Ultrasound Biometry of the Liver at the Point “G” University Hospital Center in Bamako

Introduction: Biometrics therefore corresponds to the measurement of the morphological elements of humans. One of the most common ultrasound requests by clinicians is the assessment of liver size. The aim of our study was to study liver biometry using ultrasound in healthy adult subjects. Material and Methods: This was a prospective, descriptive and analytical study, carried out at CHU Point-G over a period of 7 months. A liver ultrasound was performed on 100 individuals without lesions, by a doctor in his final year of specialization in radiology and medical imaging. For each subject, we determined the height and anteroposterior diameter of the right liver and the left liver. Results: The mean age was 39.05 ± 16.86 years. The body mass index (BMI) 18.5 - 24.9 group was the most represented with 58%. The mean height of the right liver was 138.40 ± 14.85 mm. It was 136.81 ± 14.70 mm in men and 139.92 ± 14.99 mm in women (P = 0.306). That of the left liver was 95.55 ± 14.34 mm, in men, it was 91.79 ± 13.51 mm and 99.16 ± 14.31 mm in women (P = 0.019). We found a significant correlation between right liver height and BMI (P = 0.013). Conclusion: The mean values of liver biometry were established in our series. There was a significant correlation between right liver height and BMI. Liver ultrasound remains a reliable technique for liver biometry.

Epidemiological, Clinical and Etiological Aspects of Adult Hepatomegaly at the Gabriel Touré University Hospital of Bamako in 2023

Summary: Hepatomegaly is one of the clinical signs commonly encountered in chronic liver disease. The aim of our study was to study the epidemiological, clinical and etiological aspects of hepatomegaly in the hepato-gastroenterology department (HGE) of the Gabriel Touré university hospital. This was a cross-sectional study that took place from September 2021 to October 2022 in the department. All patients aged 18 years and older with hepatomegaly, hospitalized or examined by physicians were included. We collected 100 cases of hepatomegaly, representing 3.7% of 2661 patients examined or hospitalized in the HGE department during the study period. These patients had a mean age was 46.7 ± 16.10 years with extremes of 18 and 76 years. The sex ratio was 2.7. Jaundice was the most commonly reported history with a frequency of 26%. Pertaining to patients’ lifestyle, alcohol consumption was the most common feature with 6%. The most common associated clinical signs were jaundice, ascites, and edema of the lower limbs. Painful hepatomegaly (86%), with a sharp lower edge (74%), a firm consistency (69%), and an irregular surface (52%) was frequently observed. Cytolysis (75.5%), increased alphafetoprotein levels (70%), microcytic anemia (37%), hyperleukocytosis (54.3%), and biological hepatocellular insufficiency syndrome (low albumin with 30.4%, high bilirubinemia with 61.2% and low platelets with 33.9%) were the most common observed laboratory abnormalities. Hepatitis B virus markers (61%) were the most frequently found in the study patients. At ultrasound examination, heterogeneous hepatomegaly was observed in 87.3% of the patients. Esophageal varices (43.1%) were more commonly seen than other varices during upper gastrointestinal endoscopy. The dominant etiology was hepatocellular carcinoma on cirrhosis with 66% followed by cirrhosis. Conclusion: Painful hepatomegaly was quite frequently in our urban setting hospital with several etiologies. HCC was the most common etiology, therefore measures to prevent it in the community need to be established by the concerned stakeholders to improve adult population health in Bamako.

Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology Department of Kati University Hospital

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Chronic End-Stage Renal Failure in the Nephrology Department of the University Hospital of Brazzaville in 2023

Objective: Chronic end-stage renal failure is a major public health problem in developing countries and is poorly documented. The objective of this study was to describe the epidemiological, diagnostic, therapeutic, and evolutionary aspects of patients admitted for end-stage renal failure to the Department of Nephrology at the University Hospital of Brazzaville. Patients and Methods: This was a descriptive cross-sectional study collecting prospective data that took place over 10 months. We included 128 patients who were exhaustively identified. Sociodemographic, clinical, therapeutic and developmental data were collected using a standardized and pretested pre-established survey form. The EPI info software enabled the analysis and processing of the data. Results: We reported a male predominance with a sex ratio of 2.5. The median age was 50 years. The first cause found was diabetes (55%) followed by hypertension (46%). The majority of patients had a dialysis emergency and half could not be dialyzed for financial reasons. Conclusion: Our results highlighted that certain epidemiological parameters of end-stage renal failure are constantly changing, such as frequency, while others remain static, including the main etiologies, gender, and age. However, mortality continues to increase and deserves more attention.

Epidemiological, Clinical and Prognostic Profiles of Measles in Children in the Pediatric Ward of the University Hospital of Conakry

Introduction: Measles is a highly contagious viral infectious disease. It is one of the major causes of infant morbidity and mortality in developing countries. The general objective was to study the epidemiological, clinical and prognostic aspects of measles in the paediatric department of Conakry University Hospital. Methods: This was a prospective descriptive study lasting six months, from 01 October 2021 to 31 March 2022, in the paediatric wards of Conakry University Hospital. It included all patients aged between 0 and 15 years, received in consultation and/or hospitalised for measles and whose parents agreed to participate in the study. Results: Out of 3916 cases of paediatric pathology, we collected 380 cases of measles, i.e., 9.7%. The 0 - 4 age group was the most affected, accounting for 60.8%, with an average age of 26.6 ± 18.8 months and extremes of 3 months and 150 months. Females predominated in 53.2% of cases, with a sex ratio of 0.9. Non-vaccinated children accounted for 226 cases (59.5%). Fever was the most common clinical sign in the study (97.11%), followed by oculonasal catarrh (83.9%) and maculopapular lesions (82.1%). A notion of contagion was noted in 254 patients, i.e., a rate of 66.8%. The main complications were ocular in 229 cases (60.3%), pulmonary in 139 cases (36.6%) and digestive in 124 cases (32.6%). Malnutrition was noted in only 15 patients (3.93%). Treatment was symptomatic. The outcome was favourable in 92.3% of cases. We recorded 20 cases of death (5.3%) and 9 cases of escape (2.4%). Conclusion: Despite progress in the control and management of measles, much remains to be done to improve vaccination coverage with the aim of eradicating this disease.

Epidemiology of Maternal Deaths from 2017 to 2022 in the Obstetrics and Gynaecology Department of the University Hospital of Tengandogo, Burkina Faso

Background: Although maternal mortality is declining in most countries, it remains a significant public health problem worldwide, with high rates, particularly in developing and insecure countries like ours. Objective: To study the epidemiological factors and factors associated with the occurrence of maternal death in the Gynecology-Obstetrics Department of University Hospital of Tengandogo. Method: It was a retrospective case-control study with a descriptive and analytical purpose over a period of 6 years from January 1, 2017 to December 31, 2022. Cases were women with maternal deaths during the study period. Data processing and analysis were performed using Stata version 13 software. Univariate and multivariate analyses were performed with Stata version 13 software, and logistic regression modeling was used to estimate crude and adjusted odds ratios (OR), their 95% confidence intervals (CI), and the threshold for statistical significance was set at a p value < 0.05. Results: A total of 372 patients were included in the study, including 146 cases of maternal death. The in-hospital maternal mortality rate was 1933 deaths per 100,000 live births. The average age was 28.5 years. 58.9% of patients lived in rural areas. Married patients accounted for 88.7% of cases. The average parity was 3. Direct obstetrical causes were the main causes of death, accounting for 72.6%. They were dominated by post-partum hemorrhage (24.2%), puerperal infection (18.6%), pre-eclampsia/eclampsia (16.1%) and retroplacental hematoma (8.9%). Chronic anemia (12.9%) was the main indirect obstetric cause. Risk factors associated with maternal death were primiparity (OR for paucigravida and multigravida at 0.05;P = 0.001);ambulance transport (OR for patients referred and brought in by personal vehicle = 0.3, p < 0.001) and vaginal delivery (OR for cesarean deliveries = 0.4, p < 0.001). Conclusion: To reduce maternal mortality in Burkina Faso, strategies such as educating women about danger signs during pregnancy and promoting women’s education can be adopted.

