Pure internal subtalar dislocation: review of 5 cases

Pure subtalar dislocation is a rare injury. It accounts for 1% of dislocations seen in trauma. It involves a loss of anatomical relationship between the talus, calcaneus and scaphoid, but the tibio-peroneal-astragalic congruence is maintained.  The aim of this study was to find an explanation between the occurrence of subtalar dislocation in its medial variety and the Jakarta motorbike crash.  Five male patients who had fallen from a Jakarta motorbike were included. Two cases of open dislocation were reported. They received wound trimming under spinal anaesthesia. We proceeded to reduce the dislocation using a boot puller maneuver and restraint with a plaster boot. The postoperative course was simple with wound healing. The casting lasted 6 weeks but was extended to 8 weeks for open dislocations. After removal of the cast, rehabilitation was prescribed for all patients. This consisted mainly of proprioception in order to restore the functions of the ankle. At a mean follow-up of 25.2 months, the patients did not complain of pain or stiffness and the X-rays taken were normal

Traumatic posterior dislocation of hip with ipsilateral fracture of shaft of the femur: external maneuvers reduction and osteosynthesis by screw plate about a case and review of literature at Tambacounda regional hospital in Senegal

Traumatic hip dislocation associated with an ipsilateral femoral fracture is a rare injury. It occurs in a high-energy traumatic context. The classic mechanism consists of a fall with landing on the hip, which initially dislocates and the femur fracture occurs secondarily by adduction of the proximal fragment. The diagnosis is difficult in front of the fracture whose signs mask the vicious attitude of the dislocation. We reported the case of a passenger of a motorcycle who collided with a parked car.  He was ejected from the motorcycle and landed on his right hip. We performed X-rays of hip and lower limb at his admission which revealed a dislocation of hip in its high posterior variety and a medio-diaphyseal fracture of femur on same side. Reduction of dislocation by external maneuvers was made and osteosynthesis of femur with screwed plate performed 48 h later. After 16 months of care, functional and radiological results sufficient

Adoption of Improved Variety among Rice Farmers in the Kindia Region of Guinea

This study investigated the adoption characteristics of improved rice variety among rice farmers in the Kindia region of Guinea. A Multistage sampling procedure was used to select 180 rice farmers and a well-structured interview guide was used to elicit information from the respondents. Data were analysed using percentages, mean statistics, standard deviation and Chi-square.  The most adopted rice variety was CK 90 (86.6%).  Factors influencing the adoption of improved rice varieties were market channels (84.9%), membership of associations (91.7%) and contact with extension personnel (85.5%).  Most (97.2%) rice farmers knew about growing improved rice varieties. Most (66.1%) of the respondents had a favourable attitude towards growing improved rice variety but faced constraints like insufficient loan ( = 2.89), weed infestation ( = 2.37), storage losses ( = 2.19) and low extension activities ( = 2.11). The adoption characteristics of respondents were good (88.3%) with economic characteristics having the highest mean ( 2.71). Educational qualification was significantly related (?2 =1.149) to the adoption characteristics of improved variety. Efforts should be made by research institutes to ensure increased access of rice farmers to improved seed varieties with attractive characteristics which could aid its adoption and ensure food security in Guinea

Adoption of Improved Variety among Rice Farmers in the Kindia Region of Guinea

This study investigated the adoption characteristics of improved rice variety among rice farmers in the Kindia region of Guinea. A Multistage sampling procedure was used to select 180 rice farmers and a well-structured interview guide was used to elicit information from the respondents. Data were analysed using percentages, mean statistics, standard deviation and Chi-square.  The most adopted rice variety was CK 90 (86.6%).  Factors influencing the adoption of improved rice varieties were market channels (84.9%), membership of associations (91.7%) and contact with extension personnel (85.5%).  Most (97.2%) rice farmers knew about growing improved rice varieties. Most (66.1%) of the respondents had a favourable attitude towards growing improved rice variety but faced constraints like insufficient loan ( = 2.89), weed infestation ( = 2.37), storage losses ( = 2.19) and low extension activities ( = 2.11). The adoption characteristics of respondents were good (88.3%) with economic characteristics having the highest mean ( 2.71). Educational qualification was significantly related (?2 =1.149) to the adoption characteristics of improved variety. Efforts should be made by research institutes to ensure increased access of rice farmers to improved seed varieties with attractive characteristics which could aid its adoption and ensure food security in Guinea

Services sociaux d'éducation et de santé en Guinée: Effets redistributifs de la politique gouvernementale

