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INTRODUCTION: In Burkina Faso, cardiac stimulation was introduced in October 2000 has grown over time.In orderto evaluate the effectiveness of stimulation on life, we proposed to evaluate the quality of life of patients with a pacemaker. GENERAL OBJECTIVE: to study the effect of the pacemaker on the quality of life of patients PATIENTS AND METHODS: This was a cross-sectional study aimed at describingthe wearers of a pacemaker for at least six months at the Yalgado OUEDRAOGO University Hospital and the Schiphramedical center.The AQUAREL questionnaire has been adapted to our context to establish a quality-of-life score. RESULTS: The mean age of the study population was 68 years with a female predominance (53.3%). Complete atrioventricular block was the main indication of stimulation in 55%. The average duration of implantation was 41.6 months with extremes of 8 and 128 months. The primo implantation was found in 79.1 % of patients against 18.3 % for a first change of case and2.5 % for a second change of housing. Double chamber stimulation was performed in 65% of cases. DDD mode was the most used followed by VVIR. The average quality of life score was 90.12. Negative predictors of quality of life were age and female.A correlation between quality-of-life score and age, hypertension and dyslipidemia was found (p< 0.05). On the other hand, no correlation between the number of implantation, the duration of implantation and the mode of stimulation was found (p> 0.05). CONCLUSION: patients with a pacemaker have a good quality of life. However, quality-of-life is not correlated with the number of pacemakers, nor the duration and mode of stimulation.
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Marcapaso Artificial , Calidad de Vida , Anciano , Burkina Faso , Estimulación Cardíaca Artificial , Estudios Transversales , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVES: Cardiac stimulation becomes a reality in Burkina Faso. The aim of our study was to evaluate this activity over five years and to appreciate the impact of collaboration with French hospitals of Auvergne area in its development. MATERIALS AND METHODS: Prospective study including consecutively patients who underwent pacemaker implantation since June 2011. Data collected included indications, time to care, type of stimulation, complications, cost of treatment, and education and quality of life of the patient. RESULTS: Sixty-nine patients received definitive pacemaker from June 2011 to June 2016, of whom 45.5% were women. The mean age was 69 years (extremes 35 to 89s). Almost all patients (94%) were symptomatic (54% syncope and 30% dizziness and lipothymias). The main indication for definitive cardiac pacing was complete atrioventricular block of degenerative origin (83%). The mean time between indication and surgery was 8.2 days, and only 4% of patients received temporary stimulation. The lack of financial support was the main reason for the delay in taking charge. During the study period, the two health centers received support in the form of stimulation equipment, a technical platform, and regular training and practical training. This collaboration made it possible to overcome the lack of material, human and financial resources. We recorded as complications a case of case exteriorization, two cases of benign local hematoma and two cases of probe displacement. The quality of life of the patients improved markedly, none of patients undergoing surgery remained symptomatic. CONCLUSION: The organization of cardiac stimulation in Burkina Faso is a reality. Efforts must be made to sustain the activity and strengthen collaboration with hospitals in the north.
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Estimulación Cardíaca Artificial , Marcapaso Artificial , Adulto , Anciano , Anciano de 80 o más Años , Burkina Faso , Estimulación Cardíaca Artificial/estadística & datos numéricos , Femenino , Francia , Hospitales Públicos , Humanos , Cooperación Internacional , Masculino , Persona de Mediana Edad , Marcapaso Artificial/estadística & datos numéricos , Estudios Prospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
Myanmar Tobacco Control Law of 2006 covers the control of all forms of tobacco use. After 7-year, tobacco use among adults did not see a decrease. The paper aimed to study the prevalence, details of the products, trade, legislation, tax, marketing, advertising and evidence on morbidity and mortality, and to make recommendations for policy options. Personal communications by authors and colleagues, and searches by keywords in PubMed and on Google, literature review and research from published reports, and various studies and surveys conducted in Myanmar and other countries. Smokeless tobacco use in Myanmar is the highest among ASEAN countries. A variety of SLT products used together with betel chewing poses a challenge; betel quid chewing has been accepted as a cultural norm in both rural and urban areas. Betel quid chewing usually starts at younger ages. Sale, marketing, and advertising of SLT are not under control and thus, road-side kiosks selling betel quid with SLT are mushrooming. Considerable trade of SLT products by illegal and legal means created an increase in access and availability. Low cost of SLT product enables high volume of use, even for the poor families. Taxation for raw tobacco and tobacco products is half the values of the tax for cigarettes. Effective enforcement, amendment of the law, and action for social change are needed.
