I2PA : An Efficient ABC for IoT

Internet of Things (IoT) is very attractive because of its promises. However, it brings many challenges, mainly issues about privacy preserving and lightweight cryptography. Many schemes have been designed so far but none of them simultaneously takes into account these aspects. In this paper, we propose an efficient ABC scheme for IoT devices. We use ECC without pairing, blind signing and zero knowledge proof. Our scheme supports block signing, selective disclosure and randomization. It provides data minimization and transactions' unlinkability. Our construction is efficient since smaller key size can be used and computing time can be reduced. As a result, it is a suitable solution for IoT devices characterized by three major constraints namely low energy power, small storage capacity and low computing power

Practice of diagnostic hysteroscopy after myomectomy in the prevention of intrauterine adhesions: experience of Ouakam military hospital (Dakar, Senegal)

Background: Surgical treatment of myomas may be the cause of some complications, including intrauterine adhesions. The objective of the study was to evaluate the incidence of intrauterine adhesions in patients who underwent myomectomy by laparotomy or hysteroscopic resection.Methods: We carried out a prospective single center study from August 1st 2016 to May 31st 2017 in the gynaecological and obstetrical department of Ouakam the Military Hospital (Senegal). We included patients who underwent myomectomy by laparotomy with opening of the uterine cavity or myomectomy by hysteroscopy. A diagnostic hysteroscopy was performed to search post-operative intrauterine adhesions. For each patient, we studied the socio-demographic aspects, the surgical approach, the delay of diagnostic hysteroscopy, the appearance of uterine cavity and the tolerance of hysteroscopy.Results: 54 patients underwent the diagnostic hysteroscopy. The mean age was 36 years old. The main indication of myomectomy was menorrhagia. 37 patients underwent myomectomy by laparotomy and 17 by hysteroscopy. Each case was followed by a post-operative diagnostic hysteroscopy with a mean delay time of 58 days. We found post-operative intrauterine adhesions in 7 patients (5 in the laparotomy group and 2 in hysteroscopy group).Conclusions: Early diagnostic hysteroscopy after myomectomy should be done in our context to reduce post-operative intrauterine adhesions and preserve the patient’s fertility

Funiculars anomalies during childbirth: about 562 cases collected in Pikine National Hospital

Background: Establish an epidemiological description of the different types of umbilical cord anomalies in our reference structure and to assess their impact on the prognosis of childbirth.Methods: We conducted a descriptive study, cross over a period of one year in Obstetrics and Gynecology Service Level III of Pikine Hospital. We included all women in labor have reached the term less than 28 weeks gestation and delivering a newborn with umbilical cord abnormality diagnosed during labor or during the expulsion.Results: During this period, we compiled 562 anomalies of the umbilical cord, which gave a frequency of 23.8%. Length discrepancies were far the most frequent (67.4%). Only the prolapsed cord was an independent risk factor for cesarean section (p = 0.036). The rate of episiotomy and tear was significantly higher in case of brevity (primitive or induced) cord (p = 0.042). Apgar score ≤7 was significantly related to the presence of brevity (p = 0.000), excessive length (p = 0.048) or cord prolapse (p = 0.037).Conclusions: This study has allowed us to see that the funicular abnormalities impede the smooth running of childbirth. Their occurrence is facilitated by the excess amniotic fluid, prematurity and low birth weight. Their research during prenatal ultrasounds should be systematic

Sexualité des femmes ménopausées en Afrique sub-saharienne: exemple du Sénégal

Introduction: en Afrique, la vie sexuelle après la ménopause reste un domaine mal exploré du fait de son caractère tabou. L'objectif de cette étude était d'apprécier la qualité de la sexualité du couple au cours de la ménopause. Methodes: il s'agissait d'une une enquête transversale concernant un échantillon représentatif de 320 femmes ménopausées. Les critères d'inclusion étaient la ménopause naturelle. N'étaient pas incluses de l'étude les patientes ayant fait l'objet d'une ménopause précoce ou iatrogène. La fiche d'enquête était divisée en 4 chapitres : les caractéristiques socio-culturelles de la femme, les données cliniques, les données psycho-sexuelles et les données thérapeutiques. Nous avons utilisé la comparaison des proportions et le test du Chi 2 avec un seuil de signification inférieur à 0,05. Resultats: l'âge moyen des femmes était de 60 ans. L'âge moyen de survenue de la ménopause était de 48 ans et l'ancienneté de la ménopause était de 11,3 ans. Aucune femme de notre étude n'était épargnée par les manifestations du syndrome climatérique. Les bouffées de chaleur étaient présentes dans 85,9%, la sècheresse vaginale dans 62,8% et les troubles urinaires dans 52,5%. Seules les femmes mariées déclaraient avoir des rapports sexuels avec leurs conjoints (62,1%). Ces rapports sexuels étaient occasionnels dans 68,9% des cas alors que 18,1% des femmes n'avaient plus d'activité sexuelle. La diminution de l'activité sexuelle était due aux troubles de l'érection du conjoint (62% des couples) et au manque de désir sexuel (83,5% des femmes). Une absence d'excitation sexuelle et d'orgasme étaient également retrouvée respectivement dans 92% et 100%. Cependant, 93,5 % des femmes mariées jugeaient supportable leur vécu. Conclusion: le statut marital, la dyspareunie, la sècheresse vaginale et les troubles érectiles du conjoint ont un impact réel sur la sexualité de la femme ménopausée au Sénégal

Unruptured tubal pregnancy in the second trimester

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Uterine ruptures during labor: a study of 26 cases at Nabil Choucair Medical Center, in the suburbs of Dakar

