Scorpion venom component: AGAP exhibits local anaesthetic effects and attenuates nociceptive pain

The incidences of systemic toxicity and other complications associated with existing local anaesthetics can occur at clinical concentration level and vary with the anaesthetic techniques, types of surgery and patient factors. This evidence suggests the need for therapeutic interventions in peripheral and regional anaesthesia. Buthus martensii Karsch (BmK) scorpion venom is a compound that contains mixtures of peptides that have analgesic properties. This study aimed to investigate the local anaesthetic activity of scorpion venom peptide, AGAP (analgesic-antitumor peptide) in mechanical hyperalgesia or acute inflammatory pain. Method: Formalin was injected into the left hind paw after 20 minutes of infiltration of drugs. The time of licking or flinching of the injected hind paw was recorded as indicative of nociceptive or acute inflammatory pain. Paw flinching or quick withdrawal was considered a positive response to pain in the partial sciatic nerve ligation. The paw-withdrawal threshold (PWT) was determined by consecutively increasing and decreasing the magnitude of the stimulus. Results: The results indicated that AGAP exhibited a 67.9% inhibition in licking or flinching time and an 88.1% inhibition in paw withdrawal in mechanical hyperalgesia. The addition of AGAP to lidocaine showed an 89.5% inhibition in paw withdrawal. Conclusion: The data presented in this study suggest that local infiltration of AGAP significantly reduced mechanical hyperalgesia and acute inflammatory pain

Musculoskeletal disorders in operator drivers in northwestern Namibia ­ associated factors and awareness

Background: Operator drivers are responsible for driving trackless heavy-duty mining or construction vehicles such as graders, dumpers, loaders, and bulldozers. They have an increased prevalence of musculoskeletal disorders (MSDs) due to the nature of their work. There is a paucity of data on MSDs and associated factors among operator drivers in Namibia. Objective: We assessed awareness of, and factors associated with, MSDs among operator drivers in the construction and mining industries in Namibia. Methods: In this cross-sectional study, questionnaires were administered to operator drivers, and managerial staff were interviewed, using a semi-structured interview guide. Data obtained were analysed using chi-square tests and binary logistic regression modelling. Results: 182 operator drivers completed the questionnaires, and 13 operator drivers' supervisors and managers were interviewed. Factors associated with MSDs were length of service for ≥ 10 years (OR 15.3, 95% CI 6.0­39.0), alcohol consumption (OR 2.8, 95% CI 1.1­6.7), lack of physical fitness activity (OR 8.8, 95% CI 3.8­20.4), and lack of awareness of MSDs (OR 3.1, 95% CI 1.3­7.3). Managerial staff were of the opinion that the operator drivers did not suffer from MSDs. Conclusion: We found health issues that are associated with MSDs among the operator drivers, impacting their general wellness and productivity. Monitoring of health and wellness of these workers by the companies is recommended. There is need to increase MSD awareness, personal protective equipment usage, ergonomics skills training, and physical fitness exercises for operator drivers. Employers are urged to adopt policies, and to design guidelines and interventions aimed at promoting occupational health and safety in this population.