Evolution of Viral Load in Patients Infected with HIV-1 at Point G University Hospital

Introduction: HIV, the human immunodeficiency virus, is the etiological agent of acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the evolution of the viral load in patients under treatment. Methodology: This was a study carried out from July 2017 to June 2022 at the Point G University Hospital laboratory. The determination of the viral load of patients was carried out by PCR on the ABOTT M2000sp/rt platform. Results: A total of 129 patients infected with HIV-1, aged 19 to 72 years with a mean age of 40.05 years ± 10.71;all on antiretroviral chemotherapy. The female gender predominated among our patients. The most common treatment regimen was 2INTI + 1INNTI with 72.9% followed by 2INTI + 1INI with 13.2%. As for the combinations of molecules, the combination TDF + 3TC + EFV and TDF + 3TC + DTG predominated, respectively 65.1% and 13.2%. 89.9% of our patients had undetectable viremia after 12 months of treatment (p < 0.005) with an average viral load which had evolved from 681315.65 copies/ml ± 1616908.484 to M0 at 5742.36 copies /ml ± 35756.883 at M12 (p Conclusion: Generally speaking, antiretroviral treatment had contributed to controlling viral loads, however the therapeutic combination TDF + 3TC + DTG had made it possible to obtain more patients with undetectable viremia instead.

Practice of Glycemic Self-Monitoring in Diabetic Patients Followed at the Endocrinology Department of Donka University Hospital in Guinea

Diabetes is a chronic pathology whose evolution is marked by micro and macroangiopathic complications. Optimal management can prevent the onset of complications and improve patients’ quality of life. Objectives: To determine the frequency of self-monitoring of blood glucose and to describe the errors found during self-monitoring in diabetic patients followed at the Endocrinology Department of Donka University Hospital in Guinea. Materials and methods: Descriptive cross-sectional study carried out between August and September 2020 involving diabetic patients followed up at the Endocrinology and Diabetology Department of the Donka National Hospital, CHU Conakry. Results: A total of 301 patients were enrolled, with an average age of 44.24 ± 21.01 years. 64.12% were female. Type 2 diabetes predominated in 64% of cases. The mean duration of diabetes was 6.14 ± 4.67 years, and 75.08% of patients lived in urban areas. Patients were on insulin in 36.21% of cases, insulin and biguanides (26.25%), hypoglycemic sulfonamide and biguanides (19.27%) and biguanides in 18.27% of cases. The frequency of self-monitoring of blood glucose was 43%, and 38% of patients made errors, notably reusing lancets (60%), not checking the expiration date (55.65%) and not washing their hands (48%). Conclusion: This study shows that self-monitoring of blood glucose is not performed by the majority of patients. Numerous errors were identified during blood glucose testing. Continued therapeutic education on the use of blood glucose meters will help empower patients and improve their quality of life.

Obstetric Emergencies at the Kara University Hospital Maternity Ward: Sociodemographic, Etiological and Prognostic Aspects

