Maternal Death before Admission to the Sylvanus Olympio University Hospital Center (CHU SO): Epidemiological and Etiological Aspects

Background: In Togo, the maternal mortality rate in 2017 was estimated at 396/100,000 live births. Maternal death before admission is an increasingly growing phenomenon in the gynecology-obstetrics clinic of the CHU SO. No epidemiological data is available on the subject. Objective: Determine the epidemiological and etiological profiles of a pregnant, parturient, or woman who has given birth dead before or within 10 minutes of her admission. Methods: This was a descriptive cross-sectional study from January 1, 2014, to December 31, 2021. All maternal deaths occurring before admission and within 10 minutes of admission to the clinic were included in the study of gynecology and obstetrics at CHU SO. The data were processed by Epi info version 7 software. Results: In total, 654 maternal deaths, including 153 maternal deaths before admission, were recorded, corresponding to 23.4% of all maternal deaths. The median age was 30.2 years. 37.2% of women were uneducated. 41.2% were resellers. 79.1% of women were cohabiting. 47.1% of women had performed less than 3 ANC. 43.8% of the women who died had completed their ANC in a medical center. 54.3% by a midwife, 37.3% by unqualified personnel. 62.7% of deaths occurred postpartum and 36.3% during pregnancy. 79.1% were referrals. 88.9% of the women who died arrived in a non-medical taxi car. Among the 57 patients who died during their pregnancy, 40.3% were carrying a pregnancy of 28 to 36 weeks, and 36.3% were full-term pregnancies. Among the 96 women who died postpartum, 93.3% had given birth vaginally. Among the 121 referrals, 34.7% came from a birthing center, 56.2% were referred by a state midwife and 30.6% by unqualified personnel;46.3% were referred without a reference form, 94.3% were referred without venous access. In 10.7%, the reason for evacuation was bleeding from the delivery, with an average evacuation time of one-hour 5minutes. 60.3% of women who died had an evacuation delay of more than one hour. 94.8% of patients died of direct obstetric causes, including immediate postpartum hemorrhage in 60.1% of cases. Conclusion: Deaths before admission constitute an increasingly growing problem at CHU SO. A late referral is a determining factor in maternal deaths before admission.

Epidemiological and Prognostic Aspects of Obesity and Pregnancy in the Gynecology-Obstetrics Department at the Sylvanus Olympio University Hospital Center (CHU SO) in Lomé

Introduction: Obesity and pregnancy is a major public health problem worldwide, both maternal and fetal. Objective: This is to describe the epidemiological and prognostic aspects of obesity and pregnancy in the gynecology-obstetrics department at the Sylvanus Olympio University Hospital Center (CHU SO) in Lomé. Methodology: This was a descriptive cross-sectional study concerning obesed pregnant women. The survey was conducted from the 1st to the 30th of June 2022 at the CHU SO. Results: We enrolled 55 obese pregnant women. The frequency of obesity and pregnancy was 5.14%. Resellers were represented at 41.8%. The average age was 31 years old. As risk factors, 85.5% claimed to have a fatty diet and 76% did not practice sports. The gestational pathologies found during pregnancy were hypertension in 47.4% of cases, preeclampsia in 24.6% and gestational diabetes in 7%. Caesarean section was the way of delivery in 63.6% of cases and those who gave birth vaginally presented a tear of the soft tissues in 85% of cases. Birth weight was abnormal (low weight and excess weight) in 61.8% of cases. Conclusion: The association between obesity and pregnancy constitutes an important risk factor for the mother and the fetus.

Oesophageal Mycosis: Epidemiological and Clinical Aspects and Risk Factors for Occurrence in the Digestive Endoscopy Unit of the Donka National Hospital, Conakry CHU

Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1st January to 31st December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.

Personage Column:CHU Datong(Beijing,China)

Professor Da-Tong Chu is Chief Scientist of Medical Oncology and Chairman of Ethical Committee, Cancer Institute and Hospital, Chinese Academy of Medical Sciences(CAMS), Beijing. He is President of Chinese Society of Clinical Oncology (CSCO), Vice-Chairman of the GCP Center of National Anti-Cancer Drugs, and is the member of the Expert Committee of State Food and Drug Administration(SFDA), and member of Chinese Pharmacopoeia Committee.

