Hepatocellular carcinoma(HCC) is ranked as the 5th common type of cancer worldwide and is considered as the 3rd common reason for cancer-related deaths. HCC often occurs on top of a cirrhotic liver. The prognosisis de...Hepatocellular carcinoma(HCC) is ranked as the 5th common type of cancer worldwide and is considered as the 3rd common reason for cancer-related deaths. HCC often occurs on top of a cirrhotic liver. The prognosisis determined by several factors; tumour extension, alpha-fetoprotein(AFP) concentration, histologic subtype of the tumour, degree of liver dysfunction, and the patient's performance status. HCC prognosis is strongly correlated with diagnostic delay. To date, no ideal screening modality has been developed. Analysis of recent studies showed that AFP assessment lacks adequate sensitivity and specificity for effective surveillance and diagnosis. Many tumour markers have been tested in clinical trials without progressing to routine use in clinical practice. Thus, surveillance is still based on ultrasound(US) examination every 6 mo. Imaging studies for diagnosis of HCC can fall into one of two main categories: routine non-invasive studies such as US, computed tomography(CT), and magnetic resonance imaging, and more specialized invasive techniques including CT during hepatic arteriography and CT arterial portography in addition to the conventional hepatic angiography. This article provides an overview and spotlight on the different diagnostic modalities and treatment options of HCC.展开更多
We reviewed organophosphorus pesticide use in Japan between 1982 and 2016 using data from the National Institute of Environmental Studies. Organophosphorus pesticide concentrations in river water throughout Japan were...We reviewed organophosphorus pesticide use in Japan between 1982 and 2016 using data from the National Institute of Environmental Studies. Organophosphorus pesticide concentrations in river water throughout Japan were taken from the literature, and risk assessments were performed for some organophosphorus pesticides based on risk quotients and hazard quotients. Assessments were performed for 20 common pesticides,including insecticides, fungicides, and herbicides. The amounts used decreased in the order: insecticides > herbicides > fungicides. Organophosphorus insecticide and fungicide use have decreased over the last four decades, but organophosphorus herbicide use has increased. During this period, annual organophosphorus pesticide use was the highest for chlorpyrifos(105,263 tons/year) and the lowest for glyphosate-sodium(8 tons/year). The ecotoxicological risk assessment indicated that diazinon and fenitrothion posed strong risks to the Japanese aquatic environment, and chlorpyrifos and malathion have moderate risks. None of the pesticides that were assessed posed significant risks to humans.Continued use of organophosphorus pesticides in Japan may cause strong risks to aquatic environments. These risks should be reassessed periodically.展开更多
AIM:To evaluate effective alternative antibiotics in treatment of cefotaxime-resistant spontaneous bacterial peritonitis.METHODS:One hundred cirrhotic patients with spontaneous bacterial peritonitis [ascitic fluid pol...AIM:To evaluate effective alternative antibiotics in treatment of cefotaxime-resistant spontaneous bacterial peritonitis.METHODS:One hundred cirrhotic patients with spontaneous bacterial peritonitis [ascitic fluid polymorphonuclear cell count(PMNLs) ≥ 250 cells/mm 3 at admission] were empirically treated with cefotaxime sodium 2 g/12 h and volume expansion by intravenous human albumin.All patients were subjected to history taking,complete examination,laboratory tests(including a complete blood cell count,prothrombin time,biochemical tests of liver and kidney function,and fresh urine sediment),chest X-ray,a diagnostic abdominal paracentesis,and the sample subjected to total and differential cell count,chemical examination,aerobic and anaerobic cultures.Patients were divided after 2 d by a second ascitic PMNL count into group Ⅰ;patients sensitive to cefotaxime(n = 81),group Ⅱ(n = 19);cases resistant to cefotaxime(less than 25% decrease in ascitic PMNL count).Patients of group Ⅱ were randomly assigned into meropenem(n = 11) or levofloxacin(n = 8) subgroups.All patients performed an end of treatment ascitic PMNL count.Patients were considered improved when:PMNLs decreased to < 250 cells/mm 3,no growth in previously positive culture cases,and improved clinical manifestations with at least 5 d of antibiotic therapy.RESULTS:Age,sex,and Child classes showed no significant difference between group Ⅰ and group Ⅱ.Fever and abdominal pain were the most frequent manifestations and were reported in 82.7% and 80.2% of patients in group Ⅰ and in 94.7% and 84.2% of patients in group Ⅱ,respectively.Patients in group Ⅱ had a more severe ascitic inflammatory response than group Ⅰ and this was demonstrated by more ascitic lactate dehydrogenase(LDH) [median:540 IU/L(range:150-1200 IU/L) vs median:240 IU/L(range:180-500 IU/L),P = 0.000] and PMNL [median:15 000 cell/mm 3(range:957-23 822 cell/mm 3) vs 3400 cell/mm 3(range:695-26 400 cell/mm 3),P = 0.000] counts.Ascitic fluid culture was positive in 32% of cases.Cefot展开更多
AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft...AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery.The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system.Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious,inflammatory,traumatic,mechanical,toxic or neoplastic causes mimicking idiopathic inflammation.These cases are treated by dacryocystorhinostomy(DCR).METHODS:The present study was conducted to determine the histopathologic,immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8%of the cases showed moderate chronic inflammation with a chronic inflammatory score(CIS)ranging between 4 and 6,whereas 12.12%showed severe inflammatory changes with a CIS of 7.Mild degree of inflammation was seen in6.06%with a CIS of 3.The total prevalence of grampositive,gram-negative,and culture-negative samples were 59.4%,37.5%,and 3%respectively.CONCLUSION:Non-specific chronic inflammation withfibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.展开更多
