Epidemiological and Clinical Profile of Fixed Pigmented Erythema at the Departmental University Hospital Center Borgou/Alibori (Benin)

Studying end of life in dementia patients is challenging because of ill-defined prognoses and frequent inability to self-report. We aim to quantify and compare (1) feasibility and (2) sampling issues between prospective and retrospective data collection specific to end-of-life research in long-term care settings. The observational Dutch End of Life in Dementia study (DEOLD; 2007 to 2011) used both prospective data collection (28 facilities; 17 nursing home organizations/physician teams; questionnaires between January 2007 and July 2010, survival until July 2011) and retrospective data collection (exclusively after death; 6 facilities; 2 teams, questionnaires between November 2007 and March 2010). Prospective collection extended from the time of admission to the time after death or conclusion of the study. Prospectively, we recruited 372 families: 218 residents died (59%) and 184 (49%) had complete physician and family after-death assessments. Retrospectively, 119 decedents were enrolled, with 64 (54%) complete assessments. Cumulative data collection over all homes lasted 80 and 8 years, respectively. Per complete after-death assessments in a year, the prospective data collection involved 37.9 beds, whereas this was 7.9 for the retrospective data collection. Although age at death, sex, and survival curves were similar, prospectively, decedents' length of stay was shorter (10.3 vs. 31.4 mo), and fewer residents had advanced dementia (39% vs. 54%). Regarding feasibility, we conclude that prospective data collection is many fold more intensive and complex per complete after-death assessment. Regarding sampling, if not all are followed until death, it results in right censoring and in different, nonrepresentative samples of decedents compared with retrospective data collection. Future work may adjust or stratify for dementia severity and length of stay as key issues to promote comparability between studies.

Introduction: Appendiceal abscess is a progressive complication of acute appendicitis. It is a common abdominal surgical emergency. The prognosis can be worsened by the occurrence of generalized acute peritonitis. Objectives: To study the epidemiological, clinical, and therapeutic aspects of appendiceal abscesses at CHU Pr Bocar Sidy Sall in Kati. Methodology: This was an analytical descriptive study with retrospective and prospective data collection, covering the period from January 1, 2014, to December 31, 2023, a period of 10 years. Results: During this study period, we collected 76 cases of appendiceal abscesses. This represented 1.27% of consultations, 4.68% of digestive surgical emergencies, and 20.10% of acute appendicitis cases. The average age of the patients was 30.59 years and the sex ratio was 2 in favor of men. The diagnosis was mainly clinical. The average time to admission was 5 days. Clinically, pain in the right iliac fossa and fever were present in all patients upon admission. This pain was associated with vomiting in 90.79% (n=69) of cases. Open surgery was performed in all cases. The surgical approach was a McBurney point incision in 92.10% (n=70), a subumbilical midline incision in 2.6% (n=2), and a right paramedian incision in 4 patients. The most frequently performed surgical procedure was appendectomy without burying, associated with drainage in 78.9% of cases (n=60). The average hospital stay was 4 days. We recorded 7 cases of wound infections. No deaths were reported. Conclusion: this is a relatively common condition in young adults, with a predominance in males. Surgical treatment is the only option, consisting of an appendectomy followed by drainage. Early management of acute appendicitis could reduce the occurrence of appendiceal abscesses.

