Prevalence and Factors Associated with Musculoskeletal Disorders among Biomedical Analysis Laboratory Staff in Hospitals in Cotonou

Introduction: Musculoskeletal disorders (MSDs) are a real occupational health problem. Laboratory technicians appear to be among those most affected. Objective: To assess the prevalence and factors associated with MSDs among laboratory technicians in Cotonou. Study Method: A descriptive and analytical cross-sectional study was carried out on laboratory technicians at university hospitals and area hospitals in Cotonou. It took place over a three-month period from August 10 to November 10, 2021. The data collected were analyzed using SPSS version 25.0 software. Frequencies were compared using the chi2 test for qualitative variables and the ANOVA test for quantitative parametric variables. The significance level was 5%. Results: A total of 156 technicians were included in the study, 83 of them male, i.e. a M/F sex ratio of 1.14. The mean age was 36.70 ± 6.69 years. The overall prevalence of MSD was 91.03%. For back, neck, shoulder, elbow, wrist-hand, the prevalence was 83.56%, 50.68%, 08.21%, 14.38% and 20.54% respectively. Factors associated with MSD were the non-adjustable nature of the seats (p = 0.03), job strain (p Conclusion: The prevalence of MSD is high among laboratory technicians. The study confirms the multifactorial etiology of MSDs. The preventive approach must be comprehensive, including all risk factors.

引导螺旋断层放疗用兆伏CT图像质量定量分析

目的:定量分析螺旋断层放疗系统3种兆伏CT扫描模式获取的2套模体图像质量,探索和验证螺旋断层放疗系统兆伏CT图像的半自动质控方法。方法:分别使用螺旋断层放疗系统上螺距为4 mm、8 mm、12 mm/圈的Fine、Normal和Coarse模式,获取CatPhan504和Cheese模体的兆伏CT图像。基于Pylinac、Matlab和Eclipse软件自动分析对比3种模式下图像的空间分辨率、图像噪声和低对比度分辨率。结果:对CatPhan504空间分辨率模块的分析显示,Coarse模式的前3个线对(间距分别为0.500 cm、0.250 cm和0.167 cm)清晰但从线对4(间距为 0.125 cm )开始发生了明显混叠,而Normal和Fine的前4个线对均可清晰观测。Coarse、Normal和Fine模式下Cheese模体的总体不均匀度分别为0.157 7、0.136 8和0.122 9。3种成像模式所得Cheese图像的低对比度分辨率相近,且随着构造材料与局部背景CT平均差值的增大,插件的可观测性呈近乎线性增长。结论: 3种成像模式在3个图像质量评估指标上并未呈现一致优劣性。临床上螺旋断层放疗系统成像模式的选择可基于图像观测的需求,参考本研究的评估结果,从而做出决策,相关图像质量评估工作也可参考本研究的方法,定期进行相关质控测试。

Diffusion-weighted magnetic resonance imaging in cancer: Reported apparent diffusion coefficients,in-vitro and invivo reproducibility

There is considerable disparity in the published apparent diffusion coefficient(ADC) values across different anatomies. Institutions are increasingly assessing repeatability and reproducibility of the derived ADC to determine its variation,which could potentially be used as an indicator in determining tumour aggressiveness or assessing tumour response. In this manuscript,a review of selected articles published to date in healthy extracranial body diffusion-weighted magnetic resonance imaging is presented,detailing reported ADC values and discussing their variation across different studies. In total 115 studies were selected including 28 for liver parenchyma,15 for kidney(renal parenchyma),14 for spleen,13 for pancreatic body,6 for gallbladder,13 for prostate,13 for uterus(endometrium,myometrium,cervix) and 13 for fibroglandular breast tissue. Median ADC values in selected studies were found to be 1.28 × 10-3 mm2/s in liver,1.94 × 10-3 mm2/s in kidney,1.60 × 10-3 mm2/s in pancreatic body,0.85 × 10-3 mm2/s in spleen,2.73 × 10-3 mm2/s in gallbladder,1.64 × 10-3 mm2/s and 1.31 × 10-3 mm2/s in prostate peripheral zone and central gland respectively(combined median value of 1.54×10-3 mm2/s),1.44 × 10-3 mm2/s in endometrium,1.53 × 10-3 mm2/s in myometrium,1.71 × 10-3 mm2/s in cervix and 1.92 × 10-3 mm2/s in breast. In addition,six phantom studies and thirteen in vivo studies were summarized to compare repeatability and reproducibility of the measured ADC. All selected phantom studies demonstrated lower intra-scanner and inter-scanner variation compared to in vivo studies. Based on the findings of this manuscript,it is recommended that protocols need to be optimised for the body part studied and that system-induced variability must be established using a standardized phantom in any clinical study. Reproducibility of the measured ADC must also be assessed in a volunteer population,as variations are far more significant in vivo compared with phantom studies.

