range of 4 months and 90 months. Initial glomerular nephropathy was in 19 cases (48.7%) and vascular in 14 cases (35.9%). 38 patients were hypertensive (97.4%) and 6 diabetic men (15.4%). The prevalence of ED was 74.3% (29 cases). ED score was less than 10 points in 14 cases (35.9%); 01 case (2.6%) between 11 and 16 points; 06 cases (15.4%) between 17 to 21 points; 08 cases (20.5%) between 22 and 25 points; and 10 cases (25.6%) between 26 and 30 points. Age, profession and duration of dialysis were risk factors associated with ED (P <
Prevalence and Factors Associated with Alcohol Consumption in Urban Schools in Burkina Faso  [PDF]
Mali Koura, Ivlabehire Bertrand Méda, Zanga Damien Ouattara, Couna Christiane Béré Somé, Kounpilélimé Sosthène Somda, Aboubacar Coulibaly, Sma?la Ouédraogo, Appolinaire Sawadogo
Open Journal of Gastroenterology (OJGas) , 2017, DOI: 10.4236/ojgas.2017.76020
Abstract: Background: In 2005, the World Health Assembly asked member states to develop effective strategies and programs to reduce the negative consequences of harmful use of alcohol. To develop effective policies, we must already understand the phenomenon of alcohol consumption. But in Francophone west Africa, there are very few studies on the prevalence of alcohol, consumption patterns and factors associated with this consumption. The objectives of this study were to estimate the prevalence of alcohol use in schools in Burkina Faso and to identify socio-demographic factors associated with episodes of “heavy drinking”. Method: A cross-sectional study was conducted in October 2013 in six secondary schools of Bobo-Dioulasso. Three hundred and sixty-two students randomly drawn by stratified cluster sampling were interviewed by using a self-administered questionnaire adapted from the model ESPAD and WHO AUDIT questionnaire. HED (Heavy Episodic Drinking) was defined as consuming at least six local measures of alcoholic beverages around the 30 days prior investigation. The search for factors was performed using logistic regression and estimating standard errors were adjusted for clustering data. Results: The prevalence of experimentation of alcohol was estimated to 45.6% [CI 95% = 40.4 - 50.7]. This prevalence was reduced to 34.8% [CI 95% = 29.9 - 39.7], 24.3% [CI 95% = 19.9 - 28.7] and 18% [CI 95% = 14 - 21.9] if one considered the use of alcohol at least once respectively in the 12 months, 30 days and 7 days before the survey. The prevalence of HED was 16% [CI95% = 12.2 - 19.8]. Independent factors associated with the HED were alcohol use by parents or friends and father’s occupation. Episodes of “heavy drinking” were 8.3 (CI 95% = 4.9 - 14) and 2.8 (CI 95% = 1.3 - 5.8) respectively more frequent among students whose parents and friends were drinking. Neither religion nor sex nor age was not statistically associated with HED. Conclusion: This study confirms the high prevalence of alcohol consumption in schools in Burkina Faso and challenges policy makers to adopt effective policies to fight against the harmful use of alcohol especially in schools.
Risk factors for chronic renal failure in Ivory coast: A prospective study of 280 patients
Ackoundou-N′Guessan K,Lagou D,Tia M,Gnionsahe D
Saudi Journal of Kidney Diseases and Transplantation , 2011,
Abstract: Chronic renal failure (CRF) represents the major cause of mortality in the nephro-logy unit in Ivory Coast because the means for appropriate management are lacking. The present study was performed to investigate the risk factors for CRF so that strategies for prevention could be elaborated. A case-control study was performed prospectively at the Yopougon Teaching Hos-pital in Abidjan from January 2006 to December 2006. Factors known to cause CRF were investigated in patients and controls. Their prevalence rates were compared with the general population. A total of 280 patients and 113 controls were recruited. The mean age of the patients was 37.88 ± 13.33 years and that of the controls was 41.5 ± 9.72 years. Both genders were equally represented. The main causes of CRF were chronic glomerulonephritis (47.48%), with HIV infec-tion accounting for 15% of them, and essential hypertension (HTA) (25%). Essential HTA repre-sented the only factor which, if untreated, inevitably leads to CRF. Thus, our study indicates that HTA is a major public health concern. All efforts should be implemented to reduce the high prevalence of HTA and the deleterious effect of this disorder in Ivory Coast.
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