Evaluation du risque thromboembolique veineux et pratique de la thromboprophylaxie en médecine interne

Introduction: Le risque thromboembolique veineux en médecine a été largement incriminé dans la charge humaine et financière de l'ensemble de cette pathologie. Les facteurs de risque sont identifiés et côtés pour optimiser la prise en charge. Notre objectif était d'évaluer le niveau de risque thromboembolique et la pratique de la thromboprophylaxie.Méthodes: Il s'agissait d'une étude rétrospective réalisée sur une durée de 12 mois dans le service de médecine interne du CHU le Dantec. L'inclusion des patients était systématique à l'exclusion des patients ayant une durée d'hospitalisation de moins de 3 jours et de ceux venus avec un traitement anticoagulant.Résultats: Nous avons colligé 352 dossiers. Le sexe ratio était à 1,21 en faveur des hommes. L'âge moyen des patients est de 47ans. Le niveau de risque  thromboembolique a été faible dans 23%, modéré dans 22%, élevé dans 36%, et maximal dans 19% des cas. Les facteurs de risque retrouvés sont représentés  par l'alitement (98%), l'âge compris entre 41-74 ans (47%), les néoplasies (20,1%). L'insuffisance cardiaque et les affections respiratoires graves sont  rapportées  chez respectivement 9,3% et 8,5% des patients. Une prophylaxie était nécessaire chez 77% des patients hospitalisés mais seuls 12% des patients en avait  bénéficié.Conclusion: La nécessité d'une prévention de la maladie thromboembolique veineuse est bien cernée par les praticiens mais se heurte à de nombreux obstacles d'où la nécessité d'une mise en place d'outils pratiques et fonctionnels de dépistages et de produits anticoagulants accessibles

The Impact Of Organizational Objectives On The Selection Of Defensive Marketing Strategies: Empirical Evidence From A Small Open Economy

Defensive Marketing Strategies (DMSs) do not receive enough attention as offensive or attacking marketing strategies in literature. This gap in the research constitutes a serious weakness in the marketing field. This paper aims to fill this gap in literature by conducting the first study to explore the determinants of the implemented DMSs in Kuwait. Empirically, this study examines the relationship between eight DMSs, demographics, and organizational objectives to define the most prevalent and appropriate DMSs to be deployed in the small open economy of Kuwait. Factor analysis and canonical correlation are used in this study to analyse the obtained data from surveyed board members, CEOs and executive managers of listed companies in the financial sector of Kuwait Stock Exchange (KSE). Results reveal a significant relationship between the eight DMSs and the two sets of identified variables in Kuwait context. Cost leadership strategy ranked the most effective defensive marketing strategy by respondents. Also, results show that organizational objectives are mostly affecting the choice of DMSs

Epidemiology of chronic kidney disease in northern region of Senegal: a communitybased study in 2012

Introduction: Chronic kidney disease (CKD) is an emerging worldwide epidemic but few data are  available in African populations. We aimed to assess prevalence of CKD in adult populations of Saint-Louis (northern Senegal).Methods: In a population-based survey between January and May 2012, we included  1,037 adults aged =18 years living in Saint-Louis. Socio-demographical, clinical and biological data were collected during household visits. Serum creatinine was measured by Jaffé method. We estimated  glomerular filtration rate (eGFR) using the 4-variables MDRD equation and CKD was defined by eGFR < 60 mL/min/1.73m2 and/or albuminuria > 1g/L. A multivariate logistic regression was performed to identify factors associated with CKD. Results: Mean participants age was 47.9 ±16.9 years (18-87) and sex-ratio was 0.52. Majority of participants lived in urban areas (55.3% rural) and had school education (65.6%). Overall prevalences of hypertension, diabetes and obesity were 39.1%, 12.7% and 23.4% respectively. Prevalence of CKD was 4.9% (95% CI= 3.5 6.2) and 0.9% had GFR < 30 mL/min/1.73m2. Albuminuria >1g/l was found in 3.5% of people. CKD was significantly more frequent among hypertensive patients  compared to normotensive participants. Only 23% of patients were aware of their disease before the  survey. After multivariate logistic analysis, presence of CKD was significantly associated with  hypertension (OR=1.12, p= 0.02) and age (OR=1.03, p= 0.02). Conclusion: CKD is frequent in adult population living Northern Senegal. Main associated factors are hypertension and age. Prevention strategy is urgently needed to raise awareness and promote CKD detection and early treatment in both urban and rural areas.Key words: Chronic kidney disease, epidemiology, population, Senega