Introduction: Obstetric emergencies are common throughout the world and more particularly in developing countries where they are responsible for high maternal-fetal mortality and morbidity. Objective: Study obstetric emergencies in the maternity ward of Kara University Hospital. Method: Retrospective and descriptive study from April 1, 2022 to March 30, 2023, carried out in the Obstetrics and Gynecology Department of Kara University Hospital. Results: Eight hundred and thirty-five (835) obstetric emergencies were recorded out of 2215 admissions, i.e. a frequency of 37.7%. The average age of the patients was 26.7 with a range of 14 and 45 years. They were primigravidas (36.7%) and nulliparous (38.7%), referred (84.7%) and came from rural areas (72%). Emergencies occurred in the 3rd trimester in 74.1% and in parturients (54.1%). Preeclampsia (27%), cessation of progression of labor due to feto-pelvic disproportion (12.4%), postpartum hemorrhage (7.5%) constituted the main obstetric emergencies. In 44.8%, the delivery was carried out vaginally. Magnesium sulfate was the most used drug, i.e. 30.1%;followed by antihypertensive medications in 28.1%. Blood transfusion was performed in 24.3%. The evolution was simple in 90.9%. The maternal fatality rate was 1.6%. The perinatal case fatality rate was 12.3%. Conclusion: Obstetric emergencies are common, dominated by preeclampsia, stopping progress of labor and postpartum hemorrhages. They are responsible for high morbidity and mortality.

Viral Hepatitis B and C: Epidemiological, Clinical and Paraclinical Aspects in the Internal Medicine Department of KARA University Hospital in Togo

Introduction: Viral hepatitis B and C constitute real public health problems worldwide. The objective of this work was to describe the epidemiological, clinical and paraclinical aspects of viral hepatitis B and c in the internal medicine department of Kara University Hospital. Method: this was a retrospective descriptive study carried out in the Internal Medicine department of Kara University Hospital, over a period of 3 years from March 2020 to April 2023. It included all patients seen in consultation or hospitalized for hepatitis viral B and/or C. Results: A total of 57 patients were included in our study. The average age was 44.30 years ± 16.75 and the M/F sex ratio was 1.38. Married people were in the majority 63.2%. The circumstances of the discovery of viral hepatitis B and C were dominated by abdominal pain in 35.1% of cases and hepatomegaly in 29.8% of cases and in 33.3% of cases, it was during screening voluntary. Patients with viral hepatitis B only accounted for 64.9% of cases;those with only viral hepatitis C represented 31.6% of cases and 3.5% of cases had HVB/HCV co-infection. We recorded 36.8% complications including 52.4% liver cirrhosis and 47.6% hepatocellular carcinomas. During the evolution, there were 03 deaths. Conclusion: the prevalence of hepatitis B and C virus carriage in patients followed in internal medicine at Kara University Hospital is high. It is therefore essential to put in place treatment and prevention strategies against these viruses.

Time to recovery from severe pneumonia and its predictors among pediatric patients admitted in Mizan-Tepi University Teaching Hospital,South West Ethiopia,2022

Objective:Despite trials and programs for the prevention of childhood mortality due to pneumonia,Ethiopia is among the top five countries with the highest number of deaths due to pneumonia.Although the prevalence of pneumonia has increased in the abovementioned trials,little is known about the recovery time from severe pneumonia and its predictors in the study area.Therefore,this study aimed to assess the time to recovery from severe pneumonia and its predictors among pediatric patients admitted to Mizan-Tepi University Teaching Hospital,Ethiopia,in 2022.Methods:A total of 591 children admitted for severe pneumonia were selected using simple random sampling.Data were entered into Epi-data version 4.4.2.1 and expor ted to STATA version 14 for analysis,and the assumptions of Cox propor tional hazard models and goodness of fit were assessed through Shoenfeld residual and Cox-Snell residual,respectively.Bivariate and multivariable Cox regression models were used to identify the predictors of mor tality.Results:This study revealed that 91.54%(95%confidence interval[CI]:89.00–93.53)of participants recovered with an incidence rate of 24.10(95%CI:22.15–26.21)per 100 person-day–observations.The hmedian recovery time of children was 4 days(95%CI:2–6).Children who were not exclusively breastfed(AHR=1.3;95%CI:1.03–1.66),who had a history of inability to suck/feed(AHR=0.81;95%CI:0.65–0.99)were independent predictors of the time to recovery.Conclusions:Children with severe pneumonia who had not exclusively breastfed and who had a history of inability to suck/feed were independent predictors of time to recovery.Therefore,all stakeholders and concerned health care providers should focus more on early diagnosis and management and hasten early recovery based on the identified factors.