A Motherland That One Cannot Return to An Interpretation on Song of The Chu From a Perspective of Cultural Security

Song of The Chu, a novel written by LAN Zi-- a Chinese Australian writer, recounts the struggle in Australia over 20 years （1988-2008） of a group of Chinese young people. Cultural difference or even conflict is one of the inevitable issues in terms of migration. The Chinese （Han） culture which belongs to the continental civilization and the Australian （Western） culture which belongs to the maritime one are both mighty and cannot be conquered or assimilated by each other. This means that the Chinese immigrants to Australia, compared to the ones from a less mighty culture, are more sensitive and resistant to the impact of an alien culture, which leads to a conscious or unconscious sense of security of the mother culture. Cultural security, not unidirectional, also refers to the worry by the locals of the impact brought by the immigrants. The protagonist resorts to converting to Buddhism as a solution to the cultural schizophrenia

Maternal Mortality in the Gynecology-Obstetric Department at the Yalgado Ouedraogo University Hospital Center (CHUYO), Burkina Faso: About 181 Cases Collected from January 1^stto December 31^st2016

Objective: To study maternal mortality in the obstetrics and gynecology department at Yalgado Ouedraogo teaching Hospital Center. Patients and Methods: We conducted a cross-sectional retrospective and descriptive study of 181 cases of maternal deaths during study period. The parameters studied were sociodemographic characteristics, the causes of death, the clinical data and the contributing factors. Results: The maternal mortality ratio was 2624 per 100,000 live births. The mean age of death was 26.79 with extremes of 15 years to 40 years. Direct obstetric causes accounted for 58% dominated by hypertension and complications, hemorrhage during pregnancy and postpartum, and obstetric infections. The indirect obstetric causes were 42% dominated by non-obstetric infections and chronic anemias. In addition to the delay in consultation and delay in care, the lack of antenatal care was the contributing factor to maternal deaths. Conclusion: Maternal mortality remains a public health problem in view of its high ratio. The reduction of this scourge will inevitably go through a health insurance that will allow the supply of quality care.

Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN/CAP) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry

Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). Methods: This was a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, i.e. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. Results: Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis;29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined status and 24 14.11% had a normal FLI. Conclusion: Identifying subjects at risk of metabolic steatopathy, diagnosing and managing these patients is a public health issue and one of the future challenges of hepato-gastroenterology. Fibroscan is an increasingly popular screening tool for hepatic fibrosis and steatosis. The fight against obesity must be a priority.

Chu空间下的粗糙集与证据理论结合进行内燃机诊断

证据理论是处理不确定性问题的有效工具,但其依赖专家知识提供证据,并要求各证据体相互独立,致使实际应用困难。借助粗糙集理论,剔除冗余成分,应可克服证据获取主观性和证据体相关性的缺陷。Chu空间理论提供了一种通用的代数框架,是用于诊断信息融合的一种新方法;针对此问题,研究了Chu空间表达下的粗糙集与证据理论可集成性,并提出了基于二者集成的故障诊断推理策略。柴油机的实际诊断结果验证了将粗糙集与证据理论相结合进行故障诊断的良好效果。

TD-LTE系统中Zadoff-Chu序列的研究与DSP实现

通过对Zadoff-Chu(ZC)序列生成算法的分析及理论推导,提出了一种快速、有效的Zadoff-Chu序列生成的DSP实现方案。该方案已经在TMS320C64xDSP中实现。通过在CCS3.3中运行程序,验证了方案的可行性和高效性。该方案在LTE-TDD无线综合测试仪表的开发中已经得到应用。

Environmental Risk Factors for Stomach Cancer in an African Setting about 193 Cases at the CHU Point G in Bamako/Mali

CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, cardiovascular surgery, plastic and endocrinology surgery. As a reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. Aim: To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. Patients and Methods: We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). Results: We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer or 50.79% of digestive cancers. The mean age of the patients was 57.21 ± 13 years. Male sex represented 55% (n = 106). Eating habits were dominated by the consumption of tô with potash (cereal paste) with 64.76% (n = 185). The main methods of preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n = 5). The low socio-economic class represented 126 cases or 65.38%. Housewives and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20% (n = 39) had a history of epigastric pain. Epigastralgia was the most common functional sign with 84.5% of cases (n = 169). An epigastric mass was found in 72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188). Palliative surgery concerned the majority of our patients with 64.8% of patients (n = 79). The postoperative consequences were simple in 28.57% of cases (n = 28), the postoperative morbidity and mortality were respectively 33.61% (n = 41), and 23.77% (n = 29). The overall survival rate after surgery was 10.81% at 2 years and 2.94% at 5 years. This rate was 58.83% at 2 years and 28.50% at 5 years after curative surgery. Conclusion: The risk factors for stomach cancer are many and varied. Some are particularly present in Africa. Delay in diagnosis due to a belief in traditional healers is common in our community.

