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Aspects Cliniques, Paracliniques, Thérapeutiques et Evolutifs de la Goutte au Centre Hospitalier Universitaire de Brazzaville
Get PDFObjectif : Décrire les aspects cliniques, paracliniques, thérapeutiques et évolutifs de la goutte vue en hospitalisation en Rhumatologie au Centre Hospitalier Universitaire de Brazzaville. Patients et Méthodes : Etude descriptive, transversale, rétrospective conduite du 1er janvier 2012 au 31 janvier 2017 soit 5 ans, dans le service de Rhumatologie du CHU de Brazzaville, Congo. Le diagnostic de la goutte a été retenu sur les critères de Rome 1963 et/ou de New York 1966 et/ou de l’ACR 1977. Résultats : Il s’agissait de 75 (71,43%) patients avec une prédominance masculine (80%). L’âge moyen était de 60+-11,47 ans (extrêmes de 30 et 82 ans). La durée moyenne d’évolution de la goutte était de 5+- 2,41 ans (extrêmes de 1 et 15 ans). L’atteinte articulaire était poly articulaire dans 52% des cas (n=39), suivie d’oligoarticulaire et monaoarticualaire dans 24% des cas (n=18). L’uricémie était élevée chez 47 patients (67,62%) avec une moyenne de 80mg/l+- 21,34 et des extrêmes de 54 et 136 mg /l. La radiographie standard était anormale chez 26 patients (34,21%). Elle montrait un pincement de l’interligne articulaire (29,40%) suivie du pincement de l’interligne articulaire plus géodes et du pincement de l’interligne articulaire plus image en Hallebarde dans (23,55%), de géodes et /ou érosions intra osseuses (17,60%) et de d’érosions para articulaires excentrées plus tophus intra osseux (5,90%). la prise en charge médicamenteuse était dominée par l’association Colchicine –Allopurinol, avec une mauvaise observance thérapeutique dans 95% des cas chez les patients goutteux avec comorbidités. Conclusion : Cette étude montre que la goutte reste peu fréquente en hospitalisation. Elle touche préférentiellement les adultes d’âge mur, avec une nette prédominance masculine. Le diagnostic était tardif et associé aux comorbidités et la prise en charge médicamenteuse était dominée par l’association Colchicine –Allopurinol. Les études antérieures à grandes échelles seront nécessaires afin de ressortir les particularités de cette maladie chez les sujets Noirs Africains.
Objective: To describe the clinical, paraclinical, therapeutic and evolutionary aspects of gout seen in hospitalization in Rheumatology at the Brazzaville University Hospital Centre. Patients and Methods: Descriptive, cross-sectional, retrospective study conducted from January 1, 2012 to January 31, 2017, i.e. 5 years, in the Rheumatology Department of the University Hospital of Brazzaville, Congo. The diagnosis of gout was based on the Rome 1963 and/or New York 1966 and/or ACR 1977 criteria. Results: There were 75 (71.43%) patients, predominantly male (80%). The mean age was 60+-11.47 years (extremes 30 and 82 years). The mean duration of gout was 5+- 2.41 years (extremes 1 and 15 years). Joint involvement was polyarticular in 52% of cases (n=39), followed by oligoarticular and monaoarticular in 24% (n=18). Uricemia was elevated in 47 patients (67.62%), with a mean of 80mg/l+- 21.34 and extremes of 54 and 136 mg /l. Standard radiography was abnormal in 26 patients (34.21%). It showed a pinched joint space (29.40%), followed by pinched joint space plus geodes and pinched joint space plus halberd image (23.55%), geodes and/or intra-osseous erosions (17.60%) and eccentric para-articular erosions plus intra-osseous tophus (5.90%). Medication management was dominated by the Colchicine-Allopurinol combination, with poor compliance in 95% of gouty patients with comorbidities. Conclusion: This study shows that gout is still uncommon in hospitalized patients. It mainly affects middle-aged adults, with a clear male predominance. Diagnosis was late and associated with comorbidities, and drug management was dominated by the Colchicine-Allopurinol combination. Previous large-scale studies will be necessary to highlight the particularities of this disease in black African subjects
Revisiting the Formation and Radicalisation of Boko Haram and Al-Qaeda in the Lands of the Islamic Maghreb (AQIM) through Social Movement Theory
