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Introduction: Damage to the nasal cavities and sinuses of the face concern many disciplines, especially the specialist in Otorhinolaryngology and Cervi-cal-Facial Surgery (ENT-CFS), since most symptoms have little value to direct the patient towards a precise diagnosis, radiological exploration, including three-dimensional imaging, provides diagnostic, therapeutic and follow-up support. The aim is to study the clinical and computed tomography scan as-pects of non-traumatic chronic nasosinusitis disorders at the Teaching Univer-sity Hospital of Hubert Koutoukou Maga (CNHU/HKM) in Cotonou. Materi-al and Method: It was a descriptive and analytical study with retrospective collection, carried out over a period of 36 months from January 1st, 2014 to December 31st, 2016; on 261 files of patients seen in Otorhinolaryngology (ENT) and Cervico Facial Surgery (CFS) consultating for a chronic nasosinusi-tis disorder with no trauma notion and having performed a CT scan. Results: Chronic lesions of the nasal sinus cavities accounted for 13.42% of ENT con-sultations. There was female predominance with a sex ratio of 0.85. The clinic varied, the most common signs were rhinorrhea (74%), headache (73.6%) and sneezing (38.3%). On computed tomography scan, 225 results were pathologi-cal. Sinus backfilling was in the lead with 66.7% followed by mucous thicken-ing with 60.44%, and by bone involvement in 28%. Inflammatory pathologies (82.22%) were on top of the list, followed by pseudo-tumoral pathologies (20.9%). The anterior sinus complex was the most affected (56%) with predominance of the maxillary sinuses. Conclusion: chronic nasosinusitis dis-orders are frequent in daily practice, with a varied clinic. Computed tomogra-phy scan is a major diagnostic tool that should be favored.

Background: Measuring optic nerve sheath diameter (ONSD), a relatively re-cent technique, allows an indirect and non-invasive diagnosis of intracranial hypertension. The ONSD ratio to eyeball transverse diameter (ETD) increases this reliability of the technique. The objective of this study was to determine the normal ONSD and its ratio with ETD in black African adults in Benin. Methods: A descriptive cross-sectional study was conducted between May 2019 and August 2019. Ultrasound ONSD and ONSD/ETD ratio were meas-ured in 210 healthy adults received in the medical imaging department of the Borgou and Alibori University Hospital Center in Benin. The ONSD corre-sponded to the average of 12 measurements (03 horizontal and 03 vertical for each eye) taken 3 mm behind the papilla. The transverse ETD corresponded to the average of 03 measurements. Results: The mean ONSD was 4.20 ± 0.28 mm (95% CI = [4.17; 4.24] mm and 95th percentile = 4.70 mm). The mean ETD was 24.25 ± 1.10 mm. The ONSD/ETD ratio was 0.17 ± 0.01 (95% CI = [0.17; 0.17] and 95th percentile = 0.19). There was no difference between ver-tical and horizontal ONSD and between right and left ONSD. The ONSD and the ONSD/ETD ratio were not correlated with any of the socio-demographic and anthropometric characteristics studied (sex, age, ethnicity, weight, height, body mass index, head circumference and waist circumference). The ONSD was associated with ETD (p < 0.001 and r = 0.55). Conclusion: An ONSD and an ONSD/ETD ratio respectively greater than 4.70 mm and 0.19 should sus-pect intracranial hypertension. The ONSD/ETD ratio may be a better indicator of HICT because of its small variation.

Background: Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imaging (MRI) plays an important role in the early detection of lesions. This work aimed to describe the MRI aspects of different brain lesions occurred in HIV positive patients in our practice. Methods: This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. Results: Among the 39 patients included, 19 (48.7%) had a previous brain CT scan, 11 of which were normal (28.2%). Thirty-five (89.74%) patients had a pathological MRI. The main etiologies found were toxoplasmosis (37.14%), tuberculosis (17.14%), cerebral atrophy (17.14%) and HIV encephalitis (14.28%). Among the eleven patients with a normal Computer Tomography scan, the MRI found 7 abnormalities including 1 case of toxoplasmosis, 3 cases of HIV encephalitis and 3 cases of Progressive Multifocal Leukoencephalopathy (PML). Conclusion: MRI played an important role in the diagnosis of CNS disorders in HIV-infected individuals. It can be used to differentiate and characterize various brain lesions. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV.

