Urinary tract infections related to urinary polls

They are the most common and yet occupy 65% to 80% of nosocomial infections worldwide, despite efforts to control provided by the health authorities. In Africa, on a 46.7% infection rate of these infections, 43% are due to the survey. In Morocco, there is an incidence rate of 13.4% with a rate of 7.5% nosocomial bacteriuria among patients surveyed and a rate of nosocomial colonization of 6.5%. Hence the importance of this work to describe the risk factors for these infections aims. This is a descriptive study, prospective, qualitative and quantitative data collection tools as means of a questionnaire to 35 people involved in such acts; interviews with four medical specialists and the study of 30 cases of patients with urological services and resuscitation. This study showed that the risk factors associated with these infections are advanced patient age, poor health and disease history such as urinary tract infection, prostate cancer, gallstones and diabetes. Added to this are the organization of care such as lack of supervisory, non-notification of the surveyed patients and the workload of staff. As can be seen from this study, 33% of staff did not receive training in this technique, while there are twice as many bacteriuria when the probe is asked by a staff that is not specifically trained. The combination of the results allowed us to predict the risk factors of urinary tract infection-related survey and propose corrective and preventive actions; [a] set up units to IEC for patient education; [b] strengthen the health care team to reduce the workload attributed to it; [c] ensure compliance with protocols

[Prostate cancer with PSA

Prostate cancer [PCa] is a public health issue still targeted by many studies. Unfortunately, data on that cancer are rare in Northern Africa and especially in Morocco. We present characteristics of this type of cancer. From February 2003 to March 2010, 162 PCa were diagnosed in our institution, 41 of them with PSA < 10ng/mL. In those patients, we analyzed the age, symptoms, PSA level including the free/total ratio, pathological report on biopsy, preoperative imaging [pelvic MRI and bone scintigraphy] data, therapy including adjuvant or salvage management, pathological report on specimens, and follow-up data [PSA, urinary continence, potency, mortality]. The mean age of the 41 patients was 63.93 years [range: 47-77]. PSA dosage was performed in 85.4% of them as they consulted for low urinary tract symptoms. Median PSA level was 5.76ng/mL [range: 1.26-10] at diagnosis; the mean free/total PSA ratio was 13.77%. All 41 cancers were adenocarcinomas. 87.8% of them were clinically organ-confined. According to D'Amico classification, 65.85% were low risk, 9.76% were intermediate risk and 24.39% were high risk cancers. The Gleason score at biopsy was 7[4+3] or less. Radical prostatectomy was performed in 95.12% of patients. 7.69% were pT3b, all of others were pT3a or less; the Gleason score was 6 or less in 73.34% specimens and surgical margins were positive in 30.77% of specimens. Post-prostatectomy PSA increased in 26.83% of cases. Adjuvant radiation and hormonal therapy were used in 34.15% of patients. 90.24% of the patients proved undetectable PSA on latest dosage while only 2.34% experienced biochemical recurrence. 82.05% of the patients were continent, 33.33% of them were potent. This cancer were diagnosed in younger men; 87.8% of those cancers were organ-confined; treatment option were radical prostatectomy with excellent disease-free survival rate

[Hospital acquired infections due to Klebsiella pneumaniae]

Nosocomial urinary tract infections are one of the most common hospital acquired infections and often due to multi-drug resistant bacteria. Control of spread is still priority measure of public health. To describe an outbreak caused by an extended spectrum beta-lactamase Klebsiella pneumoniae and research of its hospital reservoir. Over 12 days period, extended spectrum beta-lactamase Klebsiella pneumoniae was isolated from 5 in-patients with urinary tract infection. General warning was given and outbreak investigation was conducted. The five strains had the same antibiotype characterized by colistin, amikacin, fosfomycin and imipenem sensibility. Investigation has shown index case and the absence of identified environmental reservoir suggests that transmission was effective by hands. Eradication of epdemic strain was obtained by geographical and technical isolation and amelioration of hygiene conditions. Swift identification of an outbreak by phenotypical characterization of isolated strains allowed the control of this outbreak

[Retrovesical hydatid cyst: diagnostic and therapeutic aspects]

To evaluate the clinical, radiological and surgical features of retrovesical hydatid cysts and to discuss their etiology, and pathogenesis. Between 1988 and 2001, 8 patients with retrovesical hydatid cyst were hospitalized. and operated at the Urology Department of the Military university hospital Mohamed V Rabat, Morocco. The mean age of the patients was 44 years. Bladder irritation was the most frequent presenting symptom. Hydaturia was found in one case only. Cysto-pericystectomy was performed in all patients. The post-operative course was uneventful and only one patient developed urinary fistula which was repaired successfully Retrovesical hydatid cysts are rare and treatment is mainly surgical

School oral health survey in Kairouan, Tunisia

The aim of the oral health survey was to study oral disease prevalence in 600 schoolchildren [aged 6 years and 12 years] in Kairouan. World Health Organization methodology was used and the results were compared with the 1994 national survey findings. As well as oral examination, fluoride dosage in drinking water was assessed. Analysis showed that the findings were in agreement with the national survey except for dental caries prevalence, therapeutic index and dental fluorosis prevalence. Thus WHO recommendations made after the national survey remain valid in Kairouan