A multi-faceted Case Area Targeted Intervention (CATI) approach emphasizing the integration of Water, Sanitation and Hygiene (WASH) interventions and Oral Cholera Vaccine (OCV) campaign was employed to respond to the ...A multi-faceted Case Area Targeted Intervention (CATI) approach emphasizing the integration of Water, Sanitation and Hygiene (WASH) interventions and Oral Cholera Vaccine (OCV) campaign was employed to respond to the outbreak of cholera in Garissa County. Drinking water sources in areas heavily impacted by cholera were systematically mapped and tested for microbiological quality. The quality assessment was carried out in April 2023 during an ongoing cholera outbreak in the county. A total of 109 samples were collected and tested for thermotolerant coliforms and other in situ parameters. The finding revealed that more than 87% of the samples did not meet the World Health Organization (WHO) standard for thermotolerant coliforms;and 30% had turbidity values above the recommended threshold values. None of the 109 samples had any traceable residual chlorine. Following these findings, the county government implemented the targeted interventions which resulted in a positive impact in the fight against cholera. The WHO supported key interventions which included capacity building in water quality monitoring and prepositioning of critical WASH commodities to the cholera affected areas.展开更多
Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by ot...Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ED. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ED) seen at the University Hospital of Abeche. Erectile function was assessed using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed to take part in the study. Only 40 patients correctly completed the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented 74%. Diabetes was poorly controlled in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.展开更多
Introduction: Prevention of obstetric fistula (OF) remains a challenge in Chad where its incidence is 464 cases/year. The present study aims to determine the knowledge and attitudes of nursing staff towards obstetric ...Introduction: Prevention of obstetric fistula (OF) remains a challenge in Chad where its incidence is 464 cases/year. The present study aims to determine the knowledge and attitudes of nursing staff towards obstetric fistula. Patients and Method: This was a cross-sectional, descriptive and analytical study including nursing staff at the Abéché University Hospital. The survey took place from March to May 2023 and the sampling was exhaustive. Data collection was done using a form including a questionnaire on sociodemographic parameters, knowledge and attitudes. Participation in the study was voluntary and individual. Results: Participation in the study was 76.11%. Emergency department staff were the most represented, followed by gynecology-obstetrics staff with 34.4% and 20.91% of cases respectively. Nurses represented 53.17% of participants followed by doctors (23.52%). An exact definition of obstetric fistula was reported by 7.84% of participants and it was partial in 80.39%. The level of knowledge of risk factors was considered good in 12.41%. Exact knowledge of clinical signs was reported by 74.5% of cases. Among the participants, 1.96% reported that the treatment of obstetric fistula is traditional. Knowledge about means of prevention was considered good by 13.72% (n = 21), and attitudes by 26.79%? Obstetric fistula knowledge was influenced by profession (doctor, p = 0.011) and attitudes by service (p = 0.004) and profession (doctor, p = 0.001). Conclusion: Obstetric fistula is a curable disease whose prevention remains possible and requires good knowledge of the disease and the promotion of safe motherhood. This study should serve as a basis for the establishment of the obstetric fistula module in the curriculum of healthcare personnel and the promotion of continuing training for its eradication.展开更多
Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hosp...Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena Mother and Child University Hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.展开更多
Introduction: Acute large bursae (ALB) are a frequent reason for emergency consultations. The aim of this study was to investigate the prevalence, clinical course, treatment and evolution of ALB at Abeche University H...Introduction: Acute large bursae (ALB) are a frequent reason for emergency consultations. The aim of this study was to investigate the prevalence, clinical course, treatment and evolution of ALB at Abeche University Hospital. Patients and Method: This was a 45-month cross-sectional study from January 2020 to September 2023. Male patients of any age who had been admitted to and treated for acute large bursae at the Abeche University Hospital were included. Sociodemographic, clinical and therapeutic variables were studied. Results: Acute large bursae accounted for 7.92% of emergency admissions. The average age was 39.40 years. 60.27% of patients came from rural areas. The average consultation time was 4 days, ranging from a few hours to 18 days. The main reason for consultation was pain. Strangulated inguino-scrotal hernia was the most common, followed by acute orchi-epididymitis, accounting for 41.8% and 26% of cases respectively. Traditional treatment prior to consultation was attempted in 13.7% of cases. All patients were treated as emergencies, 41 of whom had received medical treatment. Of the patients treated surgically, orchidopexy was performed in all. Parietal suppuration and anaemia occurred in 6.2% and 4.8% of cases respectively. Conclusion: A accounts for a significant proportion of our emergency care activity. However, patients are seen with a delay, which jeopardises the functional prognosis of the testicle and intestine.展开更多