Tuberculosis among School Age (6 - 18 Years) Children Seen in University of Port Harcourt Teaching Hospital: A Need for Effective School Health Services

Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the disease in school age children is unknown because of scarcity of TB screening surveys in Nigerian schools. The aim of this study was to evaluate the proportion of school age children treated for TB in the Directly Observed Treatment Short Course (DOTS) clinic of University of Port Harcourt Teaching Hospital (UPTH). Methods: The records of all children 6 to 18 years who were treated in the DOTS clinic from 2011 to 2014 were reviewed. Information sought included age, sex, sputum Acid Fast Bacillus (AFB) status, Human Immunodeficiency Virus (HIV) status and treatment outcome. Results: One hundred and forty children aged 6 to 18 years were treated in the University Port Harcourt Teaching Hospital DOTS clinic, representing 41.79% of childhood TB cases seen over the study period. Seventy one (50.71%) patients were males and 69 (49.29%) were females. Their mean age was 12 ± 3.86. Thirty-one (22.14%) had smear positive TB. Sputum smear positivity was commonest (54.84%) among those who were 16 years and above compared to the other age groups and this is statistically significant (x2 = 17.72, p = 0.001). Forty-one (35%) patients were HIV positive and 6 (4.29%) were positive for both HIV and AFB. Ninety (64.29%) patients recovered fully following treatment, 48 (34.29%) were referred to other DOTS centres and 2 (1.43%) died. Gender, age group, AFB and HIV status showed no relationship with treatment outcome. Conclusion: School age children 6 to 18 years made up a large proportion of childhood TB cases seen within the study period in the DOTS clinic. More than one third of them were HIV/TB co-infected. An effective School Health Services should be established in schools in Port Harcourt to curb the spread of TB and other communicable diseases within the schools.

Assessment of Indoor and Outdoor Noise Pollution at a University Hospital Based on Acoustic Measurements and Noise Mapping

This paper describes an analysis of the sound pressure levels at the exterior fa&ccedil;ade and inside the Hospital de Clínicas of the Federal University of Paraná. Measurements were taken at a total of 45 points, 24 at the exterior facade and 21 points inside the hospital on all the floors of the main building and in the maternity building. These 45 measurements were used to calculate the acoustic map of the hospital, which is located on General Carneiro Street, in the city of Curitiba, state of Paraná, Brazil. A comparison of the measured outdoor sound pressure levels against those established by Curitiba Municipal Law No. 10625 revealed that they all exceeded the daytime limit of 55 dB(A) permitted for areas around hospitals. The indoor sound pressure measurements and the noise levels for acoustic comfort established by the Brazilian technical standard ABNT NBR 10152 were compared, indicating that all the measured points, including those in the neonatal intensive care unit, exceeded the established limit of 35 dB(A) to 45 dB(A).

Anxiety and perception among nurses toward the outbreak of COVID‑19 in University of Uyo Teaching Hospital, Akwa Ibom State

Purpose:This study sought to examine the anxiety and perception of nurses toward the outbreak of COVID‑19 in University of Uyo Teaching Hospital(UUTH).Two research questions one hypothesis were used.What is the level of anxiety among nurses toward the outbreak of COVID‑19?What is the perception of nurses toward the outbreak of COVID‑19?The hypothesis states that there is no significant relationship between anxiety and perception of nurses toward the outbreak of COVID‑19.Literature was reviewed based on the research variables.Methods:The research instrument used in collecting the data for the analysis was a questionnaire administered to 100 nurses in UUTH,Uyo.Their responses were analyzed using frequencies,percentages,and Chi‑square analysis,and the following results were obtained.Results:The results indicated that 36(36%)of the respondents strongly agreed that most nurses perceive that poor provision of equipment’s in the hospital result into the transmission of COVID‑19 to another person,35(35%)agreed,20(20%)of the respondents strongly agreed,whereas 9(9%)of the respondents disagreed.Majority of the respondents 56(56%)strongly agreed that nurses sometimes perceive that patients sometimes harbor COVID‑19 without showing the symptoms.Conclusion:The above data,therefore,showed that nurses in UUTH,Uyo,had moderate perception toward COVID‑19.