The food and nutrition situation in Burkina Faso, like most developing countries in sub-Saharan Africa, is marked by growing food vulnerability. The majority of local dishes are being abandoned in favor of a minority ...The food and nutrition situation in Burkina Faso, like most developing countries in sub-Saharan Africa, is marked by growing food vulnerability. The majority of local dishes are being abandoned in favor of a minority of imported cereal dishes and other ultra-processed foods. This minority of cereal foods is blamed for stunted growth in children, while ultra-processed foods are linked to chronic diseases such as hypertension, certain types of diabetes and cancer. Knowledge of the nutritional value of local foods is needed to determine their nutritional quality. The aim of this study was to determine the nutritional values of local dishes based on millet, sorghum and cowpea in the Centre-North region. The methodology consisted of making an inventory of millet-, sorghum- and cowpea-based dishes using focus groups made up of women and men from three age groups comprising young people, adults and the elderly in the communes of Lebda and Boussouma. The dishes were reproduced, and standard biochemical methods were used for nutritional characterization. A total of 34 dishes were inventoried, including 16 millet/sorghum-based dishes, 8 cowpea-based dishes and 10 dishes composed of millet/sorghum and cowpea or leaves. The mean protein, carbohydrate, ash and iron contents per 100 g DM of the three types of dishes were significantly different (p ≤ 0.05), ranging respectively from 13.61 to 22.63 g, 70.76 to 80.88 g, 1.87 to 5.96 g and 7.67 to 12.06 mg. Those for lipid, energy and zinc were not significantly different, ranging from 5.51 to 6.56 g, from 427 to 433 Kcal and from 2.98 to 3.32 mg respectively. Cowpea-based and mixed dishes cover the nutritional requirements for protein, carbohydrates, iron, zinc and energy recommended for children and adults. The consumption of mixed dishes and cowpea-based dishes could be promoted by nutritional policy to reduce stunting and recommended to obese, hypertensive and diabetic people as part of their diet.展开更多
Introduction: Despite current therapeutic advances, heart failure in sub-Saharan Africa remains a common, serious and costly disease, particularly due to rehospitalizations. The objective of this work was to determine...Introduction: Despite current therapeutic advances, heart failure in sub-Saharan Africa remains a common, serious and costly disease, particularly due to rehospitalizations. The objective of this work was to determine the proportion of rehospitalizations for heart failure and to identify etiological factors. Methodology: This was a retrospective descriptive study with a duration of 8 months from April 1 to November 30, 2021. This study included all patients rehospitalized in the department for Heart Failure and who agreed to participate in our study. Results: During the period of our study, 437 patients were hospitalized in the HF department, among which we collected 126 cases of rehospitalization for HF with a frequency of 28.83%. The mean age of our patients was 46.32 ± 18.98 years with the extremes of 15 to 84 years. The most affected age group was between 35 and 44 years old in 24 cases, i.e. a frequency of 19%. We observed a female predominance of 64 cases, i.e. a frequency of 50.8% compared to 62 cases, i.e. a frequency of 49.2% with a sex ratio (M/F) equal to 0.96. 98 cases of our patients, i.e. a frequency of 77.8%, were mutual insurance companies who felt they had the necessary support from those around them. In our sample, the underlying heart disease was mainly represented by valvular heart disease in 59 cases, followed by hypertensive heart disease in 42 cases with the respective frequencies of 46.82% and 33.33%. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. Conclusion: It appears in this study that rehospitalizations for heart f展开更多
The chemical and mineralogical composition of bauxite deposits is a key factor in the profitability of refining processes. The study of bauxites from the Saföfö site has assessed variations in chemical and m...The chemical and mineralogical composition of bauxite deposits is a key factor in the profitability of refining processes. The study of bauxites from the Saföfö site has assessed variations in chemical and mineralogical composition under various conditions, as well as the optimum conditions for their exploitation. The methodologies used in this study include experimental methods for determining moisture content, chemical composition, mineralogical composition, and specific density of bauxite. The results show significant variation in moisture content among the bauxite samples, with values ranging from 2.90% to 17.80%. The silica percentages in the samples range from 1.69% to 8.14%, while alumina percentages vary from 36.81% to 54.03%. After calcination, alumina oxide percentages range from 40% to 75%. After chemical activation, alumina oxides Al2O3 range from 40% to over 50%. Gibbsite is the most abundant mineral, accounting for about 60% - 70% of the total composition of the bauxite samples. Samples A to F have bulk densities varying between approximately 3.6 and 3.9. Sample B has the highest density, around 3.9, while sample C has the lowest, at around 3.5. Bauxite mining at the Saföfö site offers significant potential for the alumina industry, provided appropriate processing methods are selected to maximize quality and profitability while minimizing environmental impact.展开更多
