Pratiques de prise en charge de l'hypertension artérielle au Centre Hospitalier et Universitaire d' Abomey-Calavi au Bénin / NA

L'hypertension artérielle est une maladie à forte progression reste un problème de santé publique. Mais, les pratiques de sa prise en charge se heurtent à différents obstacles. Cette recherche questionne les problèmes qui caractérisent les pratiques de prise en charge de l'hypertension artérielle au Centre Hospitalier et Universitaire d'Abomey-Calavi au Bénin. Pour y parvenir, nous avons opté pour une analyse basée sur les méthodes quantitatives et qualitatives. L'échantillon est constitué de 130 personnes enquêtées. De l'analyse des résultats collectés, des difficultés éprouvées entre patients et agents de santé dans la prise en charge de l'hypertension artérielle, se caractérise par le manque de relation soignant-soigné. De même, 90% des enquêtés estiment avoir peu de ressources humaines qualifiées et du faible pouvoir d'achat des patients pour faire face aux coûts élevés du traitement de l'hypertension (86,75%). Ainsi, le manque de plateau technique et les frais de consultations spécialisées posent problèmes y compris les suivis de l'éducation hygiéno-diététique. Cet état de fait compromet les pratiques de prise en charge et les formations globales que le système soin est supposé assurer aux usagers qui le fréquentent. Ces résultats suggèrent l'urgence de formations pour le renforcement des capacités pour repérer la précarité et la réorganisation des mesures de prise en charge de l' hypertension artérielle dans le périmètre sanitaire béninois.

Arterial hypertension remains a rapidly growing public health problem. However, management practices face a number of obstacles. This research questions the problems that characterize arterial hypertension management practices at the Centre Hospitalier et Universitaire d'Abomey-Calavi in Benin. To achieve this, we opted for an analysis based on quantitative and qualitative methods. The sample consisted of 130 respondents. From the analysis of the results collected, of the difficulties experienced between patients and health workers in the management of arterial hypertension, most of those surveyed claimed to have a complexity that characterizes the training of health workers. Similarly, 90% of respondents felt that they had few non-cardiologist practitioners, and that patients had little purchasing power to meet the high costs of treating hypertension (86.75%). As a result, the cost of specialized consultations and complementary examinations poses a problem, including follow-up health and diet education. This state of affairs compromises management practices and the comprehensive training that the healthcare system is supposed to provide for its users. These results suggest the urgent need for training to identify precariousness, and the reorganization of hypertension management measures within the Beninese health perimeter.

Comparaison des coûts du traitement du paludisme en biomédecine et en médecine traditionnelle à Niono (Mali) / Comparison of costs of treatment of malaria in biomedicine and traditional medicine in Niono (Mali)

Introduction. Au Mali, la prise en charge du paludisme se fait à travers la médecine conventionnelle et la médecine traditionnelle, mais peu d'évaluation existe sur les implications fi nancières de ces approches qui coexistent et qui sont pratiqués parfois de manière concomitante. L'objectif de cette étude était d'évaluer les coûts fi nanciers de ces deux approches du point de vue des patients. Méthodes. Ainsi, une étude transversale descriptive impliquant des patients ont été sélectionnés dans trois aires de santé et plus précisément dans des ménages, structures de santé conventionnelle et chez les praticiens de la médecine traditionnelle de Niono, Sirabala et N'Debougou. Des questionnaires structurés ont été utilisés pour collecter des informations. Le calcul du coût de traitement a été utilisé pour comparer le coût moyen de traitement du paludisme en médecine conventionnelle et traditionnelle. Résultats. Au total, 300 patients ont été sélectionnés. 52,7% des patients avaient recouru à la médecine conventionnelle, contre 32% pour l'automédication et 15,3% pour la médecine traditionnelle. Les patients avaient utilisé les ressources de ces trois systèmes de santé pour quatre principaux motifs. Le coût moyen du traitement par épisode de paludisme était estimé à 12,97 Euro en médecine conventionnelle contre 6,24 Euros en médecine traditionnelle. Le coût moyen du traitement de paludisme en automédication à base de médicaments conventionnels ou traditionnels était de 0,82 Euros. Conclusion. Dans notre étude, même si le coût du traitement du paludisme en médecine conventionnelle reste plus élevé que celui en médecine traditionnelle, contrairement aux idées reçues, les coûts des ressources de la médecine traditionnelle ne sont pas aussi bas qu'on le croit.