BackgroundAcute respiratory infections (ARI) and acute gastrointestinal infections (AGI) are the most common childhood infections, and corresponding data can either be collected prospectively or retrospectively. The aim of this study was to estimate the incidence of respiratory and gastrointestinal episodes in German households with children attending day care and to compare results of prospective and retrospective data collection.MethodsWe conducted a 4 months prospective cohort study in the winter period 2014/2015 and recruited parents of children aged 0–6 years in 75 day care centers in Braunschweig, Lower Saxony, Germany. For all household members, we collected information on episodes of ARI and AGI. We applied prospective data collection in one study arm and retrospective data collection with a reporting period of 2 months in the other. Poisson regression was used to model monthly incidence rates for both study arms.ResultsIn total, 100 households (including 404 persons) participated in the retrospective group and 77 households (282 persons) in the prospective group. Incidence estimates for ARI (retrospective group: 0.52 per person month, prospective group: 0.47) were higher than for AGI (retrospective group: 0.14, prospective group: 0.13). The adjusted incidence estimates were similar in both study arms for ARI (incidence rate ratio for retrospective versus prospective data collection: 1.11 [confidence interval (CI) 95% 0.99; 1.24], p = 0.42) as well as for AGI (1.10 [CI 95% 0.89; 1.37], p = 0.27).ConclusionIf there is no need to collect biomaterials or data on severity of the diseases, incidence of infections in the household setting over a short time period (2 months) can be assessed retrospectively.

Background: The urology department of the teaching hospital of Kara is the second urology department in Togo, after that of the teaching hospital Sylvanus Olympio, in Lomé the capital. It is a very young service, created less than 5 years ago. Urological emergencies were previously managed by general surgeons, for lack of urologists. The influx of patients with urological pathologies has increased with the arrival of urologists. The update on urological emergencies having been made in Lomé, we therefore wanted to take stock of urological emergencies at the teaching hospital of Kara. Objective: To describe the epidemiological, clinical, and therapeutic aspects of urological emergencies received at the teaching hospital of Kara. Patients and Methods: This was a descriptive study with retrospective data collection. The study took place in the urology department, and in the surgical emergency department of the teaching hospital of Kara, over a period of 18 months, from January 2021 to June 2022. The on-call medical team consisted of the intern in on-call medicine, and an on-call urologist, whom the intern called upon when he received a urological emergency. Pediatric urological emergencies were managed by the pediatric surgeon and were not considered in our study. The operating room register, the surgical emergency consultation register, the urology department consultation register, and the records of patients hospitalized in the urology department were used for data collection. The following parameters were studied: age, sex, type of urological emergency, and therapeutic management; epi info 7 software was used for data processing. Results: The average age of the patients was 52.5 ± 19.6 years with extremes ranging from 16 years to 102 years. Note that 57.7% of the patients were over 50 years old. The sex ratio was 8.9. Urinary retention was the most common urological emergency in 47.7% (52) of cases; follow-up of infectious pathologies in 30.2% (33) of cases. Among the patients who had been seen for urinary retention, 84.6% (44) of the cases had presented with acute urinary retention. Urethral catheterization was the type of care most received by patients, in 30.2% (33) of cases; follow-up of medical treatment in 27.5% (30) of cases. The most common etiology of urinary retention was prostate tumours, in 71.1% (37) of cases, followed by urethral stricture in 15.3% (8) of cases. We also found in our series, traumatic emergencies in 10% of cases; these were traumatic urethral injuries, traumatic injuries of external genitalia, traumatic injury of bladder, and traumatic injury of kidney in respectively: 4.5% (5); 2.7% (3); 1.8% (2); and 0.9% (1) of cases. Torsion of the spermatic cord was found in 2.7% (3) of cases. Conclusion: Urine retention is the most common urological emergency at Kara University Hospital. They are most often found in elderly males. Urethral catheterization was the most common type of care.

Cervical cancer remains a major public health problem in Africa, particularly in Mali. The goal of this work was to investigate the epidemiological and clinical aspects of cervix cancer seen at the radiation therapy center. This was a descriptive study on the retrospective collection of data on patients found in the Radiation Therapy Centre of Bamako, for invasive cervical cancer be-tween April 2014 and April 2017. The average age of our population was 52 ± 12.5 years with extremes ranges from 18 to 95 years. The most represented age group was [50 - 65 years] with 44.2%. The predominant histological type was squamous carcinoma (CE) with 94.2%. Bleeding were found in almost all patients, most often associated with foul smelling hydrorrhea; 80.3% of our patients were stage III and 12.9% of stage IV according to the IFGO classifi-cation. Cervix cancer remains a major public health problem in Mali. The di-agnosis is often late, therefore, resulting in late care and unfavorable progno-sis. Sensitization, vulgarization of vaccination and systematization of screen-ing could be helpful in the fight against this cancer.