Introduction: exotropia is a deviation outside the visual axes. In children, an association with ametropia is often observed, however, that with hyperopia is rare. The objective of this study was to highlight the part...Introduction: exotropia is a deviation outside the visual axes. In children, an association with ametropia is often observed, however, that with hyperopia is rare. The objective of this study was to highlight the particularities of the management of exotropia associated with hyperopia in children. Subjects and Methods: this was a retrospective study over 78 months including all children aged 0 to 15 years, treated for exotropia associated with hyperopia. Results: we found 20 cases of exotropia with hyperopia, or 57.15% of exotropia. The mean age was 4.3 years and the sex ratio was 0.82. Hyperopia was mild in 30 eyes (75%), moderate in 9 eyes (22.5%) and high in 2.5% of eyes. Over a one-year follow-up, 10 children (50%) had regular follow-up, including 6 with full hyperopic correction and 4 with partial hyperopic correction. After full hyperopic correction, one child had a resolution of his exotropia;2 had a decrease in the angle of deviation and 3 had no improvement of their exotropia. Among the 4 with partial hyperopic correction children, 2 had a resolution of their exotropia. Strabismus surgery was planned in 3 children after iso-acuity. Conclusion: the association of exotropia and hyperopia poses a management problem. The total correction or not of hyperopia is discussed according to several authors.展开更多
Introduction: Intestinal resection is the disconnection or removal of part of the intestine with its meso. The aim was to describe the indications and prognostic factors for intestinal resections at the surgical depar...Introduction: Intestinal resection is the disconnection or removal of part of the intestine with its meso. The aim was to describe the indications and prognostic factors for intestinal resections at the surgical department of Kankan Regional Hospital. Patients and Methods: This was a retrospective descriptive study covering the files of patients who had undergone intestinal resections in the surgery department of the Kankan regional hospital over a period of 4 years from 1st January 2019 to December 31, 2022. Results: We collected 164 cases of intestinal resection representing 4.19% of all surgical procedures. (N = 3909). The average age of our patients was 37.78 years with extremes of 1 and 90 years. The male gender was predominant (64.6%) and the sex ratio was 1.8. The majority of patients consulted after 72 hours. Acute intestinal obstruction was the pathology motivating the most intestinal resection 42.90% followed by acute peritonitis 33%, digestive fistula 4.3%, tumors 3.6% and wounds 2.4%. Intestinal necrosis with 91 cases (56.5%) constituted the first indication for resection in our study followed by intestinal perforations 41 cases (24.9%). We performed an anastomotic resection of the small intestine in 70 cases (42.9%), an ileostomy in 4 cases (2.4%), a right hemi colectomy in 26 cases (15.9%), a left hemi colectomy in 2 cases (1.2%), segmental colectomy plus immediate anastomosis in 57 cases (34.2%) and 5 cases of colostomy. We recorded 48 deaths (29.3%). Conclusion: Intestinal resection is a common procedure in our context. These indications are multiple. An improvement in the prognosis should be achieved by reducing the diagnostic and treatment time associated with the training of surgical staff.展开更多
One of the most basic and difficult areas of computer vision and image understanding applications is still object detection. Deep neural network models and enhanced object representation have led to significant progre...One of the most basic and difficult areas of computer vision and image understanding applications is still object detection. Deep neural network models and enhanced object representation have led to significant progress in object detection. This research investigates in greater detail how object detection has changed in the recent years in the deep learning age. We provide an overview of the literature on a range of cutting-edge object identification algorithms and the theoretical underpinnings of these techniques. Deep learning technologies are contributing to substantial innovations in the field of object detection. While Convolutional Neural Networks (CNN) have laid a solid foundation, new models such as You Only Look Once (YOLO) and Vision Transformers (ViTs) have expanded the possibilities even further by providing high accuracy and fast detection in a variety of settings. Even with these developments, integrating CNN, YOLO and ViTs, into a coherent framework still poses challenges with juggling computing demand, speed, and accuracy especially in dynamic contexts. Real-time processing in applications like surveillance and autonomous driving necessitates improvements that take use of each model type’s advantages. The goal of this work is to provide an object detection system that maximizes detection speed and accuracy while decreasing processing requirements by integrating YOLO, CNN, and ViTs. Improving real-time detection performance in changing weather and light exposure circumstances, as well as detecting small or partially obscured objects in crowded cities, are among the goals. We provide a hybrid architecture which leverages CNN for robust feature extraction, YOLO for rapid detection, and ViTs for remarkable global context capture via self-attention techniques. Using an innovative training regimen that prioritizes flexible learning rates and data augmentation procedures, the model is trained on an extensive dataset of urban settings. Compared to solo YOLO, CNN, or ViTs models, the suggested model exhi展开更多
Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school ch...Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school children aged 5 to 15 at CHU-IOTA. Patients and Method: This is a prospective, descriptive cross-sectional study carried out in the ophthalmic-pediatrics department of CHU-IOTA, from October to November 2023. Results: We received 340 school children aged 5 to 15, among whom 111 presented ametropia, i.e. a prevalence of 32.65%. The average age was 11.42 ± 2.75 years and a sex ratio of 0.59. The average visual acuity was 4/10 (range 1/10 and 10/10). We found refractive defects: astigmatism 73.87%, hyperopia 23.87% of cases and myopia 2.25%. The decline in distance visual acuity was the most common functional sign. Ocular abnormalities associated with ametropia were dominated by allergic conjunctivitis (26.13%) and papillary excavation (6.31%) in astigmatics;allergic conjunctivitis (9.01%) and papillary excavation (7.20%) in hyperopic patients;turbid vitreous (0.90%), myopic choroidosis (0.45%) and allergic conjunctivitis (0.45%) in myopes. Conclusion: Refractive errors constitute a reality and a major public health problem among school children.展开更多