We conducted a randomized,open-label,parallel-controlled,multicenter trial on the use of Shuanghuanglian(SHL),a traditional Chinese patent medicine,in treating cases of COVID-19.A total of 176 patients received SHL by...We conducted a randomized,open-label,parallel-controlled,multicenter trial on the use of Shuanghuanglian(SHL),a traditional Chinese patent medicine,in treating cases of COVID-19.A total of 176 patients received SHL by three doses(56 in low dose,61 in middle dose,and 59 in high dose)in addition to standard care.The control group was composed of 59 patients who received standard therapy alone.Treatment with SHL was not associated with a difference from standard care in the time to disease recovery.Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group(93.4%vs.73.9%,P=0.006).Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia,which was evaluated by density reduction of inflammatory focus from baseline,at day 7(mean difference(95%CI),−46.39(−86.83 to−5.94)HU;P=0.025)and day 14(mean difference(95%CI),−74.21(−133.35 to−15.08)HU;P=0.014).No serious adverse events occurred in the SHL groups.This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.展开更多
Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mo...Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mortality remains very high despite therapeutic advances. Our aim was to report on the epidemiological, diagnostic and therapeutic aspects of gangrene of the external genitalia, and to identify prognostic factors. Patients and Method: This was a 5-year retrospective descriptive study, from February 2016 to February 2021, of cases of gangrene of the external genitalia admitted to and treated in the Urology Department of Abeche University Hospital. Results: We collected 49 cases of gangrene of the external genitalia. The mean age of patients was 42 ± 16.81, with extremes of 20 and 81 years. The age group most concerned was between 20 and 29. The most frequent reasons for consultation were suppuration of the external genitalia and scrotal swelling. The average consultation time was 19.05 ± 16.02 days. The most common comorbidity was diabetes (35.9%). The most frequent pathological antecedents were urinary tract infections and endourethral maneuvers, reported in 40.5% and 38.7% respectively. Urogenital aetiology was predominant in 54.7%, and idiopathic in 35.9%. Lesions involved the scrotum in 60.6%, the scrotum and penis in 16.5%, and the penis alone in 5.7% of cases. Lesions extended to the perineum in 13.6% of cases, and to the abdomen in 3.6%. Vascular filling via the central venous line was performed in 58.6% of cases, and via the peripheral venous line in 41.4%. 3rd-generation cephalosporins and associated imidazoles were the most commonly used antibiotics. Necrosectomy was performed in 37 patients (73.4%), debridement combined with bypass cystostomy in 26.6% of cases. Colostomy was performed in 4% of cases. 90.8% of patients were cured and 9.2% died. The average hospital stay was 30 ± 75 days. Conclusion: The gangrene of the external genitalia is a medical and surgical emergency which has become 展开更多
Introduction: Benign prostatic hypertrophy and inguinal hernia are related and frequent pathologies in people over 50 years old. Their incidence is 15% to 25% according to the literature. The occurrence of hernia duri...Introduction: Benign prostatic hypertrophy and inguinal hernia are related and frequent pathologies in people over 50 years old. Their incidence is 15% to 25% according to the literature. The occurrence of hernia during benign prostatic hyperplasia is favored by disorders of the lower urinary tract. Simultaneous single-stage treatment of these two pathologies makes it possible to obtain satisfactory results that can reduce the cost of hospital stay and the multiple risk of anesthesia. The aim of our study was to: 1) Report the epidemiological, anatomo-clinical and para-clinical aspects of hernias during benign prostatic hypertrophy;2) Evaluate the feasibility and the results of the combined treatment of inguinal hernia and prostatic adenectomy in a single operation. Patients and Method: This was a retrospective descriptive study over a period of 7 years from March 2014 to February 2021, including patients operated on simultaneously at the University Hospital of Abeche for inguinal hernia and benign prostatic hypertrophy. The variables studied were: age, antecedents, favouring factors, clinical symptomatology, para-clinical elements, treatments and results: Results: 356 patients underwent surgery for benign prostatic hyperplasia, 36 of whom had an associated inguinal hernia. The mean age was 65.5 years, ranging from 50 to 93 years. The main reason for consultation was chronic urinary retention. The average consultation time was 10.2 months. The inguinal hernia was located on the right in 51% of cases and on the left in 18.4%. The mean prostatic volume measured by suprapubic ultrasound was 60.5 ± 25 cc. 14% and 10.2% of patients respectively were found to have struggle bladder and bilateral ureterohydronephrosis. Transvesical suprapubic adenectomy of the prostate was performed in all patients. The Bassini technique was the most commonly used (91%) for hernia repair. The average hospital stay was 7.5 days. Conclusion: Simultaneous treatment of benign prostatic hypertrophy and inguinal hernia reduces the number of h展开更多
Introduction: Urinary calculosis is the presence of stones in the urinary tract. It is more common in adults than in children. The aetiologies are multiple and depend on age. The management of calculi in children requ...Introduction: Urinary calculosis is the presence of stones in the urinary tract. It is more common in adults than in children. The aetiologies are multiple and depend on age. The management of calculi in children requires an active aetiological search because of the frequency of hereditary abnormalities which are at the origin of recurrences. The aim of our study was to report the epidemiological, clinical and therapeutic aspects of urinary lithiasis in children in the context of our practice. Aim: To report the epidemiological, clinical and therapeutic aspects of urinary lithiasis in children in our practice context. Patients and Method: This was a retrospective descriptive study carried out in the Urology Department of the University Hospital of Abeche from January 2013 to December 2019. Thirty files of patients aged 0 to 15 years operated on for urinary lithiasis were retained. The variables studied for each patient were: age, sex, clinical, para-clinical and therapeutic aspects. Results: We selected 30 cases. Patients ranged in age from 0 to 15 years, with an average age of 5.5 years. There were 26 boys and 4 girls. 62% of the patients were from rural areas. The antecedents were bilharziasis, urinary tract infections, congenital malformation, trauma and bladder lithiasis. Clinical symptoms were dominated by acute urinary retention (n = 16) and dysuria (n = 14). Urine cytobacteriological tests were positive in 16 cases. The diagnosis was made in the majority of cases by ultrasound and/or unprepared abdomen (UA). The location of lithiasis was mainly the bladder (n = 16). Treatment was surgical in 96.7% of cases, with cystolithotomy predominating. Therapeutic results were satisfactory in 90% of cases. Conclusion: Urinary calculi in children are less common than in adults. In our region, stones are most often found in the bladder. Open surgery is still the preferred method of treatment in our practice.展开更多
