Encefalopatia toxica secundaria a vigabatrina: Reporte de caso / Toxic encephalopathy secondary to vigabatrin: Case report

El síndrome de West es una encefalopatía epiléptica caracterizada por espasmos en flexión, hipsarritmia en el electroencefalograma y retraso en el neurodesarrollo. Reportamos el caso de una paciente de 11 meses con diagnóstico de Síndrome de West y encefalopatía tóxica secundaria al uso de vigabatrina

West syndrome is an epileptic encephalopathy characterized by flexing spasms, hypsarritmia in the electroencephalogram and delayed neurodevelopment. We report an 11-month-old patient with a diagnosis of West syndrome and toxic encephalopathy secondary to the use of vigabatrin

Knowledge on prevention and management of snake bite among adults in rural area of West Bengal

Background: Snake bite and its consequences may be largely prevented with adequate knowledge. Better knowledge can lead to positive attitude and subsequently good practices. Hence, it is of utmost need that people should have adequate knowledge regarding snake bite and its management. Aims and Objectives: The aims of this study were to assess the knowledge regarding prevention and management of snake bite among adults in a rural area of West Bengal and to find out any association between sociodemographic profile and knowledge on prevention as well as management of snake bite among the study participants. Materials and Methods: A community-based and observational descriptive study was conducted in the rural field practice area of Medial College, Kolkata, West Bengal for of 2 months. The study participants who were willing to participate in the study and gave written informed consent were included in the study. A pre-designed, pre-tested, and semi-structured data collection form was used. It was developed based on similar type of previous studies and was modified according to the local culture. The data collection form comprised sociodemographic profile of the study participants, their knowledge regarding snake bite, and its prevention and availability of first aid management. Results: A total of 134 participants were included in the study. The mean age was 45.81 ± 8.00 years. It was observed that majority of the study subjects believed in the knowledge that all types of snakes are poisonous (93.2%) and leads to death (90.3%). First aid measures such as application of tourniquet that was seen in only 4.4% of the cases. However, more than half of the study subjects (71.6%) believed in sucking the venom out of the wound. It was noted that higher education status, improved social class had better knowledge score of snake bite prevention and management as compared to their counterparts and this association was found to be statistically significant (P < 0.001). Conclusion: Knowledge of the study subjects on snake bite and its prevention is good, but still a large number of participants have inadequate knowledge on snake bite and its prevention. Community-based awareness program on prevention and management of snake bite, use of personal protective measures, and training of peripheral health workers ware specifically recommended.

The first serological detection of West Nile virus infection among residents living in northern Turkey

Background & objectives: West Nile virus (WNV) is transmitted by a mosquito-borne virus whose natural reservoir is birds. Humans and horses are considered accidental hosts. Even if the vast majority of WNV infections in humans have asymptomatic or mild disease settings, serious neurological disorders with lethal outcomes can also be observed in around 1% of the cases. We aimed to serologically investigate the presence of WNV in humans living in Black sea of Turkey, and to obtain epidemiological data that will contribute to the implementation of public health policies to control and prevent potentially other life-threatening arboviral infections. Methods: In the current study, a total of 416 human sera were collected from native patients of Samsun and its boroughs attending Samsun Training and Research Hospital; these sera were tested for WNV with pooling method, using anti-IgM and IgG ELISA commercial kits. All pools that were found positive for both IgM and IgG were individually retested for the detection of positive WNV sera. After that, all positive samples were tested using realtime PCR to detect the presence of WNV-RNA particles. Results: Total seropositivity rates of WNV in terms of IgM and IgG were found as 0.96% and 0.72%, respectively. No presence of WNV-RNA could be detected in positive samples. Interpretation & conclusion: According to the data, further studies should be conducted to better understand the epidemiological dynamics of WNV in Turkey. It is recommended that other antigenically related flaviviruses which can give cross-reaction with WNV should also be investigated.