Thoraco-brachial outlet syndrome (TDSD) or cervical rib brings together all the clinical symptoms (arterial, neurological and/or venous) due to extrinsic, intermittent or permanent compression of the vascular-nervous ...Thoraco-brachial outlet syndrome (TDSD) or cervical rib brings together all the clinical symptoms (arterial, neurological and/or venous) due to extrinsic, intermittent or permanent compression of the vascular-nervous elements of the root of the upper limb during cervico-thoraco-brachial crossing syndrome. This pathology is relatively common but often overlooked;it affects women more often (between 4/1 and 2/1) and is rare in children. We report the case of a 59-year-old female patient seen in the department for paresthesia and muscular weakness of the upper limbs rated 3/5 on the right and 4/5 on the left progressively evolving over 39 years, electromyography (EMG) showed indicated compression of the brachial plexus and the CT scan confirmed the presence of bilateral cervical ribs fused with the first on the left. She benefited from physiotherapy while awaiting her surgery, and unfortunately, she died of a stroke in the traumatology department. This pathology is the first in our department to be supported by a review of the literature.展开更多
Introduction: Antibiotics are medications that have the property of destroying bacteria or preventing their proliferation. The aim of this study is to evaluate antibiotic prescriptions in oral practice: case of the de...Introduction: Antibiotics are medications that have the property of destroying bacteria or preventing their proliferation. The aim of this study is to evaluate antibiotic prescriptions in oral practice: case of the dental office of the Coyah prefectural hospital. Methods: This is a descriptive cross-sectional study which took place from August 2019 to January 2020 inclusive, i.e. a duration of six (6) months, during which 400 patients were identified. Results: Our results revealed a frequency of 70% of antibiotic prescriptions. The 16 - 25-year-old age group was the most dismayed, at 47.25% and with an average age of 27.78 years. Men represent 55% compared to 45% of women, i.e. sex ratio of 1.22. Pulp gangrene was the most common pathology in 55% of cases. The most prescribed family was Betalactamine or 61.71% and the most represented molecules were Amoxicillin with 56.10% followed by Metronidazole or 34.16%. And the favorable prognosis was observed in 99% of cases. Conclusion: Prescription should always be based on the benefit-risk ratio. This prescription by practitioners aims to prevent or eradicate infections and pain in order to obtain a good therapeutic result.展开更多
The antiretroviral treatment (ART) has significantly reduced the number of new HIV/AIDS infections and related deaths. However, cases of immunovirological discordance (IVD) are found in various locations. The objectiv...The antiretroviral treatment (ART) has significantly reduced the number of new HIV/AIDS infections and related deaths. However, cases of immunovirological discordance (IVD) are found in various locations. The objective of this study was to determine the profile of People living with HIV (PLHIV) with IVD and to identify associated factors. We conducted a cross-sectional study based on the records of PLHIV under ART for at least 6 months, followed at Hpital de Jour Donka from 2015 to 2017, and having both viral load (CV) and CD4 T-cell count. Prevalence of IVD was 34.57%, with 23.87% for immunological discordance (ID) and 10.7% for virological discordance (VD). Females were predominant (66.26%), and male gender influenced IVD with a statistically significant difference (p = 0.006) and was associated with VD (p = 0.007). The average age was 38.77 11.30 years. PLHIV were classified at WHO stages 3 and 4 (86.01%). The median initial haemoglobin level was 11.5 g/L [3.2 - 12]. The mean initial CD4 T-cell count was 272.84 cells/mm3 201.6. The median initial viral load (VL) was 147,337 copies/mL [1092 - 31,675,000]. The initial CD4 T-cell count 3 was associated with IVD with a statistically significant difference (p = 0.0009) and correlated with ID (p = 0.000). Prurigo was associated with IVD with a statistically significant difference (p = 0.003). Cerebral toxoplasmosis was not associated with IVD but was associated with ID (p = 0.04). This study allowed us to describe the profile of PLHIV with IVD. The main associated factors were male gender, initial CD4 T-cell count 3, toxoplasmosis, prurigo, and herpes zoster.展开更多
Introduction: A dental abscess is a collection of pus located in the tissues surrounding the tooth roots. The aim of this work is to describe the epidemiological, clinical and therapeutic aspects of dental abscess in ...Introduction: A dental abscess is a collection of pus located in the tissues surrounding the tooth roots. The aim of this work is to describe the epidemiological, clinical and therapeutic aspects of dental abscess in order to contribute to the management of patients suffering from this pathology at the dental office of the Siguiri Prefectural Hospital. Methods: This was a retrospective descriptive study lasting 2 months carried out on the registers of patients received between October 2017 and October 2020 at the dental office of the Siguiri prefectural hospital. Results: 4690 patient files were identified during the study, of which 546 met our selection criteria, i.e. a frequency of 11.64%. During our study, we found 51.83% female compared to 48.17% male, i.e. a sex ratio of 1.07. 54.21% of our patients resided in rural communes compared to 45.76% for the urban commune. The age group most affected was that of 16 - 25 years old or 33.69%. Swelling, pain and functional discomfort were the reasons for consultation in all patients followed by other associated reasons in 41.21%. The premolar-molar group was the most represented, i.e. 86.70%. 80.04% of our patients presented an acute abscess compared to 19.96% of chronic cases. Antibiotic, analgesic, and mouthwash were prescribed in all patients during the study followed by 96.37% of cases prescription of steroidal anti-inflammatory drugs. 93.04% of causal teeth were extracted followed by 6.78% of cases of conservative treatment in our study. In our study, 80.95% of our patients had a good post-therapeutic outcome. Conclusion: This study highlights the need for prevention and early management of dental abscesses.展开更多
