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Peritonitis: Perioperative Care in Surgical Emergencies CHU Ignace Deen

Open Journal of Anesthesiology 2023年第4期13卷 85-94页

作者： Abdoulaye Touré Amadou Yalla Camara Almamy Bangoura M’Mah Lamine Camara Marie Paul Sidohon Okou anesthesia-resuscitation service Ignace Deen Hospital Conakry Guinea Department of Medical and Surgical Emergency Donka University Hospital Conakry Guinea anesthesia-resuscitation service Donka University Hospital Conakry Guinea

Objective: Describe the perioperative management of peritonitis in surgical emergencies. Methodology: This was a prospective observational study of the descriptive type over a period of 12 months from January 01 to December 31, 2020 in the surgical emergency room at the CHU Ignace Deen. Included in the study were all patients admitted for peritonitis aged greater than or equal to 18 years. The parameters were epidemiological, clinical and anesthetic. Results: Of the 653 admissions to surgical emergencies in 2020, 185 cases presented with peritonitis, i.e. 29.3%. The average age was 38.6 ± 16.64 years with extremes of 18 and 90 years. The sex ratio was 1.89. The comorbidities were dominated by gastritis and hypertension, i.e. 22%. The patients were classified as ASA 3U (52.4%), ASA2 U (39.5%) and ASA 4 U (8.1%). Preoperative resuscitation was provided only with 100% saline. 25.5% of patients had received a blood transfusion. The response time was less than 48 hours, i.e. 77.6%. General anesthesia was performed for all patients. Ketamine was the most used IV hypnotic (56.3%) combined with 100% halothane. The curares used were suxamethonium at (81.6%), Atracurium (81.6%) and rocuronium at (18.3%). Fentanyl was the only morphine used. Senior anesthesia technicians provided anesthesia in (63.2%). Intraoperative incidents were dominated by hypotension, difficult intubation, cardiac arrest, respectively 10.3%, 8% and 0.5%. The immediate postoperative incidents were arterial hypotension, nausea and desaturation, respectively 52.9%, 80% and 32.4%. Mortality was 3.4%. Conclusion: The perioperative management of peritonitis in the emergency room must be as early as possible in order to reduce morbidity and mortality.

关键词： Surgical Emergencies Peritonitis anesthesia Perioperative

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Identifying Malaria Hotspots Regions in Ghana Using Bayesian Spatial and Spatiotemporal Models

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Infectious Diseases & Immunity 2024年第2期4卷 69-78页

作者： Abdul-Karim Iddrisu Dominic Otoo Gordon Hinneh Yakubu Dekongmene Kanyiri Kanimam Yaaba Samuel Cecilia Kubio Francis Balungnaa Dhari Veriegh Department of Mathematics and Statistics University of Energy and Natural ResourcesSunyani 233Ghana Department of Statistical service Ghana Statistical ServiceBono RegionSunyani 233Ghana Department of Mathematics and ICT Gambaga College of EducationSunyani 233Ghana Human Resources Division University of Energy and Natural ResourcesSunyani 233Ghana Department of Biological Science University of Energy and Natural ResourcesSunyani 233Ghana.

Background:Malaria remains a significant public health concern in Ghana,with varying risk levels across different geographical *** affects millions of people each year and imposes a substantial burden on the health care system and *** risk estimation and mapping are crucial for effectively allocating resources and implementing targeted interventions to identify regions with disease *** study aimed to identify regions exhibiting elevated malaria risk so that public health interventions can be implemented,and to identify malaria risk predictors that can be controlled as part of public health interventions for malaria ***:The data on laboratory-confirmed malaria cases from 2015 to 2021 were obtained from the Ghana Health service and Ghana Statistical *** studied the spatial and spatiotemporal patterns of the relative risk of malaria using Bayesian spatial and spatiotemporal *** malaria risk for each region was mapped to visually identify regions with malaria *** and heterogeneity of disease risks were established using correlated and uncorrelated structures via the conditional autoregressive and Gaussian models,*** estimates from the marginal posterior distribution were estimated within the Integrated Nested Laplace Approximation using the R ***:The spatial model indicated an increased risk of malaria in the North East,Bono East,Ahafo,Central,Upper West,Brong Ahafo,Ashanti,and Eastern *** spatiotemporal model results highlighted an elevated malaria risk in the North East,Upper West,Upper East,Savannah,Bono East,Central,Bono,and Ahafo *** spatial and spatiotemporal models identified the North East,Upper West,Bono East,Central,and Ahafo Regions as hotspots for malaria *** variations in risk were evident across regions(H=104.9,P<0.001).Although climatic and economic factors influenced malaria infection,statistical significance was not