APPORT DU SIG POUR LE CHOIX DES VILLAGES DU PROGRAMME D’ELECTRIFICATION « TRANCHE II RESEAU » D’ERA

Résumé : Au Sénégal, plusieurs actions ont été mises en œuvre pour accélérer l’accès à l’électricité aussi bien en milieu urbain qu’en milieu rural. C’est ainsi qu’un programme prioritaire d’électrification rurale a été lancé afin de répondre à la forte demande d’accès au réseau électrique dans les zones rurales. Dans le cadre de ce programme, la société d’énergie rurale africaine (ERA) a mis en place différents projets pour répondre à cet objectif. Du fait de la spécificité du monde rural (demande énergétique généralement faible, population dispersée, etc.), les projets d’électrification rurale sont souvent non rentables, d’où la question de l’optimisation de la subvention et des fonds propres se pose avec encore plus d’acuité. Les contraintes de réalisation du projet sont avant tout liées à l’identification des villages à fort potentiel de développement avec des coûts de d’électrification optimales, implicitement ce qui implique une étape de sélection de villages plus fastidieuse avec les méthodes classique de planification de projet d’électrification rurale. Pour faciliter la sélection des localités à électrifier, nous avons recouru au SIG qui est aujourd’hui l’outil par excellence d’aide à la décision dans plusieurs domaines notamment en matière de planification et de gestion des projets d’électrification rurale. Nous avons utilisé les logiciels ArcGIS, le SQL server, le power BI Desktop, SharePoint et Google Earth pour traiter, interroger, analyser et visualiser les données. L’étude a permis de connaitre les taux d’électrification et de pénétration. Elle a également permis d’identifier et de hiérarchiser les localités à fort potentiel de développement économique et social qu’il conviendrait d’électrifier en priorité, dans le but de maximiser l’impact économique et social de l’électrification rurale à l’échelle du territoire étudié

الفقه المالكي في السنغال: الانتشار والتطور - سعيد جاه ومحمد الطاهر الميساوي = The dissemination and development of the Maliki jurisprudence in Senegal

Islam reached sub-Saharan Africa early on by means of Islamic conquests that swept Africa from north to east. The Berbers at that time had all credit for spreading Islam in Sub-Saharan Africa, including Senegal. This paper accounts for a brief historical background and how Maliki jurisprudence is disseminated all over the Republic of Senegal. Senegal is situated in West Africa, where more than eighty scholarly circles, based on the teaching of Maliki jurisprudence, are spread out along the flanks of the Fulani on the banks of the Senegalese river from the heights of Fouta Djallon. These scholarly circles or schools, established by Senegalese jurists and scholars in the region and as time passed, turned from local institutions into becoming centers of learning for many international students coming from outside the country to seek knowledge. This is mostly due to the great reputation and accreditation those scholars had acquired over the years by traveling around the Islamic world to disseminate their knowledge and thoughts in places such as Hijaz (Saudi Arabia) and Morocco. This paper uses a combination of descriptive and historiographical approach to fulfil the objectives set by the study. In the end, it concludes by making some recommendations and suggestions for future studies

Pattern of Mental Disorders among the Students of the University of Gezira- Sudan

This retrospective study was conducted in the University of Gezira (U of G) - Sudan, in the year 2009. The objective of the study was to describe the pattern of mental disorders among the students of (U of G) and to assess the services provided for them. The data of 200 students suffering from mental disorders, total coverage, was obtained by reviewing the records of the health services of the university, interview with the Director General of Psychiatry and Mental Health Hospital and with the psychologist responsible for dealing with students suffering from mental disorders.  The results revealed the following: the prevalence of mental disorders among the students of (U of G) was found to be (0.8%), more than half (51.5%) were females, male students were (48.9%), (57.5%) of them were residing outside Medani. Regarding their tribes the majority were from Galli tribe the other tribes were all represented with different rates. The following types of mental disorders described among the students, depression (42%), dissociative (23%), Schizophrenia (13%), Mania (6.5%), Epilepsy (9%), Anxiety (3%), Headache (2.5%).The faculty of Computer and Mathematic of sciences showed a big number of mental disorder students compared to the other faculties.  The study also showed lack of close follow up from the students themselves and their families. A problem of continuation of the treatment was observed. The study recommended; special mental health unit in the different faculties, Free drugs for mental disorders, Provision of mental health promotional services at the university including mental health education and screening services

Distribution, host preference and infection rates of malaria vectors in Mauritania