文摘Hepatocellular carcinoma(HCC) is ranked as the 5th common type of cancer worldwide and is considered as the 3rd common reason for cancer-related deaths. HCC often occurs on top of a cirrhotic liver. The prognosisis determined by several factors; tumour extension, alpha-fetoprotein(AFP) concentration, histologic subtype of the tumour, degree of liver dysfunction, and the patient's performance status. HCC prognosis is strongly correlated with diagnostic delay. To date, no ideal screening modality has been developed. Analysis of recent studies showed that AFP assessment lacks adequate sensitivity and specificity for effective surveillance and diagnosis. Many tumour markers have been tested in clinical trials without progressing to routine use in clinical practice. Thus, surveillance is still based on ultrasound(US) examination every 6 mo. Imaging studies for diagnosis of HCC can fall into one of two main categories: routine non-invasive studies such as US, computed tomography(CT), and magnetic resonance imaging, and more specialized invasive techniques including CT during hepatic arteriography and CT arterial portography in addition to the conventional hepatic angiography. This article provides an overview and spotlight on the different diagnostic modalities and treatment options of HCC.
基金The Japan Society for the Promotion of Science(JSPS)supported by JSPS KAKENHI grant number16KT0149,Japan
文摘We reviewed organophosphorus pesticide use in Japan between 1982 and 2016 using data from the National Institute of Environmental Studies. Organophosphorus pesticide concentrations in river water throughout Japan were taken from the literature, and risk assessments were performed for some organophosphorus pesticides based on risk quotients and hazard quotients. Assessments were performed for 20 common pesticides,including insecticides, fungicides, and herbicides. The amounts used decreased in the order: insecticides > herbicides > fungicides. Organophosphorus insecticide and fungicide use have decreased over the last four decades, but organophosphorus herbicide use has increased. During this period, annual organophosphorus pesticide use was the highest for chlorpyrifos(105,263 tons/year) and the lowest for glyphosate-sodium(8 tons/year). The ecotoxicological risk assessment indicated that diazinon and fenitrothion posed strong risks to the Japanese aquatic environment, and chlorpyrifos and malathion have moderate risks. None of the pesticides that were assessed posed significant risks to humans.Continued use of organophosphorus pesticides in Japan may cause strong risks to aquatic environments. These risks should be reassessed periodically.
文摘AIM:To evaluate effective alternative antibiotics in treatment of cefotaxime-resistant spontaneous bacterial peritonitis.METHODS:One hundred cirrhotic patients with spontaneous bacterial peritonitis [ascitic fluid polymorphonuclear cell count(PMNLs) ≥ 250 cells/mm 3 at admission] were empirically treated with cefotaxime sodium 2 g/12 h and volume expansion by intravenous human albumin.All patients were subjected to history taking,complete examination,laboratory tests(including a complete blood cell count,prothrombin time,biochemical tests of liver and kidney function,and fresh urine sediment),chest X-ray,a diagnostic abdominal paracentesis,and the sample subjected to total and differential cell count,chemical examination,aerobic and anaerobic cultures.Patients were divided after 2 d by a second ascitic PMNL count into group Ⅰ;patients sensitive to cefotaxime(n = 81),group Ⅱ(n = 19);cases resistant to cefotaxime(less than 25% decrease in ascitic PMNL count).Patients of group Ⅱ were randomly assigned into meropenem(n = 11) or levofloxacin(n = 8) subgroups.All patients performed an end of treatment ascitic PMNL count.Patients were considered improved when:PMNLs decreased to < 250 cells/mm 3,no growth in previously positive culture cases,and improved clinical manifestations with at least 5 d of antibiotic therapy.RESULTS:Age,sex,and Child classes showed no significant difference between group Ⅰ and group Ⅱ.Fever and abdominal pain were the most frequent manifestations and were reported in 82.7% and 80.2% of patients in group Ⅰ and in 94.7% and 84.2% of patients in group Ⅱ,respectively.Patients in group Ⅱ had a more severe ascitic inflammatory response than group Ⅰ and this was demonstrated by more ascitic lactate dehydrogenase(LDH) [median:540 IU/L(range:150-1200 IU/L) vs median:240 IU/L(range:180-500 IU/L),P = 0.000] and PMNL [median:15 000 cell/mm 3(range:957-23 822 cell/mm 3) vs 3400 cell/mm 3(range:695-26 400 cell/mm 3),P = 0.000] counts.Ascitic fluid culture was positive in 32% of cases.Cefot
文摘AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery.The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system.Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious,inflammatory,traumatic,mechanical,toxic or neoplastic causes mimicking idiopathic inflammation.These cases are treated by dacryocystorhinostomy(DCR).METHODS:The present study was conducted to determine the histopathologic,immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8%of the cases showed moderate chronic inflammation with a chronic inflammatory score(CIS)ranging between 4 and 6,whereas 12.12%showed severe inflammatory changes with a CIS of 7.Mild degree of inflammation was seen in6.06%with a CIS of 3.The total prevalence of grampositive,gram-negative,and culture-negative samples were 59.4%,37.5%,and 3%respectively.CONCLUSION:Non-specific chronic inflammation withfibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.