Effect of Optimization of Agricultural Supply-side Factors on Characteristic Modern Agriculture--A Case Study of Chu Orange Manor

The structural imbalance of supply and demand of agricultural products is the result of agricultural products overemphasizing quantitative growth and neglecting quality improvement. The structural reform of agricultural supply side is to optimize the allocation of agricultural production factors,improve the quality and efficiency of supply,and meet the quality needs of consumers. The optimization of agricultural supply factors is the result of effective supply,rational allocation and comprehensive utilization of natural resources and social resources. The success of Chu Orange Manor has explained the function of the optimization of supply factors to the development of characteristic agriculture. That is,it has promoted the development of high-end agriculture,promoted the brand value of agricultural products,promoted the competitiveness of agriculture,broken the international green trade barrier of agricultural products,promoted the development of modern agriculture with characteristics,and realized the sustainable development of rural areas.

文本解读与历史研究——以古藏文中的词语chu Gang、lta zhig、rje blas为例

古藏文中的chu Gang、lta zhig、rje blas等三个词语,屡次出现在吐蕃时期的石碑文、敦煌文、简牍文等中,在后期的部分《甘珠尔》《丹珠尔》文献中,也以变异或拆解的形式出现多次。通过古藏文学者对此类词语的解读和辨认,解答了chu Gang、lta zhig、rje blas等三个词语的部分含义。但随着文字考古研究的不断深入,古藏文的文化及阐释语境有了更大的拓展,也给研究古藏文的学者们提供了更全面的阐释空间。比如:古藏文chu Gang一词,在吐蕃时期仅用来表达君臣之间的忠信关系,至后宏时期其意义逐渐延伸,可以指称婚姻里的忠诚与信任,因此不能将其单纯地理解为英勇忠良之意;而lta zhi一词的语义不断虚化,逐渐具有了介词和虚词的功能,其所指也因语句搭配而发生变化,一味地将其解释为“他”或“他本人”是不准确的;通过词语考究和语素分析发现,rje dlas一词中的“rje”指的是君王,而“dlas”(藏文dlas后来作slas)则指帐中亲信,因此,rje dlas一词可以用来表达忠诚侍奉君王的一种责任和义务,rje dlas一词的这一含义也被后来的历史叙事所继承,部分教法史在叙述“六大决议法”(bkav gros chen mo)时,常以“保护赞普,不遗余力地侍奉”(rjevi sku vtsho zhing zho sha blar dbul)来扩解rje dlas一词。

Evolutionary and Prognostic Aspects of Thrombolysed Patients for Acute Coronary Syndrome ST+ at CHU Ernesto Guevara De La Serna. Las Tunas (Cuba)

Introduction: Acute myocardial infarction (IDM) occupies the first place in terms of mortality, among ischemic pathologies. Thrombolysis in the case of medical treatment for acute myocardial infarction (AMI) is undoubtedly the most revolutionary performed to date in this context, with a significant reduction in the mortality rate. The aim of our study was to describe the epidemiological aspects, the criteria for myocardial reperfusion post thrombolysis, the complications during thrombolysis and the complications of acute myocardial infarction in the cardiology department of the CHU Ernesto Guevara De La Serna of Las Tunas (Cuba). Methods: A retrospective cross-sectional descriptive study was carried out from June 2009 to December 2011. The patients hospitalized during this period in the USIC (coronary intensive care unit) for SCA ST(+) were included in the study. The variables studied were: Age, sex, myocardial reperfusion criteria, complications during thrombolysis and complications of myocardial infarction. Results: A total of 207 patients were included. The male sex represented 72.5% of the cases, giving a sex ratio of 2.63. The age group > 60 years was predominant with 54.2% of the cases. Thrombolysed patients represented 65.2% of the cases. Myocardial reperfusion criteria were observed in the majority of thrombolysed patients: relief of precordial pain (77%), regression of the ST segment to 50% of its previous level (81.5% of patients). Bleeding was observed in 1.5% of thrombolysed cases. Complications were encountered in 57% of non thrombolysed patients with a lethality of 5.6%. Conclusion: The male sex was the most affected. Thrombolysis was effective in the majority of patients. The post thrombolysis bleeding rate was low. More than half of the cases of SCA ST(+) not thrombolysed presented complications.

Solving the Education Puzzle

LENORA Chu is a Chinese-American mother who was born and grew up in the U.S.,but is currently working as an American correspondent in China.Her husband Rob Schmits is also a journalist who wrote the book,Street of Eternal Happiness:Big City Dreams along a Shanghai Road,telling the story of“Chinese common people”living and working on the Street of Eternal Happiness in Shanghai.