Get PDFThis paper uses social movement theory to examine the rise and development of Boko Haram and AQIM into radical groups. Boko Haram and AQIM were initially established as moderate and conservative Islamist groups in Nigeria and Algeria respectively. AQIM was originally a political party – the FIS but changed names to the GIA, the GSPC, and AQIM each with a different modus operandi. Boko Haram was a local organization that has been espousing an anti-system frame alongside violent tactics since 2009. Relying on secondary data, this paper found that the emergence and eventual transformation of Boko Haram and AQIM into radical movements signify the existence of social movement factors of political opportunity structures, mobilizing structures, and framing processes in Nigeria and Algeria. Results from content analysis of the data show that while the two movements emerged in two distinct socio-economic and political environments, they were rational actors who continued to utilize the available political structures opportunity, mobilizing structures and framing processes to mobilize and sustain collective actions. It is evident that government repression only made the two groups change tactics and strategies when what they regarded as free spaces diminished at times they gathered material and non-material resources. That coincided with the radical views of some of the groups’ members, the presence of mobilizing structures, and a frame resonance that ensured recruitment into the two movements
Hématuries Macroscopiques dans le Service d’UrologieAndrologie du CHU de KARA, Togo: Aspects Epidémiologiques, Cliniques, Etiologiques, et Thérapeutiques
Get PDFIntroduction : L’hématurie macroscopique est un motif fréquent de consultation en urgence dans un service d’urologie. L’objectif de cette étude était d’évaluer les aspects épidémiologiques, cliniques, étiologiques et thérapeutiques des hématuries macroscopiques, dans le service d’Urologie-Andrologie du CHU de KARA. Méthodologie : Il s'est agi d'une étude descriptive transversale, avec une récolte rétrospective des données. Elle avait porté sur 45 patients avec hématurie macroscopique, hospitalisés dans ledit service au cours de la période allant de janvier 2020 à septembre 2023 soit 45 mois. Résultats : La fréquence hospitalière était de 10,5%. Les patients étaient majoritairement de sexe masculin (95,6%) avec un âge moyen de 62,5±16,2 ans. L’hématurie était totale chez 43 cas soit (95,6%). L’hypertrophie bénigne de la prostate était l’étiologie principale retrouvée dans 40% des cas, suivie du cancer de la prostate observé dans 24,4% des cas, et de la tumeur vésicale dans 15,5% des cas. Le Sondage uretrovesical suivi de l’irrigation ont été réalisés chez 88,9% des patients ; Quinze (15) ont été opérés dont 33,3% d’adénomectomie prostatique d’hémostase par voie haute. Aucun décès n’a été enregistré. Conclusion : L’hématurie est une urgence urologique à spectre diagnostique très large allant de pathologies bénignes comme l’infection (cystite hémorragique) ou le calcul à des tumeurs malignes. Elle implique une prise en charge précoce et rigoureuse.
Introduction : Macroscopic hematuria is a frequent reason for emergency consultation in a urology department. The objective of this study was to evaluate the epidemiological, clinical, etiological and therapeutic aspects of macroscopic hematuria, in the Urology-Andrology department of KARA University Hospital. Methodology: This was a descriptive, cross-sectional study, with retrospective data collection. It focused on 45 patients with macroscopic hematuria, hospitalized in the said department during the period from January 2020 to September 2023, either 45 months. Results : Hospital frequency was 10.5%. The patients were predominantly male (95.6%) with a mean age of 62.5±16.2 years. Hematuria was total in 43 cases (95.6%). Benign prostatic hypertrophy was the main etiology found in 40% of cases, followed by prostate cancer observed in 24.4% of cases, and bladder tumor in 15.5% of cases. The uretrovesical catheterization followed by irrigation was carried out in 88.9% of patients; Fifteen (15) were operated on, including 33.3% for prostatic adenomectomy for upper hemostasis. No deaths have been recorded. Conclusion : Hematuria is a urological emergency with a very broad diagnostic spectrum ranging from benign pathologies such as infection (hemorrhagic cystitis) or stones to malignant tumors. It involves early and rigorous treatment
Participation of Georgian Local Authorities in the Process of Hospital Care Reforms
Get PDFThe article addresses power distribution issues within the context of scientific discourse and explores potential solutions to be implemented by local authorities in the realm of Hospital Care reforms in Georgia, particularly in the conditions of authority decentralization. The significance of addressing this scientific issue stems from the financial challenges faced by many communities, especially in economically depressed Georgian regions. Prior to the reform, the network of hospital facilities relied on subsidies from higher-level budgets.