Objective: The aim of this piece of work is to study the contribution of pelvic ultrasound while exploring pelvic pathologies at Hubert Koutoukou Maga Teaching University Hospital “CNHU-HKM” and at the Teaching University Hospital of Mother and Child “CHU-MEL” of Cotonou. Patients and Methods: A descriptive, cross-sectional and analytical study with prospective collec-tion was carried out at the University Clinic of Gynecology and Obstetrics “CUGO” at the CNHU-HKM and in the gynecology department of the CHU-MEL, over a period of 4 months (May to August 2018). We included in this study women over 12 years old who performed a pelvic ultrasound and were followed in the aforementioned health centers. Results: The population of the study consisted of 181 patients. The pelvic ultrasound request frequency was 18.84% compared to all ultrasound examinations. The age group of 25 - 29 years old was the most represented (22.10%). Pelvic pain was the first mo-tive for pelvic ultrasound request (39.8%). The abnormalities found by ultra-sound were uterine and ovarian respectively in 55.4% and 38% of cases. Uter-ine pathology was dominated by uterine myoma (44%). Ovarian cyst (13%) and ovarian dystrophy (14%) were the main ovarian pathologies. There was a statistically significant relationship between certain reasons for consultation, mainly metrorrhagia, dysmenorrhoea, amenorrhoea, leucorrhoea (p < 5%) and the ultrasound result. Conclusion: The ultrasound remains the first choice examination and is of a great value in exploring pelvic pathologies. In most cases, it helps to find the responsible lesion and to make the appropriate ther-apeutic decisions.

Background & Aim: Surgical management of lumbar spinal stenosis (LSS) is a common practice. The aim of this study to was to report morbidity and mortality observed during surgical treatment of LSS and the outcome of these patients after management over an 8-year study period. Methods & Materials/Patients: It was a retrospective, descriptive and transversal study performed at Departmental Teaching Hospital of Borgou in Republic of Benin (West Africa) from January 2010 to December 2018. This study concerned patients who underwent surgical management for LSS. Each type of complication, its management and the patient’s outcome was registered. Results: During the study period, 270 patients underwent laminectomy for lumbar spinal stenosis; 239 (88.5%) were selected. These patients were divided into 135 men (56.5%) and 104 women (43.5%). The mean age of the patients was 52.36 ± 10.94 years. Laminectomy was performed on one, two and three lumbar spinal segments in 42(17.6%), 133(55.6%) and 64 (26.8%) cases respectively. Laminectomy was associated with dissectomy in 15 patients (6.3%). No arthrodesis with spinal fixation was performed. The postoperative evolution was simple and uncomplicated for 215 (90%) patients. Functional postoperative results were considered excellent, good, acceptable and poor in 32.1%, 52.1%, 10.9% and 4.9% of cases respectively. Five types of complications were observed in 22 patients (9.2%). A reoperation was performed in 4 (1.6%) patients. These different complications was : dural tear (4.6%), Wound infection (3.3%), Stroke (0.8%), Pseudomeningocele (0.4%) and Cauda equina syndrom (0.4%). Mortality was 0.8% (n=2). Conclusion: Lumbar canal stenosis surgery is not without complications. Careful selection of patients, consideration of risk factors, and selection of an appropriate surgical strategy can reduce or avoid these complications.

Background: Childhood cerebral malaria is one of the most frequent complications of malaria, with high morbidity and mortality. Raised Intracranial Pressure (ICP) is currently recognized as a fundamental element of the severity of that disease. This study aims to look into the prognostic role of the sonographic measurement of optic nerve sheath diameter (ONSD) in the context of that disease. Methods: This study was conducted in the pediatric and imaging departments of the University Hospital Center of Parakou in Republic of Benin in West Africa. This was a descriptive cross-sectional study with a prospective data collection conducted over a period of 6 months, from March 1st to August 31st, 2014. There were two groups of children with severe malaria and conscious impairment: one with unrousable coma or Cerebral Malaria (Group 1) and the other without unrousable coma (Group 2), benefitting from ONSD sonographic measurement. ONSD was measured 3 mm behind the papilla. Correlation between depth of coma, outcome and ONSD measure on ultrasound was investigated. Results: Group 1 consisted of 37 children and Group 2 of 50 children, i.e. a sample of 87 children. The mean age was 27.21 ± 20.11 months and sex ratio (Male/Female) estimated at 0.89. The average ONSD of the sample was 4.39 ± 0.94 mm with a significant difference (p = 0.0001) between Group 1 (5.09 ± 1.09 mm) and Group 2 (3.87 ± 0.17 mm). Raised ICP prevalence was 48.28% with a significant difference between Group 1 (83.78%) and Group 2 (22%) with p < 0.0001. ONSD was higher in children with unfavorable clinical outcome than in those cured (p = 0.0012). Conclusion: Sonographic measurement of ONSD could be a leading prognostic tool in childhood cerebral malaria management.

