Willingness of WHO staff to work in health emergencies in the African Region: opportunity for phased deployment of staff and ensure continuity of health services

A human resource base that ensures appropriate deployment of staff to emergencies, addressing different shock events in emergencies, without disrupting continuity of service is germane to a successful response. Consequently, the WHO Health Emergencies programme in the African Region, in collaboration with Africa Centre for Disease Control (ACDC) launched the African Volunteer Health Corps (AVoHC) and Strengthening and Utilization of Response Group for Emergencies (SURGE), an initiative aimed at ensuring a pool of timely responders. We explored the willingness of WHO staff to work in emergencies. A call for expression of interest to be part of the Elite Emergency Experts (Triple E) was published on 5th July 2022 via email and was open for 5 weeks. The responses were analyzed using simple descriptive statistics and presented with graphic illustrations. A total of 1253 WHO staff, from all the six WHO regions, cutting across all cadre, applied to the call. The applicants had various trainings and experiences in emergency and have responded to mostly disease outbreaks. Two-third of the applicants were males. This paper did not explore reasons for the willingness to work in emergencies. However, contrary to fears expressed in literature that health workers would not want to work in emergencies with potential for infections, the applicants have worked mostly in infectious emergencies. Literature identified some themes on factors that could impact on willingness of health workers to work in emergencies. These include concerns for the safety of the responders and impact of partners, child and elderly care, as well as other family obligations, which emergency planners must consider in planning emergency response.

Anti-inflammatory and healing activity of an hydroethanolic extract of Voacanga africana stapt ex Scoot-Elliot (Apocynaceae): In vivo model

Background: The mastery and supervision of traditional medicine in our country, particularly Senegal, would be of capital importance for the population. We were interested in the physiological effects of Voacanga africana (VOC) extracts in wound healing and topical inflammation. Aims and Objectives: This work was to evaluate the effects on inflammation and tissue repair of an hydroethanolic extract of V. africana. Materials and Methods: Wounds were created from a rat burn model and wound healing was evaluated (Kamoshida method) topical inflammation in a murine model of croton oil-induced inflammatory edema. For each experiment, batches of rats or of a mouse were formed, and every batch included five animals. Results: VOC’s 30% root bark ointment showed complete healing by day 16 for the burn test. As for inflammation, the 10% ointment inhibits 80% of the inflammatory edema in the same manner as indomethacin, used as the standard anti-inflammatory drug. Conclusion: VOC could have dose-dependent effects on inflammation and burn healing.

Investigations on the cytotoxicity and antimicrobial activities of terezine E and 14-hydroxyterezine D

Secondary metabolites produced by endophytes are an excellent source of biologically active compounds. The newly isolated natural products terezine E and 14-hydroxyterezine D are endophytic metabolites exhibiting anticancer activity recently identified by our team (https://doi.org/10.1080/14786419.2018.1489393). In our current study, we evaluated their affinity for binding to the active site of histone deacetylase (PDB ID: 4CBT) and matrix metalloproteinase 9 (PDB ID: 4H3X) by molecular docking using AutoDock Vina software after having tested their cytotoxic activities on three cell lines (human ductal breast epithelial tumor cells (T47D)-HCC1937), human hepatocarcinoma cell line (HepG2)-HB8065), and human colorectal carcinoma cells (HCT-116)-TCP1006, purchased from ATCC, USA)). Additionally, their antimicrobial activities were investigated, and their minimum inhibitory concentration (MIC) values were determined against P. notatum and S. aureus by the broth microdilution method. Higher cytotoxicity was observed for terezine E against all tested cell lines compared to 14-hydroxyterezine D. Molecular docking results supported the high cytotoxicity of terezine E and showed higher binding affinity with 4CBT with an energy score of 9 kcal/mol. Terezine E showed higher antibacterial and antifungal activities than 14-hydroxyrerezine D: MIC values were 15.45 and 21.73 µg/mL against S. aureus and 8.61 and 11.54 µg/mL against P. notatum, respectively.

