Insulin reference intervals in Brazilian adolescents by direct and indirect approaches: validation of a data mining method from laboratory data

Abstract Objective To determine reference intervals (RI) for fasting blood insulin (FBI) in Brazilian adolescents, 12 to 17 years old, by direct and indirect approaches, and to validate indirectly determined RI. Methods Two databases were used for RI determination. Database 1 (DB1), used to obtain RI through a posteriori direct method, consisted of prospectively selected healthy individuals. Database 2 (DB2) was retrospectively mined from an outpatient laboratory information system (LIS) used for the indirect method (Bhattacharya method). Results From DB1, 29345 individuals were enrolled (57.65 % female) and seven age ranges and sex partitions were statistically determined according to mean FBI values: females: 12 and 13 years-old, 14 years-old, 15 years-old, 16 and 17 years-old; and males: 12, 13 and 14 years-old, 15 years-old, 16 and 17 years-old. From DB2, 5465 adolescents (67.5 % female) were selected and grouped according to DB1 partitions. The mean FBI level was significantly higher in DB2, on all groups. The RI upper limit (URL) determined by Bhattacharya method was slightly lower than the 90 % CI URL directly obtained on DB1, except for group female 12 and 13 years old. High agreement rates for diagnosing elevated FBI in all groups on DB1 validated indirect RI presented. Conclusion The present study demonstrates that Bhattacharya indirect method to determine FBI RI in adolescents can overcome some of the difficulties and challenges of the direct approach.

The time motion study of an out-patient department in a tertiary care hospital in Tamil Nadu

Background: The time taken by the patients during their visit to the hospital out-patient department (OPD) at various service delivery points, the time motion study and by assessing the patient satisfaction regarding the hospital out-patient department, the present study was conducted. This study established the clinical workflow of various events and the operational efficiency of the out-patient department in a busy tertiary care hospital in Tamil Nadu. Methods: The data pertaining to the time motion study was recorded in hours, minutes and seconds. The patient satisfaction questionnaire (PSQ-10 item questionnaire) was requested by interviewing the patients. The data was statistically analyzed using Microsoft Excel and the SPSS v26.0. Results: The maximum time spent was at the investigation counter 00:15:12 and SD was ±00:08:56. The total average waiting time spent during the hospital visits was 00:32:25±00:18:17. The patient satisfaction questionnaire revealed that the overall satisfaction was found to be good in 38 (62.3%) and excellent in 10 (16.4%). Conclusions: The time spent at the investigation counters which was at the peak can be reduced by prioritization and faster case work-up. The staffing pattern was adequate except on government holidays, there were no particular delay in the OPD care setting.

Assessment of anemia in cases of acute myocardial infarction in a tertiary care hospital in central India

Background: Anemia is a known risk factor for ischemic heart disease and heart failure. It is also associated with increased mortality in acute myocardial infarction (AMI) patients. The study aimed to determine the anemia status of AMI patients and educate them on anemia and its impact on health. Methods: This was cross-sectional study conducted among 100 AMI patients admitted to ICCU of Hamidia hospital, Bhopal over 2 months. Haemoglobin levels were recorded and patients classified as non-anemic, mildly, moderately or severely anemic based on WHO criteria. Patients' sociodemographic profile and risk factors also collected. Results: Of the 100 patients (mean age 55.6 years), 76% were males. 88% patients had anemia-74% mild, 13% moderate and 1% severe. The 30-45 years age group reported the highest frequency of mild anemia cases (20 out of 31). Absence of anemia was highest among the younger <30 years group (9 out of 31). Anemia was higher in females, Patient with vegetarian diet had comparatively more anemia than the patient consuming mixed diet. Conclusions: A high prevalence of anemia was found among AMI patients. Counselling can help improve health by increasing awareness of anemia management. Screening AMI patients for anemia and therapeutic interventions were recommended.