Healthy aging and care of the older adult with chronic disease: a qualitative needs assessment in 14 eastern and southern Caribbean islands / Envejecimiento saludable y atención de las personas mayores con enfermedades crónicas: evaluación cualitativa de las necesidades en 14 islas del Caribe oriental y meridional / Envelhecimento saudável e atenção à pessoa idosa com doença crônica: avaliação qualitativa das necessidades em 14 ilhas do Caribe oriental e meridional

ABSTRACT The objectives of this qualitative needs assessment were to assess perceived needs of health and social services professionals in the Caribbean Region to enhance services supporting healthy aging and care of older adults and to assess perceived facilitators and barriers to increasing capacity to serve their aging populations. The assessment, informed by the Consolidated Framework for Implementation Science, was conducted in 14 islands in the eastern and southern Caribbean. The results demonstrated need for education of professionals and the general population about the prevention and treatment of non-communicable diseases (NCDs), assessment and services for individuals with dementia, Alzheimer's disease, depression, and harmful alcohol use, all of which pose significant challenges for older adults. Education of health and social services professionals, families, and the public on the risk factors for NCDs and common mental and physical health problems is critical. Barriers to implementation of educational programs include lack of community awareness and resources within the islands. The needs assessment findings are foundational to planning educational interventions. These will be developed by local health providers with the collaboration and support of external resources including those of the Pan American Health Organization/World Health Organization Collaborating Centre in Gerontological Nursing Education.

Resumen Los objetivos de esta evaluación cualitativa de las necesidades fueron evaluar las necesidades que perciben los profesionales de la salud y de los servicios sociales en el Caribe a fin de mejorar los servicios de apoyo al envejecimiento saludable y el cuidado de las personas mayores, así como evaluar los factores percibidos como facilitadores y como obstáculos para mejorar su capacidad de atender a la población que está envejeciendo. La evaluación, basada en el marco consolidado para la ciencia de la implementación, se realizó en 14 islas del Caribe oriental y meridional. Los resultados mostraron la necesidad de capacitar a los profesionales y educar a la población en general acerca de la prevención y el tratamiento de las enfermedades no transmisibles (ENT), la evaluación y los servicios para las personas con demencia, alzhéimer, depresión y problemas de consumo nocivo de alcohol, todos los cuales plantean importantes desafíos para las personas mayores. Es imprescindible capacitar a los profesionales de la salud y de los servicios sociales, así como educar a las familias y al público en general sobre los factores de riesgo de las ENT y los problemas de salud mental y física más habituales. Entre los obstáculos a la aplicación de los programas educativos se encuentran la falta de concientización de la comunidad y la falta de recursos en las islas. Los resultados de la evaluación de las necesidades son fundamentales para planificar las intervenciones educativas, que serán formuladas por los prestadores de atención de salud locales con la colaboración y el apoyo de recursos externos, incluidos los del Centro Colaborador de la Organización Panamericana de la Salud/Organización Mundial de la Salud en Educación en Enfermería Gerontológica.

RESUMO Os objetivos desta avaliação qualitativa das necessidades foram avaliar as necessidades percebidas do pessoal da saúde e dos serviços de assistência social na região do Caribe, visando a melhorar os serviços de apoio ao envelhecimento saudável e de atenção às pessoas idosas e determinar os facilitadores e as barreiras percebidos, com vistas a melhorar a capacidade de prestar assistência às populações idosas. Esta avaliação foi realizada com base na Consolidated Framework for Implementation Science em 14 ilhas do Caribe oriental e meridional. Os resultados obtidos demonstraram que é necessário prover conhecimento aos profissionais e à população geral sobre a prevenção e o tratamento de doenças não transmissíveis, e a avaliação de pessoas com demência, doença de Alzheimer, depressão e uso prejudicial de álcool e os respectivos serviços, visto que são enormes desafios enfrentados pelas pessoas idosas. É fundamental que o pessoal da saúde e dos serviços sociais, os familiares e o público em geral conheçam os fatores de risco para doenças não transmissíveis e os problemas comuns de saúde mental e física que afligem a população idosa. A falta de sensibilização da comunidade e a escassez de recursos são barreiras à implementação de programas educacionais. As conclusões desta avaliação servem de base para o planejamento de intervenções educacionais a serem desenvolvidas localmente pelo pessoal da saúde, com a colaboração e o apoio de entidades internacionais, como o Centro Colaborador da Organização Pan-Americana da Saúde/Organização Mundial da Saúde para Educação em Enfermagem Gerontológica.