关键词： Malaria Disease hotspot Bayesian modeling Conditional auto-regressive Integrated Nested Laplace Approximation Spatial and spatiotemporal models

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Evaluation of the Quality of Life of Patients Suffering from Chronic Rhinosinusitis in a Hospital Setting in Kinshasa

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第1期13卷 41-52页

作者： Hilaire K. Kalala Patricia K. Kakobo Honoré N. Yalombe Lievin K. Mvita Léon N. Muamba Dieudonné T. Nyembue Otorhinolaryngology service University of Kinshasa Democratic Republic of Congo Imaging Department University of Kinshasa Democratic Republic of Congo Ophthalmology service University of Kinshasa Democratic Republic of Congo

Background and objective: Chronic rhinosinusitis (CRS), a common disease worldwide, has a major impact on patients’ quality of life (QoL). In recent years, the measurement of health-related QoL has made it possible to assess the patient’s state of health, the severity of the CRS and the treatment. The aim of this study was to assess the QoL of patients with CRS in a hospital setting in Kinshasa. Methods: This was a cross-sectional analytical study conducted from June 2020 to May 2021 in the ENT service of the Kinshasa University Hospital and the Monkole Hospital Center. The study involved 113 patients aged at least 18 years, whose QOL was compared with that of a control group consisting of 100 non-patients. QOL was assessed using the Sino-Nasal Outcome Test (SNOT-22) Questionnaire. Results: The mean age of the patients was 41.0 years (18 - 74 years) and that of the controls was 39.1 years (19 - 77 years). More than half of the participants were university graduates. The median SNOT-22 score was 44 (14 - 78) in patients and 7 (1 - 40) in controls. Compared with subjects without CRS, patients with CRS had significantly higher scores in all four domains of the SNOT-22. Around 9 out of 10 patients had a severely impaired QoL compared with 2 out of 10 controls. Considering mildly impaired QoL, we found that in the otological and sleep domains, scores were not significantly different between patients and controls. In the case of severely impaired QoL, however, only the otological domain showed a non-significant difference in scores between the two groups. Conclusion: CRS is a real public health problem in our environment and significantly alters the QoL of patients suffering from it, with repercussions on their professional productivity;hence the need for better management.

关键词： Chronic Rhinosinusitis Quality of Life SNOT-22 ENT Kinshasa

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Prevalence of Depression and Anxiety in Patients with Autoimmune Disease: A Comparative Study with a Diabetic Population

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Open Journal of Internal Medicine 2024年第2期14卷 159-166页

作者： Michel Assane Ndour Mouhamed Dieng Omar Boun Khatab Diouf Léon Birwe Boundia Djiba Ibrahima Mané Diallo Matar Ndiaye Nousradine Mourno Tarsa Djiby Sow Anna Sarr Demba Diedhiou Maimouna Ndour Mbaye service de Mdecine Interne Centre Hospitalier Abass Ndao Dakar Senegal service de Mdecine Interne Centre Hospitalier Aristide Le Dantec Dakar Senegal