Causes de décès au service de médecine de l'hôpital régional de Sikasso / Causes of death in the medicine department of the regional hospital of Sikasso

Les causes de décès revêtent une grande importance dans l'évaluation de l'état de santé de la population et de la qualité des soins. Leur étude pourrait orienter les politiques de santé visant à accroître l'espérance de vie. Objectifs : C'était de déterminer les causes de mort ; d'étudier les caractéristiques sociodémographiques des défunts. Matériels et méthodes : Il s'agissait d'une étude rétrospective et descriptive portant sur tous les décès survenus dans le service de Médecine de l'hôpital de Sikasso de Janvier 2018 à Décembre 2020. Résultats : Parmi 265 décès recensés, l'âge moyen était de 45,12±17,5 ans. Le sex-ratio était de 1,59. Il s'agissait en majorité de citadins et 51,64% résidaient à Sikasso ville. La durée moyenne d'hospitalisation était 7,09 ± 6,38 jours. L'insuffisance rénale constituait le 1er motif d'hospitalisation. L'infection à VIH était la 1ère cause de décès (29,8%), suivie de l'insuffisance rénale (24,2%). Le sexe masculin était majoritaire dans toutes les causes de décès hormis l'infection à VIH et l'anémie. Les décès liés à l'insuffisance rénale ont quintuplé de 2018 à 2020. Conclusion : Les décès liés au VIH/SIDA reste en tête malgré leur forte réduction ; ceux liés à l'insuffisance rénale ont quintuplé

The causes of death are of great importance in assessing the health status of the population and care'squality. Their study could guide health policies aimed at increasing life expectancy. Objectives: It was to determine the causes of death; to study the socio-demographic characteristics of deceased. Materials and methods: This was a retrospective and descriptive study of all deaths that occurred in the Medical Department of Sikasso Hospital from January 2018 to December 2020. Results: Among 265 deaths recorded, the mean age was 45.12 ± 17.5 years. The sex ratio was 1.59. They were mostly city dwellers and 51.64% lived in Sikasso city. The mean length of hospitalization was 7.09 ± 6.38 days. Kidney failure was the first reason for hospitalization. HIV infection was the leading cause of death (29.8%), followed by renal failure (24.2%). The male sex was predominant in all causes of death except HIV infection and anemia. Deaths linked to kidney failure have increased fivefold from 2018 to 2020. Conclusion: Deaths related to HIV/AIDS remain in the lead despite their strong reduction; those related to kidney failure have increased fivefold

Aspects épidémiologique et clinique des uvéites au Niger: analyse rétrospective d'une série de 127 cas colligés sur 5 ans / Epidemiological and clinical aspects of uveitis in Niger: A retrospective analysis of a series of 127 cases collected during 5 years

Contexte & objectif L'uvéite est peu très peu documentée en Niamey. L'objectif de la présente étude était de décrire les aspects épidémiologique et clinique des uvéites. Méthodes. Il s'agissait d'une étude rétrospective et descriptive portant sur 127 dossiers des patients suivis pour uvéites à la clinique lumière de Niamey sur une période de 5 ans (2015 ­ 2020). Les paramètres sociodémographiques, cliniques et thérapeutiques ont été recueillis. Résultats. La fréquence hospitalière des uvéites était de 0,21 %. Le sex-ratio était de 1,01. L'âge moyen des patients était de 40,76 ans. La douleur oculaire représentait le motif de consultation le plus fréquent avec 51 ,97 %. La majorité des patients avait présenté 2 épisodes d'uvéites soit 57,48 %. L'atteinte était unilatérale dans 70,97 % et les uvéites antérieures étaient les plus fréquentes 66,93 %. Les étiologies étaient identifiées chez seulement 7,87 % des patients dont près de la moitié était la tuberculose. 33,07 % des patients avaient présenté des complications. Conclusion. Il ressort de cette étude que l'uvéite touche plus des jeunes adultes, ses étiologies sont indéterminées dans la majorité de cas. Les formes antérieures sont plus fréquentes.

Context and objective Little is known about Uveitis in Niamey. This study aimed to analyze the epidemiological and clinical aspects of uveitis. Methods. This was a retrospective, descriptive study of 127 records of patients followed up for uveitis at the Niamey Lumière Clinic over a 5-year period (2015 ­ 2020). Sociodemographic, clinical and therapeutic parameters were collected. Results. The hospital frequency of uveitis was 0.21%. The sex ratio was 1.01. The mean age of patients was 40.76 years. Ocular pain was the most frequent reason for consultation, accounting for 51.97 %. The majority of patients (57.48%) had presented with 2 episodes of uveitis. Involvement was unilateral in 70.97 %, and anterior uveitis was the most frequent, at 66.93 %. Etiologies were identified in only 7.87 % of patients, of which tuberculosis accounted for almost half. Complications occurred in 33.07 % of patients. Conclusion. This study shows that uveitis affects mainly young adults, and its etiologies are undetermined in most cases. Anterior forms are more frequent.