A study to assess the health care utilization and the activities of the daily living status amongst the geriatric population residing in urban and rural field practice areas of a medical college in Tamil Nadu

Background: The prevalence of disability in the activities of daily living (ADL), could probably have a significant impact on the healthcare utilization amongst the geriatric population with disability. Methods: A cross-sectional study in the urban and rural field practice areas of a medical college in Tamil Nadu, using a sample size of 402 elderly individuals. Using the pre-tested, semi-structured questionnaire; the socio-demographic variables, healthcare utilization variables and a comprehensive Katz ADL assessment were used. Results: The overall prevalence of ADL limitation amongst the elderly was seen in 49 (12.2%) elderly individuals mostly with a score of 5 (mildest form) was found in 36 (74%) of the elderly. There was an association found between the follow-up care at health centres, frequency of visits, distance from home to health centres and the ADL limitation with a P- value less than 0.05 (C.I.-95%) using the Pearson chi-square test using SPSS v.26.0. Conclusions: The association between ADL limitation and healthcare utilization calls for initiatives at the family and community level.

Knowledge attitude and practice towards COVID-19 booster dose among health care workers: a cross sectional study

Background: Amidst the emerging COVID-19 variants worldwide, India started the COVID precautionary or booster dose vaccination by early 2022. Protecting the healthcare force is crucial, as they are critical drivers in increasing vaccine uptake among the public. Objective was to assess COVID-19 Booster dose vaccine coverage among Health Care Workers (HCWs) and to know the reasons for vaccine booster dose hesitancy. Methods: A cross-sectional study was conducted among health care workers in Vijayapura city, during April-May 2022. The questionnaire in google form was shared to the target population, wherever necessary phone in interview was done. Data was tabulated in MS office Excel and analyzed using appropriate statistical tests. Results: Out of 275 participants from different levels of health care system, 50% were males, 75% in age group <40 years and 67% were from urban area. 37% of the participants took precautionary dose of vaccine against COVID-19. Among those who did not take a booster shot, 22.5% were hesitant to take the vaccine and the reasons were: “Lack of faith in vaccination”, “two doses are sufficient”, and “Fear of side effects”. Socio demographic factors such as age, gender and residence were found to be statistically significant with the COVID Booster vaccination status. Conclusions: Majority health workers are aware of booster dose vaccination, reasons for not taking booster dose were mainly lack of need and fear of side effects.

Efficacy of convalescent plasma in hospitalized COVID-19 patients: findings from a controlled trial

The COVID-19 pandemic has driven the search for alternative therapies, including convalescent plasma, historically used in infectious diseases. Despite results in other diseases, its effectiveness against COVID-19 remains uncertain with conflicting results in clinical trials. A pragmatic, single-center, prospective, and open randomized controlled trial was carried out in a hospital in Brazil, with the aim of evaluating the impact of convalescent plasma on the clinical improvement of patients hospitalized with COVID-19. The World Health Organization (WHO) ordinal scale was used to measure clinical improvement, focusing on the reduction in disease severity by up to 2 points, while antibody and C-reactive protein levels were monitored over time. After hospital admission, participants were randomized 1:1 to receive convalescent plasma and standard treatment or to be part of the control group with standard treatment. Follow-up was carried out on days 1, 3, 7, 14 and/or at discharge. From January 14 to April 4, 2022, 38 patients were included, but 3 were excluded due to protocol deviations, resulting in a total of 35 patients: 19 in the control group and 16 in the plasma group. There was no significant difference in clinical improvement between the convalescent plasma group and the control group, nor in secondary outcomes. The study had limitations due to the small number of patients and limited representation of COVID-19 cases. Broader investigations are needed to integrate therapies into medical protocols, both for COVID-19 and other diseases. Conducting randomized studies is challenging due to the complexity of medical conditions and the variety of treatments available.