Fundamental experiments were carried out in a wave flume on internal solitary wave （ISW） of depression-type propagating over a submerged ridge. The seabed ridge included either triangular or semicircular shape - reg...Fundamental experiments were carried out in a wave flume on internal solitary wave （ISW） of depression-type propagating over a submerged ridge. The seabed ridge included either triangular or semicircular shape - regarded as topographic obstacles. Influenced by the submarine ridge, the transmitted waves were found to always consist of a leading pulse （a solitary wave） followed by a dispersive wave train. The wave profile propagating over a triangular ridge was similar to that caused by a semicircular obstacle. Apparently, the smooth face of a semicircular ridge produced time lag of wave propagation. From experimental results available, the reduction in wave energy induced by a semicircular ridge was larger than that by a triangular one. The events of wave distortion, strong breaking, internal bolus, and stratification mixing happened in case that the crest of an ISW was great enough to interact with the topographic obstacle. The reduction in wave energy was induced by strong breaking, and it depended on the ridge height rather than the geometric shape of the ridge.展开更多
Geoportals are a consolidated web-based solution to provide open spatial data sharing and online geo-information management.Their roles and possible advancements according to the Digital Earth vision and implementatio...Geoportals are a consolidated web-based solution to provide open spatial data sharing and online geo-information management.Their roles and possible advancements according to the Digital Earth vision and implementation require investigations.This paper presents a review of the literature concerning geoportals and serves the following primary purposes.First,various geoportal approaches for discovering and accessing Earth observation data and geo-information,mainly with scientific purposes,are summarized according to their characteristics and functionalities.Second,current major challenges in geoportals are identified in terms of functionalities,technologies,and especially big data support,from geoportal cases of China.Finally,based on lessons learned from the international and Chinese geoportals,solutions and recommendations for the challenges in geoportals are proposed in terms of their architectures,services,and technologies.The results show that geoportals usually provide access to distributed data systems,offering maps,data discovery,and data downloads.Some of them are also capable of offering online analysis and processing service,enhanced semantic search engines,and dynamic visualization tools.The strength of geoportals could lead to a full-fledged online Digital Earth system that could provide better data sharing and dissemination solutions to the challenges posed by big data.展开更多
A novel method for converting an array of out-of-phase lasers into one of in-phase lasers that can be tightly focused is presented.The method exploits second-harmonic generation and can be adapted for different laser ...A novel method for converting an array of out-of-phase lasers into one of in-phase lasers that can be tightly focused is presented.The method exploits second-harmonic generation and can be adapted for different laser arrays geometries.Experimental and calculated results,presented for negatively coupled lasers formed in a square,honeycomb,and triangular geometries are in good agreement.展开更多
Christelle Chene,from France,is international affairs director at Ningxia Xige Estate and French director at Ningxia Helan Mountains East Foothill Wine Education Institute,in Northwest China's Ningxia Hui Autonomo...Christelle Chene,from France,is international affairs director at Ningxia Xige Estate and French director at Ningxia Helan Mountains East Foothill Wine Education Institute,in Northwest China's Ningxia Hui Autonomous Region.She has made it her mission to promote Chinese wines,in both the Chinese and international markets.展开更多
Isolated mediastinal lymphangiomas are uncommon. We report a case of a 14 ×8 mm right paracardiac cyst diagnosed at 20 weeks’ gestation. The prenatal evolution was uneventful and a magnetic resonance imaging...Isolated mediastinal lymphangiomas are uncommon. We report a case of a 14 ×8 mm right paracardiac cyst diagnosed at 20 weeks’ gestation. The prenatal evolution was uneventful and a magnetic resonance imaging at 31 weeks showed the limited extension of the cyst into the anterior mediastinum. At birth, the baby was asymptomatic, but the size of the lesion increased steadily (48 ×29 mm). At 7 months of life, he underwent a thoracoscopic resection of the cyst without intra or postoperative complications. Histological examination showed a lymphangioma. This case is remarkable for its prenatal diagnosis, the thoracoscopic treatment and the 8 years of followup without recurrence.展开更多
