The characterization of a hospitalized population at the pediatric emergency service of mother and child hospital, Marrakech, Morocco

Introduction: the pediatric emergency department is the first contact between the population and the hospital. Consequently, its dysfunction influences the quality of general health care. However, any successful policy must first be based on convincing results hence the need to better explore this service, diagnose the various dysfunctions, and survey disease trends to identify the needs of the local population. In this perspective, we propose to describe the epidemiological profile of children hospitalized at the emergency service of the Mother-Child hospital, University Hospital Centre Marrakech, and establish the prevalence table for childhood pathologies. Methods: a retrospective study was carried out in pediatric emergency services for 1658 hospitalized patients between March 2015 and December 2018. The collected data concerns mainly the socio-demographic, clinical profile, evolution status, mode of admission, and medical history. Results: the characterization of the studied population by sex and age showed a predominance of Male with a sex ratio of 1.36, infants with 625 patients. Concerning the final diagnosis, the most frequent pathologies affected the respiratory system in 28% of cases, then the digestive system (11.3%), while infectious pathologies represented 10.7% of admissions. The death rate in the emergency department was 7.4%. Multivariate analysis of the data showed a statistically significant relationship between the final diagnosis (16 diseases by a system according to The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) and age, season, and weight. Thus, for the association between Diseases of the digestive system and weight (aOR=1.052, 95% CI= 1.019-1.086, p=0.02). While for Diseases of the skin and subcutaneous tissue and the autumn season (aOR=11.37, 95% CI= 1.272-<101.777, p=0.03) and age has a negative significance for most diseases. Conclusion: the epidemiological profile study will allow knowledge of patient´s pathologies typology for a well-supported and better definition of needs.

Influence of third cemetery location on the quality of domestic and groundwater resources in Benin City, Nigeria

ABSTRACT: The present study investigates impact of burial practices on water quality in Benin City, Nigeria by collecting groundwater samples from boreholes located by the peripheral area of Third Cemetery in Benin City and a reference site approximately 4 km away using standard methods. With the exception of SO4, CaCO3, Fe and DO, the concentrations of other parameters were higher in water samples obtained from the peripheral area of Third Cemetery than that from the reference site. Principal component analysis (PCA) revealed that pH, Fe, and CaCO3 were differentiating parameters related to reference site, similar condition was attributed to SO4 and Mg for site 2 and Pb, Mn, Cu, Ni, Zn and DO for sites 1 & 3. Cluster analysis (CA) placed the reference site as outlier to other sites. Higher concentrations of Cl, NO3, Na, K and BOD5 in samples obtained by cemetery peripheral when compared to reference site and positive correlations among these parameters are indications of impacts of decomposing activities in cemetery upon water quality in underlying aquifer. Limiting water quality index (WQI) computation to pH, EC, Cl, NO3, SO4, Na and BOD5 showed that quality of groundwater obtained from cemetery peripheral is not good for domestic uses

Can prostate cancer be predilected in BHP patients with elevated serum PSA negative initial sextant biopsy? A multivariate analysis study

Objective To define a predictor of prostate cancer in BPH patients with an intermediate PSA (4.1-10 ng/ml) and a negative initial sextant biopsy. Patients and Methods During 1999; 193 BPH patients with an intermediate PSA (4.1-10 ng/ml) underwent TRUS and sextant biopsy. The patients whose initial biopsies were negative for prostate cancer were re-evaluated by serum PSA every 6 months. A total of 76 patients were subjected to an extended 11-core biopsy in view of: (1) PSA velocity ? 1 ng/ml/year; (2) a PSA rise to 10 ng/ml and (3) suspicious biopsy findings (atypical adenomatous hyperplasia or high-grade prostatic intraepithelial neoplasia). Overall; 160 patients were subjected either to TURP (n=127) or open prostatectomy (n=33). Results On initial sextant biopsy; prostate cancer was diagnosed in 22 out of 193 patients (11.4). The specificity of the sextant biopsy was 91.8and its positive predictive value (PPV) was 61.1. A repeat 11-core biopsy revealed prostate cancer in 11 out of 76 patients (14.5). The specificity of the 11-core biopsy was 95.4and its PPV was 78.6. Three cancers out of 160 (2) were discovered on definitive pathology. The PSA velocity cut-off point at 1.4 ng/ml/year and the PSA density cut-off point at 0.12 were optimal for the prediction of cancer using receiver operating characteristic curves. The multivariate analysis (stepwise logistic regression) revealed that PSA density (p=0.011); PSA velocity (p=0.002) and age (p=0.021) were the most significant predictors of cancer when the data were inserted as a continuous format. The sensitivity; specificity and overall accuracy of the model were 80; 98.7and 95.9; respectively. When the data were re-inserted as a coded format; PSA velocity and PSA density were the only predictors. All the analyzed risk factors (age; PSA; DRE; prostate echogenicity and PSA/TZ index) were excluded from the model. Conclusion PSA velocity and PSA density were the most significant predictors of prostate cancer in BPH patients with an intermediate PSA (4.1-10 ng/ml) and a negative initial sextant biopsy