Faktor-faktor yang Berpengaruh pada Loyalitas Pengguna Rawat Inap Rumah Sakit Umum Daerah Kabupaten Buton

Penelitian ini bertujuan untuk mengetahui hubungan antara kualitas layanan,kepuasan pasien, citra rumah sakit dan nilai terhadap loyalitas pasien. Penelitian ini adalahpenelitian kuantitatif dengan desain studi cross-sectional. Populasi dalam penelitian iniadalah Pasien rawat inap RSUD Kabupaaten Buton, sampel berjumlah 67 orang danmerupakan pasien yang telah atau sedang melakukan pengobatan di pelayanan rawat inapRumah Sakit Umum Daerah Kabupaten Buton. Pengumpulan data dengan menggunakankuesioner yang dilakukan selama bulan September-November 2015 di RSUD KabupatenButon Data yang terkumpul dianalisis dengan metode analisis regresi berganda. Hasilpenelitian secara simultan menunjukkan bahwa variabel kualitas pelayanan, kepuasan, citrarumah sakit dan nilai berpengaruh signifikan terhadap loyalitas pasien.dapat diketahui nilaiR2 sebesar 44,6% maka dapat disimpulakan bahwa loyalitas pasien dapat dijelaskan olehkualitas layanan, kepuasan pasien, citra dan nilai, sedangkan sisanya yaitu 55,4% loyalitaspasien dapat dijelaskan oleh variabel-variabel lainnya yang tidak diteliti dalam penelitian ini

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

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%)

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre 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%)

Infections bactériennes néonatales au CHU de Tokoin

(Journal de la Recherche Scientifique de l'Université de Lomé: 2001 5(1): 225-230

Accident paroxytiques revelateurs d'hypertension arterielle chez l'enfant

Aretrospective study of 28 cases of high blood pressure in children, recorded during 18 months in the paediatric ward of the Teaching Hospital of Lomé (Togo), showed that all cases were revealed by hypertensive paroxysmal strokes (HPS). These HPS occurred especially in 10-15 years old children (57%) and with severe high blood pressure. They were predominantly neurological (89%) and haemorrhagic (57%). Most of patient had symptoms few years or months ago, but their blood pressure had never been checked before occurrence of stroke. Death rate during hospitalization was 32% of cases and reached 43% one year after stroke discovery.  The belated diagnosis, the care problems for in patients or outpatients, the lack of systematic checking of blood pressure in children, might explain the revelation of high blood pressure in children through paroxysmal attacks as well as its severe prognosis at HPS stage. Par une étude rétrospective de 28 cas d’hypertension artérielle chez l’enfant, recueillis sur une période de 18 mois dans le service de pédiatrie du Centre hospitalier universitaire de Lomé (Togo), nous avons constaté que tous les cas ont été révélés par des accidents paroxystiques hypertensifs (APH). Ceux-ci ont compliqué, surtout chez l’enfant de 10 à 15 ans, une hypertension artérielle sévère. Il s’agissait essentiellement d’accidents neurologiques (89%) et hémorragiques (57%). La plupart des patients avaient ces signes depuis quelques mois ou années mais n’avaient pas bénéficié d’une mesure de la tension artérielle avant la survenue des APH. Nous avons enregistré neuf décès (32%) durant l’hospitalisation et en tout 12 décès (43%) au bout d’un an de suivi médical après l’APH. Le retard au diagnostic, les problèmes de prise en charge des malades à l’hôpital et hors de l’hôpital, et l’insuffisance de la prise systématique de la tension artérielle au cours de tout examen de l’enfant, expliquent en partie le diagnostic de l’hypertension artérielle par ses accidents paroxystiques et le pronostic sévère de celle-ci

Bilan auditif systematique chez l’enfant en age scolaire interets et limites dans notre pratique (Etude prospective menee sur 100 eleves ages de 8 a 10 ans)

