QUEUING CHARACTERISTICS OF THE DENTAL DEPARTMENT AT ESSIKADO HOSPITAL

In this paper, the queuing characteristics at the dental department of Essikado Hospital in the Sekondi-Takoradi Metropolis was analysed using a Single-server queuing Model. The data was collected over a period of one week, from 8:30am-11:30 am each day. By using the queuing rule First-come, First-served as practiced by the case study and M/M/s queuing model, the performance measures were calculated. The average/mean arrival and mean service times were found to be 1.6 patients/hour and 4.4477 patients/hour respectively. The average number of patients in the system and in the queue was 0.5619 patients and 0.2021 patients respectively. Also, the average time spent in the system and the average time it takes for service to start was 0.3512 hours and 0.1263 hours respectively. The paper recommends the need to obtain a central tray setup system for instruments required for the different dental procedures so as to reduce the time spent in sorting them up thereby reducing the amount of time spent in queue.  It also respectfully submits a suggestion on the need to increase the number of dentist from one to two. Keywords: Essikado Hospital; Queuing characteristics; First-come, First- served; Single-server Model; Utilization Factor; M/M/s Queuing Model; Mean Arrival Rate; and mean Service Rates

Aspects Épidémiologiques, Diagnostiques Et Thérapeutiques Des Traumatismes Abdominaux À Bembéréké-Nord Bénin

Objective: describe the epidemiological, diagnostic aspects and therapeutic approaches at Bembereke in northern Benin. Patients and methods: all victims of abdominal trauma received in the department of surgery between 1 st January 2010 and 30 July 2013 and with complete records were included in this retrospective study. Results: The abdominal trauma accounted for 1.1% of hospitalization and 10% of abdominal emergencies. The average age of patients was 28.04 ± 22.25 years with extremes of 02 and 67 years. The sex ratio equaled to 7.17. Half of the patients were children under 15 years. The first three circumstances abdominal trauma was road traffic accidents 31 (31.63%) cases, animal aggression 27 (27.55%) cases and falls from a tree 14 (14,29%) cases. Contusions were found in 73 (74.50%) cases and wounds in 25 (25.50%) cases. Fifty four (55.10%) laparotomy were performed. The rate of white laparotomy is 5.55% with 3 cases. The spleen was the most affected organ (15%) followed by small bowel (13%). Morbidity was 8.16% dominated by parietal suppuration. The rate of mortality was 2.04%. Mean hospital stay was 10.7 days. Conclusion: abdominal trauma interested young adult male in northern Benin. Road traffic accidents and animal injuries were the leading cause

Facteurs prédictifs de succès des étudiants en première année de médecine à l’université de Parakou

Introduction: Plusieurs facteurs dont les notes obtenues au BAC peuvent influencer les performances académiques des étudiants en première année de médecine. L'objectif de cette étude était d'évaluer la relation entre les résultats des étudiants au BAC et le succès en première année de médecine. Méthodes: Nous avons réalisé une étude analytique ayant inclus l'ensemble des étudiants régulièrement inscrits en première année à la Faculté de Médecine de l'université de Parakou durant l'année académique 2010-2011. Les données concernant les notes par discipline et mention obtenue au BAC ont été collectées. Une analyse multivariée utilisant la régression logistique et la régression linéaire multiple a permis d'établir les meilleurs prédicteurs du succès et de la moyenne de l'étudiant en fin d'année. Le logiciel SPSS version 17.0 a été utilisé pour l'analyse des données et un p<0,05 a été considéré comme statistiquement significatif. Résultats: Parmi les 414 étudiants régulièrement inscrits les données de 407 ont pu être exploitées. Ils étaient âgés de 15 à 31 ans; 262 (64,4%) étaient de sexe masculin. 98 étaient admis avec un taux de succès de 23,7%. Le sexe masculin, la note obtenue en mathématiques, en sciences physiques, la moyenne au BAC et la mention étaient associés au succès en fin d'année mais en analyse multivariée seule une note en sciences physiques > 15/20 était associée au succès (OR: 2,8 [1,32-6,00]). Pour la moyenne générale obtenue en fin d'année seule une mention bien obtenue au BAC était associée (coefficient de l'erreur standard: 0,130 Bêta =0,370 et p=0,00001). Conclusion: Les meilleurs prédicateurs du succès en première année étaient une bonne moyenne en sciences physiques au BAC et une mention bien. La prise en compte de ces éléments dans le recrutement des étudiants en première année pourrait améliorer les résultats académiques.Pan African Medical Journal 2016; 2

Epidemiological aspects of surgical site infections in an income country. The case of regional hospital center, Borgou (Benin)