Online capacity building for the health workforce: the case of the Integrated Disease Surveillance and Response for the African region

Background: The World Health Organisation (WHO) Regional Office for Africa (AFRO) has developed a comprehensive capacity development programme to support the successful implementation of the Integrated Disease Surveillance and Response 3 rd edition Technical Guidelines (IDSR). As part of the learning program, a series of asynchronous online courses are offered on Open WHO in English, French and Portuguese. This paper describes the use of five IDSR online courses and reports on feedback received from learners on Course 1 in the English series. Methods: An online learner survey was developed, and a descriptive analysis was conducted. This paper also reports on use related empirical metadata from the Open WHO platform. Results: Overall, learners (97%-n/N) of Course 1 IDSR English series indicated a positive perception toward their online learning experience because of the quality of course content, its organization, ease of use and relevance to their workplace needs. In addition, 88% (n/N) of learners reported that they had used their acquired knowledge at least sometimes and 54.4% (n/N) had shared their learning with others. Lastly, the quiz analyses showed an average of right answers of 78.97% for quiz 1 and 69.94% for quiz 2. Conclusion: Online learning is an essential component of a blended capacity development programme and provides cost effective, equitable and impactful learning. Learners who have a learning goal and find their needs met in courses tend to show more satisfaction and motivation to share their learning.

Performance of two SARS-CoV-2 rapid antigen detection tests in resource limited settings, the case of Mali

Introduction: While real-time reverse transcription PCR (RT-PCR) is the recommended laboratory method to diagnose severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, its use in resource limited settings can be difficult to maintain due to high testing demand and shortage of reagents. The aim of this study was to evaluate the performances of Realy Tech™ and Standard Q™ in comparison to RT-PCR in a relatively low COVID-19 prevalence setting, Mali. Methods: We conducted a cross-sectional study between January and April 2021 in Bamako and Kati regions to evaluate both rapid tests during a large SARS-CoV-2 prevalence study in Mali. Results: Of the 390 samples tested, the sensitivity and specificity of Realy Tech™ and Standard Q™ were 57.1% (95%CI: 44.1-69.2), 95.8% (95%CI: 93.1-97.5); 61.9% (95%CI: 46.8-75.0), and 94.1% (95%CI: 89.5-96.8) respectively. Using RT-PCR, the global prevalence of SARS-CoV-2 was 14.4% (56/390). In both rapid antigen tests, the performance was better when used in suspected patients compared to positive patients under treatment. Moreover, higher viral loads equivalent to Ct < 25 were associated with better detection rates. Conclusion: While waiting for more complete data, these preliminary studies suggest that Realy Tech™ and Standard Q™ should not be used alone for COVID-19 diagnosis in Mali.

Cone-beam computed tomography-based radiographic considerations in impacted lower third molars: Think outside the box

Purpose@#This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document,and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning. @*Materials and Methods@#Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication. @*Results@#Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal. @*Conclusion@#The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.(Imaging Sci Dent 2023; 53: 137-44)

Relation between Vitamin B12 Levels and Smell Affection in COVID-19 Patients

Abstract Introduction Olfactory and gustative alterations are frequent in the initial stages of the COVID-19 infection. Vitamin B12 deficiency has been linked to olfactory dysfunction. Objective The present study aimed to assess the relationship between vitamin B12 levels and smell affection in COVID-19 patients. Methods The present study included 201 laboratory-confirmed COVID-19 patients. Smell affection was assessed using self-rated olfactory function. Serum vitamin B12 levels were assessed using commercial enzyme-linked immunosorbent assay (ELISA) kits. Results According to the smell function assessment, the patients were classified into three categories: normal osmesis (n = 77), hyposmia (n = 49), and anosmia (n = 75) (►Fig. 1). Four weeks later, 195 patients (97.0%) had their normal smell function restored. The remainder 6 patients included 4 anosmic and 2 hyposmic patients. Patients with hyposmia or anosmia had significantly lower vitamin B12 levels when compared with patients with normal osmesis (median [IQR]: 363.0 [198.0-539.0] versus 337.0 [175.0-467.0] and 491.0 [364.5-584.5] pg/ml, respectively, p < 0.001). Conclusion Vitamin B12 appears to have some contribution to smell affection in patients with COVID-19 infection.

