Family And Community Practices Relating To Infant Feeding In Central Togo:A study preceding implementation of the family and community component of the «Integrated Management of Childhood Illness» strategy (C-IMCI).

The aim of this study was to assess neonate and infant feeding practices in the central region of Togo before implementation of the community component of the «Integrated Management of Childhood Illness» (C-IMCI) strategy. It was a cross-sectional study from 29th March to 8th April 2004 and included a random sample of 983 households, 506 caretakers and 733 under-five children. Using the Epi-info and SPSS softwares, this study assessed mainly breast feeding, the use of breast milk substitutesand weaning practices. It was noted that out of the 733 children, 52% were males and 48% females, 27% less than one year and 21.6% between 12 and 23 months. After delivery, 29.3% of infants were breastfed within one hour, and 75.6% within the first 24 hours. Only 78.4% of the children received colostrum after birth. It was also noted insufficient breast milk flow in 53.1% of the mothers and water was the main substitute for breast milk in 21% of the children. If 57.7% of the children were exclusively breastfed for the first 6 months, only 9.5% of the infants were breastfed up to the 23rd month. Complementary foods were introduced at an average age of 6 months with water, pap, «diuri» (a plant decoction), and at an average age of 11 months with other family foods. Altogether,65% of mothers stopped breastfeeding between 18 and 30 months for varying reasons : 7% because of pregnancy, 6% due to insufficient breast milk flow, 3% professional constraints and 3% death. From this study we recommend that sustained efforts have to be made on the sensitization of mothers during C-IMCI implementation on cultural practices that do not support optimal feeding of the neonate and young infant

Les valvulopathies cardiaques en milieu hospitalier à Lomé (Togo)

Introduction: notre étude a consisté en l'identification les principales valvulopathies retrouvées en milieu hospitalier à Lomé (Togo).Méthodes: il s'agit d'une étude rétrospective, transversale, multicentrique menée du 1er janvier 2006 au 31 décembre 2010 et portant sur lesdossiers de patients suivis dans le service de cardiologie du CHU Campus de Lomé. Résultats: du 1er janvier 2006 au 31 Décembre 2010,5412 patients ont été consulté dans le service de cardiologie du CHU Campus. Parmi eux, 241 (4,45%) présentaient une valvulopathie. On notait une prédominance féminine avec un sex-ratio H/F à 0,60. La moyenne d'âge était de 62,32 ans avec des extrêmes allant de 16 à 89 ans et un écart type de 14,27. Les antécédents le plus souvent retrouvés étaient l'hypertension artérielle (26,97%) et le diabète (8,29%). Parmi les motifs de consultations, les plus fréquents étaient la dyspnée (39,00%), les précordialgies (32,78%) et les palpitations (21,16%).A l'examen physique 30,70% des patients  présentaient des signes de d'insuffisance cardiaque. A l'échographie, on notait des atteintes d'une seule valve (77,17%), de 02 valves (17,42%) ou 03 valves (5,4%). L'insuffisance mitrale (56,84%) et l'insuffisance aortique (30,70%) ont été les valvulopathies les plus fréquemment retrouvées. La maladie mitrale a été notée chez 05 patients. Les principales étiologies étaient dégénératives et ischémiques.Conclusion: les valvulopathies sont relativement fréquentes à Lomé.  L'insuffisance cardiaque est leur principal mode de révélation. Les plusretrouvées sont l'insuffisance mitrale et aortique

Rearward visibility assessment and a proposed performance scoring for ASEAN NCAP

Asia has the highest number of registered motorcycles globally and the recent data has shown that motorcycles fatalities has been the major accident and death cases in ASEAN Region. One of the major concerns is the visibility of motorcycles to other vehicles on the road. Thus, in this project, ECE R46 and FMVSS regulations have been referred as the base guidelines to establish a novel test protocols for vehicles rearward visibility assessment. Sixteen cars have been benchmarked and analysed in term of their rear-view mirror (Class I) and external mirror (Class III) performance. Motorcycles visibility to the vehicles’ Class I and Class III mirrors also been assessed by converting the measured data into number of motorcycles based on its width. A proposed performance scoring system for ASEAN NCAP has been developed based on that to address the Motorcycle Safety pillar

Etude de l’anémie chez les enfants séropositifs au VIH naïfs au traitement antirétroviral à Lubumbashi, République Démocratique du Congo

Introduction: Beaucoup d'enfants infectés par le VIH arrivent à la consultation dans un état d'anémie.  Notre objectif était d'évaluer la prévalence et le typage de l'anémie chez ces enfants.Méthodes: C'est une étude transversale réalisée dans 3 centres de prise en charge des Personnes Vivant avec le VIH à Lubumbashi de Mai 2010 à Mai 2011. La population d'étude était de 152 enfants, âgés de 6 à 180 mois, naïfs au traitement antirétroviral. Les statistiques descriptives usuelles ont été utilisées. Résultats: La prévalence globale de l'anémie (définie comme l'hémoglobine < 11g/dl) était de 69,1% (n=105) et 11,4% avaient une anémie sévère (Hg < 7,0 g/dl). Parmi eux, 16% ont été transfusés au moins 1 fois. L'anémie sévère était positivement associée au stade clinique de la maladie (p=0,02). L'anémie microcytaire était majoritaire dans les deux tranches d'âge. Elle était plus hypochrome chez les enfants en âge préscolaire soit 9,5% et plus normochrome en âge scolaire soit 15,2%. L'anémie  normocytaire était plus normochrome dans les deux tranches d'âge soit 12,4% en âge préscolaire et 6,7% en âge scolaire. L'anémie macrocytaire était rare.Conclusion: Environ sept enfants sur dix, âgés de moins de 15 ans infectés par le VIH naïfs au traitement antirétroviral dans notre milieu sont  anémiques. L'anémie est corrélée à la sévérité de la maladie. Il est important d'associer une prise en charge nutritionnelle et corriger l'anémie avant une trithérapie antirétrovirale.Key words: Anémie, enfants séropositifs au VIH/SIDA, Lubumbashi, RD Cong

REARWARD VISIBILITY ASSESSMENT FOR SELECTED PASSENGER IN ASEAN COUNTRIES

ASEAN region consists of the greatest number of motorcycle-related accidents with severe and fatal casualties in Asia. Limited or blocked rearward visibility of vehicles has long been viewed as one of the causes of motorcycle accident. In this study, the rearward visibility of sixteen passenger vehicles have been assessed and analyzed using a new assessment based on some aspects of ECE46 and FMVSS III international protocols for Class I (internal rearview mirror) and Class III (side-view mirror). A novel scoring system based on the average width of underbone-type motorcycles in Malaysia and Indonesia is proposed to highlight the importance of rearward visibility towards the conspicuity of motorcycles. The results of the assessment show that there are two distinct vehicle groups in terms of rearward visibility: pick-up trucks and non-pickup vehicles. Pick-up trucks tend to have more prominent rearward visibility for CLASS I and III due to its bigger mirror, windscreen and body structure

Left atrial giant thrombus infected by Escherichia Coli. Case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients’ (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16–22) and failed intubation in 1 in 312 (95%CI 1 in 169–667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)