ABSTRACT
Background: Acute pain is a leading cause of presentation to emergency departments (EDs) worldwide, yet robust data from sub Saharan Africa remain limited. Understanding its epidemiology is essential to optimise triage, analgesic strategies, and patient outcomes. Objective: To characterise the epidemiological profile of acute pain and identify independent determinants of severe pain among patients presenting to the ED of Essos Hospital Center. Methods: We conducted a prospective observational study over three months. Consecutive adult patients (≥18 years) presenting with acute pain were enrolled. Pain intensity was assessed at triage using a 10 point visual analogue scale (VAS). Etiologies were categorised as trauma-related, abdominal, obstetric/gynecological, or other medical. Multivariable logistic regression identified independent predictors of severe pain (VAS ≥7). Results: Among 220 patients (mean age 36 ± 12 years; 54% female; sex ratio 0.85), trauma-related pain accounted for 38% of presentations, abdominal 31%, obstetric/gynecological 18%, and other medical 13%. Severe pain was reported in 64% of patients. Independent predictors of severe pain were female sex (OR 1.7; 95% CI 1.1–2.7), trauma-related etiology (OR 2.3; 95% CI 1.4–3.8), and delayed presentation >2 hours (OR 1.9; 95% CI 1.2–3.1). Conclusion: Trauma, abdominal, and obstetric/gynecological conditions are the predominant causes of acute pain. Early, structured, context-adapted analgesia protocols are essential to reduce oligoanalgesia and improve emergency care quality in resource-limited settings.

ABSTRACT
Introduction: Currently, infertility constitutes a real public health problem due to its prevalence, distribution, and the difficulties related to its management. The general objective of this study was to contribute to the study of male infertility in its epidemiological, clinical, and therapeutic aspects at the Urology-Andrology department of Ignace Deen National Hospital. Methodology: This was a retrospective descriptive study lasting five (5) years, from January 1, 2020, to December 31, 2024. All patient records admitted for male infertility, having clinical observation and at least two sperm analyses during the study period, were included in this study. Results: We collected 272 records during our study over a period of five (5) years. The average age of patients was 36.50 years (ranging from 20 to 68 years). The 30-39 age group was most represented, accounting for 44.85% (n=122). Risk factors were dominated by smoking and heat exposure, with 30.51% (n=83) and 22.06% (n=60), respectively. Infertility was primary in 74.63% (n=203) of patients and secondary in 25.37% (n=69) of cases. On examination, 68% (n=185) of patients had varicocele. Regarding quantity, the spermogram was abnormal in 95.2%. From a therapeutic perspective, varicocelectomy was performed in 185 patients, representing 68% of cases, compared to 32% of cases (n=87) where spermatogenesis induction and/or dietary supplements were provided for azoospermic patients or those with oligo-astheno-teratospermia (OATS). Conclusion: The prevalence of male infertility in our study was remarkable. Over a period of 5 years, 272 records were collected in our department. This represents a real public health problem. The sperm profile was dominated by oligoasthenoteratozoospermia.