Evaluation de la douleur néonatale liée aux soins et gestes

Introduction : Il est actuellement admis que le Nouveau-Né (NN) est capable de ressentir, de percevoir et même de mémoriser la douleur. En l'absence d'une prise en charge, la douleur pourrait avoir des conséquences délétères à court, moyen et long terme, particulièrement sur le cerveau. Objectif : Evaluer l'ampleur de la douleur du NN liée aux soins et gestes, au moyen de l'échelle Douleur Aiguë du Nouveau-né (DAN). Méthodes : Etude descriptive et transversale, réalisée au service de néonatologie et à la maternité des Cliniques Universitaires de Kinshasa (CUK), de mai 2017 à mars 2018. Elle a porté sur les NN à terme et prématurés d'au plus quatorze jours de vie post-natale ayant fait l'objet d'une évaluation de la douleur. Les tests X² de Pearson, d'indépendance, le t de Student ainsi que l'ANOVA ont été utilisés selon les conditions d'application. Résultats : Sur les 201 NN recrutés, 148 (73,6%) provenaient du service de néonatologie et 53 (26,37%) de la maternité. La majorité des NN étaient à terme (71,14%), de sexe masculin (54,23%), avec un âge lors du recrutement variant entre 0 et 7 jours (94,53%). Nous avons répertorié 623 gestes, dont 94,7% étaient douloureux. Soixante-neuf pourcents de gestes avaient un seuil de douleur très intense, avec un score moyen de 8,48 ± 2,462. L'injection intramusculaire (84,21%), le prélèvement sanguin (80,76%), la pose de la voie veineuse périphérique (75,00%) ainsi que l'ablation d'adhésif (64,63%), étaient les gestes qui avaient généré une douleur maximale (p < 0.0005). Conclusion : Les NN subissent plusieurs gestes au cours de leur séjour aux CUK, et la majeure partie de ceux-ci s'avèrent très douloureux

Strengthening quality of acute care through feedback from patients in Ghana

Introduction :Quality of acute care has attracted attention in recent years with policy initiatives in Ghana. Such initiatives need to be complemented with patient feedback systems for strengthening quality. Therefore the goal of this study is to examine factors associated with quality of acute care and to propose a range of options for improving the existing model of healthcare delivery. Methods: Cross-sectional data were collected from 379 patients presenting to emergency centres in five public health facilities. A structured questionnaire developed based on the literature and expert advice by physicians and nurses was used to collect data. Principal component analysis (PCA) was used to extract the factors salient to patients' perspective of quality of care. Logistic regression was then used to examine association between these factors and overall quality of acute care. Results :The majority of the patients (17.2) presented with obstetrical related conditions; 15 with Road Traffic Accidents (RTAs); 11.3 with diarrhoea related problems and the least number (8.4) with bronchial asthma. The average days of admission was high for patients with bronchial asthma (mean = 9); RTA (mean = 8) and burns (means = 7). The PCA produced four factors of quality (interpersonal care; prompt care; physical environment and privacy; drugs and equipment) all of which had a positive statistically significant association with overall quality of acute care after controlling for patient's socio-demographic characteristics.Conclusion Study findings provide important feedback not only for optimising clinical operations but also for improving in-hospital quality of acute care with short-term and long-term approaches

Les etiologies medicales des douleurs abdominales de l'enfant a Bouake (Cote d'ivoire)

Contexte : Les douleurs abdominales aigues (DAA) posent en urgence un probleme diagnostique et prise en charge therapeutique. Les causes medicales n'ont pas encore ete precisees chez l'enfant a Bouake. Objectif : Identifier les principales etiologies de la DAA de l'enfant Patients et methodes : Il s'agit d'une etude retrospective et descriptive realisee au CHU de Bouake du 1 er janvier au 31 decembre 2012. Elle a inclus 90 enfants ages de 2 a 14 ans hospitalises pour DAA. Les parametres d'etudes etaient epidemiologiques et diagnostiques. Resultats : Les 90 cas de DAA ont ete retenus parmi 3677 admissions soit 2;5 . Le sexe ratio etait de 0;95 et l'age median de 72 mois (24-168 mois). La tranche d'age 60-119 mois representait 46;5. Le delai avant la consultation etait superieur a 48 heures dans 63;1. Les principaux signes fonctionnels associes etaient la fievre 86;7; les vomissements 62;2; l'anorexie 50; l'asthenie 37;7; le trouble de la conscience 20 et les convulsions 15;5. Les principaux signes physiques etaient la fievre 67;7; l'anemie 63;4 ; la splenomegalie 23;6; le coma 19 et le tirage intercostal 11;8 . Le paludisme (62;1); la drepanocytose (6;6); la pneumonie (5;7); la fievre typhoide (5;5) et la gastroenterite (4;4) etaient les principales causes. Conclusion : Les principales causes medicales des DAA de l'enfant sont le paludisme; la drepanocytose et la pneumonie. L'amelioration du pronostic des DAA necessite le controle de ses principales causes