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Malpractice litigation and spine surgical procedure from the National Health Service: one particular tertiary-level centre perspective over Twelve a long time.
ciated with enteric bacterial infection compared to hand washing before meal preparation. Conclusion Sanitation, hygiene, nutritional and clinical factors were associated with enteric bacterial infections causing diarrhea among children below five years in the study area. Childhood diarrhea in Murang'a County is a major public health problem. © Oliver Waithaka Mbuthia et al.Epidermoid cyst is a benign embryonic tumor. It is an anomalous localization of ectoderm-derived tissue. Cervical epidermoid cyst is rare. It can cause diagnostic difficulties, especially in patients with voluminous and compressive cysts. We report a case of large epidermoid cyst of the neck with signs of compression of the upper aerodigestive tract. The patient underwent cervicotomy with mass resection. Pathological examination of the surgical specimen showed epidermal cyst. © Nogognan Ignace Lengane et al.Introduction Prostate cancer (PCa) is the leading cause of cancer-related deaths in men aged 40 years and older. Incidence and mortality rates are higher in African men. PCa is amenable to early detection by screening which can prevent and reduce cancer deaths. Late-stage presentation and diagnosis often occur due to poor screening practices. This study assessed the knowledge, attitude, prevalence and barriers towards PCa screening among males in an urban area in Nigeria using a mixed method approach. Methods This cross-sectional descriptive study used quantitative and qualitative methods among men aged 40 years and older. A pretested structured questionnaire was used to interview 344 respondents through multi-stage sampling. Additionally, two focus group sessions were held using a pre-tested guide. Results Respondents were between 40-89 years with a mean age of 52.8 ± 9.9 years. Majority (54.9%) had poor knowledge of prostate cancer and its screening methods however, 65.7% expressed positive attitudes towards screening. Only 73 (21.2%) had ever been screened. The focus groups showed that respondents expressed a willingness to undergo PCa screening. The main barriers to screening were the fears of a positive result, ignorance and financial constraints. Participants preferred male physicians during digital rectal examinations. Conclusion Respondents showed poor levels of knowledge. They expressed positive attitudes towards screening. However, this was not translated into practice. Public health interventions should educate men about benefits of early detection while addressing fears of positive findings and gender biases during rectal examinations. Efforts at providing low-cost alternatives for PCa screening are needed. © Uzoamaka Valerie Ugochukwu et al.Introduction Skin cancers are malignant keratinizing tumors of epidermal, melaninic or adnexal origin. These cancers are still little known. However they affect people living in Madagascar where the amount of sunshine remains very high with an impact that varies depending on the skin type. The purpose of our study was to determine the epidemio-clinical profile of skin cancers in Antananarivo. Methods We conducted a retrospective descriptive study of skin cancers in the Department of Oncology of the Joseph Ravoahangy Andrianavalona Hospital, Antananarivo over a period of seven years. It included patients with tumoral skin lesions confirmed by histological examination. Results We collected data from 47 cases of skin cancers (male predominance; sex ratio 1.13). The average age of patients was 49.3 years. Farmers were the most affected. The lesions mainly occurred in the head, neck (44%) and lower limbs (42%). Localized skin cancers were detected in 61.7% of cases. Squamous cell carcinoma was the most common skin cancer in Madagascar (37%), followed by the melanoma (21%) and the basal cell carcinoma (11%). Treatment was mainly based on surgery (74.19%). Conclusion Squamous cell carcinoma is the most common cancer in Madagascar, followed by melanoma and basal cell carcinoma. Skin cancers affect mainly the young population and require appropriate management. © Andrianarison Malalaniaina et al.Introduction reducing the incidence of new HIV infections is a public health goal. The purpose of this study was to evaluate the knowledge and willingness to prescribe PrEP in Kinshasa. Methods we conducted a cross-sectional analytical study among care providers of 4 health facilities where HIV treatment was offered in the city of Kinshasa from April to October 2017. Univariate and multivariate logistic regression analyses were carried out to identify the factors associated with knowledge and willingness to prescribe PrEP. Results eighty-five care providers responded at the survey. Less than one quarter of care providers knew PrEP before the survey and half of them were willing to prescribe it. Reluctance was due to resistance (83%). Factors associated with the knowledge of PrEP were the specialty of infectious disease and the expertise in addressing HIV. Factors associated with the willingness to prescribe PrEP were an age greater than 40 years, the specialty of infectious disease and the expertise in addressing HIV. Conclusion the knowledge of the PrEP in Kinshasa was low and only half of care providers were willing to prescribe it. Being an infectious diseases specialist and an expert in HIV was associated with the knowledge and the willingness to prescribe PrEP. Education programs should strengthen the knowledge on PrEP and address concerns leading to reluctance to prescribe it. © Benilde Bepouka Izizag et al.Introduction The purpose of this study was to analyze the epidemiological, diagnostic, therapeutic and evolutionary features of hemoglobinuria in children hospitalized in the Pediatric University Hospital Charles de Gaulle, Ouagadougou. Methods We conducted a cross-sectional descriptive study over