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Diagnosis of CAh in a Sub Saharan Country: Visible Part of Iceberg

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Open Journal of Pediatrics 2024年第2期14卷 227-233页

作者： Suzanne Sap Ritha Mbono hélène.kamo Jocelyn Tony Charlotte Eposse Jeannette Epée Isabelle Mekone Adele Bodieu Gaelle Ntsoli Paul Olivier Koki Mother and Child Center of the Chantal Biya Foundation University of Yaoundé I Yaoundé Cameroon laquintinie hospital University of Douala Douala Cameroon Genral hospital of Garoua University of Garoua Garoua Cameroon human Reproductive Center and Research on Fertility of Yaoundé University of Yaoundé I Yaoundé Cameroon Yaounde General hospital University of Yaoundé I Yaoundé Cameroon Yaounde Central hospital Yaoundé Cameroon laquintiinie hospital Douala Cameroon

Introduction :Congenital adrenal hyperplasia (CAh) is the most common cause of primary adrenal insufficiency. It is a rare monogenic recessive disorder. In African setting in absence of neonatal screening, the diagnosis is still late, based on a clinical approach. During this clinical enquiry, information from past history or pedigree of the patient is of a huge importance and may revealed surprises. Patients and Methods: In this observational study, we retrospectively included all patients with a diagnosis of CAh. The diagnosis of CAh was retained based on a high 17 hydroxyprogesterone level in addition to clinical and morphological findings. From patients’ files, we extracted data on family history of disease, pedigree, clinical findings and genetics when available of 39 patients from two endocrinopeadiatric centers. Results: In 13 (30%) families, we found 20 reported deaths of infant less than 12 months. In these 13 families, half of the patients followed had 21 hydroxylase deficiencies and had 11 hydroxylase deficiencies. Unsurprisingly, we suspected adrenal insufficiency in these patients at verbal autopsy even in families with a patient with 11 hydroxylase deficiency. Other non DSD malformations or genetic disorders with apparently no link with CAh were reported in 3 families. The father of a patient reported to have hypospadias. Conclusion: Each diagnosis of CAh made in our context is visible part of an iceberg. Behind a diagnosis of CAh made in our setting, is a long course of care, a dramatic past history revealing access to appropriate care disparity. neonatal screening should thus be considered as an emergency.

关键词： Congenital Adrenal hyperplasia

Clinical and Evolutive Aspects of Severe Acute Malnutrition in Children Aged 0 - 59 Months at Maroua Regional hospital in Cameroon’s Far North Region

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Open Journal of Pediatrics 2024年第4期14卷 700-711页

作者： Palma haoua Abouame Selangai hélène.kamo Sime Tchouamo Arielle Annick Fernando Kemta lepka Daniel nemsi Sadjo Salihou Aminou haman Soureya Yolande Feudjo Ulrich Dama Félicitée Nguefack Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Maroua Regional hospital Maroua Cameroon Garoua General hospital Garoua Cameroon Yaounde Gynaeco-Obstetrics hospital Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Douala General hospital Douala Cameroon Department of health Sciences Catholic University of Central Africa Yaounde Cameroon University of lisala Lisala Democratic Republic of the Congo Faculty of Medicine and Biomedical Sciences University of Yaound I Yaounde Cameroon

Introduction: Severe acute malnutrition remains one of the most important causes of under-five mortality. In Cameroon, the northern regions have the highest prevalence, with 1.4% in the Far North in 2021. These children are managed at the Internal therapeutic and Nutrional Centre, one of which is located at Maroua Regional hospital, the third level referral hospital. We therefore proposed to carry out a study on the clinical and evolutive aspects of these children. Materials and Methods: it was a descriptive, cross-sectional study from January 2020 to December 2022, at the ITNC (CNTI) of Maroua Regional hospital. The sample size was obtained from the lorentz formula. Patient records were used for data collection. We excluded all incomplete records and patients with less than 24 hours of admission. Results: Out of the 873 patients we recruited, the prevalence of severe malnutrition was estimated at 18 %. The average age was 14 months, with a male predominance. The main reasons for consultation were fever (42%) and diarrhoea (35%). Marasmus was the predominant clinical form. The major medical complications were sepsis (32.9%) and malaria (16.8%). hIV prevalence was 2.5% and tuberculosis was 4.9%. Most patients had haemoglobin levels between 7 and 10g/dl. 79.3% were cured and 6.5% died. The main causes of death were sepsis and malaria. Conclusion: Severe acute malnutrition remains a major problem in the Far North region. Several joint actions are needed to break this cycle.

关键词： Severe Acute Malnutrition Children Far North Cameroon

Acceptance and Experience of hIV-Infected Adolescents in Two hospitals in Yaoundé

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Open Journal of Pediatrics 2024年第2期14卷 435-443页

作者： Isabelle Mekone Nkwele nelly Kamgaing Pierrette Amanda Emah Manga Jeannette Épée Ngoué hélène.kamo Sélangai Claude Audrey Meguieze Nsoh Ndeh-Fofang Serge Tchoukoua Jean-Baptiste Fotso Djemo Paul Koki Ndombo Department of Pediatrics Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Institut Supérieur des Sciences de la Santé de Bangangté Université des Montagnes Bangangté Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon

Introduction: Access to antiretroviral drugs has improved the survival of children infected with the human Immunodeficiency Virus (hIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of hIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned hIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University hospital Centre (ChUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.***.2.6. Results: One hundred and thirteen hIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with hIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .

关键词： hIV Adolescent Acceptance Experience

Spalling characteristics of high-temperature treated granitic rock at different strain rates

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Journal of Rock Mechanics and Geotechnical Engineering 2024年第4期16卷 1280-1288页

作者： l.F.Fan Q.h.Yang X.l.Du The Key laboratory of Urban Security and Disaster Engineering of Ministry of Education Beijing University of TechnologyBeijing100124China

The dynamic spalling characteristics of rock are important for stability analysis in rock *** paper presented an experimental investigation on the dynamic spalling characteristics of granite with different temperatures and strain rates.A series of dynamic spalling tests with different impact velocities were conducted on thermally treated granite at different *** dynamic spalling strengths of granite with different temperatures and strain rates were determined.A model was proposed to correlate the dynamic spalling strength of granite,high temperature and strain *** results show that the spalling strength of granite decreases with increasing ***,the spalling strength of granite with a higher strain rate is larger than that with a lower strain *** proposed model can describe the relationship among dynamic spalling strength of granite,high temperature and strain rate.

关键词： Dynamic spalling characteristics high temperature Strain rate Dynamic loading Granite

Traumatic Diaphragmatic hernia in Children: A Case Report

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Surgical Science 2024年第3期15卷 111-117页

作者： lucienne Irène Patricia Ondima Rhodia hélène Bosseba Missengue Nuptia Erica Akobande Cardinale Princilia Okiemy Niendet Jean-Claude Mieret Caryne Mboutol-Mandavo Department of Pediatric Surgery Marien Ngouabi University Brazzaville Congo Department of Paediatric Surgery Hospital and University Centre (HUC) Brazzaville Congo

Introduction: Traumatic diaphragmatic hernia is a rare condition in children complicating closed or penetrating trauma to the abdomen and thorax. We report the case of an 11-year-old girl with a traumatic diaphragmatic hernia. Case Presentation: An 11-year-old girl was seen in the paediatric surgery department for a thoracolumbar spine deformity and intermittent chest pain. These symptoms occurred after a domestic accident involving a fall from a low wall onto the thoracolumbar spine 5 months previously. The diagnosis was suggested by the presence of a left hemithoracic hydroaera and confirmed by a thoraco-abdominal CT scan. Surgical exploration revealed a linear rupture of the entire left hemi-diaphragm with herniation of the stomach, small intestine, cecum, transverse colon and omentum. We performed a double-layer suture of the diaphragmatic rupture with a non-absorbable suture without edge rejuvenation after the reduction of the hernia. The outcome was favourable with normal postoperative radiographs at one year follow-up. Conclusion: Traumatic diaphragmatic hernia, although uncommon and difficult to diagnose, is a condition that is relatively easy to manage surgically, even if it is discovered late. In all cases of trauma to the thoracolumbar spine, regular follow-up and repeat X-rays are necessary if pain persists.

关键词： hernia Diaphragm Trauma Child Case Report

neonatal Intestinal Obstruction in Acute Renal Failure in Premature Infant: A Case Report

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Open Journal of Pediatrics 2024年第2期14卷 338-343页

作者： Ondima lucienne Irène Patricia Okiemy Niendet Cardinale Princilia Gandzali-Ngabe Pierre Eric Caryne Mboutol-Mandavo Bosseba Missengui Rhodia hélène Akobande Nuptia Erica Department of Paediatric Surgery CHU Brazzaville Brazzaville Congo Faculty of health Sciences Marien Ngouabi University Brazzaville Congo Department of nephrology and Dialysis Brazzaville University Hospital Brazzaville Congo

Introduction: Intestinal obstruction is a common cause of abdominal surgery in the neonate. Diagnosis is straightforward using standard radiology, and surgical technique depends on the underlying anatomical lesion. Peritoneal dialysis (PD) is an effective, albeit invasive, therapy for neonatal renal failure. We report a case of neonatal obstruction with severe renal failure treated by PD to highlight our hospital practice and possible remedies in a context of limited resources. Case Presentation: This was a female neonate of moderate prematurity admitted on day 4 of life for management of a flat neonatal obstruction. Radiological diagnosis suggested small bowel atresia. Biological tests revealed severe renal failure with creatinine levels of 416 micromoles per liter and blood urea of 27.1 micromoles per liter. Management consisted of preoperative peritoneal dialysis for 48 hours followed by laparotomy. The intraoperative diagnosis was GROSFElD type IIIa digestive atresia. The postoperative course was favourable, transit was resumed on day 5 and the patient returned home on day 12. Progress at 3 months was satisfactory. Conclusion: neonatal intestinal obstruction with renal failure in premature infants is associated with a poor prognosis, even more so if there is a delay in treatment. Peritoneal dialysis seems to be a suitable alternative for this management in our working conditions with limited resources.