COVID-19: profil virologique et clinique des patients diagnostiqués dans deux laboratoires à Ouagadougou, Burkina Faso / COVID-19: Virological and clinical profile of patients diagnosed in two laboratories in Ouagadougou, Burkina Faso

Contexte/objectif : La maladie à coronavirus (COVID-19) est une maladie émergente, dont l'agentpathogène est le virus du syndrome respiratoire aigu sévère dû au coronavirus 2 (SRAS-CoV-2). L'objectif de cette étudeétait de décrire le profil virologique et clinique des patients diagnostiqués dans deux laboratoires. Matériels et méthodes : Il s'est agi d'uneétude descriptive avec collecte rétrospective de données des patients atteints de COVID-19, qui a couvert la période du 04 avril au 31 décembre 2020. Le test de khi deux et le test exact de Fisher sont les tests statistiques utilisées. Résultats : Au total, 28 872 échantillons ont été testés dans les deux laboratoires. L'étude arévélé 1965 cas positifs soit 6, 80% (63 % hommes et 37,05 % femmes). La tranche d'âge de 20 à 50 ans représentait 68,68 %. La province de la capitale a enregistré autant le plus grand nombre d'échantillons (26277 soit91,00%) que le plus grand nombre des cas positifs (91,15%). Les manifestations cliniques étaient dominées par la toux 68,42%, la fatigue générale (43,86%), les céphalées (43,86%), l'écoulement nasal (40,93%), la fi èvre (39,18%). Les comorbidités les plus fréquentes étaient l'hypertension artérielle (HTA) et le diabète. Conclusion: Cette étude a montré unepopulation jeune testée. La capitale (Ouagadougou) a enregistré le plus grand nombre de demandeurs de tests et de cas positifs. La toux était la principale manifestation clinique. Les patients avec comorbidités dont l'HTA et le diabète ont été les plus nombreux a effectué le test

Background/Purpose. Coronavirus disease (COVID-19) is an emerging disease, whose pathogen is the severe acute respiratory syndrome virus due to coronavirus 2 (SARS-CoV-2). The objective of this study was to describe the virological and clinical profile of patients diagnosed in two laboratories. Methods. This was a descriptive study with retrospective data collection of patients with COVID-19, which covered the period from 04 April to 31 December 2020. Chisquare test and Fisher's exact test were used as statistical tests. Results. A total of 28,872 samples were tested in the two laboratories. The study revealed 1965 positive cases or 6, 80% (63% male and 37.05% female). The age group 20-50 years represented 68.68%. The capital province recorded both the largest number of samples (26277 or 91.00%) and the largest number of positive cases (91.15%). Clinical manifestations were dominated by cough 68.42%, general fatigue (43.86%), headache (43.86%), nasal discharge (40.93%), fever (39.18%). The most frequent comorbidities were arterial hypertension (AH) and diabetes. Conclusion. This study showed a young population tested. The capital (Ouagadougou) recorded the highest number of testers and positive cases. Cough was the main clinical manifestation. Patients with comorbidities including hypertension and diabetes were the most numerous to be tested

Effects of a Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet on Symptoms of Functional Abdominal Pain in Pediatric Patients / 대한소아소화기영양학회지

Purpose@#Recently, great interest has been focused on dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) for the treatment of functional abdominal pain (FAP). Several meta-analyses, including those on the adult population, have been published, potentiating its role. However, pediatric studies are scarce. We aimed to evaluate the effect of a low-FODMAP diet on the severity of FAP in children. @*Methods@#This clinical trial included 50 patients aged 3–18 years with irritable bowel syndrome and FAP that were not otherwise specified. The patients were instructed to receive a low FODMAP diet guided by a dietitian. The primary outcome was the percentage of responders after 2 months of dietary intervention compared with baseline. Other outcomes included changes in stool consistency and quality of life (QoL) scores using the KIDSCREEN-10 questionnaire, and weight-for-age z-scores. @*Results@#After the dietary intervention, 74% of patients showed more than 30% lower pain intensity, as examined using the Wong-Baker Faces pain rating scale. Their QoL significantly improved, and patients have gained weight. @*Conclusion@#A low FODMAP diet can improve pain intensity and QoL among children with functional abdominal pain, with no detrimental effects on body weight.