文摘The food and nutrition situation in Burkina Faso, like most developing countries in sub-Saharan Africa, is marked by growing food vulnerability. The majority of local dishes are being abandoned in favor of a minority of imported cereal dishes and other ultra-processed foods. This minority of cereal foods is blamed for stunted growth in children, while ultra-processed foods are linked to chronic diseases such as hypertension, certain types of diabetes and cancer. Knowledge of the nutritional value of local foods is needed to determine their nutritional quality. The aim of this study was to determine the nutritional values of local dishes based on millet, sorghum and cowpea in the Centre-North region. The methodology consisted of making an inventory of millet-, sorghum- and cowpea-based dishes using focus groups made up of women and men from three age groups comprising young people, adults and the elderly in the communes of Lebda and Boussouma. The dishes were reproduced, and standard biochemical methods were used for nutritional characterization. A total of 34 dishes were inventoried, including 16 millet/sorghum-based dishes, 8 cowpea-based dishes and 10 dishes composed of millet/sorghum and cowpea or leaves. The mean protein, carbohydrate, ash and iron contents per 100 g DM of the three types of dishes were significantly different (p ≤ 0.05), ranging respectively from 13.61 to 22.63 g, 70.76 to 80.88 g, 1.87 to 5.96 g and 7.67 to 12.06 mg. Those for lipid, energy and zinc were not significantly different, ranging from 5.51 to 6.56 g, from 427 to 433 Kcal and from 2.98 to 3.32 mg respectively. Cowpea-based and mixed dishes cover the nutritional requirements for protein, carbohydrates, iron, zinc and energy recommended for children and adults. The consumption of mixed dishes and cowpea-based dishes could be promoted by nutritional policy to reduce stunting and recommended to obese, hypertensive and diabetic people as part of their diet.
文摘Introduction: Despite current therapeutic advances, heart failure in sub-Saharan Africa remains a common, serious and costly disease, particularly due to rehospitalizations. The objective of this work was to determine the proportion of rehospitalizations for heart failure and to identify etiological factors. Methodology: This was a retrospective descriptive study with a duration of 8 months from April 1 to November 30, 2021. This study included all patients rehospitalized in the department for Heart Failure and who agreed to participate in our study. Results: During the period of our study, 437 patients were hospitalized in the HF department, among which we collected 126 cases of rehospitalization for HF with a frequency of 28.83%. The mean age of our patients was 46.32 ± 18.98 years with the extremes of 15 to 84 years. The most affected age group was between 35 and 44 years old in 24 cases, i.e. a frequency of 19%. We observed a female predominance of 64 cases, i.e. a frequency of 50.8% compared to 62 cases, i.e. a frequency of 49.2% with a sex ratio (M/F) equal to 0.96. 98 cases of our patients, i.e. a frequency of 77.8%, were mutual insurance companies who felt they had the necessary support from those around them. In our sample, the underlying heart disease was mainly represented by valvular heart disease in 59 cases, followed by hypertensive heart disease in 42 cases with the respective frequencies of 46.82% and 33.33%. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. The majority of our patients were rehospitalized (1 - 3) times after a first episode of HF flare-up in 117 cases or 92.9%. Irregularity at control and therapeutic break were the most common decompensation factors with frequencies of 75.8% and 74.2% respectively. Conclusion: It appears in this study that rehospitalizations for heart f
文摘The chemical and mineralogical composition of bauxite deposits is a key factor in the profitability of refining processes. The study of bauxites from the Saföfö site has assessed variations in chemical and mineralogical composition under various conditions, as well as the optimum conditions for their exploitation. The methodologies used in this study include experimental methods for determining moisture content, chemical composition, mineralogical composition, and specific density of bauxite. The results show significant variation in moisture content among the bauxite samples, with values ranging from 2.90% to 17.80%. The silica percentages in the samples range from 1.69% to 8.14%, while alumina percentages vary from 36.81% to 54.03%. After calcination, alumina oxide percentages range from 40% to 75%. After chemical activation, alumina oxides Al2O3 range from 40% to over 50%. Gibbsite is the most abundant mineral, accounting for about 60% - 70% of the total composition of the bauxite samples. Samples A to F have bulk densities varying between approximately 3.6 and 3.9. Sample B has the highest density, around 3.9, while sample C has the lowest, at around 3.5. Bauxite mining at the Saföfö site offers significant potential for the alumina industry, provided appropriate processing methods are selected to maximize quality and profitability while minimizing environmental impact.