Introduction: Systemic diseases are a variety of heterogeneous autoimmune and/or autoinflammatory diseases and syndromes usually affecting multiple systems and resulting from immune system dysregulation. We evaluated risk factors for depression and anxiety in an autoimmune disease cohort compared with diabetic patients. Patients and Methods: We conducted an observational, cross-sectional, case-control survey comparing two groups: individuals with connective tissue disease (CTD) and diabetic controls who were followed within three Dakar University hospitals during the period from April to June 2023. Results: The sample comprised 106 participants, of whom 51 (48%) had CTD and 55 (52%) served as diabetic controls. In the CTD group, the majority had lupus (19) and rheumatoid arthritis (23). The CTD patients had a mean age of 41.0 years (SD 16.9), while the diabetic patients had a mean age of 55.9 years (SD 11.7), with a significant difference observed (p Conclusion: Compared to a chronic disease, devastating in Africa and evolving over the long term, autoimmune diseases are more strongly and more frequently associated with anxiety and depression. This is a factor to be taken into account in the holistic management of these patients.

关键词： Connective Tissue Disease Lupus Rhumatoid Arthritis Diabetes Depression Anxiety Disability

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Accurate Shortwave Radiation Simulation with a Two-Layer Aerosol Model in Xinjiang Region

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Journal of Meteorological Research 2024年第1期38卷 69-87页

作者： Guan HUANG Yonghang CHEN Qiong LIU Pengtao WANG Qianshan HE Qing HE Shuai LI Weiling SHAO Ting FAN School of Tourism&Research Institute of Human Geography Xi’an International Studies UniversityXi’an 710128 Center for Silk Road and Eurasian Civilization Studies Xi’an International Studies UniversityXi’an 710128 College of Environmental Science and Engineering Donghua UniversityShanghai 201620 Shanghai Meteorological service Shanghai 200030 Shanghai Key Laboratory of Meteorology and Health Shanghai 200030 Taklimakan Desert Meteorology Field Experiment Station of China Meteorological Administration Institute of Desert MeteorologyUrumqi 830002 Xinjiang Climate Centre Xinjiang Meteorological ServiceUrumqi 830002

To harness the rich solar energy resources in Xinjiang Region of Northwest China,this study tries to address the issue of lack of downward surface shortwave radiation(DSSR)observations and the need to improve the accuracy of satellite retrieval and numerical simulation of DSSR under varied sky and meteorological conditions.(1)A two-layer aerosol model specific to Xinjiang was developed to capture the vertical distributions of aerosols based on multiple data sources including lidar,GPS sounding,ground meteorological observations,and profiles from the ECMWF reanalysis version 5(ERA5)*** results show that the ERA5/PBLH(planetary boundary layer height)and ERA5/ALH(aerosol layer height)could be used to establish the two-layer aerosol model and characterize the vertical distribution of aerosols in Xinjiang Region.(2)Using the Santa Barbara Discrete Atmospheric Radiative Transfer(SBDART)model,a localized inverse model of clear-sky DSSR was *** parameter adjustment and using the optimal combination of input parameters for DSSR simulation together with the two-layer aerosol model,the model-simulated DSSR(DSSRSBD)under clear-sky conditions improved significantly compared to the initial results,with all fitting indices greatly improved.(3)In addition,the study demonstrated that the impact of the two-layer aerosol model on DSSR was more pronounced under dust conditions than clear-sky conditions.(4)Using the localized clear-sky DSSR inversion model and its required parameters,simulations were also conducted to capture the spatiotemporal distribution of DSSR under clear-sky conditions in Xinjiang from 2017 to *** annual average DSSR_(SBD)under clear-sky conditions in Xinjiang during 2017–2019 was 606.78 W m^(-2),while DSSR from CERES(DSSR_(CER))under the same conditions was generally higher(703.95 W m^(-2)).(5)It is found that satellite remote sensing products experienced data loss in high-altitude snow areas,where numerical simulation technology could ser

关键词： downward surface shortwave radiation(DSSR) aerosol vertical distribution Clouds and the Earth’s Radiant Energy System(CERES) Santa Barbara Discrete Atmospheric Radiative Transfer(SBDART) Xinjiang

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Eutrophication of Jiangsu Coastal Water and Its Role in the Formation of Green Tide

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Journal of Ocean University of China 2024年第1期23卷 109-118页