The potential inhibitory impact of curcumin, epigallocatechin gallate and their combinations on infectious bronchitis virus in vivo

Aims@#Infectious bronchitis virus (IBV) is a highly contagious, acute viral respiratory disease that mostly affects chickens. The poultry sector has suffered enormous losses as a result of IBV. Currently, live attenuated vaccines are routinely used to prevent and control IBV. However, due to the enormous genetic variety, vaccinations are becoming ineffective, with low cross-protection effects among vaccine serotypes. The present study aimed at investigating the possible antiviral effects of curcumin, epigallocatechin gallate (EGCG) and their mixtures against IBV in vivo.@*Methodology and results@#Curcumin, EGCG and their combinations were administered to infected and uninfected chicken groups and viral load titers were determined by real-time PCR. The clinical symptoms of both the negative and positive control groups were also compared. Finally, the trachea tissues of each group were examined histopathologically. According to our findings, the viral titer and the clinical signs dropped significantly during the pretreatment infection procedure. Curcumin, EGCG and their combinations also show significant antiviral activities.@*Conclusion, significance and impact of study@#This study clearly shown that natural compounds and their combinations, such as curcumin or/and ECGC can reduce viral pathogenicity in vivo, suggesting that they might have therapeutic implications in the poultry sector.

Technological potential of under-utilized starches from eight varieties of legumes grown in Cameroon / Potencial tecnológico de amidos subutilizados de oito variedades de leguminosas cultivadas nos Camarões

Abstract Starch samples from eight legumes cultivars instar of one variety of Vigna unguiculata L. (Cowpea), one variety of Vigna subterrenea V. (Bambara groundnut) and six varieties of Phaseolus vulgaris L. (Common bean), grown in Cameroon were isolated, and their physicochemical and pasting properties were evaluated. The objectives of the study were to investigate the starch properties and processing characteristics of different bean varieties, and to establish the basic foundation of improving the functionality of beans and their starch grown in the region. The result revealed significant differences amongst the properties of the starches. The swelling power of the legume starch isolates put them in the category of highly restricted-swelling starch. This characteristic is desirable for the manufacture of value-added products such as noodles and composite blends with cereals. The pasting properties were determined using a rapid visco analyzer, and various legumes bean starches exhibited different pasting profiles. The high breakdown viscosity (BV) was founded for Cowpea and Bambara groundnut and confirmed their low. ability to resist heat and shear stress when compared to Common bean varieties studies. The factors which influence the pasting characteristics resulting to decrease in peak viscosity (PV), trough viscosity (TV) and final viscosity (FV) of starch are attributed to the interaction of starch with the protein, fat, etc. which depended to their variety.

Resumo Foram isoladas amostras de amido de oito cultivares de leguminosas ínstar de uma variedade de Vigna unguiculata L. (feijão caupi), uma variedade de Vigna subterrenea V. (amendoim Bambara) e seis variedades de Phaseolus vulgaris L. (feijão comum), cultivadas nos Camarões, e suas propriedades físico-químicas e de pasta foram avaliadas. Os objetivos do estudo foram investigar as propriedades do amido e as características de processamento de diferentes variedades de feijão e estabelecer as bases básicas para melhorar a funcionalidade do feijão e do amido cultivado na região. O resultado revelou diferenças significativas entre as propriedades dos amidos. O poder de inchamento dos isolados de amido de leguminosas os coloca na categoria de amido com inchamento altamente restrito. Esta característica é desejável para o fabrico de produtos de valor acrescentado, tais como macarrão e misturas compósitas com cereais. As propriedades de pasta foram determinadas usando um analisador rápido de visco, e vários amidos de feijão leguminosos exibiram diferentes perfis de pasta. A alta BV foi fundada para o amendoim Cowpea e Bambara e confirmou sua baixa. capacidade de resistir ao calor e tensão de cisalhamento quando comparado com estudos de variedades de feijão. Os fatores que influenciam as características colantes resultantes da diminuição do pico de viscosidade (PV), da viscosidade mínima (TV) e da viscosidade final (FV) do amido são atribuídos à interação do amido com a proteína, gordura, etc., que dependem da sua variedade.