Diagnosis and pharmacologic management of neuropathic pain among patients with chronic low back pain

Chronic low back pain consists of both nociceptive and neuropathic mechanisms and can be classified as a mixed pain syndrome. Neuropathic component of chronic low back pain has often been under-recognized and under-treated by the physicians. Recent studies have demonstrated that approximately 20%-55% of chronic low back pain patients have neuropathic pain symptoms. An altered peripheral, spinal, and supraspinal processing of pain arising as a result of a lesion affecting the nerves system are the major contributor to neuropathic low back pain. The clinical evaluation is still the gold standard for assessment and diagnosis of neuropathic low back pain. Although diagnosis can be difficult due to the lack of reliable gold standard diagnostic test for neuropathic low back pain, screening tools may help non-specialists, in particular, to identify potential patients with neuropathic low back pain who require further diagnostic evaluation and pain management. Several screening tools for neuropathic pain have been developed and tested with different patient populations. Among the screening tools, the pain DETECT questionnaire and the Standardized Evaluation of Pain are validated in patients with low back pain. The Standardized Evaluation of Pain may lead to more effectivein discriminating between neuropathic and nociceptive pain in patients with low back pain according to the higher rate of sensitivity and its validity in patients with low back pain. However, the most appropriate approach is still to combine findings on physical and neurologic examinations and patient's report in distinguishing neuropathic pain from nociceptive pain. The clinical examination including bedside sensory tests is still the best available tool for assessment and diagnosis neuropathic pain among patients with chronic low back pain. Due to the fact that chronic low back pain consists of both nociceptive and neuropathic mechanisms, a multimodal treatment approach is more rational in the management of patients with chronic low back pain. Therefore, combination therapy including drugs with different mechanisms of action should be given to the patients with chronic low back pain.

Normative Values of Cardio-Respiratory Endurance in Adults in Benin

Cardiorespiratory endurance is a determining factor in the assessment of the state of health of a person. Objective: To determine the reference values for cardiorespiratory endurance in Beninese adults. Methods: Prospective transversal study, with a descriptive and analytical aim. It was carried out on healthy adult subjects (18 to 50 years old), of Cotonou and Abomey cities, from October 2017 to May 2018, without clinically identifiable orthopedic, cardiorespiratory, osteoarticular or neuromotor impairment. These subjects performed three different cardio-respiratory endurance tests: The six-minute walk test (WT6), cycloergometer test (CT) and the step test (ST). Data processing and analysis were done using SPSS version 22 software. A linear regression model was used to establish the prediction equation of maximal oxygen uptake (VO2 max) with the WT6 data. The significance level chosen was 5%. Results: Subjects average age was 30.0 ± 9.8 years. It was especially men (54.20%), students (42.13%), with a normal corpulence (69.91%). At WT6, they walked 365 m to 798 m (557.1 ± 93.6 m) with extreme heart rates (EHR) of 67 to 189 (136.7 ± 19.0) beats per minute. At ST, the extreme powers developed were 2.7 watts/kg and 11.8 watts/kg (6.4 ± 1.8 watts/kg), with EHR of 99 to 204 (168.4 ± 15.4) beats per minute. The predictor equation of VO2 max by WT6 was function of the subject’s weight, age and sex (R = 0.73). Conclusion- Discussion: These normative values of cardio-respiratory endurance of Beninese subjects seem to be specific to them. An extension of the present study to a larger sample nevertheless seems desirable.

