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Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

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Open Journal of Nursing 2024年第4期14卷 127-138页

作者： Madjiadoumbeye romain Imar Djibrine Soudy Ministè re de la Sant&#233 Publique et de la Pr&#233vention (Tchad) N&#8217Djamena Tchad Laboratoire de Recherche en Sciences des Aliments et Nutrition Facult&#233 des Sciences de la Sant&#233 Humaine (FSSH) Universit&#233 de N&#8217Djamena N&#8217Djamena Tchad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

关键词： Integrated Management Child 6 - 59 Months SAM

Comparative Study of the Widal Test against Stool Culture in the Diagnosis of Suspected Cases of Typhoid Fever in Some Low Income Communities in the Adamawa Region of Cameroon

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Journal of Biosciences and Medicines 2024年第6期12卷 178-190页

作者： Mariane Lucie Ngueguim Bernard Viban Tangwa Victor Ngu Ngwa Jules romain Ngueguim Abdoulmoumini Mamoudou School of Veterinary Medicine and Sciences University of Ngaoundere Ngaoundere Cameroon Department of Veterinary Medicine University of Buea Buea Cameroon Institute de Recherhe Agricole pour le Development (IRAD) Ngaoundere Cameroun

Introduction: Infectious diseases constitute a major concern of public health in developing countries. Facilities and well trained staff have been shown to be one of the major obstacles in the rapid and quality diagnosis of these diseases. As such, we carried out an analysis to compare the Widal test and stool culture to identify febrile patients with Salmonella infection. Method: A cross sectional study was conducted to diagnose salmonella infection with out-patients who demonstrated signs of salmonella infection. Serum was harvested from blood collected from 368 (Vina = 234, Mayo Banyo 65, and Djerem = 69) patients accompanied by stool, Widal test was conducted on the spot and stool was taken to a reference laboratory for culture using standard microbiological methods, sociological set up was calculated in percentages, prevalence was calculated using excel while statistical difference was calculated using SPSS. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to compare the Widal test against stool culture. Results: A total of 368 (50.8% females and 49.2% males) participants took part in the survey. Salmonella prevalence (66.24%) in stool culture in the Vina division was significantly different (p 0.05). The sensitivity,specificity, PPV, and NPV of slide agglutination test against stool culture varied from different areas (Vina: 51.6%, 73.62%, 79.21% and 43.61%;Mayo Banyo: 60.53%, 77.78%, 79.31% and 58.33%;Djerem: 53.18%, 83.73% 73.91% and 67.39%) respectively. Slide agglutination test has a fair agreement with the stool culture (kappa, Vina = 0.202;Mayo Banyo = 0.37 and Djerem = 0.38). Conclusion: Generally, in the three areas of study, the Widal test had a fair correlation with the stool culture;This means the Widal test should not be used alone but in combination with stool culture in the detection of salmonella infections.

关键词： Salmonella Infections Stool Culture Widal Test Adamawa Region Cameroon

Noninvasive Respiratory Strategies in Patients with Acute Hypoxemic Respiratory Failure and COVID-19 in Gabon: A Prospective Observational Study

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Open Journal of Emergency Medicine 2024年第1期12卷 18-27页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Fernande Manga Stéphane Oliveira Jean Marcel Mandji-Lawson romain Tchoua Department of Emergency Anesthesia Resuscitation Omar Bongo Ondimba Army Training Hospital Libreville Gabon Department of Anesthesia and Resuscitation Libreville University Hospital Center Libreville Gabon Department of Anesthesia and Resuscitation Akanda Army Training Hospital Libreville Gabon

Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High Flow Nasal cannula (HFNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO2/FiO2 ratio ≤ 300, a FR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanic

关键词： Respiratory Failure COVID 19-Intensive Care Units Military Hospital Gabon

Cameroon Climate Predictions Using the SARIMA-LSTM Machine Learning Model: Adjustment of a Climate Model for the Sudano-Sahelian Zone of Cameroon

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Open Journal of Statistics 2024年第3期14卷 394-411页

作者： Joseph Armathé Amougou Isidore Séraphin Ngongo Patrick Forghab Mbomba romain Armand Soleil Batha Paul Ghislain Poum Bimbar Dpartement de Gographie Universit de Yaound 1 Yaound Cameroon Observatoire National sur les Changements Climatiques (ONACC) Yaound Cameroon Laboratoire dAnalyse et Modlisation Multidisciplinaire Statistique (SAMM) Universit de Paris 1 Panthon Sorbonne Paris France Ecole Nationale Suprieure Polytechnique de Yaound 1 Yaound Cameroon Dpartement de Mathmatiques Ecole Normale Suprieure de Yaound Yaound Cameroon Dpartement dInformatique Universit de Yaound 1 Yaound Cameroon

It is acknowledged today within the scientific community that two types of actions must be considered to limit global warming: mitigation actions by reducing GHG emissions, to contain the rate of global warming, and adaptation actions to adapt societies to Climate Change, to limit losses and damages [1] [2]. As far as adaptation actions are concerned, numerical simulation, due to its results, its costs which require less investment than tests carried out on complex mechanical structures, and its implementation facilities, appears to be a major step in the design and prediction of complex mechanical systems. However, despite the quality of the results obtained, biases and inaccuracies related to the structure of the models do exist. Therefore, there is a need to validate the results of this SARIMA-LSTM-digital learning model adjusted by a matching approach, “calculating-test”, in order to assess the quality of the results and the performance of the model. The methodology consists of exploiting two climatic databases (temperature and precipitation), one of which is in-situ and the other spatial, all derived from grid points. Data from the dot grids are processed and stored in specific formats and, through machine learning approaches, complex mathematical equations are worked out and interconnections within the climate system established. Through this mathematical approach, it is possible to predict the future climate of the Sudano-Sahelian zone of Cameroon and to propose adaptation strategies.