Objective To assess the effectiveness of intraarticular injection of hyaluronate (HA) on temporomandibular disorders (TMD). Methods Searching various databases available, handsearching 15 Chinese dental journals to fi...Objective To assess the effectiveness of intraarticular injection of hyaluronate (HA) on temporomandibular disorders (TMD). Methods Searching various databases available, handsearching 15 Chinese dental journals to find articles, abstracts and unpublished literature with randomized or quasi-randomized design on the effects of intraarticular injection of HA on TMD. Data extraction, appraisal, and the methods for Meta-analysis were conducted based on the Cochrane guidelines. Results 12 RCTs and 2 CCT on TMD and 1 RCT on rheumatoid arthritis involving temporomandibular joints (TMJ) were located, 10 of them fulfilled inclusion criteria in which 561 patients were reported. Except 71 cases with only qualitative data, 490 cases could be calculated in Meta-analysis: 277 on HA, 113 on placebo or non-treatment (PL) and 100 on corticosteroids (CO). In comparison with PL, HA injection showed no statistically significant effect on short and long term improvement of symptoms, and short term improvement of VAS as well. But it presented significant better effects than PL in short and long term improvement of clinical signs, especially mouth opening. When sensitivity analysis was conducted for improvement of short term signs, the conclusion was not stable. Comparison of the effect between HA and CO showed the same efficacy levels. Adverse reactions of HA were mild and transient. Conclusions HA may improve short and long term clinical signs of TMD and have only mild and transient adverse reactions. However, more RCTs are needed to confirm its therapeutic effect.展开更多
Aim: Resolvins, maresins and lipoxins are lipid mediators issued from essential polyunsaturated fatty acids which are the first anti-inflammatory and pro-resolving signals identified during the resolution phase of inf...Aim: Resolvins, maresins and lipoxins are lipid mediators issued from essential polyunsaturated fatty acids which are the first anti-inflammatory and pro-resolving signals identified during the resolution phase of inflammation. As borage oil and/or borage seed extracts have shown beneficial action in treatment of atopic dermatitis or eczema in human and canine, we have modified a borage oil component by using biotechnology in order to get a compound structurally related to a polyunsaturated fatty acid, and we have studied its ability to reduce inflammation mediators production through the generation of resolvins, maresins and/or lipoxins. Additionally, we have demonstrated the potent anti-inflammatory effect of this new compound which consists in borage seed oil aminopropanediol amides, through an in vivo study concerning subjects suffering from psoriasis or atopic dermatitis. Study Design/Methods: For the in vitro study, inflammation was induced in co-cultures of human dendritic cells and normal keratinocytes by the addition of PMA and the calcium ionophore A23187. Ability of our borage seed oil aminopropanediol amides to increase resolvin D2, maresin 1 and lipoxins A4 and B4 synthesis was then measured. Pro-inflammatory cytokines (IL-1β, IL-6, IL-8) and PGE2 productions were also quantified. For the in vivo study, 36 subjects suffering from psoriasis or atopic dermatitis have used twice a day during 30 days, a formulation containing borage seed oil aminopropanediol amides. Before the beginning of the study and after 30 days’ treatment, the severity of psoriasis and of atopic dermatitis was evaluated by using the PGA and the SCORAD scoring scales, respectively. Results: Borage seed oil aminopropanediol amides were able to significantly increase the resolvin D2, maresin 1 and lipoxins A4 and B4 synthesis. Concomitantly, they were also able to significantly inhibit the production of IL-1β, IL-6, IL-8 and PGE2 induced by the PMA and the calcium ionophore A23187 in the in vitro co-culture model used. Introduced 展开更多
Ensuring drug safety in the early stages of drug development is crucial to avoid costly failures in subsequent phases.However,the economic burden associated with detecting drug off-targets and potential side effects t...Ensuring drug safety in the early stages of drug development is crucial to avoid costly failures in subsequent phases.However,the economic burden associated with detecting drug off-targets and potential side effects through in vitro safety screening and animal testing is substantial.Drug off-target interactions,along with the adverse drug reactions they induce,are significant factors affecting drug safety.To assess the liability of candidate drugs,we developed an artificial intelligence model for the precise prediction of compound off-target interactions,leveraging multi-task graph neural networks.The outcomes of off-target predictions can serve as representations for compounds,enabling the differentiation of drugs under various ATC codes and the classification of compound toxicity.Furthermore,the predicted off-target profiles are employed in adverse drug reaction(ADR)enrichment analysis,facilitating the inference of potential ADRs for a drug.Using the withdrawn drug Pergolide as an example,we elucidate the mechanisms underlying ADRs at the target level,contributing to the exploration of the potential clinical relevance of newly predicted off-target interactions.Overall,our work facilitates the early assessment of compound safety/toxicity based on off-target identification,deduces potential ADRs of drugs,and ultimately promotes the secure development of drugs.展开更多
文摘A multi-faceted Case Area Targeted Intervention (CATI) approach emphasizing the integration of Water, Sanitation and Hygiene (WASH) interventions and Oral Cholera Vaccine (OCV) campaign was employed to respond to the outbreak of cholera in Garissa County. Drinking water sources in areas heavily impacted by cholera were systematically mapped and tested for microbiological quality. The quality assessment was carried out in April 2023 during an ongoing cholera outbreak in the county. A total of 109 samples were collected and tested for thermotolerant coliforms and other in situ parameters. The finding revealed that more than 87% of the samples did not meet the World Health Organization (WHO) standard for thermotolerant coliforms;and 30% had turbidity values above the recommended threshold values. None of the 109 samples had any traceable residual chlorine. Following these findings, the county government implemented the targeted interventions which resulted in a positive impact in the fight against cholera. The WHO supported key interventions which included capacity building in water quality monitoring and prepositioning of critical WASH commodities to the cholera affected areas.
