Profil étiologique et évolutif de l’insuffisance rénale de l’enfant en milieu hospitalier au Togo

ObjectiveTo determine the etiological and evolutionary profile of renal failure of chidren in Togo.MethodsThis is a cross-sectional study over the period of 12 months (2016–2017) including children aged 1 to 18 years hospitalized in the pediatric ward of Sylvanus Olympio university teaching hospital of Lome (Togo) for renal failure.ResultsOf 2374 patients hospitalized in our unit, 58 (2.4%) had renal failure. The mean age was 8.17 ± 4 years with a sex ratio of 1.32. The average consultation time was 11.9 days. The mean duration of hospitalization was 12.7 ± 7.7 days. Thirty-seven patients (63.8%) were referred from a peripheral center. Thirty-seven children out of 58 (63.1%) were oligoanuric. Renal failure was acute in 94.8% and chronic in 5.2%. Anemia was found in 84.4% of children. The main etiologies found were severe malaria (63.8%), glomerulonephritis (10.3%) and nephrotic syndrome (10.3%). Thirteen children (22.4%) benefited from dialysis sessions. The evolution was favorable in 79.3% of the cases.ConclusionThe renal failure of child is relatively common in our daily practice. The low socio-economic level and the lack of adapted equipment make the care difficult.     

Prediagnostic serum glyceraldehyde-derived advanced glycation end products and mortality among colorectal cancer patients

Glyceraldehyde-derived advanced glycation end products (glycer-AGEs) could contribute to colorectal cancer development and progression due to their pro-oxidative and pro-inflammatory properties. However, the association of glycer-AGEs with mortality after colorectal cancer diagnosis has not been previously investigated. Circulating glycer-AGEs were measured by competitive ELISA. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for associations of circulating glycer-AGEs concentrations with CRC-specific and all-cause mortality among 1034 colorectal cancer (CRC) cases identified within the European Prospective Investigation into Cancer and Nutrition (EPIC) study between 1993 and 2013. During a mean of 48 months of follow-up, 529 participants died (409 from CRC). Glycer-AGEs were statistically significantly positively associated with CRC-specific (HR_{Q5 vs Q1} = 1.53, 95% CI: 1.04-2.25, P_trend = .002) and all-cause (HR_{Q5 vs Q1} = 1.62, 95% CI: 1.16-2.26, P_trend < .001) mortality among individuals with CRC. There was suggestion of a stronger association between glycer-AGEs and CRC-specific mortality among patients with distal colon cancer (per SD increment: HR_{proximal colon} = 1.02, 95% CI: 0.74-1.42; HR_{distal colon} = 1.51, 95% CI: 1.20-1.91; P_{effect modification} = .02). The highest HR was observed among CRC cases in the highest body mass index (BMI) and glycer-AGEs category relative to lowest BMI and glycer-AGEs category for both CRC-specific (HR = 1.78, 95% CI: 1.02-3.01) and all-cause mortality (HR = 2.15, 95% CI: 1.33-3.47), although no statistically significant effect modification was observed. Our study found that prediagnostic circulating glycer-AGEs are positively associated with CRC-specific and all-cause mortality among individuals with CRC. Further investigations in other populations and stratifying by tumor location and BMI are warranted.     

Feasibility study for production of I-131 radioisotope using MNSR research reactor

A feasibility study for (131)I production using a Low Power Research Reactor was conducted to predict the yield of (131)I by cyclic activation technique. A maximum activity of 5.1GBq was achieved through simulation using FORTRAN 90, for an irradiation of 6h. But experimentally only 4h irradiation could be done, which resulted in an activity of 4.0×10(5)Bq. The discrepancy in the activities was due to the fact that beta decays released during the process could not be considered.     

HIV/AIDS knowledge and attitude towards people living with HIV/AIDS (PLWHA): a cross-sectional study of primary school teachers

BackgroundTeachers are in advantage position to propagate correct information with regard to HIV/AIDS thereby influencing attitude towards PLWHA. With correct information stigmatization leading to spread of the scourge might be prevented.Aims & ObjectivesThe study was conducted to determine knowledge and attitude of primary school teachers towards PLWHA.Methods & MaterialsThe cross-sectional survey was used to study a sample of 400 primary school teachers in Ebonyi State, Nigeria. The instrument used for data collection was researchers'' designed questionnaire. Out of 400 copies of questionnaire administered; 394 representing 98.5% return rate, were used for analysis of data.ResultsResults showed respondents had moderate (57.4%) knowledge concerning HIV/AIDS and positive attitude (3.09 ± 0.98) to PLWHA. Female teachers'' dispositions to PLWHA were better than the males based on their attitude scores and the difference was not significant in general knowledge of HIV/AIDS and attitude to PLWHA.ConclusionOur findings underscore the need for a universal health education programme, focusing on HIV/AIDS education, in education institutions that train teachers in Nigeria so as to possibly mitigate the discrepancy in knowledge regarding curability of AIDS and any undesirable attitude towards PLWHA that may arise among teachers.     

Identifying priorities for quality improvement at an emergency Department in Ghana

Background

Healthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigation of emergency department (ED) staff priorities for QI at a tertiary care hospital in Ghana. The aims of the study were to educate staff about the World Health Organization’s (WHO) definition of quality in healthcare, and to identify an initial focus for building a departmental QI program.

