Assessment of medication adherence among hypertensive patients in a tertiary care teaching hospital in India

Background: Hypertension is a chronic disorder and a prevalent non-communicable disease in India. With the increasing burden of hypertension, adherence to antihypertensive therapy plays a vital role to control blood pressure and preventing its complications. Therefore, this study was done in our tertiary care hospital to understand the medication adherence level in hypertension patients. Aims and Objectives: To assess adherence to antihypertensive medications in hypertensive patients using pre-tested structured questionnaire. Materials and Methods: A prospective observational study was conducted for 3 months in 100 hypertensive patients. The adherence status of patients to antihypertensive medications was assessed using an eight-item Morisky’s Medication Adherence Scale (MMAS-8). Results: Majority of the study participants in our study were >50 years (68%) and females (64%). We observed that patients taking combination therapy better adhered to medication than monotherapy. We assessed in detail the medication adherence level among study participants using MMAS-8 and analyzed the reasons for non-adherence. Conclusion: The medication adherence rate in our study was found to be moderate to high, which needs to be maintained to attain optimal clinical benefit and also to prevent hypertension-related complications.

Compliance and perception towards COVID-19 preventive protocols among hospital staff in a tertiary health facility, Southwest Nigeria

Background: The COVID-19 outbreak response in Nigeria was challenged by the existing weak health sector and the frontline health workers for COVID-19 pandemic response are exposed to the pathogen. One militating factor undermining the control and prevention of COVID-19 in Nigeria was poor compliance to preventive measures. This study assessed the compliance with COVID-19 prevention protocols among healthcare workers in Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. Methods: A cross sectional study and subjects were selected through a multi-stage sampling technique. Data collection was done using interviewer-administered semi-structured questionnaire over a period of five months (JuneOctober, 2021). Data was analyzed using IBM, Statistical Package for Social Sciences (SPSS) version 27.0 and p value was set at <0.05 as the threshold for statistical significance. Results: Majority (60.1%), of the respondents got information on COVID-19 protocols through seminars and workshops. However, more than a quarter (28.8%) of the respondents said the use of available PPE was suboptimal. More than one-third, (35.8%), of respondents believe the protocols are too strict. There is, however, good perception (93.3%), but relatively lower compliance (58.7%) of COVID-19 protocols among the staff. Age, marital status and sex were associated with compliance towards COVID-19 protocols in this study (P<0.05). Identified significant predictors (p<0.05) of compliance include age (AOR=1.944), female sex (AOR=7.829). Conclusion: Most respondents had good knowledge of availability, perception of effectiveness, but relatively lower compliance with the COVID-19 protocols in this facility. The government or hospital authority make sure that necessary steps to further boost compliance are taken

Study of the Antioxidant and Immunomodulatory Activity of the Total Aqueous Extract of Clerodendrum splendens (G.Don) Leaves (Lamiaceae)

Post-harvest storage of oilseeds, particularly groundnut, is a real problem for farmers and traders whose stocks are subject to attacks by pests and fungal contaminants in the shops. In order to find alternative solutions to this problem, a survey was conducted in Côte d’Ivoire, specifically in the markets of the communes Abobo, Adjamé and Yopougon in city of Abidjan, Côte d’Ivoire. The objective of this work is to evaluate the main risk factors for spoilage of groundnut seeds sold during storage in the Abidjan markets. To this end, a survey was conducted among 75 groundnut seeds sellers in the three aforementioned communes of Abidjan and identified the main risk factors favorable to spoilage of groundnut seeds sold during storage. The lack of exact knowledge of the origin of the groundnut seeds sold (92 to 100%), the storage of groundnut seeds in polyethylene bags (84 to 100%), the lack of knowledge of spoilage (28 to 44%), the long periods of sale (22.2 to 86.7%), moisture (0 to 72.2%) and insect pests (5.6 to 20%° were identified as the main factors of these risk of spoilage.

Propuesta teórica para el cambio de conducta en el consumo excesivo de alcohol en adolescentes / Theory-based proposal for changing the behavior of adolescents consuming alcohol in excess / Proposta teórica para mudança de comportamento no consumo excessivo de álcool em adolescentes