Anesthetic Activities of Scheduled Surgery at CHU Gabriel Touré

Concept: We opted for this study because the hospital unit Gabriel Touré was renovated with 7 surgical specialties. Our study was the very last study before the advent of coronavirus disease 2019 (COVID 19). Goal: Evaluate the anesthetic activities of the planned surgery at the University Hospital Center CHU Gabriel Touré. Method and Material: This was a descriptive prospective study carried out in the cold operating theater of the CHU Gabriel Touré from January to December 2018. It focused on all patients operated on for regulated surgery and who had benefited from anesthesia. Our data was entered and analyzed on SPSS 25 software. Word processing performed on Microsoft WORD® 2016 and graphics on Microsoft EXCEL® 2016. Results: During the study period 1700 patients were operated on in the operating room for scheduled surgery. The age range of 0 to 5 years accounted for (14.8%). The average age was 6.64 years;male predominance (52.6%) of operated patients with a sex ratio of 1.1. A history of general anesthesia was found in 62.1%. The classification of the American Anesthesia Society (ASA) ASA1 class represented 92.7%. Tonsillitis was the most common operative diagnosis (9.5%). Hernia cures and eventrations were the most common surgical technique (11.8%). General anesthesia was achieved in 65.3% of patients. Hypotension was the most common adverse event in the operating room, 44.5%. The intraoperative mortality was 0.11%. Conclusion: Our study covered the entire population anesthetized. It provided an update on the practice of anesthesia in the intensive care unit anesthesia. General anesthesia was the most used technique;a predominance of cardiovascular adverse events, occurring more often in induction and mainly favorable outcome with mortality intraoperative 0.11%. A growing presence of MAR and DES who had performed more than 30% of anesthesia.

Study on Five-sense Landscape of Chu Ci Plants Based on NVivo

Chu Ci plants carry profound cultural connotation,and entrust with the poets’ rich emotional understanding and sensory experience.The plant-related sentences in Chu Ci were extracted by NVivo software,and the verses were analyzed and compared based on the five-sense theory.The five-sense images of plants in Chu Ci were extracted from the five aspects of vision,hearing,smell,touch and taste,and the five-sense landscape characteristics of Chu Ci plants were analyzed.The results showed that Chu Ci plants had rich five-sense images,profound artistic conception,magnificent momentum and bold imagination,and had good application potential in landscape architecture.This paper provides a reference for the landscape application of five-sense landscape of Chu Ci plants and a new idea for the inheritance and development of Chu Ci culture.

Debating the Xing (性): In the Light of Xing Zi Ming Chu and Xunzi

Xing性is an important topic of ancient Chinese philosophy.The discovery of unearthed documents has deepened our understanding of xing.Xing Zi Ming Chu性自命出is probably the Guodian manuscript that has generated the most interest among scholars.This article takes Xing Zi Ming Chu and Xunzi as investigations to explore the significance of xing in the Warring States Period in China.This article believes that the xing in Xing Zi Ming Chu only refers to natural properties,and it is not as specific as Mencius and Xunzi to indicate whether it is good or bad.The article will first review the background of Guodian manuscript,introduce the basic situation of Confucian documents in Guodian manuscripts.This article will also introduce the meaning of xing in Xing Zi Ming Chu and Xunzi,which is of great value for us to understand the meaning of xing in the Warring States Period.

Surgical Management of a Case of Splenic Necrosis at Point G Chu in Bamako

Splenic infarction is a rare condition (1/500,000 and 1/100,000) but potentially fatal. The prognosis depends on the diagnostic delay and above all on the speed of treatment. It usually occurs in a particular area such as myeloproliferative syndrome, sickle cell anemia, thalassemia etc. The objective of this work was to report a clinical case of necrosis of the spleen.

The Beauty of Chu Mirror with Its Inheritance and Transcendence

Chu mirror is one of the important components of Chu culture,and its decoration is an exotic flower of decorative arts garden in China. The Chu bronze mirror carries a rich Jingchu culture connotation. Its superb craftsmanship,fine carved decorative patterns and inaage- rounded shapes reflect the mysterious religion belief, rigorous life attitude, romantic humanism and deep moral universe structure view of Chu people.It is the valuable cultural heritage that the ancestors left for the Jingchu land and the Chinese people. Digging the beauty of Chu mirror and its inheritance and transcendence, in the ＂global＂ and ＂globalization＂ context, conform to the issue of the 18th CPC National Congress ＂ improving the national cultural soft power, playing the role of the cultttral leading customs, educating people, serving the society and promoting the development＂ .

国际化背景结合本土化管理,落地创意化设计——访More Design Office创始人Jaycee Chu与Justin Bridgland

'中国设计最大的优势,在于它有非常大的市场,提供了很多项目机会。'正是这种大量实践机会吸引了全球范围内众多设计师来到中国。与早年国际成熟设计公司通过分支机构将管理模式复制到中国的情况不同,近年来,越来越多国际背景设计师,选择直接在中国创业发展。这些境外人士开办的中国设计公司,既具备国际化的理念,同时在公司运营,设计及施工管理也已经充分实现本土化。