The methodological approach involves the use of desk research, secondary analysis of literary, research, and analytical sources, along with regulatory methods. The research spans from 1991 to 2022, focusing on the power of local self-governments, both their inherent powers and those delegated to them, given that almost 60% of medical services are provided at the territorial community level.
The article presents empirical analysis results regarding the distribution of financial power in the new model of Hospital care management. It demonstrates that, fundamentally, the new model remains budget-funded, consistent with the pre-reform structure. The research empirically and theoretically supports the assertion that the overall direction of reforms has been appropriately chosen, a sentiment echoed by positive assessments from international experts.
The findings of the research can be valuable for local authorities representing the interests of territorial communities and for local executive authorities involved in the implementation of these reforms. Additionally, the research aligns with Georgia's commitment to the path towards European integration changes.
This process is developing very slowly in Georgia. This is a loss of opportunity to raise the standard of living of local communities
Análisis Comparativo del Posicionamiento Preciso Utilizando el Receptor de Bajo Costo GNSS ZED-F9P en Conjunto con la Antena BEIBT300 y Diferentes Modelos de Antena de Orden Geodésico
Get PDFCon el avance de la Geodesia y la mejora de las especificaciones técnicas de los receptores de bajo costo, los GNSS abren nuevas alternativas para investigar las capacidades técnicas y rendimiento real que proveen este tipo de receptores para diferentes propósitos geodésicos. En este contexto, la precisión alcanzable fue analizada usando el receptor de bajo costo GNSS ZED-F9P en conjunto con dos antenas de orden geodésico (ASH701975.01B y LEIAS10 NONE) y una antena de bajo costo (BEIBT300 NONE). Las observaciones GNSS fueron llevadas a cabo en un periodo de dos días para cada modelo de antena. El análisis fue realizado en tiempos de observación de 12, 6 y 1 h, respectivamente. Estas observaciones fueron procesadas usando el método relativo estático mediante la inclusión de una estación de referencia continua del Instituto Nacional de Estadística y Geografía, la cual está localizada a una distancia aproximada de 4 km. Los resultados demuestran que la mayor precisión es lograda en un periodo de 12 h, con diferencias mínimas de 3 cm para la componente Norte y 33 cm para la vertical. En este sentido, la solución menos precisa es obtenida en el periodo de 1 h resultando diferencias de 70 cm, 46 cm y 2.3 m para la componente Norte, Este y vertical respectivamente.
With advancements in geodesy and enhancements in the technical specifications of low-cost receivers, GNSS opens up new avenues for investigating the capabilities and performance provided by these receivers for various geodetic purposes. In this context, the precision achievable using the low-cost GNSS receiver ZED-F9P in conjunction with two geodetic antennas (ASH701975.01B and LEIAS10 NONE) and a low-cost antenna (BEIBT300 NONE) was analyzed. GNSS observations were conducted over a 2-day period for each antenna model. The analysis involved observation durations of 12, 6, and 1 h. These observations were processed using the static relative method alongside a continuously operating GNSS station from the Active National Geodetic Network of the National Institute of Statistics and Geography, situated at ~4 km. The results demonstrate that the highest precision was achieved over a 12 h period, with minimal differences of 3 cm for the North component and 33 cm for the vertical component. Conversely, the least accurate solution was obtained within a 1 h observation period, resulting in differences of up to 70 cm, 46 cm, and 2.3 m for the North, East, and vertical components, respectively
Navigating Chronic Disease Management with Digital Healthcare Solutions amidst the COVID-19 Pandemic: A Systematic Literature Review
Get PDFPurpose: The purpose of this paper is to critically evaluate data collected from various studies on Chronic Disease Management during the COVID-19 pandemic and the emergence of Digital Healthcare as a means of providing innovative approaches to manage chronic diseases. Methodology: A systematic literature review was applied. Studies were found after a search in the Pubmed database with no publication date time limit, given that COVID–19 emerged in 2019. A Prisma diagram was created to record the way and the criteria by which we included and excluded studies for our research. Out of the 567 records identified through various sources 85 were used for a qualitative synthesis. Results: During the first wave of the pandemic, a significant reduction or complete cancellation of scheduled health appointments was observed. Shortages of medication used to manage chronic conditions were also observed at the beginning of the COVID-19 pandemic due to global supply chain disruptions. Governments acted rapidly at the beginning of the pandemic to promote the use of teleconsultations by introducing enabling legislation and revising laws ensuring continuity of care for people with chronic diseases, thus transitioning rapidly to remote care and monitoring. Conclusion: Telemedicine and involving community pharmacists in chronic patient management are key for sustained adherence. Long-term policies are vital to prevent pandemic-driven health disparities. Lessons should be derived for future preparedness, managing subsequent waves, and ensuring testing in primary care