This study reports for the first time on the distribution, host preference and infection rates of malaria vectors in Mauritania. It was conducted during an outbreak of Rift valley fever. Three anopheline species were reported. An. arabiensis was the predominant species observed in all regions whereas An. pharoensis and An. funestus were observed along the south border in the Senegal River valley where extensive irrigation schemes are present. The distribution limits of anopheline species were observed from the Senegal River basin in the Trarza region up to the south limit of the Saharan desert in Tidjikja city. Overall, all An. funestus and An. pharoensis were fed respectively on human and ovine hosts whereas the mean anthropophilic rate of An. gambiae s.l. was 53%. A low Plasmodium falciparum infection rate was observed for species of the An. gambiae complex (0.17%) represented mainly by An. arabiensis. Because of the specific nature of this investigation, longitudinal studies are essential to better characterize the malaria vectors and their respective role in malaria transmission

Problem of obstetrical evacuations of patients coming from maternities outside the coverage zone of the university and hospital center of Treichville (Abidjan-Côte d’Ivoire)

Background: In developing countries, the organization of obstetrical evacuations is experiencing real problems causing certain preventable maternal and fetal morbidity and mortality. Objective of present study was to describe the sociodemographic characteristics and conditions of transfer of patients from peripheral maternities not dependent on the health coverage zone of the University and Hospital Center of Treichville (called maternity out of zone).Methods: This is a prospective and descriptive study, conducted at the maternity of the University and Hospital Center of Treichville, from 1st August 2012 to 31st July 2014 about 266 patients evacuated from maternity out of zone.Results: Only 30% of the patients had properly documented evacuation records. Patients had an average age of 26.9 years, poor follow-up of their pregnancy (92.1%), and were generally low socio-economic level: without monthly income (61.7%), not attending school (35.3%). The majority of evacuations were decided by midwives (60.9%) and were done by taxi (69.5%). In 71.4% of the cases, the patients were re-evacuated to our department with the main reason for the unavailability of the operating rooms (84.3%). 46.6% of the patients took more than 3 hours to arrive in our department and 35% arrived in an aggravated condition and sometimes without venous routes. In our department, complications occurred in 27.1% of the patients, and maternal and fetal death rates were respectively 1.5% and 21.3%.Conclusions: This study revealed malfunctions encountered during evacuations: unsafe transportation, transfer card misinformed, long transfer time

Curriculum Development of the Faculties of the Health and Agricultural Sectors University of Gezira 15.12.2011 to 15.6.2012

The University of Gezira adopts nobel goals, community orientation and community development- and it set curricula capable of achieving those goals which are essential for sustainability of its excellence. Periodic development, upgrading and modernization of curricula is a fundamental requirement for all universities; knowledge is growing and changing very fast, also there are rapid changes in community needs and expectations and hence  graduates should be equipped with competencies which enable them to contribute significantly and efficiently in the total development of their societies. The University has a wealth of experience in development of its curricula since its foundation and hence it included it as one of the main four components of the University Development Project. The project is sponsored by the Islamic Bank for Development-Jeddah and the Ministry of Finance Sudan and has been launched in December 2011. The Project aimed to develop the Faculties of agricultural and health sectors- curricula, manpower and infrastructure. Those sectors were chosen to be sectors of excellence for students in the Islamic countries. The Vice Chancellor of the University of Gezira formed a committee to manage the whole task of development of all the curricula of the faculties in the health and agricultural sectors; Medicine, Medical Laboratory Sciences, Animal Production, Veterinary Medicine, Applied Medical Sciences, Dentistry, Pharmacy, Health and Environmental Sciences, Agricultural Sciences. The committee set the justifications, determined its strategies and designed the process of its work. The whole task was accomplished in the stipulated time - 4 months

Polyflagellated macrocephalic spermatozoa: failure factor in IVF/ICSI

The authors report two cases of male infertility characterized by spermatic abnormalities of polyflagellated macrocephalic spermatozoa type affecting the entire gametes population. They demonstrate, on the one hand, the technical limitations of microinjection with such spermatozoa due to the large volume of their head and, on the other hand, the unfavourable outcome of the IVF-ICSI with this type of spermatozoa carrying abnormalities constituent. Molecular analysis of the somatic DNA of these subjects revealed a homozygous c.144delC mutation of the Aurora Kinase C gene. Consanguinity at the level of these subjects’ parents appears to be the main risk factor.  This situation constitutes a factor of failure of the IVF and leads to direct the couple towards the donation of gametes or the adoption as solution to the parental project