Apport de la TDM thoracique pour le dépistage de la COVID-19 et impact médico-économique de la pandémie à COVID-19 au service de radiologie de Fann (Dakar-Sénégal) / Contribution of thoracic CT for COVID-19 screening and medico-economic impact of the COVID-19 pandemic in the radiology department of Fann (Dakar-Senegal)

Objectifs :Évaluer l'apport de la TDM thoracique dans le diagnostic des patients suspects de COVID-19en comparaison avec la technique de référence (RT-PCR) et déterminer l'impact médico-économique de la COVID-19 au service de radiologie du CHU de Fann. Matériels et méthodes: Il s'agissait d'une étude rétrospective, descriptive sur une période de 4 mois allant du 1er avril au 31 Juillet 2020, au service de radiologie du CHU de Fann.Ont été inclus les patients reçus pour suspicion clinique de COVID-19, qui avaient eu une TDM thoracique et un prélèvement naso-pharyngé par écouvillonnage pour RT-PCR, soit au total 314 patients. Nous avons étudié les données épidémiologiques, cliniques, les images évocatrices de COVID-19 (opacités en verre dépoli, condensation, topographie lésionnelle), existence ou non d'une embolie, les anomalies en faveur de surinfection, les lésions associées, l'impact sur la fréquentation des différentes modalités etl'impact sur les recettes. Résultats:L'âge médian était de 62 ans et le sex-ratio 1,61. La fièvre a été présente chez 7 patients (2,23%); la toux chez 17 patients (5,41%); la dyspnée chez 30 patients (9,55%) et un syndrome de détresse respiratoire chez 63 patients (20,07%). La clinique n'a pas été précisée chez 163 patients (51,91%). La TDM thoracique était normale chez 20 patients (6,37%), évocatrice de COVID-19 chez 274 patients (87,26%) et non évocatrice de COVID-19 chez 20 patients (6,37%). La RT-PCR était positive chez 125 patients soit 39,80%. La sensibilité et la spécificité de la TDM étaient respectivement de 91,2% et 15,34%. La valeur prédictive positive, la valeur prédictive négative et le taux de précision étaient respectivement de 42%, 72,5% et 45,5%. La baisse du taux de fréquentation était de 59% en radiographie standard, 55% en échographie, 24% au scanner et 87% en mammographie. Dans notre étude on a noté une baisse de 40% des recettes au second trimestre de 2020 comparativement au premier trimestre. Conclusion: La TDM thoracique a une bonne sensibilité pour le diagnostic de la COVID-19. De ce fait, elle peut être considérée comme un outil principal pour la détection des lésions pulmonaires évocatrices de pneumonie COVID-19. Les impacts médico-économiques de la COVID-19 ont été considérables.

Difficultés d'accessibilité aux activités de PTME dans le district de santé de Niamey V en 2016 / NA

Bien que la couverture des services de PTME soit relativement bonne mais avec des disparités selon les régions, de nombreuses femmes et nourrissons au Niger n'ont pas accès à ces interventions à temps. L'objectif de cette étude était d'identifier les facteurs limitant l'utilisation du service de PTME par les femmes vues en soins prénatals à l'hôpital de district de Niamey V en 2016. Méthodologie : Il s'agissait d'une étude transversale et analytique menée dans trois services de consultation prénatale, basée sur des entretiens avec toutes les femmes enceintes et les agents qui répondaient à nos critères d'inclusion. Notre échantillon comprenait 251 femmes enceintes et 8 agents de santé. Pour l'analyse des données nous avions utilisé les logiciels Epi info et Stata. Le test Ch2 de Pearson avait été utilisé pour relier les différentes variables. Résultats : L'âge variait de 15 à 47 ans avec une moyenne de 26,24 ans (écart type 6,19). La tranche d'âge des 21 à 35 ans était la plus représentée avec 78,49 %. Le niveau de connaissance sur le VIH/SIDA était satisfaisant. La TME avait été citée à 76,10, 56,57 % des femmes connaissaient l'existence du programme PTME et 56,57 % avaient cité les centres de santé comme source d'information. On avait noté que 25 % des agents de santé avaient une bonne connaissance des objectifs de PTME. L'analyse bivariée avait montré que la grossesse (Chi 2 Pearson = 8,29, p = 0,040) était positivement corrélée avec la connaissance du programme PTME alors que nous n'avions pas trouvé de relation significative avec le niveau d'éducation (Chi2 Pearson = 0,70, p = 0,401) Conclusion : Notre enquête nous a permis de constater que les femmes enceintes avaient une assez bonne connaissance du VIH/SIDA mais peu en PTME