作者： XIAO Mingyan SONG Weina ZHANG Haibo SHI Xiaoyong SU Rongguo Key Laboratory of Marine Chemistry Theory and Technology Ministry of EducationOcean University of ChinaQingdao 266100China National Marine Environmental Monitoring Center Dalian 116000China National Marine Hazard Mitigation service Beijing 100194China

Since 2007,the large-scale green tide caused by Ulva prolifera(***)have occurred as a recurrent phenomenon in the southern Yellow Sea of *** surveys and satellite remote sensing showed that the small scattered patches of green tide algae were first observed along the Porphyra agriculture area of the Subei Shoal in late *** this study,we attempted to identify the role of eutrophication in the origin of the green tide in the Subei Shoal and its adjacent *** Shoal and its adjacent area are characterized by rich nutrients,especially NO_(3)^(-)-N,NH_(4)^(+)-N,PO_(4)^(3-)-P,and other bioavailable components(such as urea-N and amino acids).In the spring of 2017,the average concentrations of NO_(3)^(-)-N were 19.01±11.01μmolL^(-1),accounting for 86.68%of the dis-solved inorganic nitrogen(DIN).In addition,the average concentration of NH4^(+)-N was 2.51±1.60μmolL^(-1).PO_(4)^(3-)-P had an average concentration of 0.14±0.13μ*** average concentrations of urea-N and total hydrolyzed amino acids(THAA)were 1.73±1.36μmolL^(-1)and 1.33±0.80μmolL^(-1),*** nutritive substances play a key role in the rapid production of *** and make the Jiangsu coastal water an incubator for green tide.

关键词： green tide nutrients algae Ulva prolifera eutrophication Subei Shoal

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Comparison of a Spectral Bin and Two Multi-Moment Bulk Microphysics Schemes for Supercell Simulation:Investigation into Key Processes Responsible for Hydrometeor Distributions and Precipitation

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Advances in Atmospheric Sciences 2024年第5期41卷 784-800页

作者： Marcus JOHNSON Ming XUE Youngsun JUNG Center for Analysis and Prediction of Storms University of OklahomaNormanOK 73072USA School of Meteorology University of OklahomaNormanOK 73072USA Office of Science and Technology Integration National Weather ServiceSilver SpringMD 20910USA

There are more uncertainties with ice hydrometeor representations and related processes than liquid hydrometeors within microphysics parameterization(MP)schemes because of their complicated geometries and physical *** supercell simulations are produced using the WRF model coupled with“full”Hebrew University spectral bin MP(HU-SBM),and NSSL and Thompson bulk MP(BMP)***-SBM downdrafts are typically weaker than those of the NSSL and Thompson simulations,accompanied by less rain ***-SBM produces more cloud ice(plates),graupel,and hail than the BMPs,yet precipitates less at the *** limiting mass bins(and subsequently,particle size)of rimed ice in HU-SBM and slower rimed ice fall speeds lead to smaller melting-level net rimed ice fluxes than those of the *** from plates in HU-SBM,together with snow–graupel collisions,leads to a greater snow contribution to rain than those of the *** HU-SBM’s fall speeds using the formulations of the BMPs after aggregating the discrete bin values to mass mixing ratios and total number concentrations increases net rain and rimed ice ***,they are smaller in magnitude than bulk rain,NSSL hail,and Thompson graupel net fluxes near the ***,the melting-layer net rimed ice fluxes are reduced when the fall speeds for the NSSL and Thompson simulations are calculated using HU-SBM fall speed formulations after discretizing the bulk particle size distributions(PSDs)into spectral *** results highlight precipitation sensitivity to storm dynamics,fall speed,hydrometeor evolution governed by process rates,and MP PSD design.