Japanese encephalitis virus associated post-infectious relapsing acute onset chronic demyelinating polyradiculoneuritis

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an uncommon manifestation of Japanese encephalitis (JE) virus infection. JE is a neurotropic viral tropical disease affecting both CNS and PNS. Hereby report a case of acute onset CIDP (A-CIDP) following primary infection with JE who presented as symmetric flaccid areflexic sensorimotor quadriparesis with subsequent clinical improvement with steroids and plasmapheresis.

Responses of Different Levels of Pruning and Biofertilizer on Fruit Growth and Quality of Assam Lemon [Citrus limon (L.) Burm] under the Foothills of Arunachal Pradesh, India

The present experiment was conducted in the Department of Fruit Science, College of Horticulture and Forestry, Pasighat, Arunachal Pradesh, during the year 2021-2022. The trial was laid out using two factorial RBD replicated thrice. Assam lemon trees were pruned at 25% (P1), 50% (P2) from the top apex and soil drenching with Pseudomonas fluorescens @ 90g/plant (B1), Trichoderma @ 90g/plant (B2), Azotobacter @ 15g/plant (B3) and a combination of PGPR (Pseudomonas fluorescens) @ 90g/plant + Trichoderma @ 90g/plant + Azotobacter @ 15g/plant (B4) at two feet away from the tree trunk with the interaction of both factors and were compared with control. The results revealed that the morphological and biochemical characters were significantly affected by high pruning intensity (50%) and biofertilizers treatment B4 (Pseudomonas fluorescens @ 90g/plant + Trichoderma @ 90g/plant + Azotobacter @ 15g/plant) and their combinations. It was concluded that the treatment P2B4 pruning 50% + Pseudomonas fluorescens @ 90g/plant + Trichoderma @ 90g/plant + Azotobacter @ 15g/plant in Assam lemon were vital for fruit morphological and biochemical characteristics.

Overweight and obesity screening indicator using neck circumference

Background: Overweight and obesity can be assessed through anthropometric measurements using the body mass index (BMI). Some studies suggest that neck fat is positively correlated with visceral fat, insulin resistance, and metabolic syndrome. Neck circumference has been shown to be closely correlated with BMI and can be used as a practical screening tool for identifying overweight or obese individuals in both men and women. However, the correlation of neck circumference with measurements of body fat percentage in obesity has not been studied. Methods: This study is an analytical study that conducted sensitivity and specificity analyses of neck circumference to describe indicators of overweight and obesity in children. Data collected included neck circumference, weight, height (converted into BMI), and other characteristics of the children. Neck circumference measurements were taken using neck circumference tape. Results: The results showed that the body weight of school-age children had an average of 28.3 kg. Height had an average of 133.2 cm. Neck circumference measurements had an average of 30.3 cm. The correlation analysis using the Pearson product moment test showed a significant value of r=0.483 and p=0.00. Conclusions: There is a significant relationship between neck circumference and BMI. The greater the neck circumference, the greater the BMI, and the area under the curve (AUC) of the ROC curve indicates that neck circumference is a better diagnostic tool for identifying BMI. The results of the ROC curve showed a UAC value of 0.783, indicating that neck circumference can diagnose obesity with an accuracy of 78.3%.

Knowledge, comprehension, attitude to and practice of the five levels of prevention in child healthcare in a Nigerian teaching hospital

Background: Preventive Paediatrics involves all activities geared towards protecting, promoting and maintaining the health and wellbeing of children. The aim of this study to determine the knowledge, attitude and practice of the five levels of prevention by child-care doctors at the University of Port Harcourt Teaching Hospital. Methods: This was a descriptive cross-sectional survey using a self-administered questionnaire. Information on socio-demographics, knowledge, comprehension and attitude of the respondents towards the five levels of prevention and its utilization by the doctors at the University of Port Harcourt Teaching Hospital was sought. Data were analyzed using descriptive statistics. Results: 295 doctors participated. 26 (8.8%) doctors had good knowledge of the five levels of prevention. As the doctors’ age increased, they were less likely to be knowledgeable about the levels of prevention (OR=0.955; 95% CI: 0.917-0.995; p-value=0.029). Doctors in Pediatrics were four times more likely to be knowledgeable about the levels of prevention than the others (OR=3.637; 95% CI: 1.496-8.844; p-value= 0.004). 287 (97.3%) doctors had good attitude towards preventive activities while practice was by 222 (75.3%). There were no significant differences across gender, age, department, designation and years of practice. Doctors with good knowledge significantly practiced more levels of prevention compared to those with poor knowledge (p=0.049, 0.024, 0.001 and 0.010 respectively). Conclusions: Majority of the doctors have poor knowledge of the five levels of prevention, despite having a good attitude and practice which suggests a knowledge-practice gap. Interventions to improve doctors’ knowledge are recommended.