文摘Introduction: Erectile dysfunction (ED) is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised or its management is delayed because it is often overshadowed by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ED. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ED) seen at the University Hospital of Abeche. Erectile function was assessed using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed to take part in the study. Only 40 patients correctly completed the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented 74%. Diabetes was poorly controlled in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.
文摘Introduction: Prevention of obstetric fistula (OF) remains a challenge in Chad where its incidence is 464 cases/year. The present study aims to determine the knowledge and attitudes of nursing staff towards obstetric fistula. Patients and Method: This was a cross-sectional, descriptive and analytical study including nursing staff at the Abéché University Hospital. The survey took place from March to May 2023 and the sampling was exhaustive. Data collection was done using a form including a questionnaire on sociodemographic parameters, knowledge and attitudes. Participation in the study was voluntary and individual. Results: Participation in the study was 76.11%. Emergency department staff were the most represented, followed by gynecology-obstetrics staff with 34.4% and 20.91% of cases respectively. Nurses represented 53.17% of participants followed by doctors (23.52%). An exact definition of obstetric fistula was reported by 7.84% of participants and it was partial in 80.39%. The level of knowledge of risk factors was considered good in 12.41%. Exact knowledge of clinical signs was reported by 74.5% of cases. Among the participants, 1.96% reported that the treatment of obstetric fistula is traditional. Knowledge about means of prevention was considered good by 13.72% (n = 21), and attitudes by 26.79%? Obstetric fistula knowledge was influenced by profession (doctor, p = 0.011) and attitudes by service (p = 0.004) and profession (doctor, p = 0.001). Conclusion: Obstetric fistula is a curable disease whose prevention remains possible and requires good knowledge of the disease and the promotion of safe motherhood. This study should serve as a basis for the establishment of the obstetric fistula module in the curriculum of healthcare personnel and the promotion of continuing training for its eradication.
文摘Introduction: Caesarean section is a surgical procedure which allows childbirth after opening the abdominal wall and the uterus. Objective: To study caesarean section in the N’Djamena Mother and Child University Hospital (NMCUH). Patients and Method: This was a cross-sectional, analytic descriptive study over a 5-month period from 10 January to 10 June 2023, focusing on caesarean sections section in the N’Djamena Mother and Child University Hospital (NMCUH). Studied variables were epidemiological, clinical and prognostic. Patients were divided according to the classification of Robson into 10 groups. Results: During the study period, we recorded 724 caesareans sections among 3,565 deliveries, giving a rate of 20.3%. The age group from 25 to 29 represented 39.2%. The average age was 31.2 ± 2.8 years, with extreme ranging from 14 to 44 years. Nulliparous women accounted for 42% and 26% had at least one previous caesarean section (n = 188). Patients with full-term pregnancies (37 - 40 gestational weeks + 6 days) represented 64.1%. Emergency caesareans accounted for 92.8% (n = 672). Robson’s group 1 was noted to be 40.3%. Hemorrhage was the main intraoperative complication, with 7.2%. In post-operatively, anemia was the main complication at 23.8%. We recorded 16 maternal deaths, giving a maternal death rate of 2.2%. Live newborns accounted for 81.1%. Conclusion: Caesarean section is a common procedure in the CHUME maternity unit. The main indications are those of Robson’s group I. Caesarean sections are associated with both maternal and fetal complications.
