Prevalence and characteristics of accidental perineal tears during childbirth in a communal medical center in Guinea-Conakry: a cross-sectional study

Background: Prevalence studies are still rare in sub-Saharan Africa on perineal tears. We conducted this cross-sectional study in a communal hospital in Guinea-Conakry, with the objective of this study was to determining the prevalence and characteristics of post-obstetric perineal lesions.Methods: All deliveries between March 1st and August 31st, 2014 were reviewed. We included in the analysis all the single deliveries with perineal tears. The Anglo-Saxon classification of perineal tears was used.Results: The prevalence of perineal tears was 5.7% with 5.4% benign lesions and 0.3% severe lesions. We did not register 4th degree lesions. The average age of parturient was 22 years. The majority (96.6%) of parturient had a history of genital mutilation and perineal scarring (60.3%).Conclusions: This prevalence appear low compared to those reported in other studies in Africa and point to the need for more sophisticated studies to have a better estimate of the prevalence of perineal tears in Guinea-Conakry

Management of pre-eclampsia and its complications in the department of gynecology and obstetrics at Donka national hospital Conakry, Guinea

Background: Vascular-renal syndrome, also known as pre-eclampsia, is a condition specific to pregnancy, usually occurring in the last trimester of pregnancy. Pregnant women are sometimes at risk of unpredictable obstetrical complications such as: hemorrhage, kidney failure, HELLP syndrome, sometimes even brain damage requiring prompt care and multidisciplinary collaboration. Vascular-renal syndromes are the third leading cause of maternal death and also the world's leading cause of perinatal death. Objectives of this study were to analyse the management of vascular-renal syndromes. Calculate their frequency, describe the sociodemographic characteristics of patients, describe the clinical and biological signs of patients, evaluate the maternal-fetal prognosis.Methods: The study was conducted in the department of obstetrics and gynecology of Donka National Hospital. It was a prospective, descriptive, cross-sectional, 6-month study from March 1st to August 31st, 2015, of pregnant women with pre-eclampsia.Results: The study included 217 cases of pre-eclampsia out of a total of 3054 patients, i.e. a proportion of 7.10%. The proportion of pre-eclampsia was high in patients aged between 15 and 19 years, housewife, married, primary. The predisposing factors were primigestitis, obesity and twinkling. The clinic was dominated by headaches and visual disturbances. Severe preeclampsia in 78.49%, eclampsia in 21.65% or simple hypertension in 1.75%. Maternal and fetal complications were dominated by eclampsia 26.26%, PPH (2.63%), eclamptic coma (0.46%), acute fetal distress 27.19%, and fetal death in utero (11.40%). In order to improve maternal and fetal prognosis it is necessary to provide multidisciplinary care, which unfortunately is not always available in our context.Conclusions: Obstetric emergency is a frequent situation for which a better management would improve the maternal-fetal prognosis

Renew the bands Green Isac and Green Isac Orhestra’s digital platforms to bring forth greater interest in their music

Vår oppgave har gått ut på å designe to nye nettsider for de to musikkbandene “Green Isac Orchestra” og “Green Isac”. Målet var å lage to nettsider som reflekterte musikken deres godt, og fremme musikken deres slik at den kan nå ut til flere. For å nå disse målene har vi tatt i bruk Scrum som arbeidsmetodikk. Denne smidige arbeidsmetodikken startet tregt grunnet mindre erfaring, men ble etterhvert godt implementert som metode. Sluttresultatet vårt består av en fornyet side for hvert band, hvor resultatet er tilsvarende likt det oppdragsgiver ønsket seg og matcher de målene vi har satt oss

Effect of premature rupture of membranes on the maternal and fetal prognosis during childbirth at the gynecology-obstetrics department of the Matam Communal Medical Center, Conakry, Guinea

Background: Premature rupture of membranes (RPM) is defined by rupture of the amnion and chorion before entering labor within 24 hours leading to vaginal discharge of amniotic fluid without uterine contractions. Objective of this study was to improving the management of premature Ruptures of the membranes received in the service.Methods: This was a descriptive and analytical prospective study lasting six months from January 1 to June 30 2016.Results: During the study period, we collected 108 cases of RPM out of 1543 deliveries, representing a hospital frequency of 7%. RPM had more frequently concerned pregnant women aged 25-29 (37.04%), housewife (37.03%), primiparous (45.37%) and referral (52.78%). 95.37% were single pregnancies with cephalic presentation (80%) received between 37-42 weeks (84.26%). Management mainly consisted of antibiotic prophylaxis (100%), fetal pulmonary maturation and childbirth. The vagina was the main mode of delivery (62.04%). The maternal prognosis was dominated by chorioamnionitis (12.96%). The fetal one was made up of respiratory distress (40.71%) and prematurity (12.39%).Conclusions: RPM is frequent at the Matam municipal medical center. It is essential for its prevention to ensure health education of the population in general and genital hygiene in particular, to make a coherent prenatal follow-up while putting a particular accent on the detection and the treatment of genital infections

Resurgence of Ebola Virus Disease in Guinea Linked to a Survivor With Virus Persistence in Seminal Fluid for More Than 500 Days.