Methods

Semi-structured interviews were conducted with ED staff using open-ended questions to probe their understanding and valuation of the six dimensions of quality defined by the WHO. Participants were then asked to rank the dimensions in order of importance for QI. Qualitative responses were thematically analyzed, and ordinal rank-order was determined for quantitative data regarding QI priorities.

Results

Twenty (20) members of staff of different cadres participated, including ED physicians, nurses, orderlies, a security officer, and an accountant. A majority of participants (61%) ranked access to emergency healthcare as high priority for QI. Two recurrent themes - financial accessibility and hospital bed availability - accounted for the majority of discussions, each linked to all the dimensions of healthcare quality.

Conclusions

ED staff related all of the WHO quality dimensions to their work, and prioritized access to emergency care as the most important area for improvement. Participants expressed a high degree of motivation to improve healthcare quality, and the study helped with the development of a departmental QI program focused on the broad topic of access to ED services.

     

Comparison of a fluorometric assay kit with high-performance liquid chromatography for the assessment of serum retinol concentration

Background

Although high-performance liquid chromatography (HPLC) is the commonly used method for the analysis of retinol in biological samples, simple and rapid test kits are available.

Objectives

This study compared a rapid test kit (ICHECK Fluoro®) to HPLC for the assessment of serum retinol concentrations.

Methods

For the analysis by HPLC, sample preparation included standard deproteinization and extraction phases. The analysis by ICHECK was performed by injecting serum into IEX reagent vials (n=89) and mixing manually for separation. After precipitation of the proteins, the vial was introduced into the chamber of the ICHECK Fluoro and analysed at 0 min (ICHECK0min) and 15 min later (ICHECK15min). Bland and Altman approach was applied to test the agreement between HPLC and ICHECK.

Results

Mean HPLC, ICHECK0min and ICHECK15min values were 421.2±106.0 µg/L, 423.1±118.3 µg/L and 413.2±107.6 µg/L, respectively. Retinol concentrations significantly decreased in the IEX solution over time (p<0.001). No significant proportional bias was observed between HPLC and ICHECK0min (r-0.038, p=0.73) and ICHECK15min (r=−0.024, p=0.82). Fixed biases (HPLC minus ICHECK) for ICHECK0min and ICHECK15min were respectively −1.9±23.1 µg/l (p=0.45) and 8.0±22.7 µg/l (p=0.002).

Conclusion

ICHECK Fluoro may offer a reliable mean for assessing serum retinol for measurements performed with no significant time delay.     

Gallstones and incident colorectal cancer in a large pan-European cohort study

Gallstones, a common gastrointestinal condition, can lead to several digestive complications and can result in inflammation. Risk factors for gallstones include obesity, diabetes, smoking and physical inactivity, all of which are known risk factors for colorectal cancer (CRC), as is inflammation. However, it is unclear whether gallstones are a risk factor for CRC. We examined the association between history of gallstones and CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a prospective cohort of over half a million participants from ten European countries. History of gallstones was assessed at baseline using a self-reported questionnaire. The analytic cohort included 334,986 participants; a history of gallstones was reported by 3,917 men and 19,836 women, and incident CRC was diagnosed among 1,832 men and 2,178 women (mean follow-up: 13.6 years). Hazard ratios (HR) and 95% confidence intervals (CI) for the association between gallstones and CRC were estimated using Cox proportional hazards regression models, stratified by sex, study centre and age at recruitment. The models were adjusted for body mass index, diabetes, alcohol intake and physical activity. A positive, marginally significant association was detected between gallstones and CRC among women in multivariable analyses (HR = 1.14, 95%CI 0.99–1.31, p = 0.077). The relationship between gallstones and CRC among men was inverse but not significant (HR = 0.81, 95%CI 0.63–1.04, p = 0.10). Additional adjustment for details of reproductive history or waist circumference yielded minimal changes to the observed associations. Further research is required to confirm the nature of the association between gallstones and CRC by sex.     

Fibrinolytic activity in women on oral contraceptive pills: variation due to haemoglobin genotype.

Plasma fibrinogen levels and euglobulin lysis time (ELT) were determined in 84 women with haemoglobin genotype AA (HbAA) and in 38 with haemoglobin genotype AS (HbAS), aged 17-35 years, who were on oral contraceptive pills (OCP). The control group included 23 HbAA and 27 HbAS age-matched, apparently healthy women, who had regular menstruation and no history of OCP usage. The controls showed statistically significant elevations in fibrinogen levels in women with genotype HbAS (+13%; P < 0.05) compared with women with genotype HbAA. Among OCP users, the difference in fibrinogen levels (+5%) between HbAS and HbAA women was not statistically significant. The elevation in fibrinogen levels which was restricted to the HbAA women, was probably caused by OCP use, and may be dependent on the Hb genotype. In contrast, the observed elevations in euglobulin lysis time among OCP users (P < 0.005) were independent of Hb genotype. Thus, while OCP may constitute a risk factor for the development of thromboembolism in women, the S-gene may confer partial protection against this development in women who have the HbAS genotype.