Background: This study aims to clarify the epidemiological profile of patients and describe the diagnostic, therapeutic and prognostic aspects of uterine ruptures at Nabil Choucair Health Center, in the suburbs of Dakar.Methods: This was a retrospective and prospective, descriptive and analytical study conducted over a period of 112 months, from July 31, 2005 and March 31, 2015; it concerned all diagnosed cases with uterine rupture, managed at Nabil Health Center Choucair Dakar. Data were collected from antenatal notebooks, delivery records, surgical reports and anesthetic records. The following parameters were studied: socio-demographic characteristics (frequency, chracteristics of patient), the course of pregnancy, diagnostic, prognostic, and therapeutic aspects. Data analysis was performed using SPSS software (version 11.0).Results: During the study period, we recorded 26 uterine ruptures from a total of 34,097 deliveries, that is a frequency of 8 out of 10,000 births. The epidemiological profile of the patients was that of a 30-year old woman, on average, few previous deliveries with an average parity of 3, who received on average 3 antenatal and evacuated in 50% of cases. Uterine rupture occurred in 17 patients on a new uterus (65, 4%) and in 9 patients on a scarred uterus (34.6%). Two patients (7%) were in hemorrhagic shock. A laparotomy aimed at specifying the place of rupture and making the treatment was performed in all patients. It was 18 uterine segmento-corporeal ruptures (69.2%), 5 segmental ruptures (19.2%) and 2 corporeal ruptures (7.6%). We recorded 9 uterine ruptures with living fetus (38.5%). Twenty-three patients (88.5%) underwent conservative suture against only 3 hemostasis hysterectomy (11.5%). The postoperative courses were uneventful in 57.7% of cases. Eleven patients (42.3%) had anemia and we recorded maternal deaths, which is a maternal mortality of 3.84%.Conclusions: Uterine rupture is a serious complication that is still responsible for significant maternal and fetal mortality. Prevention is based on careful monitoring of pregnancy and delivery

Pseudo tumor tuberculosis of the uterine cervix: about a case at the colposcopy and cervico vaginal pathologies unit of the University hospital Le Dantec, Dakar, Senegal

Tuberculosis is still common in developing countries and particularly in sub-Saharan Africa since the advent of the HIV/AIDS. Genital tuberculosis usually affects young women in genital activity period. The most frequent locations are tubal, endometrial and ovarian. The cervical location is rare. We report on the case of a 36 years old patient with eight pregnancies and eight deliveries who lives in a rural area and has got in her history 8 vaginal deliveries with four living children and 4 dead children and who was referred by a colleague for a "tumor of the uterine cervix". In her medical history, there was a BCG vaccination during childhood and she had never received Pap smear. The colposcopy revealed an ulcerating budding tumor of the cervix with necrotic areas. The colposcopy biopsy revealed fibrocaseous tuberculosis of the uterine cervix. Tuberculosis is still a common disease in developing countries. The cervical localization is rare but should be considered in case of an ulcerating tumor budding of the cervix

Migration of intrauterine device into the pelvic cavity: exploration strategy and management in African environment

IUD migration is a rare complication. We report our experience in the treatment of five cases of uterine perforation and migration of IUDs. The average age of patients was 34.6 years, an average parity was 4. All patients felt an unusual pain during insertion of the IUD Tcu 380A. The location of the IUD was done through ultrasound and hysterography. Removal by laparoscopy was performed in all cases. The immediate impacts of the surgery were simple. Hysterography has its place in the location of the migrated IUD. Prevention is a good IUD insertion technique

Assessment of the quality of the management of childbirth by vaginal delivery in 5 reference maternity clinics in Dakar, Senegal

Background: The current strategy to fight maternal and perinatal mortalities is mainly based on three pillars: family planning, skilled delivery and emergency obstetric and neonatal cares. The objective of the study was to assess the quality of the management of low-risk deliveries in 5 reference maternity clinics in the region of Dakar.             Methods: This is an observation-based multicentric, prospective and descriptive study, carried out over a four-month period, from September 1st to December 31st, 2012, in 5 reference maternity hospitals in the region of Dakar. For each delivery, the focus was put on parturient socio-demographic features, the surveillance techniques of the labour, the handling of the exit and delivery phases, materno-fetal complications but also on the new-born care. To assess the quality of childbirth management, a comparison between the practices was made and observed on the field and the World Health Organization's recommendations which fall into 4 categories (A, B, C and D) depending on the appropriateness or not of their use. For data input and analysis, we used the 13.0 version of the SPSS software. Results: During the study period, 200 childbirths were observed. The epidemiologic profile used for this study was that of a literate woman with a low record of childbirth who was 27 on average with a mean parity of 3. Forty seven percent of childbirth deliveries were observed in Roi Baudouin hospital centre. The A-category recommendations of the World Health Organization, such as the consumption of drinks, mobility during labour, the use of a partograph, the active management of the third stage of labour (AMTSL) and the examination of the placenta were applied in 22.5%, 86.2%, 23.4%, 100% and 23.4% of cases respectively. As for the B-category recommendations, which recommend the removal of those practices deemed harmful such as the back position during labour, the placement of an intravenous line and the oxytocin infusion, they were carried out in 91.84%, 98.08% and 7.28% of cases respectively. C and D categories which deal with non-recommended practices such as the use of abdominal expressions during labour and episiotomy were used in 47.6% and 39.7% of cases respectively.Conclusions: In our study, the most followed A-category recommendations from the WHO are: encouraged mobility, the use of single-use equipment, AMTSL and skin-on-skin contact. However, some B, C and D-category practices are still widely used in our maternity hospitals. The health authorities should make sure that the WHO recommendations are followed