PENGARUH PERSEPSI PASIEN TENTANG KUALITAS PELAYANAN RAWAT INAP TERHADAP IMAGE DI RUMAH SAKIT UNIVERSITAS HASANUDDIN TAHUN 2013

Penelitian ini berangkat dari identifikasi masalah yang menunjukkan persepsi masyarakat tentang Rumah Sakit Pendidikan serta survei kepuasan pasien rawat inap yang fluktuatif, yang kemudian dianalisis melalui kualitas pelayanan. Pertanyaan penelitian ini adalah bagaimana pengaruh kualitas pelayanan yang dilihat dari dimensi professionalism and skills, attitudes and behavior, reliability and trustworthiness, accessibility and flexibility, service recovery dan serviscape terhadap image di Rumah Sakit Universitas Hasanuddin. Jenis penelitian ini adalah penelitian kuantitatif dengan menggunakan metode cross sectional. Teknik pengambilan sampel mengunakan stratified random sampling. Responden dari penelitian ini berjumlah 110 responden, dimana responden adalah pasien rawat inap di Rumah Sakit Universitas Hasanuddin. Alat analisa data yang digunakan adalah program SPSS 20.0 Hasil penelitian ini menunjukkan bahwa professionalism and skills, attitudes and behavior, accessibility and flexibility, service recovery dan serviscape berpengaruh positif secara signifikan terhadap image. Variabel reliability and trustworthiness tidak berpengaruh positif secara signifikan terhadap image. Hasil penelitian juga menunjukkan bahwa jika variabel diuji secara simultan, kualitas pelayanan akan berpengaruh signifikan terhadap image. Tetapi jika diuji secara parsial, reliability and trustworthiness tidak memiliki pengaruh terhadap image. Disarankan kepada pihak Rumah Sakit Universitas Hasanuddin sebaiknya tetap mempertahankan serta meningkatkan kualitas pelayanan agar tetap memiliki kesan atau image yang baik di mata masyarakat

Aspects Histo-Epidemiologiques Des Cancers Solides Du Rein De L’enfant En Cote D’ivoire

Objectifs: A partir d’une étude rétrospective transversale, les auteurs  rapportent 34 cas de cancer du rein histologiquement confirmés chez l’enfant de moins de 16 ans, observés dans les services d’Anatomie Pathologique des centres hospitaliers et universitaires d’Abidjan (République de Côte d’Ivoire) au cours de la période allant de janvier 1984 à décembre 2007e.Patients et méthodes: Le matériel d’étude était constitué de pièce de  néphrectomie. Après fixation dans le formol à 10%, les prélèvements ont été inclus en paraffine et coloré à l’hématéine éosine.Résultats: Le cancer du rein de l’enfant représentait 0.28% de l’ensemble des cancers. Il y avait 18 garçons (52.94%) et 16 filles (47.06%). L’âge moyen était de 4.88 ans. Au plan histologique nous avons observé 31 cas de néphroblastome (91.18%), 2 cas de lymphome de Burkitt (5.88%) et 1 cas de carcinome à cellule rénale (2.94%).Conclusion: Les cancers solides du rein de l’enfant sont dominés par le néphroblastome

Epidemiological and Pathological Aspects of Cervical Cancer in Ivory Coast

Abstract: Cervical cancer is the most common and the leading cause of women death in developing countries. Purpose: To specify the epidemiological and pathological characteristics of cervical cancers in Ivory Coast. Material and methods: This was a retrospective and descriptive study on the cervical cancers histologically confirmed and identified from the registers for recording laboratory of pathological anatomy of Abidjan teaching hospital. The study period was 24 years (January 1984 to December 2007). The parameters analyzed were: frequency, age, sociodemographic status, macroscopic and histological aspects and the prognosis. Results: The cervical cancer represented 78.78% (2064 cases) of gynecological cancers, 42.71% of woman cancer and 17.41% of all cancers. The average age was 48.36 years ranging from 2 to 88 years and a peak incidence between 45-54 years (29%). Multiparity was observed 57.04% (n = 231) and the low socioeconomic level was predominant (70.41%). Concerning pathological examination, the tumor lesions were predominantly budding (51.52%). Squamous cell carcinomas (92.88%) were the most frequent of histological types with 95.1% (n = 1823) of invasive carcinomas. The average age of patients with squamous cell carcinoma was 49 years with 41.5 years for intraepithelial carcinomas and 46.8 years for invasive carcinomas. At the prognosis, squamous cell carcinomas were diagnosed most often in stage pT2 (57.41%) and with extra-cervical represented 66.4% (n = 519). Conclusion: Cervical cancer is the most common cancer in Ivory Coast taking into account male and female together. Its poor prognosis associated with late diagnosis should encourage the establishment of a cytology screening program