Self-medication and its associated factors in Amdanga block of West Bengal

Background: The WHO defines the use of medications without prior medical consultation regarding indication, dosage and duration of treatment as self-medication. The practice is a global problem. Aims and Objectives: The study was conducted to describe the care seeking behavior of rural self-medicators living in Amdanga Block of West Bengal and to assess the belief in medicines by the self-medicators. Material & Methods: A descriptive cross-sectional study was conducted by interviewing with a pretested semi-structured questionnaire on 665 self-medicators out of 1740 adults who were interviewed in 80 villages of Amdanga Block, West Bengal. A three-stage sampling method was used to reach the study population. A three month recall on self-medication practice was considered operationalizing the “pull” and “push” factors of self-medicators using a Pshycho-social framework. The variables were Socio-demographic factors, Care Seeking Behaviors, Health System related factors, Belief in Medicines according to the framework. Results: The prevalence of self-medication was found to be 38.2%. 63% of the study subjects were female and 56.3% had a literacy status of middle school and above. 54.4% relied on their old prescription for self-medication. 68.7% had an initial choice to consult a doctor but later self-medicated of whom 53.2% changed their choice due to monetary and transport issues while 38.5% thought of self-medication considering their disease was mild in nature. Conclusion: Awareness and health education can link rural subjects with primary care facility and right decisions on care can be provided.

Isolation of Bacterial Contaminants from Operating Theatres in EnNahud City, West Kordofan State – Sudan

Background: The prevalence of nosocomial infections has continued to rise due to microbial contamination of the hospital environment. Operating room contamination, on the other hand, is one of the most common and life-threatening sources of nosocomial infections. Objective: The goal of this research is to isolate and identify bacterial contaminants in operating rooms and equipment in EnNahud, West Kordofan. Methods: A total of 45 samples (from three hospitals) were collected from various operating theatre sites between September and December 2020. Using the accepted bacteriological methods (ISO/TC 147/SC 4 Microbiological techniques), all isolated bacteria were identified. S. Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923 were employed as control bacterial strains to track the entire bacteriological process. Results: Five kinds of bacteria were recovered from the 45 (100%) positive specimens in three hospitals in this study. The number of polluted hospitals is on the rise (100%). The most prevalent bacterial pollutants identified from operation theaters were Staphylococcus aureus 24 (53.3%), Pseudomonas aeruginosa 13 (28.8%), Bacillus spp 6 (13.3%), Proteus spp 1 (2.2%), and Salmonella spp 1 (2.2%), according to the findings (2.2%). All of the places where samples were taken were found to be completely contaminated. Conclusion: The relatively high degree of bacterial contamination in hospital operating rooms highlights the need for ongoing microbiological surveillance aimed at detecting bacterial contamination levels and their impact on nosocomial infection early.

Evaluation of the Rashtriya Bal Swasthya Karyakram (RBSK): A National Children Healthcare Program in a health district of West Bengal, India

Background: The Rashtriya Bal Swasthya Karyakram (RBSK) was launched in 2013 to screen and manage birth defects, deficiencies, diseases, and developmental delays including disabilities in Indian children, with the help of designated mobile health teams and grassroot workers across the country. Objectives: Performance of the RBSK program in three selected blocks of a health district of a large Indian state (West Bengal) was assessed. Methods: The performance assessment was based on input, process, and output performances, using checklists based on RBSK operational guidelines. Results: While some essential evaluation tools were available in required numbers at the block level, many were unavailable. There were deficiencies in the number of health staff appointed. Although most screening camps were conducted as per microplan, some were not. Anthropometric measurements were not done in some camps; Information, Education, and Communication (IEC) materials were not used adequately. Issues with fund management were also noted. The intervention rate at higher centers (District Early Intervention Centre) was low with regard to the children referred for management. Involvement of grassroot workers such as ASHA was also found to be lacking. Conclusion: Frequent orientation training of medical officers and staff is needed along with the efforts to strengthen the referral system and the patient tracking system. Sensitizing the children and their guardians regarding the importance of the relevant health issues is also needed with the help of the proper implementation of IEC services.