La surdité est une infirmité qui nécessite un dépistage et une prise en charge précoce et adaptée dès le jeune âge afin d’assurer à l’individu une bonne intégration socio-éducative. Si dans les pays développés des structures de dépistage et de prise en charge précoces existent, il n’en est pas de même dans les pays en développement comme le Togo. Il s’agit d’évaluer l’impact de l’état auditif et des conditions socio-économiques des parents sur le cursus scolaire des enfants. L’étude prospective est réalisée du 08-2-2001 au 17-3-2001 chez des élèves âgés de 8 à 10 ans. De cette étude il ressort que : les antécédents otologiques, les pertes auditives supérieures à 20 dB et le bas niveau socio-économique des parents sont des facteurs qui ont un impact négatif sur le cursus scolaire des élèves. Des mesures préventives s’imposent afin d’améliorer la scolarité des élèves, d’autant plus qu’il s’agit d’affections qui dans leur majorité sont curables. Cependant, des moyens d’exploration plus sophistiqués sont nécessaires pour permettre un dépistage plus précoce. Deafness is a disability which necessitates a screening and an early and adapted care from a tender age in order to ensure a good socio-educational integration of the individual. If in the developed countries screening and early care exist, it is not the same in the developing countries like Togo. We evaluate the impact of the auditory condition and the socioeconomic conditions of parents on the schooling of the children.The prospective study is carried out from 8-2-2001 to 17-3-2001 with pupils between the ages of 8 and 10. From this study it stands out that : the otological case history, the intercurrent otological disorder, the auditory loss above 20 dB and the low socioeconomic level of parents are factors which have a negative impact on the schooling of the children. Some preventive measures are called for in order to improve the schooling of the children, especially as these disorders in most cases are curable. However, more sophisticated means of exploration are necessary to allow a very early screenin

Dysgenesie spenique et syndrome d'ivemark

The authors report a Togolese case of splenic dysgenesis associating in a boy aged of 6 years: a splenic hypoplasia, a median and hypertrophic liver, an abdominal aorta and an inferior vena cava all both situated at the right side of the backbone, a dextrocardia by dextroversion, a single auricle and a complete type of endocardial cushion defect. Difficulties of diagnosis and care of that seldom entity are exposed. Les auteurs rapportent l’observation d’un cas de dysgénésie splénique associant chez un garçon de 6 ans : une rate hypoplasique à un foie médian et hypertrophique, une aorte abdominale et une veine caveinférieure situées toutes deux à droite de la colonne vertébrale, une dextrocardie par dextroversion et une oreillette unique avec un canal atrio-ventriculaire complet. Ils exposent les difficultés diagnostiques, et de prise en charge de cette affection rare dans leur service

Lymphome de Burkitt : circonstances de diagnostic dans un centre hospitalier secondaire du Burkina Faso

No Abstract Available J. Rech. Sci. Univ. Lomé (Togo) 2002, 6(2) : 211-21

Enquete sur la prise de la tension arterielle Au cours de l’examen clinique de l’enfant

Ayant constaté, grâce à une étude antérieure, que les cas  d’hypertension artérielle chez l’enfant sont souvent révélés chez la plupart de nos patients par des accidents paroxystiques hypertensifs qui compliquent une hypertension artérielle jusque-là méconnue, nous avons mené une étude prospective sur la prise systématique de la tension artérielle au cours de l’examen clinique de l’enfant. Cette étude a concerné 162 examinateurs d’enfants : médecins, assistants médicaux et infirmiers, dans diverses structures sanitaires. Seuls 24% d’entre eux : 35% des médecins, 20% des assistants médicaux et 18% des infirmiers, possédaient un sphygmomanomètre pédiatrique sur leur lieu de travail. D’entre eux, 83% prenaient la tension artérielle surtout devant des accidents paroxystiques hypertensifs ou des symptômes persistants, mais jamais systématiquement lors de tout examen clinique de l’enfant, comme ils le font chez l’adulte.Le retard au diagnostic, les problèmes de prise en charge des malades à l’hôpital et hors de l’hôpital, et l’insuffisance de la prise systématique de la tension artérielle au cours de tout examen de l’enfant, expliquent en partie le diagnostic de l’hypertension artérielle par ses accidents paroxystiques et le pronostic sévère de celle-ci. A former study showed that about all the cases of high blood pressure in children were revealed by hypertensive paroxysmal strokes (HPS). In most of patients, these HPS complicated a high blood pressure unknown until then. This situation made us carry out a cross-study about systematic checking of blood pressure during any child examination. That study concerned 162 child health practitioners of all grades in various health centres. Only 24% of practitioners: 35% of physicians, 20% of medical assistants and 18% of nurses, had a paediatric sphygmomanometer in their work places and 83% of them took children’s blood pressure during examinations especially in case of attacks or some persistent symptoms, but never systematically as they did during adult examinations. The belated diagnosis, the care problems for in patients or outpatients, the lack of systematic checking of blood pressure in children, might explain the revelation of high blood pressure in children through paroxysmal attacks as well as its severe prognosis at HPS stage