RESUMEN Introducción El consumo de alcohol en los adolescentes es un problema cada vez más frecuente y va en aumento debido a que el consumo episódico excesivo es una tendencia cada vez más común en esta población. Para el profesional de enfermería de primer nivel de atención, se vuelve necesario implementar herramientas sustentadas en evidencia científica como una alternativa factible que responda a las necesidades actuales. Objetivo Desarrollar una propuesta de aplicación a partir de la Teoría de Situación Específica del Modelo de Intención de Cambio (I-Change) enfocada al cambio de conducta del consumo excesivo de bebidas alcohólicas en adolescentes. Desarrollo Se utilizó la metodología de tres pasos propuesta por Fawcett. Para la revisión de literatura sobre consumo excesivo de bebidas alcohólicas, se emplearon términos en inglés y español, así como los operadores booleanos AND y OR en diversas bases de datos, posteriormente se construyó una estructura conceptual teórico-empírica de la propuesta de la Teoría de Situación Específica para el consumo excesivo de bebidas alcohólicas. Conclusiones La presente propuesta supone una alternativa para lograr el cambio de conducta del consumo excesivo de bebidas alcohólicas a través de un proceso motivacional de tres fases (premotivacional, motivacional y postmotivacional). Implementar esta propuesta, busca dar solución a una problemática que genera una carga importante de salud en una población vulnerable. Los hallazgos derivados de su aplicación pueden aportar evidencia para la labor del profesional de enfermería en el campo de la prevención del consumo de alcohol.

ABSTRACT Introduction Alcohol consumption among adolescents is a growing and frequent problem. Moreover, the episodic but excessive consumption of alcohol is becoming more common among the population. This situation makes it necessary for the nursing professional practicing in primary care to implement strategies and tools based on scientific evidence to address this problem. Objective Based on the Change Intention Model Specific Situation Theory (I-Change), to develop a proposal aimed at changing the behaviors of adolescents who binge drinking. Development The three steps methodology proposed by Fawcett was used. Using both English and Spanish terms, as well as the boolean operators AND and OR, diverse databases, were consulted regarding the literature on binge drinking. The conceptual theoretical- empirical structure of the proposal based on the Specific Situation Theory (binge drinking) was then constituted. Conclusions The present proposal offers an alternative to achieve a behavior change regarding binge drinking through a motivational process of three phases: pre-motivational, motivational, and post-motivational. This proposal can be implemented in order to address the problem of binge drinking among adolescents. The findings derived from this application can further provide evidence to the nursing professionals practicing alcohol consumption prevention.

RESUMO Introdução O consumo de álcool em adolescentes é um problema cada vez mais frequente e está aumentando, pois o consumo episódico excessivo é uma tendência cada vez mais comum nessa população. Para o profissional de enfermagem de atenção básica, torna-se necessária a implementação de ferramentas baseadas em evidências científicas como uma alternativa viável que responda às necessidades atuais. Objetivo Desenvolver uma proposta de aplicação baseada na Teoria da Situação Específica do Modelo de Intenção de Mudança (I-Change) focada na mudança comportamental no consumo excessivo episódico de álcool em adolescentes. Desenvolvimento Foi utilizada a metodologia de três etapas proposta por Fawcett. Para a revisão da literatura sobre o consumo episódico excessivo de álcool, foram utilizados termos em inglês e espanhol, bem como os operadores booleanos AND e OR em diversas bases de dados, posteriormente foi construída uma estrutura conceitual teórico-empírica da Teoria proposta. para o consumo episódico excessivo de álcool. Conclusões A presente proposta supõe uma alternativa para alcançar a mudança de comportamento do consumo episódico excessivo de álcool através de um processo motivacional de três fases (pré-motivacional, motivacional e pós-motivacional). A implementação desta proposta busca responder a um problema que gera uma carga significativa de saúde em uma população vulnerável. Os achados derivados de sua aplicação podem fornecer evidências para a atuação do profissional de enfermagem no campo da prevenção do consumo de álcool.

Preliminary Investigations on the Health Benefits of Citrullus colocynthis (L.) Schrad Seeds

Aims: To evaluate the composition of Citrullus colocynthis (L.) Schrad seed as a means of assessing its health and possible therapeutic benefits. Study Design: Test-tube Lab Research. Place and Duration of Study: Federal Institute of Industrial Research, Oshodi, Nigeria, between June 2018 and March 2019. Methodology: Intact dehulled Citrullus colocynthis (L.) Schrad seeds were analyzed for their proximate and elemental content using standard methods and atomic absorption spectroscopy, respectively. The seed oil was extracted with n-hexane via cold maceration and the extracted oil was analyzed for its physiochemical properties. The fatty acid profile was determined using gas chromatography-mass spectrometry. Results: The proximate analysis values were determined to be 6.51%, 51.46%, 21.62%, 13.26%, 3.76% and 3.39% for the moisture, crude fat, crude protein, crude fiber, ash and total carbohydrate content respectively. Results of the elemental analysis show the seed contains; 3653.0322 mg/kg Na, 6639.7818 mg/kg K, 2329.0612 mg/kg Ca, 235.6057 mg/kg Fe, 5252.5884 mg/kg Mg, 27.9056 mg/kg Zn and 7.0068 mg/kg Pb. The predominant fatty acid detected with an area percentage of 20.31 was cis-11-octadecenoic acid. Other fatty acids detected include cis-9, cis-12-octadecadienoic acid, cis-9-octadecenoic, hexadecanoic acid, octadecanoic acid and icosanoic acid. Squalene, a biosynthetic precursor of cholesterol, was detected with an area percentage of 8.54. Conclusion: The evaluation of the compositional data provided evidential support for its beneficial health impact particularly in regards to nutritional and cardio-vascular health.