Epilepsy and Neurodevelopmental Outcomes in a Cohort of West Syndrome Beyond Two Years of Age

Objective To determine epilepsy and neurodevelopmental outcomes beyond 2 y of age and their putative prognostic factors in children with West syndrome (WS). Methods This cross-sectional study was initiated after approval from Institutional Ethics Committee. A follow-up cohort of 114 children (aged?2 y) diagnosed and treated for WS at the authors' center were assessed in-person for epilepsy and neurodevelopmental outcomes using Vineland Social Maturity Scale - Malin’s adaptation for Indian children. Subsequently, age at onset, lead-time-to-treatment, etiology, and response to any of the standard therapies were analyzed as possible predictors of these outcomes. Results Of 114 children (mean age: 55±32 mo, 91 boys), structural etiology was the predominant underlying etiology (79.8%) for WS. At 2 y of age, 64% had ongoing seizures. At the last follow-up, 76% had social quotient<55, and 39% had cerebral palsy (spastic quadriparesis in 21%). An underlying structural etiology was associated with ongoing seizures [OR (95% CI) 3.5 (1.4–9); p=0.008] at 2 y of age and poor developmental outcomes [OR (95% CI): 3.3 (1.3–8.9); p=0.016]. Complete cessation of spasms with the standard therapy was signifcantly associated with better seizure control [OR (95% CI): 5.4 (2.3–13); p<0.001] and neurodevelopmental outcome [OR (95% CI): 5.2 (1.8–14.9); p<0.001]. Conclusion The majority of children with WS have a poor neurodevelopmental outcome and epilepsy control on follow-up. The underlying etiology and response to initial standard therapy for epileptic spasms have a prognostic role in predicting the neurological outcome in these patients on follow-up.

Eco-physiological behavior of tamarind (Tamarindus indica L.) in dry environment of West Africa (case study of Senegal).

Water deficit is considered by several authors to be the most limiting factor for agricultural production in the subtropics (Kizito et al., 2006; Porcel and Ruiz-Lozano, 2004; Bader et al., 2006; Logan et al., 2010; Rodriguez-Gamir et al., 2011; Conedera et al., 2011). On woody plants, only a few isolated studies (on Acacia, and combretaceae) exist in the tropical zone south of the Sahara. Noteworthy are the works done on Sahelian forest species, Acacia tortilis (Diouf, 1996), Combretum glutinosum, Guiera senegalensis; Piliostigma reticulatum; Balanites aegyptica, Boscia senegalensis, A. senegal and Ziziphus mauritiana (Fournier, 1995; Kizito et al., 2006; Lufafa et al., 2008). Characterization of plant water functioning is a tool for selecting plants and/or varieties for their tolerance to water deficit (Lufafa et al., 2008; Zhu Qiuan et al., 2011; Logan et al., 2010). It is most often done at young age for ease of use (nursery and early field establishment of seedlings). However, even as adults, woody plants remain dependent on climatic factors such as rainfall (Kisito et al., 2007; Lufafa et al., 2008). It is therefore important to understand the in situ water functioning of adult plants to better explain the depressive effects of such complex water stress at a young age. However, the behavior of plants in situ is influenced by the climatic conditions and the uniformity (age) of the subjects (tamarind plants) to be followed. The present work was carried out on adult T. indica plants in situ in Senegal (Niokhoul in the Sahelian zone and Mbassis in the Sudano-Sahelian zone) and aimed mainly to: (1) understand and describe the physiological water management strategies of tamarind under arid conditions; and (2) understand the impact of this water management strategy on phenology and productivity. The study was conducted in Senegal, characterized by a dry and arid climate. It adopted a field approach (Seghieri, 2010; Conedera et al., 2010) based on adult stands and climatic data collected at the study sites. Ultimately, the adaptation mechanism of tamarind to water deficit would be that of avoidance, described by various authors (Khalfaoui, 1985; Lacape, 1996; Nwalozie and Annerose, 1996; Rouhi et al., 2007; Roussel, 2008; Maes et al., 2009). Indeed, the plant first proceeds to a decrease in water potential (case of the Mbassis stand) and in case of continuous water deficit, it integrates the reduction of the leaf surface by the progressive fall of the leaves and flowers which can go up to the total defoliation (case of the stand of the Sahelian zone in Niokhoul).