Results of Chronic Neck Pain Rehabilitation at Cotonou

Background: Neck pain is a real public health problem. Its treatment uses different techniques, such as functional rehabilitation, whose results are not widely popularized, from developing countries in Black Africa. Objective: To assess the result of rehabilitation of chronic common neck pain (CCNP) at the CNHU-HKM in Cotonou. Methods: Cross-sectional, retrospective, descriptive and analytical study. It was carried out from May to September 2020, based on the files of former patients followed in functional rehabilitation department at CNHU-HKM in Cotonou, from 2015 to 2019, for CCNP. The result of rehabilitation was assessed based on the progress, between the start and the end of the rehabilitation sessions, of pain intensity, mobility of the cervical spine, muscle strength and functional capacity of the patient. Anova and chi-square tests were used for the analysis of factors associated with the result of rehabilitation. Results: The sample consisted to 73 patients. They were predominantly female (58.90%), with a mean age of 53.60 ± 14.08 years. The neck pain, at least of moderate intensity (97.26%), was present since 12.54 ± 8.54 months, on average. Patients have done 10 to 20 functional rehabilitation sessions, the result of which was satisfactory in 67.12%. This result was mainly associated with patient’s age, sports practice and the seniority of pain progression. Discussion-Conclusion: Rehabilitation results in the management of CCNP are interesting. They prove the need to sensitize patients and prescribers on the importance of early treatment of CCNP.

The Frequency of Fibromyalgia Syndrome and the Quality of Life in Patients with Peritoneal Dialysis

,b>Objective: The aim of this study was to determine the frequency of fibromyalgia (FM) in patients on Peritoneal Dialysis (PD) and to investigate its impact on the quality of life of that population. Methods: A hundred and twenty four patients with end stage renal disease who had undergone PD, and a control group of 54 age and sex-matched healthy volunteers were included to the study. Demographic characteristics including age, sex, disease and dialysis duration were recorded. Fibromyalgia Impact Questionnaire (FIQ) and Nottingham Health Profile (NHP) were also measured. Results: The mean age of the patients (68 female, 56 male) and control subjects (36 female, 18 male) were 43.5 ± 13.4 and 41.2 ± 9.2 years respectively. The prevalence of FM in the PD patients and controls were determined as 9.7% (12 patients) and 11.1% (6 controls) respectively and were found to be similar (p = 0.983). The mean score of sub- groups of NHP except pain and emotion subgroups, were significantly higher in PD patients than in the control group. The mean FIQ levels, the scores of all the subgroups of NHP except the social subgroup were significantly higher in PD patients with FM than in those without FM. Conclusion: In conclusion although the prevalence of FM appears to be similar in PD patients and control subjects, the functional disability is common and quality of life is worse in PD patients with FM than in patients without FM. Detection and treatment of FM may lead to improvement in the quality of life of PD patients with this syndrome.

怀孕30～50周胎儿的视网膜电图变化

Maturation of the electroretinogram (ERG) reflects retinal development. Serial ERGs recorded from a preterm infant between 30 and 50 weeks after conception showed rapid maturation. A transient loss of retinal sensitivity coincided with clinical signs of stage 2 retinopathy of prematurity (ROP).

Treatment of 36 Cases of Infantile Enuresis by Acupuncture

Treated 36 cases of infantile enuresis by acupuncturing Zuyunganqu (Foot Motor Sensory Area) Guanyuan (CV 4), Qihai (CV 6), Zhongwan (CV 12), Zusanli (ST 36), Yinlingquan (SP 9), Pishu (BL 20), Weishu (BL 21) and Shenshu (BL 23). After two courses, 29 cases were cured, 5 cases were improvement and 2cases were no effect. Key Words Enuresis - Scalp Acupuncture - Acupuncture Therapy - Child

An acupoint-originated human interstitial fluid circulatory network

To the Editor:Since 1027,when the Tian Sheng Bronze Statue showing acupoints and meridians was first introduced for medical practitioners,it has evolved to the currently used acupoints and meridians atlas in traditional Chinese medicine(TCM).[1]To date,the acupoints represent defined areas on the body surface relative to certain landmarks.The acupoints in the extremity endings would connect anatomically with diverse associated visceral organs or tissues,forming a Meridian and Collateral network.Illustrated on the atlas,each main meridian is usually a virtual line connecting a group of adjacent acupoints that correlate with certain visceral organ.In modern medical science,the anatomical structures of main meridians remain largely unclarified.