ABSTRACT
Introduction: The global progression of diabetes mellitus (DM) pandemic is a real public health problem. This growth, more remarkable in low- and middle-income countries is linked to risk factors (RF) and urbanization. This study contributes to the updating of epidemiological data on diabetes and its RF in rural and urban areas in Congo. Aim of the Study: To describe epidemiological and diagnostic aspects of DM and its RF in rural and urban areas in Congo. Patients and Method: A cross-sectional, retrospective and multicenter study, including patients in 20 centers (urban/rural) from October 2010 to 2017.Studied parameters were: socio-demographic profile, duration of diabetes, anthropometric measurements, RF, types of DM and glycaemia. Data were analyzed by Epi info 7.2.1.0, using Chi-2 and Student, with a significance threshold of 0.05. Results: A total of 4758 patients were received, including 4116 patients (86.51%) in urban areas and 642 patients (13.49%) in rural areas. Among them, 2460 men (51.70%) and 2298 women (48.30%), M/F ratio of 1.07. The mean age was 51.67±15.45 years [range 2 to 95 years].3021 patients (63.5%) were known to be diabetic, with a mean duration of 5.97 years and 1737 patients (36.5%) were newly diagnosed. The annual incidence was 248 new cases/year. The socio-professional status was dominated by the unemployed (33.80%), employees (26.2%), students/pupils (12.9%) and retirees (11.9%). T2D (84.72%) and T1D (8.53%) were more represented. RF: Hypertension (39.34%), affects 90.60% of patients in urban areas and 9.40% in rural areas (p = 0.000). Overweight (37.89%) and obesity (27.77%), predominantly urban, female and in T2D (p = 0.000)). Metabolic syndrome of urban predominance was found in 17.12% of patients. The mean glycaemia was 283 ± 14 mg /dl. Conclusion: Our study shows that DM and its RFs are common in Congo, with a strong predominance in urban areas, requiring specific strategies to reduce the impact of urbanization.

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Background: There exists a strong association between prediabetes and TB, which brings about disease activation, relapse and several other unfavourable treatment outcomes among TB patients. The association between prediabetes and TB have also revealed a concomitant increase in the prevalence of prediabetes among TB patients. This study determined the prevalence of prediabetes among tuberculosis patients attending the DOTS clinic of the University of Ilorin Teaching Hospital (UITH) Nigeria. Method: This was a cross-sectional study involving one hundred and eighty consenting TB patients, selected using systematic random sampling techniques. Socio-demographic data was collected using a questionnaire. Laboratory investigation was done using NICE guidelines to determine the prevalence of prediabetes among TB patients. Demographic information was entered, calculated and analysed using Statistical Packages for Social Sciences (SPSS 23). Results: The age of the participants ranged from 18 to 95 years with a mean age of 37 (SD ± 15.01). The prevalence of prediabetes among TB patients was 8.9%. Conclusions: The study showed a high prevalence of prediabetes among TB patients attending DOTS clinics at UITH, Ilorin.

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Introduction: Postoperative pancreatic fistula (POPF) remains one of the most challenging complications following pancreatoduodenectomy, contributing significantly to morbidity and mortality. This study explores the relationship between clinical, biochemical, and surgical factors and the development of POPF, with a focus on identifying predictors. Methods: This observational study was conducted in Dhaka Medical College & Hospital (DMCH), Dhaka, from January 2023 to December 2023. 30 patients with the Whipples procedure were selected as study subjects by purposive simple random sampling technique. Analysis was done manually by MS Word & MS Excel worksheet and SPSS. The unpaired t-test and Chi-square test were done for data analysis. Result: POPF was significantly associated with a smaller main pancreatic duct diameter (≤3 mm, p = 0.006) and soft pancreatic texture (p = 0.00005). Elevated drain fluid amylase levels, particularly on postoperative day 5, highlighted its role in the early detection of POPF. Periampullary carcinoma was the most common diagnosis overall, though only chronic pancreatitis showed a significant association with POPF (p = 0.032). The duct-to-mucosa anastomotic technique significantly reduced the risk of POPF compared to the dunking method (p = 0.00001). Other variables, including blood loss and procedure type, were not significantly linked to POPF development. Conclusion: This study highlights that postoperative pancreatic fistula (POPF) following pancreatoduodenectomy is strongly influenced by factors such as small main pancreatic duct diameter (≤3 mm), soft pancreatic texture, and the anastomotic technique used. Elevated drain fluid amylase levels in the early postoperative period emerged as a reliable marker for POPF risk.

