Search

The rapid access of the population to basic and comprehensive health care determines the prognosis of the disease and decreases mortality and morbidity., Methodology: we carried out a prospective study over 12 months at the Bla Reference Health Center. All patients evacuated for obstetric complications were included. Women admitted on an emergency basis by self-referral were not included. The data was analyzed from the software Epi Info version: 3.5.4, the text entry from the software version Word 2013., Results: We recorded 430 evacuations or 42.36% of admissions to the maternity hospital in Bla. The patients were young under 20 years 17.9% (n = 77), nulliparous 22.1% (n = 95). They had not performed an antenatal consultation in 30.7% of cases (n = 132). Matrons evacuated in 50.2% of cases (n = 216). The transfer diagnosis was hemorrhage in 14.2% of cases. The main intervention performed was cesarean section (92.3% of cases). The evacuation time was greater than one hour in 95.1% (n = 21). The actors for the financing of the fund were the district council, the town halls and the Community Health Associations (ASACO). The mobilization rate of ASACOs was 82%, that of town halls 17%. The circle council did not pay its quota., Conclusion: A better financial involvement of the communities in the management of the evacuation reference system in the health district of Bla is a necessity., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

This study was opened and conducted from colligated patient folders during 5 years (from January 1999 to December 2003). The main objective was the description of epidemiological, diagnostically and prise and prise of charge aspects of microscopy negative pulmonary tuberculosis. Patients were enrolled in this study in accordance to WHO criteria. During these 5 years, pulmonary tuberculosis has constituted 72.2% on all froms of tuberculosis with 20.2% of microscopy negative pulmonary tuberculosis. The BCG vaccine scar has been observed in 50.8% of cases. The IDR was negative in 21.3% of cases; this rate was about 68.1% in HIV positive patients. More than 60% of the patients have more than 3 negative bacilloscopy. The 69.4% of our patients have been hospitalized and 64% have been treated with III category system.

Unlabelled: Orbital pseudo-tumors account for approximately 8% of the orbital tumors. They are scarcely described in children and raise diagnostic dilemas, especially when they present as an isolated extra-ocular muscle swelling called idiopathic orbital myositis (IOM)., Case Reports: A diagnosis of inflammatory orbital pseudotumors (IOPT) was made in three children aged 7, 13 and 14 years from clinical and CT scan and/or MRI findings associated with histological data in two of them. Two of these IOPT presented as IOM. Analysis was made in a effort to eliminate intra-orbital tumors, especially rhabdomyosarcoma., Conclusion: The abrupt onset of the orbital signs, often related in the literature, was not a specific diagnostic criterion regarding to embryonic rhabdomyosarcoma. The inconstant presence of inflammatory signs and the absence of local osseous defect could be more discriminating. Although diagnostic procedure, including histological documentation, was difficult, even dangerous, surgical biopsy should be recommended. Eventually, considering the mandatory multidisciplinary care, steroid therapy response should be evaluated as a diagnostic test.

Three distinct monoclonal gammopathies were identified in the serum of a 79 year-old man. In 1972 he presented with Waldenström's macroglobulinemia IgM Kappa. Twenty years later multiple myeloma was diagnoses. Serum protein electrophoresis performed at this time showed three monoclonal bands. Immunofixation identified these bands as monoclonal IgM kappa, IgG kappa and IgA kappa. Twenty-six cases of triclonal gammopathies were previously reported. Sixteen cases were associated with malignant immuno-proliferative diseases (non-hodgkin lymphoma, Waldenström's macroglobulinemia, multiple myeloma); five cases with non-hematologic diseases; three cases were of undetermined significance. The origin of three distinct monoclonal proteins may derive from three unrelated clones or alternatively from a single clone in which an isotype switch has occurred.

Ambulatory mechanical left ventricular assistance has become a reality but clinical experience of long-term tolerance is limited for setting up a randomised trial comparing this technique with cardiac transplantation. On the other hand, it is justified in proposing this long-term circulatory assistance to a subgroup of patients on the waiting list for transplantation but who have little chance of being transplanted before irreversible multivisceral failure sets in. Some specific contraindications to left ventricular mechanical assistance should be respected. After implantation of a portable system, the possibility of being reinscribed on the waiting list for cardiac transplantation should be envisaged if the patient so wishes.

In order to assess the role of dietary sodium with or without chloride on the development of 2 kidney, 1 clip renovascular hypertension, 49 male Sprague-Dawley rats were fed 3 different diets for 4 weeks after clipping: ad libitum sodium chloride, sodium citrate or sodium-free diet. Sham operated rats were used as control. The final conscious systolic arterial pressure was similar in all hypertensive groups regardless of diet. No change in cardiac index occurred in clipped animals whereas total peripheral resistance raised to a similar extent. In conclusion, sodium restriction did not prevent hypertension. In addition, the anion linked to sodium had no influence on the level of arterial pressure.

Non insulin-dependent diabetes is often associated with obesity and always with some degree of insulin resistance. First choice treatment consists of appropriate and sometimes hypocaloric diet and oral hypoglycemic agents. Using insulin becomes mandatory in patients with associated pathology or at risk of metabolic imbalance. Insulin administration must be discussed in each individual case when it aims at a long-term improvement of blood glucose control, taking into account the lack of consensus on this point and the potential drawbacks of insulin therapy, notably weight increase and risk of hypoglycaemia.

Hypercholesterolemia, quite frequent in industrialized countries is a major risk factor of atherosclerosis, especially in the coronary arteries. Consensus conferences, in the United States as well as Europe, have established a practical approach to this field. The dietetic treatment, from a population standpoint, remains the corner-stone of the treatment of primary dyslipoproteinemias. The quality and quantity of lipids in the food, play a definite role. In order to lower cholesterolemia, the intake of total lipids and cholesterol must be lowered and the consumption of polyunsaturated or mono-unsaturated fatty acids must be increased. The advantage of fish (omega 3 fatty acid), soy-bean and food fibers, are discussed.

The prevention of atherosclerosis implies a better knowledge of dyslipoproteinemias. The metabolic disease must first be defined before considering its treatment and evaluate the atherogenic risk. The clinician must take advantage of two different classifications. The WHO classification (WHO: World Health Organization) permits to consider six phenotypes (I, IIa, IIb, III, IV, V), according to the serum levels of cholesterol and triglycerides. The genetic classification permits to relate one or several genetic anomaly to these phenotypes. The main clinical and biological characteristics of primary dyslipoproteinemias are summarily reported.