Knowledge, comprehension, attitude to and practice of the five levels of prevention in child healthcare in a Nigerian teaching hospital

Background: Preventive Paediatrics involves all activities geared towards protecting, promoting and maintaining the health and wellbeing of children. The aim of this study to determine the knowledge, attitude and practice of the five levels of prevention by child-care doctors at the University of Port Harcourt Teaching Hospital. Methods: This was a descriptive cross-sectional survey using a self-administered questionnaire. Information on socio-demographics, knowledge, comprehension and attitude of the respondents towards the five levels of prevention and its utilization by the doctors at the University of Port Harcourt Teaching Hospital was sought. Data were analyzed using descriptive statistics. Results: 295 doctors participated. 26 (8.8%) doctors had good knowledge of the five levels of prevention. As the doctors’ age increased, they were less likely to be knowledgeable about the levels of prevention (OR=0.955; 95% CI: 0.917-0.995; p-value=0.029). Doctors in Pediatrics were four times more likely to be knowledgeable about the levels of prevention than the others (OR=3.637; 95% CI: 1.496-8.844; p-value= 0.004). 287 (97.3%) doctors had good attitude towards preventive activities while practice was by 222 (75.3%). There were no significant differences across gender, age, department, designation and years of practice. Doctors with good knowledge significantly practiced more levels of prevention compared to those with poor knowledge (p=0.049, 0.024, 0.001 and 0.010 respectively). Conclusions: Majority of the doctors have poor knowledge of the five levels of prevention, despite having a good attitude and practice which suggests a knowledge-practice gap. Interventions to improve doctors’ knowledge are recommended.

A study to assess the pattern of alcohol and tobacco usage in the rural field practice area of a medical college in Tamil Nadu

Background: Tobacco usage and alcohol consumption is a serious health issue to the society for ages. The consumption of alcohol and tobacco usage leads to medical and societal issues. An assessment of the pattern of tobacco usage and alcohol consumption in adult population is important to estimate the burden, and the risk factors associated with the same on the rural communities. There is a strong impact on the prevalence of NCDs by reduction in the usage of tobacco and alcohol products in the forthcoming decades. Methods: A community based cross-sectional study was conducted in the rural field practice area of a medical college, using pre-validated, semi-structured questionnaire amongst 275 study participants a rural area. The adults aged 18 years and above who were currently using tobacco products and consuming alcohol were selected by simple random sampling using the tobacco assessment and AUDIT questionnaire for alcohol consumption. Results: The results showed a significant association between all the socio-demographic variables (except for gender) in the usage of tobacco products; the study found higher literacy levels in using the products more frequently. The age distribution, family arrangement and socio-economic status were associated with alcohol consumption as well. In the multivariate regression the socio-economic class were associated with alcohol consumption. Conclusions: The interventions should be targeted at the family and community level. There is a need for health education programs and de-addiction camps.

