Research Article Bacteraemia in Intensive Care Unit: Clinical, Bacteriological

Objectives. We conducted a one-year observational study from December 2012 to November 2013 to describe the epidemiology of bacteraemia in intensive care units (ICU) of Mohammed V Military Teaching Hospital of Rabat (Morocco). Methods. The study consisted of monitoring all blood cultures coming from intensive care units and studying the bacteriological profile of positive blood cultures as well as their clinical significance. Results. During this period, a total of 46 episodes of bacteraemia occurred, which corresponds to a rate of 15,4/1000 patients. The rate of nosocomial infections was 97% versus 3% for community infections. The most common source of bacteraemia was the lungs in 33%, but no source was identified in 52% of the episodes. Gram negative organisms were isolated in 83,6% of the cases with Acinetobacter baumannii being the most frequent. Antibiotic resistance was very high with 42,5% of extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and 100% of carbapenemase in Acinetobacter baumannii. The antibiotherapy introduced in the first 24 hours was adequate in 72% of the cases. Conclusions. Bloodstream infections in ICU occur most often in patients over 55 years, with hypertension and diabetes. The bacteria involved are mainly Gram negative bacteria multiresistant to antibiotics. Early administration of antibiotics significantly reduces patients mortality

L’évaluation de la douleur chez l’adulte: Objectifs et outils

La douleur est un phénomène complexe, personnel et subjectif. Elle n’est pas systématiquement liée à une lésion et chacun la ressent différemment. Son évaluation est difficile, elle tente de la quantifier et de la rendre plus objectifs. Cette évaluation permet d’atteindre plusieurs objectifs d’une grande importance pour le patient  et  son soignant dans la prise en charge de la douleur. On distingue deux modes d'évaluation : l’auto-évaluation et l’hétéro-évaluation. Dans ce deux modes s’intègrent plusieurs type d’échelles uni ou multidimensionnelles. Le choix de l’un ou de l’autre doit respecter certaines règles liées au patient, au soignant et à l’outil lui-même

Evaluation d’un enseignement par les étudiants appliquée au module « aide à la rédaction de thèse»: destiné aux internes des hôpitaux des Armées au Centre d’épidémiologie et de Santé Publique des Armées, Marseille

Introduction: En éducation, l'évaluation concerne les institutions de formation, les programmes, les enseignants ou les étudiants. Elle peut être prédictive, sommative ou formative. L'Evaluation d'un Enseignement par les Etudiants (EEE) est l'un des outils de ce dernier type. Objectif : évaluer l'enseignement de la première partie de la formation « aide à la rédaction de thèse ». Méthodes: C'est une étude transversale classée dans le cadre « EEE » qui a porté sur le module « aide à la rédaction de thèse » dispensée au CESPA au profit de 27 participants préparant leur projet de fin d'étude. Résultats: Le taux de réponse des participants présents était de 100%. D'un sexe ratio F/M de 2 et de une moyenne d'âge de 25,5 ans +/- 2,7 ans, les questionnés étaient majoritairement des internes de médecine générale. Plus de 85% affirmait n'avoir bénéficié d'aucune formation au préalable dans les domaines traités. Les participants avaient des attentes qui rejoignaient sommairement les objectifs de la formation. A part le rythme jugé non adapté par plus de la moitié, 80% des participants ont été satisfaits des autres aspects évalués et 95,8 % parmi eux prévoyaient d'assister à la deuxième partie de la formation Pour tout les participants, la formation a permis d'amélioré de façon significative leur connaissance et aurais certainement un impact positif sur leurs travaux de recherche. Conclusion: Notre travail était un moyen d'installer une certaine complicité entre les étudiants et les enseignants pour atteindre un objectif commun : « AMELIORER LA FORMATION ».Pan African Medical Journal 2016; 2

Evaluation d’un enseignement par les étudiants appliquée au module « aide à la rédaction de thèse»: destiné aux internes des hôpitaux des Armées au Centre d’épidémiologie et de Santé Publique des Armées, Marseille

International audienceIntroduction: Educational assessment focuses on training institutions, programs, teachers or students. It may be predictive, summative or formative. Assessment of teaching by students (ATS) is one of the assessment tools included in the last category.Objective: Assessing teaching of the first part of the "Help thesis writing" training course.Material and methods: This is a cross-sectional study classified under the "ATS" agreement and focused on the "Help thesis writing" module provided to 27 participants preparing their end-of-study at CESPA.Results: Participant representativeness was 100%. F/M sex ratio was 2, the average age was 25.5 years +/- 2.7 years, the respondents were mainly students serving as interns in general medicine. Over 85% of students said he had received no prior training in the treated areas. The participants had expectations that roughly met the objectives of the training. Apart from teaching rhythm which was deemed unsuitable by more than half of participants, 80% of participants were satisfied with the other aspects evaluated and 95.8% of them were planning to attend the second part of training. All the participants judged the training as helpful to significantly improve their knowledge and were certain it might have a positive impact on their research projects.Conclusion: Our study aimed to develop teacher-student complicity in order to achieve a common goal: "IMPROVING THE FORMATION"

Tubular Microdiscectomy versus Conventional Surgery for Sciatica. A Comparative Prospective Enzyme Study