A Comparative Pharmacokinetics Study of the Anti-Parkinsonian Drug Pramipexole

The present study aimed to compare pharmacokinetic parameters of two pramipexole 0.25 mg formulations in order to show bioequivalence. The study was conducted in a randomized, open-label, two-period, two-sequence, and crossover design, involving 23 healthy volunteers. One of the 0.25 mg formulations of pramipexole evaluated in the study was manufactured by PT Dexa Medica, Palembang, Indonesia, the other, used as the reference, by Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany. All eligible subjects were required to fast before each drug administration period, which was separated by a one-week washout period. Pramipexole concentrations in plasma were assayed using a validated ultra performance liquid chromatography with mass spectrometry (UPLC-MS/MS) detector. The evaluated pharmacokinetic parameters included the area under the plasma concentration curve from time zero to the last observed measurable concentration (AUC0-t), the area under the plasma concentration curve extrapolated to infinite time (AUC0-∞), the maximum plasma concentration (Cmax), the time to reach Cmax (tmax), and the plasma concentration half-life (t1/2). To evaluate the bioequivalence of those two pramipexole formulations, 90% confidence intervals (CIs) for geometric mean ratios of both formulations were calculated for AUC and Cmax parameters, while tmax and t1/2 differences were analyzed on the non-transformed data using Wilcoxon matched-pairs and a Student’s paired t-test, respectively. The 90% CIs for the geometric mean ratios of the two pramipexole formulations were 95.89% (90.73%–101.34%), 95.53% (89.75%–101.68%), and 92.11% (84.35%–100.58%) for AUC0-t, AUC0-∞, and Cmax, respectively. There were no statistically significant differences for tmax and t1/2 between the two pramipexole formulations. It is concluded that two pramipexole formulations in this study were bioequivalent

Risk factors for cervical intraepithelial neoplasia in HIV-infected women on antiretroviral treatment in Côte d'Ivoire, West Africa.

Facing the dual burden of invasive cervical cancer and HIV in sub-Saharan Africa, the identification of preventable determinants of Cervical Intraepithelial Neoplasia (CIN) in HIV-infected women is of paramount importance.A cervical cancer screening based on visual inspection methods was proposed to HIV-infected women in care in Abidjan, Côte d'Ivoire. Positively screened women were referred for a colposcopy to a gynaecologist who performed directed biopsies.Of the 2,998 HIV-infected women enrolled, 132 (4.4%) CIN of any grade (CIN+) were identified. Women had been followed-up for a median duration of three years [IQR: 1-5] and 76% were on antiretroviral treatment (ART). Their median most recent CD4 count was 452 [IQR: 301-621] cells/mm3. In multivariate analysis, CIN+ was associated with a most recent CD4 count >350 cells/mm3 (OR: 0.3; 95% CI: 0.2-0.6) or ≥200-350 cells/mm3 (OR 0.6; 95% CI 0.4-1.0) (Ref: <200 cells/mm3 CD4) (p<10-4).The presence of CIN+ is less common among HIV-infected women with limited or no immune deficiency. Despite the potential impact of immunological recovery on the reduction of premalignant cervical lesions through the use of ART, cervical cancer prevention, including screening and vaccination remains a priority in West Africa while ART is rolled-out

Cervical cancer screening by visual inspection in Côte d'Ivoire, operational and clinical aspects according to HIV status

<p>Abstract</p> <p>Background</p> <p>Cervical cancer screening is not yet standard of care of women attending HIV care clinics in Africa and presents operational challenges that need to be addressed.</p> <p>Methods</p> <p>A cervical cancer screening program based on visual inspection methods was conducted in clinics providing antiretroviral treatment (ART) in Abidjan, Côte d'Ivoire. An itinerant team of midwives was in charge of proposing cervical cancer screening to all HIV-positive women enrolled in ART clinics as well as to HIV-negative women who were attending the Abidjan national blood donor clinic. Positively screened women were systematically referred to a colposcopic examination. A phone-based tracking procedure was implemented to reach positively screened women who did not attend the medical consultation. The association between HIV status and cervical cancer screening outcomes was estimated using a multivariate logistic model.</p> <p>Results</p> <p>The frequency of positive visual inspection was 9.0% (95% CI 8.0-10.0) in the 2,998 HIV-positive women and 3.9% (95% CI 2.7-5.1) in the 1,047 HIV-negative ones (<it>p </it>< 10^-4). In multivariate analysis, HIV infection was associated with a higher risk of positive visual inspection [OR = 2.28 (95% CI 1.61-3.23)] as well as more extensive lesions involving the endocervical canal [OR = 2.42 (95% CI 1.15-5.08)]. The use of a phone-based tracking procedure enabled a significant reduction of women not attending medical consultation after initial positive screening from 36.5% to 19.8% (<it>p </it>< 10^-4).</p> <p>Conclusion</p> <p>The higher frequency of positive visual inspection among HIV-positive women supports the need to extend cervical cancer screening program to all HIV clinics in West Africa. Women loss to follow-up after being positively screened is a major concern in cervical screening programs but yet, partly amenable to a phone tracking procedure.</p