We report on an Ebola virus disease (EVD) survivor who showed Ebola virus in seminal fluid 531 days after onset of disease. The persisting virus was sexually transmitted in February 2016, about 470 days after onset of symptoms, and caused a new cluster of EVD in Guinea and Liberia

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Perception du vaccin anti-Covid 19 chez les migrants à Cherbourg

Context.The Covid 19 epidemic has caused a higher mortality rate among the migrant population, which is precarious in health and social terms. Low vaccination coverage was observed in this community when it was more than necessary to stem the epidemic and protect them from severe expressions of covid. This population is known for its distrust and lack of access to information. We wanted to collect the perception of the Covid vaccine among the migrant population in Cherbourg in order to identify obstacles that could explain these anti-Covid 19 vaccine barriers.Method.This is a qualitative study by semi-directed interviews with a diverse population of migrants followed at the Cherbourg reception and asylum center (CADA) but also outside, carried out in the premises of the CADA and of the PASS (permanence of access to health care) of the Pasteur Hospital of Cherbourg. We used an interview guide containing open-ended questions until the data was saturated, then we proceeded to an analysis of the data with triangulation. We are inspired by grounded theory and use the COREQ grid for a quality study.Results.We conducted 12 interviews between February and April 2022; the participants expressed different perceptions according to their experience of Covid, their experience of confinement, their state of health prior to Covid, their confidence in the health system and in research experts.The migrants interviewed for the most part expressed an initial fear at the arrival of the anti-Covid 19 vaccine, which faded with the information, the reassurance of social support workers, health professionals and the effect of theentourage already vaccinated. but they still remain worried about the future side effects of the anti-Covid vaccine.The targeted reluctance of migrants concerned a feeling of persecution impacting their relationship to the anti-Covid vaccine, reassured later by the extension of the anti-Covid vaccine to the general population.Reluctance to the anti-Covid vaccine was similar to that of the general population and concerned the side effects of the vaccine, vaccine reminders, the proliferation of vaccine brands, and rumors spread on social networks. Most of our studied population was vaccinated by force at the establishment of the health pass. The experience of confinement, the precariousness of this population were also factors influencing their perception of the anti-Covid vaccine.Conclusion.Our study aimed to provide elements to better understand the expectations of this population and improve their primary health status. According to our results, the environment, medical follow-up, mode of information, health and social support play a crucial role in the perception of anti-covid19 vaccination. It is therefore essential to reassure and provide targeted information tools.Contexte : l’épidémie du Covid 19 a provoqué un taux de mortalité plus élevé chez la population migrante, précaire sur le plan sanitaire et social. Une faible couverture vaccinale a été constatée chez cette communauté alors qu’elle était plus que nécessaire pour endiguer l’épidémie et les protéger des expressions sévères du covid. Cette population est connue pour sa méfiance et son manque d’accès aux informations. Nous avons voulu recueillir la perception du vaccin du Covid chez la population migrante à Cherbourg afin d’identifier des freins qui pourraient expliquer ces barrières vaccinales anti-Covid 19. Méthode : il s’agit d’une étude qualitative par entretiens semi dirigés auprès d'une population diversifiée de migrants suivis au centre d’accueil et de demande d’asile de Cherbourg (CADA) mais aussi en dehors, réalisés dans les locaux du CADA et de la PASS (permanence d’accès aux soins de santé) de l’hôpital pasteur de Cherbourg. Nous avons utilisé un guide d’entretiens contenant des questions ouvertes jusqu’à saturation des données puis nous avons procédé à une analyse des données avec triangulation. Nous nous inspiré de la théorie ancrée et utiliser la grille COREQ pour une étude de qualité. Résultats : nous avons réalisé 12 entretiens entre février et avril 2022 ; les participants ont émis des perceptions différentes selon leur expérience du Covid, leur vécu du confinement, leur état de santé antérieur au Covid, leur confiance au système de santé et aux experts de la recherche. Les migrants interrogés ont pour la plupart émis une crainte initiale à l’arrivée du vaccin anti-Covid 19 qui s’est estompée avec les informations, la réassurance des accompagnants sociaux, des professionnels de santé et l’effet de l’entourage déjà vacciné mais ils restent tout de même inquiets sur les futurs effets secondaires du vaccin anti-Covid. Les réticences ciblées des migrants concernaient un sentiment de persécution impactant leur rapport au vaccin anti-Covid, rassurés par la suite par l’extension du vaccin anti-Covid à la population générale. Les réticences au vaccin anti-Covid se rapprochaient de celles de la population générale et concernaient les effets secondaires du vaccin, les rappels vaccinaux, la multiplication des marques de vaccin, et rumeurs propagées sur les réseaux sociaux. La plupart de notre population étudiée s’est vaccinée par contrainte à l’instauration du pass sanitaire. Le vécu du confinement, la précarité de cette population ont aussi été des facteurs influant sur leur perception du vaccin anti-Covid. Conclusion : notre étude visait à fournir des éléments pour mieux appréhender les attentes chez cette population et améliorer leur état de santé primaire. Selon nos résultats, l’environnement, le suivi médical, le mode d’information, l’accompagnement sanitaire et social joue un rôle capital dans la perception vaccinale anti-covid19. Il est donc primordial de rassurer et fournir des outils d’informations ciblés

Fornye bandene Green Isac og Green Isac Orchestra sine digitale plattformer med mål om å fremme interesse for deres musikk

Vår oppgave har gått ut på å designe to nye nettsider for de to musikkbandene “Green Isac Orchestra” og “Green Isac”. Målet var å lage to nettsider som reflekterte musikken deres godt, og fremme musikken deres slik at den kan nå ut til flere. For å nå disse målene har vi tatt i bruk Scrum som arbeidsmetodikk. Denne smidige arbeidsmetodikken startet tregt grunnet mindre erfaring, men ble etterhvert godt implementert som metode. Sluttresultatet vårt består av en fornyet side for hvert band, hvor resultatet er tilsvarende likt det oppdragsgiver ønsket seg og matcher de målene vi har satt oss