Goal: The aim of this work is to study the relationship between the pneumatization of the adjacent structures of sphenoid sinuses and the protrusion of the neurovascular structures in the sinuses. Methods: A review of 225 CT scans skull was done for subjects aged at least 16 years old from November 1st to December 31st 2017. The pneumatization of adjacent structures of sphenoid sinuses and its relation with the protrusion of neurovascular structures surround the sinuses have been investigated. We used Fischer Exact test for comparison. The p value < 0.05 was expressed as significant. Results: Statistically significant associations were found between anterior clinoid process bilateral pneumatization and bilateral protrusion of carotid canal (p < 0.05) and of optic canal (p < 0.001). There were also, statistically significant correlations between bilateral pterygoid process pneumatization and bilateral protrusion of carotid canal and of optic canal (p < 0.001); and between pterygoid process bilateral pneumatization and bilateral protrusion of maxillary and vidian nerves (p < 0.001). An association was also found between bilateral pneumatization of great wings and bilateral protrusion of maxillary nerves (p < 0.001) and of vidian nerves (p < 0.05). Conclusion: Compared to the literature, the prevalence of pneumatization of the adjacent structures of sphenoid sinuses was lower on Beninese than Caucasian and Asian. But there were the same correlations with the protrusion of neurovascular structures. In case of endonasal surgery of the sphenoid sinuses, surgeon should be aware of the high possibility the injury of optic nerves and internal carotid artery.

Background: Acute kidney injury (AKI) is a frequent complication of snakebite envenomation, which is still little known in sub-Saharan Africa. This study aims to describe the clinical, biological and ultrasonographic aspects of AKI following severe snakebite envenomation managed in the intensive care unit. Method: A prospective observational survey was performed in Benin over a period of 18 months. All patients suffering severe snakebite envenomation (SBE) were included. The diagnosis of AKI was made using the KDIGO criteria. Kidney ultrasound exam was performed in all patients to assess internal bleeding and morphological and structural abnormalities of the kidneys. Results: Fifty-one cases of severe SBE were included. All patients presented inflammatory syndrome and showed abnormal WBCT whereas bleeding was found in 46 of them (90%). The median time to hospital presentation was three days. The majority of patients were male (M/F sex ratio = 1.55) and the median age was 26. Sixteen patients (31%) showed AKI according to the KDIGO criteria. Severe AKI (KDIGO stage 2 and 3) was observed in three patients, including one stage 2 and two stage 3. Kidney ultrasound revealed three cases of kidney capsular hematoma (6%), two cases of kidney hypertrophy (3%), three cases of kidney injury (4%), two stage 1 KDIGO and one stage 2 KDIGO. Only one patient benefited from hemodialysis. All patients showing AKI recovered without sequels. The median duration of hospital stays was four days. Seven patients died (14%) including four among the 16 AKI patients. Antivenom has been administered to 41 patients (80%). The comparison between patients without and with AKI did not show any significant difference except gender (p = 10-2). Conclusion: AKI is a common complication of severe snakebite envenomation. Resulting from inflammatory and hemorrhagic disorders, AKI may prove to be a short-term life-threatening factor.

Les abcès cérébraux sont pourvoyeurs d'une importante morbidité chez les patients atteints de cardiopathie cyanogène. Dans les pays à ressources limitées leur prise en charge est difficile et leur pronostic réservé. Nous rapportons ici un cas d'abcès cérébraux révélant une forme rare de cardiopathie cyanogène, la trilogie de Fallot à Parakou au Nord du Bénin. Il s'est agi d'un garçon de 9 ans, référé d'un hôpital primaire pour une hémiparésie gauche. L'interrogatoire et l'examen physique avaient permis de retrouver une symptomatologie évoluant depuis deux mois faite de céphalées intenses, de fièvre, de vomissements et d'une impotence fonctionnelle de l'hémicorps gauche. Un état général altéré, une cyanose généralisée; une hémiparésie gauche, un souffle systolique au foyer pulmonaire. Le scanner cérébral avait montré des abcès en région pariétale droite et temporale gauche et une hydrocéphalie. L'écho-doppler cardiaque avait montré une sténose pulmonaire serrée, une communication interauriculaire et une hypertrophie ventriculaire droite. Une antibiothérapie faite de ceftriaxone de gentamycine et métronidazole avait été démarrée en urgence et l'indication chirurgicale d'une trépano-ponction posée mais n'a pu être réalisée car l'évolution avait été rapidement défavorable. Les abcès cérébraux constituent une complication classique des cardiopathies cyanogènes. L'issue est fatale en l'absence de prise en charge adéquate d'où l'intérêt d'un diagnostic et d'une prise en charge précoces de ces cardiopathies.