Cette étude a pour objectif d'identifier la progressivité des services publics d'éducation et de santé en Guinée, en s'appuyant sur les schémas de consommation tirés de l'enquête sur le niveau de vie de 2002-2003. Les résultats suggèrent que l'éducation publique primaire est plus progressive que l'éducation publique secondaire et universitaire, les consultations médicales et soins prénatals dans les centres et postes de santé sont mieux assurés que dans les hôpitaux. Cependant, on observe un biais anti-féminin dans la répartition des bénéfices tirés de la fourniture des services publics d'éducation. Ces résultats de recherche induisent la nécessité de rendre plus équitable l'accès aux services publics même si la taille du budget reste constante. Ils montrent aussi que, malgré la progressivité de l'éducation publique primaire et secondaire, l'expansion de leur couverture totale n'est pas une garantie pour l'amélioration de l'équité dans l'accès à ces services.Taux de couverture, incidence moyenne, incidence marginale, progressivité, dominance, courbe de concentration

Traumatological emergencies: epidemiological and problematic aspects of care in the orthopedics traumatology department of the CHU Ignace Deen in Conakry

Background: A trauma emergency is any aggression (direct or indirect) external to the body for which no therapeutic delay is allowed at the risk of endangering the patient's life or the functional prognosis of his limbs. The objective of this study was to report the results of the management of traumatological emergencies. Methods: This was a descriptive cross-sectional study from 11 January 2021, to 11 July 2021. It focused on patients seen for traumatological emergencies in the CHU Ignace Deen Orthopaedics-Traumatology department. Results: Trauma emergencies constitute 75.2% of admissions to the emergency department. The average age of the patients was 32.2 years, with extremes of 1 and 91 years. There was a predominance of 76.3% males with a ratio (M/F) of 3.2. Road traffic accidents were the most found aetiology in 82.9%, and motorcycles were involved in 68.7%. Limb fractures were found in 34.7%. The treatment time was ≤6 hours in 67.5%, and 203 patients received drug treatment, i.e., 49.7%. Conclusions: Trauma emergencies constitute, by their frequency and seriousness, a real public health problem in Africa in general and in Guinea in particular

Recours a la Médecine Traditionnelle chez les Rhumatisants en Guinée

Aim: To determine the frequency and pattern of use of traditional medicine in rheumatic patients at Ignace Deen National Hospital in Conakry, Guinea. Patients and methods: Descriptive cross-sectional study in the rheumatology department of HNID between January and March 2018 Results: Of the 108 patients interviewed, 40 had used traditional medicine (37.03%). There was a female predominance (21 women, 52.5%) with a sex ratio of 0.90. The mean age of the patients was 44.75 ± 17.24 years. Rheumatoid arthritis and knee osteoarthritis were the main rheumatic diseases observed with 41.86% and 16.27% respectively. The diagnostic delay was 6.54 ± 1.25 years. The nature of the treatment used was dominated by taking a decoction (57.50%) and the reason for using traditional treatment was to relieve pain (85%). The oral route was the main mode of use of traditional treatment (67.5%). More than half of the patients (52.50%) were not satisfied with the outcome of traditional treatment received and did not know the name of the treatment used in their vernacular language. In 47.50% of cases they thought that traditional treatment had adverse effects and had possible interactions with modern drug therapy. Conclusion: More than a third of rheumatology consulting patients use traditional medicine even though they believe it has side effects. This phenomenon leads to a delay in consultation with the rheumatologist, hence the need for better communication between the different actors.Objectif : Déterminer la fréquence et le profil de l’utilisation de la médecine traditionnelle chez les patients souffrant de rhumatisme à l'hôpital national Ignace Deen de Conakry (Guinée). Patients et méthodes : Etude transversale de type descriptif dans le service de rhumatologie de l'HNID entre janvier et mars 2018. Résultats : Sur 108 patients interrogés, 40 avaient eu recours à la médecine traditionnelle soit 37,03 %. On notait une prédominance féminine (21 femmes ; 52,5 %) avec un sexe ratio de 0,90 H/F. L’âge moyen des patients était de 44,75 ± 17,24 ans. La polyarthrite rhumatoïde et la gonarthrose étaient les principales affections rhumatologiques observées avec respectivement 41,86% et 16,27%. Le délai diagnostique était de 6,54 ±1,25 ans. La nature du traitement utilisé était dominée par la prise de décoction (57,50%) et le motif d’utilisation du traitement était de soulager la douleur (85%). La voie orale était le principal mode d’utilisation (67,5%). Plus de la moitié des patients (52,50%) n’étaient pas satisfaits du résultat du traitement traditionnel reçu et ne connaissaient pas le nom du traitement utilisé dans leur langue vernaculaire. Ils pensaient dans 47,50% des cas que le traitement traditionnel entrainait des effets indésirables et avait de possibles interactions avec le traitement médicamenteux moderne. Conclusion : Plus du tiers des patients consultant en rhumatologie ont recours à la médecine traditionnelle même s’ils croient qu’elle a des effets indésirables. Ce phénomène entraîne un retard à la consultation chez le rhumatologue, d’où la nécessité d’une meilleure communication entre les différents acteurs