Time Series and Empirical Orthogonal Transformation Using Meteorological Parameters across the Climatic Zones in Nigeria

Time series and empirical orthogonal transformation analysis was carried out for four (4) selected tropical sites, which are situated across the four different climatic zones, viz. Sahelian, Midland, Guinea savannah and Coastal region in Nigeria using measured monthly average daily global solar radiation, maximum and minimum temperatures, sunshine hours, rainfall, wind speed, cloud cover and relative humidity meteorological data during the period of thirty one years (1980-2010). Seasonal Auto Regressive Integrated Moving Average (ARIMA) models were developed along with their respective statistical indicators of coefficient of determination (R2), Root Mean Square Error (RMSE), Mean Absolute Percentage Error (MAPE) and Mean Absolute Error (MAE). The results indicated that the models were found suitable for one step ahead global solar radiation forecast for the studied locations. Furthermore, the results of the time series analysis revealed that the model type for all the meteorological parameters show a combination of simple seasonal with one or more of either ARIMA, winter’s additive and winter’s multiplicative with the level been more significant as compared to the trend and seasonal variations for the exponential smoothing model parameters in all the locations. The results of the correlation matrix revealed that the global solar radiation is more correlated to the mean temperature except for Akure where it is more correlated to the sunshine hours; the mean temperature is more correlated to the global solar radiation; the rainfall is more correlated to the relative humidity and the relative humidity is more correlated to the rainfall in all the locations. The results of the component matrix revealed that three seasons are identified in Nguru located in the Sahelian region namely, the rainy, the cool dry (harmattan) and the hot dry seasons while in Zaria, Makurdi and Akure located in the Midland, Guinea savannah and Coastal zones two distinct seasons are identified namely, the rainy and dry seasons.

Computer Based Learning Modalities In Anatomy Dissection

Background: Cadaveric dissection has been used for centuries for teaching gross anatomy all over the world. Ithas been considered as a necessity to learn gross anatomy and helps the medical students in understanding thethree-dimensional relationship of different anatomical structures and variations. But the paucity of cadaversand high financial cost has considerably contributed to the development of alternative teaching techniques.Advancement in web-based medical technology leads to the development of virtual dissection programs. Theseprograms have been found to be an effective way to teach anatomy and are being preferred over cadavericdissection. Is cadaveric dissection simply a rite of passage or is it a necessity? The aim of our study was todetermine whether cadaveric dissection is a necessity in medical education, and if it can be replaced by neweralternative techniques like computer based dissection procedure.Materials and Methods: A batch of 150, 1st MBBS students of Malla Reddy Institute of Medical Sciences, Hyderabadwere studied by dividing them into 2 groups of 75 each after subjecting them to Conventional based Learning(CNVL) of dissection versus Computer Based Learning (CBL). A questionnaire was given to both the students andthe faculty. Based on the response to the questionnaire statistical analysis was done.Results: The present study indicated that the Computer Based Learning in dissection (CBL) method was found tobe more effective method for teaching anatomy by 79% of the students and 84% of faculty doctors. The valuer=0.89 shows the pre & post score has correlated positively and has an effect of study. (Paired Two Sample t-test:p=3.24E-29<0.05). As well the results were found to be increased with the pre (35%) to post test (65%) and p<0.05implies the effect.Conclusion: The three dimensional (3D) modeling of anatomical structures in the human body was presented indetailed step by step cadaveric dissections. It also provided detailed human anatomical training for students,where there is a lack of cadaver facility and where there are more students to cadaver ratio. Thus, the multimediaequipped interactive anatomical laboratory software enhance both memorization and visual learning skills ofthe medical students

Coût financier de la prise en charge des hépatites virales chroniques B et C au CHU de Brazzaville (Congo)