Some Mites Occurring On Edible And Wild Mushrooms From Three Districts Of West Bengal With Their Economic Importance

The present paper reports occurrence of 15 species of mites under 10 families and 12 genera collected from edible and wild mushrooms from three districts of West Bengal during, September 2021 to April 2022. Among the mites, there were 9 predatory and 3 each of damage causing and of uncertain association. All the species have been listed giving collection data and remarks pertaining to their importance as damage causing, predatory, or of uncertain association. The mites like Tyrophagus putrescentiae, Fuscuropoda marginata and Leiodinychus krameri were abundantly encountered and were regarded as pest species. Similarly, the mites like Parasitus consanguineous and Asca biswasi were observed to be predator in nature

Vigabatrina comparado con hormona adrenocorticotrópica para el tratamiento de espasmos infantiles y Síndrome de West / Vigabatrin compared with adrenocorticotropic hormone for the treatment of infantile spasms and West Syndrome

OBJETIVO: Determinar los riesgos y beneficios del uso de vigabatrina comparada con hormona adrenocorticotrópica (ACTH) para el tratamiento de espasmos infantiles. MÉTODO: Se realizó una búsqueda en Epistemonikos. Se extrajeron datos desde las revisiones identificadas. Se realizó un metaanálisis a partir de estudios primarios y se utilizó el método GRADE para la presentación de resultados. RESULTADOS: Se identificaron nueve revisiones sistemáticas. Se observó que el uso de vigabatrina en comparación con ACTH disminuye la resolución de espasmos (RR 0,8, IC 95% 0,65 - 0,98) y podría disminuir la resolución de hipsarritmia (RR 0,71, IC 95% 0,48 - 1,05). No fue posible determinar si el uso de vigabatrina disminuye el riesgo de desarrollar efectos adversos (RR 0,75, IC 95% 0,23 - 2,45) por certeza de evidencia muy baja. CONCLUSIONES: La evidencia parece inclinarse a favor del uso de ACTH. Sin embargo debe considerarse la necesidad de nuevas investigaciones para esclarecer su seguridad.

OBJECTIVE: To determine the risks and benefits of the use of vigabatrin compared to ACTH for the treatment of infantile spasms. METHOD: A search in Epistemonikos was performed. Data were extracted from the identified reviews. A meta-analysis was performed from primary studies and the GRADE method was used to present the results. RESULTS: Nine systematic reviews were identified. Vigabatrin use compared to ACTH was found to decrease resolution of spasms (RR 0.8, 95% CI 0.65 - 0.98) and might decrease resolution of hypsarrhythmia (RR 0.71, 95% CI 0 .48 - 1.05). It was not possible to determine whether the use of vigabatrin reduces the risk of developing adverse effects (RR 0.75, 95% CI 0.23 - 2.45) due to very low certainty of evidence. CONCLUSIONS: The evidence seems to lean in favor of the use of ACTH. However, the need for new research should be considered to clarify its safety.