Introduction Plusieurs etudes a travers le monde ont montre l'importante survenue des comportements de maltraitance subis par les etudiants en medecine. Notre objectif a ete d'etudier les comportements de maltraitance subis par les etudiants et les facteurs associes au sein de la Faculte de Medecine de Parakou (FM/UP) en 2018. Methodes Une enquete transversale descriptive et analytique a ete conduite du 1er au 28 fevrier 2018 chez les etudiants de la FM/UP. Les participants etaient les etudiants en 2eme annee medecine (PCEM2), en 4eme annee de medecine (DCEM2) et en 6eme annee de medecine (DCEM4) inscrits au titre de l'annee universitaire 2017-2018 qui ont librement donne leur consentement eclaire pour participer a l'etude. Resultats Cent pourcent des etudiants de la FM/UP avaient subi au moins une fois un comportement de maltraitance. Les etudiants subissaient frequemment un comportement de maltraitance dans 34,34% des cas. L'humiliation, la violence verbale et le fait d'etre amene a effectuer un service personnel etaient les formes de violences les plus subies. Cependant, environ 10% des etudiants ont subi un harcelement sexuel. Les auteurs de ces comportements de maltraitance subis par les etudiants etaient d'abord les medecins/enseignants, et les infirmiers puis les internes. Les etudiantes etaient trois fois plus harcelees sexuellement que leurs camarades du sexe oppose (p=0,0069). Plus les etudiants etaient âges et inscrits au deuxieme cycle des etudes medicales, plus ils subissaient l'humiliation (p=0,0001 pour l'âge et p

>Objective: To investigate the compliance of computed tomography (CT) scan requests in the X-ray units of Sub-Saharan Africa. Methods: Multi-centric, exhaustive, descriptive and cross-sectional study (Burkina Faso and Benin) focused on CT scan requests implemented and interpreted from May 1 to July 31, 2014. Request compliance was assessed according to the criteria of the French High Authority for Health to which was added a criterion for fulfillment of description of patient clinical information. An exam was deemed compliant when all criteria were met. Ratios were compared by means of Chi2 test at 0.05% significance level. Results: Among the 426 colligated computed tomography prescriptions, the least filled fields were allergy concept (0%), creatinine-mia (0.3%), examination purpose (50.2%). The overall compliance rate was 35%. The requests made by medical specialists were more compliant than those made by general practitioners and students (p = 0.003). Fulfillment of clinical information description was also better among medical specialists compared to the other prescribers (p = 0.002). Conclusion: It is important to improve the quality of computed tomography (CT) scan requests in the hospitals of Bobo-Dioulasso (Bur-kina Faso) and Parakou (Benin).

Goal: The goal of this study is to define the epidemiological profile and identify the different brain lesions diagnosed in ultrasonography in preterm infants in Benin environment. Patients and methods: It is a prospective cross-sectional study of analytical aiming. It took place over a period of 6 months, from May 1st to October 31st, 2012 at the National Hospital University Centre Koutoukou Hubert Maga in neonatal units and medical scanning unit. It covered 105 premature newborn, classified into the very prematurity and the moderate prematurity. Results: The very premature represented 35.2% and the moderate premature 64.8%, with an average of 33.5% and 1.9 of standard deviation. The average age when implementing ultrasonographic transfontanellar was 7.2 ± 4.6 days old. The lowest birth weight was observed in very premature with p = 0.0025. The nasopharyngeal septum pellucidum was the most found lesions in 46 preterm infants (43.8%) with no statistically significantly difference in two groups, followed by the ventricular haemorrhage found in 21 preterm infants accounting for 20%, and the grade 1 or sub-ependymal haemorrhage prevailed in 14 premature accounting for 66.7%, afterward periventricular leukomalacia in 4 premature infants and hydrocephalus in 2 premature. Conclusion: The nasopharyngeal septum pellucidum and the sub-ependymal ventricular haemorrhage were the predominant anomalies in premature infants followed by leukomalacia.

The choledochal cyst is a rare congenital malformation of the bile ducts. It is considered as a precancerous state. The incidence of cancer in choledochal cyst increases with age and occurs around 32 years old. Therefore, young adults are often involved. In adults, clinical signs are rare and unspecific. We are reporting here the case of a cholangiocarcinoma in choledochal cyst in young adult diagnosed by ultrasonography, CT scan, and MRI and confirmed by histopathological examination.