文摘Introduction: exotropia is a deviation outside the visual axes. In children, an association with ametropia is often observed, however, that with hyperopia is rare. The objective of this study was to highlight the particularities of the management of exotropia associated with hyperopia in children. Subjects and Methods: this was a retrospective study over 78 months including all children aged 0 to 15 years, treated for exotropia associated with hyperopia. Results: we found 20 cases of exotropia with hyperopia, or 57.15% of exotropia. The mean age was 4.3 years and the sex ratio was 0.82. Hyperopia was mild in 30 eyes (75%), moderate in 9 eyes (22.5%) and high in 2.5% of eyes. Over a one-year follow-up, 10 children (50%) had regular follow-up, including 6 with full hyperopic correction and 4 with partial hyperopic correction. After full hyperopic correction, one child had a resolution of his exotropia;2 had a decrease in the angle of deviation and 3 had no improvement of their exotropia. Among the 4 with partial hyperopic correction children, 2 had a resolution of their exotropia. Strabismus surgery was planned in 3 children after iso-acuity. Conclusion: the association of exotropia and hyperopia poses a management problem. The total correction or not of hyperopia is discussed according to several authors.
文摘Introduction: Intestinal resection is the disconnection or removal of part of the intestine with its meso. The aim was to describe the indications and prognostic factors for intestinal resections at the surgical department of Kankan Regional Hospital. Patients and Methods: This was a retrospective descriptive study covering the files of patients who had undergone intestinal resections in the surgery department of the Kankan regional hospital over a period of 4 years from 1st January 2019 to December 31, 2022. Results: We collected 164 cases of intestinal resection representing 4.19% of all surgical procedures. (N = 3909). The average age of our patients was 37.78 years with extremes of 1 and 90 years. The male gender was predominant (64.6%) and the sex ratio was 1.8. The majority of patients consulted after 72 hours. Acute intestinal obstruction was the pathology motivating the most intestinal resection 42.90% followed by acute peritonitis 33%, digestive fistula 4.3%, tumors 3.6% and wounds 2.4%. Intestinal necrosis with 91 cases (56.5%) constituted the first indication for resection in our study followed by intestinal perforations 41 cases (24.9%). We performed an anastomotic resection of the small intestine in 70 cases (42.9%), an ileostomy in 4 cases (2.4%), a right hemi colectomy in 26 cases (15.9%), a left hemi colectomy in 2 cases (1.2%), segmental colectomy plus immediate anastomosis in 57 cases (34.2%) and 5 cases of colostomy. We recorded 48 deaths (29.3%). Conclusion: Intestinal resection is a common procedure in our context. These indications are multiple. An improvement in the prognosis should be achieved by reducing the diagnostic and treatment time associated with the training of surgical staff.
文摘One of the most basic and difficult areas of computer vision and image understanding applications is still object detection. Deep neural network models and enhanced object representation have led to significant progress in object detection. This research investigates in greater detail how object detection has changed in the recent years in the deep learning age. We provide an overview of the literature on a range of cutting-edge object identification algorithms and the theoretical underpinnings of these techniques. Deep learning technologies are contributing to substantial innovations in the field of object detection. While Convolutional Neural Networks (CNN) have laid a solid foundation, new models such as You Only Look Once (YOLO) and Vision Transformers (ViTs) have expanded the possibilities even further by providing high accuracy and fast detection in a variety of settings. Even with these developments, integrating CNN, YOLO and ViTs, into a coherent framework still poses challenges with juggling computing demand, speed, and accuracy especially in dynamic contexts. Real-time processing in applications like surveillance and autonomous driving necessitates improvements that take use of each model type’s advantages. The goal of this work is to provide an object detection system that maximizes detection speed and accuracy while decreasing processing requirements by integrating YOLO, CNN, and ViTs. Improving real-time detection performance in changing weather and light exposure circumstances, as well as detecting small or partially obscured objects in crowded cities, are among the goals. We provide a hybrid architecture which leverages CNN for robust feature extraction, YOLO for rapid detection, and ViTs for remarkable global context capture via self-attention techniques. Using an innovative training regimen that prioritizes flexible learning rates and data augmentation procedures, the model is trained on an extensive dataset of urban settings. Compared to solo YOLO, CNN, or ViTs models, the suggested model exhi
文摘Introduction: Undetected refractive errors constitute a health problem among school children who cannot take advantage of educational opportunities. The authors studied the prevalence of refractive errors in school children aged 5 to 15 at CHU-IOTA. Patients and Method: This is a prospective, descriptive cross-sectional study carried out in the ophthalmic-pediatrics department of CHU-IOTA, from October to November 2023. Results: We received 340 school children aged 5 to 15, among whom 111 presented ametropia, i.e. a prevalence of 32.65%. The average age was 11.42 ± 2.75 years and a sex ratio of 0.59. The average visual acuity was 4/10 (range 1/10 and 10/10). We found refractive defects: astigmatism 73.87%, hyperopia 23.87% of cases and myopia 2.25%. The decline in distance visual acuity was the most common functional sign. Ocular abnormalities associated with ametropia were dominated by allergic conjunctivitis (26.13%) and papillary excavation (6.31%) in astigmatics;allergic conjunctivitis (9.01%) and papillary excavation (7.20%) in hyperopic patients;turbid vitreous (0.90%), myopic choroidosis (0.45%) and allergic conjunctivitis (0.45%) in myopes. Conclusion: Refractive errors constitute a reality and a major public health problem among school children.