UNRAVELING THE COILS OF MYSTERY : A BRIEF ACCOUNT OF PYTHON (REPTILIA: SQUAMATA: PYTHONIDAE) DIVERSITY IN WEST BENGAL

Pythons ( Reptilia : Squamata : Pythonidae ) are an ancient group of snakes that have slithered across the swamps, grasslands and rainforests of the world from the Miocene till the present day. The name python was first proposed by Francois Marie Daudin in 1803. In West Bengal, an Indian State on the eastern part of the country, is the host of three major python species – Indian rock python (Python molurus) in the savanna regions; Burmese python (Python bivittatus) in the temperate wetlands and the mangroves and the longest extant snake, the Reticulated python (Malayopython reticulatus) in the mangrove regions of Sundarbans. Once abundant, these giant reptilians are now on the brink of extinction due to habitat loss and illegal hunting and other anthropogenic encroachments in their natural habitats

Length-Weight Relationship and Condition Factor of Twenty Fish Species in Ebrie Lagoon (Aghien-Potou Sectors Abidjan, C魌e d扞voire)

Aims: This study investigated Length-weight relationships and condition factors of fish species in Ebrie Lagoon (Aghien-Potou sector, C魌e d扞voire) Place and Duration of Study: Ebrie Lagoon (Aghien-potou sector) from April 2019 to March 2020. Methodology: study was conducted during 3 to 4 days continuously in Ebrie Lagoon (Aghien-Potou Sector). Furthermore, monthly fish samples were collected from commercial fishing area at random using gillnets, cast nets, traps, hooks and beach seines. Results: All Length-Weight regressions were highly significant with the coefficient of determination (r2) ranging from 0.61 in Schilbe mandibularis to 0.90 in Monodactylus sebae and Chrysichthys maurus. An isometric growth was observed for most of species except three of them namely Ethmalosa fimbriata, Pseudotolithus elongatus, and polydactylus quadrifilis. The k values varied from 0.19�001 in S. melanotheron to 6.10�3 in Monodactylus sebae. The values of b and k denote that the Ebrie lagoon could provide a favourable environment and suitable habitat for the growth of those fish species. Conclusion: The study provides basic information on length-weight parameters for twenty major fish species collected from Ebrie lagoon (Aghien-Potou sector). Three species namely Ethmalosa fimbriata, Pseudotolithus elongatus and Polydactylus quadrifilis exhibited a trend of positive growth whereas seventeen fish species showed isometric growth. The condition factor k was superior to 1 for 75% of the fish species and inferior to 1 for 25 % of the fish species. These growth trends denote that the lagoon could provide a favourable environment and suitable habitat for the growth of those fish species. Thus it would be interesting to create a protected area near the lagoon in order to ensure the protection of fish species.

NCD Risk Factors in Different Administrative Divisions of West Bengal: An Insight Analysis from National Family Health Survey-5 Report

Introduction : This study was designed to find out the group mean prevalence of NCD risk factors in different administrative divisions of West Bengal (WB) and to explore the probable reasons of these differences in different indigenous habitat wise groups of districts of West Bengal. Methods : This descriptive study was conducted on available secondary data from National Family Health Survey- 5 (NFHS-5) regarding NCD risk factors. For this study, WB’s districts were divided into five administrative divisions namely Presidency, Medinipur, Burdwan, Malda and Jalpaiguri. Again WB State divided into three groups namely Jangalmahal (forest region), Pahar (Himalayan Hilly region) and “Rest of West Bengal” (ROW) on the basis of habitat of major indigenous people. Data are analyzed by Microsoft excel software in percentage and group mean. Results : Presidency (M: 20.6% versus F: 21.9%) with Medinipur (M: 20.3% versus F: 19%) divisions and Jangalmahal group of districts (M: 22.1% versus F: 16.5%) have higher group me n prevalence of high blood sugar in West Bengal. High group mean prevalence of high blood pressure was observed in Pahar (M: 26.6% versus F: 25.2%) group of districts and Jalpaiguri (M: 24.7% versus F:24%) division. The group mean prevalence of alcohol intake is very high in Jalpaiguri division (M: 25.2% versus F: 3%). The group mean prevalence of obesity (women aged 15-49 years) is increased from the last NFHS -4 survey. Conclusion : The group mean prevalence of alcohol intake and high blood pressure are very high in Pahar. The tobacco use related habit is comparatively high in Jangalmahal and Pahar group of districts. The group mean prevalence of high blood sugar is comparatively high in Jangalmahal and Presidency division areas.