ABSTRACT Background: Surgical site infection is frustrating for the care team and depressing for the patient. Objective: To determine the epidemiological aspects of surgical site infections in regional hospital, Borgou. Methods: The study was crossed with prospective data collection. Recruitment was done for six months (from February 2013 to July 2013), each patient operated in both surgical services (general surgery and maternity) consents to be followed for one month or year. The surgical site infection was defined according to the CDC/NHSN 2009. Results: The frequency of surgical site infections was 7.3% (44/603). The mean age was 30.7 ± 15.8 years with minimum and maximum of 5 months and 70 years, respectively. They were significantly (p<0.05) more common in general surgery than that of maternity and visceral surgery and obstetrics were more concerned (14/44 each); the median time to SSI onset was 7.8 ± 3.8 days. The deep incisional infection was the most frequent (34/44). The most encountered organism was Escherichia coli (64.7%); multidrug resistance was 41.2%. The healing time averaged 30.5 ± 13.8 days with minimum and maximum of 20 and 92 days. Conclusion: Monitoring measures must be taken to reduce surgical site infection at the Regional Hospital Centre of Borgou.Background: Surgical site infection is frustrating for the care team and depressing for the patient. Objective: To determine the epidemiological aspects of surgical site infections in regional hospital, Borgou. Methods: The study was crossed with prospective data collection. Recruitment was done for six months (from February 2013 to July 2013), each patient operated in both surgical services (general surgery and maternity) consents to be followed for one month or year. The surgical site infection was defined according to the CDC/NHSN 2009. Results: The frequency of surgical site infections was 7.3% (44/603). The mean age was 30.7 ± 15.8 years with minimum and maximum of 5 months and 70 years, respectively. They were significantly (p<0.05) more common in general surgery than that of maternity and visceral surgery and obstetrics were more concerned (14/44 each); the median time to SSI onset was 7.8 ± 3.8 days. The deep incisional infection was the most frequent (34/44). The most encountered organism was Escherichia coli (64.7%); multidrug resistance was 41.2%. The healing time averaged 30.5 ± 13.8 days with minimum and maximum of 20 and 92 days. Conclusion: Monitoring measures must be taken to reduce surgical site infection at the Regional Hospital Centre of Borgou

Kyste De L’ouraque Infecte : A Propos De Trois Cas Cliniques Au Chu De Parakou Au Benin

Bacground: The urachus is a fibrous remnant of the allantois. That connects the bladder dome to the anterior abdominal wall. After birth it is obliterated in general. In some cases it may persist as cyst , fistula , sinus or diverticulum. This persistence of the urachus often is signaled by a complication. Infection is the most common complication and the most dangerous is his degeneration. The infection can be misunderstood and confused with other pathologies of the navel. Methods: Our study reports three clinical cases of infected urachal cyst. Result: these report cases illustrate the need to think of this diagnosis before the painful of the navel and abdomen. The ultrasound examination can help for the diagnosis

Composition en chlorure de sodium des produits panifiés commercialisés dans la commune de Kara (Togo)

Knowledge about the salt content of foods is necessary to help reduce salt consumption. The objective of this study is to determine the dietary salt (NaCl) content of bread products and to assess the level of knowledge of bakers on the role of salt in diseases related to its excessive consumption and preventive measures. The salt assay was carried out on 50 samples of bread products. The silver titration method is used for the determination of salt in bread. Direct interview is used to collect information from bakers. According to 66.7% of respondents, salt plays the role of flavour in bread. They stated that excessive consumption of cooking salt would be the cause of certain diseases such as hypertension. The salt content of the bread samples ranged from 0.21 ± 0.01 g (0.21%) to 2.21 ± 0.01 g per 100 g (2.21%) with an average content of 0.95 ± 0.42 g per 100 g. Given the role of bread in the daily diet, efforts should be made to reduce the salt content of bread. Reducing the salt content of bread products would contribute to reducing the risk of cardiovascular disease. Keywords: bread, salt content, cardio-vascular diseasesLa connaissance sur la composition en sel des aliments est nécessaire pour contribuer à la réduction de la consommation de ce dernier. L’objectif de cette étude est de déterminer la teneur en sel alimentaire (NaCl) des produits panifiés et d’évaluer le niveau de connaissance des boulangers sur le rôle du sel et les maladies liées à sa consommation excessive. Le dosage du sel a porté sur 50 échantillons de produits panifiés. La méthode de titrage argentométrique est utilisée pour le dosage du sel dans le pain. L'entretien par interview directe est utilisé pour collecter les informations auprès de boulangers. Selon 66,7% des enquêtés, le sel joue le rôle de saveur dans le pain. Ils ont affirmé que la consommation excessive du sel de cuisine serait à l’origine de certaines maladies comme l’hypertension. La teneur en sel des échantillons de pain a variée de 0,21 ± 0,01 g (0,21%) à 2,21 ±0,01 g pour 100 g (2,21%) avec une teneur moyenne de 0,95 ± 0,42 g pour 100 g. Au regard du rôle que joue le pain dans l’alimentation quotidienne, il convient d’œuvrer pour la réduction de la teneur en sel du pain. La réduction de la teneur en sel des produits panifiés contribuerait à la réduction des risques de maladies cardiovasculaires. Mots clés: pain, teneur en sel, maladies cardio-vasculaire