关键词： neonate Occlusion Peritoneal Dialysis Case Report

Effect of radiative loss mechanisms on FIR thermometric parameters of Nd^(3+)-doped lithium tellurite glasses

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Journal of Rare Earths 2024年第7期42卷 1250-1257,I0002页

作者： C.Y.Morassuti A.P.l Silva l.A.O.Nunes S.M.lima l.h.C.Andrade Optical and Photothermal Spectroscopy Group(GEOF) Center for Studies in Natural Resources(CERNA)State University of Mato Grosso do Sul(UEMS)C.P.351DouradosMSBrazil Renato Archer Information Technology Center Dom Pedro I Highway(SP-65)Km 1436-Chácaras Campos dos AmaraisCampinasSPBrazil Institute of Physics of São Carlos University of São PauloSão CarlosSPBrazil

Nd^(3+)-doped tellurite glasses are promising materials for thermometers based on the fluorescence intensity ratio(FIR)***,at high Nd^(3+)concentrations,energy transfer(ET)processes such as optical reabsorption and cross-relaxation can affect the Nd^(3+)emission,which has been little explored in the ***,the present work investigated the use of Nd^(3+)-doped tellurite glass(samples doped with Nd^(3+)at 0.2 mol%,0.5 mol%,2.0 mol%,and 4.0 mol%)in fluorescence thermometers,in the temperature range from 299 to 371 *** results indicate a strong dependence of the FIR parameters on the Nd^(3+)concentration,due to changes in the emission band profiles caused by optical reabsorption of the Nd^(3+)emissions and cross-relaxation processes.A decrease of the relative sensitivity of the ratio^(4)F_(5/2)→^(4)I_(9/2)/^(4)F_(3/2)→^(4)I_(9/2)is observed for samples doped with higher amounts of Nd^(3+).The maximum relative sensitivity at 299 K is 3.00%/K,which is the highest value among the reported Nd^(3+)ions.

关键词： Nd^(3+)-doped tellurite glass Fluorescence intensity ratio Optical thermometry Judd-Ofelt Rare earths

Bithalamic Ischemic Stroke in Sickle Cell Patient at the Kamenge University hospital in Burundi: Case Report

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Open Journal of Medical Imaging 2024年第2期14卷 72-78页

作者： Sébastien Manirakiza Daniel Nduwayo Patrice Barasukana Chantal Murekatete Jean Bosco Bizimana Alice Ndayishimiye léopold Nzisabira hélène Bukuru Department of Radiology Kamenge University Hospital Center University of Burundi Bujumbura Burundi Department of Internal Medicine Neurology Kamenge University Hospital Center University of Burundi Bujumbura Burundi Department of Surgery Neurosurgery Kamenge University Hospital Center University of Burundi Bujumbura Burundi Department of Pediatrics Kamenge University Hospital Center University of Burundi Bujumbura Burundi

Aim: To describe the clinical and radiological diagnostic for a sickle cell patient who got a bithalamic vasculature accident. Observation: This was a 4-year-old female child admitted to the pediatric ward for convulsive seizures in a feverish context. The physical examination did not find signs of meningeal irritation. The effective workup including thick gout, lumbar puncture, complete blood count, and C reactive protein was normal. An electrocencephalogram was not performed due to lack of availability of the device. Based on clinical data and the fact that Burundi is an area of high malaria prevalence, antimalarial and anticonvulsant treatment has been started. An alteration of consciousness (the Glasgow score of 7) had motivated a CT scan. Bithalamic hypodensities in favor of a vascular accident have been demonstrated. Etiological investigation revealed homozygous sickle cell disease ss during hemoglobin electrophoresis. The final evolution has been characterized by a return to normal consciousness. Conclusion: The complexity of the clinical picture following occlusion of Percherons artery makes it difficult to diagnose. Sickle cell disease may favour the occurrence of ischaemic lesions. Cerebral imaging enables the diagnosis to be made with certainty and avoids delays in treatment.

关键词： Stroke Bithalamic Infarction Sickel Cell Percheron Artery

Effect of cold-working on corrosion induced damage in lug joints

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Defence Technology（防务技术） 2024年第6期36卷 175-182页

作者： Ramanath M.N Chikmath l. Murthy h. Department of Aerospace Engineering Indian Institute of Technology-MadrasChennai 600036India Department of Aeronautical Engineering KLS Gogte Institute of TechnologyBelagavi 590008India

lug joints are preferred joineries for transferring heavy loads to parent components in aerospace *** experience corrosion due to environmental conditions,improper surface finishes and rubbing displacement between the pin and *** causes damage of different sizes and shapes near the *** degradation due to corrosion-induced damage is modelled as a through-pit at one of the identified critical locations through stress *** effect of this pit on fatigue crack initiation life is ***-hole is pre-stressed by cold-working and the benefits of inducing plastic wake on the intended performance of the lug joint during the damages due to corrosion are brought out and compared with non-cold-worked *** analysis is performed on this lug joint with *** results obtained highlight the benefits of cold-working and the methodology can be extended to damage growth and analyse the effect of surface treatments for better structural integrity of components of aerospace vehicles.

关键词： lug joint Corrosion Crack initiation Cold-working Structural integrity