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Salud Pública/legislación & jurisprudencia , Fumar/legislación & jurisprudencia , Tabaquismo/epidemiología , Tabaco sin Humo/efectos adversos , Cultura , Regulación Gubernamental , Humanos , Mianmar , Población RuralRESUMEN
UNLABELLED: In emerging countries, nonunion in the shaft of fractured long bones is common. PATIENTS AND METHODS: In a 3-year long prospective study, 50 patients (38 men, 12 women) with an average age of 40.9 years (range 17-60) were treated for neglected diaphyseal nonunion an average of 11 months (range 6-48) after the fracture event. The femur was involved 14 times, tibia 22 times, humerus eight times and forearm bones six times. All of these patients had consulted initially with a traditional bone setter at the time of fracture. The surgical procedure consisted of osteoperiosteal decortication followed by repermeabilization of the medullary canal and then internal fixation. Compression plating was used for the humerus, radius and ulna. Nonunion of the middle-third of the femur and tibia was treated by intramedullary nailing and nonunion of the proximal third of the femur with an inverted DCS screw-plate. Patients were reviewed clinically and with X-rays on postoperative days 21, 45, 90 and 120. RESULTS: Bone union was obtained in under 90 days in the upper limb and under 120 days in the lower limb. No additional grafting was needed. There were only two cases of leg length differences. DISCUSSION: Osteoperiosteal decortication is a reliable technique that leads to predictable, satisfactory results, given the limited materials required to treat long bone nonunion in emerging countries.
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Fijación Interna de Fracturas/instrumentación , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Fracturas Mal Unidas/cirugía , Osteotomía/métodos , Adolescente , Adulto , Placas Óseas , Tornillos Óseos , Diáfisis/cirugía , Femenino , Fracturas del Fémur/cirugía , Humanos , Fracturas del Húmero/cirugía , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Fracturas de la Tibia/cirugía , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: In developing countries, malunion, after diaphyseal femur fractures initially untreated by internal fixation, is not rare. Their difficult management contrasts with the deficiency of the technical operating room facilities. PATIENTS AND METHODS: Our prospective study, conducted over a 1-year period, reports 16 open osteotomies fixed using Küntscher intramedullary nailing in patients who presented malunion of the femoral diaphysis. Twelve males and four females (mean age, 34.5 years; range, 18-67 years) were managed with a mean time to surgery of 8 months (range, 4-14 months). All had initially consulted a bonesetter. The mean length inequality was 3 cm (range, 2-6 cm); the mean knee flexion limitation was 90° (range, 10°-120°). Locking of the rotation was obtained by the obliquity of the osteotomy line. No bone filling was added but reaming and decortications were systematic. The patients were clinically and radiographically assessed at D21, D45, D90, and D120, based on the evaluation of the length inequality, mobility, and bone union. Rotational malunion or deformity were not analyzed. RESULTS: Fifteen patients had achieved union in 90 days. In one case, secondary incurvation of the nail led to changing the nail, allowing union with no axis deformity at D120. The mean postoperative knee flexion was 120° (range, 45°-130°). The mean gain in length was 2 cm (range, 1.5-4 cm). DISCUSSION: This open technique using non-interlocking material allowed us to obtain bone union while improving joint mobility and length inequality. LEVEL OF EVIDENCE: Level IV. Retrospective study.