Background: Tuberculosis (TB is a frequent and fatal infectious disease, despite the existence of effective treatment. It is now a major public health problem worldwide. It is estimated that 10.6 million people will have developed tuberculosis worldwide by 2022. Several studies have been carried out to assess the epidemiological aspects of pulmonary tuberculosis in Mali and elsewhere in the world, but few in the Djenné health district. The aim of our work was to study the epidemiological aspects of pulmonary tuberculosis in the Djenné health district in Mali from January to December 2021. Methodology: This was a cross-sectional descriptive and analytical study with retrospective data collection using a questionnaire to assess the epidemiological aspects of pulmonary tuberculosis in the Djenné health district in Mali. It took place from 1 January to 31 December 2021. Results: A total of 304 patients consulted for a cough lasting more than 15 days, 77 (25.32% were microscopy-positive (BAAR). The 77 BAAR-positive patients were surveyed. The predominance of males was 62.30%. Tuberculosis/HIV coinfection was found in 9.72% of cases. The case fatality rate was 11.7%. Conclusion: At the end of this study, we can conclude that the incidence of tuberculosis remains high in the Djenné health district. Tuberculosis remains a threat to developing countries, as it is a truly fatal disease in young adults. However, it is preventable if the DOTS strategy is effectively implemented.

Background. Postoperative morbidity has immediate and delayed consequences for surgical patients, including excess risk of premature death. Capturing these data objectively and routinely in large electronic databases using tools such as the Postoperative Morbidity Survey (POMS) would offer tremendous clinical and translational potential. However, POMS has thus far only utilised prospective data collection by research staff. We hypothesised that retrospective data collection from routinely collated hospital data from paper and electronic charts, medical and nursing notes was non-inferior to prospective data collection requiring research staff capturing POMS-defined morbidity in real-time.Methods. Morbidity was recorded by a trained investigator as defined by POMS prospectively on postoperative days 3 and 7. Separately, an independent investigator blinded to prospectively acquired data retrospectively assessed the same patients’ morbidity as defined by POMS criteria, using medical charts, nursing summaries and electronic data. Equivalence was accepted when the confidence limits for both modes of data collection fell completely inside the equivalence bounds, with the maximum equivalence difference (i.e., the largest value of the difference in sensitivities deemed to reach a conclusion of equivalence) set a priori at 0.2. Differences for confidence limits between retrospective and prospective data collection were based on Nam’s RMLE method. The relationship between morbidity on postoperative day 3 as recorded by each data collection method on time to become morbidity free and length of hospital stay was compared using the log-rank test.Results. POMS data from 85 patients undergoing elective or emergency surgery were analyzed. At postoperative day 3, POMS-defined morbidity was similar regardless of whether data were collected prospectively or retrospectively (95% CI [−0.13–0.013]; p < 0.001). Non-inferiority for sensitivity was observed for all other POMS domains and timepoints. Time to become morbidity free Kaplan–Meier plots were indistinguishable between POMS obtained prospectively or retrospectively (hazard ratio: 1.09 (95% CI [0.76–1.57]); p = 0.33, log rank test). Similarly, the mode of data collection did not alter the association between early postoperative morbidity on postoperative day 3 and delayed hospital discharge.Conclusions. Postoperative morbidity as defined by the Post Operative Morbidity Survey can be assessed retrospectively. These data may therefore be easily captured using electronic patient record systems, thereby expanding the potential for bioinformatics approaches to generate new clinical and translational insights into recovery from surgery.