Although the coverage of PMTCT services is relatively good but with disparities by region, many women and infants in Niger do not have access to its interventions on time. The objective of this study was to study the factors limiting the use of the PMTCT service by women seen in antenatal care at the Niamey V District Hospital in 2016. Methodology :This is a cross-sectional, analytical study carried out in three antenatal clinics, based on interviewing all pregnant women and agents who met our inclusion criteria. Our sample consists of 251 pregnant women and 8 health workers. For the data analysis we used the software Epi info and Stata. Pearson's Ch2 test was used to relate the different variables. Results :The age ranges from 15 to 47 years old with an average of 26.24 years (standard deviation 6.19). The 21 to 35 age group was the most represented with 78.49%. The level of knowledge about HIV / AIDS is satisfactory. In terms of HIV transmission, MTCT was cited at 76.10%. It was noted that 56.57% of the women were aware of the existence of the PMTCT program and 56.57% had cited health centers as a source of information. It was also noted that 25% of health workers had a good knowledge of PMTCT goals. Bivariate analysis showed that pregnancy (Chi 2 Pearson = 8.29, p = 0.040) was positively correlated with knowledge of the PMTCT program while we did not find a significant relationship with educational level (Chi2 Pearson = 0.70, p = 0.401) Conclusion :Our survey allowed us to note that pregnant women have fairly good knowledge about HIV / AIDS but low on PMTCT

Formulation and stability studies of metformin hydrochloride in a controlled porosity osmotic pump system

This study was designed to formulate, for the first time, metformin hydrochloride (MH, 850 mg/tablet) as a controlledporosity osmotic pump (CPOP) system to achieve zero-order release pattern. MH core tablet was coated with celluloseacetate membrane containing PEG 400. The effect of different percentages and molecular weights of polyethyleneoxide (PEO, 900K and 4M) in tablet core was studied. The United States Pharmacopeia (USP) apparatus II andphosphate buffer pH 6.8 were used for the release studies; meanwhile, a promising formula was tested in biorelevantmedia. The stability of some selected formulations was carried out for 6 months, at bench and accelerated conditions.Evaluation included: MH content, Differential scanning calorimetry (DSC), Scanning electron microscopy (SEM),drug release, and kinetics. Results revealed that increasing PEO percentage within the core decreased MH release.SEM verified formation of pores in the membrane that accounts for MH release. Almost all stored tablets werestable for all studied parameters. MH endothermic peak maintained its position and energy of enthalpy on storageas confirmed by DSC. MH release rate from a promising formula, following zero-order release model, increased by28% in biorelevant media compared to phosphate buffer. Subsequently, in vitro release in biorelevant media could beemployed as a tool to anticipate in vivo tone of CPOP formulations

antibacterial, antioxidant activities, and phytoconstituents analysis of medicinal plants used in Benin: Acacia macrostachya (Rchb

Microbial infections remain public health problems because of the upsurge of bacterial resistance. The presentstudy aimed to evaluate the anti-quorum sensing, antimicrobial activities, and chemical compositions ofAcacia macrostachya. Total phenolic, flavonoid, and condensed tannin content were determined according toFolin–Ciocalteu, aluminum chloride, and Broadhurst methods, respectively. The microdilution method usingp-iodonitrothétrazolium was used to evaluate the antibacterial activity. Inhibition of pyocyanin and violaceinproduction by extract and fraction was used to evaluate anti-quorum sensing activity. The antioxidant activitywas evaluated using 2,2-diphenyl-1-picryl-hydrazyl, Ferric reducing, and hydrogen peroxide scavengingmethods. The minimum inhibitory concentration of the extracts and fractions ranged from 0.312 to 5 mg/ml.At 100 µg/ml, ethyl acetate fraction significantly inhibited the production of violacein (56.45%) and pyocyanin(48.88%). The total phenolic, flavonoids, and condensed tannin contents ranged from 31.85 ± 0.31 to 21.26± 0.67 mg gallic acid equivalent (GAE)/100 mg, 26.35 ± 0.71 to 25.42 ± 0.36 mg quercetin equivalent (QE)/100mg, and 18.24 ± 0.12 to 15.9 ± 0.17 mg Catechin equivalent (CE)/100 mg, respectively. The antioxidantactivity correlates with phenolic, flavonoids, and tannin contents. High Pressure Liquide Chromatography(HPLC) analysis of the ethyl acetate fraction allowed to identify three phenolic acids and five flavonoids. Theresults described here could justify the use of A. macrostachya by traditional healers to treat infections, andparticularly, gastrointestinal disorders.