the period 01st July-31st December 2014. All children aged 0-15 years hospitalized in the Department of Medical Pediatrics of the Pediatric University Hospital Charles de Gaulle and diagnosed with macroscopic hemoglobinuria during the study period were enrolled. Results Thirty-eight patients were included in the study. Hospitalization rate for hemoglobinuria was 1.9%. The average age of patients was 80.8 ± 44.1 months (ranging from 21 to 168). The study involved 23 boys (60.5%) and 15 girls (39.5%). The major clinical signs were fever (86.8%), dark urines like « coca cola » (86.8%), pallor (63.2%), hepatomegaly (50%). Glomerular filtration flow was less than 80 mL/min/1.73m2 in 23 patients (69.7%); 21 patients had Glucose-6-phosphate dehydrogenase (G6PD) deficiency. The main suspected causes of hemoglobinuria were severe malaria, bacterial and viral infections, G6PD deficiency, biliary haemoglobinuric fever. Treatments included artemisinin derivatives, antibiotics and antipyretics. One patient underwent dialysis. Conclusion Hemoglobinuria is a symptom mainly causing diagnostic problems in our context. It is a severe disorder which can result in acute renal failure (ARF). © Hamidou Savadogo et al.Introduction Despite the efforts of nutrition stakeholders in Burkina Faso to improve infant and young child feeding (IYCF) practices, the country is still struggling to stem undernutrition. Wasting, or acute malnutrition, is the form of malnutrition that has the most harmful short-term consequences for children. The objective of our study was to estimate the prevalence of wasting in children aged 6-23 months in the Sahel region of Burkina Faso and to identify its associated factors. Methods We conducted a secondary analysis of data from the 2015 National Nutrition Survey. The factors associated with wasting in the studied population were identified using a logistic regression. Results A total of 956 children participated in the study. The prevalence of wasting was 25% (95% CI [22.28, 27.87]) in the Sahel region. Only 24.37% of children received a minimum meal frequency and 13.38% received a minimum dietary diversification the day before the survey. In the multivariate analysis, being male (aOR = 1.99; 95% CI [1.46, 2.72]), breastfeeding the day before the survey (aOR = 2.43; 95% CI [1.13, 5.22]), and having a history of illness (aOR = 2.32; 95% CI [1.67, 3.21]) significantly increased the risk of acute malnutrition. Conclusion In 2015, the prevalence of wasting among children was high in the Sahel region and good IYCF practices were still inadequate. There is an urgent need to implement good IYCF practices and strengthen interventions to improve infant health in this region. © Boyo Constant Paré et al.Mycetoma is a chronic inflammatory process during which exogenous fungal or actinomycosic agents produce grains. The infection involves the skin, the subcutaneous tissues, the muscles and the bones. We report the case of a 39-year old woman, a teacher, living in Brazzaville, who had regularly resided in the village. She presented with a painless suppurative mass in the left thigh that had been treated with bandages over the past 4 years. The patient didn't have fever. Her general condition was good. Physical examination showed poly-lobed, firm tumor mass in the posterior surface of the left thigh, measuring 11cm in diameter on the major axis, with ulcerations discharging purulent serosity. There was no satellite adenopathy. The remainder of the physical examination was normal. Bacteriological analysis showed sterile serosity. Skin biopsy revealed alteration of the connective tissue and the presence of small foci of grains, typical of Actinomadura pelletieri. CRP level was 48mg/L; blood count, blood glucose, blood lipids and LDH were normal. Standard radiography of the affected thigh was normal. The diagnosis of actinomycosic mycetoma was retained. Patient's outcome, after a 12-month treatment with cotrimoxazole, was marked by the epidermization of the ulcers and the persistence of the tumor mass, justifying secondary surgical resection. © Edith-Sophie Bayonne Kombo et al.Introduction Multidrug-resistant organisms (MDROs) have been a major concern in King Saud Medical City (KSMC) recently. The number of cases with colistin resistance was growing rapidly in the first half of 2016, challenging the infection control practices and mandating a thorough outbreak investigation. https://www.selleckchem.com/products/pf-07321332.html The objective of this study was to determine the extent of the outbreak, identify potential risk factors and prevent further increase in the rates of MDROs. Methods Reviewing the medical records of the 22 admitted cases with colistin resistance using an abstraction form composed of demographical data, comorbidities, details of current admissions, and procedures. Also, tracking patients' movements in the hospital, reviewing all cultures isolates, and reviewing the surveillance and infection control strategies. Results Mean age was 49.71±17.824 (20-79 years), 90.9% were males, 63.6% cases admitted under medical unit. The average duration of stay in the ED was 1.23 day. Over 2/3 had hypertension and diabetes mellitus. Majority of patients staying between 20-40 days in the hospital & the average number of days until developing colistin resistance was 44.18. Resistance was solely related to two organisms that were Acinetobacter baumanni (59.1%) and Klebsiella pneumoniae (40. 9%). Ventilators and folly's catheters were equally (95.5%) used by 21 patients. The most common site of infection was respiratory (41.3%), of which most were sputum samples. Resistance of over 75% is recorded by antibiotics like tazocin, ciprofloxacin, imepenen and oxacillin. Conclusion The uncontrolled use of antibiotics, prolonged stay in the Intensive Care Unit (ICU), frequent uses of different devices, are the potential risk factors of developing colistin resistance. © Zayid Al-Mayahi et al.
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