Advances in General Practice of Medicine

Objective: Status Epilepticus (SE) is a condition characterized by an epileptic seizure that persists long enough or recurs at sufficiently short intervals to create a fixed and lasting epileptic condition. The objective of this study was to determine the prevalence and to identify predictors of in-hospital death among SE patients in Lubumbashi, Democratic Republic of the Congo (DRC).
Methods: We conducted a retrospective study from January 2020 to December 2022.
Results: Out of 3,006 patients admitted to the neurology department of the University Clinics of Lubumbashi, 97 presented with SE (i.e., a hospital prevalence of 3.23%). The mean age of the patients was 38.38±14.74 years, and men represented 77.3% of the cases. Epileptic patients represented 21.65% of the cases and 66.7% of them were on antiepileptic drugs (AEDs). Seizures were generalized in 72.16% of the patients. Seizures lasted 30 minutes or more in 50.52% of the cases. The most frequent etiologies were strokes, followed by central nervous system (CNS) infections. In-hospital mortality was 24.74% and the predictors of this mortality were CNS infections (adjusted OR = 22.34 [2.69-222.65]; p = 0.0006) and seizures lasting ≥ 30 minutes (adjusted OR = 10.98 [2.89-62.70]; p<0.0001).
Conclusion: SE is a major neurological emergency requiring early and multidisciplinary management to preserve the vital prognosis because, without treatment, SE causes important neurological complications and even death. The present study found a mortality of 24.74% which was associated with seizure duration of more than 30 minutes as well as with infectious etiologies.

Purpose: To compare the accuracy of mortality prediction of four CT severity scoring systems for COVID-19: CT severity score three levels, CT severity score, Total severity score, and Chest CT score.
Methods: This was a retrospective study of 278 patients hospitalized with COVID-19 confirmed by a positive polymerase chain reaction (PCR) and in whom a CT scan was performed to assess the severity of lung involvement. This assessment was performed using four different scoring systems, including the CT severity score three levels, the CT severity score, the Total severity score, and the Chest CT score.
Results: A total of 278 COVID-19 patients had chest CT scans, of whom 59 (21.22%) died and 219 (78.78%) survived. The ROC curves showed outstanding performance for the four chest CT severity scoring systems: 0.9580 for the CT severity score; 0.9532 for the CT severity score three levels; 0.9474 for the Total severity score; and 0.9327 for the Chest CT score. The comparison of these four ROC curves revealed no statistically significant difference between the four scoring systems (X² = 3.89; p = 0.2740).
Conclusion: The four chest CT severity scoring systems used predicted mortality in COVID-19 patients with excellent agreement and outstanding performance.

Background: The objectives of this study were to determine the proportion of uncontrolled hypertension in hypertensive patients followed up on an outpatient basis and to investigate the factors associated with this poor control.
Methods: This was a cross-sectional analytical study of 167 hypertensive patients followed in eight health facilities in Goma city. Uncontrolled hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg.
Results: The proportion of uncontrolled hypertension was 95.2%. In bivariate analysis, no factor was associated with uncontrolled hypertension.
Conclusion: Almost all hypertensive patients in our study were poorly controlled by antihypertensive treatment. These results highlight the need for a cohort study to determine the factors associated with this excessively high prevalence of uncontrolled hypertension in hypertensive patients on antihypertensive drugs, in order to allow targeted actions to try to control hypertension by antihypertensive drugs.