Cytotoxic Metabolites Of Alternaria Alternata, An Endophyte Of The Medicinal Plant Bidens Bipinnata

Objective: Endophytes are widely spread in the plant kingdom and represent a very promising source of biologically active natural products. The medicinal plant Bidens bipinnata Lin. (Asteraceae) which is known for its anti-inflammatory, antifungal and antitumor effects has been chosen for the investigation of its endophyte to search for bioactive metabolites. Methods: An endophytic Alternaria alternata species was isolated from the leaves of the plant B. bipinnata Lin. To investigate the metabolic profile of this endophytic fungus it was cultivated in several culture media as static and shaken culture. The antimicrobial and cytotoxic activities of the ethyl acetate extracts of the fungus were examined. Extracts exhibiting highest antimicrobial activities in agar diffusion assay and cytotoxicity against HeLa cancer cell line were subjected to activity-guided chromatographic fractionation for the identification of bioactive metabolites. A cytotoxic assay was performed on the isolated compounds against HeLa cancer cell lines as well as cytostatic activity tests against HUVEC and K-562 cell lines. Results: Chromatographic fractionation resulted in the isolation and identification of alternariol and tentoxin from the extract of the fungus cultivated in medium M5 while sterigmatocystin was isolated in addition to alternariol and tentoxin from the extract of the fungus grown in medium M25. Both alternariol and sterigmatocystin proved to be of moderate cytotoxicity and weak cytostatic activity with alternariol showing higher cytotoxic activity than sterigmatocystin. Highest cytotoxicity against HeLa cell lines was observed for tentoxin with a CC50 of 22.5 µg/ml. Conclusion: This study presents the isolation and identification of the bioactive metabolites alternariol, sterigmatocystin and tentoxin from the endophyte A. alternata in addition to the antifungal activity of the strain extract as well as the cytotoxic and cytostatic activities of the isolated metabolites against HeLa, HUVEC and K-562 cell lines, respectively.

Reducing ultrasound in diagnosing deep vein thrombosis by using clinical scores and D-dimer testing

Background: To reduce unnecessary venous ultrasound examination in cases suspected to have deep venous thrombosis (DVT) in emergency department by using D dimer and wells score. venous duplex is widely used to diagnose DVT increasing burden on ultrasound in overcrowded emergency department. Authors can decrease this burden by using clinical probability scores and D dimer.Methods: This is prospective study done on 50 consecutive patients suspected to have DVT represented to emergency department of   Menoufia University Hospital during the period from June 2018 to June 2019. Full history, physical examination, assessment of clinical probability score, d dimer level and results of venous duplex collection.Results: According to wells score, the majority of cases diagnosed as DVT were of high probability group 13(68.4%), 5 patients with moderate probability and only one patient with low probability was diagnosed as DVT. The mean of D dimer level in cases diagnosed as DVT is (4173.6±2173.1) and in cases without DVT is (927.4±1064.6). Using wells score and D dimer together, sensitivity is 100%, Specificity is 94%. PPV is 90%, and NPV is 100% in predicting DVT. All cases with negative d dimer and low risk probability do not have DVT.Conclusions: Based on this result, using wells score and d dimer level in early work up of patients suspected to have DVT will decrease overusing and cost of venous duplex.

Aural foreign bodies in children in a pediatric Senegalese hospital

Introduction: aural foreign bodies (FB) are frequent in pediatric otorhinolaryngology and in pediatric emergencies. The objective of this study was to describe the socio-demographic, clinical and therapeutic aspects of aural FB in children in a pediatric hospital in Senegal. Methods: this was a four-year hospital-based descriptive study performed in the Otorhinolaryngology department of the Children's Hospital of Diamniadio, from 1st January 2013 to 31 December 2016 including all children under 15 years of age received for aural FB. The variables studied were age, gender, provenance, presenting symptom, time to consultation, the type of FB and morbidity. Results: sixty three FB were extracted. Mean age was 6 years 4 months. 52.4% of patients were under 5 years old. There was a slight female predominance (32/63). Location was in the right ear canal in 55.6%. Seventy three percent of patients presented in our office were asymptomatic. The median time to consultation was 4 days. Within the first 24 hours after insertion, 22.2% of children presented to our office. Beads were the first FB (29.68%), followed by seeds and cotton (12.5% respectively). Foreign bodies' extraction were performed in consultation for 79.4% of patients. The morbidity was 20.6%. It was primarily otitis externa (8%). Myringoplasty was performed in one patient who had sequelae of tympanic membrane perforation. Conclusion: aural FB is a common accident in under-5 year-olds. In our context there is a delayed consultation. Morbidity is similar to that of the literature