文摘Thoraco-brachial outlet syndrome (TDSD) or cervical rib brings together all the clinical symptoms (arterial, neurological and/or venous) due to extrinsic, intermittent or permanent compression of the vascular-nervous elements of the root of the upper limb during cervico-thoraco-brachial crossing syndrome. This pathology is relatively common but often overlooked;it affects women more often (between 4/1 and 2/1) and is rare in children. We report the case of a 59-year-old female patient seen in the department for paresthesia and muscular weakness of the upper limbs rated 3/5 on the right and 4/5 on the left progressively evolving over 39 years, electromyography (EMG) showed indicated compression of the brachial plexus and the CT scan confirmed the presence of bilateral cervical ribs fused with the first on the left. She benefited from physiotherapy while awaiting her surgery, and unfortunately, she died of a stroke in the traumatology department. This pathology is the first in our department to be supported by a review of the literature.
文摘Introduction: Antibiotics are medications that have the property of destroying bacteria or preventing their proliferation. The aim of this study is to evaluate antibiotic prescriptions in oral practice: case of the dental office of the Coyah prefectural hospital. Methods: This is a descriptive cross-sectional study which took place from August 2019 to January 2020 inclusive, i.e. a duration of six (6) months, during which 400 patients were identified. Results: Our results revealed a frequency of 70% of antibiotic prescriptions. The 16 - 25-year-old age group was the most dismayed, at 47.25% and with an average age of 27.78 years. Men represent 55% compared to 45% of women, i.e. sex ratio of 1.22. Pulp gangrene was the most common pathology in 55% of cases. The most prescribed family was Betalactamine or 61.71% and the most represented molecules were Amoxicillin with 56.10% followed by Metronidazole or 34.16%. And the favorable prognosis was observed in 99% of cases. Conclusion: Prescription should always be based on the benefit-risk ratio. This prescription by practitioners aims to prevent or eradicate infections and pain in order to obtain a good therapeutic result.
文摘The antiretroviral treatment (ART) has significantly reduced the number of new HIV/AIDS infections and related deaths. However, cases of immunovirological discordance (IVD) are found in various locations. The objective of this study was to determine the profile of People living with HIV (PLHIV) with IVD and to identify associated factors. We conducted a cross-sectional study based on the records of PLHIV under ART for at least 6 months, followed at Hpital de Jour Donka from 2015 to 2017, and having both viral load (CV) and CD4 T-cell count. Prevalence of IVD was 34.57%, with 23.87% for immunological discordance (ID) and 10.7% for virological discordance (VD). Females were predominant (66.26%), and male gender influenced IVD with a statistically significant difference (p = 0.006) and was associated with VD (p = 0.007). The average age was 38.77 11.30 years. PLHIV were classified at WHO stages 3 and 4 (86.01%). The median initial haemoglobin level was 11.5 g/L [3.2 - 12]. The mean initial CD4 T-cell count was 272.84 cells/mm3 201.6. The median initial viral load (VL) was 147,337 copies/mL [1092 - 31,675,000]. The initial CD4 T-cell count 3 was associated with IVD with a statistically significant difference (p = 0.0009) and correlated with ID (p = 0.000). Prurigo was associated with IVD with a statistically significant difference (p = 0.003). Cerebral toxoplasmosis was not associated with IVD but was associated with ID (p = 0.04). This study allowed us to describe the profile of PLHIV with IVD. The main associated factors were male gender, initial CD4 T-cell count 3, toxoplasmosis, prurigo, and herpes zoster.
文摘Introduction: A dental abscess is a collection of pus located in the tissues surrounding the tooth roots. The aim of this work is to describe the epidemiological, clinical and therapeutic aspects of dental abscess in order to contribute to the management of patients suffering from this pathology at the dental office of the Siguiri Prefectural Hospital. Methods: This was a retrospective descriptive study lasting 2 months carried out on the registers of patients received between October 2017 and October 2020 at the dental office of the Siguiri prefectural hospital. Results: 4690 patient files were identified during the study, of which 546 met our selection criteria, i.e. a frequency of 11.64%. During our study, we found 51.83% female compared to 48.17% male, i.e. a sex ratio of 1.07. 54.21% of our patients resided in rural communes compared to 45.76% for the urban commune. The age group most affected was that of 16 - 25 years old or 33.69%. Swelling, pain and functional discomfort were the reasons for consultation in all patients followed by other associated reasons in 41.21%. The premolar-molar group was the most represented, i.e. 86.70%. 80.04% of our patients presented an acute abscess compared to 19.96% of chronic cases. Antibiotic, analgesic, and mouthwash were prescribed in all patients during the study followed by 96.37% of cases prescription of steroidal anti-inflammatory drugs. 93.04% of causal teeth were extracted followed by 6.78% of cases of conservative treatment in our study. In our study, 80.95% of our patients had a good post-therapeutic outcome. Conclusion: This study highlights the need for prevention and early management of dental abscesses.