Emphysematous cystitis is a severe urinary tract infection which threatens patients’ life. Thus, it requires early diagnosis and computed tomography (CT) is the reference medical exam used to address it. However, ultrasound, which is a non-ionizing and very accessible technique, may also contribute to diagnosis. The aim of this study was to illustrate the contribution of ultrasound to the diagnosis of emphysematous cystitis. We report three cases of emphysematous cystitis diagnosed by ultrasound. In all the cases, ultrasound identified basic signs showing presence of gas, including a hyperechoic cystic parietal thickening, repeat echoes and dirty shadow cones of intraluminal focus. Diagnostic confirmation was made in two cases through X-ray and in one case by means of computed tomography. Through simple basic signs, ultrasound directs most usefully towards an emphysematous urinary tract infection. CT enables a more accurate diagnostic work-up of lesions and differential diagnosis with vesico-digestive fistula.

Background In Africa, snakebite envenomations are frequently complicated by life-threatening hemorrhagic syndromes. The authors of the present study conducted a prospective analysis at the University Hospital of Parakou (north of Benin) for seven months (January 1 to July 31, 2014) to assess the contribution of ultrasonography to the diagnosis of internal bleedings and management of envenomation. Methods An ultrasound examination was performed in all patients with clinical envenomation regardless of its severity. The study involved 32 patients admitted to the ICU of the University Hospital of Parakou. Results The average age was 27 ± 13.9 years. The main signs of severity were: prolongation of clotting time (88 %), severe anemia (41 %), clinical hemorrhage (47 %), and shock (19 %). The ultrasound imaging showed internal hemorrhage in 18 patients (56 %). There were hematomas (22 %), hemoperitoneum (13 %) or a combination of both (22 %). The occurrence of internal bleeding and hemoperitoneum were mainly related to the delay of hospital presentation (p = 0.007) and the existence of external bleeding (p = 0.04). Thirty patients (94 %) received antivenom. Case fatality rate was 3.1 %. Conclusion Ultrasonography may help in diagnosing internal bleeding, even in patients that did not show external hemorrhages, and evaluating its importance. As a consequence, the management of snakebite victims may be significantly improved.

L’histoplasmose est une mycose systemique rare causee par deux champignons, Histoplasma capsulatum var capsulatum et Histoplasma capsulatum var duboisii qui sevit en Afrique. Nous rapportons deux cas d’histoplasmoses disseminees a Histoplasma capsulatum var. duboissii diagnostiques par examen mycologique microscopique des pus cutanes chez deux beninois de sexe masculin immunocompetents. Le premier cas est celui d’un sujet de 17 ans presentant une histoplasmose cutanee pris a tort pour une maladie de Recklinghausen. L’evolution a ete marquee par une poussee a localisations osteoarticulaire et pulmonaire un mois apres l’arret d’un traitement au ketoconazole qui avait dure huit mois. La guerison definitive a ete obtenue apres une nouvelle cure d’un an. Le second cas est celui d’un patient de 50 ans presentant une histoplasmose cutanee dont l’aspect clinique evoquait une cryptococcose cutanee. Mis sous ketoconazole, l’evolution a ete marquee par une tendance a la guerison des lesions cutanees et par la survenue d’une poussee a localisations osseuses et digestives. Ce patient est sorti contre avis medical apres deux mois de traitement. Ces observations mettent en exergue le polymorphisme et l’aspect souvent trompeur de cette affection rare, souvent consideree a tort, comme exclusivement opportuniste du sida. Elles permettent egalement de souligner, la difficulte d’une bonne observance therapeutique du fait de la duree et du cout eleve du traitement dans notre contexte de pays en developpement.

Introduction:l'objectif de cette étude était de déterminer le diamètre échographique de l'enveloppe du nerf optique (DENO) dans une population d'enfants sains noirs Africains au Bénin. Méthodes:une étude transversale descriptive a été menée sur une période de 6mois. Le DENO a été mesuré chez 304 enfants sains. Deux mesures échographiques du DENO (coupe transversale et sagittale) ont été réalisées 3mm en arrière de la papille sur chaque œil. Le DENO d'un patient est égal à la moyenne des quatre mesures. Résultats:l'âge moyen était de 35, 72 ± 35,38 mois et la sex-ratio H/F de 0,96. La mesure moyenne du DENO était de 3, 31±0,54mm avec des extrêmes de 2,02 et de 4,44mm. Le DENO croît avec l'âge avec une moyenne corrélation significative (r=0,58 et p