关键词： precipitation spectral bin microphysics bulk microphysics parameterization microphysics processes WRF model supercell storm

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Post Blast Tympanic Perforations, Clinical and Paraclinical Study at Six Yaounde Hospitals

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第2期13卷 126-134页

作者： Andjock Nkouo Yves Christian Lekassa Pierrette Meva’a Biouele Roger Christian Moboung Prudence Mindja Eko David Djomou Francois Njock Richard Ndjolo Alexis Ophthalmology-Ear-Nose-Throat (ENT)-Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon ENT-Cervico-Facial-Surgery (CFS) service Yaounde General Hospital Yaounde Cameroon ENT-CFS service Omar Bongo Ondimba Military Teaching Hospital Libreville Gabon ENT-CFS service Yaounde Central Hospital Yaounde Cameroon ENT-CFS service Yaounde Teaching Hospital Yaounde Cameroon ENT-CFS service Douala General Hospital Douala Cameroon

Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.

关键词： Tympanic Perforation Blast Yaounde

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Optimal Scheduling of Regional Integrated Energy Systems Considering Hybrid Demand Response

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CSEE Journal of Power and Energy Systems 2024年第3期10卷 1208-1219页

作者： Ganyun Lyu Bin Cao Dexiang Jia Nan Wang Jun Li Guangyu Chen Department of Electrical Engineering Nanjing Institute of TechnologyNanjing 211167China State Grid Energy Research Institute Co. LTDBeijing 102209China State Grid Integrated Energy service Group Co. LTDBeijing 100032China IEEE CSEE

Flexible load can optimize the load curve,which is an important means to promote renewable energy *** peculiarities of electricity,heat,cooling and gas loads are analyzed in this paper,considering the fuzzy degree of human perception for water temperature,and the characteristic model of hot water load is *** the fuzzy degree of human perception of ambient temperature,the characteristic model of cooling load is established by using PMV and PPD ***,considering four combinations of cut load,translatable load,transferable load and alternative load,and considering the coupling relationship of composite parts,different response models of load are established *** the minimum cost of the system,including operation and compensation costs as the objective function,the optimization scheduling model of the regional integrated energy system is established,and the Gurobi solver is used for simulation analysis to solve the optimal output and load response curve of each piece of *** results show that the load curve can be optimized,the flexible regulation ability of the regional integrated energy system can be enhanced,the energy loss of the system can be reduced,and the wind power consumption ability of the system can be increased by considering the integrated demand response.

关键词： Alternative load day ahead optimal scheduling integrated demand response PMV and PPD index regional integrated energy system

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The Reasons for Admission of Elderly Subjects in Intensive Care at the CHU Ignace Deen

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Open Journal of Emergency Medicine 2023年第3期11卷 100-109页

作者： Abdoulaye Touré Amadou Yalla Camara Almamy Bangoura Donamou Joseph M’mah Lamine Camara anesthesia-resuscitation service University Hospital of Ignace Deen of Conakry Conakry Guinea Medical and Surgical Emergency Department Donka University Hospital Conakry Guinea anesthesia-resuscitation service Donka University Hospital Conakry Guinea

Objective: To determine the reasons for admission of elderly subjects and the prognosis in general intensive care. Patients and Methods: Observational descriptive and analytical study with prospective collection of data over a period of one year from January 1 to December 31, 2021. Patients aged 65 or over were included. Abstract: During the study period, 223 cases were collected out of 587 patients admitted, giving a prevalence of 37.9%. The average age was 74.127.39 ± years with extremes of 65 and 96 years and a male predominance (58.7%). The comorbidities were dominated by arterial hypertension (71.3%). The patients were: transferred from medical and surgical emergencies (75.8%). The average admission time was 48.8 ± 29.8 hours. One hundred and eight patients had a Glasgow score between 3 and 7. The reasons for admission were dominated by vascular causes (51.6%). Strokes of any type accounted for 43.9% of these reasons for admission. The average time for carrying out the biological assessments and imaging was 41.8 ± 27.3 hours with the extremes of 3 and 89 hours, 37.2% had a complete assessment within 24 hours. The average duration of hospitalization was 7.10 ± 8.87 days with extremes of 1 and 72 days. The mortality rate was 71.7%. Conclusion: This study has made it possible to take stock of the reasons for the admission of elderly subjects to intensive care. It appears that vascular causes are the main reasons for admission with heavy comorbidities which results in high mortality.

关键词： Reasons for Admission Elderly Subject resuscitation

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