Introduction. In Mali, malaria management is done through conventional and traditional medicine, but little evaluation exists on the fi nancial implications of these approaches which coexist and are sometimes practiced concomitantly. The objective of this study was to evaluate the fi nancial costs of these two approaches from the patients' point of view. Methods. Thus, a descriptive cross-sectional study involving patients selected in three health areas and more precisely in households, conventional health structures and traditional medicine practitioners in Niono, Sirabala and N'Debougou. Structured questionnaires were used to collect information. The calculation of the cost of treatment was used to compare the average cost of treating malaria in conventional and traditional medicine. Results. Finally, 300 patients were selectionned and 52.7% of patients had used conventional medicine, compared to 32% for self-medication and 15.3% for traditional medicine. Patients had used the resources of these three health systems for four main reasons. The average cost of treatment per malaria episode was estimated at 12.97 Euros for conventional medicine versus 6.24 Euros for traditional medicine. The average cost of treatment of malaria by self-medication with conventional or traditional medicines was 0.82 Euros. Conclusion. In our study, even if the cost of treating malaria with conventional medicine remains higher than with traditional medicine, contrary to popular belief, the resource costs of traditional medicine are not as low as one might think

Alloimperatorin activates apoptosis, ferroptosis, and oxeiptosis to inhibit the growth and invasion of breast cancer cells in vitro.

Breast cancer is the most common malignant tumour in women. Our research on alloimperatorin from Angelica dahurica showed that alloimperatorin inhibited breast cancer cell viability in a concentration- and time-dependent manner; it also showed that apoptosis and ferroptosis inhibitors significantly weakened the antisurvival effect of alloimperatorin. Alloimperatorin clearly induced breast cancer cell apoptosis and increased the activities of caspase-3, caspase-8, caspase-9, and poly (ADP-ribose) polymerase; it also caused significant mitochondrial shrinkage, promoted the accumulation of Fe2+, reactive oxygen species, and malondialdehyde, and significantly reduced mRNA and protein expression levels of SLC7A11 and GPX4, indicating that alloimperatorin induces ferroptosis. In addition, alloimperatorin significantly promoted Kelch-like ECH-associated protein 1 (Keap1) expression; although it did not affect the expression of PGAM5 (mitochondrial serine/threonine protein phosphatase) and apoptosis-inducing factor mitochondria associated 1 (AIFM1), it significantly reduced the phosphorylation level of AIFM1. After downregulating the expression of Keap1, PGAM5, or AIFM1, the inhibitory effect of alloimperatorin on cell viability was significantly weakened, indicating that alloimperatorin regulates the Keap1/PGAM5/AIFM1 pathway to promote oxeiptosis. Alloimperatorin significantly inhibited the invasion of breast cancer cells, while Keap1 siRNA or GPX4 overexpression vectors significantly enhanced cell invasion and effectively reversed the anti-invasive effect of alloimperatorin. Therefore, alloimperatorin induces breast cancer cell apoptosis, ferroptosis, and oxeiptosis, thereby inhibiting cell growth and invasion.

Traditional Medicine and Type 2 Diabetes in First Nations Patients.