文摘Introduction: Acute large bursae (ALB) are a frequent reason for emergency consultations. The aim of this study was to investigate the prevalence, clinical course, treatment and evolution of ALB at Abeche University Hospital. Patients and Method: This was a 45-month cross-sectional study from January 2020 to September 2023. Male patients of any age who had been admitted to and treated for acute large bursae at the Abeche University Hospital were included. Sociodemographic, clinical and therapeutic variables were studied. Results: Acute large bursae accounted for 7.92% of emergency admissions. The average age was 39.40 years. 60.27% of patients came from rural areas. The average consultation time was 4 days, ranging from a few hours to 18 days. The main reason for consultation was pain. Strangulated inguino-scrotal hernia was the most common, followed by acute orchi-epididymitis, accounting for 41.8% and 26% of cases respectively. Traditional treatment prior to consultation was attempted in 13.7% of cases. All patients were treated as emergencies, 41 of whom had received medical treatment. Of the patients treated surgically, orchidopexy was performed in all. Parietal suppuration and anaemia occurred in 6.2% and 4.8% of cases respectively. Conclusion: A accounts for a significant proportion of our emergency care activity. However, patients are seen with a delay, which jeopardises the functional prognosis of the testicle and intestine.
基金This work was supported by the National Key R&D Program of China(No.2020YFC0841400)Tongji Hospital Clinical Research Project(Nos.XXGZBDYJ009 and 2019YBKY019).
文摘We conducted a randomized,open-label,parallel-controlled,multicenter trial on the use of Shuanghuanglian(SHL),a traditional Chinese patent medicine,in treating cases of COVID-19.A total of 176 patients received SHL by three doses(56 in low dose,61 in middle dose,and 59 in high dose)in addition to standard care.The control group was composed of 59 patients who received standard therapy alone.Treatment with SHL was not associated with a difference from standard care in the time to disease recovery.Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group(93.4%vs.73.9%,P=0.006).Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia,which was evaluated by density reduction of inflammatory focus from baseline,at day 7(mean difference(95%CI),−46.39(−86.83 to−5.94)HU;P=0.025)and day 14(mean difference(95%CI),−74.21(−133.35 to−15.08)HU;P=0.014).No serious adverse events occurred in the SHL groups.This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.
文摘Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mortality remains very high despite therapeutic advances. Our aim was to report on the epidemiological, diagnostic and therapeutic aspects of gangrene of the external genitalia, and to identify prognostic factors. Patients and Method: This was a 5-year retrospective descriptive study, from February 2016 to February 2021, of cases of gangrene of the external genitalia admitted to and treated in the Urology Department of Abeche University Hospital. Results: We collected 49 cases of gangrene of the external genitalia. The mean age of patients was 42 ± 16.81, with extremes of 20 and 81 years. The age group most concerned was between 20 and 29. The most frequent reasons for consultation were suppuration of the external genitalia and scrotal swelling. The average consultation time was 19.05 ± 16.02 days. The most common comorbidity was diabetes (35.9%). The most frequent pathological antecedents were urinary tract infections and endourethral maneuvers, reported in 40.5% and 38.7% respectively. Urogenital aetiology was predominant in 54.7%, and idiopathic in 35.9%. Lesions involved the scrotum in 60.6%, the scrotum and penis in 16.5%, and the penis alone in 5.7% of cases. Lesions extended to the perineum in 13.6% of cases, and to the abdomen in 3.6%. Vascular filling via the central venous line was performed in 58.6% of cases, and via the peripheral venous line in 41.4%. 3rd-generation cephalosporins and associated imidazoles were the most commonly used antibiotics. Necrosectomy was performed in 37 patients (73.4%), debridement combined with bypass cystostomy in 26.6% of cases. Colostomy was performed in 4% of cases. 90.8% of patients were cured and 9.2% died. The average hospital stay was 30 ± 75 days. Conclusion: The gangrene of the external genitalia is a medical and surgical emergency which has become
文摘Introduction: Benign prostatic hypertrophy and inguinal hernia are related and frequent pathologies in people over 50 years old. Their incidence is 15% to 25% according to the literature. The occurrence of hernia during benign prostatic hyperplasia is favored by disorders of the lower urinary tract. Simultaneous single-stage treatment of these two pathologies makes it possible to obtain satisfactory results that can reduce the cost of hospital stay and the multiple risk of anesthesia. The aim of our study was to: 1) Report the epidemiological, anatomo-clinical and para-clinical aspects of hernias during benign prostatic hypertrophy;2) Evaluate the feasibility and the results of the combined treatment of inguinal hernia and prostatic adenectomy in a single operation. Patients and Method: This was a retrospective descriptive study over a period of 7 years from March 2014 to February 2021, including patients operated on simultaneously at the University Hospital of Abeche for inguinal hernia and benign prostatic hypertrophy. The variables studied were: age, antecedents, favouring factors, clinical symptomatology, para-clinical elements, treatments and results: Results: 356 patients underwent surgery for benign prostatic hyperplasia, 36 of whom had an associated inguinal hernia. The mean age was 65.5 years, ranging from 50 to 93 years. The main reason for consultation was chronic urinary retention. The average consultation time was 10.2 months. The inguinal hernia was located on the right in 51% of cases and on the left in 18.4%. The mean prostatic volume measured by suprapubic ultrasound was 60.5 ± 25 cc. 14% and 10.2% of patients respectively were found to have struggle bladder and bilateral ureterohydronephrosis. Transvesical suprapubic adenectomy of the prostate was performed in all patients. The Bassini technique was the most commonly used (91%) for hernia repair. The average hospital stay was 7.5 days. Conclusion: Simultaneous treatment of benign prostatic hypertrophy and inguinal hernia reduces the number of h