Optimization of Spirulina’s Phycocyanin Extraction Yield Using Response Surface Method

Besides cultivation, extraction is also a critical stage in enhancing the yield of phycocyanin production - a highly valuable compound from Spirulina biomass. In this study, the combined effect of three important variables in the ultrasonic-assisted extraction process on phycocyanin extraction yield, namely extraction temperature, sonication time, and solvent pH were investigated through a central composite design experiment. Furthermore, the response surface method was applied in order to define an optimal condition to achieve the highest extraction yield. The results showed that when temperature ranged from 35ºC to 45ºC, sonication time from 20 to 50 minutes, and solvent pH from 6 to 8, the average yield of 30.135±1.552 mg/g was obtained with an average purity of 0.871±0.043. A regression model was also successfully developed, which allowed a good prediction of extraction yield based on the three mentioned variables. On the other hand, an optimal condition for extraction was also proposed with sonication time = 43.57 minutes, extraction temperature = 37.6oC, and solvent pH = 6.7. These results were practically valuable for the improvement of phycocyanin extraction from Spirulina biomass

Efectos de las diluciones homeopáticas altas sobre las plantas: revisión de la literatura / Effects of high homeopathic dilutions on plants: a review of the literature

Entre los supuestos no convencionales de la homeopatía, el uso de medicamentos en diluciones altas (HD, por sus siglas en inglés) es una causa de objeciones y escepticismo entre la comunidad científica, formada dentro del paradigma de la dependencia de la dosis de la farmacología clásica. La investigación que busca evidenciar los efectos de las HD homeopáticas recurre a varios modelos experimentales (in vitro, plantas y animales). Objetivo: Describir los resultados de estudios con alta calidad metodológica que han demostrado los efectos positivos de las HD homeopáticas sobre las plantas. Métodos: Tomando como fuente de referencia las revisiones publicadas hasta 2015, actualizamos la información añadiendo datos de estudios recientes incluidos en la base de datos PubMed. Resultados: De los 167 estudios experimentales analizados, 48 cumplieron los criterios mínimos de calidad metodológica, de los cuales 29 detectaron efectos específicos de las diluciones homeopáticas altas sobre las plantas mediante la comparación con controles adecuados. Conclusiones: A pesar de que la mayor parte de los experimentos presentaba una calidad metodológica por debajo del estándar, los estudios que emplearon sistemáticamente reproducibilidad y controles negativos demostraron indiscutibles efectos significativos de las HD homeopáticas sobre las plantas.

Among the non-conventional assumptions of homeopathy, the use of medicines in high dilutions (HD) is a cause for objections and skepticism among the scientific community, trained within the dose-dependency paradigm of classic pharmacology. Research aiming at evidencing the effects of homeopathic HD has resource to several experimental models (in vitro, plants and animals). Aim: To describe the results of studies with high methodological quality that demonstrated positive effects of homeopathic HD on plants. Methods: Taking reviews published until 2015 as reference source, we updated the information through addition of data from recent studies included in database PubMed. Results: From 167 experimental studies analyzed, 48 met the minimum criteria of methodological quality, from which 29 detected specific effects of homeopathic high dilutions on plants through comparison to adequate controls. Conclusions: Despite the substandard methodological quality of most experiments, studies with systematic use of negative controls and reproducibility demonstrated significant indisputable effects of homeopathic HD on plants.

Leisure-time physical activity and its relationship with gender and walkingtime to the park or gym / Atividade física de lazer e seu relacionamento com gênero e tempo de caminhada até o parque ou academia

In this cross-sectional study, we describe the leisure-time physical activity (LTPA) of 374 adults who answered an online questionnaire. We also explored the relationship between LTPA, gender, and walking time to the nearest park or gym from the participant's residence. As expected from a recruitment process prone to include physically active individuals, the prevalence of LTPA during the last week was 80.2% (CI95%: 75.8 -84.1). Our median participant reported having performed 280 (CI95%: 240 ­340) minutes of LTPA during the last week. The prevalence of LTPA and the duration of light and total LTPA were similar between men and women. However, in our sample, women practiced more moderate LTPA and men more vigorous LTPA. The relationship between LTPA and walking time distance to the nearest park or gym is not linear, meaning that living closer to parks or gyms does not necessarily imply more LTPA.