Quest to Improve Management of Prostate Cancer in West Africa Development of a Clinical Audit Tool

In 2010 and during the following decade, two guidelines werepublished for the management of prostate cancer in West Africa.A key recommendation of the guidelines was the need for thedevelopment of a Clinical Audit Tool which should helpsurgeons and institutions to identify the gaps between therecommended standards and current practice. In this paper, aClinical Audit Tool, WAPCAT, was developed to facilitate andimplement the audit process for the management of Prostatecancer in a West African healthcare institution

Comparative cost of diets for low-income families in the Caribbean / Costo comparativo del régimen alimentario de las familias de bajos ingresos en el Caribe / Custo comparativo da alimentação para famílias de baixa renda no Caribe

ABSTRACT Objective. To assess the ability of low-income families to obtain a standard basket of healthy foods before and during the COVID-19 pandemic. Methods. The costs of 191 food items were averaged from supermarkets, municipal markets, wholesalers, and community food outlets in high- and low-income areas in three Caribbean countries. The analysis compared foods not only by selecting high- and low-ranked commodities but by the proportions of those foods, by food group, that will be required to meet a low-cost, nutritionally balanced diet of 2 400 kcal. Results. The main finding was that low-income households will need between 22% and 47% of their earnings to obtain a healthy diet. Despite higher food prices in Saint Kitts and Nevis, low-income households there will need a smaller proportion of their income to obtain a similar basket of foods than in Jamaica or Saint Vincent and the Grenadines. Conclusions. While the COVID-19 pandemic has added economic stressors to low-income households the basic vulnerability of the poor to obtain a healthy diet remains. Despite country variations, the findings point to the need for an increase in the minimum wage, particularly in Jamaica. It is essential to embed policies that ensure reduced economic and social vulnerability at the household level.

RESUMEN Objetivo. Evaluar la capacidad de las familias de bajos ingresos para obtener una cesta estándar de alimentos saludables antes y durante la pandemia de COVID-19. Métodos. Se promediaron los costos de 191 alimentos en supermercados, mercados municipales, mayoristas y puestos de venta de alimentos en la comunidad en zonas de altos y bajos ingresos de tres países del Caribe. En el análisis se compararon los comestibles por grupo de alimentos mediante una selección de productos de alto y bajo rango, así como por las proporciones necesarias para tener un régimen alimentario nutricionalmente equilibrado de 2 400 kcal y de bajo costo. Resultados. La conclusión principal fue que los hogares de bajos ingresos necesitan entre 22% y 47% de sus ingresos para tener un régimen alimentario saludable. A pesar de los elevados precios de los alimentos en Saint Kitts y Nevis, los hogares de bajos ingresos necesitarán una proporción menor de sus ingresos para obtener una cesta de alimentos similar en Jamaica o San Vicente y las Granadinas. Conclusiones. La vulnerabilidad básica de las personas pobres para tener un régimen alimentario saludable persiste, a lo que se suma que la pandemia de COVID-19 ha agregado factores económicos estresantes a los hogares de bajos ingresos. A pesar de las variaciones entre países, los resultados apuntan a la necesidad de incrementar el salario mínimo, particularmente en Jamaica. Es esencial incorporar políticas que garanticen una reducción de la vulnerabilidad económica y social a nivel de los hogares.

RESUMO Objetivo. Avaliar a capacidade das famílias de baixa renda de adquirir uma cesta básica de alimentos saudáveis antes e durante a pandemia de COVID-19. Métodos. Calculou-se a média do custo de 191 produtos alimentícios em supermercados, mercados municipais, atacadistas e estabelecimentos comunitários em áreas de alta e baixa renda em três países do Caribe. A análise comparou os alimentos não apenas pela escolha de produtos classificados em posição alta e baixa, mas também pelas proporções desses alimentos, por grupo alimentar, necessárias para ter uma alimentação de baixo custo e nutricionalmente equilibrada, com 2 400 kcal. Resultados. A principal constatação foi que as famílias de baixa renda precisarão gastar entre 22% e 47% de sua renda para ter uma alimentação saudável. Apesar do maior preço dos alimentos em Saint Kitts e Nevis, as famílias de baixa renda nesse país precisarão usar uma menor proporção da renda para comprar uma cesta de alimentos semelhante à adquirida na Jamaica ou em São Vicente e Granadinas. Conclusões. Embora a pandemia de COVID-19 tenha agregado fatores de estresse econômico às famílias de baixa renda, persiste a vulnerabilidade subjacente das pessoas pobres em relação à obtenção de uma alimentação saudável. Apesar das variações entre os países, as constatações indicam a necessidade de um aumento do salário mínimo, sobretudo na Jamaica. É essencial a incorporação de políticas que reduzam a vulnerabilidade econômica e social no âmbito familiar.