Perception and attitude of theatre staff to preoperative HIV testing at the University of Port Harcourt Teaching Hospital

Objective:To elucidate the awareness and approach to pre-operative human immunodeficiency virus(HIV) testing and emphasis on the attendant components of HIV testing.Methods: The study was conducted at the theatres of the University of Port Harcourt Teaching Hospital among 123 nursing,anaesthetic,and operating staff.A descriptive cross sectional design was adopted with stratified sampling.The study instrument was a structured,self administered pro forma.Results:All respondents were all aware of HIV infection and all had transmission through infected blood and tissues(100.0%).88.6%had infection through needle stick injuries, 62.6%through vertical transmission,and 98.4%through blood transfusion.Sixty three percent of respondents correctly knew what preoperative testing was,while 58.5%were aware of the preoperative testing policy of the hospital.All respondents favoured the policy of preoperative testing.Attitudinal values to seropositive patients were not very different as 72.4%of respondents claimed they treated every patient as high risk,and all respondents used personal protective equipment.Conclusions:Routine HIV testing now represents a conventional means providing patients with knowledge of their HIV status.Such testing should be accompanied by informed consent,counselling,confidentiality,protection,and access to treatment.

Renal Failure of Lithiasis Origin: Frequency and Management in the Nephrology and Haemodialysis Department of the Point G University Hospital in Mali

Background: The term urinary lithiasis (UL) from the Greek “lithos” refers to the disease characterised by the result of abnormal precipitation of normal constituents of the urine within the urinary tract. The aim of this work was to determine the frequency of obstructive renal failure (ORF) of lithiasis origin and to describe the therapeutic indications. Methods: This was a retrospective prospective study in patients hospitalised in the nephrology department of Point G University Hospital for ORF of lithiasis origin over a 26-month period from 1 January 2018 to 1 February 2020 inclusive. Results: Among 1898 hospitalized patients, 32 met the inclusion criteria, i.e. a frequency of 1.7%. The male sex was 68.75% with a sex ratio of 2.2. The mean age was 48.38 ± 13.423 years with extremes of 20 and 65 years. Dysuria and urinary bilharzia were the main uro-nephrological antecedents, accounting for 25% of the cases each. Pain syndrome was the main functional sign, accounting for 100%. Ultrasound of the urinary tract (n = 28) showed stones in 92.85%. These stones were bilateral in 22.22% of cases. The dilatation was pyelocalic in 14 cases (51.8%). The uroscanner showed a pyelic location of the stones in both kidneys;42.1% on the right and 33.3% on the left. Hydronephrosis was the most common dilatation: 37.8% on the right and 29.7% on the left. Renal lithiasis was complicated by acute kidney injury (ARI) in 17 cases (53.1%) versus 15 cases (46.9%) of chronic kidney disease (CKD). Urethral catheter was the means of drainage in 24 (75%) followed by nephrostomy in 8 cases (25%). Nephrolithotomy accounted for 9.4% of cases. The case fatality rate was 28.12% (9 cases). Deaths occurred in the context of uraemic coma 6 cases and cardiorespiratory arrest 3 cases. Conclusions: The management of urinary lithiasis complicated by renal failure calls for the correction of hydrolytic disorders, drainage of the excretory tract and treatment of the stone, of which percutaneous nephrolithotomy seems to be the modality of choice.