RISK FACTORS OF SURGICAL SITE INFECTION AT THE REGIONAL AND TEACHING HOSPITAL CENTER OF BORGOU (BENIN)

Introduction: The reduction of the SSI rate requires knowledge of its risk factors. Objective: To analyze the risk factors of SSI occurrence at CHD-B Methods: Prospective, descriptive and analytical study involving 603 patients undergoing general surgery (218) and obstetrics and gynecology (385) from 1st&nbsp;January to 31st&nbsp;July 2013. Results: 44 patients have developed SSI (7.3%). The SSI frequency was 12.8% in general surgery and 4.2% in gynecology-obstetrics (p significant). The mean age of patients developing SSI was 30.7 ± 15.8 years with a minimum and maximum 5 months and 70 years, respectively; and for general surgery patients, there were 23 men and 5 women (p not significant). The presence of preoperative infectious spot at admission (P = 0.003), the preoperative shaving of the site to be incised (p = 0.000), the ASA score (p = 0.000), the surgery contamination class (p = 0.000), and the NNIS score (p = 0.000) were all significantly related to SSI occurrence. Considering all these factors, the NNIS score ≥2 remained the predictive tool by multiplying by 3.4 the risk of SSI occurrence. Conclusion: NNIS score is the best SSI prediction tool at CHD-B. KEYWORDS: Surgical site infection; Risk factor; NNIS score

RISK FACTORS OF SURGICAL SITE INFECTION AT THE REGIONAL AND TEACHING HOSPITAL CENTER OF BORGOU (BENIN)

Introduction: The reduction of the SSI rate requires knowledge of its risk factors. Objective: To analyze the risk factors of SSI occurrence at CHD-B Methods: Prospective, descriptive and analytical study involving 603 patients undergoing general surgery (218) and obstetrics and gynecology (385) from 1st&nbsp;January to 31st&nbsp;July 2013. Results: 44 patients have developed SSI (7.3%). The SSI frequency was 12.8% in general surgery and 4.2% in gynecology-obstetrics (p significant). The mean age of patients developing SSI was 30.7 ± 15.8 years with a minimum and maximum 5 months and 70 years, respectively; and for general surgery patients, there were 23 men and 5 women (p not significant). The presence of preoperative infectious spot at admission (P = 0.003), the preoperative shaving of the site to be incised (p = 0.000), the ASA score (p = 0.000), the surgery contamination class (p = 0.000), and the NNIS score (p = 0.000) were all significantly related to SSI occurrence. Considering all these factors, the NNIS score ≥2 remained the predictive tool by multiplying by 3.4 the risk of SSI occurrence. Conclusion: NNIS score is the best SSI prediction tool at CHD-B. KEYWORDS: Surgical site infection; Risk factor; NNIS score

Aspects Bacteriologiques Des Infections Du Site Operatoire Au Centre Hospitalier Departemental Du Borgou A Parakou (Benin)

Objective : Describe the bacteriological aspects of surgical site infections (SSI) at the regional hospital centre Borgou. Methods : From a descriptive, prospective study from february 2013 to july 2014, about 603 patients operated during the recrutment period(six mounths), the bacteriological data of 44 cases of SSI diagnosed according to the criteria CDC/NHSN have been analysed. Results : The frequency of SSI was 7.3% of the operated (44/603). The superficial incisional infections were 6, the deep infections were 34 and the organ infections or infections of space were 4. The sampling culture of the liquid was negative with 12 cases (27.3%) and positive with 32 cases (72.7%). Two germs were isolated in two cases. The negative Gram germs were the most isolated with 22 cases (64.7%) of Escherichia coli. The multiresistance was noted with 14 cases out of 34 (41.2%). Conclusion : The negative Gram germs were those which predominate in the infections of the operating site at the regional hospital center Borgou. The high rate of resistance to usual antibiotics must raise preventive and hard actions in order to inflect the graph of frequency and protect the antibiotics

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London