Approche Géospatiale de la Localisation des Stations-Services au Cameroun
Get PDFLes opérateurs du secteur pétrolier aval appelés « marketeurs » se déploient en construisant des stations-services. Les implantations de ces infrastructures de distribution des produits pétroliers soulèvent des questions de par les objets qui les entourent. La proximité des stations-services d’avec les lieux publics exprime des positions antinomiques au regard de la réglementation sur les distances applicables à ces infrastructures classées comme dangereux. Cette proximité se manifeste par une concentration autour des stations-services des activités humaines et des maisons d’habitations. Ce qui les expose davantage aux risques sanitaires tels que la pollution de l’air, l’inhalation des odeurs des carburants, les explosions et les incendies. Les marketeurs doivent respecter une distance légale de cinq cent (500) mètres au minimum entre une station et les lieux fréquentés par le public. Des observations de terrain suivies des levés de coordonnées de géolocalisation restituent une cartographie des positions de chaque station-service. Les entretiens avec les sous-gérants nous renseignent sur les préférences d’implantation des stations-services et les services qui accompagnent la vente des produits pétroliers. Les résultats indiquent que les stations-services se trouvent en moyenne à trente (30) mètres des lieux publics. L'implication citoyenne dans la gestion intégrée des établissements humains peut se faire par la collecte et la production des coordonnées géographiques de chaque station en se servant de leur téléphone portable. L'adoption de cette approche s'emploierait à sensibiliser davantage pour réduire les risques portés par la présence des stations-services dans notre environnement.
Operators in the downstream oil sector called “marketers” are deployed through the construction of filling stations. The establishment of these petroleum product distribution infrastructures raises a set of questions due to the objects that surround them. The proximity of service stations to public places expresses contradictory positions with regard to the regulations on distances applicable to these infrastructures classified as dangerous. This proximity is manifested by a concentration around service stations of human activities and residential houses. This further exposes them to health risks such as air pollution, inhalation of fuel odors, explosions and fires. Marketers must respect a legal distance of at least five hundred (500) meters between a station and places frequented by the public. Field observations followed by geolocation coordinate surveys produce a map of the positions of each service station. Interviews with sub-managers provide us with information on the preferences for the location of service stations and the services that accompany the sale of petroleum products. The results indicate that gas stations are located on average thirty (30) meters from public places. Citizen involvement in the integrated management of human settlements can be done by collecting and producing the geographic coordinates of each station using their mobile phone. Adopting this approach would work to raise awareness to reduce the risks posed by the presence of gas stations in our environment
Evaluation de la Mise en Oeuvre des SONU dans le Département des Collines (Benin) en 2022
Get PDFObjectif : Evaluer la mise en œuvre des soins obstétricaux et néonataux d’urgence (SONU) dans le département des Collines (Bénin). Cadre et méthodes : Il s’agissait d’une étude transversale, descriptive à visée évaluative ayant porté sur l’adéquation de la structure, le processus ainsi que le niveau de performance des 9 centres SONU que compte le département des Collines. Le traitement et l’analyse des données ont été faits à l’aide du logiciel Microsoft Excel 2016. Résultats : La qualité de la structure était bonne dans 3 centres SONU sur 9. La qualité du processus quant à elle était bonne dans 2 centres SONU sur 9. Les points forts de la mise en oeuvre étaient la réalisation des audits de décès maternels et néonatals suivis de rétro-information, la disponibilité du personnel de santé qualifié dans les centres SONU, la permanence et la continuité des soins. Conclusion : Il ressort de cette évaluation que la performance des centres SONU du département des Collines est globalement moyenne et mérite des actions correctives.