Strong fisheries management and governance positively impact ecosystem status

Fisheries have had major negative impacts on marine ecosystems, and effective fisheries management and governance are needed to achieve sustainable fisheries, biodiversity conservation goals and thus good ecosystem status. To date, the IndiSeas programme (Indicators for the Seas) has focussed on assessing the ecological impacts of fishing at the ecosystem scale using ecological indicators. Here, we explore fisheries Management Effectiveness' and Governance Quality' and relate this to ecosystem health and status. We developed a dedicated expert survey, focused at the ecosystem level, with a series of questions addressing aspects of management and governance, from an ecosystem-based perspective, using objective and evidence-based criteria. The survey was completed by ecosystem experts (managers and scientists) and results analysed using ranking and multivariate methods. Results were further examined for selected ecosystems, using expert knowledge, to explore the overall findings in greater depth. Higher scores for Management Effectiveness' and Governance Quality' were significantly and positively related to ecosystems with better ecological status. Key factors that point to success in delivering fisheries and conservation objectives were as follows: the use of reference points for management, frequent review of stock assessments, whether Illegal, Unreported and Unregulated (IUU) catches were being accounted for and addressed, and the inclusion of stakeholders. Additionally, we found that the implementation of a long-term management plan, including economic and social dimensions of fisheries in exploited ecosystems, was a key factor in successful, sustainable fisheries management. Our results support the thesis that good ecosystem-based management and governance, sustainable fisheries and healthy ecosystems go together.IOC-UNESCO; EuroMarine; European FP7 MEECE research project; European Network of Excellence Eur-Oceans; FRB EMIBIOS project [212085]info:eu-repo/semantics/publishedVersio

Determinants of Transmission Risk During the Late Stage of the West African Ebola Epidemic.

Understanding risk factors for Ebola transmission is key for effective prediction and design of interventions. We used data on 860 cases in 129 chains of transmission from the latter half of the 2013-2016 Ebola epidemic in Guinea. Using negative binomial regression, we determined characteristics associated with the number of secondary cases resulting from each infected individual. We found that attending an Ebola treatment unit was associated with a 38% decrease in secondary cases (incidence rate ratio (IRR) = 0.62, 95% confidence interval (CI): 0.38, 0.99) among individuals that did not survive. Unsafe burial was associated with a higher number of secondary cases (IRR = 1.82, 95% CI: 1.10, 3.02). The average number of secondary cases was higher for the first generation of a transmission chain (mean = 1.77) compared with subsequent generations (mean = 0.70). Children were least likely to transmit (IRR = 0.35, 95% CI: 0.21, 0.57) compared with adults, whereas older adults were associated with higher numbers of secondary cases. Men were less likely to transmit than women (IRR = 0.71, 95% CI: 0.55, 0.93). This detailed surveillance data set provided an invaluable insight into transmission routes and risks. Our analysis highlights the key role that age, receiving treatment, and safe burial played in the spread of EVD

Long-term cellular immunity of vaccines for Zaire Ebola Virus Diseases

Recent Ebola outbreaks underscore the importance of continuous prevention and disease control efforts. Authorized vaccines include Merck’s Ervebo (rVSV-ZEBOV) and Johnson & Johnson’s two-dose combination (Ad26.ZEBOV/MVA-BN-Filo). Here, in a five-year follow-up of the PREVAC randomized trial (NCT02876328), we report the results of the immunology ancillary study of the trial. The primary endpoint is to evaluate long-term memory T-cell responses induced by three vaccine regimens: Ad26–MVA, rVSV, and rVSV–booster. Polyfunctional EBOV-specific CD4+ T-cell responses increase after Ad26 priming and are further boosted by MVA, whereas minimal responses are observed in the rVSV groups, declining after one year. In-vitro expansion for eight days show sustained EBOV-specific T-cell responses for up to 60 months post-prime vaccination with both Ad26-MVA and rVSV, with no decline. Cytokine production analysis identify shared biomarkers between the Ad26-MVA and rVSV groups. In secondary endpoint, we observed an elevation of pro-inflammatory cytokines at Day 7 in the rVSV group. Finally, we establish a correlation between EBOV-specific T-cell responses and anti-EBOV IgG responses. Our findings can guide booster vaccination recommendations and help identify populations likely to benefit from revaccination