Shotgun metagenomic sequencing of the first case of monkeypox virus in Brazil, 2022

ABSTRACT Monkeypox virus (MPXV), a zoonotic virus endemic to the African continent, has been reported in 33 non-endemic countries since May 2022. We report an almost complete genome of the first confirmed case of MPXV in Brazil. Shotgun metagenomic sequencing was completed in 18 hours, from DNA extraction to consensus sequence generation.

Consensual coital vaginal laceration in hypovolaemic shock: A report of two cases

Background:Certain life-threatening complications and morbidities may occur following consensual sexual intercourse which may not be commonly experienced in clinical practice. One of such complications is hypovolaemic shock resulting from profuse bleeding.AbstractMethods:Two cases of vaginal laceration complicated by hypovolaemic shock following consensual sexual intercourse are presented.Results:Both patients had resuscitation with intravenous fluid, blood transfusion and subsequent examination under anaesthesia with repair of laceration in theater. Post-operative recovery period was uneventful and they were both discharged after proper counselling. Conclusion:Bleeding from coital laceration could be life threatening. Prompt treatment should be instituted in such cases

Strengthening equitable health systems in West Africa: The regional project on governance research for equity in health systems

The West African Health Organization (WAHO) supported an innovative regional initiative that contributes to building effective decision making, community and researcher partnerships to strengthen equitable health systems and influence local programmes and policies. Four projects were funded in Nigeria, Sierra Leone, Burkina Faso and Senegal, supported by a Regional Advisory Committee of experts and local Steering Committees. Based on a framework drawn from WAHO objectives, we reviewed documents, conducted 56 project stakeholder interviews and undertook thematic analysis. A diverse range of stakeholders perceived that the projects were in line with national priorities, were well managed and were equitably implemented. The projects generated evidence that could increase access to and improve quality maternal health services. Sustainable partnerships were formed and stakeholder and research team capacity were strengthened. Our study provides insight into project implementation in West Africa, bearing in mind context-specific issues. (Afr J Reprod Health 2022; 26[5]: 81-89).

Health policy and systems research capacity development to support maternal, newborn, child and adolescent health in West and Central Africa

Objectives: To examine how and why a South-South capacity development and networking program for leadership, research, practice and advocacy on maternal new-born, child and adolescent health and health policy and systems strengthening in West Africa and Cameroon worked and identify lessons for low- and middle-income countries. Design: Single qualitative case study drawing on data from document review, observations, key informant interviews and a deliberative workshop. Ethics approval for primary data collection was obtained from the Ghana Health Service Ethical Review Committee (GHS-ERC 012/10/18). Setting: West Africa and Cameroon Participants: Researchers, policy and programme managers and frontline health workers Interventions: Networking and capacity development Results: The programme made good progress in implementing many but not all planned capacity development and networking activities. The opportunity to network with other organisations and individuals and across countries, disciplines, and languages as well as to learn, to develop skills, and obtain mentorship support, were considered valuable benefits of the partnership. Human and financial resource constraints meant that not all planned interventions could be implemented. Conclusions: Lessons for health policy and systems research capacity building in LMIC include the potential of South-South partnerships, the need for dedicated resources, the potential of Sub-regional health organizations to support capacity building and recognition that each effort builds on preceding efforts of others, and that it is important to explore and understand where the energy and momentum for change lies.