Objective: Evaluate the implementation of Emergency Obstetric and Neonatal Care (SONU) in the Collines department (Benin). Framework and methods: This was a cross-sectional, descriptive study with an evaluative aim which focused on the adequacy of the structure, the process as well as the level of performance of the 9 EmONC centers in the Collines department. Data processing and analysis were done using Microsoft Excel 2016 software. Results: The quality of the structure was good in 3 out of 9 EmONC centers. The quality of the process was good in 2 EmONC centers out of 9. The strong points of the implementation were the carrying out of maternal and neonatal death audits followed by feedback, the availability of qualified health personnel in the EmONC centers, the permanence and continuity of care. Conclusion: It appears from this evaluation that the performance of the SONU centers in the Collines department is generally average and deserves corrective actions
Acceptance of Papillomavirus Vaccination among Females in Al-leith Province, Saudi Arabia
Get PDFA community-based study was carried out among females in Al-leith province, Saudi Arabia to identify the acceptance of females to be vaccinated against Human Papillomavirus (HPV). We interviewed 315 females in ages from 11 to 26, the target group of HPV vaccination. The relevant data were collected using a simple questionnaire. The findings illustrated that majority of participants were in age group (15 – 26 years), the actual target of vaccination against HPV, most of participants were Saudi females, and most of them were not married. It was found that less than half (43.8%) of females were willing to receive the vaccine, and the rest of the total females did not accept vaccination. The study concluded that still high percentage of females in Saudi Arabia did not accept vaccination against Human papillomavirus, the issue that need more efforts to increase the percentage of vaccination acceptance
Evaluation de la Qualité Physico-Chimique et Microbiologique des eaux de Puits Consommées dans le Quartier Kombé à Brazzaville
Get PDFNaturellement, les eaux souterraines sont potables de façon générale et devraient être consommées sans aucun traitement préalable. Malheureusement, ces eaux sont soumises actuellement à une forte pression anthropique. Cette étude vise d’évaluer la qualité physico-chimique et microbiologique des eaux de puits consommées dans le quartier Kombé à Brazzaville. Quatre puits ont été identifiés et caractérisés. La caractérisation a montré trois puits équipés des mêmes systèmes de protection et de remontée d'eau et, un seul point de prélèvement diffère des autres par le système de remontée d'eau. Trente-trois paramètres physico-chimiques et neuf paramètres microbiologiques ont été évalués par des méthodes normées et référencées. Les résultats obtenus révèlent du point de vue physico-chimique que, les eaux de puits étudiées sont faiblement minéralisées et tous les paramètres physicochimiques répondent aux normes de l'OMS, excepté le pH, la concentration des ions cadmium, chrome, phosphate ainsi que de la silice dans certains cas. Une seule famille chimique est mise en évidence : les eaux chlorurées sodique et potassique. Malheureusement, ces eaux sont fortement chargées en Escherichia. coli, Salmonella et Shigella, coliformes totaux, Pseudomonas aeruginosa, germes totaux, staphylocoques, levures et moisissures. Elles sont impropres à la consommation humaine et doivent subir quelques traitements préliminaires comme la correction du pH à la chaux et la désinfection à l’hypochlorite de sodium.
Naturally, groundwater is generally drinkable and should be consumed without any prior treatment. Unfortunately, these waters are currently subject to strong anthropogenic pressure. This study aims to evaluate the physicochemical and microbiological quality of well water consumed in the Kombé district of Brazzaville. Four wells were identified and characterized. The characterization showed three wells equipped with the same protection and water rise systems and only one sampling point differed from the others by the water rise system. Thirty-three physicochemical parameters and nine microbiological parameters were evaluated using standardized and referenced methods. The results obtained reveal from the physicochemical point of view that the well water studied is poorly mineralized and all the physicochemical parameters meet WHO standards, except pH, the concentration of cadmium, chromium, phosphate ions as well as than silica in certain cases. Only one chemical family is highlighted: sodium and potassium chloride waters. Unfortunately, these waters are heavily loaded with Escherichia. coli, Salmonella and Shigella, total coliforms, Pseudomonas aeruginosa, total germs, staphylococci, yeasts and molds. They are unfit for human consumption and must undergo some preliminary treatments such as pH correction with lime and disinfection with sodium hypochlorite