文摘Introduction: Urinary calculosis is the presence of stones in the urinary tract. It is more common in adults than in children. The aetiologies are multiple and depend on age. The management of calculi in children requires an active aetiological search because of the frequency of hereditary abnormalities which are at the origin of recurrences. The aim of our study was to report the epidemiological, clinical and therapeutic aspects of urinary lithiasis in children in the context of our practice. Aim: To report the epidemiological, clinical and therapeutic aspects of urinary lithiasis in children in our practice context. Patients and Method: This was a retrospective descriptive study carried out in the Urology Department of the University Hospital of Abeche from January 2013 to December 2019. Thirty files of patients aged 0 to 15 years operated on for urinary lithiasis were retained. The variables studied for each patient were: age, sex, clinical, para-clinical and therapeutic aspects. Results: We selected 30 cases. Patients ranged in age from 0 to 15 years, with an average age of 5.5 years. There were 26 boys and 4 girls. 62% of the patients were from rural areas. The antecedents were bilharziasis, urinary tract infections, congenital malformation, trauma and bladder lithiasis. Clinical symptoms were dominated by acute urinary retention (n = 16) and dysuria (n = 14). Urine cytobacteriological tests were positive in 16 cases. The diagnosis was made in the majority of cases by ultrasound and/or unprepared abdomen (UA). The location of lithiasis was mainly the bladder (n = 16). Treatment was surgical in 96.7% of cases, with cystolithotomy predominating. Therapeutic results were satisfactory in 90% of cases. Conclusion: Urinary calculi in children are less common than in adults. In our region, stones are most often found in the bladder. Open surgery is still the preferred method of treatment in our practice.
基金The work was supported by the National Science Council under Grant Nos . NSC 95-2221-E-366-001 and NSC 95-2218-E-132-001 .
文摘Fundamental experiments were carried out in a wave flume on internal solitary wave （ISW） of depression-type propagating over a submerged ridge. The seabed ridge included either triangular or semicircular shape - regarded as topographic obstacles. Influenced by the submarine ridge, the transmitted waves were found to always consist of a leading pulse （a solitary wave） followed by a dispersive wave train. The wave profile propagating over a triangular ridge was similar to that caused by a semicircular obstacle. Apparently, the smooth face of a semicircular ridge produced time lag of wave propagation. From experimental results available, the reduction in wave energy induced by a semicircular ridge was larger than that by a triangular one. The events of wave distortion, strong breaking, internal bolus, and stratification mixing happened in case that the crest of an ISW was great enough to interact with the topographic obstacle. The reduction in wave energy was induced by strong breaking, and it depended on the ridge height rather than the geometric shape of the ridge.
文摘Geoportals are a consolidated web-based solution to provide open spatial data sharing and online geo-information management.Their roles and possible advancements according to the Digital Earth vision and implementation require investigations.This paper presents a review of the literature concerning geoportals and serves the following primary purposes.First,various geoportal approaches for discovering and accessing Earth observation data and geo-information,mainly with scientific purposes,are summarized according to their characteristics and functionalities.Second,current major challenges in geoportals are identified in terms of functionalities,technologies,and especially big data support,from geoportal cases of China.Finally,based on lessons learned from the international and Chinese geoportals,solutions and recommendations for the challenges in geoportals are proposed in terms of their architectures,services,and technologies.The results show that geoportals usually provide access to distributed data systems,offering maps,data discovery,and data downloads.Some of them are also capable of offering online analysis and processing service,enhanced semantic search engines,and dynamic visualization tools.The strength of geoportals could lead to a full-fledged online Digital Earth system that could provide better data sharing and dissemination solutions to the challenges posed by big data.
基金supported in part by the Minerva FoundationIsrael Science Foundation (ISF) Bikura foundation
文摘A novel method for converting an array of out-of-phase lasers into one of in-phase lasers that can be tightly focused is presented.The method exploits second-harmonic generation and can be adapted for different laser arrays geometries.Experimental and calculated results,presented for negatively coupled lasers formed in a square,honeycomb,and triangular geometries are in good agreement.
文摘Christelle Chene,from France,is international affairs director at Ningxia Xige Estate and French director at Ningxia Helan Mountains East Foothill Wine Education Institute,in Northwest China's Ningxia Hui Autonomous Region.She has made it her mission to promote Chinese wines,in both the Chinese and international markets.
文摘Isolated mediastinal lymphangiomas are uncommon. We report a case of a 14 ×8 mm right paracardiac cyst diagnosed at 20 weeks’ gestation. The prenatal evolution was uneventful and a magnetic resonance imaging at 31 weeks showed the limited extension of the cyst into the anterior mediastinum. At birth, the baby was asymptomatic, but the size of the lesion increased steadily (48 ×29 mm). At 7 months of life, he underwent a thoracoscopic resection of the cyst without intra or postoperative complications. Histological examination showed a lymphangioma. This case is remarkable for its prenatal diagnosis, the thoracoscopic treatment and the 8 years of followup without recurrence.