Neste estudo transversal, descrevemos a atividade física no lazer (AFL) de 374 adultos que responderam a um questionário online. Também exploramos a relação entre AFL, gênero e tempo de caminhada até o parque ou academia mais próximo da residência do participante. Como esperado de um recrutamento propenso a incluir indivíduos fisicamente ativos, a prevalência de AFL na última semana foi de 80,2% (IC95%: 75,8 - 84,1). Nosso participante mediano relatou ter realizado 280 (IC95%: 240 ­ 340) minutos de AFL na última semana. A prevalência de AFL e a duração da AFL leve e total foram semelhantes entre homens e mulheres. No entanto, em nossa amostra, as mulheres praticaram mais AFL moderadas e os homens AFL vigorosas. A relação entre AFL e distância de caminhada até o parque ou academia mais próxima não é linear, indicando que morar mais perto de parques ou academias não implica necessariamente em mais AFL.

Prevalence of incidental distal biceps signal changes on magnetic resonance imaging

Background@#Knowledge of the base rate of signal changes consistent with distal biceps tendinopathy on magnetic resonance imaging (MRI) has the potential to influence strategies for diagnosis and treatment of people that present with elbow pain. The aim of this study is to measure the prevalence of distal biceps tendon signal changes on MRIs of the elbow by indication for imaging. @*Methods@#MRI data for 1,306 elbows were retrospectively reviewed for mention of signal change in distal biceps tendon. The reports were sorted by indication. @*Results@#Signal changes consistent with distal biceps tendinopathy were noted in 197 of 1,306 (15%) patients, including 34% of patients with biceps pain, 14% of patients with unspecified pain, and 8% of patients with a specific non-biceps indication. Distal biceps tendon changes noted on radiology reports were associated with older age, male sex, and radiologists with musculoskeletal fellowship training. @*Conclusions@#The finding that distal biceps MRI signal changes consistent with tendinopathy are common even in asymptomatic elbows reduces the probability that symptoms correlate with pathology on imaging. The accumulation of signal changes with age, also independent of symptoms, suggests that tendon pathology persists after symptoms resolve, that some degree of distal biceps tendinopathy is common in a human lifetime, and that tendinopathy may often be accommodated without seeking care.Level of evidence: IV.

Do fall armyworm's Metaflumizone resistante populations affect the activity of Trichogramma pretiosum? / Populações da lagarta-do-cartucho resistentes à Metaflumizona afetam a atividade de Trichogramma pretiosum?

The possible interference of resistant pest’s populations to insecticides in natural enemies in the action thas not been clarified yet. Thus, this study aimed to evaluate Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) performance on Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) eggs with resistance frequency to the Metaflumizone over six generations of product exposure. Egg cards (2.0 x 7.0 cm) containing eggs from two populations of S. frugiperda, (resistant to Metaflumizone and the other susceptible), were exposed to T. pretiosum females for 24 hours in free-choice and no-choice testing in three generations (G1, G4, and G6). A completely randomized experimental design was used with 25 replications, each consisting of an egg card (experimental unit) containing 20 eggs. The parameters evaluated were: parasitism (%), emergence (%), sex ratio, number of emerged parasitoids per egg and males/females longevity. ANOVA and Tukey test (P≤ 0.05) were applied on the results. Results showed a reduction in parasitism [41.0% (G1) and 28.4% (G4)], egg emergence (17.5%) and parasitoids/egg [16.2 (G4) and 17.2 (G6)] in eggs originating from the population with resistance frequency. Females emerging from G6 populations eggs without exposure to Metaflumizone had greater longevity (3.5 days more) than the resistant population. The sex ratio and male longevity were not affected. The results indicate a reduction in T. pretiosum activity if S. frugiperda populations have some frequency of resistance to Metaflumizone.