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Países en Desarrollo , Fracturas del Fémur/cirugía , Fijación Intramedular de Fracturas , Fracturas Mal Unidas/cirugía , Osteotomía , Adolescente , Adulto , África Occidental , Anciano , Femenino , Fracturas del Fémur/diagnóstico por imagen , Fracturas del Fémur/fisiopatología , Fracturas Mal Unidas/diagnóstico por imagen , Fracturas Mal Unidas/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Radiografía , Rango del Movimiento Articular , Recuperación de la Función , Resultado del Tratamiento , Adulto JovenRESUMEN
The XbaI digestion patterns of chromosomal DNA of 42 aeromonads isolated from French breeding snails during a new epizootic disease, which rapidly progressed to death during the summer of 1994, were analyzed by pulsed-field gel electrophoresis. Biochemical identification to species level was also performed. Interestingly, we found that 76% of the aeromonads isolated from diseased snails clustered into a unique pulsotype (P1) whatever their geographic origin, and were assessed to belong to Aeromonas hydrophila. Other strains belonged to Aeromonas caviae or remained unspecified. Our results provide retrospective supplementary epidemiological evidence for implication of A. hydrophila strains in the snail summer disease.
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Aeromonas/clasificación , Aeromonas/aislamiento & purificación , Crianza de Animales Domésticos , Técnicas de Tipificación Bacteriana , Caracoles Helix/microbiología , Aeromonas/genética , Aeromonas hydrophila/clasificación , Aeromonas hydrophila/genética , Aeromonas hydrophila/aislamiento & purificación , Animales , Desoxirribonucleasas de Localización Especificada Tipo II/metabolismo , Electroforesis en Gel de Campo Pulsado/métodos , FranciaRESUMEN
This prospective cohort study was carried out in the neonatal unit of the Yangon Children Hospital, Myanmar, to gather more information on the types of feedings and hand-washing practices of mothers as the determinant of severe dehydration in infants with acute diarrhoea due to Escherichia coli. The study subjects included 100 infants with diarrhoea, aged less than 4 months, admitted to the hospital from June 1997 to May 1998. Data on isolation of E. coli from rectal swab samples, types of feedings, hand-washing practices, and dehydration status were collected. Of the 100 cases, E. coli was isolated from rectal swab samples of 48 infants. Of these 48 cases, 28 had some dehydration and 20 had severe dehydration. Exclusive breast-feeding was observed only in the age group < 1 and > 1-2 month(s). The association of the severity of dehydration with other types of feedings compared to exclusive breast-feeding was not statistically significant. In this study, most mothers washed their hands with water only after cleansing their children's defaecation, and before and after feeding their children. The severity of dehydration was statistically significant in hand-washing practices when compared to washing with water only and washing with soap and water. This study has shown the association between types of feedings and hand-washing practices with dehydration in infants with acute diarrhoea due to E. coli. The results of the study suggest that there is a need for appropriate intervention programmes to promote exclusive breast-feeding and hand-washing practices with soap and water after cleansing children's defaecation, and before and after feeding children.
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Lactancia Materna , Deshidratación/etiología , Diarrea Infantil/microbiología , Infecciones por Escherichia coli , Desinfección de las Manos/métodos , Estudios de Cohortes , Diarrea Infantil/complicaciones , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/complicaciones , Infecciones por Escherichia coli/microbiología , Humanos , Lactante , Estudios Prospectivos , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
Since cases of lepra reaction following smallpox vaccination and BCG vaccination had been reported the effect of tetanus immunisation on leprosy patients (whether it may provoke a lepra reaction or not) was studied. Three doses of purified tetanus toxoid (one ml initially, one ml after six weeks and one ml after six months) were given to 357 leprosy patients and 60 patients living in the same environ were followed as controls. The antibody response following immunisation was followed in six lepromatous leprosy patients using toxin antitoxin neutralisation test at the Lf/1000 level in mice and in three of them the antibody titre of leprosy patients rose to satisfactory level. The number of lepra reactions in these patients was monitored for nine months (two months before vaccination, during the six months period of vaccination and one month after the last dose of vaccine). There was no significant rise in the number of patients with reaction following the vaccination.