Introduction. Les dépenses de santé ont considérablement augmenté dans le monde lors de la dernière décennie. Les hépatites virales chroniques B et C sont des affections chroniques nécessitant un traitement prolongé et qui est encore coûteux, le Congo ne disposant pas encore d'assistance maladie universelle. Le but de cette étude était d'évaluer le coût de la prise en charge des hépatites virales B et C au Congo. Matériels et Méthodes. Il s'agit d'une étude transversale rétrospective et descriptive, réalisée du 1er juin au 31 Décembre 2016 dans le service de Gastro-entérologie et médecine interne du CHU de Brazzaville. Nous avons colligé les dossiers des patients suivis pour hépatite B et C. Les variables d'étude ont été les coûts des examens paracliniques et les coûts des traitements. Résultats. les coûts des examens paracliniques étaient de 296 000 FCFA (451€) pour le coût maximum de l'hépatite B, celui de l'hépatite C était de 596 500 FCFA (910,6 €). Les coûts du traitement de l'hépatite virale C étaient de 1 050 000 FCFA (1603,05 €) pour trois mois. Pour l'hépatite B, ils étaient de 389 987 (595,4€) par semestre. Le coût global de la prise de l'hépatite virale C était de 1 345 313 FCFA (2053,9€) et de 535 569 (817,662 €) pour l'hépatite B. Conclusion. Les coûts de la prise en charge des hépatites B et C sont encore trop élevés au Congo. Une prise en charge globale s'avère nécessaire, similaire à celle de l'infection à VIH

Influence of soaking time and sodium hydroxide concentration on the chemical composition of treated mango seed shell flour for composite application

ABSTRACT: Lignin and hemicelluloses are the major impurities to be removed in natural fibers for it to be suitable in composite application and other uses. This research is based on evaluating the influence of soaking time and sodium hydroxide concentration on the chemical composition of treated mango seed shell (MSSF) by immersing the MSSF in NaOH solution at concentration of 2.5 - 7.5 wt % and soaking time of 2-6 hr, in order to decrease the lignin and hemicellulose content while increasing its cellulose content. The optimum conditions obtained for concentration and soaking time of NaOH were 6.09 % and 5.22 hr, respectively. At these conditions, cellulose content was increased to 94.8002%, while the hemicelluloses and lignin content were reduced to 2.2779% and 0.508502%, respectively. The process parameter of MSSF was optimized using central composite design (CCD) to predict the cellulose, hemicelluloses, and lignin content. The quadratic model of response surface model (RSM) was adopted for the prediction of cellulose, hemicelluloses, and lignin content. The maximum error between the predicted using CCD and experimental results was less 0.38%. These errors in variation for both the predicted by the RSM and the actual gave good alignment with both results. Therefore, at these treatment conditions, MSSF can be utilized for composite application and other industrial purpose

Patrones de tratamiento con agentes biológicos: Eficacia y sobrevida a largo plazo en pacientes con artritis reumatoidea / Treatment patterns with biological agents: Efficacy and long-term survival in patients with rheumatoid arthritis

En nuestro país existen pocos datos acerca de los patrones de tratamiento y la sobrevida de las Drogas Modificadoras de la Artritis Reumatoidea biológicas (DMARb) en pacientes con Artritis Reumatoidea (AR). El objetivo de nuestro estudio fue estimar la sobrevida del 1° y 2° agente biológico, determinar sus causas de suspensión y evaluar factores que influyan en la sobrevida de estos agentes. Material y métodos: Se realizó un estudio multicéntrico retrospectivo. Se incluyeron pacientes ≥18 años de edad que cumplieran con criterios ACR/EULAR 2010 para AR y que iniciaron su 1° y/o 2° DMARb entre 01/2006 y 06/2017, la recolección de datos se realizó mediante la revisión de historias clínicas. Se consignaron variables sociodemográficas y clínicas. Resultados: Se incluyeron 347 pacientes con edad mediana de 57,8 años, 89,6% mujeres, 96,5% tenían Factor Reumatoideo (FR) positivo. El 53,9% de los pacientes discontinuaron el tratamiento con la 1°DMARb, treinta y ocho pacientes (41,3%) discontinuaron el 2° DMARb. La causa más frecuente de suspensión del primer biológico fue la falta de provisión, mientras que la del segundo biológico fue la ineficacia. Las supervivencias medianas fueron: para la 1° DMARb 31 meses (IC 95%: 21,8-40,1) y para 2° DMARb 11 meses (IC 95%: 4-17,9), no observamos diferencias significativas en la supervivencia entre los distintos agentes, los factores independientemente asociados a menor supervivencia del 1° DMARb fueron el tabaquismo y menor edad y del 2° DMARb fue haber discontinuado el primer agente biológico debido a evento adverso. Conclusión: Las supervivencias medianas del 1° DMARb y del 2° DMARb fueron 2,6 años y menor a 1 año, respectivamente. A diferencia de otras cohortes de países desarrollados, la causa más frecuente de suspensión del primer biológico fue la falta de provisión de la medicación por parte del pagador, mientras que la del segundo biológico fue la ineficacia.