文摘Objective To assess the effectiveness of intraarticular injection of hyaluronate (HA) on temporomandibular disorders (TMD). Methods Searching various databases available, handsearching 15 Chinese dental journals to find articles, abstracts and unpublished literature with randomized or quasi-randomized design on the effects of intraarticular injection of HA on TMD. Data extraction, appraisal, and the methods for Meta-analysis were conducted based on the Cochrane guidelines. Results 12 RCTs and 2 CCT on TMD and 1 RCT on rheumatoid arthritis involving temporomandibular joints (TMJ) were located, 10 of them fulfilled inclusion criteria in which 561 patients were reported. Except 71 cases with only qualitative data, 490 cases could be calculated in Meta-analysis: 277 on HA, 113 on placebo or non-treatment (PL) and 100 on corticosteroids (CO). In comparison with PL, HA injection showed no statistically significant effect on short and long term improvement of symptoms, and short term improvement of VAS as well. But it presented significant better effects than PL in short and long term improvement of clinical signs, especially mouth opening. When sensitivity analysis was conducted for improvement of short term signs, the conclusion was not stable. Comparison of the effect between HA and CO showed the same efficacy levels. Adverse reactions of HA were mild and transient. Conclusions HA may improve short and long term clinical signs of TMD and have only mild and transient adverse reactions. However, more RCTs are needed to confirm its therapeutic effect.
文摘Aim: Resolvins, maresins and lipoxins are lipid mediators issued from essential polyunsaturated fatty acids which are the first anti-inflammatory and pro-resolving signals identified during the resolution phase of inflammation. As borage oil and/or borage seed extracts have shown beneficial action in treatment of atopic dermatitis or eczema in human and canine, we have modified a borage oil component by using biotechnology in order to get a compound structurally related to a polyunsaturated fatty acid, and we have studied its ability to reduce inflammation mediators production through the generation of resolvins, maresins and/or lipoxins. Additionally, we have demonstrated the potent anti-inflammatory effect of this new compound which consists in borage seed oil aminopropanediol amides, through an in vivo study concerning subjects suffering from psoriasis or atopic dermatitis. Study Design/Methods: For the in vitro study, inflammation was induced in co-cultures of human dendritic cells and normal keratinocytes by the addition of PMA and the calcium ionophore A23187. Ability of our borage seed oil aminopropanediol amides to increase resolvin D2, maresin 1 and lipoxins A4 and B4 synthesis was then measured. Pro-inflammatory cytokines (IL-1β, IL-6, IL-8) and PGE2 productions were also quantified. For the in vivo study, 36 subjects suffering from psoriasis or atopic dermatitis have used twice a day during 30 days, a formulation containing borage seed oil aminopropanediol amides. Before the beginning of the study and after 30 days’ treatment, the severity of psoriasis and of atopic dermatitis was evaluated by using the PGA and the SCORAD scoring scales, respectively. Results: Borage seed oil aminopropanediol amides were able to significantly increase the resolvin D2, maresin 1 and lipoxins A4 and B4 synthesis. Concomitantly, they were also able to significantly inhibit the production of IL-1β, IL-6, IL-8 and PGE2 induced by the PMA and the calcium ionophore A23187 in the in vitro co-culture model used. Introduced
基金supported by National Key Research and Development Program of China(2022YFC3400504 to Mingyue Zheng)National Natural Science Foundation of China(T2225002 and 82273855 to Mingyue Zheng,82204278 to Xutong Li)+2 种基金Lingang Laboratory(LG202102-01-02 to Mingyue Zheng)SIMMSHUTCM Traditional Chinese Medicine Innovation Joint Research Program(E2G805H to Mingyue Zheng)Shanghai Municipal Science and Technology Major Project.
文摘Ensuring drug safety in the early stages of drug development is crucial to avoid costly failures in subsequent phases.However,the economic burden associated with detecting drug off-targets and potential side effects through in vitro safety screening and animal testing is substantial.Drug off-target interactions,along with the adverse drug reactions they induce,are significant factors affecting drug safety.To assess the liability of candidate drugs,we developed an artificial intelligence model for the precise prediction of compound off-target interactions,leveraging multi-task graph neural networks.The outcomes of off-target predictions can serve as representations for compounds,enabling the differentiation of drugs under various ATC codes and the classification of compound toxicity.Furthermore,the predicted off-target profiles are employed in adverse drug reaction(ADR)enrichment analysis,facilitating the inference of potential ADRs for a drug.Using the withdrawn drug Pergolide as an example,we elucidate the mechanisms underlying ADRs at the target level,contributing to the exploration of the potential clinical relevance of newly predicted off-target interactions.Overall,our work facilitates the early assessment of compound safety/toxicity based on off-target identification,deduces potential ADRs of drugs,and ultimately promotes the secure development of drugs.