A possível interferência de populações de pragas resistentes na ação de inimigos naturais ainda não foi esclarecida. Assim, este trabalho teve como objetivo avaliar o desempenho de Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) em ovos de Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) com frequência de resistência à Metaflumizona ao longo de seis gerações de exposição ao produto. Cartelas (2,0 x 7,0 cm) com ovos de duas populações de S. frugiperda, (resistente à Metaflumizona e outra suscetível), foram expostas às fêmeas de T. pretiosum por 24 horas em condições de livre escolha e sem chance de escolha por três gerações (G1, G4 e G6). O delineamento experimental foi inteiramente casualizado com 25 repetições, sendo cada repetição composta por uma cartela (unidade experimental) contendo 20 ovos. Os parâmetros avaliados foram: parasitismo (%), emergência (%), razão sexual, número de parasitoides emergidos por ovo e longevidade de machos e fêmeas. ANOVA e teste de Tukey (P≤ 0,05) foram aplicados aos dados coletados. Os resultados mostraram redução do parasitismo [41,0% (G1) e 28,4% (G4)], emergência de ovos (17,5%) e parasitoides/ovo [16,2 (G4) e 17,2 (G6)] em ovos oriundos da população com frequência de resistência. As fêmeas emergidas de ovos da população G6 sem exposição à Metaflumizona, tiveram maior longevidade (3,5 dias a mais) do que a população exposta ao inseticida. A razão sexual e a longevidade de machos não foram afetadas. Os resultados indicam uma redução na atividade de T. pretiosum se as populações de S. frugiperda apresentarem alguma frequência de resistência à Metaflumizona.

Do fall armyworms Metaflumizone resistante populations affect the activity of Trichogramma pretiosum?

Abstract The possible interference of resistant pests populations to insecticides in natural enemies in the action thas not been clarified yet. Thus, this study aimed to evaluate Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) performance on Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) eggs with resistance frequency to the Metaflumizone over six generations of product exposure. Egg cards (2.0 x 7.0 cm) containing eggs from two populations of S. frugiperda, (resistant to Metaflumizone and the other susceptible), were exposed to T. pretiosum females for 24 hours in free-choice and no-choice testing in three generations (G1, G4, and G6). A completely randomized experimental design was used with 25 replications, each consisting of an egg card (experimental unit) containing 20 eggs. The parameters evaluated were: parasitism (%), emergence (%), sex ratio, number of emerged parasitoids per egg and males/females longevity. ANOVA and Tukey test (P 0.05) were applied on the results. Results showed a reduction in parasitism [41.0% (G1) and 28.4% (G4)], egg emergence (17.5%) and parasitoids/egg [16.2 (G4) and 17.2 (G6)] in eggs originating from the population with resistance frequency. Females emerging from G6 populations eggs without exposure to Metaflumizone had greater longevity (3.5 days more) than the resistant population. The sex ratio and male longevity were not affected. The results indicate a reduction in T. pretiosum activity if S. frugiperda populations have some frequency of resistance to Metaflumizone.

Resumo A possível interferência de populações de pragas resistentes na ação de inimigos naturais ainda não foi esclarecida. Assim, este trabalho teve como objetivo avaliar o desempenho de Trichogramma pretiosum Riley (Hymenoptera: Trichogrammatidae) em ovos de Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) com frequência de resistência à Metaflumizona ao longo de seis gerações de exposição ao produto. Cartelas (2,0 x 7,0 cm) com ovos de duas populações de S. frugiperda, (resistente à Metaflumizona e outra suscetível), foram expostas às fêmeas de T. pretiosum por 24 horas em condições de livre escolha e sem chance de escolha por três gerações (G1, G4 e G6). O delineamento experimental foi inteiramente casualizado com 25 repetições, sendo cada repetição composta por uma cartela (unidade experimental) contendo 20 ovos. Os parâmetros avaliados foram: parasitismo (%), emergência (%), razão sexual, número de parasitoides emergidos por ovo e longevidade de machos e fêmeas. ANOVA e teste de Tukey (P 0,05) foram aplicados aos dados coletados. Os resultados mostraram redução do parasitismo [41,0% (G1) e 28,4% (G4)], emergência de ovos (17,5%) e parasitoides/ovo [16,2 (G4) e 17,2 (G6)] em ovos oriundos da população com frequência de resistência. As fêmeas emergidas de ovos da população G6 sem exposição à Metaflumizona, tiveram maior longevidade (3,5 dias a mais) do que a população exposta ao inseticida. A razão sexual e a longevidade de machos não foram afetadas. Os resultados indicam uma redução na atividade de T. pretiosum se as populações de S. frugiperda apresentarem alguma frequência de resistência à Metaflumizona.