Objective Muscle injury is inevitable during surgical exposure of the spine, and it is quantified by the release of creatine phosphokinase. The aim of the present study is to make a comparison between tubular microdiscectomy and conventional microdiscectomy by using the pre- and postoperative serum concentrations of creatine phosphokinase as an indicator of muscle injury. Materials and Methods A total of 28 patients who underwent surgery for lumbar disc herniation were allocated into 2 groups: 12 patients (group A) operated by transflaval microdiscectomy, and 16 patients (group B) operated by tubular microdiscectomy. The serum concentration of total creatine phosphokinase was measured before surgery (creatine phosphokinase 1) and 1 day after surgery (creatine phosphokinase 2). Results There were 12 women and 16 men; the mean age of the patients and the mean duration of the surgery were respectively 49.5 years and 56 minutes for group A, and 47.3 years and 60 minutes for group B. The p-values of creatine phosphokinase 1, creatine phosphokinase 2 and the creatine–phosphokinase ratio were respectively 0,34; 0,31; and 0,57 (p < 0.05). Conclusion The present study demonstrated that there was no significant difference between tubular microdiscectomy and conventional microdiscectomy according to the analysis of the levels of creatine phosphokinase

Predictors of infertility stress among couples diagnosed in a public center for assisted reproductive technology

Background: All around the world, infertility, in many ways, is recognized as a stressful and a critical experience that can have impact on social and marital life of a couple. Infertility stress may affect the treatment and its outcome for such couples. The objective of the present study is to assess the predictors of high stress of infertility among married couples. Materials and Methods: This cross-sectional study was conducted on 120 couples (240 patients) who were diagnosed with primary and secondary infertility from June 2017 to June 2018. A psychological self-assessment questionnaire (Perceived Stress Scale-10) was used as a tool to evaluate the presence of high infertility stress among couples after obtaining their consent. Furthermore, other socioepidemiological data of patients were collected. Statistical Analysis: Data were analyzed using SPSS software (version 20). Univariate statistical analysis was used followed by multiple logistic regressions between high infertility stress and the predictor variables. Results and Discussion: The prevalence of high infertility stress was 53.3% among women and 40.8% among men. For women, multivariate analysis showed leading associations of high infertility stress with level of education, infertility type, infertility duration, and etiologies of infertility. However, for men, multivariate analysis showed leading associations between high infertility stress and alcohol status and inadequate sleep and infertility type

In vitro evaluation of the susceptibility of Acinetobacter baumannii isolates to antiseptics and disinfectants: comparison between clinical and environmental isolates

Abstract Background This study aims to assess the susceptibility of Acinetobacter baumannii isolates to the antiseptics and disinfectants commonly used, and to the non-approved product. Methods This is a prospective study carried out from February to August 2015, in the Bacteriology department of Mohammed V Military Teaching hospital of Rabat on A.baumannii isolates collected from colonized and/or infected patients and environmental samples. The antiseptics and disinfectants susceptibility testing was assessed using the micromethod validated in our department. The antiseptics and disinfectants studied were: 70% ethyl alcohol, chlorhexidine, povidone-iodine, didecyldimethylammonium chloride and a commercial product which was presented as a hospital disinfectant (non-registered product). Results Povidone-iodine, 0.5% chlorhexidine digluconate, 70% ethyl alcohol and didecyl dimethyl ammonium chloride in combination with N- (3-aminopropyl) -N-dodecylpropane-1, 3-diamine were effective against all the 81 A.baumannii isolates tested, and their logarithmic reduction ≥ 5 were observed in 100% of the isolates in their undiluted form. The strains isolated from patients were more resistant than environmental strains: at a dilution of ½ for 70% ethyl alcohol (37.77% vs 11.11%, p = 0.007) and at a dilution of 1/10 (100% vs 69.44%, p < 0.001) for povidone iodine. The non-registered product was ineffective with a resistance rate of 96.29% at a dilution of 1/50, 45.67% at a dilution of 1/10 and 13.58% in its purest form. Conclusion Our study revealed the effectiveness of the main disinfectants and antiseptics used in Morocco; three antiseptics tested were effective in their purest form against the 81 A.baumannii isolates. Regarding disinfectants, our results showed an efficacy of didecyl dimethyl ammonium at the recommended use concentration and in its purest form. This study emphasizes the need for using disinfectants and antiseptics in dilutions recommended by the manufacturer because the insufficient dilutions of these products are not effective. Our findings also demonstrated an inefficiency of the non-registered product against A.baumanii isolates. However, the non-registered products should be prohibited

Bacteraemia in Intensive Care Unit: Clinical, Bacteriological, and Prognostic Prospective Study

Objectives. We conducted a one-year observational study from December 2012 to November 2013 to describe the epidemiology of bacteraemia in intensive care units (ICU) of Mohammed V Military Teaching Hospital of Rabat (Morocco). Methods. The study consisted of monitoring all blood cultures coming from intensive care units and studying the bacteriological profile of positive blood cultures as well as their clinical significance. Results. During this period, a total of 46 episodes of bacteraemia occurred, which corresponds to a rate of 15,4/1000 patients. The rate of nosocomial infections was 97% versus 3% for community infections. The most common source of bacteraemia was the lungs in 33%, but no source was identified in 52% of the episodes. Gram negative organisms were isolated in 83,6% of the cases with Acinetobacter baumannii being the most frequent. Antibiotic resistance was very high with 42,5% of extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and 100% of carbapenemase in Acinetobacter baumannii. The antibiotherapy introduced in the first 24 hours was adequate in 72% of the cases. Conclusions. Bloodstream infections in ICU occur most often in patients over 55 years, with hypertension and diabetes. The bacteria involved are mainly Gram negative bacteria multiresistant to antibiotics. Early administration of antibiotics significantly reduces patients mortality