BACKGROUND: Diabetes may be a cultural experience for many First Nations patients. In this study, we explore the potential role for traditional medicine in the treatment of diabetes. METHODS: A responsive interviewing qualitative methodology was used for 10 First Nations key informant interviews. The first objective was to accurately "re-tell" participants' stories. The second was to develop an overview of traditional medicine and its role in health and diabetes management by synthesizing academic literature, pre-existing local knowledge and perspectives, and stories shared by elders and traditional healers. The traditional medicine healers gave specific permission for this study and its publication. RESULTS: There is a strong cultural and historic context for the experience of diabetes in First Nations. Political and cultural suppression, lifestyle change and ongoing social determinants of health place diabetes in a unique context and generate a sense of fatalism. Traditional medicine can facilitate individual empowerment by connecting a patient with the lessons of previous generations and traditional beliefs and practices. CONCLUSIONS: Traditional medicine can be a valuable resource for First Nations patients living with diabetes and should be considered as a therapeutic modality.

[Gabonese traditional medicine, a complementary and alternative medical art]. / La médecine traditionnelle gabonaise, un art médical complémentaire et alternatif.

In Gabon, people use traditional medicine. This medical art has been built up over centuries upon the cultural diversity of the country and the richness of the fauna and the flora. It is an alternative and complementary medicine to the allopathic one. For the Gabonese, it is often the only option when faced with health structures that are geographically poorly distributed and that do not function well.

Neo-Traditional Medicines: Ethnographic Contributions to Conceptual Definition.

Since the end of 1970, the World Health Organization has encouraged the development of public policies that expand the approach to care and the therapeutic possibilities offered by its member states beyond technoscientific health care. In Brazil, the institutionalization of this approach is related to the promotion of popular and traditional knowledge associated with the usage of medicinal plants. With this convergence as an argumentative horizon, in this ethnography we examine the institutionalization of pharmaceutical services that have become known in Brazilian public health policy as living pharmacies. This term has been mobilized throughout the history of phytotherapy in Brazil and refers to the possibility of instituting the use of medications that expand care approaches and problem resolution possibilities beyond the domain of the biomedical sciences, evoking alliances with so-called traditional and popular knowledge and practices. For this, we propose and discuss the concept of neo-traditional medicines as a comprehensive-interpretative category, verifying the approximation and distancing points assigned to it in contemporaneous anthropological literature. Beyond the domain of science over other fields of knowledge, we argue in favour of this category in order to present new arrangements and social dynamics that define Brazil's medication policies.

[Wholesale distribution and delivery of plant-based medicinal products through the pharmaceutical system of Burkina Faso]. / Distribution en gros et délivrance des médicaments à base de plantes à travers le circuit pharmaceutique du Burkina Faso.

OBJECTIVE: In order to improve the contribution of medicines from traditional pharmacopoeia to health care, African countries like Burkina Faso have adopted for several years, policies and regulations organizing their distribution. This study aims to analyze the situation of the wholesale and retail sale of herbal medicines imported by the official pharmaceutical facilities. METHOD: This is a retrospective study involving all 18 drug wholesalers and 115 pharmacies in the city of Ouagadougou (Burkina Faso). It consisted of a collection of sales data of herbal medicines from 2013 to 2016 and interviews of the pharmacists responsible for the facilities surveyed. RESULTS: All the pharmacies surveyed obtain their supplies from national wholesalers, but eleven of them do so directly from manufacturers or non-wholesalers. Only 40% (44/111) of herbal medicines distributed by wholesalers and pharmacies had valid marketing authorizations. Also, although the average growth rates of annual sales by wholesalers and private pharmacies, respectively 23.67% and 11.94%, are significant, the turnover generated from their sale remains low. CONCLUSION: Supporting local producers with appropriate funding and adequate promotion of herbal medicines is still needed to boost the share of the national herbal medicines market.

[Between tradition and modernity, traditional medicine and nursing in Ivory Coast]. / Entre coutume et modernité, médecine traditionnelle et soins infirmiers en Côte d'Ivoire.

As is the case in many African countries, traditional medicine is deeply rooted in the Ivorian culture and healthcare system and has long been the only form of medical care available. In line with the WHO's strategy, the Ivorian health authorities provide a framework and practice guidelines in order to limit aberrations and facilitate a form of patient care which combines both traditional practices and conventional medicine.

[Traditional Chinese medicine and cancer recurrence]. / Médecine traditionnelle chinoise et rechutes de cancers.