Impact of Metabolic-Syndrome Risk Factors on the Absenteeism of Health Workers from a Brazilian University Hospital

Objective: Analyzing the association between Metabolic Syndrome (MS) risk factors and work absenteeism due to illnesses among University Hospital employees in Salvador City, Bahia, Brazil. Methods: Cross-sectional study comprised 1173 Bahia Federal University Hospital employees: 57.3% of them were federal employees (statutory officers) and 42.7% were civil servants (CLT employees). Participants were in the age group 41.5 years: 69.4% were female and 30.6% were male. Results: MS prevalence in employees reached 6.6%;women accounted for 69.7% of the total. The percentage increases with age and has similar proportion among directcare providers and ancillary supports personnel, 40.8% and 39.5%, respectively. The risk factor analysis showed 25% hypertension, 54.6% weight excess (18.4% obese and 36.2% overweight patients), 20% hypercholesterolemia, 9.9% hypertriglyceridemia and 6.5% diabetes mellitus prevalence. Absenteeism longer than one day within the studied population reached 40.1%. Osteoarticular diseases were the most common reason for absenteeism, accounting for 50.7% of it: 62.6% of whom were either overweight or obese. The mean cost with absenteeism per employee was R$5492.87 ($2347.00 US Dollars), and it corresponds to annual cost of R 2,587,139.53 ($1,105,610.00 US Dollars). The highest cost with absenteeism caused by illnesses was recorded for female workers;for federal employees who were patient caregivers, who worked in the Pediatric Centre and who worked at night shifts. Conclusion: The high Metabolic Syndrome risk factors and overweight incidence are responsible for the increased costs faced by hospitals due to high absenteeism rates.

Evaluating of Training and Internship Programs of University Hospitals

Objective: This study aimed to assess training and internship programs (courses) of basic and clinical sciences in hospitals based on surveying the students of Tehran University of Medical Sciences. Material and Methods: The present study was a cross-sectional one with survey descriptive designs. The data collection tool was a questionnaire with 14 five-point likert style items. The Research and Development Center of Tehran University of Medical Sciences surveyed all 185 students of training and internship programs, using a questionnaire with the Cronbach’s alpha coefficient of 81%, for the purpose of adjusting the education to the society’s needs and improving its quality. Result: The mean scores of the assessment of training and internship programs were 3.32%, 2.98%, 3.38% and 3.29%, respectively for theoretical classroom training related to practical training, mental, communicational and practical skills courses. The students’ satisfaction rate regarding the quality of educational courses of training and internship programs was 50.2%. Conclusion: Educational authorities have made necessary attempts to implement these programs and use potential resources for realizing the objectives and achieving the educational quality;however, they should make further attempts in this regard.

Face of the Myocardial Infarction and Diabetes: Epidemiological and Clinical Aspects in the Cardiology Department of the University Hospital Ignace Deen about 46 Cases

The purpose of this study was to describe myocardial infarction in diabetics at the Cardiology Department Ignace Deen. Introduction: New international recommendations defined myocardial infarction, any coronary syndrome accompanied by a modification of cardiac troponin even minimal Tc or Ic [1]. Then for diabetes is defined by the World Health Organization (WHO) a blood glucose greater than 1.10 g/l and/or capillary blood glucose greater than 2.26 g/l after eight hours of fasting [2].?Patients and Methods: Were eligible for both male and female patients at any age admitted to cardiology for myocardial infarction and receiving an ECG echocardiogram;A biological evaluation including blood glucose and troponin Tc or Ic. Discussion: The risk of myocardial infarction is clearly increased in diabetics and is a determinant of coronary heart disease severity and a potential test for other cardiovascular risk factors at the Ignatius Deen Cardiac Department with a frequency of 16.08%. Our result is lower than that of DIOUMM et al. in the Fanh cardiology department of Dakar, Senegal [6], which should reduce the frequency of 22.3%. The high frequency of this pathology in the study DIOUMM is related to the size of their sample on the one hand and secondly the duration of the study, the service capacity on the other hand that could be explained. Conclusion: Diabetes mellitus is a scary medium and long-term disease that causes complications. In addition to infectious and metabolic complications, heart and coronary heart attacks are becoming more common. The tare is dominated by atherosclerosis, which must be prevented through the analysis of diabetic responsibility, with cardiovascular control of risk factors and monitoring of myocardial ischemia, and good cooperation between diabetes specialists, cardiologists and patients.