Prevalence of cerebrovascular accident and its associated risk factors among patients admitted into the neurological ward of university of Benin teaching hospital

Stroke is the second leading cause of death, accounting for 11.13 % of total deaths, and the main cause of disability worldwide. Objective: To determine the prevalence of stroke, its associated risk factors and survival rate among patients admitted to the neurological ward of University of Benin Teaching Hospital, Benin City, Edo State. Methods: A retrospective descriptive survey of patients admitted to the neurological ward of University of Benin Teaching Hospital, Benin City, Edo State from 2015 to 2020. A proforma was used to collect relevant data from medical records. Data was analyzed with IBM SPSS Statistics version 23, using descriptive and inferential statistics at 5% level of significance. Result: The average prevalence of cerebrovascular accident over the six years under review was 58.9%. Highest (69.3%) prevalence was recorded in 2018. Males (52.9%) were more affected than females and the age range 70-89 years was most affected (47.6%). The commonest comorbidities were hypertension and diabetes mellitus. Survival rate was high during the period under review, it was at the least in 2016 at 67.1% and highest in 2019 at 76%. Multiple logistic regression shows that patients who had CVA at below 30 years old were less likely to survive (OR;0.06: CI: 0.000-0.114; p = 0.001). Being married conferred a greater likelihood of surviving a CVA (OR;5.34: CI: 1.135 -25.135; p = 0.034) than being unmarried (OR;2.89: CI: 2.702-49.673; p = 0.004). Tertiary level of education conferred the greatest likelihood of surviving a CVA (OR;8.00: CI: 24.401-1168.674; p = 0.000). Conclusion: The prevalence of stroke from this study was high. Hypertension and diabetes mellitus were the most common risk factors associated with stroke. In-hospital stroke survival rate was high. The findings from this study can support advocacy for more efficient community-based programs geared towards awareness creation about stroke, its risk factors and prevention.

Les mini implants dans la stabilisation de la PAC

La prothèse amovible complète (PAC), malgré tous les progrès qu'à connue la dentisterie, constitue jusqu'à nos jours une thérapeutique très répandue dans nos populations. La PAC bénéficie actuellement de la possibilité de voir ses avantages et ses impératifs d'équilibre nettement améliorés par la mise en place d'implants. Cependant, dans un certain nombre de cas, les déficits du volume osseux peuvent contre-indiquer l'utilisation d'implants standards sans aménagement préalable de la crête, lorsque cela n'est pas souhaité par le patient pour des raisons financières, d'allongement du temps de traitement ou du nombre d'intervention, etc., ou par le praticien pour des raisons anatomiques ou médicales, les miniimplants prennent leur place d'alternative de choix. Technique reconnue par la FDA (Food and Drug Administration: 12 mai 1998). Son taux de survie avoisine celui des implants de diamètre plus large. Le confort fonctionnel et esthétique immédiat et le coût modéré de cette technique expliquent son succès. A travers un cas clinique nous allons passer en revue le protocole chirurgical et prothétique et essayer de démontrer jusqu'à quelle mesure cette solution thérapeutique peut répondre aux exigences de nos patients en comparaison avec une stabilisation conventionnelle avec des implants standards

Predictors of survival among HIV-positive children on ART in Swaziland

The objective of the study was to determine predictors of survival among HIV-positive children (<15 years) in Swaziland. A retrospective cohort analysis of medical records for 4 167 children living with HIV who were initiated on antiretroviral therapy (ART) between 2004 and 2008, and followed up until 2014 was conducted in clinical settings at 36 health facilities. The Kaplan Meier Estimator, signed-ranks test, and the Cox proportional hazards regression model were applied to determine survival probabilities, significant difference among stratified survival functions and adjusted hazard ratios respectively. The results reveal that the median survival time for children was 78 months (95% CI: 77­79). Children who were initiated early on ART had higher survival probability over time (HR: 0.35 [95% CI: 0.21­0.57], p < 0.001) compared to those whose ART initiation was delayed. Children within the age group of <1 years had higher hazard (HR = 1.55 [95% CI: 1.16­2.08], p < 0.001) of death than children within the age group of 1­14 years. Children who were nourished had 88% lower hazard of death (HR: 0.12 [95% CI: 0.07­0.19], p < 0.001) than severely malnourished children. The study demonstrates that ART paediatric services are effective in increasing survival among HIV infected children and early initiated children have high survival probability. Active tuberculosis (TB), malnutrition, and delayed ART initiation remain predictors of poor survival among children living with HIV

Survie actuarielle comparée des malades atteints de cancer du sein et de l'estomac

Le cancer de l'estomac atteint un organe profondément situé, dont l'accessibilité n'est rendue possible que par l'endoscopie. Par contre le sein est un organe accessible à l'examen clinique mais chargé de symbolismes : féminité, maternité, sexualité. Cette différence dans l'apparence nous a conduits à en évaluer la survie globale à cinq ans, à partir des données du Registre des cancers de Brazzaville. Nous avons alors utilisé la méthode actuarielle pour construire les courbes de survie qui ont été comparées par la suite selon le test du log-rank. Ces différents calculs nous ont permis de constater l'absence de différence statistiquement significative entre les survies globales des malades atteints de ces cancers d'apparence si dissemblable

Improved survival rate in neonatal tetanus among babies of immunised mothers

Fifty-two neonates admitted for tetanus into our neonatal unit at Wesley Guild Hospital; Ilesa over a thirty-month period were analysed in relation to maternal immunisation with tetanus toxoid during pregnancy. Seventeen (32.7) of the babies were delivered to mothers who had tetanus toxoid immunisation during pregnancy. The male to female ratio; mean age and weight of babies in the two groups were similar. Six mothers took discharge of their babies against medical advice. Twenty (43.5) of the remaining 46 babies died. The fatality rates in the 16 infants of mothers who had tetanus toxoid and 30 infants of mothers who did not have tetanus toxoid during pregnancy were 12.5and 60respectively (P0.01). This report thus shows that neonatal tetanus can occur in babies of mothers immunised with tetanus toxoid during pregnancy but that maternal immunity probably improved the prognosis of neonatal tetanus in such infants