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Background: Venous invasion is not only an important prognostic indicator in colorectal cancer, but also an important factor of deciding treatment plan for adjuvant therapy. Vascular invasion is usually assessed using hematoxylin and eosin (H & E). But the accuracy of detection of venous invasion using H & E is debatable. Verhoeff's elastic stain is a staining protocol used to demonstrate normal or pathologic elastic fibers, which can be used to improve the detection of venous invasion. Objectives: To evaluate the role of Verhoeff’s elastic stain to detect venous invasion in colorectal adenocarcinoma. Methods: This was a cross-sectional study carried out among 91 cases of colorectal adenocarcinoma. The duration for this study was from March, 2020 to February, 2022. Demographic and histopathological variables were assessed. Venous invasion with both H& E and Verhoeff’s stains were evaluated. Results: Mean age was 51.7 ± 10.9 years. The majority of the patients were males (61.5%). The most common site of the tumor was colon (74.7%). Tumors having size ≥5 cm in diameter (71.4%) were more common. Majority (78.0%) were found to be moderately differentiated neoplasm by histological grading. The rate of venous invasion detection was higher with Verhoeff’s elastic stain compared to H & E stain. Positive results for venous invasion were observed in 21 (23.1%) and 40 (44.0%) cases stained with H & E and Verhoeff’s elastic stain, respectively. Conclusion: This study found that Verhoeff's elastic stain is better at detecting venous invasion in colorectal adenocarcinoma than H&E stain. Therefore, Verhoeff's elastic stain can be routinely employed to detect venous invasion in resected samples of colorectal carcinoma.

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Background: The global growth in the number of elderly people is associated to the increasing of CVD and their complications. The Congolese population is predominantly young, with predominance of diabetes between 40 and 60 years of age. This study highlights the particularities of diabetes in elderly congolese diabetics. Aim of the study: To describe clinical, epidemiological and therapeutic aspects of elderly Congolese diabetics. Method: Retrospective study based on the analysis of the records of patients aged 65 and above admitted from 2010 to 2016 to Adolphe Sicé General Hospital. The studied parameters are: sociodemographic, duration of diabetes, CVRF, complications, glycaemia, HbA1c, treatment and evolution. The analysis was done by Epi info 7.2.1.0, using Student's and Chi-2 tests with p < 0.05 significant. Results: A total of 2816 patients were admitted, among them 326 patients (8.64%) were aged 65 and above. 53.70% women and 46.30% men, the mean age was 72.77±5.83. Sex ratio is 0.8. Mean duration of diabetes was 5.7 years. 60.00% were known diabetics, with mean duration of 9.5 years and 40.00% were newly diagnosed. T2DM represents 98.00%. Hypertension was found in 63.50% of patients and metabolic syndrome (30%). Macro and microvascular complications: stroke (24.54%), PAD (21.00%), neuropathy (51.00%) and nephropathy (42.40%). Hyperosmolar coma represented 20.20% of acute complications, hypoglycemia (7.36%). Mean glycaemia was 3.44±1.25 g/l and HbA1c 9.94±3.54. Mortality was 8.00%. Conclusion: This study shows that diabetes in the elderly Congolese subject is not rare. Its association with CVRF is frequent, increasing the risk of cardiovascular complications.

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The prevalence of undernutrition of pregnant women remains high in Indonesia, and also deficiency of micronutrition such as iron, folic acid, or vitamin B which affected low level of hemoglobin. The insufficient hemoglobin levels in erythrocytes could disturb delivery oxygen needed to the tissues and fetus as well. The occurrence of anemia in pregnant women varies depending on diet, infections, lifestyle, environment, and socioeconomic factors. This study aims to describe the erythrocyte morphology of pregnant women in Kupang City, located in a dry island region. The research involved 24 pregnant women living in Kupang City, using a cross-sectional observational method. The results of erythrocyte morphology from peripheral blood smears showed that 12 subjects (50%) had microcytic hypochromic anemia and 1 subject (4.2%) had microcytic normochromic anemia. This indicates that, based on erythrocyte morphology, nutritional deficiencies and the possibility of chronic inflammation among pregnant women are still very high. Geographical background could be a predisposing factor for this anemia. Continuous education about adequate and balanced nutrition for pregnant women and further investigations to determine the etiology of inflammation are greatly needed.

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Since 2012, Mali has been going through a security crisis, characterized by armed attacks against civilians and soldiers; in the form of terrorist attacks or ambushes using different vulnerable agents. The lesions observed are often multiple and serious and can affect all organs to varying degrees. We report a case of ballistic trauma to the right scrotum with rupture of the testicular tunica albuginea in a soldier at his guard post in central Mali. This was a 28-year-old military patient, married, father of a child and with no medical or surgical history. The onset would go back a few hours approximately during an armed attack on their guard post located 30 kilometers from the hospital. Examination of the wound showed a bleeding albuginea with devitalization of a large part of the noble testicular tissue. The patient was hemodinamically stable and the operative blood test was normal. The abdominopelvic ultrasound was unremarkable. A debridement of the necrotic tissues was performed followed by closure of the tunica albuginea. The postoperative course was satisfactory. The patient received antitetanus serum therapy.