The Launch and Scale Speedometer aims to accelerate the introduction and uptake of lifesaving health interventions, primarily products such as drugs, devices, diagnostics, and vaccines in low- and middle-income countries (LMICs), by developing evidence-based actionable insights about the timelines, enablers, barriers, and pathways taken by these interventions to reach and sustain reach to intended users. The Duke Global Health Innovation Center (Duke GHIC) developed the Launch and Scale Speedometer framework to collect and analyze data to facilitate insights to accelerate the scaling of life-saving interventions. To date, the Speedometer program has collected data on over 50 interventions to understand their scaling timelines. This data and analyses are available on the Duke GHIC website (dukeghic.org). The Speedometer program has systematically analyzed the pathways, timespans, and influencing characteristics that accelerate the introduction and scaling of interventions. We intend for Speedometer resources and tools to be a global public good, and will continue to collect and analyze data to address the global need to accelerate scaling of life-saving health interventions. We hope that researchers, innovators, development organizations, and others will contribute to the database over time to increase its collective value. The Speedometer achieves its goals by: • Cultivating a community of global stakeholders to provide guidance to the work and build consensus on framework and metrics; • Collecting launch and scale data and evidence—from proof of concept to global scale-up—on health interventions and developing a data clearinghouse as a public good; and • Generating and sharing valuable insights and good practices to advocate for the acceleration of launch and scale of lifesaving health interventions and products at global and country levels. Applications of the Speedometer Framework The Speedometer Framework is designed for both retrospective and prospective data collection, to consistently measure and effectively organize data around pathways of scaling health interventions. It offers point- in-time measurement for specific milestones and longitudinal measurement to look at the introduction and scale-up of an intervention over time, thereby facilitating greater awareness of the overall process. By applying the Speedometer Framework, funders, researchers, and product developers will be able to measure and analyze the specific pathways, timelines, and key factors associated with the scale-up of health interventions. Analyzing this information will generate key insights to pinpoint opportunities for maintaining or accelerating the introduction and uptake pathways of interventions. The Speedometer Framework can be used to: • Track and facilitate understanding of characteristics of enablers and obstacles to scale • Benchmark milestones, timespans of activities, and comparisons across products • Understanding how fast (the speed at which) activities occur. Note that ‘fast’ is not necessarily better, but understanding timelines of launch and scale gives an idea of how long it may take an intervention to reach end users. • Enable investment scoping and selection • Provide portfolio view and measurement of launch and scale • Assist planning and monitoring of intervention introduction and uptake • Measure longitudinal scale-up • Support retrospective and prospective evaluation of end-to-end scaling journey • Support product designer and implementing agencies in their design of new innovations that take account of delineated barriers (or enablers) in the design process and implementation plans This Framework presents an opportunity to donors, product developers, and researchers to understand and track the scaling pathways of health interventions – either individual interventions or comprehensive portfolios. While audiences may be interested in a unique phase of the scaling pathway, this Framework can provide an informational bridge and feedback loop for the complete end-to-end pathway of launch and scale. Prospective data collection approaches can track “growth” of a portfolio of interventions, capturing the launch and scale pathways of both successful and unsuccessful interventions. Retrospective data collection can offer insight to benefit new products, accelerating progress at lower cost. Additionally, this Framework offers a unique opportunity to closely connect with key stakeholders at the data collection stage and generate real-time actionable insights to affect the launch and scale process. Reflecting this use, real-time insights were able to be drawn from the aggregation of COVID-19 vaccine purchasing data by countries thus helping identify disparities in purchases, which, given the initial manufacturing constraints showed supply being sent to high- income countries over low-income countries. Based on the results of this analysis, subsequent data collection focused on vaccine donations, leveraging the data to call attention to vaccine purchasing and distribution inequities (Taylor, Biru, &amp; Udayakumar, 2022). Additional collective value will be developed through contribution and aggregation of additional data over time, enabling more robust analyses to provide key insights to accelerate scaling of life-saving interventions.