In our country there are few data about the treatment patterns and the survival of the Biologic Disease Modifying Antirheumatic Drugs (bDMARD) in patients with Rheumatoid Arthritis (RA). The objective of our study was to evaluate the survival of the 1st and 2nd biological agent, determine the causes of suspension and factors that influence on the survival of these agents. Material and methods: A retrospective multicenter study was conducted. We included patients ≥18 years of age who met the ACR/EULAR 2010 criteria for RA and who started in 1st and/or 2nd bDMARD between 01/2006 and 06/2017, the data collection was done by reviewing clinical charts The sociodemographic and clinical variables were recorded. Results: We included 347 patients with a median age of 57.8 years, 89.6% women, 96.5% had positive Rheumatoid Factor (RF). 53.9% of patients discontinued treatment with 1st bDMARD, thirty-eight patients (41.3%) discontinued the 2nd bDMARD. The most frequent cause of suspension of the first biological was the lack of provision, while the second biological was inefficacy. The median survivals were: for the 1st bDMARD 31 months (95% CI: 21.8-40.1) and for the 2nd bDMARD 11 months (95% CI: 4-17.9), we did not observe significant differences in survival between the different agents. The independent factors associated with lower survival of the 1st bDMARD were smoking and lower age and the 2nd bDMARD was to have discontinued the first biological agent due to an adverse event. Conclusion: The median survivals of the 1st bDMARD and the 2nd bDMARD were 2.6 years and less than 1 year, respectively. Unlike other cohorts of developed countries the most frequent cause of suspension of the first biological was the lack of provision of the drug by the payer, while the second biological was inefficacy.

Blood pressure pattern and the relationship with body mass index among apparently healthy secondaryschool students in Sokoto metropolis, Nigeria

Background. Childhood obesity may result in the premature onset of cardiovascular risk factors, particularly hypertension, hence the need for proper screening. However, blood pressure (BP) is measured only once in most studies in Nigeria, probably because of difficulties in returning to the study areas for repeat measurement.Objective. To determine the BP pattern and assess its relationship with body mass index (BMI) in apparently healthy secondary-school students aged 10 - 18 years in Sokoto metropolis, Nigeria.Methods. This study was descriptive and cross-sectional, and carried out between 13 October 2014 and 30 January 2015. In total, 800students from 6 schools were selected through multistage sampling. BP was measured on three separate days according to the National High Blood Pressure Education Program charts. BMI was categorised according to the Centers for Disease Control charts. The relationship of BP level with BMI was determined.Results. There were 424 (53.0%) males and 376 (47.0%) females, with a ratio of approximately 1:1. BP increased with age. The mean systolic and diastolic BP was significantly higher in females than males (systolic 113.1 mmHg v. 110.5 mmHg, and diastolic 69.0 mmHg v. 66.5 mmHg, respectively; p=0.01). Females had a higher mean BMI than males (18.7 kg/m2 v. 17.9 kg/m2, respectively; p<0.01). BP increased as the BMI percentile increased (p<0.001). The prevalence rates of hypertension were 6.1%, 3.5% and 3.1% at the first, second and third screenings, respectively, while the corresponding prevalence rates of prehypertension were 14.3%, 8.4% and 7.1%. The prevalence of obesity and overweight was 0.3% and 5.9%, respectively.Conclusion. The prevalence rate of prehypertension and hypertension reduced with subsequent measurements, and the prevalence rates of overweight and obesity were low. However, higher BP levels were associated with higher BMI, supporting its predictive significance for elevated BP

Correlación de diferentes métodos de valoración de la rigidez matinal con índices de actividad y discapacidad en pacientes con artritis reumatoidea / Correlation of different methods of assessment of morning stiffness with activity and disability indexes in patients with rheumatoid arthritis

La rigidez matinal (RM) es un síntoma complejo en los pacientes con AR. Existen diferentes formas de valorar la RM. Sin embargo, la mejor manera de evaluarla es aún controversial. Objetivos: Comparar la severidad y la duración de la RM, evaluada por el médico y por cuestionarios autorreportados, con la actividad de la enfermedad y la capacidad funcional en pacientes con AR. Métodos: Estudio observacional de corte transversal. Se incluyeron pacientes con diagnóstico de AR. Se consignaron datos demográficos, características de la AR y medidas clinimétricas. Los pacientes fueron asignados aleatoriamente a uno de dos grupos: el primer grupo fue interrogado sobre la duración de la RM en minutos; el segundo grupo fue evaluado mediante un cuestionario autorreportado que cuantificaba la severidad de la RM (EVA numérica y no numérica) y la duración (en minutos y en escala de Likert). Resultados: Participaron 111 pacientes (86% mujeres). La edad media fue de 52 años y la mediana de duración de la enfermedad fue 8 años. El 51% presentaba RM. La correlación de la RM en minutos medida por el médico fue buena con HAQ-A y aceptable con DAS28 y CDAI; mientras que la severidad medida por EVA correlacionó mejor con los índices de actividad de la AR que con discapacidad. Cuando la intensidad de la RM fue evaluada por EVA se observó que un valor >5,5 cm se asoció con actividad severa de la enfermedad (Sensibilidad: 44%; Especificidad: 100%). Conclusión: La duración de la rigidez matinal, evaluada en minutos por el médico, estaría relacionada tanto con la actividad de la enfermedad como con la discapacidad. La intensidad de la rigidez matinal se asoció más fuertemente con la actividad inflamatoria en los pacientes con AR