关键词： Adjustment Calibration Climate Sudano-Sahelian Zone Numerical Model

Postoperative Analgesia and Cesarean Section under General Anesthesia: Multicenter Study

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Open Journal of Anesthesiology 2024年第1期14卷 1-12页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Pascal Christian Nze Obiang Stéphane Oliveira Jean-Marcel Mandji-Lawson romain Tchoua Department of Anesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon

Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4th post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia

关键词： Cesarean General Anesthesia Morphine Parietal Infiltration Epidural Catheter Transversus Abdominis Plane Block Intravenous Analgesia

“FISH VERTEBRA” about 3 Sickle Cell Patients Followed at Laquintinie Hospital, Douala

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第1期14卷 20-25页

作者： Same Bebey Francine Mbono Betoko Ritha Eloundou Onomo Paul Mantho Fopa Pauline Eposse Ekoube Charlotte Megne Tamo Estelle Ebene Mbende romain Singwe Ngandeu Madeleine Rheumatology Unit Laquintinie Hospital Douala Douala Cameroon Paediatric Unit Laquintinie Hospital Douala Douala Cameroon La Cite Verte Hospital Yaounde Yaounde Cameroon Paediatric Surgery Unit Laquintinie Hospital Douala Douala Cameroon La Cite des palmiers Hospital Douala Douala Cameroon Rheumatology Unit Central Hospital Yaounde Yaounde Cameroon

Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Douala. When the vertebral fractures were diagnosed, the 3 patients had back pain and kyphosis deformities of the dorsal spine. Treatment with an infusion of biphosphonates (zoledronic acid at a dose of 0.5 mg·per·kg) was offered to all three patients. Two out of three patients received treatment with biphosphonates with a successful outcome. Profound vitamin D deficiency is associated with increased bone remodeling and a history of fractures. In sickle cell anemia, vertebral fractures may also result from bone fragility, which is often overlooked as aseptic osteonecrosis and osteomyelitis, which are very often suspected.

关键词： Vertebral Fractures Sickle Cell Anemia Vertebral Bone Fragility

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光明的向往巴黎2位建筑师的住宅

室内设计与装修 2024年第9期 42-45页

作者： [法国]toledano+architects 秋落(编译) romain Ricard(摄影) toledano+architects

“2位建筑师的住宅”位于巴黎拉丁区卢森堡花园前一座19世纪的建筑内,是公寓的再次翻新。公寓位于大楼的五楼,视野非常开阔,设计师想突出这个天然的优势。像巴黎这样人口密集的城市,光线是稀缺的资源,是需要放大的主要元素之一。

关键词：住宅建筑师公寓卢森堡花园巴黎

Thermo-mechanical simulation of frost heave in saturated soils

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Frontiers of Structural and Civil Engineering 2023年第9期17卷 1400-1412页

作者： Saeed VOSOUGHIAN romain BALIEU Department of Civil and Architectural Engineering KTH Royal Institute of TechnologyStockholm 10044Sweden

Roads are exposed to various degradation mechanisms during their *** pavement deterioration caused by the surrounding environment is particularly severe in winter when the humidity and subfreezing temperatures *** heave-induced damage is one of the winter-related pavement *** occurs when the porewater in the soil is exposed to freezing *** study of frost heave requires conducting a multiphysics analysis,considering the thermal,mechanical,and hydraulic *** paper presents the use of a coupled thermo-mechanical approach to simulate frost heave in saturated soils.A function predicting porosity evolution is implemented to couple the thermal and mechanical field *** function indirectly considers the effect of the water seepage inside the *** frost heave scenarios with uniform and non-uniform boundary conditions are considered to demonstrate the capabilities of the *** results of the simulations indicate that the thermo-mechanical model captures various processes involved in the frost heave phenomenon,such as water fusion,porosity variation,cryogenic suction force generation,and soil *** characteristics and consequences of each process are determined and discussed ***,the results show that non-uniform thermal boundaries and presence of a culvert inside the soil result in uneven ground surface deformations.

关键词： frost heave multiphysics analysis thermo-mechanical approach saturated soils

Quantitative interactomic of CD40 in primary B cells

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hLife 2024年第2期2卷 88-93页

作者： Jeremy Argenty Emilie Maturin Mylene Camus Valentin Mellado Jeanne Perroteau Benoit Pasquier Guillaume Voisinne Odile Burlet-Schiltz Lih-Ling Lin Anne Gonzalez de Peredo romain Roncagalli Bernard Malissen Centre d’Immunologie de Marseille-Luminy Aix Marseille UniversitéINSERMCNRSMarseilleFrance Centre d’Immunophénomique Aix Marseille UniversitéINSERMCNRS UMRMarseilleFrance Institut de Pharmacologie et de Biologie Structurale Département Biologie Structurale BiophysiqueProtéomique Génopole Toulouse Midi Pyrénées CNRS UMR 5089205 Route de NarbonneToulouse CedexFrance Checkpoint Immunology Immunology and Inflammation Therapeutic AreaSanofiVitryFrance Checkpoint Immunology Immunology and Inflammation Therapeutic AreaSanofiCambridgeUSA

INTRODUCTION Over the past few decades,antibody-based therapies have emerged as an additional tool to treat patients developing cancer and auto-immune *** natural properties of the developed antibodies may lead to agonist or blocking functions for the targeted ***,antibodies developed for clinical trials are extensively analyzed in vitro and in vivo for safety and efficacy,yet they are not routinely evaluated for their potential signaling effectiveness.

关键词： routine antibodies clinical