Introduction: Sudden cardiac death (SCD) remains a major public health issue. In Senegal, there is a lack of data on this phenomenon; this underlies the relevance of this study whose objective is to study the epidemiological profile of victims experiencing unrecovered sudden cardiac arrest at Aristide LE DANTEC Hospital. Patients and Methods: This is a transverse study with retrospective data collection from January 1, 2016 to January 31, 2017. Included, in the study were all victims of sudden cardiac death in Dakar who had a necropsy in the morgues of Aristide Le Dantec Hospital. Results: We recorded 69 cases of sudden death of cardiovascular origin from 169 forensic autopsy reports, or 40.8% of autopsies. The average age was 44 years with a male predominance in 76.81%. The large majority of death occurred at home (26%), without witnesses (48%) and at rest (36%). Two cases of sudden death, or 3%, occurred at exertion. These deaths were recorded in 16% of cases in the middle of the day. The highest death rate was recorded during the month of December (15.9%). Malaise was the predominant symptom (13%) followed by emotional stress (6%). The existence of a history could only be clarified in 4% of cases. The electrocardiogram was only performed in 1 case. At necropsy, ischemic heart disease was the leading disease (46%), 26% of which was due to myocardial infarction, followed by hypertrophic cardiomyopathy (16%) and mixed cardiomyopathy (13%). Tamponade, dilated cardiomyopathy and aortic dissection were found in 9%, 6% and 4% of cases, respectively. Conclusion: Sudden cardiac death is a major public health problem. In the Senegalese population, victims of unrecovered SCD are relatively young with a predominance of men. Coronary artery disease is the most frequently implicated pathology. Faced with this observation, a national program for the integrated control of cardiovascular risk factors is necessary.

Introduction: Pancreatic head cancer is increasing in incidence and remains characterized by late diagnosis, responsible for high mortality. Objective: To describe the epidemiological aspects and prognosis of pancreatic head cancer in a context of limited technical resources at Zinder National Hospital (HNZ) in Niger Republic. Materials and Methods: This was a cross-sectional study with retrospective data collection from June 01, 2020, to May 30, 2024, covering cases of pancreatic head cancer followed up in the hepato-gastroenterology (HGE), digestive surgery and medical oncology departments of Zinder National Hospital (HNZ). Results: Of 432 digestive cancers identified, 57 involved the pancreas (13.2%), including 46 located in the head (80.7%). The mean age was 56.3 ± 15.1 years (extremes: 20-83 years), with a male predominance (sex ratio: 2.28). The average consultation time was 7.9 months. The main complaints were jaundice (95.7%) and abdominal pain (76.1%). On examination, a large palpable gallbladder was found in 65.2% of cases, and hepatomegaly in 51.1%. Visceral metastases were present in 66.7% of patients. All received palliative care, and bypass surgery was performed in 45.7% of cases. Survival rates at 3, 6 and 12 months were 19.6%, 4.3% and 0% respectively. Mean survival was 2.6 months. Conclusion: Pancreatic head cancer is increasingly common in Zinder. Diagnosis remains late, limiting the possibilities of curative treatment and clouding the prognosis, with a very poor mean survival in our series

Preamble......237 Medicine is experiencing an unprecedented focus on quantifying and improving health care quality. The American College of Cardiology (ACC) and the American Heart Association (AHA) have developed a multi-faceted strategy to facilitate the process of improving clinical care. The