Etude de la prise en charge de l'infection à Helicobacter Pylori dans les villes de Pointe-Noire et de Brazzaville en 2015

Introduction : L'infection à Helicobacter Pylori affecte environ 50% de la population mondiale. Sa prévalence est plus élevée dans les pays en développement. Elle est à l'origine de pathologies gastroduodénales et son éradication est de ce fait recommandée.Nous avons réalisé une étude dont l'objectif a été d'évaluer les possibilités diagnostiques, thérapeutiques et la séroprévalence de l'infection à Helicobacter pylori dans les villes de Pointe-Noire et Brazzaville.Méthodes: Etude transversale descriptive et analytique menée de mars à septembre 2015.Résultats : Sur (7) sept tests existants et validés dans le monde; seuls (4) quatre tests étaient disponibles. La non disponibilité du test respiratoire à l'urée marquée au carbone 13 était à l'origine du non contrôle de l'éradication après traitement. Les protocoles d'éradication étaient la quadrithérapie séquentielle ou continue sur 10 jours sans sel de bismuth, non disponible au Congo-Brazzaville.Au total 130 patients ont été inclus; 54(41,5%) hommes et 76 (58,5%) femmes dont 121 (93,1%) patients étaient testés positifs à l'helicobacter pylori, avec une prédominance féminine. Le reflux gastro-oesophagien était la pathologie la plus représentée chez les patients testés positifs mais sans différence significative (P=0,287).Conclusion: L'insuffisance des tests diagnostiques de l'infection à Helicobacter pylori notamment du test respiratoire à l'urée marquée au carbone 13 au Congo-Brazzaville ne permettait pas aux praticiens de contrôler l'éradication. La quadrithérapie bismuthée n'était non plus disponible alors que la séroprévalence hospitalière reste élevée. Ainsi nous faisons le plaidoyer pour l'acquisition du test respiratoire à l'urée marquée au carbone 13 et la mise sur le marché des sels de Bismuth au Congo-Brazzaville

Evaluation de la prise en charge de l'hépatite C chronique à Pointe-Noire en 2015

Introduction : La prise ne charge de l'hépatite virale C a connu un tournant décisif depuis la découverte des antiviraux directs. Sa prévalence au Congo-Brazzaville est estimée à 10% avec prédominance du génotype 4 et son traitement se heurte à plusieurs écueils notamment l'accessibilité au traitement. Nous avons réalisé une étude dont l'objectif a été d'évaluer les possibilités de diagnostic et de prise en charge thérapeutique des malades infectés par le virus de l'hépatite C à Pointe-Noire.Méthodes: Il s'est agi d'une étude expérimentale, prospective, descriptive et analytique réalisée dans le service de Gastroentérologie de l'hôpital général de Loandjili de Pointe-Noire.Résultats: Au total notre file active comptaient 81 dossiers des cas d'hépatite C et 34 (41,9%) cas traités ont été inclus. Il s'agissait de 21(61,76%) hommes et de 13(38,24%) femmes d'âge médian 50ans. Il y avait 15 (44,1%) patients alcooliques; 4 (11,8%) patients fumeurs; 15 (44,1%) patients sans intoxication. L'hépatite C était découverte lors d'un dépistage chez 19(55,8%) patients et suite aux symptômes chez 15 (44,1%) patients. Parmi ces 34 malades; 6 (17,6%) étaient du génotype 1 et 23 (67,6%) étaient du génotype 4; chez 5 (14,7%) patients le génotype était inconnue. Le financement du traitement était assuré par l'assurance maladie pour 5 (14,7%) patients; l'employeur pour 13 (38,2%); l'argent personnel pour 12 (35,3%); l'aide des parents pour 3 (8,8%) patients; non identifié chez 1 (2,9%) patient. Sur 34 patients traités par bithérapie pégylée 13(38,2%) étaient guéris et 21(61,7%) n'étaient pas guéris. Il restait 21 patients non guéris dont 2 patients traités par sofosbuvir + ribavirine (24 semaines) et 2 malades traités par sofosbuvir +daclastavir (12 semaines); tous ces 4 malades étaient guéris. Il restait 17 patients non guéris et non traités par les antiviraux directs faute de financement. En analyse uni et multivariée la charge virale était un facteur influençant l'efficacité du traitement.Conclusion : La prise en charge optimale de l'hépatite C chronique est possible au Congo-Brazzaville. Cependant la non disponibilité des médicaments, le prix exorbitants des antiviraux et le manque de couverture sociale, constituent des freins exposant les malades aux complications mortelles. Ainsi la création du programme national de lutte contre les hépatites virales au Congo Brazzaville pourrait lever ces obstacles inadmissibles en 2016