Being diagnosed with cancer and having to undergo gruelling treatment is an ordeal. A recurrence of the disease is equally traumatic and can have a profound impact on the patient's balance. In this context, traditional Chinese medicine can strengthen vitality and help to improve the patient's quality of life.

Synergistic activity between Echinophora platyloba DC ethanolic extract and azole drugs against clinical isolates of Candida albicans from women suffering chronic recurrent vaginitis.

OBJECTIVE: Candida albicans is one of the main causes of vaginitis, especially in women with recurrent episodes. The appearance of drug resistant C. albicans and adverse effects of chemical agents have raised interest in Echinophora platyloba as one of four native species in Traditional Persian-Iranian medicine. MATERIALS AND METHODS: This study evaluates the antifungal activity of ethanolic extract from dried aerial parts of E. platyloba against 27 clinical isolates of C. albicans from women suffering chronic recurrent vaginitis by micro-broth dilution assay. The synergistic effect of azole drugs and E. platyloba ethanolic extract were also determined by disc diffusion method after determining the MIC90. RESULTS: The results of this study showed a potent synergistic effect of E. platyloba ethanolic extract and itraconazole (P<0.01) and fluconazole (P<0.001) but an antagonistic effect between E. platyloba ethanolic extract and clotrimazole and miconazole against clinical isolates of C. albicans. CONCLUSION: These results must be confirmed by clinical application and by further clinical studies.

El tratamiento de electroacupuntura en la sacrolumbalgia aguda no específica / The electro-acupuncture as treatment for the no-specific acute sacrolumbar pain

INTRODUCCIÓN: Las crisis de sacrolumbalgias agudas no específicas presentan una alta incidencia y constituyen un problema que afecta mayormente a pacientes en edad laboral. El presente trabajo tiene como objetivo principal el de establecer diferencias entre el uso o no de la electroacupuntura en el tratamiento de la crisis de sacrolumbalgia aguda no específica. MÉTODOS: Se realizó un estudio experimental terapéutico del tipo ensayo clínico, en 100 pacientes de ambos sexos y edades entre 27 y 65 años que asistieron al departamento de medicina tradicional, sección de consulta externa del Complejo Científico Ortopédico Internacional Frank País procedentes de la consulta externa de ortopedia de la institución y de áreas de salud del municipio La Lisa.Se aplicaron criterios de exclusión y se dividieron en dos grupos, uno recibió tratamiento de electroacupuntura y el otro tratamiento convencional. RESULTADOS: El tratamiento con electroacupuntura mostró ser más eficaz tanto en relación con el inicio en la remisión de los síntomas dolorosos como en el tiempo necesario para la remisión completa. CONCLUSIÓN: Por lo anterior la terapia con electroacupuntura se recomienda en el tratamiento de la sacrolumbalgia aguda no específica

INTRODUCTION: The scapulothoracic friction syndrome is a pain cause in the posterior area of the shoulder and that may be provoked by a dysfunction of this joint. When conservative treatment fails or when it is due to tumor injuries, surgical treatment is prescribed. The aim of present paper is to assess the results obtained with this type of treatment in our study group. METHODS: An intervention study was conducted in 17 patients with a scapulothoracic friction syndrome operated on the Upper Member Service of the Frank País International Orthopedics Scientific Complex from March, 2002 to March, 2008. Surgical technique was in correspondence with the triggering cause of this syndrome. Functional assessment of results was made at 6 months after surgery taking into account three categories of the Shoulder Functional Assessment Test of the Los Angeles University, California (pain, function and the patient's satisfaction grade), also for our study, three categories more were added to this test (flexion, abduction and antepulsion). RESULTS: Mean age in our series was of 31,8 years; 15 patients (89,4 percent were women, the more involved age groups were those under 20 years and between 31 to 40 years each, with predominance of the dominant limb in 10 patients (58,8 percent) with greater frequency in the intellectual ones. Assessment of pain, function, flexion, abduction and antepulsion showed a significant trend to improve of score. The 82 percent of patients showed excellent or good results