Colorectal cancer is the most common form of digestive cancer. &amp;lt;i&amp;gt;The aim of this study was to investigate the therapeutic aspects of colon cancer. Patients and method: &amp;lt;/i&amp;gt;This was a descriptive study with retrospective data collection, from January 2020 to June 2023 (3 years and 6 months), including all patients treated in the digestive surgery department of the Brazzaville University Hospital for colon cancer. &amp;lt;i&amp;gt;Results:&amp;lt;/i&amp;gt; During the study period, 64 patients were treated for colon cancer, representing a frequency of 2.9% of all hospitalised patients. The average age of our patients was 54.8 ± 14.02 years (extremes 29 and 79 years), with a predominance of males (sex ratio 1.8). Most patients were referred to us by gastroenterologists. Cancer was diagnosed preoperatively in 20 patients. Thoracic-abdominopelvic CT scans in 82% of patients showed irregular thickening of the colonic wall. All patients underwent laparotomy. Right colectomy with tumour removal was performed in 20 patients; left colectomy in 29 patients; right colectomy combined with antrectomy with tumour removal as a single block in one patient; left colectomy combined with antrectomy and caudal pancreatectomy with tumour removal as a single block in one patient; and left segmental colectomy (sigmoidectomy) was performed in 8 patients. Lymph node dissection was satisfactory in 42 patients and inadequate in 9. The resection limits were healthy in all our patients. Post-operative management was straightforward in most patients. &amp;lt;i&amp;gt;Conclusion:&amp;lt;/i&amp;gt; Colonic cancers are the most common cancers of the digestive tract. It is treated surgically. when operated on at an early stage, it improves survival.

Background: Since March 2020, WHO declared a pandemic of COVID-19 and the world is facing an unprecedented challenge. Several regions have been forced to increase intensive care unit (ICU) capacity in a short period of time to deal with an expressive number of critically ill patients. This study aims to evaluate the impact of staff preparedness by comparing the outcomes between two ICUs units from the same hospital, one previously well-established and one recently assembled to deal with a markedly increased volume of patients brought by COVID-19 pandemic.Methods: This is an observational cohort study with retrospective collection of data, conducted in Instituto de Infectologia Emílio Ribas, São Paulo-SP, Brazil. We included all patients who were admitted to an ICU with suspected COVID-19, from March 1st until April 30th, 2020. The assessed outcome was the rate of in-hospital mortality.Findings: 114 cases with severe acute respiratory syndrome were included.The median age was 57 years, with a male predominance. More than half of patients had at least one comorbidity, hypertension, diabetes or obesity. Data on respiratory pathogens were available for 112 patients, of whom 86 (77%) had a SARS-CoV-2 confirmed by polymerase chain reaction (PCR) and 4 (4%) tested positive for influenza, also by PCR method. Age > 60 years, need of invasive mechanical ventilation and an ICU type (recently assembled) were independently associated with in-hospital mortality among patients with severe acute respiratory syndrome during the COVID-19 pandemic.Interpretation: This finding highlights the importance of considering the ICU type as a possible determinant of mortality during an epidemic, together with the already well-described risk factors of age and comorbidities, suggesting that we should develop support strategies for recently assembled ICUs, as training and mentorship programs.Funding: This study has no sponsor.Declaration of Interests: The authors have nothing to disclose.Ethics Approval Statement: The National Research and Ethics Commission (CONEP) approved this study (CAAE 30632820.2.0000.0061).

Objective: To find a more accessible and less restrictive mean such as serum-ascites albumin gradient (SAAG) to predict esophageal varices (EV) in cirrhotics with ascit. Patients and methods: Descriptive and analytical studies based on the retrospective collection of data on 125 patients' records in the hepatogastroenterology unit of the University Hospital Campus of Lome (Togo) from January 1, 2008 to March 31, 2018 were included. Cirrhotic patients aged 15 years and older had performed cytochemical analysis of ascites fluid and upper gastrointestinal fibroscopy and had a protidogram. Statistical analysis was done by R Studio Software 3.4.2. Results: The mean age was 48.70 years; there was a male predominance (70.40%) with a sex ratio of 2.38. Protein levels in ascitic fluid was Conclusion: Our study noted that at an upper threshold of 1.10 g/dl, the SAAG significantly predicted the presence of EV.

Outcome of Patients with Diffuse Large B Cell Lymphoma Treated in a Tertiary Care Centre in Uae; A Retrospective Review