Declining prevalence of duodenal ulcer at endoscopy in Ile-Ife, Nigeria

Background. Duodenal ulcer is the most common peptic ulcer disease worldwide. In the past, sub-Saharan Africa has been described as an area of mixed prevalence for peptic ulcer disease, but recent reports have disputed this. Changes in the prevalence of duodenal ulcer have been reported, with various reasons given for these.Objective. To describe the change in endoscopic prevalence of duodenal ulcer at Obafemi Awolowo University Teaching Hospital (OAUTH), Ile-Ife, Nigeria, between January 2000 and December 2010.Methods. This was a retrospective, descriptive study of patients who underwent upper gastrointestinal endoscopy in the endoscopy unit of OAUTH between January 2000 and December 2010. The data were obtained from the endoscopy register, demographic indices, presenting symptoms and post-endoscopic diagnoses being retrieved for each patient. The study period was divided into the years 2000 - 2004 and 2005 - 2010, the frequencies of duodenal ulcer and other post-endoscopic diagnoses being compared between these two time periods to see whether there were changes.Results. Over the study period, 292 patients (15.8%) were diagnosed with duodenal ulcer, second only to 471 patients (26.2%) with acute gastritis. The prevalence of duodenal ulcer for 2000 - 2004 was 22.9% (n=211 patients) compared with 9.2% (n=81) for 2005 - 2010 (p<0.001).Conclusion. There was a significant decline in the endoscopic prevalence of duodenal ulcer over the decade

Tumeur d'Abrikossoff de l'estomac : une localisation rarissime

La tumeur d'Abrikossoff ou tumeur à cellules granuleuses est une lésion rare, souvent unique et bénigne. L'âge de son diagnostic habituellement est compris entre 40 et 60 ans. Elle prédomine légèrement chez les femmes, notamment de race noire. Elle est de siège ubiquitaire et préférentiellement cervico-céphalique. La langue reste la localisation la plus fréquente avec 28% des cas. Les autres localisations sont beaucoup moins fréquentes. Nous rapportons le premier cas documenté au Congo Brazzaville, de localisation gastrique, suivi d'une revue de la littérature

Comparative in vitro Study of the Bond Strength on Dentin of Two Sealing Cements: BC-SEALER and AH-PLUS / Estudio comparativo in vitro de la fuerza de adhesión sobre dentina de dos cementos selladores BC-Sealer y AH-plus

Abstract: Gutta-percha with a sealer cement has been used for many years as a fill for root canal therapies, new materials and techniques have been recently developed that could increase the success rate of endodontic treatments. It is important to compare materials that are used today, with those that are coming to the market, which possess considerable advantages that may well increase the rate of successful treatments. The purpose of this research is to evaluate the adhesion properties of a new bioceramic sealer: EndoSequence® BC SealerTM using BC Points. For this, the following techniques were used: Single cone obturation and lateral condensation with AH-Plus. The results demonstrated differences between the groups of AH-Plus and BC-Sealer. On the bond strength that was applied in the different thirds of the root canal, the sealer cement BC-Sealer proved to be the best adhesion material in all thirds of the root canal being significantly more noticeable in the apical third. The two sealants are effective root canal adhesives, used properly, any of there may grant an acceptable result.

Resumen: A pesar de que la gutapercha con cemento sellador ha sido utilizada durante muchos años, últimamente se han desarrollado nuevos materiales y técnicas que podrían incrementar la tasa de éxito en los tratamientos endodónticos. Es importante comparar materiales que en la actualidad se utilizan con los nuevos que están saliendo al mercado con considerables ventajas que puedan así aumentar el índice de tratamientos exitosos. Por lo tanto, el propósito de esta investigación es evaluar las propiedades de adhesión de un nuevo sellador biocerámico EndoSequence® BC SealerTM usando BC Points. Para esto, se utilizó la técnica de obturación cono único y condensación lateral con AH- Plus. Se encontraron diferencias entre los grupos de AH-Plus y BC-Sealer. Sobre la fuerza de adhesión que se aplicó en los diferentes tercios del conducto radicular, el cemento sellador BC-Sealer demostró ser el material con mejor adhesión en todos los tercios del conducto radicular siendo significativamente más notable en tercio apical. Los dos cementos selladores son efectivos para la adhesión en los conductos radiculares, cualquiera de estos bien utilizados otorgará un resultado aceptable.