Aspects cliniques et évolutifs de la pré-éclampsie sévère traitée à la maternité Befelatanana, Madagascar / Clinical aspects and outcome of severe pre-eclampsia treated at the Befelatanana maternity hospital, Madagascar

Pre-eclampsia is a major public health problem and is one of the main causes of maternal-fetal morbidity. The main objective of this study is to describe the clinical and evolutionary aspects of severe pre-eclampsia. Methods: This was a retrospective, monocentric, descriptive, observational and cross-sectional study of 6 months, from January 01, 2019 to June 30, 2019, conducted at the level of the resuscitation service of the university hospital of gynecology obstetrics Befelatanana (CHU GOB). Results: Three hundred and fourteen (5.10%) cases out of 6153 admissions of severe pre-eclampsia were collected in the study; the average age was 27.29 ±7.47 years. Eclampsia (30.25%, n= 95), retroplacental hematoma (13.38%, n= 42) and acute renal failure (7.96%, n= 25) were the most frequent maternal complications. Maternal prognosis was favorable in 92.36% of cases (n= 290). Maternal death represented 3.18% (n= 10). Prematurity (44.82%, n= 95), fetal hypotrophy (37.26%, n= 79) and fetal asphyxia (14.15%, n= 30) were the most common fetal complications. Fetal death was 26.47% (n= 81). Conclusion: It is necessary to reinforce the information and education of parturients on the first signs for an early detection, diagnosis and management

Choc hémorragique péri-opératoire au Centre Hospitalier Universitaire Androva, Mahajanga, Madagascar

Introduction : Le choc hypovolémique est une défaillance circulatoire aiguë et critique, mettant rapidement en jeu le pronostic vital. L'objectif de l'étude était de déterminer les aspects épidémio-cliniques et la prise en charge du choc hémorragique periopéraoire au centre hospitalier de Mahajanga. Méthodes : Il s'agit d'une étude rétrospective, descriptive, observationnelle et monocentrique réalisée dans le service de Réanimation Chirurgicale du CHU PZaGa de Mahajanga, sur une période de 52 mois. Les données socio-démographiques, les paramètres cliniques périopératoires, la prise en charge médico-chirurgicale, l'évolution et les retentissements organiques de l'état de choc hémorragique ont été les paramètres étudiés. Résultats : Nous avons collecté 6896 dossiers des patients, dont 70 cas de choc hémorragique ont été recensés (1,02%) pour tout type de chirurgie ; 62 dossiers ont été retenus dans l'étude. La majorité des cas était du genre féminin (87,10%). Les pathologies gynéco-obstétricales étaient la principale source de l'état de choc de (77,4%), dont 59,4% d'hémorragie du post-partum. L'insuffisance rénale aiguë était la principale atteinte viscérale (61%, n=38) suivie de 10% (n=6) des cas des troubles neurologiques. Tous les patients ont bénéficié d'une oxygénothérapie, et d'un remplissage vasculaire par des cristalloïdes et 3,2% ont eu des colloïdes. Les substances vasoactives utilisées étaient l'éphédrine 41,9%, suivie de l'adrénaline 27,4% et de la noradrénaline 17,7%. Vingt-sept virgule quarante pourcent de nos patients étaient décédés, et la cause la plus incriminée était la coagulopathie par défibrination. Conclusion: Les hémorragies obstétricales constituent la première cause de choc hémorragique ; le taux de mortalité reste encore élevé.