Evolution fatale à moyen terme d'une cirrhose virale C traitée par bithérapie pégylée

La prévalence de l'hépatite C au Congo-Brazzaville est élevée avec prédominance du génotype 4. Nous rapportons un premier cas clinique traité dont la réponse virologique en fin de traitement a été négative du fait que la patiente présentait tous les facteurs prédictifs de mauvaise réponse. L'évolution s'est faite vers les complications classiques mortelles. Les limites d'accès aux explorations et au traitement ont influencé négativement l'évolution. Nous venons de présenter un premier cas d'hépatite C traité à Pointe-Noire avec échec thérapeutique. Ce premier cas de notre expérience nous a permis de vivre la réalité de l'histoire naturelle et des difficultés de la prise en charge de l'hépatite C à Pointe-Noire

Evaluation de la satisfaction des accouchées du service de gynécologie obstétrique du Centre Hospitalier Départemental du Borgou de Parakou (Bénin)

Introduction : La satisfaction des patients est une composante essentielle de la qualité des soins. Cependant, l'évaluation de la satisfaction est une pratique presque inexistante dans les établissements de santé au Bénin. L'objectif de cette étude était de mesurer la satisfaction des bénéficiaires de l'offre de soins lié à l'accouchement au Centre Hospitalier Départemental du Borgou (CHD-B).Patientes et méthodes : nous avons réalisé une étude transversale à visée descriptive et analytique du 2 juin au 15 septembre 2014. Elle a concerné 180 accouchées, recrutées de façon systématique avec un pas de sondage égale à 2. Les données ont été collectées grâce à des entrevues individuelles associées à l'exploitation des dossiers des patientes. Résultats : Le taux de satisfaction pour l'accouchement en général a été de 73,89%. Ce taux était plus élevé en cas d'accouchement par césarienne (78,05%) que par voie basse (68,37%). Les patientes ont été satisfaites de l'accueil (78%), du délai d'attente aux urgences (87,83%) et de la régularité des soins (74%). Par contre elles ont été insatisfaites des conditions de séjour (47,32%), de la restauration (53,09%) et de la prise en charge de la douleur (35,9%). Les accouchées disent n'avoir pas été informées sur leur état de santé (66,67%) ni sur celui de leur enfant (68,33%). Les facteurs associés à la satisfaction des accouchées ont été la parité, le niveau intellectuel et socio-économique et les interventions par voie basse. Conclusion : Les patientes étaient satisfaites des soins liés à l'accouchement au CHD-B. Il a été possible d'identifier certains facteurs qui influencent la satisfaction des accouchées

Scope of Neonatal Care Services in Major Nigerian Hospitals

Background: Neonatal survival bespeaks the quality of neonatal care services available and accessible to the population. Intensive care improves outcome of high-risk infants with serious illness. The tiered level of care is yet to be applied to newborn care in Nigeria. Classification of care is key to improving neonatal survival with enhanced referral of high-risk patients to higher-level centres. Objective: To ascertain the scope and classify available newborn services offered at major Nigerian hospitals.Methodology: A semi-structured validated questionnaire was administered to attendees during 2015 Pediatric Association of Nigeria conference. The information derived was used to categorize neonatal care services.Results: The respondents consisted of doctors 201 (84.8%) and nurses 36 (15.2%) in 54 health facilities from all geopolitical regions of Nigeria. Of the 54 facilities; 34 (63%) were located in state capitals and 47 (87%) in public hospitals. Half of the evaluated units belonged to Class I; 22 (40.7%) Class II; and 5 (9.3%) Class III levels of neonatal care. Majority (81.6%) of the doctors have been trained on neonatal resuscitation; with senior residents being the highest 49 (89%) and Medical officers (MO) the least 4 (40%) trained. Doctors with training in mechanical ventilation (MV) were 39.2%; Consultants (51.2%); MO's the least 1(11.2%) trained (p=0.025). Monitoring is usually by pulse oximeters 54 (100%); multi parameter monitors 23 (42.6%) and rarely ABGs 6 (11%).Conclusion: Neonatal care in Nigeria is still developing. Most centres provide basic neonatal care services. Regionalization of care may be the solution to higher level neonatal care